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Biomedical subjects

L C Richman

Publications and source records attributed to L C Richman.

At least 19 recordsLinked to original sources
PubMed2001

Psychological screening of children for participation in nontherapeutic invasive research.

BACKGROUND: The need for children to participate in research has raised concerns about ethical issues surrounding their participation. OBJECTIVES: To describe a protocol of preresearch psychological screening and postresearch outcomes and to present the results of the screening process for a nontherapeutic, invasive research study. DESIGN AND SETTING: Descriptive study carried out at The University of Iowa Hospitals and Clinics, Iowa City. PARTICIPANTS: Twenty-eight children (mean age, 10.6 years) were screened, with 4 not completing the research study and another 4 unavailable for psychological follow-up. MAIN OUTCOME MEASURES: Prescreening interviews with parent and child and screening measures of appropriate child cognitive abilities and behavior; postscreening parent and child questionnaires. RESULTS: Of the 4 children who did not complete the research study, 3 were identified with increased anxiety during the screening and were advised to not participate in the study. The primary motivator for participation was monetary reimbursement (14 parents [82%]; 15 children [75%]), followed by altruistic reasons (10 parents [59%]; 4 children [20%]). Before participating, none of the children reported concerns related to participating in the study. However, on follow-up, 9 (45%) of the children reported that they had had concerns before participating. Follow-up assessment showed that parents underestimated their children's concerns related to sexual development assessment and intravenous insertion. CONCLUSIONS: Children with increased anxiety may not be appropriate participants in potentially anxiety-provoking research. Children's reports of concerns may change from preparticipation to postparticipation, and discrepancies may exist between parent and child reports of concerns with research participation. Further research is needed to ensure children's safe participation in research.

Adolescent↗
PubMed2001

Different cleft conditions, facial appearance, and speech: relationship to psychological variables.

OBJECTIVE: The purpose of this investigation was to study the adjustment and learning characteristics of children with different types of clefts. The hypotheses were that there may be different relationships among cleft variables (speech and appearance) according to the cleft types. DESIGN: The study compared three cleft groups on behavior rating, anxiety scales, depression scales, and self-perception (analyses of variance) and examined the influence of facial and speech ratings on self-perception (multiple regression analyses). SETTING: All patients were treated at a university hospital cleft palate clinic. PATIENTS: Sixty-five children aged 8 years to 17 years were selected based on nonsyndromic cleft (unilateral cleft lip and palate [ULP], bilateral cleft lip and palate [BLP], and cleft palate only [CPO]) and no significant neurological condition or hearing loss. RESULTS: The findings indicated children with CPO showed greater problems with parent- and teacher-reported depression, anxiety, and learning related to speech than children with ULP or BLP. The later two groups showed fewer problems and a greater relationship of problem to facial appearance. The children with ULP self-reported lower levels of depression than the other two groups. CONCLUSIONS: Children with cleft show relatively good overall adjustment, but some problems appear related to speech and facial appearance. Subgroups may need to be studied separately.

Achievement↗
PubMed1998

Learning disability, school achievement, and grade retention among children with cleft: a two-center study.

OBJECTIVE: This study examined the prevalence of learning disability (LD), level of school achievement; and prevalence of grade retention by type of cleft and gender at two craniofacial centers. SETTING: The setting included two university-based craniofacial centers. DESIGN/PATIENTS: Participants included 84 consecutively evaluated patients from one center who were matched by cleft type, age, and gender with 84 patients evaluated at the second center. OUTCOMES: The outcomes included learning disability, school achievement, and grade retention. RESULTS: The results revealed that 46% of subjects with cleft had LD, 47% had deficient educational progress, and 27% had repeated a grade (excluding kindergarten) in school. Males with cleft palate only (CPO) had a significantly higher rate of LD than any other subject group. Males with CPO and females with cleft lip and palate (CLP) were more likely to repeat a grade in school than were females with CPO and males with CLP. CONCLUSIONS: Children with cleft are at risk for learning disability, low school achievement, and grade retention.

Adolescent↗
PubMed1997

Brief report: cleft lip and palate: longitudinal behavior and relationships of cleft conditions to behavior and achievement.

Analyzed longitudinal behavior ratings (ANOVAs) for 44 children (ages 4-12) with cleft lip and palate and cleft palate only (CLP) and examined the relationship of speech, hearing, and facial disfigurement at age 9 in predicting behavioral characteristics and school achievement (multiple regression). Results indicate increasing levels of social inhibition over age for girls with CLP, but less so for boys. There were also increasing levels of conduct problems for older girls with CLP with variable age fluctuation for boys. Attempts to relate speech, hearing, or facial disfigurement to prediction of behavior or achievement at age 9 were not revealing and further analysis with larger samples is indicated.

Achievement↗
PubMed1997

Facial and speech relationships to behavior of children with clefts across three age levels.

OBJECTIVE: This study was conducted to examine relationships of facial and speech ratings to behavior at three ages. DESIGN: Multiple correlations to control for gender, IQ, and socioeconomic status (SES). Partial correlations between speech or facial ratings and behavior. SETTING: A university hospital interdisciplinary cleft/craniofacial center. PATIENTS: Sixty-five children with CP or CLP and no other anomalies seen at ages 6, 9, and 12 years. INTERVENTIONS: Speech ratings, facial ratings, hearing assessment, and SES ratings, were collected at ages 6, 9, and 12. MAIN OUTCOME MEASURE: The Behavior Problem Checklist was used and internalizing problems were expected. RESULTS: Less severe speech problems associated with behavioral inhibition were noted at age 9 years (p < .01). Greater facial disfigurement was correlated with greater inhibition at age 12 (p < .001). CONCLUSIONS: Longitudinal data indicates different associations of speech and facial variables were made to behavior at different ages (9 and 12). No significant relationships were identified at age 6.

Acting Out↗
PubMed1997

Continuity of care: University of Iowa Cleft Lip/Palate Interdisciplinary Team.

INTRODUCTION: Patient satisfaction with the continuity of care is an important aspect of care delivery that may be evaluated to assess team effectiveness. This study was conducted to evaluate the number of patients seen by each team member, and the patients' perceived importance of continued care by the same health care provider during their overall treatment. METHODS: A survey was constructed by the members of the Cleft Lip/Palate Team at the University of Iowa Hospitals and Clinics. One hundred and thirty-eight subjects were invited to participate during consecutive clinic days over a 5-month period; 101 subjects (73.1%) responded. RESULTS: The survey revealed that the percentage of patients seen by each member of the team ranged from 92.1% (93/101) for the surgeon to 24.8% (25/101) for the genetic counselor. Strong agreement with continuity of care by health professionals ranged from 85.6% (83/97) for the surgeon, 63.7% (58/91) for the orthodontist, 63% (17/27) for the psychologist, to 23.1% (19/82) for the audiologist. The percentages dropped somewhat if the patients thought that they may have to wait longer for their next appointment. CONCLUSION: There is a strong preference for continuity of health care.

Adolescent↗
PubMed1995

Neuropsychological development in adolescents: cognitive and emotional model for considering risk factors for adolescents with cleft.

This article reviews neurologic, endocrinologic, and neuropsychological developments that affect our understanding of the adolescent patient. Neuroimaging and neuroradiologic techniques have assisted in identifying brain-behavior relationships and how different neuropsychological patterns result in different ways of thinking. Psychoneuroendocrinologic studies have shown that sex differences in maturation and hormonal effects on behavior need taking into account. At adolescence, the individual with a cleft or craniofacial condition may be at risk for adjustment problems due to earlier developmental events, which may affect language, behavior, and self-esteem.

Adolescent↗
PubMed1993

Presidents' perceptions: an historic review of fifty years of the American Cleft Palate-Craniofacial Association.

This historic review of the American Cleft Palate-Craniofacial Association was written by the Historian charged by the ACPA Executive Council for the purpose of updating the history of the organization in honor of its 50th Anniversary. The data base for this review was the previously published 36-year history by Historian Charlotte Wells, the minutes of ACPA Executive Council meetings from 1979 to 1993, and a questionnaire survey of the 32 living Past Presidents (with a 90% return rate). This review highlights the important issues and critical decisions as recalled by Past Presidents. It also includes the recollection of humorous anecdotes, since the scholarly debate of this interdisciplinary organization is often brought to a positive interpersonal level through the good natured humor of many of its members.

Cleft Palate↗
PubMed1992

Comparison of visual-spatial performance strategy training in children with Turner syndrome and learning disabilities.

This study examined the effects of a verbal mediation strategy on three groups of subjects who had visual-spatial deficits. Thirteen females with Turner syndrome, 13 females with nonverbal learning disabilities, and 14 males with nonverbal learning disabilities, who ranged in age from 7 to 14 years, were taught via a cognitive behavioral modification approach to verbally mediate a spatial matching task. Pretest and posttest performance differences on parallel forms of a visual-spatial orientation task were examined. All three groups showed significant improvement in visual-spatial task performance after the training. There were no significant differences in the degree of improvement among the three groups. The results suggest that children with Turner syndrome may benefit from problem-solving strategy training in a manner similar to children with nonverbal learning disabilities.

Adolescent↗
PubMed1989

Immediate memory functions in reading disability subtypes.

This study examined immediate memory processes in specific reading disability subtypes. Three subgroups (n = 15 in each subgroup) of reading disabled children were examined: (a) perceptual-motor disorder, (b) verbal disorder-general, and (c) verbal disorder-specific (memory). The three groups were matched for age and full scale IQ. All children received a memory-for-colors task (Color Span Test) designed to evaluate intra- and intermodal serial memory functioning. Comparison of memory profiles for the three reading disability subtypes revealed that patterns varied depending on mode of stimulus presentation or response. Although all three groups performed considerably below normative levels on each of the four subtests of the Color Span Test, all subjects performed significantly better on verbally presented items than on visually presented items. The findings were interpreted to suggest that these reading disabled children may not consistently utilize verbal strategies for coding or retrieval of information when stimuli are visually presented.

Child↗
PubMed1988

Reading disability in children with clefts.

The prevalence of reading disability was examined in 172 elementary school children with cleft lip and palate (CLP) or cleft palate only (CPO). Approximately 35 percent of the sample displayed a moderate degree of reading disability, and 17 percent of the group exhibited severe reading disability. Reading disability was more prevalent at younger ages, presumably because of peripheral speech deficits. For older children, those with CLP displayed an incidence of reading disability similar to the general population (9 percent), whereas children with CPO exhibited a much higher rate of reading disability (33 percent). There were no sex differences in the prevalence of reading disability in this sample. The study supports earlier suggestions that children with CPO may be more likely to experience general language disorders leading to long-term reading disabilities. Children with CLP appear to manifest reading problems that tend to resolve with increased age.

Adolescent↗
PubMed1986

"Mental imbalance" and the prediction of recurrent delinquent behavior.

Cognitive and personality patterns of 84 court-referred adolescents were examined to identify predictors of recurrent delinquent behavior. Continued behavioral problems at follow-up were more likely in adolescents with discrepancies between Verbal and Performance IQ or large differences between "neurotic" and "psychotic" scale elevations on the MMPI. Positive outcomes were most likely for adolescents who could be described as "mildly neurotic." Combining the discrepancy scores from the intelligence and personality tests with other background variables in a Bayesian conditional probability model resulted in accurate predictions of later behavior for 81% of the sample. These findings suggest that imbalances in cognitive and personality development may limit a delinquent adolescent's ability to interact appropriately with the environment.

Adaptation, Psychological↗
PubMed1985

Adolescents with cleft lip and palate: self-perceptions of appearance and behavior related to personality adjustment.

Two groups of adolescents with cleft lip and palate were compared on their self-ratings of facial appearance and behavior. The two groups were identified as well adjusted (N = 19) or poorly adjusted (N = 17), based on their parents' ratings of behavior. T-test comparisons indicate that the group with good adjustment have realistic perceptions of facial appearance (based on independent ratings by their teachers), and their self-perceptions of behavior are similar to those of their parents. The poorly adjusted group have unrealistic perceptions of facial appearance and perceive their behavior as more socially acceptable than do their parents.

Adolescent↗
PubMed1985

Cross-national comparisons of developmental dyslexia in Italy and the United States.

This study was designed to examine whether the phonetic regularity of a language can significantly influence the prevalence and pattern of developmental dyslexia. Demographically matched samples of fifth-grade children in Italy (N = 448) and the United States (N = 1,278) were evaluated to identify children with specific reading disabilities. Reading disabled children with average intelligence were compared to normal controls on a series of neuropsychological tests to evaluate specific cognitive deficits associated with reading disorders in each country. The findings suggested that (a) dyslexia is more prevalent in the United States than in Italy, (b) reading disabilities are strongly associated with disorders of verbal processing in both countries, although some American dyslexics also show visual-motor deficits, and (c) there is a greater dissociation between reading comprehension and decoding in Italian than in English.

Child↗
PubMed1985

Cognitive profiles of children with insulin-dependent diabetes.

Intellectual and reading skills were evaluated and related to disease variables in 42 children with Type I (insulin-dependent) diabetes. A significant interaction revealed lower Wechsler Intelligence Scale for Children-Revised (WISC-R) Performance IQ for children with early disease onset (less than 7 years) and long disease duration (greater than or equal to 5 years). IQ scores were nevertheless in the average range. Although there was no specific pattern of visual spatial impairment, functioning on the Performance subtests was uniformly lower for this group. Slower responding to the timed tasks of the Performance scale may account for generally lower scores. Children with early onset-long duration also evidenced higher rates of reading and memory impairment. These results indicate the importance of ascertaining educational skills in diabetic children before planning diabetic treatment regimens, especially for children with disease of early onset and long duration, who may be especially vulnerable to skill deficits.

Adolescent↗
PubMed1984

Psychological effects of idiopathic adolescent scoliosis.

This article reviews the literature concerning psychological characteristics of adolescents with idiopathic scoliosis. Although much has been written on the topic, it is largely based on clinical judgment rather than empirical data. In spite of methodological flaws, the few empirical studies available raise questions regarding the following issues: maladjustment occurs in a significant number of adolescents with scoliosis; there are sex and age differences in response to scoliosis diagnosis and treatment; and noncompliance is a major factor in treatment. Implications for further research are discussed.

Adaptation, Psychological↗