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PubMed1992

[The effects of early manual instruction on the oral language development of two deaf children].

The speech and language training for deaf children at our clinic is performed using a multisensory method, which consists of reception and expression training for sign language and fingerspelling as well as auditory training, lip reading, and written language training (the Kanazawa Method). We have already reported that acquisition of written language is not dependent on oral language, and that written language is easier to learn than oral language for deaf children. In the present investigation, we analyzed the acquisition of comprehensible and expressive vocabulary in sign language and fingerspelling. The subjects were two children congenitally deaf at levels higher than 105dB. Recorded language samples by the age of 48 months were analyzed. Acquisition of sign language was found to be significantly easier than acquisition of oral language. The development of expressive noun words, function words, and Wh-question words in sign language at the early period was almost equivalent to that of hearing peers, and then the sign language appeared transfer to the oral language. These results suggest that early presentation of sign language with written and oral language is effective in the acquisition of communicative attitudes, function words and interrogative sentences which are most difficult for the hearing-impaired. It was shown that early presentation of sign language with written and oral language serves to promote acquisition of oral language.

Child↗
PubMed1998

Historical clues to the diagnosis of the dysfunctional child and other psychiatric disorders in children.

This article focuses on selected historical clues that can help the busy pediatrician identify children who are at risk for or already suffering from psychosocial dysfunction. Certain historical elements have been chosen because they reveal either common areas of childhood dysfunction or potentially dire outcomes. The major function realms of a child's life are covered, such as family, school, peer relationships, activities, and emotions, as well as related topics such as injury, poverty, substance abuse, and risk-taking behavior. Questions designed to elicit the relevant historical clues are suggested. Used as a set, these questions are intended to bring to light sufficient psychosocial history for pediatricians to identify most dysfunctional children.

Child↗
PubMed1982

Symptoms associated with menstruation.

Symptoms associated with menstruation during the teenage and young adult years may represent a spectrum of possibilities varying from a relatively benign deviation from normal to a serious life-threatening disease. Nevertheless, even for the young woman found to be without serious disease, menstrual problems have special meaning associated with the fear of being different from peers, concern about being less than complete or wholesome, and anxiety regarding future functioning as a normal woman. The physician must be aware of the adolescent's sensitivity in this area. Her apprehension should influence the manner in which the various abnormalities of menstruation are evaluated and managed. The physician must understand and appreciate the potential for profound emotional effects and psychological implications of menstrual conditions. The manner in which we care for the adolescent with menstrual symptoms will determine to a significant degree how successfully the patient will cope with abnormalities of menstruation.

Adolescent↗
PubMed1997

Clinical characteristics of psychiatrically referred adolescent outpatients with substance use disorder.

OBJECTIVE: There is increasing interest in the developmental relationship of psychopathology and substance use disorders (SUD) in youths. Because the bulk of literature is focused in inpatient or incarcerated youths, inferences and generalizations are limited in outpatient settings. The clinical characteristics of psychiatrically referred outpatients were studied to determine whether differences existed in the nature and severity of comorbid psychiatric disorders when substance abuse was involved. METHOD: All diagnoses were derived from structured psychiatric interviews completed on all youths on intake assessment. Adolescents with an identified SUD (n = 38) were compared with those without SUD (n = 321) on a number of variables including past and current psychopathology, cognitive and school functioning, and overall impairment. RESULTS: Eleven percent of referred outpatients (mean age = 15.9 +/- 1.3 years) met full criteria for a SUD by parental report. Controlling for age, adolescents with SUD had higher risk for mood and disruptive behavioral disorders compared with psychiatric controls. In the majority of cases, the onset of psychopathology preceded the onset of SUD by at least 1 year. The group with SUD also had lower overall functioning and more school dysfunction and psychiatric hospitalizations than their non-SUD peers. CONCLUSIONS: Despite the small number of adolescents with SUD in this sample, these data indicate that SUD is common in outpatient psychiatry referrals. Youths with SUD appear to be at increased risk for more psychopathology and dysfunction in a number of domains.

Adolescent↗
PubMed1995

Social competence in the school setting: prospective cross-domain associations among inner-city teens.

In this 6-month prospective study of 138 ninth-grade inner-city students, associations among different aspects of school-based social competence were examined. In addition, links between initial emotional adjustment and subsequent social competence at school were explored. Aspects of social competence examined included academic achievement, peer reputation, and teacher-related classroom behaviors. Emotional adjustment was measured based on self-reported internalizing and externalizing symptoms. Consonant with views positing continuity and coherence of development, high temporal consistency was found within each social competence domain. In addition, superior adjustment in one domain was sometimes associated with subsequent improvements in other spheres as well. Exceptions found to this pattern were that (a) both as an antecedent and as a consequent variable, peer-rated sociability was negatively linked with other indices of school-based functioning, and (b) among girls, high anxiety was related to improved performance at school over the year. Ecological influences in adolescent adjustment are discussed, and implications of the findings for future research are explored.

Adolescent↗
PubMed1997

Social and psychological adjustment of Soviet-born and Israeli-born adolescents: the effect of the family.

This study examined the impact of family functioning on the educational, social and emotional behavior of Soviet-born and Israeli-born adolescents in Israel. The parents of the Israeli-born adolescents were born in Russia; thus, this study controlled for their national background. The results showed that the two groups were similar in their perception about the way their families function. Both groups perceived that social and psychological well-being among adolescents were significantly related to family functioning. Multivariate analysis revealed that family functioning was the major factor predicting the level of self-esteem and peer relationships among adolescents, as well as a myriad of psychological symptoms. Directions for future research are discussed.

Adaptation, Psychological↗
PubMed1999

Treatment results in dental school orthodontic patients in 1983 and 1993.

The effect of incremental changes in materials and techniques on orthodontic treatment outcomes is difficult to evaluate objectively. Treatment results for two groups of patients whose treatments were completed approximately 10 years apart were evaluated using the peer assessment rating (PAR) index and the index of orthodontic treatment need (IOTN) using the Wilcoxon matched-pairs signed-rank test. Patients in the later group who had been treated by postgraduate students primarily (using fixed appliances) had significantly lower IOTN and PAR scores at the end of treatment and showed a significantly greater reduction in the PAR score than a similar group of patients in the earlier group. There were no significant differences in treatment results between patients in the early and late groups who were treated with removable appliances. Differences in treatment results were most likely the result of changes in materials and techniques that had occurred in the 10 intervening years.

Adolescent↗
PubMed1999

Psychological symptoms in chronic fatigue and juvenile rheumatoid arthritis.

OBJECTIVE: To determine if psychological morbidity in youth with chronic fatigue is caused by the stress of coping with a chronic illness. STUDY DESIGN: Case-control study comparing pediatric patients with debilitating chronic fatigue and matched subjects with juvenile rheumatoid arthritis, a chronic medical illness with similar functional sequelae. SETTING: Pediatric Infectious Diseases Clinic and Juvenile Rheumatoid Arthritis Clinic of Kosair Children's Hospital. PARTICIPANTS: Nineteen children and adolescents with debilitating chronic fatigue and 19 age- and sex-matched peers with juvenile rheumatoid arthritis. Outcome. Structured Interview, Kaufman Brief Intelligence Test, Child Behavior Checklist, and Youth Self-Report. RESULTS: Intellectual functioning on the Kaufman Brief Intelligence Test Composite was average (103, standard score) for both groups. Pediatric patients with chronic fatigue had higher levels of internalizing psychological distress than patients suffering from juvenile rheumatoid arthritis, despite the fact that both groups had a similar pattern of decline in social and physical activities. Duration of illness did not explain the difference in psychological symptoms. CONCLUSIONS: Psychological factors may play a more active role in debilitating chronic fatigue in pediatric patients than can be explained by the stress of coping with a similar chronic, non-life-threatening illness.

Adaptation, Psychological↗
PubMed1994

The sexual and reproductive consequences of congenital genitourinary anomalies.

The major congenital anomalies of the genitourinary tract may result in disturbances of sexual and reproductive function. In general the children grow up with the same aspirations as their more normal peers, which are to marry, have intercourse and produce children. Some achieve this despite the deformities and in others specific reconstructive surgery may be needed. In exstrophy the vagina lies parallel to the floor when the girl is standing and the introitus is seen on the lower abdominal wall rather than in the perineum. Episiotomy is required in 34% and formal vaginoplasty in 23% of the cases. The exstrophy penis has a tight dorsal chordee that must be corrected to allow intercourse. The neurological and social consequences of myelomeningocele do not prevent patients from having an interest in sex. Those who are able to walk are likely to have normal sexual function compared to about 50% of those who are wheelchair bound. The recurrence risk for neural tube defects in their offspring is 1:50 for sons and 1:13 for daughters regardless of the sex of the affected parent. The physiological consequences of posterior urethral valves result in weak ejaculation in 50% and highly viscous and alkaline semen in 50% of the cases. Of male patients with ambiguous genitalia or micropenis 75% have normal intercourse.

Epispadias↗
PubMed1985

Psychosocial functioning in prepubertal major depressive disorders. I. Interpersonal relationships during the depressive episode.

Psychosocial environment and relationships with parents, peers, and siblings of 115 prepubertal children were measured by interview with their parent(s) for the three-month period preceding the assessment. The children had a current diagnosis of major depression (52 children) or nondepressed neurotic disorder (23) or were assessed to be normal (40). Most aspects of psychosocial relationships were found to be significantly impaired in the psychiatric groups. This impairment was generally worse in the depressives and significantly worse for aspects of verbal and affective communication with parents and siblings. Prepubertal children with major depressive disorder regularly present social relation deficits in which two components can be distinguished: one general to childhood psychiatric disorder and another specific to major depression.

Age Factors↗
PubMed1997

The incidence of chronic headache in children with shunted hydrocephalus.

Report of chronic headache amongst children with shunted hydrocephalus is frequent, and often leads to investigation for raised intra-cranial pressure and shunt malfunction, and much debate has appeared in the literature concerning possible cause. However headache is a common neurological symptom amongst children, and studies of prevalence indicate incidence of frequent non-migrainous headache to be 6.8%, and migrainous headache 4% in the general child population. A relationship between stress and anxiety and headache is recognised, and the hydrocephalic child has many reasons above those of his/her peers to be subject to stress. It is also hypothesised that this group may be more vulnerable than peers to developing a migraine-like condition in the face of adequate shunt function. The clinician dealing with complaint of chronic headache in a hydrocephalic child must therefore be wary of over-investigation in a child with a working shunt, or missing possible shunt malfunction when the only symptom is chronic headache. It was speculated therefore that incidence of non-shunt related chronic headache in this group would be high, and an attempt was made to document incidence of migrainous and non-migrainous headache in the medical notes, and in replies to postal questionnaire sent to a sample of 130 children with shunted hydrocephalus of varying aetiology. Incidence of migrainous headache was documented in the medical notes in 8.5% of cases, with incidence rising to 21.5% using self-report. Incidence of non-migrainous headache was also very high (15.4%) and the overlap between migraine and tension headache, combined with difficulty of diagnosis in children may indicate migraine to be more frequent still. The concept of "Shunt Migraine" is therefore worthy of consideration. Report of chronic headache led to investigation in a large proportion of cases, but symptomatology often continued. Even when shunt malfunction was indicated, shunt revision did not "cure" complaint of headache. Headache was not found to be related to diagnosis associated with hydrocephalus, to presence of seizure disorder, or to the sex of the child, although in common with other studies, there was a strong trend towards girls being statistically more likely to experience headache than boys. There was a relationship however between report of chronic headache, and the sort of school a child was likely to attend; children who attended mainstream school without the support of a Statement of Special Educational Need were more likely to report headache than their peers, and it is hypothesised that these children may be suffering sufficient stress to contribute to maintenance of headache. The importance of the multi-disciplinary team in assessment of children's physical, intellectual and emotional status is stressed, in order that medical interventions have the greatest chance of success.

Cerebrospinal Fluid Shunts↗
PubMed1998

Rating and recognition of peers' personal odors by 9-year-old children: an exploratory study.

Eighteen elementary school children assessed the pleasantness and perfumed aspect of familiar peers' odors, sampled through tee shirts worn without modification of hygienic habits. The participants were also requested to categorize the odors by sex and to recognize those of several target classmates varying in sex and socioemotional status (the participant's most preferred classmate vs. a mere acquaintance). The ratings of odors by familiar peers appeared consistent with those obtained from nonfamiliar peers and adults and varied according to the sex of wearer of the tee shirts. For the five categories of peers examined, as well as for the participants themselves, olfactory recognition was better than chance. Moreover, it was higher for the same-sex preferred peers than for the others only for the female perceivers. The results are discussed in terms of their behavioral relevance for peer relationships, focusing especially on (a) the relations between sex differences in odors and gender development and (b) the function of olfactory memory in the emotional regulation of friendships.

Adult↗
PubMed1980

Clinic children with poor peer relations: who refers them and why?

Children who have poor peer relationships are at high risk for developing psychopathology in adulthood. Schools can provide an essential link between these children and mental health services by proper identification and referral. The role of schools in the referral process was evaluated for 298 boys and 98 girls seen at a child guidance clinic. Half of these referrals were made by schools, but referral because of poor peer relationships was unusual. It is suggested that teachers learns to attend more closely to children's social functioning as an important identifier of children at risk.

Adolescent↗
PubMed1994

Interpersonal functioning and depressive symptoms in childhood: addressing the issues of specificity and comorbidity.

Research has supported linkages between depression and social impairment in youngsters, but has often focused on depressive symptoms in isolation. We collected data on depressive, anxiety, and externalizing symptoms in 161 school children. Information about interpersonal competence was gathered from several sources, including children, teachers, and behavioral observations. Depressive symptoms were found to be related to difficulties in multiple areas of competence, including maladaptive social problem-solving styles, conflict-negotiation and affect-regulation deficits, and peer rejection. Comparisons of the relative contributions made by depressive and anxiety symptoms to the prediction of functioning yielded some evidence for a specific relation between depressive symptoms and impairment. Children with cooccurring internalizing and externalizing symptoms generally suffered from the most social dysfunction. If replicated in clinical samples, findings such as these may help to guide intervention efforts with depressed children.

Analysis of Variance↗
PubMed2000

Axiographic evaluation of mandibular mobility in children with angle Class-II/2 malocclusion (deep overbite).

Correction of the occlusion in Angle Class-II/2 patients is often more complicated and tedious than in Class-II/1 cases. Reasons given are the more comprehensive remodeling and functional adaptation processes of the temporomandibular joints (TMJ) since the articular tuberculum is more strongly developed in deep overbite, and a deep bite leading to a locked occlusion is dominant due to the steeper condylar path. Both characteristics are, however, considered to be the consequence of pronounced incisor retrusion. The present study covered 28 untreated Class-II/2 patients aged 8 to 12 years in whom functional TMJ adaptation to the retroclined maxillary incisors was studied with the help of electronic, 3D axiographic registrations of mandibular movements. Comparison with eugnathic age peers revealed increased mobility in mandibular protrusion and a somewhat steeper condylar path, although the latter was less pronounced than in adult patients. The results corroborate the concept of functional TMJ adaptation to incisor inclination and speak for early uprighting of maxillary incisors.

Adaptation, Physiological↗
PubMed1989

School adjustment, school performance and peer relations among first-graders in a Swedish suburban area.

A study of 95 first-graders in one school management area used teacher ratings of problems and sociometric ratings to assess school adjustment and peer relations; 14% of the children had difficulties in reading/writing, motor skill, concentration and psychosocial function. Behavioural problems did not generally coincide with poor scholastic performance, but a small group (6.3%) exhibited problems in both reading/writing, concentration, gross and fine motor skill and psychosocial functions. Sociometric results showed only moderate agreement with teacher ratings. Extremely popular boys had no teacher-rated problems, but children with teacher-rated problems did not to any high degree tend to be isolated. Poor gross motor skill did distinguish isolated boys from others, a relationship that was not evident among the girls. The need to study the validity of teacher ratings as well as the prognostic value of school adjustment in first grade was stressed.

Achievement↗