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PubMedDate not supplied

Developmental patterns of visually handicapped children.

This article reports a comparative study of the developmental patterns of blind, partially sighted and fully sighted children during the first few years of life. Using the (previous reported) Reynell-Zinkin developmental scale for visually handicapped children, the groups were compared in the five developmental areas of (a) social adaptation, (b) sensori-motor understanding, (c) exploration of environment, (d) verbal comprehension and (e) expressive language. It was found that 10 to 12 months was the age at which the sighted group began to outstrip the visually handicapped children in most of the developmental areas. This divergence increased until towards, the upper end of scale (4 to 5 years for the visually handicapped) when more abstract thought processes began to develop. The effect of visual handicap was also seen in the greater advantage of the partially sighted over the blind children. The patterns of development varied somewhat in the five different areas. The reasons for this are discussed. The findings point to the need for intensive help for visually handicapped children from the earliest months of life.

Age Factors↗
PubMedDate not supplied

Profile: the voluntary council for handicapped children.

The Voluntary Council for Handicapped Children is an independently elected Council, established under the aegis of the National Children's Bureau in 1975. The Council arose from a recommendation in the Eileen Younghusband Working Party's report, Living with Handicap, in 1970. This major report draws attention to the gaps, overlaps and general lack of co-ordination and information about services for handicapped children. It recommended the creation of a genuinely multidisciplinary council to provide a forum for joint discussion and action, to offer a comprehensive advisory and information service covering all aspects of childhood disability. The Voluntary Council for Handicapped Children is unique in providing a comprehensive service for all categories of handicap, and for statutory and voluntary agencies. Parents and professionals can use the Council as a resource centre on an individual basis, although casework cannot be provided. The role of the Council is essentially that of a signpost to existing resources. It is, in effect, an advisory body collecting, evaluating and disseminating information, promoting study and discussion by organizations and individuals and seeking to identify gaps in present services.

Child↗
PubMedDate not supplied

Some conditions affecting manipulative play with objects in severely mentally handicapped children.

Four experiments investigated contact and manipulative activity with play materials in severely handicapped children functioning at the 1--2-year-old stage of normal development. Experiment 1 found that many mentally handicapped children were as quick to contact and manipulate a novel object as were comparable normal children and that auditory (or visual) feedback seemed to be effective in sustaining attentive activity with an object. A small minority of the handicapped children, however, were very slow to contact either familiar conventional toy or a novel object. Experiments 2 and 3 found that adding stimulus features such as lights, sounds or bright colours to an object had no consistent effect on the latencies of these 'slow responders' to contact the object. Experiment 4 found that the amount and kinds of manipulative play of mentally handicapped children differed from the normal children only in that they interacted less with an attendant adult and displayed less frequent representational use of toys in pretend play. The play of both normal and handicapped children was relatively unaffected by whether only a few (four) or many (15) toys were provided.

Acoustic Stimulation↗
PubMedDate not supplied

Some family problems associated with the presence of a child with handicap in Nigeria.

The problems presented in 53 families by the presence of handicapped children arising from cerebral palsy, poliomyelitis, Erb's palsy, talipes, arthrogryposis multiplex congenita and trauma, were studied in Benin City, Nigeria. Among other things, most fathers were found to be indifferent to their handicapped children and there was a highly significant difference in attitude between educated and enlightened fathers of handicapped children, and their barely educated counterparts. A statistically significant proportion of handicapped children were prevented from going to school because of their disabilities and in half of the families studied, occasional squabbles arose because of the presence of a handicapped child. It is suggested that Nigeria and similar developing countries should lay emphasis on health education in their on-going primary health care schemes.

Attitude to Health↗
PubMed1988

A comparison of sources of nursing stress and job satisfaction among mental handicap and hospice nursing staff.

This study compares sources of nursing stress and job satisfaction among 181 mental handicap and 24 hospice nurses. It was hypothesized that nursing stress varies as a consequence of nursing specialty. Analysis of variance revealed differing features of nursing stress between the two specialties. Hospice nurses reported stress as primarily associated with death and dying and inadequate preparation to meet the emotional needs of patients and their families, while mental handicap nurses reported stress related to workload, conflict with other nurses and nursing environment. The results suggest that two additional factors that did not differ between specialties require further examination, namely patient behaviour and purposelessness of nursing care. Job satisfaction also differed between specialties with hospice nurses reporting higher satisfaction with supervision, co-workers, and pay, and lower satisfaction with promotion in comparison to mental handicap nurses. Within the mental handicap groups nursing stress correlated with job satisfaction, state-trait anxiety and non-psychotic psychiatric disturbance in predicted directions. Analysis of the above variables with respect to mental handicap nursing grade was also undertaken. Overall results indicate the importance of nursing specialty as a major factor influencing nursing stress.

Hospices↗
PubMed1991

Sleep patterns and sleep problems amongst people with mental handicap.

This paper is in two parts. The first part reviews the available literature describing sleep patterns of people with mental handicap and the nature and prevalence of sleep disorders amongst this client group. Both electroencephalographic studies and informant-based reports are included. The literature is small, particularly in terms of the latter reports, and most of the information from both E.E.G. and informant sources describes populations of children with mental handicap. The need for further investigation of sleep and sleep problems, particularly amongst adults with mental handicap, therefore, becomes evident. The second part presents the results of a detailed sleep survey of 120 adults with mental handicap, approximately half of whom were resident in hospital and half in the community. A descriptive summary of the total sample is provided. Fifteen per cent of the sample presented significant sleep problems, particularly in the form of intermittent wakenings. The results of comparisons between (1) good and poor sleepers (2) hospital and community residents and (3) people with mental handicap and 'normal' adults (using data from another study) are then presented. The relationships between sleep and daytime functioning and the potential usefulness of behavioural approaches to management of sleep pattern are discussed.

Adult↗
PubMed1994

Assessing the impact of the All-Wales Mental Handicap Strategy: a survey of four districts.

The All-Wales Mental Handicap Strategy (AWS) pledged government leadership and additional resources for the task of developing community based residential, domiciliary, respite, daycare and professional services for people with mental handicaps and their families throughout Wales. Ultimately, the authors of the AWS sought to affect for the better the extent to which people with mental handicaps experience typical community life. A large random sample of people with mental handicaps in four diverse districts was used to track changes in services received, professional input, involvement in individual planning, the number of community activities pursued, and the size and range of individuals' social networks across the middle 4 years of the AWS. The balance between private housing and service residence remained unchanged although, with the ageing of the cohort, there was a decrease in the proportion living with parents and an increase in those living independently or in another family situation. There was an increase in the availability of residential services in the form of ordinary housing and an associated contraction in large congregate care facilities. However, not all moves were towards more ordinary living. Some people moved from large statutory sector specialist facilities to other atypical forms of residence, as did some people from family homes. Family support services in the form of family aides and short-term care increased significantly, but indicators still suggest that an expansion of these services is merited. Day services diversified slightly, but without affecting the major role of the traditional centre. There was a decrease in the numbers receiving a fulltime service. Only a third of the sample received regular individual plan reviews of the services they received and the developmental goals set in their name. In general, individuals were involved in a greater number of community activities that brought them into contact with other citizens. However, such an increase has not led to significant changes in the size or composition of people's friendship networks. Overall, the changes in service provision and family and user experience have been in line with the direction set by the AWS. However, the degree of change still required before the new pattern of services envisaged by the AWS is substantially in existence, or the experience of people with mental handicaps conforms with the guiding principles which underpin it, is considerably greater than that achieved after 7 of its initial 10 years.

Adolescent↗
PubMed1984

Maternal responsivity in interactions with handicapped infants.

The present study investigated the influence of 3 infant characteristics on mothers' interactions with their handicapped young children. These 3 characteristics are chronological age, mental age, and handicapping condition. Maternal responsivity was hypothesized to increase with mental and chronological age and to be more closely linked to mental than chronological age. In addition, it was expected that handicapped group membership would be related to maternal behavior, but that many of these effects would be accounted for by mental age. 111 handicapped young children and their mothers were observed in a 15-min free-play session. The children ranged in age from 3 to 36 months of age and were classified as Down's syndrome (N = 56), developmentally delayed (N = 21), or cerebral palsied (N = 34). Maternal responsivity to their infants' behavior was explored for total behavior and for proximal and distal behaviors separately using proportion scores to control for overall levels of infant and maternal behavior exhibited. Infants but not mothers emitted more behavior in the free-play setting as the infants' mental and chronological age increased. As expected, mothers were more responsive proportionately to their infants' behavior as their children became more mature mentally and chronologically older, even after controlling for age-related increases in infant behavior. Since mental and chronological age were related, partial correlational analyses were performed. The age-related increases in maternal responsivity were accounted for by mental but not chronological age. Differences as a function of handicapped group membership also were found. Cerebral palsied infants exhibited less behavior than did the Down's syndrome and developmentally delayed infants. Mothers of developmentally delayed infants exhibited more responsive behavior proportionately than did mothers of the other 2 groups. However, this difference was due to the higher mental age of the infants.

Cerebral Palsy↗
PubMed1984

Age and handicapped group differences in infants' visual attention.

102 handicapped children who ranged in age from 3 to 36 months and who were classified as Down's syndrome, cerebral palsied, developmentally delayed, or multiply handicapped were given a visual attention task. Subjects were presented 6 repeated trials of nonsocial stimuli followed by a seventh novel trial (20-sec trials, 20-sec intertrial intervals). Habituation to the repeated stimulus was assessed by examining fixation trends across the 6 trials. Differences in habituation as a function of chronological age, mental age, and handicapped group membership were examined. Over the entire sample, linear trends were found, as looking time decreased over trials. An age effect was found as the 3-7-month-olds did not exhibit a decrease in fixation over the 6 trials, while the older infants did exhibit response decrement. Parallel mental age differences in response decrement were found. No differences in fixation patterns were found for the 4 handicapped groups. Cluster analyses revealed 3 distinct fixation patterns over the 6 redundant trials, which were characterized by (1) high initial fixation and response decrement, (2) low initial fixation and no response decrement, and (3) moderate initial fixation and monotonic decrease in fixation over trials. Individual differences in cluster membership were found as a function of chronological and mental age but not handicapped group membership.

Attention↗
PubMed1979

A longitudinal study of very low-birthweight infants. II: Results of controlled trial of intensive care and incidence of handicaps.

Between 1966 and 1970, infants with birthweights between 1000 and 1500g entered a randomized controlled trial to determine the short-term and long-term results of neonatal intensive care. Of 158 long-term survivors, five were lost to follow-up, but the multidisciplinary research team prospectively followed 143 children up to the age of eight years. Useful data were available for the other 10 children. Of the long-term survivors 74 had received routine, and 84 had received intensive nursery care. At eight years of age there were no statistically significant differences in the frequencies of a variety of individual abnormalities; fewer of the intensively managed children had cerebral palsy, but sensorineural deafness and ocular abnormalities occurred more frequently. Individual children were graded into four carefully defined groups: (a) profound handicap (4.4 per cent of entire study group); (b) severe handicap (10.1 per cent); (c) significant handicap (37.3 per cent); and (d) trivial or no handicap (41.8 per cent). Inadequate data were available for 6.3 per cent of the children. It was apparent that the improved survival attributed to intensive neonatal care was achieved at the expense of additional severely handicapped children, and this feature is discussed.

Cerebral Palsy↗
PubMed1986

The relationship between child abuse and handicapping conditions.

This article discusses the relationship of child abuse, including neglect and sexual abuse, to the presence of handicapping conditions, both physical and psychological. Child abuse can cause physical and psychological disabilities in children who otherwise would have been normal. Studies show that children who are handicapped, or otherwise perceived as different by potentially abusive parents, are at high risk for abuse. Evidence also indicates that the handicaps of some children who were diagnosed originally as disabled are exacerbated by abuse. While cause and effect are not easily determined in specific cases, researchers agree that a pervasive relationship exists between handicapping conditions and abuse. Abused children are overrepresented in special education classes and handicapped children are overrepresented in the abused population. Many abused children become abusers as adults. Several suggestions concerning the problem are offered for school personnel.

Child↗
PubMedDate not supplied

Maternal perceptions of child behavior: handicapped versus nonhandicapped.

This study compares the ratings of child behavior in short stories by mothers of children with handicapping conditions versus those whose children had no handicapping conditions. Each of the mothers rated 12 short stories or vignettes and indicated their self-perceived level of stress. The results showed that the mothers of children with handicapping conditions expressed significantly greater stress levels and rated inappropriate child behavior in a more tolerant fashion than the mothers of children without handicapping conditions. This information may be of value to the dentist who treats patients with handicapping conditions, and it provides a greater understanding of the mothers' concerns and daily life stresses.

Adult↗
PubMed2003

Malocclusion and orthodontic treatment need of handicapped individuals in South Canara, India.

AIMS: To estimate the prevalence and the severity of malocclusion and treatment need for 329 handicapped individuals. SUBJECTS AND SETTING: 329 handicapped individuals aged 11-30 years, attending eight different nonresidential special schools of South Canara, India. METHOD: Examination and recording using the Dental Aesthetic Index (DAI). RESULTS: 53% had a dental appearance which required no orthodontic treatment, 24% had a definite malocclusion, where treatment was 'elective' and treatment for a further 12% was considered to be 'highly desirable'. The remaining subjects (11%) had a handicapping malocclusion where treatment was considered mandatory. CONCLUSIONS: The prevalence of definite and severe malocclusions was higher in the mentally subnormal individuals when compared to other handicapping conditions. Orthodontic services for the handicapped have generally been neglected.

Adolescent↗
PubMed1989

Projecting the number of patients with first ever strokes and patients newly handicapped by stroke in England and Wales.

The common assumption that future increases in the number of elderly people will result in a parallel increase in the burden of care of long term disabled survivors of stroke was examined. The number of patients with first ever strokes and the net number of people handicapped after these strokes in England and Wales every five years until 2023 have been projected. Between the base year 1983 and the year 2023 an increase in population of about 5% will occur; first ever strokes are projected to increase by about 30% and deaths within six months of first ever strokes by about 40%. The net number of severely handicapped people six months after a first ever stroke is projected to increase by only about 8%, however, and the net number of people who are moderately or severely handicapped by only 4%. This paradox occurs because first ever stroke often kills people who have been handicapped by other causes, particularly if they are elderly. It is concluded that despite the limitations of these data they strongly suggest that the increased burden of health care of patients with first ever strokes in the next 40 years will be primarily that of caring for those in the acute stages of stroke and not with the management of chronic handicap after a stroke.

Age Factors↗
PubMed1989

Hypernatraemic dehydration in patients in a large hospital for the mentally handicapped.

OBJECTIVE: To determine the prevalence of hypernatraemic dehydration and to assess the hydration and nutritional state of patients in a large hospital for the mentally and physically handicapped; also to assess the efficacy of an intervention programme to reduce the prevalence of hypernatraemic dehydration in the hospital. DESIGN: Prospective study of patients admitted with hypernatraemic dehydration from a large hospital for mentally and physically handicapped patients (hospital A) to a district general hospital between 1986 and 1988. In 1986 the hydration and nutritional state of a random sample of patients from hospital A was compared with a random sample of patients from a small hospital for the physically and mentally handicapped (hospital B) and with control groups from the community. The hydration of the patients from hospital A examined in 1986 was reassessed in 1988. PATIENTS: 12 Patients were admitted from hospital A to the district general hospital during 1986-8 (seven women, five men; age range 29-82). In 1986, 72 patients were randomly selected for the assessment of hydration and nutritional state from hospital A, 33 who required help with feeding and 39 who could feed independently. Fifty patients were similarly selected from hospital B, half of them requiring help with feeding. In 1988 the hydration state of 60 of the 72 patients from hospital was reassessed. Control values were taken from two published studies. INTERVENTIONS: In 1987 nursing staff in hospital A were asked to provide between 2.5 and 3.0 litres of fluid daily for all patients. The use of hypertonic enemas was discontinued, and the ratio of staff to patients was increased. MAIN OUTCOME MEASURES: Serum concentrations of urea and electrolytes (hydration) and body mass index (nutritional state). RESULTS: Of the 10 patients admitted with hypernatraemic dehydration from hospital A to the district general hospital in 1986, four died of intercurrent infection. No patients were admitted from hospital B with hypernatraemic dehydration during the same time. In 1986 the hydration and nutritional state of patients in hospital A were inferior to those in patients from hospital B and control subjects from the community (serum urea concentrations were 6.1 (SD 1.8) mmol/l v 5.5 (1.9) and 5.6 (0.4) mmol/l, respectively) 50% (36/72) of patients in hospital A had a body mass index less than or equal to 20 compared with 34% (17/50) of patients from hospital B and 12% (1141/9434) of control subjects). After the initiation of the preventive programme only one patient was admitted with hypernatraemic dehydration in each of the years 1987 and 1988. The mean serum urea concentration of the 60 patients who were reassessed in 1988 fell significantly between 1986 and 1988 from 6.1 (SD 1.8) mmol/l to 5.7 (2.1) mmol/l, the value in a control group matched for age and sex. CONCLUSIONS: Hypernatraemic dehydration, subclinical underhydration, and undernutrition were common in a large hospital for the mentally and physically handicapped. The problem of hypernatraemic dehydration was successfully dealt with by the hospital management team. Similar problems may be encountered in hospitals for patients who are mentally and physically handicapped and mentally ill, including psychogeriatric units.

Adult↗
PubMed1981

Young mentally handicapped adults in three London boroughs: prevalence and degree of disability.

A survey of 282 young adults, mentally handicapped on an administrative definition, was undertaken in th London Boroughs of Hounslow, Hammersmith, and Ealing between October 1978 and April 1980. The prevalence of mental handicap in the age group born between 1958 and 1963 was calculated, and variations were shown between the three boroughs and within the borough of Ealing. The findings suggested that the prevalence of severe mental handicap in this area is not markedly different from rates found in other British studies, but the administrative prevalence is inflated because numbers of mildly handicapped school leavers subsequently use the services for the mentally handicapped. Subjects were classified according to behavioural disabilities: young people in residential care were more likely to be severely incontinent, not literate, and without speech, but overall there was no relationship between degree of disability and placement in residential care.

Adolescent↗
PubMed1999

The need to handicap the recipient's native liver in the rat model of heterotopic auxiliary liver transplantation.

In the rat model of heterotopic auxiliary liver transplantation (HALTx), the opinion varies on whether and how the recipient's native liver should be handicapped. To avoid atrophy of the transplanted organ, in this study, two different handicaps were evaluated and their effects on post-operative animal survival and liver biology are described. With a sole portacaval shunt (group 1) all rats survived longer than 3 months. An additional handicap of the liver with either a 68% partial hepatectomy (68% PH) (group 2), or both a 68% PH and a common bile duct ligation (CBDL) (group 3) led to a 100% mortality within 2 days after surgery. When an auxiliary liver was transplanted to the rats handicapped with a 68% PH (group 4), serum Bilirubin and ALAT values were significantly lower than those handicapped with both a 68% PH and a CBDL (group 5). Autopsy and histology of the long-term survivors revealed the atrophy of the engrafted livers and the regeneration of the native livers in group 4, whereas it showed the opposite in group 5. Thus the various manipulations of the native liver do influence differently the post-transplant animal survival, serum liver biochemistry and the outcome of the engrafted liver in this rat model of HALTx.

Animals↗
PubMedDate not supplied

Sense of coherence - a mediator between disability and handicap?

BACKGROUND: The aim of this study was first to analyze the associations between disability and handicap and Antonovsky's concept of sense of coherence (SOC); secondly, to find out how the SOC concept could be integrated in the WHO model of impairments, disabilities, and handicaps (ICIDH). METHODS: Data from two studies were used: one on patients with rheumatoid arthritis, one on severely injured accident victims. Objective measures of the illness or the injury were conceptualized as indicator variables for disability, whereas variables related to the patients' subjective judgement were conceptualized as indicator variables for handicap. Correlations were calculated between both sets of variables and the SOC scale total score. RESULTS: SOC showed no significant correlation with 'disability variables' (rheumatoid arthritis: HAQ, SF36 physical functioning; accidental injuries: ISS, GCS). However, significant correlations were found between SOC and all 'handicap variables' (rheumatoid arthritis: HAD, SF36 social functioning; accidental injuries: CAPS-2, IES, SCL-90-R depression subscale). CONCLUSIONS: SOC is related to the psychosocial effects of health problems. It may be understood as a mediator between disability and handicap. Prospective studies are needed to clarify whether the SOC scale can be used as an outcome predictor with regard to psychosocial adaptation, in acute as well as in chronic health problems.

Accidents↗