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PubMed1984

Selective auditory preferences and the use of automated equipment by severely, profoundly and multiply handicapped children.

Using automated equipment, contingent responding and auditory preferences were examined in 15 severely, profoundly and multiply handicapped children (CMAs 3-20 months) and 2 non-handicapped children at ages 5.0 and 9.5 months. 15 children showed contingent responding; prolonged responding was shown by the profoundly handicapped group. Where auditory preferences were apparent, they were the same as those seen in Down's syndrome and non-handicapped groups at the same developmental level. Children at the 5 months developmental level and less, had difficulty in making choice responses. Implications for intervention are discussed.

Association Learning↗
PubMed1986

Stress levels in families with intellectually handicapped preschool children and families with nonhandicapped preschool children.

Family stress levels were examined using the Questionnaire on Resources and Stress (QRS) in 42 New Zealand families with preschool intellectually handicapped (moderately and severely retarded) children and 42 families with nonhandicapped preschool children. Maternal age was employed as a blocking factor (less than 30 years versus 30 years and above). The families with intellectually handicapped children showed significantly higher stress levels on 13 of the 15 QRS scales, but maternal age did not appear to be implicated in family stress levels. The results suggest that stress levels are somewhat elevated in families with preschool children, the tendency being particularly marked in families with intellectually handicapped children. The implications of these findings for family intervention and support programmes are considered, together with the need for research into the various ecological contexts of the individual, family, peer group and social institutions, as well as of the interactions within and between these contexts as mediators of coping resources in families with intellectually handicapped children.

Adult↗
PubMed1987

The elderly mentally handicapped in hospital: a clinical study.

In a study of 99 long-stay hospital residents aged 65 years and over, two thirds were functioning in the moderately to mildly handicapped range, two thirds were under the age of 75 years and there was an overall female to male ratio of 2:1. As in the general population, mobility problems, a tendency to falls and fractures, cardiorespiratory disease, deteriorating eyesight, and hearing and urinary incontinence were commonly found; all increased in frequency with age. A fifth exhibited psychiatric disorder: the commonest conditions, as expected, were the psychoses and dementia. It is suggested that retirement provision for the elderly mentally handicapped should be made within the mental handicap services and that the small group with significant geriatric problems would be most appropriately cared for within the generic geriatric services. A plea is made for evaluative studies before large scale implementation of resettlement programmes for the elderly mentally handicapped in hospital.

Aged↗
PubMed1990

A study of doctors' and parents' attitudes to people with mental handicaps.

The attitudes to people with mental handicaps held by a group of parents of children with mental handicaps and a group of doctors with some involvement in this area were compared using postal questionnaires. Doctors' estimates of how parents would respond were also compared with parents' responses and doctors' own responses. Four Likert-type scales were refined covering attitudes towards the effect on the family, the place in society of people with mental handicaps, their quality of life, and independence and autonomy. Results indicated that parents had more positive attitudes than doctors except with regard to independence and autonomy, to which doctors had the most positive attitudes. Doctors were aware that parents were likely to see the effect on the family in a more positive light, and independence less positively, than themselves. However, they underestimated the degree of positivity of parents about the place of people with mental handicaps in society, and their quality of life, to the extent that they expected parents to be significantly less positive about quality of life than they themselves were, whilst parents in fact proved significantly more positive. The differing perspectives and experiences of parents and doctors are discussed and some suggestions made of ways in which doctors' appreciation of the parental perspective could be developed in an attempt to facilitate sympathetic communication between them.

Adaptation, Psychological↗
PubMed1991

Ways of telling new parents about their child and his or her mental handicap: a comparison of doctors' and parents' views.

Views about ways of telling parents their child has a mental handicap were collected from a group of parents of children with mental handicaps and a group of doctors with some involvement in this field, using postal questionnaires. Four Likert-type scales were refined covering views about the fullness of information, how early parents should be told, whether parents should be protected from shock and unpleasant information, and who should take a primary role in decision-making. Results indicated that parents were more in favour of being given information about their children's handicaps at an early stage than doctors were, and that they saw themselves as the primary decision-makers in matters to do with their children, whilst doctors were more neutral about this. There were no differences in how parents and doctors felt about the fullness of explanations or about the explicit 'protection' of parents from shock and unpleasant information. The results support the findings of other studies which have stressed parents' wishes to be given as much information as early as possible and to be treated as the people primarily responsible for their child. In addition, a difference between what doctors believe to be the best approach and what parents believe to be the best approach is suggested, and the importance of doctors being given opportunities to learn directly from parents and people with mental handicaps themselves is emphasized.

Adaptation, Psychological↗
PubMed2005

Costs of self-handicapping.

Four studies examined the relation of trait self-handicapping with health-related measures. Study 1 showed that, over time, self-handicapping and maladjustment reinforce each other. Study 2 showed that self-handicappers reported a loss in competence satisfaction which, in turn, mediated the relation of self-handicapping with negative mood. Study 3 found that, over time, self-handicappers report an increase in substance use. Study 4 showed that self-handicappers reported a loss in intrinsic motivation for their jobs. It was suggested that people with unstable (or contingent) self-esteem use self-handicapping to bolster a fragile self-concept.

Adaptation, Psychological↗
PubMed2006

The handicap caused by atopic dermatitis--sick leave and job avoidance.

BACKGROUND: The handicap caused by skin diseases is insufficiently described in comparison to other types of diseases (e.g. rheumatological diseases). Estimates of disease handicap provide important data for overall disease assessment, resource planning and background data for planning possible preventive intervention studies. OBJECTIVE: Primarily to describe the degree of handicap caused by atopic dermatitis (AD) in relation to the choice of education and occupation. Secondarily to describe the frequency of social pensions awarded due to AD in Denmark and the development of pensions awarded over time. METHODS: A descriptive study based on questionnaires gathered from members of the Danish Association of Atopic Eczema. Information was obtained on age, disease duration, severity, localization of eczema and Dermatology Life Quality Index (DLQI). Additional data about sick days due to eczema and patients' choice of education or employment were obtained from the Danish Ministry of Social Affairs. RESULTS: Study population 112 (24 males and 88 females), aged 15 years and older, self-assessed morbidity was mild (1/3), moderate (1/2) or severe (approximately 1/5). Mean DLQI score was 9.67. Mean loss of working days due to AD was 5.8 days/6 months (95% CI: 0.36-11.30). The mean total loss of working days due to eczema alone was 148% of the national average, and 38% of the respondents had abstained from a specific education or a job due to AD. Since 1970, the average number of pension due to AD awarded in Denmark has grown from 4.2 per year for 1970-1976 to 18.0 per year for 1999-2002. CONCLUSION: Even mild to moderate AD causes handicap as seen from increased sick leave and the number of awarded early retirement pensions. There are therefore both individual as well as societal consequences of AD.

Adolescent↗
PubMed1985

Handedness in the mentally handicapped.

The prevalence of left-handedness and the degree of handedness were examined in 130 normal and mentally handicapped pupils of both sexes, aged between seven and 18 years. Handedness was assessed by means of 10 performance items. The prevalence of left-handedness among normal pupils (10.6 per cent) was significantly lower than that for the mentally handicapped group (26.5 per cent). There was no significant difference in the prevalence of left-handedness between the mentally handicapped pupils with and without Down's syndrome. The degree of handedness was also reduced in the mentally handicapped group, but again there was no difference between those with and without Down's syndrome.

Adolescent↗
PubMed1986

Handicap and rehabilitation: two types of information upsetting family organization.

This article aims to show that the birth of a physically handicapped child should be regarded as powerful information, compelling the family to reorganize. The three subsystems most frequently challenged by the onset of a handicap are examined: the extended family, the couple, and the siblings. Further potent information involving the whole family arises in the rehabilitation program by placing demands on parents that may radically upset the existing equilibrium, and inevitably entailing a highly significant relationship with the child's therapists. Rehabilitation staff should be adequately trained to monitor the various phases during which family members adjust to both these types of information (handicap and rehabilitation) in order to ward off the development of dysfunctional games. A family therapy approach is appropriate in the all too many cases in which a rigid dysfunctional game has already set in such that the handicapped member is playing the role of identified patient.

Adolescent↗
PubMed1997

Oral health condition of 12-year-old handicapped children in Flanders (Belgium).

The dental condition of 626 12-year-old handicapped children with mild mental or moderate to severe mental retardation or learning impairment, being 25% of the population of each of these groups, was examined in Flanders. An evaluation of oral cleanliness showed poor oral hygiene in 31.8% of the children. No significant differences were found in oral cleanliness among types of handicapping conditions. The mean DMFT score was 2.9 (s: 2.6) and DMFS score was 5.4 (s: 5.6). Almost 21% of the children were free of caries or fillings. No significant differences were found among groups of handicapped children. Handicapped children presented a low level of restorative care (restorative index score: 48.7%). Mildly mentally retarded children demonstrated the lowest restorative index (43.9%). The caries experience of first permanent molars represented the largest part of the DMFT score (64.1%). Sealants were present in 7.9% of children examined. A considerable percentage of mildly mentally retarded children and learning impaired children did not brush daily (22.1% and 20.9%) and did not receive help with toothbrushing from their parents or carers (91.0% and 94.7%, respectively).

Belgium↗
PubMed1993

Nordic children with myelomeningocele. Parents' assessments of the handicap and physicians' classifications of the disabilities.

The differences between parents' assessments of their child's handicap and professionals' assessment of disabilities were studied in 486 Nordic children with myelomeningocele aged 4-18 years. Although disability and handicap are conceptually different, agreement between the parents' assessments of the handicap and the degree of disability according to Lorber's classification was found in 51% of cases. The parents' assessments showed close agreement with overall disability according to Lagergren's method in 45% of cases. The factors most strongly associated with parental assessment of the handicap were the child's motor disability, intellectual functioning, faecal and urinary incontinence and the parents' inclination to feel inadequate with respect to the child's needs. Data from professional assessment of disabilities alone are of limited value in understanding the impact of disabilities on the daily life of a child.

Adolescent↗
PubMed1981

Mildly handicapped children in the mainstream--implications for the health educator.

The Education for All Handicapped Children Act of 1975, PL 94-142, will cause mildly handicapped children to be integrated into mainstream academic classes including health education. Because of the disparate needs of these children, health educators will have to provide for a diverse group of learners. Since it is clear that health education encompasses topics crucial to the overall social and personal development of the handicapped, it is essential that health educators become prepared to maximize learning opportunities for the handicapped child in the mainstream.

Child↗
PubMed1983

One hundred and twenty visually handicapped children below 7 years of age.

120 visually handicapped pre-school children are evaluated according to eye disease and its etiology, and the associated handicap, all related to the different levels of functioning. One third of the children fulfil the expectations on visually handicapped children. The group consists mainly of children suffering from hereditary ocular disorders and some children with retrolental fibroplasia. One third of the children are moderately or severely intellectually impaired, bearing a heavy burden of additional handicaps; many are born premature or dysmature, having suffered perinatal complications. The final third are children who fall outside the other 2 groups, some with a brain damage syndrome, some with light or moderate behavioural and emotional disturbance. The moderate and severe emotional disturbance and its relation to a brain dysfunctional syndrome are discussed.

Affective Symptoms↗
PubMed1984

Social skills training with mentally handicapped people: a review.

Four questions are asked about the use of social skills training procedures with mentally handicapped people. The first is, 'What are social skills in the context of mental handicap?', and it is suggested that they involve a complex array of perceptual, cognitive, motor and motivational processes, all of which can be disrupted due to various problems common among mentally handicapped people. The second question, 'What changes do social skills training programmes aim to achieve?', leads to the conclusion that most programmes have concentrated on motor, and to some extent on motivational processes, at the expense of perceptuo-cognitive ones. In asking, 'Have the programmes been successful in achieving these changes?', the answer is a guarded 'yes', given the limited aims of most investigators. Generalization to the natural environment has only occasionally been established, though it is often not measured. The fourth question is, 'What is the clinical significance of the changes obtained by such programmes and how can future ones be made more clinically relevant?'. The answer to the first part of the question is that, in general, their clinical utility has not been established. Future programmes could be made more clinically relevant if they were integrated with strategies for producing more benign and stimulating environments for mentally handicapped people.

Adolescent↗
PubMed1978

Acquisition and performance difference between normal and mentally handicapped adults on a complex assembly task.

Several single studies concerned with work training with the mentally handicapped have been reported in the literature (Bitter & Bolanovich, 1966; Huddle, 1967; Gold, 1969; Screven, Straka & Lafond, 1971). Most have been concerned with issues of acquisition and motivation to perform. No studies have been reported which focus on the evaluation of different techniques of training or which assess rate of acquisition against that of non-handicapped controls. The aim of this experiment is twofold. It uses a complex task, analysed by MTM-2, to enable comparison between the performances of mentally handicapped adults and adults from a 'normal' population, in the acquisition of new work skills. Various strategies of training were compared and the increase in the rate and quality of performance following acquisition was measured for both, in terms of speed and accuracy of production. Results add further support for the notion that the potential of mentally handicapped individuals is commonly underestimated. It is hoped that the findings provide a basis from which further experiments can be developed and evaluated.

Adult↗
PubMed2001

Causes of severe visual impairment and blindness in children attending schools for the visually handicapped in the Czech Republic.

AIMS: To describe the causes of severe visual impairment and blindness in children in schools for the visually handicapped in the Czech Republic in 1998. METHODS: Pupils attending all 10 primary schools for the visually handicapped were examined. A modified WHO/PBL eye examination record for children with blindness and low vision was used. RESULTS: 229 children (146 males and 83 females) aged 6-15 years were included in the study: 47 children had severe visual impairment (20.5%) (visual acuity in their better eye less than 6/60), and 159 were blind (69.5%) (visual acuity in their better eye less than 3/60). Anatomically, the most affected parts of the eye were the retina (124, 54.2%), optic nerve (35, 15.3%), whole globe (25, 10.9%), lens (20, 8.7%), and uvea (12, 5.2%). Aetiologically (timing of insult leading to visual loss), the major cause of visual impairment was retinopathy of prematurity (ROP) (96, 41.9 %), followed by abnormalities of unknown timing of insult (97, 42.4%), and hereditary disease (21, 9.2%). In 90 children (40%), additional disabilities were present: mental disability (36, 16%), physical handicap (16, 7%), and/or a combination of both (19, 8%). It was estimated that 127 children (56%) suffer from visual impairment caused by potentially preventable and/or treatable conditions (for example, ROP, cataract, glaucoma). CONCLUSIONS: Establishing a study group for comprehensive evaluation of causes of visual handicap in children in the Czech Republic, as well as for detailed analysis of present practice of screening for ROP was recommended.

Adolescent↗
PubMed1997

Retrospective study of doctors' "end of life decisions" in caring for mentally handicapped people in institutions in The Netherlands.

OBJECTIVES: To gain insight into the reasons behind and the prevalence of doctors' decisions at the end of life that might hasten a patient's death ("end of life decisions") in institutions caring for mentally handicapped people in the Netherlands, and to describe important aspects of the decisions making process. DESIGN: Survey of random sample of doctors caring for mentally handicapped people by means of self completed questionnaires and structured interviews. SUBJECTS: 89 of the 101 selected doctors completed the questionnaire. 67 doctors had taken an end of life decision and were interviewed about their most recent case. MAIN OUTCOME MEASURES: Prevalence of end of life decisions; types of decisions; characteristics of patients; reasons why the decision was taken; and the decision making process. RESULTS: The 89 doctors reported 222 deaths for 1995. An end of life decision was taken in 97 cases (44%); in 75 the decision was to withdraw or withhold treatment, and in 22 it was to relieve pain or symptoms with opiates in dosages that may have shortened life. In the 67 most recent cases with an end of life decision the patients were mostly incompetent (63) and under 65 years old (51). Only two patients explicitly asked to die, but in 23 cases there had been some communication with the patient. In 60 cases the doctors discussed the decision with nursing staff and in 46 with a colleague. CONCLUSIONS: End of life decisions are an important aspect of the institutionalised care of mentally handicapped people. The proportion of such decisions in the total number of deaths is similar to that in other specialties. However, the discussion of such decisions is less open in the care of mental handicap than in other specialties. Because of distinctive features of care in this specialty an open debate about end of life decisions should not be postponed.

Adolescent↗
PubMed1976

Degree of physical handicap, education, and occupation of 51 adults with spina bifida.

51 adults with spina bifida, aged between 18 and 56 years, resident in South Wales, were interviewed in their home. Although only four had obvious hydrocephalus, one-third of them were severely handicapped and a further 40% had moderate handicap. Over half of them had had their secondary education in a normal school, with the remainder having special schooling or home tuition. Seventy per cent of the series was in normal, full-time occupation, including half those severely handicapped. Those in work were largely in managerial/technical, clerical, and light manual occupations. It is concluded that extendance and training, followed by special job placement, would help to integrate them into the community. These patients show that, in the absence of mental retardation, even severe physical handicap is no bar to normal occupation and that paralysis and incontinence alone are probably not valid selection factors for or against 'aggressive' treatment for spina bifida.

Adolescent↗