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PubMedDate not supplied

[Functional outcome of visually handicapped children cared for at the Department of Visual Stimulation--"Fundação Altino Ventura"].

PURPOSE: To analyze the functional outcome of visually handicapped children. METHODS: Twenty-seven children were evaluated using the standard functional PEDI test. Seventeen who attended school at "Escola Municipal Alto do Maracanã", Recife - Pernambuco, Brazil, had normal visual acuity and the other ten had visual handicap, and were cared for at Stimulation Visual Department - "Fundação Altino Ventura", in the same city. RESULTS: The children who had visual handicap showed significantly worse performance in self-care and mobility than normal children. CONCLUSION: Visual handicap may have limited the performance regarding self-care, mobility, understanding, communication, home works, in the studied group.

Activities of Daily Living↗
PubMedDate not supplied

Development of bladder control in mentally handicapped children.

PURPOSE: To analyze the role of mental handicap as a possible source of lack of development of bladder control and to find out the chance of continence to advise future patients. MATERIALS AND METHODS: The parents and relatives of 100 consecutive mentally handicapped patients were inquired by a personal interview. Questions included the age when they stopped using diapers, enuretic events, frequency, urgency and leakage episodes, urinary infections. Etiology of their mental problem was unknown in 34, perinatal anoxia in 17, Down syndrome in 15, phenylketonuria in 18 and others minors causes. The grade of mental deficiency were profound in 1, severe in 10, moderate in 39, mild in 33 and normal inferior value in 17. The age varied from 7 to 37 years old, with an average of 14 by the time of the interview, comprising 60 males and 40 females. RESULTS: All profound and severe patients presented leakage episodes regardless of the age. The mild and normal inferior value acquired progressive urinary control with aging, and 33% still remain with urinary symptoms above 16 years old. Urinary infection was similar in males and females, around 29%. The most committed group presented less urinary infections. The etiology of the mental handicap was not correlated to the incidence of urinary leakage. CONCLUSIONS: The lack of bladder control was correlated to the grade of mental handicap. In severe and profound groups, the expectancy of control is disappointing. In the less compromised groups, there is a delay in bladder training, with achievement of control in (2/3) after 16 years of age. Those in the normal inferior value have a chance of postponed urinary control, easily misdiagnosed by normal urological interviews.

Journal Article↗
PubMed1987

New motor control assessment techniques for evaluating individuals with severe handicaps: a case study.

Prescription of assistive devices for motor-handicapped individuals requires assessment of their motor capabilities. When patients' motor deficits are particularly severe, wide individual differences in the location and type of abnormalities complicate the assessment process. The precision of assessment has been greatly increased in recent years by the use of quantitative, computer-aided motion analysis, which facilitates statistical examination and comparison with normal individuals. This paper discusses a case study wherein a 24-year-old male nonvocal cerebral palsy patient was assessed for his ability to operate assistive communication devices. Three computer-aided measurement protocols were employed to evaluate the patient and two controls: performance using the patient's existing communication aid was evaluated in terms of rate and accuracy of communication using standardized spelling and response time tasks; volitional myoelectric activity was surveyed to identify possible myoelectric control sites for communication aid operation; a study of head position and its time derivatives was conducted to explore the feasibility of proportional control of a communication aid. Comparison of handicapped and control subject data indicated that, despite several characteristic motor control deficits, the handicapped subject was capable of proportional control of lateral head rotation and binary control of frontalis myoelectric signals. These movements could be used to operate a proportionally-controlled, direct-selection communication aid that could substantially increase the subject's communication rate. Work in progress includes the expansion of the handicapped and unimpaired subject databases and further development of the techniques discussed here to include three-dimensional motion analysis and objective measurement of muscle fatigue.

Adult↗
PubMed1982

Cytogenetic and dermatoglyphic studies on severely handicapped patients in an institution.

Cytogenetic and dermatoglyphic studies were performed on a group of 197 institutionalized patients with severe mental and physical handicaps in order to evaluate the contribution of chromosomal aberrations on the etiology of the condition, and to determine whether any association exists between the dermatoglyphics and the severe handicaps. There were 4 patients with trisomy 21 and 2 patients with a de novo balanced reciprocal translocation. In addition, 9 patients were found to have a pericentric inversion of chromosome 9 (inv (9) (p11q13)). Other chromosome variations identified included inv (1) (p11q11) (one case), elongation of 1 qh (one case), and telocentric chromosome 13 (two cases). Dermatoglyphics from the patients excluding cases with Down syndrome were compared with those from 500 normal controls. Significant differences were observed in several dermatoglyphic characteristics, including simian crease, fingertip pattern, mean a-b ridge count, thenar/first interdigital pattern, hypothenar pattern, and hallucal pattern. The present study indicated that de novo balanced translocation as well as chromosome duplication or deficiency is causally related to the severe combined handicaps. This study also showed that the incidence of inv (9) (p11q13) in the patients was 4.2 times higher than that in the general Japanese population. If a real association exists between the inv (9) (p11q13) and severe handicaps, the increase of inv (9) (p11q13) in the patients may be explained by the concept of a risk factor. Moreover, the dermatoglyphic deviations found in patients may be evidence that pathological factors had been operating during early embryonic life in some of them.

Adolescent↗
PubMed1991

Teaching persons with profound multiple handicaps: a review of the effects of behavioral research.

The behavioral research on teaching individuals who have profound multiple handicaps is reviewed. The primary focus is on determining the degree to which behavioral research has demonstrated the teaching of meaningful skills to this population. Results of the review indicate that investigations have demonstrated, albeit inconsistently, that behavior change has resulted from contingency management interventions with persons who have profound multiple handicaps. However, there is little evidence that such interventions have resulted in meaningful behavior change according to currently accepted criteria for beneficially affecting the quality of life of persons with serious handicaps. Potential explanations for the lack of such evidence are offered, including the relative lack of research attention given to this issue, the possible ineffectiveness of the components of the technology applied, and possible ineffective application of the potentially effective technology. Suggestions for future research are discussed in terms of developing more effective educational and habilitative services for persons with profound multiple handicaps. In particular, we suggest research on a wider variety of behavioral teaching procedures, providing more comprehensive evaluations of the applications of procedures and developing treatment programs that do not focus solely on traditional skill acquisition.

Activities of Daily Living↗
PubMedDate not supplied

The influence of self-ascribed handicapped status on the positive and negative affect of the elderly.

Recently, Stock and Okun found that self-ascribed handicapped elders, relative to self-ascribed nonhandicapped elders, had significantly lower mean scores on six measures of subjective well-being. Using the same data base, in the present study, we examined whether self-ascribed handicapped status accounted for variance in positive and negative affect, net of intra- and interpersonal resources, and social status. On the bivariate level, self-ascribed handicapped status was related significantly to positive and negative affect. However, it did not account for more than 2 percent of the variance in either. As anticipated, self-ascribed handicapped status was not a significant predictor of positive and negative affect when social status and intra- and interpersonal resources were statistically controlled. Contrary to expectations, social status was a unique predictor of positive and negative affect.

Activities of Daily Living↗
PubMedDate not supplied

[Demographic and audiological factors as predictors of hearing handicap].

INTRODUCTION: Currently available evidence reveals comparatively few studies of psychological effects of hearing impairments, in spite of the fact that clinicians have for a long time been aware of a connection between the acquired hearing impairment and mental disorders. They are focused on the investigation of dysfunction in general. Thus, three domains of the auditory imbalance may be distinguished: disorder, disability and handicap. 'Handicap', according to the definition of the World Health Organization, is a hindrance in an individual that results from an impairment or disability and represents psychological response of the individual to the impairment. OBJECTIVE: Validation of acquired hearing impairment as a risk factor of psychical disorders as well as an analysis of relation of some demographic factors (sex, age, education) and audiological factors (degree and duration of the impairment) with the frequency of hearing handicap. METHOD: MMPI-201 has been applied in 60 subjects affected with otosclerosis, potential candidates for stapedectomy, before and after the surgery. RESULTS: Individuals with acquired hearing impairment manifest more frequent disorders of psychical functioning in comparison with general population, while demographic and audiometric parameters did not correlate with acquired hearing handicap. CONCLUSION: It may be assumed that the very recognition of demographic and audiological factors can not help much in the understanding of the psychological stress associated with hearing impairment.

Adult↗
PubMed1982

Spontaneous EEG correlates of intellectual functioning in talented and handicapped adolescents.

EEG correlates of intellectual functioning were investigated in 35 academically talented and 20 academically handicapped adolescents. EEG data from Ertl's Brainwave Analyzer were factor-analyzed and factor scores entered into regression equations predicting four primary mental abilities, verbal, numerical, reasoning, spatial, and two sequential tests of educational progress, reading and mathematics. Analysis indicated that (1) frequency ratio, with relatively greater left-hemisphere activity was the most important EEG variable related to mental functioning in the talented group; (2) while EEG period and alpha ratio were the two most important EEG variables related to intellectual functioning in the mentally handicapped group; (3) hemispheric symmetry was of some importance for both groups, with greater symmetry being associated with superior performance. Contrary to Ertl's neural efficiency theory, (1) neural information transfer rate was significantly positively (not negatively as predicted) related to intellectual performance (for the handicapped group only), and (2) alpha was significantly related to intellectual functioning (for the handicapped group only). Further research is needed to extend and confirm the above findings dealing with persons scoring in the normal IQ range and during mentally active as well as resting conditions.

Adolescent↗
PubMed1991

Effects of field-based training on teachers' knowledge and attitudes and the motor proficiency of their handicapped students.

The purpose of this study was to evaluate the effects of field-based training on the knowledge and attitudes of regular physical education teachers and the motor proficiency of their handicapped students. Twenty-four physical education teachers from a large, city school district completed a program in two phases, one on appropriate motor development for special populations followed by an implementation phase involving 46 handicapped students. An inventory was designed to measure teachers' knowledge, the Measurement of Attitudes Toward Disabled Persons scale measured teachers' attitudes, and the Bruininks-Oseretsky Test of Motor Proficiency measured handicapped students' motor ability. Analysis showed that teachers' knowledge increased significantly from pre- to midproject. Nonsignificant changes were noted for teachers' attitudes although positive increases occurred throughout the project. There was a significant increase in the motor ability of the handicapped students as a result of appropriate programming. Some change among teachers and students was encouraging.

Adolescent↗
PubMed2001

Risk for occupational injury of handicapped workers in Taiwan.

The current study investigated occupational risk of handicapped workers relative to nonhandicapped workers and used the standardized mortality ratio as an index that handicapped workers were at elevated risk for occupational injury. A total of 6,327 records of disabling occupational injuries beyond first aid treatment from January to December, 1999 were collected and analyzed. The ratio of the standardized mortality ratio of the handicapped vs nonhandicapped workers indicated that occupational injury risk of handicapped workers must be seriously examined for the reasons for this unexpectedly high occupational risk.

Adult↗
PubMed1993

Structure of perceived handicap in middle-aged males with noise-induced hearing loss, with and without tinnitus.

By using a modified stepwise regression analysis technique, the structure of self-perceived handicap and tinnitus annoyance in 89 males with noise-induced hearing loss was described. Handicap was related to three clusters of variables, reflecting individual, environmental, and socioeconomic aspects, and 60% of the variance in self-perceived handicap was explained by the representatives of these clusters: i.e. 'acceptance of hearing problems', 'social support related to tinnitus' and 'years of education'. Tinnitus had no impact of its own on self-perceived handicap and only a modest portion (36%) of the variance in tinnitus annoyance was explained by 'sleep disturbance' and 'auditory perceptual difficulties'.

Adaptation, Psychological↗
PubMed1991

Teaching mental handicap to medical students.

An innovative approach to the teaching of mental handicap to pre-clinical medical students as part of their Behavioural Sciences course is first described. The teaching is organized around a number of extended placements which allow students to interact with people with a mental handicap on a basis of equality and reciprocity. Students respond positively to the seminar, regarding it as enjoyable, interesting and relevant to their future work as doctors. Questionnaires administered to students participating in the seminar suggest that they have a generally positive image of mentally handicapped people and hold vaguely liberal views as to how they should be treated by Society. Few, however, wish to work in the mental handicap area. There is no evidence that the experience of the seminar leads to any significant change in these attitudes.

Behavioral Sciences↗
PubMed1992

Somatic and psychological factors contributing to handicap in people with vertigo.

Questionnaires assessing symptoms, disability and handicap, predisposition to anxiety, and current anxiety and depression were completed by 127 people attending neuro-otology clinics with a major complaint of vertigo or dysequilibrium. Definite signs of vestibular dysfunction (spontaneous or positional nystagmus, or canal paresis) were found in 56% of the sample, but the presence or absence of abnormal vestibular test results was unrelated to diagnosis, reported symptoms, handicap and psychological status. Two-thirds of employed respondents admitted to occupational difficulties, and more than one in seven had left work because of vertigo. Although the number of people in the sample with a predisposition to anxiety was not unusually high, over a third of the sample had abnormally elevated levels of current anxiety. Multiple regression analyses indicated that disability was determined mainly by physical factors (vertigo severity and duration, age and sex). Handicap was influenced by a mixture of somatic and psychological variables, including the severity of autonomic symptoms. Anxiety and depression were only indirectly related to the severity and duration of the vertigo, insofar as this contributed to handicap. The partial dissociation between these different aspects of patient well-being suggests a need for separate evaluation and differing management of problems at each level of functioning.

Adaptation, Psychological↗
PubMed1988

Evaluation of community-based rehabilitation in Punjab, Pakistan: II: The prevalence of diseases, impairments, and handicaps.

A health survey using the impairment and handicap classifications from the ICIDH was carried out in conjunction with a study of the WHO community-based rehabilitation programme in a village and a slum area in Pakistan. The prevalence of handicaps defined in this way was about half that of impairments, the most common handicaps being with mobility, occupation, and social integration. There was a slightly higher degree of handicap in the village. In both areas diseases of the musculoskeletal system, the ear, and the respiratory tract were common, but the frequency of infectious, respiratory, endocrine, blood, and digestive diseases was higher in the slum area.

Community Health Services↗
PubMedDate not supplied

The assessment of handicap: an evaluation of the Environmental Status Scale.

The assessment and measurement of disability and handicap are of particular relevance in rehabilitation, as these are the main foci of therapeutic intervention. The area of handicap is the least developed with few measuring tools to provide an objective assessment of status. The Environmental Status Scale (ESS) is now becoming increasingly utilized to measure handicap. It was used in a study of 50 patients on admission and discharge in a neurorehabilitation unit, to analyse its validity and usefulness as an outcome measure of the rehabilitation process. The results suggest it has limited validity, mixes disability and handicap issues and in some sections has a misleading scoring system. It requires modification to overcome these difficulties.

Disability Evaluation↗
PubMedDate not supplied

Disability, resources, role demands and mobility handicap.

Research on disablement highlights a wide variability in the impact of disabling conditions on individuals' lives. However, in most of this work, the relationships between impairment/disability and features of individuals' social and physical environments are not specified conceptually. Recent conceptual work in the context of the International Classification of Impairments, Disabilities, and Handicaps (ICIDH) suggests that the impact of impairment/disability on individuals' lives is contingent on levels of resources and other aspects of social context. The research question addressed in this paper is whether selected social factors affect the impact of impairment/disability on mobility handicap, defined as 'the individual's ability to move about effectively in his/her surroundings'. Two types of social factors are considered: resources such as help from others or having a car available; and social role obligations such as having a job or visiting relatives. Data are derived from a 1986 probability sample of 570 individuals with disabilities living in communities in Calderdale, Yorkshire, England. Multiple-regression models indicate that the impact of walking disability on mobility handicap was reduced by availability of a car in the household and school or job obligations. Other impairments/disabilities, resources and social role demands examined did not act on mobility outcomes in this manner. Implications for conceptualizing and testing relationships between impairment, disability, handicap and social and physical environments are discussed. A critical task for future research is the investigation of personal and social resources and barriers that may moderate the impact of disability on individuals' lives.

Activities of Daily Living↗
PubMed1996

Hearing impairment, disability and handicap in elderly people living in residential care and in the community.

This study aimed to compare the prevalence of hearing impairment, disability and handicap in the elderly living in residential care with those living in the community, and to examine the relationship between impairment, disability and handicap in both groups. Fifty community-based and 129 residential subjects were assessed using pure-tone audiometry as a measure of impairment, and a self-assessment questionnaire as a measure of disability and handicap. Community-based subjects were also assessed using a test of speech discrimination as an objective measure of disability. Results indicated 95% of residential subjects and 70% of community-based subjects were hearing-impaired, while 27% of residential subjects and 42% of community-based subjects demonstrated significant disability/handicap. Significant correlations were obtained between impairment, disability and handicap in both subject groups. The implications of the findings for the aural rehabilitation of the elderly are discussed.

Aged↗
PubMed1995

[Multivariate analysis of everyday handicap of patients with dizziness].

A preliminary questionnaire consisting of 30 questions was developed to evaluate handicaps in everyday life for 105 patients with dizziness. Factor analysis divided the questions into 5 principal factors of handicap due to dizziness: 1) disturbance of social activity, 2) body motion precipitating dizziness, 3) limitation of physical activity, 4) emotional disturbance, and 5) disturbance of interpersonal communications. The score of each factor was calculated as the sum of the scores of three principal questions in the corresponding factor. There was no contribution of clinical diagnosis, patient's age or gender, or duration of the disease to the score of each factor. Thus, it is concluded that the reorganized questionnaire which consists of three principal questions in 5 factors can be used for evaluating dizziness handicaps in everyday life. The score of the emotional factor in patients with Meniere's disease was higher than that for other vestibular disease. The score of the body motion factor in patients with vestibular neuronitis was higher than that for vertebro-basilar artery insufficiency. Thus, the re-organized questionnaire can also be used for evaluating the contribution of each factor to dizziness handicaps in everyday life.

Activities of Daily Living↗