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PubMedDate not supplied

Group programmes for parents of children with various handicaps.

Programmes were conducted with groups of parents of school-aged, physically handicapped, hearing impaired, and, mildly and moderately mentally handicapped children. In this paper the salient features of the organization of these parent programmes are discussed. Programmes have involved six to eight weekly 2 hour sessions. The format of each session included both lecture presentation and discussion in small groups. Discussions were led by educational psychologists using a combination of reflective and behavioural procedures. Evaluation, by means of post-programme questionnaires and attendance checks, has shown that parents have found programmes to be valuable. An integral part of the parent programmes has been the training of special education teachers in the attitudes and skills necessary for working with parents of handicapped children. The introduction of group programmes is considered to complement the individual training and counselling services already available to such parents in New Zealand.

Adolescent↗
PubMedDate not supplied

An assessment of the cognitive abilities of multiply handicapped children: adaptations of the Uzgiris and Hunt scales and their use with children in Britain and Singapore.

Educational achievement is measured by many forms of assessment. The assessment of some children, and disabled children, has elicited much concern and debate. In particular, problems have arisen with test design, construction, administration and recording. In the West, legislation and public opinion have drawn attention to the need to provide more suitable measuring instruments. The purpose of this paper is to illustrate the use of an adapted assessment procedure for monitoring educational achievement and progress. A study is discussed where the major aim is to use situations which are both stimulating and which most closely resembled the children's natural settings, in order to elicit communication and language skills. The study is being carried out in Singapore with a group of multiply handicapped children. The adaptations to the administration of the test enable the examiner to note the behaviour as it occurs rather than look for expected behaviours. It is possible then to record behaviours at a later stage. The results of the study show that it is possible to elicit the required responses from a group of children who are diagnosed as multiply handicapped and whose competencies are difficult to assess. In the original research in Britain, with a large group of multiply handicapped children, there was evidence of reliability, validity and ordinality in the children's responses. Analysis of these children's scores showed patterns of responses inconsistent with a popular view of development. This paper describes the Singapore study and the original study upon which it is based.

Child↗
PubMedDate not supplied

Observation of emotional functioning in young handicapped children.

Young children with handicaps are at greater risk of emotional problems than young children without handicaps because of several factors, two of which include (a) altered parent-child interaction patterns from infancy onward and (b) societal attitudes regarding handicaps. Early interventionists are in a unique position to observe signs of emotional problems and assist families in obtaining psychological help. Greenspan's framework for systematically observing aspects of emotional development is described, and ways of drawing conclusions from observations are presented in order to assist interventionists from many disciplines to observe emotional development with greater clarity.

Affective Symptoms↗
PubMedDate not supplied

Genetic prognosis in severe mental handicap.

698 children below age sixteen years with severe mental handicap (below IQ50) who were admitted to hospital between 1956 and 1959 were surveyed for genetic prognosis. They were divided into 23.7% ascribed primarily to environmental factors, 50.9% unclassified aetiologically, 16.2% of Down's syndrome, 5.3% other genetic syndromes and 3.9% with congenital hydrocephalus. The incidence of a similar degree of mental retardation among the sibs of 660 whose families were traced, was 1.1% in the "environmental" group; 4.7% for the unclassified; 1.7% for Down's syndrome, 11.5% for other genetic syndromes and 4.3% for hydrocephalus with spina bifida. There were no affected sibs of the uncomplicated cases of congenital hydrocephalus. This survey underlines the fact that a high proportion of cases of mental handicap remain without aetiological diagnosis. It emphasises the value of such a diagnosis for genetic counselling. Advice given depends on the circumstances of the particular case which requires a detailed social history and sympathetic rapport by members of the team as well as appropriate clinical expertise (Kirman, 1971, 1972). When families with similarly affected new relative or previous severely mentally handicapped sibs are set aside, the recurrent risk for unclassified cases is reduced to three per cent.

Adolescent↗
PubMed1980

Organic acidurias and amino acidurias in the aetiology of long-term mental handicap.

In order to evaluate the contribution of patients with organic aciduria and amino acidopathies to populations with severe long-term mental handicap, urine from a total of 1,778 such patients from four hospitals has been examined for organic acids and amino acids. The patients have been classified into eight groups according to the nature of their handicap. It is concluded that, apart from phenylketonuria originating from before dietary treatment was available, known inherited metabolic diseases do not contribute significantly to the incidence of mental handicap in the population studied.

Amino Acid Metabolism, Inborn Errors↗
PubMed1981

Severe mental handicap in Northern Ireland.

A retrospective study was made of all individuals with severe mental handicap (IQ less than 50) in Northern Ireland who are resident in institutions and in the community. Some 4,701 individuals were ascertained and the annual prevalence rate based on the period 1950-69 was 3.67 per 1,000 live births. Classification of individuals by cause into genetic, environmental and unknown groups shows an increase in the genetic group and a decline in the unknown group. This is thought to be due to increases in medical knowledge rather than to any real biological change. The annual prevalence rates for the years 1950-69 exhibit no definite decline. The most common causes of severe mental handicap are Down syndrome, conditions associated with pregnancy and delivery and the recurrence of severe mental handicap in children born into families who already have one affected person with an IQ less than 40 of unknown aetiology.

Adolescent↗
PubMed1983

A national survey of young people's perceptions of mental handicap.

Over 1300, 15 and 16-year-old students throughout Ireland, completed a range of questionnaires which covered their past contact with mentally handicapped adults, their perceptions of them, their views on integration within society and their knowledge about the causes of this disability. It was found that only one quarter of the students had ever interacted with a mentally handicapped adult and nearly half of them had never been in their company. There were marked differences between these subgroups in their perceptions of, and attitudes to, mentally handicapped people. Equally striking were the differences between male and female students, although the effects of social background, city versus country and socio-economic status, were less pronounced. The implications for school-based, educational programmes on disability are discussed and areas for further research are highlighted.

Adolescent↗
PubMed1985

The mentally handicapped child and family crisis.

The defences of family members were studied in order to observe the reactions of the family when faced with a dysfunction in one of its members. Thirty families with a mentally handicapped child were studied, and the attitudes of parents, grandparents and siblings towards the handicapped child were examined. The data showed that the birth of a mentally handicapped child interrupts the normal life-cycle of the family, leading to a crisis. The first reaction in the parents was most often found to be denial, but ultimately adaptation was demonstrated in nearly 80% of the parents. Many of the siblings' and grandparents' reactions differed significantly from those of the parents, being more positive than those of the latter.

Adaptation, Psychological↗
PubMed1987

Cognitive psychology and mental handicap.

The psychology of mental handicap has been influenced by two traditions in general psychology, pychometric measurement following Binet and experimental psychology first initiated by Wundt. The weakness of the former is its lack of explanatory power and, of the latter, its lack of sound alignment with the neuropathology of mental handicap. A closer association of experimental psychology and neuropathology might help us to reframe our concepts of intelligence, cognitive functions and their handicaps.

Education of Persons with Intellectual Disabilitie↗
PubMed1991

A community-based mental handicap out-patient clinic: a 5-year retrospective study.

A 5-year retrospective study of mentally handicapped patients referred to the only community-based mental handicap out-patient clinic in a county with an approximate population of 360,000 is presented. The clinic has been functioning for about 10 years and has been consultant-based. Areas for study include: referral rate; source of referral; degree of handicap; superimposed mental illness, behaviour disorder and epilepsy; and the proportion of patients needing admission to the unit for further assessment/treatment. Some implications are discussed.

Activities of Daily Living↗
PubMed1992

Demographic characteristics of a population of people with moderate, severe and profound intellectual disability (mental handicap) over 50 years of age: age structure, IQ and adaptive skills.

Studies characterizing community populations of older people with intellectual disability (mental handicap) have frequently derived data from mental handicap registers. Such large-scale studies permit the establishment of reliable age trends, yet may utilize unreliable information and omit some individuals. Here, a functional characterization of a 50+ years sample with moderate, severe and profound intellectual disability is described, in which an extensive outreach exercise to identify individuals not known to mental handicap service providers ensured that almost 100% of people fulfilling the residence, age and ability criteria were included. Functional level, assessed by the Adaptive Behaviour Scale (ABS), is reported in relation to six factors derived from factor analysis. Overall, the sample was relatively high functioning and generally free of severe problem behaviours. There was no evidence for significant age-related functional decline.

Activities of Daily Living↗
PubMed1992

Dexamethasone suppression test and response to antidepressants in depressed mentally handicapped subjects.

Nineteen mentally handicapped subjects who were referred to the service with clinically significant depression were assessed with a view to determining the value of the dexamethasone suppression test (DST) in clinical diagnosis and in predicting response to antidepressant treatment. They were assessed initially and then 3 months after they had been treated with a tricyclic antidepressant. It was found that a significant proportion had an abnormal DST response which reversed after recovery in some but not in others. Non-reversal was more likely to occur in the more severely handicapped patients. It was concluded that DST was of little value as a diagnostic tool for the detection of depression in mentally handicapped subjects.

Adolescent↗
PubMed1993

Hepatitis B in the non-residential mentally handicapped population.

This study describes seroprevalence and risk factors for hepatitis B in seven centres caring for non-residential mentally handicapped individuals. Overall, 11% were hepatitis B marker seropositive and 4% had the hepatitis B surface antigen (HBsAg). Male sex and increasing age were associated with seropositive status, and Down's syndrome was associated with the presence of HBsAg. Immediate family members of those with hepatitis B markers were screened and 22% had evidence of hepatitis B markers. Forty-one family members were identified when the mentally handicapped individual was HBsAg positive and of these 13 (32%) were seropositive. This study demonstrates that hepatitis B is a problem for the non-residential mentally handicapped population and confirms the risk of infection to their immediate families.

Adolescent↗
PubMed1993

Parents' and teachers' praxes of and attitudes to the health and sex education of young people with mental handicaps: a study in Stockholm and Tokyo.

In 1989/1990, parents and teachers of young people with mental handicaps in Stockholm (41 parents and 20 teachers) and Tokyo (106 parents and 111 teachers) were given a questionnaire about their praxes of and attitudes towards health and sex education. Results from the study indicated that, compared to parents and teachers in Tokyo, parents and teachers in Stockholm gave more information about health and sex to their 15-16-year-old young people with mental handicaps. This was especially so regarding information about HIV/AIDS. More parents and teachers in Stockholm also had positive attitudes towards sex and interpersonal relationships--not only for young people in general but also for young people with mental handicaps--compared to parents and teachers in Tokyo. Some questions of an ethical nature were found difficult to answer in both Stockholm and Tokyo.

Adolescent↗
PubMed1994

Autopsy findings in patients with mental handicap.

Autopsies were carried out on 60 mentally handicapped patients and the brain was examined in detail in all cases. The clinical records were studied and correlated with the pathological findings. A variety of pathological changes were found in the central nervous system, and there was a high incidence of microcephaly and gross abnormalities among the patients with epilepsy and neurological dysfunction. The incidence of Alzheimer's disease was very high among patients with Down's syndrome, but in those patients without Down's syndrome, the incidence appeared to be much the same as in the general population. The most common cause of death was respiratory disease, followed by cardiovascular disease. There was a high incidence of volvulus among the group with epilepsy. The findings are discussed, and reference made to the long-term care of the mentally handicapped. The study demonstrates the importance of the autopsy in terms of furthering knowledge in the field of mental handicap.

Adult↗
PubMed1982

Visual handicap in children.

Vision is the primary mode of learning and if it is absent or impaired, other pathways must be stimulated. The range of appropriate services available to visually handicapped children is explained in relation to the school run by the Royal Victorian Institution for the Blind in Melbourne. A period of residential education may be needed for children with multiple impairment. Those whose handicap is primarily visual can usually live at home and have their education integrated with that of their normal peers. Home-based services and parent support systems for preschool and kindergarten age children are outlined. To be successful, they require sharing confidential medical and education information. The school provides a major input to a discussion group of all professionals dealing with such children. Information from the group includes the causes, and educational implications of visual handicap in Victorian children. The commonest pathologies are macular problems and congenital cataract.

Australia↗
PubMed1997

A computer-generated test of acuity for multi-handicapped children.

Assessment of visual function in severely intellectually handicapped children is difficult but necessary for educational purposes. The difficulties encountered include: lack of literacy skills; lack of verbal and fine motor skills; and low interest level of the optotypes. A computer-generated test has been developed that helps overcome these difficulties. This test presents pictures equivalent in line width to Snellen, which are manipulated on screen to provide movement and change of size to facilitate non-verbal responses and to increase interest level. Evaluation trials were conducted with 96 cognitively normal children and 37 multi-handicapped children. The computer test facilitated testing of significantly more of the multi-handicapped children. Data from both trial groups indicated a good positive correlation between the computer test and a standard optotype test. Further refinement and evaluation of this computer test is continuing.

Adolescent↗
PubMed1984

Determinants of patient compliance, control, presence of complications, and handicap in non-insulin-dependent diabetes.

Factors affecting patient compliance with diet and medication, clinical control, complications, and handicap were studied in 114 subjects with non-insulin-dependent diabetes mellitus who were attending a hospital diabetic clinic. Compliance with diet and hypoglycemic medication was correlated. The perceived importance, and the ease of compliance were the principal correlates of patient compliance. Factors independently related to diabetic control were compliance with diet, and the quality of the patient's diet. Diabetes which was poorly controlled, and which was of several-years' standing, was more likely to involve complications. Both poor control and the presence of complications contributed to handicap. Increased dietary education and counselling, with emphasis placed on the importance and benefits of compliance with prescribed diets, may improve control, decrease the incidence of complications, and ultimately minimise handicap due to diabetes in non-insulin-dependent patients.

Adult↗