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Measuring functional status and family support in older school-aged children with cerebral palsy: comparison of three instruments.

OBJECTIVE: To compare a pediatric and an adult version of a functional status measure and a family support measure for assessing school-age children with spastic cerebral palsy. DESIGN: A prospective study involved functional status measurements using the Pediatric Functional Independence Measure (WeeFIM), the Adult Functional Independence Measure (FIM), and a family support measure, the Amount of Assistance Questionnaire (AAQ). PARTICIPANTS: The feasibility sample consisted of 47 children aged 2 to 12 yrs with cerebral palsy. The study sample consisted of 20 children aged 7 to 16 yrs with spastic cerebral palsy (50% diplegia, 50% quadriplegia). INTERVENTIONS: Initial assessment interview included the WeeFIM, developmental milestones, educational achievement information, and the AAQ. Within 1 month, a follow-up phone interview using the FIM was completed. MAIN OUTCOME MEASURE: The WeeFIM and FIM measure independence in self-care, sphincter control, mobility, locomotion, communication, and social cognition. The AAQ measures the time and assistance required by a child in essential daily tasks. RESULTS: Pearson's correlation coefficient exceeded .97 for WeeFIM and FIM total score in the total sample as well as in two subgroups of children: those with diplegia and quadriplegia. Total scores in WeeFIM and FIM as well as domain scores were significantly different between children with diplegia and quadriplegia. Parental amount of assistance on the AAQ was significantly correlated with WeeFIM and FIM scores. CONCLUSION: Either the WeeFIM or FIM can be used for monitoring functional status through adolescence in children with spastic cerebral palsy. Functional limitations are highly related to requirements for parental assistance.

Activities of Daily Living↗

Functional neuroanatomical differences between adults and school-age children in the processing of single words.

A critical issue in developmental cognitive neuroscience is the extent to which the functional neuroanatomy underlying task performance differs in adults and children. Direct comparisons of brain activation in the left frontal and extrastriate cortex were made in adults and children (aged 7 to 10 years) performing single-word processing tasks with visual presentation; differences were found in circumscribed frontal and extrastriate regions. Conceivably, these differences could be attributable exclusively to performance discrepancies; alternatively, maturational differences in functional neuroanatomy could exist despite similar performance. Some of the brain regions examined showed differences attributable to age independent of performance, suggesting that maturation of the pattern of regional activations for these tasks is incomplete at age 10.

Adolescent↗

Ethics committees in Japanese medical schools.

The present features and functions of ethics committees in 80 Japanese medical schools were surveyed by employing questionnaires. Seventy-nine schools had already established committees on each campus (however, the ethics committee at Kitasato Medical University was formally established after the completion of this survey). The major role of Japanese ethics committees may be said roughly to correspond to that of Institutional Review Boards (IRB) in the U.S., although ethics committees have other functions as well. Among the ethics committees' many problems, two significant weaknesses should be underscored. The first is the inappropriate composition of the membership of the committees: more non-campus members, younger professionals, and women should be invited to participate. The second concern is the committees' essentially closed review process: this process has not been adequately open to the public even in cases in which the issue of the patient's confidentiality does not arise. However, several schools are now preparing to open their meetings to non-members and this policy should improve the present situation. It is fortunate, however, that the ethics committees in Japan's medical schools were established by members from each campus and not as a response to national directives or legislation.

Community Participation↗

Social skills and problem behaviours in school aged children with high-functioning autism and Asperger's Disorder.

The social skills and problem behaviours of children with high-functioning autism and Asperger's Disorder were compared using parent and teacher reports on the Social Skills Rating System. The participants were 20 children with high-functioning autism, 19 children with Asperger's Disorder, and 17 typically developing children, matched on chronological and overall mental age. The children with autism and Asperger's Disorder were not differentiated on any social skill or problem behaviour based either on teacher or parent report. However, both clinical groups demonstrated significant social skill deficits and problem behaviours relative to the typically developing children, and the original standardization sample. The findings were compatible with the view that autism and Asperger's Disorder belong on a single spectrum of disorder.

Asperger Syndrome↗

Neuropsychological characteristics of school-age children with high-functioning autism: performance on the NEPSY.

Utilizing standardization and validation data from the NEPSY, this study presents a reanalysis of the High-Functioning Autism (HFA) versus Typical samples using IQ as a covariate. The reanalysis in the present paper should prove important to clinicians and researchers by (1) determining if the original findings can be replicated for the HFA sample when controlling for IQ, and (2) providing neuropsychological description for children with HFA versus Typical children across the NEPSY variables. The sample included 23 children with HFA who ranged in age from 5 years 5 months to 12 years 11 months (Mean = 9.59 years). The HFA Group comprised 19 males, 22 Caucasians, and was 87% right handed. All of the parents had between 12 to 15 years of education. A Typical Group was selected from the standardization sample of the NEPSY and matched on the variables of chronological age, race, gender, parental education, and region of the country. A MANCOVA revealed significant group differences on 8 of the 14 core subtests of the NEPSY, with the HFA Group performing lower than the Typical Group. While these findings significantly overlapped with those from the original validation study, significant group differences also were uncovered for the subtests of Phonological Processing, Auditory Attention and Response Set, and Speeded Naming; Comprehension of Instructions and Narrative Memory were no longer significant after controlling for IQ. When the groups were compared with respect to the number of cases falling below the 10th percentile, the HFA Group showed a higher rate of occurrence on each subtest, but only significantly so on the Arrows Subtest. These findings provide additional support for the phenotypic neurocognitive presentation of individuals with HFA, and they suggest that the NEPSY can contribute to the neuropsychological description of children with HFA.

Analysis of Variance↗

The auditory threshold in a school-age population is related to iodine intake and thyroid function.

The aim of this study was to determine the relationship between auditory capacity and urinary iodine, taking into account thyroid volume and function, in a population of school-age children. Audiometry was carried out in 150 children (ages 6-14 years), together with measurements of thyroid volume, thyrotropin (TSH), free T3, free T4, thyroglobulin, antiperoxidase and anti-TSH receptor antibodies, as well as iodine in a casual urine sample. Children with a TSH >5 microU/mL were excluded from the study. In the children with palpable goiter, there was an inverse relation between the auditory threshold at all frequencies and ioduria. Children with thyroglobulin values >10 ng/mL had a higher auditory threshold at all frequencies. In the children with palpable goiter and ioduria <100 microg/L, the levels of thyroglobulin and ioduria and the age accounted for 75% of the decibel (dB) variance at 2000 (Hertz), with similar results at other frequencies. The children with a thyroid sized at the >95th percentile had an odds ratio of 3.86 (95% confidence interval: 2.59-5.10) of having a threshold >20 dB. The results warn that iodine prophylaxis is needed to prevent not only goiter but also other iodine-deficiency disorders, such as involvement of the auditory threshold in school-age children.

Adolescent↗

Dating aggression, sexual coercion, and aggression-supporting attitudes among college men as a function of participation in aggressive high school sports.

Aggressive male sports have been criticized as bastions of sexism and training grounds for aggression against women, but there have been few empirical demonstrations of these alleged relationships. The authors studied self-reported dating aggression and sexual coercion in 147 college men. Men who had participated in aggressive high school sports, as compared with other men, engaged in more psychological aggression, physical aggression, and sexual coercion toward their dating partners, caused their partners more physical injury, were more accepting of violence, had more sexist attitudes and hostility toward women, were more accepting of rape myths, and were less tolerant of homosexuality. Results indicate that participation in aggressive high school sports is one of the multiple developmental pathways leading to relationship violence.

Adult↗

Family functioning and metabolic control of school-aged children with IDDM.

The relationship of two aspects of family life to metabolic control were examined as part of a longitudinal study of school-aged children with newly diagnosed insulin-dependent diabetes mellitus (IDDM). Glycosylated hemoglobin level was the primary index of metabolic control; weight-adjusted insulin dosage served as an indirect index. Neither the quality of family life nor aspects of the parents' marriage predicted the child's metabolic control over the next 3-4 mo, and they were also unrelated to concurrent weight-adjusted insulin dosage. Longitudinal data spanning a 6-yr period of the child's diabetes also failed to reveal an association between aspects of family life and metabolic control. The significance of the findings are discussed in light of the sample's characteristics and possible methodological constraints.

Adult↗

Comparison of culturally deprived school achievers and underachievers on memory function and perception.

To compare the memory function and perception of culturally deprived achievers with underachievers, 36 culturally deprived children were assigned to one of two groups according to their achievement level, in relation to their age and IQ. Underachievers were children achieving 6 mo. or more below expected level. Achievers were children achieving within at least 5 mo. of expected level. All subjects were between the ages of 8 and 12 yr. and were in Grades 4, 5, or 6. Four tests were administered, the Block Design and Digit Span subtests of the WISC, Memory-for-Designs, and the Minnesota Percepto-Diagnostic Test. The two groups did not differ on the first three tests, but the achievers performed significantly better on the last test than the underachievers. It was speculated that the differences were related to level of motor execution.

Achievement↗