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PubMed1985

Maternal withdrawal from handicapped toddlers.

Videotaped observations of the free-play interaction of mothers and (a) 12 physically handicapped, (b) 14 premature and (c) nine healthy 2-year-olds were evaluated. Mothers of handicapped toddlers were significantly more likely to ignore their children at 24 months than were mothers in other groups. Further, although children's Bayley scores had not differed when seen previously at 1 year, children of mothers who ignored at 2 years had lower concurrent 2-year IQ scores and experienced an average 30-point drop between the two evaluations. These results support clinical reports of maternal withdrawal from handicapped young children and suggest that the mother-child dyad in such cases may be at continuing risk throughout the early years.

Child, Preschool↗
PubMed1975

The significance of motor handicap in the prognosis of childhood epilepsy.

A total of 244 epileptic children were collected in an epidemiological and prognostic investigation on epilepsy. The children were divided into four groups according to their motor performance. There were 150 children with no motor handicap, 32 with clumsiness, 51 with cerebral palsy and 11 with severe muscular hypotonia associated with grave mental handicap. A study was made of age at onset of epilepsy, intelligence level, maximum frequency of seizures, grand mal status, results of medical treatment, and the time elapsed since the last seizure. A significant correlation was found between severity of motor handicap and poor prognosis of epilepsy.

Adolescent↗
PubMed1977

Teaching medical students about mental handicap.

The care and management of mental handicap is a relatively increasing problem, and medical responsibilities for the prevention, detection, treatment and management of mental handicap are undergoing significant changes in emphasis. The present paper examines the current position of undergraduate medical training in this field in medical schools in the United Kingdom and in Eire. Although there are considerable training variations between different schools, the over-all style of presentation is not thought to facilitate appropriate learning in this subject for future doctors. There is a suggestion that medical students themselves would welcome more attention to this field. Greater co-ordination is needed within existing teaching programmes. The appointment of senior academics with multiple departmental attachments and a major commitment to the subject of mental handicap may be a valuable step forward.

Curriculum↗
PubMed1999

Effects of incorporating memory confidence ratings and language handicap modifications on intracarotid amobarbital procedure (Wada test) memory asymmetry scores.

PURPOSE: Intracarotid amobarbital procedure (IAP) memory asymmetry scores are often considered in determining lateralization of temporal lobe seizure foci. Additionally, these scores sometimes influence treatment plans for epilepsy surgery candidates. We examined the effects of two scoring modifications on IAP asymmetry scores: incorporating memory confidence ratings (MC), and use of a language handicap (LH) (i.e., adding a point to the memory score with anesthetization of the language-dominant hemisphere), both of which could be applied to most IAP protocols despite variations in testing methods among epilepsy surgery programs. METHODS: Sixty-nine consecutive unilateral temporal lobe epilepsy (TLE) patients with subsequent good surgical outcomes (Engel I or II) underwent bilateral IAP testing. Confidence ratings were obtained for all memory responses. The incorporation of confidence ratings and the application of a language handicap for dominant-hemisphere injections were applied to memory asymmetry scores in all combinations, resulting in four scoring methods. Results of the four methods were compared with respect to the proportion of patients lateralized accurately by each method. RESULTS: No patients were falsely lateralized with any method. Percentage of patients correctly lateralized with each scoring method is shown in Table 2. The results obtained with MC and with MC + LH (67% and 64% of patients accurately lateralized, respectively) were significantly better than results obtained with LH (55%, p<0.05). No other differences were significant. CONCLUSIONS: Although not statistically superior to standard methods, these results suggest that incorporating memory confidence ratings into IAP protocols may increase the likelihood of obtaining asymmetry scores that accurately lateralize to the hemisphere of seizure onset. In contrast, inclusion of a language handicap for scores obtained with the language-dominant ICA injection were not helpful and may even decrease the probability of obtaining clinically useful lateralizing data. These scoring modifications can be applied to most IAP protocols.

Adult↗
PubMed1986

Families with physically handicapped children: social ecology and family systems.

This paper reviews research on families with physically handicapped children, and integrates this work within a social ecological perspective. Methodological difficulties in past research that contribute to a lack of consensus in the area are discussed. Research on stresses experienced by various subsystems within families with handicapped children is presented, with recommendations for future family-oriented research and intervention. The interactions of families with handicapped children with their social support networks are reviewed, underscoring the importance of these processes for coping and adaptation.

Autistic Disorder↗
PubMed1979

How dental conditions handicap the elderly.

A sociodental investigation was carried out among 254 elderly people living at home in Nottinghamshire. The aim of the inquiry was to ascertain whether this group of people were handicapped by their dental conditions. The dental status of the sample was generally poor. 74% were edentulous and the condition of the full dentures worn by many of the subjects was unsatisfactory. A high proportion (59%) of the subjects had lesions of the oral mucosa. Many members of the sample were orally handicapped, either functionally or socially. 32% complained of oral pain and 30% claimed to have difficulty chewing. Also, subjects were embarrassed by the appearance of their teeth and by their dentures dropping during social contact. The perception of handicap, however, was not strongly related to dental status.

Activities of Daily Living↗
PubMed1989

Correlation of manual dexterity and comprehension with oral hygiene and periodontal status in mentally handicapped adults.

Although there is relatively little information concerning the oral health of handicapped adults there is increasing evidence to suggest that their oral condition, particularly periodontal health, is poor. The present investigation involved assessment of 382 handicapped patients attending four different Adult Training Centres in Birmingham. The caries status, oral hygiene, and periodontal conditions were evaluated and the Community Periodontal Index of Treatment Need (CPITN) was calculated. In order to assess the manual dexterity and the comprehension of the trainees a standard test was devised. This consisted of timing each participant in carrying out simple instructions to pick up and position certain common objects. The results indicated high levels of plaque, calculus, and bleeding with a mean CPITN of 7.43. The mean time taken for the manual dexterity and comprehension test was 23.9 seconds with a range from 10 to 80 seconds, S.E.+/- 1.33. This compares with results from 34 "normal" adults of a mean time of 8.2 seconds +/- 1.8 with a range of 6 to 12 seconds. There was no significant correlation between the Manual Dexterity and Comprehension scores and the periodontal indices in the handicapped adults.

Adult↗
PubMed1997

Impairments, disabilities and handicaps in children and adolescents with epilepsy.

The patterns of motor and sensory impairments, disabilities and handicap were assessed in 217 children and adolescents with epilepsy. Motor and sensory dysfunctions were found to be common even in children without major additional neurodisorders such as cerebral palsy and mental retardation. Handicap was most severe in the dimensions of physical independence and orientation and increased significantly with duration of epilepsy. It was more severe when the onset of seizures was early and when secondary generalized seizures were present. Handicap was significantly reduced after epilepsy surgery.

Adolescent↗
PubMed2005

A non-handicapped cohort of low-birthweight children: growth and general health status at 11 years of age.

AIMS: To describe and compare physical growth, current health status, functional limitations and neurodevelopmental impairments (defined as low IQ, school problems or psychiatric disorder) at 11 y of age in a population of non-handicapped low-birthweight (LBW) children with that of normal-birthweight (NBW) children. METHODS: A population-based sample of 130 LBW children (weighing less than 2000 g at birth) without major handicaps, and a random sample of 131 NBW children born at term. Somatic and mental health and cognitive abilities were assessed through questionnaires to parents, a physical examination, standardized tests of cognitive function (WISC-R) and a semi-structured interview (Children Assessment Schedule). RESULTS: General somatic health status was similar for the LBW and NBW children. The LBW children were shorter (mean difference -2.5 cm; 95% CI -0.9 to -4.2) and had a smaller head circumference (mean difference -0.8 cm; 95% CI -0.4 to -1.1) but similar weights and body mass indices. Differences and similarities in anthropometric measures were the same at 5 and 11 y of age. The LBW children had higher systolic (mean difference 3.2 mmHg; 95% CI -0.6 to -0.3) but similar diastolic blood pressure. A higher proportion of LBW children had decreased visual acuity and hearing impairment. Forty per cent of LBW children had neurodevelopmental impairments, compared to 20% of NBW children (OR 2.6; 95% CI 1.5 to 4.5). CONCLUSION: At 11 y of age, survivors of moderately low birthweight without major handicaps may have generally good health, but are at risk of neurodevelopmental impairments.

Anthropometry↗
PubMed1979

Integrating the physically handicapped child.

This paper will serve several purposes: (1) to provide information on the incidence of physically handicapped children (exclusive of the blind and deaf) who are likely to be integrated into schools for normal non-physically impaired children, (2) to describe briefly the major handicapping conditions and their educational implications, (3) to comment on why integration has come about and why it promises to enrich the lives of normal children, (4) to suggest how physicians, physical therapists, and occupational therapists might help to make schools programs successful, (5) to comment briefly on financial implications of this program and to suggest ways in which the complexity of the medical management might be simplified, (6) to provide factual knowledge about the handicapped child and his potential to teachers who are already on the firing line to "improve" the academic achievement of the alleged normal child.

Arthritis, Juvenile↗
PubMed1980

Psychosocial assessment of the handicapped.

Assessment of the child with a handicap is in a state of flux due to new constraints regarding the use of tests which label and shunt children into restrictive environments. The process of identifying and assessing youngsters is a time-consuming and costly process, particulary when what we call "standard practices" are employed. The present flux may, in fact, permit a careful re-evaluation of the role of individualized assessment resulting in positive changes. The trend of the future suggests a shift to a more comprehensive framework for assessment, one that takes into account the behavior of the environment and its influences upon the individual. Assessors will have to be trained to understand and use these methods, particularly as they contribute to the development of educationally relevant data and more appropriate educational programs for handicapped youngsters. Health workers have an important role to play in this shift, for many of them will recognize that, because of economic and practical constraints, a public health orientation may be important and necessary as we seek to provide a free, publicly supported education to all handicapped children and youth.

Affective Symptoms↗
PubMed1980

Predictions: education of the handicapped.

Because all changes in our society evolve slowly, we must now begin to develop comprehensive future plans for educating the handicapped. In order for the educational system of the future to meet the needs of society, programs must be designed to accommodate the uniqueness of each student. The system must focus on vocational orientation and realistic preparation for adult living to support the concept that handicapped individuals have a potential for community integration. Comprehensive training, realized through cooperation of schools and ongoing community resources, will prepare the handicapped to take their place in a work force which will need to utilize the potential of every qualified individual available.

Child↗
PubMed1982

National Association of State School Nurse Consultants define role of school nurse in "PL 94-142--education for all handicapped children act of 1975".

In summary, school health services are a very important and, at times, a mandatory "related service". A child is better able to benefit from the educational process, if he/she is functioning in an optimal health condition. The school nurse is best prepared to identify the health needs of the child and facilitate remediation of the condition or assist the school setting in adapting to the child's needs. Most states have a state law, as well as the Federal law, which mandates services for the handicapped or exceptional child. In addition, there is Section 504 of the Rehabilitation Act that was passed in 1973. Section 504 states "no qualified handicapped person shall on the basis of handicap, be excluded from participation in, be denied the benefits of, or otherwise be subjected to discrimination under any program or activity which receives or benefits from Federal financial assistance". All three laws need to be considered when developing state guidelines and school district policies.

Child↗
PubMed1989

Handicapped and able-bodied children's ideas of health.

The findings of a study of 240 handicapped and able-bodied children's ideas of health and health self-concept are reported. Children ages six-14 were interviewed using a semistructured format to determine what the word "health" meant to them, how they could tell when someone was healthy, if they saw themselves as healthy, and whether a child with a broken leg, in a wheelchair, or after an operation could be healthy. The Child Health Self-Concept Scale (CHSCS) was administered to 100 children. Results revealed both handicapped (N = 104) and able-bodied (N = 136) children viewed health similarly, and ideas were influenced more by age than by handicap. Even when they declare someone else with a disability as unhealthy, both groups see themselves as healthy. Implications for research are presented and ideas about society's emphasis on physical fitness are discussed.

Activities of Daily Living↗
PubMedDate not supplied

Hypoxemia due to inserting a bite block in severely handicapped patients.

In severely handicapped patients with severe cerebral palsy, stridor can be caused by a bite block in the mouth. So that dental treatment can be performed safely for these patients, the effect of a bite block on the respiratory function of 30 severely handicapped patients was investigated with two pulse oximeters. Of the 30 subjects examined, 96.7% showed SpO2 values above 95% in the resting state, and 26.7% showed SpO2 values under 94% after insertion of a small or middle-sized bite block. Patients who did not show SpO2 decrease while using a small bite block did have deterioration of SpO2 values when a middle-sized bite block was used. According to analysis by AIC, patients whose weight was less tha 20 kg, who were shorter than 130 cm, and who were more severely handicapped tended to have a deterioration of breathing function when using a bite block

Adolescent↗
PubMed1979

The effects of social reinforcement on dominant and dependent mildly intellectually handicapped school-leavers.

The aim of this study was to replicate Exline & Messick's (1967) study of eye-contact interview behaviour with college students on a group of mildly intellectually handicapped students. Twenty subjects (mean CA 14.02 years, SD 0.45 years, mean IQ 72.0, SD 7.6) attending a metropolitan school for the mildly mentally handicapped were classified as dominant or dependent by teacher ratings and sociogram analysis. They were given large or small amounts of reinforcement for eye-contact when interviewed by their teacher. Although the study failed to replicate some of Exline & Messick's findings, results indicated a feedback rather than reward model in explaining the effects of social reinforcement on eye-contact in interviews. Implications for communication training for such intellectually handicapped students is discussed.

Adolescent↗
PubMed1986

An experimental study of the effectiveness of different techniques of questioning mentally handicapped child witnesses.

In response to recent changes in the Home Office recommendations concerning police interviewing of mentally handicapped persons, an experiment was carried out to investigate the usefulness of different interviewing techniques with mildly mentally handicapped children. Previous research carried out with children of normal intelligence (Dent & Stephenson, 1979) indicated that their recall of an incident was most accurate when unprompted. Theoretical research in the field of mental handicap suggested that such children's recall would be poorest when either unprompted or when heavily prompted, and that some form of intermediate cueing of recall may prove optimal. The experiment described here investigated the accuracy of recall of a live incident by a group of children with IQs ranging from 50 to 70 points in response to one of the following methods of elicitation: free recall, general questions and specific questions. As predicted, the general questions produced recall that was optimal in terms of completeness and accuracy.

Child↗
PubMed1988

Dementia and mental handicap: emotional distress in carers.

A postal survey was conducted to examine levels of emotional distress in three groups of carers, namely, daughters caring for a dementing parent, mothers caring for a mentally handicapped child and mothers caring for a mentally handicapped adult. Daughters caring for a dementing parent reported significantly higher levels of distress than both groups of mothers. Emotional distress for all groups was higher than found in the general population, although this difference was only significant for the group of daughters and the mothers with a mentally handicapped child. Findings are discussed in relation to service provision and level of disability.

Activities of Daily Living↗