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PubMedDate not supplied

A review of controlled surveys of dental disease in handicapped persons.

The need is demonstrated for large scale, definitive, standardized epidemiologic investigations of dental disease in those handicapped groups for whom this information is unavailable. Treatment needs of all groups should also be assessed, because this is not readily deduced from the indices of dental disease reviewed in this article. While a preventive orientation in dental care for the handicapped is most desirable, it must be emphasized that priorities in prevention and treatment should focus as much on periodontal disease as on caries, and due consideration must also be given to malocclusion. Current methods of preventing periodontal disease in the handicapped are quite inadequate.

Cerebral Palsy↗
PubMed1976

Identifying handicapped people in general practice.

This study used the age-sex register of a group medical practice as the population base for a postal and follow-up interview enquiry to locate handicapped people and examined the possibility of the combined use of a practice diagnostic index and the patients' medical records for the same purpose. The age-sex register was found to contain deficiencies and inaccuracies despite the substantial efforts of members of the practice team to maintain it, for example, 13.5 per cent of the forms were returned as the addressee was unknown at the address.The 81.5 per cent of householders who responded identified 353 impaired people who were subsequently interviewed about the nature of their impairment, the underlying condition, and the range of their activities. Depending upon the answers to these questions, a proportion of these people were classified as handicapped and were asked further questions. The number of impaired people and their distribution in sex and age-groups were broadly similar to the findings from other surveys. The diagnoses of the underlying conditions given by the impaired people were discussed with the general practitioners and confirmed or otherwise by the use of the patients' notes or the recollections of the general practitioners.It was concluded that while the use of a diagnostic index would be helpful for some conditions, there would remain a substantial number of people with a disease that is potentially disabling who would have to be approached for further screening and also a substantial number of people who are handicapped, but who would be missed.

Persons with Disabilities↗
PubMed1992

Rehabilitation status in multiple handicap.

The Edinburgh Rehabilitation Status Scale (ERSS) was applied to 129 attenders at a day center for physical disability. All of the attenders had significant neurological impairment dating from birth or from infancy. Fifty-nine of the subjects (46%) had been diagnosed on conventional grounds as having mental handicap as well as physical disability. ERSS scores were compared with Barthel Index scores in all subjects and with PULSES profile in 50 subjects (27 physical disability alone, 23 combined with mental handicap). The ERSS scores clearly demonstrated significant differences in the level of disablement between the two groups in all four subscales as well as in total scores; the Barthel scores showed differences in self-care and total scores, and, to a lesser extent, in mobility. PULSES failed to differentiate the groups except in one of its subscales. The ERSS is a sensitive index of overall function and is useful in highlighting the additive effect of mental handicap and physical disability, a difference which may not be apparent when other assessment scales are used.

Activities of Daily Living↗
PubMed1977

The handicapped driver: an insurer's point of view.

This paper reviews the approach used by one automobile insurer to underwrite and to medically evaluate a handicapped driver. Significant factors which must be carefully developed for each application for automobile insurance are discussed. In the final analysis. The extent of any physical or mental impairment must be considered along with information verifying the capability of the handicapped person to safely operate an automobile. Cooperation in research programs among many disciplines, namely, state motor vehicle bureaus, insurers, product manufacturers, health professionals and driver educators as well as handicapped drivers, is clearly indicated.

Accidents, Traffic↗
PubMedDate not supplied

Orthodontic treatment need of mentally handicapped children in Ibadan, Nigeria, according to the dental aesthetic index.

PURPOSE: Proper well-organized orthodontic treatment planning for special needs patients quantifies such needs with a valid screening method to determine priority treatment. The aim of this study was to determine the orthodontic treatment needs of mentally handicapped children in Ibadan, Nigeria. METHODS: The sample consisted of 124 mentally handicapped children, 68 boys and 56 girls who were 6 to 18 years old with mean age of 14.5 +/- 1.5 years, drawn from 7 special centers/schools in the city. RESULTS: Less than 42% had normal or minor malocclusions needing slight or no treatment; 17% had definite malocclusions with treatment elective; 9% had severe malocclusions and treatment highly desirable; 32% had very severe or handicapping malocclusions with treatment considered mandatory. Significant gender differences were found in the mean dental aesthetic index (DAI) scores (P < .05) and significant association noted (P < .05) between severe mental retardation and DAI scores deserving treatment. CONCLUSIONS: There were considerable orthodontic treatment needs among the study population with a reasonable percentage deserving treatment in publicly funded programs.

Adolescent↗
PubMedDate not supplied

Pre-assessment of severely handicapped patients suitable of dental treatment under general anesthesia.

OBJECTIVE: To analyze the importance of an individualized preoperative assessment in severely handicapped patients suitable of dental treatment under general anesthesia (GA). DESIGN: The study group consisted of 564 patients referred to a Special Needs Unit specialized in the dental care of handicapped people, who would be treated under GA. Medical and dental records of every patient were evaluated, as well as the findings in the oral examination and the assessment carried out by the anesthesiologists. RESULTS: Approximately 15% of patients (n=84) did not have any dental needs at the time of the examination; 42% (n=234) underwent treatment under GA and 43% (n=242) were treated under local anesthesia. Only 1.7% of the patients liable to undergo GA were discharged by the anesthesiologist due to their systemic condition. Medical and dental complications were scarce and, generally mild. During the follow-up period (mean 44 +/- 6 months) 4.8% of patients needed another treatment session under GA due to new dental pathology. CONCLUSION: Applying systematic selection criteria to perform any dental treatment under GA in severely handicapped patients reduces the indiscriminate use of this technique, minimizing complications as well as the necessity of new interventions.

Adolescent↗
PubMed1992

Posttraumatic disablement: a prospective study of impairment, disability, and handicap.

This study was designed to evaluate both the frequency and the course of impairments, disabilities, and handicaps resulting from trauma. It was conducted in Aquitaine, France, on a sample of 1005 trauma patients (mean ISS, 10.5 +/- 0.3) in which severe trauma (ISS > 25) was rather overrepresented (169 of 1005). A prospective follow-up of disablement according to the WHO classification was based on medical examinations performed 6 and 12 months after the trauma. Of 664 survivors reviewed at 6 months, the findings were cross tabulated with Injury Severity Score (ISS) and age. There was a good relationship between ISS and the mean length of stay in the hospital (r = 0.46; p < 0.001), the duration of rehabilitation, and the time away from work or school. Out of this sample of 1005 patients with rather major injuries, 73% of the survivors suffered from at least one impairment, with a consistently lower frequency in children whatever the severity. At least one disability was encountered in 52.3% of these patients depending on both ISS and age. Handicap was noted in at least 26% of the cases. Between the sixth month and the end of the first year, the minimal handicap regression was 35.8%, whereas the minimal regression of the disability rate was 19.5%. The best improvement was observed essentially in the low ISS categories. Whereas for minor trauma the course of disablement seems to be fixed 1 year after the injury, such is not the case for severe trauma.

Absenteeism↗
PubMed1992

The therapeutic sterilisation of the mentally handicapped. Experience with the Abortion and Sterilisation Act of 1975.

The Abortion and Sterilisation Act of 1975 gives legal sanction for the sterilisation of persons with a mental handicap, and by 1989, 1,817 such persons had been sterilised in South Africa. In this paper, we review our experience in investigating all 291 persons who were referred to the Pregnancy Advisory Service of Groote Schuur Hospital for this purpose. Referrals included 37 white, 233 coloured and 21 black patients. One hundred and eight (37.1%) were severely retarded, 104 (35.7%) were moderately retarded, 70 (24%) were mildly retarded and 9 (3.2%) were not testable. None could give informed consent and the applications for sterilisation came from burdened families of whom one-third were already caring for illegitimate children born to these mentally handicapped women. Of the 291 applications, 231 (79%) were recommended for sterilisation. The main issues involved in making a decision to sterilise mentally retarded individuals are the valid assessment of the degree of retardation, the availability of alternative means of fertility control, and the complex ethical factors that have to be considered with regard to the sterilisation of persons with a mental handicap.

Adolescent↗
PubMedDate not supplied

[Care of handicapped children under general anaesthesia. Relationships with various clinical parameters. Preliminary notes].

Losses of teeth are significant and frequent among handicapped patients. For this study a sample of 58 children handicapped out of the 412 children dealt with for preserving dental care under general anaesthesia, was analyzed. If at equal age these children present a CAD on permanent teeth more significant, their undertake, the procedure of general anaesthesia and the preserving treatments under general anaesthesia do not present more difficulties than the child is handicapped or not. The factor determining in the effectiveness and the speed of the exempted acts seems to be the training of the dental care team.

Analysis of Variance↗
PubMedDate not supplied

[Handicap and rehabilitation in hospitalized hemodialized patients: study of 20 patients].

Twenty hemodialyzed patients, received rehabilitation while they were hospitalized. They were all handicapped in the beginning; when they left the hospital, 10 patients were completely independent, six needed help at home and 4 were completely dependent. The authors search, from their own practice, the etiologies of handicap with hemodialyzed patients and how to prevent this handicap, with the target of giving to their patients the best quality of life. The rehabilitation is very important in the strategies of global care of these patients.

Activities of Daily Living↗
PubMed1978

A comparative study of five groups of handicapped children in vocational rehabilitation.

This study explored the vocational and educational plans, work values, realism, initiative commitment to choice, and awareness of occupational information of five groups of handicapped children compared with a group of normal children in grades 6--12. Handicapped children tested significantly lower on all measures of vocational development. Only the cystic fibrosis group approached the high scores of the normal group. Age, grade, and social class were the best predictors of vocational development in all six groups. The findings confirmed the hypothesis that handicapped children are less prepared for vocational training and placement and consequently require special rehabilitation programs to prepare them for work.

Adolescent↗
PubMed1992

[Thermal regulation disturbance in severely handicapped patients--the second report].

Thirty-three severely handicapped patients were investigated on body temperature regulation by rectal temperature monitoring and hypophyseal hormonal function. The lowest body temperature in the day in the cases with handicaps of prenatal onset tended to be lower than that of peri or postnatal onset. This finding suggests that different causes make regulation disturbance of body temperature in handicapped children. On the other hand, low urine osmolarity in the morning and irregular menstruation were recorded suggesting hypothalamic dysfunction in poor regulation cases.

Body Temperature Regulation↗
PubMed1992

[Occurrence of anomalies of the central nervous system in handicapped children].

We surveyed anomalies of the central nervous system using cranial CT scan in handicapped children who were institutionalized or staying at their homes. At the institutions for severely retarded children, fourteen cases were found and the rate was 6.1%. All of them were very severely retarded. At the institution for physically handicapped children, 12 cases including 10 cases of hydrocephalus were found and the rate was 9.3%. Most of them could take care of themselves. Nineteen cases were found among children staying at their homes and the rate was 9.4%. Most of them were very severely retarded. We conclude that the anomalies of the central nervous system play an important role in the pathogenesis of handicapped children, especially severely retarded children, and that the burden derives from them is a big problem in our daily clinic and special education.

Anencephaly↗
PubMed2003

Needs for dental treatment in handicapped children.

The study covered 96 handicapped children, 3-17 years old. Complex dental treatment was performed in all children: under general anaesthesia in 45.83% and ambulant treatment in 54.17%. The study found high frequency of dental caries both in deciduous and permanent teeth. Mean numbers of tooth decay, extractions and fillings (d, m, f and D, M, F for deciduous and permanent teeth, respectively) were high. The dental treatment index was low, unsatisfactory especially in deciduous teeth. Dental care provided for handicapped children needs to be intensified, with special attention paid to preventive measures. It is important to make the parents of handicapped children with systemic disease aware of early prevention and treatment.

Adolescent↗
PubMed1992

Vision examination of children in Riyadh's handicapped children house.

Fifty-eight children with neuromuscular handicap participating in a habilitation program at Riyadh, Saudi Arabia underwent an abbreviated vision examination evaluating their visual status. Manpower, time, language and equipment constraints prevented the performance of routine, complete eye examinations for each child. This initial effort was designed to assess the subjects' vision as well as examination time, space, manpower, and any other unforeseen problems in treating this population. This vision evaluation showed that 63.7 percent had ocular findings, and only 17.2 percent had a history of previous eye examination. Currently, a program of evaluation, training and education is underway to treat these children with motor and social handicaps at the Handicapped Children House. Routine vision examination, more complete than undertaken with this study, should be instituted, incorporating ocular history, external examination, refraction, dilated ophthalmoscopy, slit lamp with further evaluation and treatment of those children with findings.

Child↗
PubMed1978

[Reformatory educational approaches in early special education of the physically handicapped - a survey based on the "Journal for the Care of Cripples" 1909--1929 (author's transl)].

An historical survey of special education of the physically handicapped is necessary because the dialectic relationship between the educational attention for the physically handicapped on the one hand and the educational rejection of the most severely handicapped on the other hand, seems to be occurring today as in the first decades of this century. At first, the article reviews the social-biological approach of the orthopaedist K. Biesalski and the "educational psychology of cripples" of H. Würtz, who worked together with Biesalski. The educational demands for cripples which result from their theories are briefly described. The influence of reformatory educational theory on both the pre-scientific educational theories concerning cripples before 1920 and the experimental-psychological and special educational concepts until 1929 are outlined. Finally the article analyses the resource material including articles of Agahd 1909; Delitsch 1909; Denzer 1910; Plass 1912; Würtz 1912, 1913; Legel 1914; Köhler 1926; Herold 1929 und Winkler 1929.

Child↗
PubMedDate not supplied

[Care of handicapped children under general anesthesia in relation to different clinical parameters. Preliminary notes].

Losses of teeth are significant and frequent among handicapped patients. For this study a sample of 58 children handicapped out of the 412 children dealt with for preserving dental care under general anaesthesia, was analyzed. If at equal age these children present a CAD on permanent teeth more significant, their undertake, the procedure of general anaesthesia and the preserving treatments under general anaesthesia do not present more difficulties than the child is handicapped or not. The factor determining in the effectiveness and the speed of the exempted acts seems to be the training of the dental care team.

Analysis of Variance↗
PubMed2006

Test-retest reliability of the Dutch version of the Dizziness Handicap Inventory.

In the last fifteen years the Dizziness Handicap Inventory (DHI) has gained wide acceptance as a useful measure of handicap resulting from dizziness and unsteadiness. The objective of this study was to calculate measurement error and test-retest reliability of the Dutch version of the DHI. The translation into Dutch was performed according to a double translation method. One hundred and six patients with balance problems (range 26-78 years), scheduled for vestibular rehabilitation, completed the DHI on two occasions on the same day. The test-retest reliability was excellent, with Intraclass Correlation Coefficients ranging from 0.94 to 0.99 for DHI sub-scores and DHI total score. Most weighted kappa values (kappaW) exceeded 0.80 indicating substantial item per item test-retest reliability. Over 80% agreement was noted for all items except for item 8 (74%). Item 8 asks whether the subject feels dizzy or unsteady while doing ambitious activities like sports, dancing and household activities. Consequently measurement errors were calculated, suggesting that, after an intervention, the pretreatment DHI total score should at least decrease with 12 points (lower bound 99% confidence interval for a true change) before the intervention could be said to be effective for an individual patient. Based on these data, the Dutch version of the DHI showed itself to be a highly reliable instrument to assess the self-perceived handicap imposed by vestibular system diseases.

Adult↗