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PubMed1991

The sterilization of people with a mental handicap: the views of parents.

The issue of sterilization in people with mental handicap has re-emerged in recent years. Historical aspects are briefly reviewed, and attention is drawn to the different context in which this issue has been revived. A postal survey of parental views was undertaken. Fifty-three per cent of the respondents indicated that they had or would consider sterilization for their child with mental handicap, and a large majority of the parents felt that they alone, or in conjunction with a doctor, should be able to consent on behalf of the person with mental handicap. Consideration needs to be given to parental anxieties with regard to sexual and reproductive health issues which are surfacing with the current emphasis on community care and the philosophy of normalization.

Adolescent↗
PubMed1991

Changes in causes of visual handicaps in Tokyo.

Newly registered visually handicapped patients at the Tokyo Metropolitan Rehabilitation Center for the Physically and Mentally Handicapped were studied in 1968 (when the facility was opened), 1978, and 1988. Examinations were carried out by the same physicians and diagnoses were made by uniform criteria. Since approximately 10% of the total population of Japan lives in Tokyo, the statistics on the causes of visual handicaps in this area deserve to be reported. The changes observed over the past twenty years are as follows: There were few changes in the percentages of high myopia, retinal degeneration and senile cataract. The percentages of corneal opacity, retinopathy of prematurity, congenital cataract and optic atrophy decreased, while those of diabetic retinopathy, glaucoma and retinal macular degeneration increased. Advances in medical treatment and the shift into an aging society in Japan are responsible for these changes observed.

Adolescent↗
PubMed1991

Behavioral training for mothers of mentally handicapped children: teaching of self-help skills.

Deficits in self help skills are an inevitable problem with the mentally handicapped. The acquisition of self-help skills, learned effortlessly by more intelligent children, is a crucial aspect of the overall development of the mentally handicapped child. In the present study, thirty seven mothers of mentally handicapped children aged between 3 1/2 and 8 years, with an IQ of less than 70, were trained in behavioral techniques such as shaping, task analysis, prompting, and modelling, to develop independent self-help functioning in their children. The self-help areas were toileting, feeding, bathing, washing, and dressing. Thirty two per cent of mothers reported complete skill learning. The problems encountered in the course of training and the subsequent evaluation of its efficacy are discussed.

Adult↗
PubMed1991

Physical activity from rehabilitation to independent community function: the role of physical activity in handicapping conditions.

All ingredients are there--philosophies and principles, models and examples, competent and committed professionals, ready and willing agencies and organizations, and anxious-to-get-involved persons with handicapping conditions. The time has never been so right to go forward and onward to the heights with sport, recreation, and physical activity to produce lives worth living by persons with handicapping conditions. George Washington warned: "We ought not to look back unless it is to derive useful lessons from past errors, and for the purpose of profiting by dearly bought experience." In this case some might advise not to look back at all, because pessimists and disbelievers may be trying to overtake optimists and believers. As Henry David Thoreau stated: "If you build castles in the air, your work need not be lost; that is where they should be. Now put the foundations under them." Physical activity, recreation, and sport are important in physical, mental, emotional, and social adjustment of individuals with handicapping conditions. In many cases, active participation in such activities provides more effective and efficient rehabilitation and therapy than formal rehabilitation and therapeutic modalities and approaches. Throughout history some pioneers striving to introduce and use such techniques and approaches have been rebuffed and rejected by many facets of the medical establishment. Often, progress has come from highly committed advocates from various professional specializations with interests in activity programs for their populations. Although progress continues to be made, much greater recognition by and involvement of the medical profession are needed from the classrooms in medical schools, through all internships and residencies, to hospitals and clinics of all types, and among all medical branches and specialties.

Activities of Daily Living↗
PubMed1991

The handicapped child: psychological effects of parental, marital, and sibling relationships.

Although the nature and severity of a handicapping condition are not the sole determinants of family functioning, the presence of a child with a pervasive developmental disorder has a significant effect on family members. Maternal mental health suffers, and the resulting depression affects her role as mother and marriage partner. Unlike other handicapping conditions with obvious physical stigmata, the invisible handicap of the autistic child and the frequent delay in diagnosis contribute to the mother's self-doubt about her parental competence. While the impact on paternal psychological health is less, the fathers of autistic children are nevertheless highly stressed and appear to be particularly vulnerable to the stress generated by these difficult children. Living within this family climate, the risks for emotional and behavioral problems for siblings must be evaluated, along with their intrinsic strengths, to plan preventive interventions for these children. Effective work with these families requires an understanding of the evolution of family system problems and their dynamic and reciprocal interaction over time.

Adaptation, Psychological↗
PubMed1991

[A study of blink reflex in person with severely handicapped].

1) We evaluated blink reflex from 50 cases of severe handicapped. 7 cases (14%) had normal blink reflex. Abnormality of prolonged latency or no response of blink reflex was much more easily seen on R2 and R2' than R1, and dysfunction of spinal trigeminal complex or bulbar reticular formation might be existed in those cases. 2) We found abnormal blink reflex had some relationship with mental disturbance or bulbar function. Result of ABR and head CT also suggested that some kinds of cerebral factors might influenced to blink reflex of severe handicapped cases. 3) Blink reflex was one of the useful records for severe handicapped patients to evaluated underline pathogenesis of brain stem function.

Adult↗
PubMed1991

[Vision tests for the severely handicapped].

The methods available for acuity assessment of multi-handicapped persons are limited by lack of verbal, manual and locomotor response indicators. However, eye activity itself, can provide a clue to what is seen. The results in the present study suggest that the preferential looking technique, using gratings as stimuli and eye movements as response indicators, is a useful tool for assessing the acuity of multi-handicapped people. However, acuity testing of multi-handicapped people was very time consuming, and called for many individual adaptations.

Blindness↗
PubMed1991

[The psychodynamics in families with a handicapped child].

Parental reactions to the birth of a handicapped child are reported. The effect on the wish to give birth to further children after a handicapped child has been born is described on the basis of objective data. Thereafter irrational reactions to the birth of a handicapped child are discussed. Topics as feelings of guilt, anxiety, aggression, problems of adolescence and possibilities of psychotherapeutic aid are mentioned. Finally a case study from a Community Youth- and Family Counseling Center is given.

Adaptation, Psychological↗
PubMed1991

Balance function test correlates of the Dizziness Handicap Inventory.

Balance Function test data alone cannot capture the reaction that a patient has to balance system disease. The present investigation examined the relations among components of the balance function examination (electronystagmography, rotational testing, and platform posturography) and self-perceived dizziness handicap, as quantified by the Dizziness Handicap Inventory (DHI). The DHI is a 25-item self-assessment scale designed to quantify the functional, emotional, and physical effects of dizziness and unsteadiness. The DHI was administered to 367 patients seen consecutively for balance function evaluations. The results indicated that the largest proportion of significant correlations existed between DHI and the sensory organization subtests of platform posturography. Further, greater perceived handicap was documented for patients with (1) spontaneous nystagmus and (2) decreased postural stability quantified by evaluating the inter-relations among vestibular, visual, and proprioceptive systems (posturography).

Activities of Daily Living↗
PubMedDate not supplied

[Handicap caused by clefts of the lips, jaws and/or palate and velum].

Due to clefts of the lips, jaws and/or palate and velum no normal structures are formed in the orofacial system, and thus all processes of growth and development as well as function are disturbed to an extent varying with the extension of the malformation. Integration of these children in kindergartens or regular schools is impossible unless surgery is performed. Apart from qualified interdisciplinary initial care the acknowledgement of these children as severely handicapped persons in accordance with the law could be of great help and relief for the parents. The German law for securing the integration of severely handicapped persons in work, profession and society (Schwerbehindertengesetz) pays particular attention to severely handicapped children. The basic considerations in writing medical opinions are described.

Child↗
PubMed1991

[Results of regular dental care of mental and physical handicapped patients].

The results of the regular dental care of 192 mental and physical handicapped patients were analysed in a 5-year-period. The care system in which the prevention, the therapy in narcosis and the annual control are combined is very effective on a long-term basis. The handicapped patients had a lower prevalence of caries, a higher percentage of filled teeth and less extractions compared to a group of handicapped patients without continuous dental care.

Adolescent↗
PubMed1991

Comparative study of oral health status of mentally sub-normal, physically handicapped, juvenile delinquents and normal children of Bombay.

Prevalence study on dental caries and periodontal disease carried out in 94 mentally subnormal, 92 physically handicapped, 74 juvenile delinquents and 206 normal children (11-14-year-old) revealed high prevalence of periodontal disease in handicapped (95 to 100%) and low in normal children (54.37%). The point prevalence of dental caries was higher in normal children (84.9%, DMFS 6.19) followed by juvenile delinquents (75.67%, DMFS 4.3), physically handicapped (73.91%, DMFS 4.3) and mentally subnormal (64.9%, DMFS 4.48).

Adolescent↗
PubMed1991

Iron status in a group of long-stay mentally handicapped menstruating women: some dietary considerations.

As part of a longitudinal study aimed at assessing the dietary intakes and nutritional status of a group of long-stay mentally handicapped subjects, 15 women of menstruating age were considered for a substudy to assess the influence of intake levels of dietary iron, energy, tea, coffee and vitamin C on their iron status. The assessment comprised a week-long weighed dietary survey and the measurement of a number of haematological indices that included serum ferritin concentration. Information on duration of menses was also collected and included in the assessment. Two-fifths of the subjects assessed had a serum ferritin concentration less than 12 micrograms/l indicating iron deficiency, including one who was considered anaemic as suggested by a haemoglobin level less than 12 g/dl. Duration of menses showed a negative significant correlation with serum ferritin concentration. The mean iron intake in the group was 9.5 +/- 1.5 mg/day. Energy intakes were low and positively correlated with iron intake. Although serum ferritin showed no correlation with iron intake, it showed significant negative correlations with the daily and meal-time intakes of tea and a significant positive correlation with the meal-time intakes of vitamin C. The six iron-depleted subjects were assessed as a separate group (Group I) in comparison with the other nine subjects who had a serum ferritin concentration greater than 12 micrograms/l. The results of this assessment showed that, while there were no significant differences in duration of menses or the mean daily intakes of iron and energy between the two groups. Group I subjects had significantly higher daily and meal-time intakes of tea and significantly lower meal-time intakes of vitamin C compared to Group II subjects. The study provides some evidence suggestive of an association between the iron deficiency states observed and tea intake in adversely affecting iron status, particularly in the absence of adequate meal-time intakes of vitamin C. The findings from the study also suggest that long-stay mentally handicapped women of menstruating age, in addition to their handicap and dependency states which may often predispose them to a low dietary intake, are at particular risk of iron deficiency.

Adult↗
PubMedDate not supplied

[Development of auditory handicap after a multi-electrode cochlear implantation].

The efficacy of cochlear implantation as an aid to communication for profoundly hearing impaired persons is now established. International data show that some comprehension without visual cues is possible in many cases. Up to now, the bulk of research has been focused on psychoacoustical and speech perception measures. Hearing handicap changes following an implantation were rarely explored. On a longitudinal study on the benefits of cochlear implantation for twelve adults with profound acquired deafness, we explored the evolution of the hearing loss handicap. Two questionnaires were completed by the participants before and after implantation. A descriptive analysis of the data shows a rather moderate diminution of the handicap. The importance of the diminution appears inversely correlated to the length of deafness.

Adolescent↗
PubMed1990

[Assessment and treatment of respiratory dysfunction in severely handicapped children: respiratory disorders during sleep].

In severely handicapped patients, chronic respiratory insufficiencies and recurrent hypoxemia especially during sleep are one of the major problems to take care of them. To clarify the pathophysiology of respiratory disorders during sleep, we examined 5 severely handicapped patients with no respiratory distress during wakefulness, but with signs of latent respiratory insufficiency by means of polygraphical all-night study including the arterial oxygen saturation (SaO2) monitoring. In the severely handicapped patients, sleep hypoxemia occurred frequently. The value of SaO2 decreased in proportion to the intensity of apnea determined by polygraph. The relationship between the value of SaO2 and sleep stage was variable in each patient. Four patients had mainly obstructive respiratory disorders and one had a central type respiratory disorder. The density of REM stage decreased in the obstructive type. In the central type, the repeat of REM stage with normal REM density was not observed. In one patient with obstructive type and one with central type, hypoxemia was improved with an increased number of REM stage by O2 inhalation.

Adult↗
PubMed1990

[Epilepsy in severely handicapped children].

Clinical and electroencephalographic studies were performed to elucidate the characteristics of epilepsy in severely handicapped children. The subjects were 56 severely mentally and physically handicapped children whose ictal seizures were documented by simultaneous EEG-VTR monitoring. Seizure types were infantile spasms in 17 (30.4%), atypical absence in 5 (8.9%), myoclonic seizures in 3 (5.4%), generalized tonic-clonic seizures in 2 (3.6%), secondary generalized partial seizures in 11 (19.6%), and undetermined in 4 (7.1%). Epilepsy types were also classified by the ictal seizure types and clinical courses: West syndrome in 27 (48.1%), Lennox-Gastaut syndrome (LGS) (at onset) in 5 (8.9%), partial epilepsy in 13 (23.2%) and others (at onset) in 11 (19.8%). Among 29 cases with West syndrome, 22 (81%) developed LGS, and among 11 cases with others group, 64% developed LGS. After all, LGS appeared in 60.7% of all 56 severe epileptic children associated with severe physical and mental handicaps.

Child↗
PubMed1990

[Visual handicap, autonomy and third party compensation. Evaluation trials].

Nowadays visual disability compensation, as for other disabilities, is mainly contingent on the patient's obtaining an allowance for a third party, but this is increasingly related to the concept of autonomy in the main activities of everyday life. This concept cannot be applied to visual handicaps. A special allowance, however, which need not be identical to that of third party compensation but would cover the poor-sighted currently in groups 2 and 3, whatever the extent of their handicap, may be the right solution for the Authorities to adopt, due to the specific nature of the visual handicap.

Activities of Daily Living↗
PubMed1990

A method for allocation of hearing handicap.

A three-stage method is proposed for allocation of hearing handicap. First, for a given injury or noise exposure period, the percentage of loss allocable for each ear is calculated as a simple ratio of hearing change (after age correction) to final hearing level. Second, final hearing handicap is divided between the two ears using a formula derived from the 1979 AAO-HNS/AMA standard. The percentage of hearing handicap allocable to a given period for each ear is simply the product of that ear's scores from the first two steps.

Age Factors↗