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PubMed1990

[Investigation into the actual condition of physically handicapped children--specially the consciousness in parents].

The purpose of this paper was to investigate the dental situation of children who visited the pedodontics clinic of Nihon University at Dental-Hospital during the period from Jan. 1983 to Dec. 1987. The subject is the awareness in parents of 68 children who carried out the administration of medical care. The results were as follows. 1) Recently we observed that the ratio of physically handicapped children was was on the increase among the first visit patients. 2) The principal diseases of the physically handicapped children were cyclothymic, allergy and blood dyscreasia. 3) The majority of the patients visited for receiving caries treatment. 4) We presumed that the parents of the physically handicapped children showed deep concern for oral diseases.

Attitude to Health↗
PubMed1990

Causes of mental handicap in Cape Town.

A cross-cultural study of the cause of the mental handicap of greater than 1,000 children born in the Cape Town area between 1974 and 1986 was carried out. Acquired causes were noted to be more prevalent among the black ethnic group. This study showed that at least 80-100 additional cases of moderate-severe mental handicap can be expected in the Cape Town area each year. Attention is drawn to the expanded facilities that will be required to provide for the ongoing special needs of these children. Possible areas for prevention of mental handicap are discussed.

Adolescent↗
PubMed1975

Dental treatment for handicapped adults.

Handicapped adults can be grouped into those who are mentally subnormal, those with major organic disease, those who are emotionally disturbed and those for whom local anaesthesia is unsuccessful. At the first visit the degree of handicap and the state of the mouth are assessed and a plan of treatment is formulated. In most of the patients, satisfactory conditions for operating can be achieved by the use of intravenous diazepam and local anaesthesia, though some may require a full general anaesthetic. The results of treatment of a group of 139 patients are analysed and it is shown that the average DMF score in handicapped adults is appreciably higher than in normal adults of the same age. The reason for the inability of some of these patients to seek and accept dental treatment under normal surgery conditions is discussed and it is shown that with suitable initial treatment many of them become able to accept treatment in the ordinary circumstances of a dental surgery.

Adult↗
PubMed1987

Effect of intraventricular hemorrhage on the one-year mental and neurologic handicaps of the very low birth weight infant.

The effect of intraventricular hemorrhage on developmental handicaps was studied in 303 surviving very low birth weight (less than 1500 g) infants at corrected one year of age. The outcomes were established by Bayley mental and psychomotor developmental scales as well as by neurologic handicaps. Infants with no intraventricular hemorrhage had a statistically significant incidence of higher mean mental scores (96.5 +/- 18.1 versus 90.1 +/- 18.3) and psychomotor scores (95.5 +/- 17.6 versus 86.7 +/- 16.8), and a lesser proportion of serious neurologic handicaps (7 versus 11.5%), than those with minor hemorrhages (grade I or II), although no difference was noted between infants who had experienced grade I versus grade II hemorrhages. Similarly, the outcomes of those infants with severe intraventricular hemorrhage were significantly worse than those with minor hemorrhages, with the worst outcomes in those with grade IV. Evaluation of 94 infants at three years of age indicates that the mental and neurologic assessments performed at one year of age were accurate predictors of later status.

Cerebral Hemorrhage↗
PubMed1989

[Psychosocial adjustment of the handicapped child--possibilities and problems of rehabilitation].

A successful childhood is to be striven after particularly for a handicapped child. Habilitation and rehabilitation, only carefully adapted to one another referring to medical specialties in colaboration with the family, may rise to the demand of the individuality of every one handicapped child. On prior conditions children with chiefly physical handicaps may be integrated into the polytechnical secondary school providing general education in the home town. The total-body examination of these children remains to be the basis for all paediatric actions.

Adaptation, Psychological↗
PubMed1989

[Neuropsychiatric disorders in newborn infants with very low birth weight (VLBW infants)--before and following introduction of modern perinatal medicine. 1. Overview of the problem, criteria for quality of survival, major CNS disorders (major handicap)].

The survival quality of very low birthweight infants (VLBW infants) is highly actual just even in the time of modern perinatal medicine. Through the development and permanent improvement of the perinatal intensive therapy the survival chances of VLBW infants could be improved significantly in the last 25 years. In the 70's survival rates of 60-84 per cent were achieved in VLBW infants, in the leading centers even rates of 86 and 90.5 percent, respectively. In the 70's an enormous improvement in the survival rates from 20-45 per cent was achieved in tiny premature infants (birth weight 1,000 gm and less), too. However, the efforts of gynecologists and neonatologists to reduce the mortality of low birth-weight infants are again and again blamed for possibly obtaining successes with an increase in CNS morbidity. The parallel analysis of some brain damage groups in VLBW infants seems suitable to gain a clear statement if modern perinatal medicine contributes to reduce the frequency of early infantile cerebral damages and their consecutive handicaps altogether. In an extensive review of literature it is tried to prove this for the major CNS handicaps altogether and separately for the infantile cerebral palsies, epilepsies and mental retardations (oligophrenias). Simultaneously with an average increase from 29.7 to 69.5 per cent of the healthy surviving children, there was a reduction of major CNS handicaps on the average from 36 to 12 per cent.

Brain Damage, Chronic↗
PubMed1989

[Coping with a handicapped child].

The birth of a handicapped child is a non-normative event the mother has to come to terms with individually. It has been examined whether mothers who had contacts with the handicapped before the birth of their handicapped child had acquired qualifications to cope with this situation. A group of twelve mothers with specific experience was compared to a group of twelve mothers without any much experience, under consideration of control variables involved. Changes in the self-image, the mood and the choice of existence techniques were assessed in a longitudinal and a cross section survey over a period of seven years using standardized methods and a semistructured self report. Evaluation by non-parametric and variance analyses showed that women who disposed of experience data before the occurrence of the critical event coped with the new experience of being personally concerned with small identity restriction over a limited period of time. The social development of their children was significantly better. Though not showing any pathological reactions, women without any prior experience showed less confidence in their own possibilities, tended towards a rather anxious and depressive general mood, and confined themselves to a narrowed range of contact experiences. Learning by practical experience proved to be more helpful in the mastery of this non-normative event than information, the activating moment not being the novelty of the situation but the specific experiences made.

Adaptation, Psychological↗
PubMed1989

Using the International Classification of Impairments, Disabilities, and Handicaps in surveys: the case of Spain.

A survey was conducted in Spain in 1986 to estimate the number of people with disabilities and to identify the impairments which had given rise to them. The survey also set out to identify the causes of these impairments and to analyse the nature and extent of the handicaps resulting from these impairments and disabilities. The frame of reference for the survey was the WHO International Classification of Impairments, Disabilities, and Handicaps (ICIDH), which was adapted in a number of ways. The most radical departure was to begin the survey with disabilities, which were considered easier to identify. 15% of the population presented a disability, the rate mostly increasing with age, with substantial differences between the sexes and pronounced gradients in relation to socioeconomic status in some cases. Analysis of disabilities and impairments by administrative area also revealed some significant geographical variations. The study of handicaps posed some particularly complex problems of methodology. In conclusion, the work of the Spanish survey was facilitated by the use of the ICIDH, but this classification requires several substantial modifications before it can be systematically used in surveys of this type.

Activities of Daily Living↗
PubMed1989

[The behavior of mothers during dental treatment for their handicapped children. 1. Relationship between mothers' behavior and child patients' factors].

The purpose of this study was to find out factors which determine whether or not mothers of handicapped children chose to be with their children while receiving dental care. The subjects were 46 pairs consisting of a handicapped child and his or her mother who came to the pedodontic clinic of Aichi-Gakuin University Dental School. Such factors of the patients as the various abilities of the patients, their behavior and other items were surveyed with a behavior evaluation. These factors are considered to be related to determining the behavior of the mothers. The results of the survey are summarized as follows: 1. Patients whose mothers chose to be with them tended to be slightly inferior in basic language use and mouth rinsing ability, when compared with patients whose mothers chose to stay in the waiting room. 2. Patients who were autistic more often had mothers who chose to be with them than patients with other disabilities. 3. Patients whose mothers chose to be with them got higher Behavior Evaluation Scores in all dental care situations so that they tended not to adapt to dental care, when compared with patients whose mothers chose to stay in waiting room. 4. From the analyses of Quantification Type II, a height correlation ratio was obtained in the distinction efficiency of the mothers' behavior. Also the behavior of the mothers could be predicted by the factors of the children. 5. There were four factors present in those handicapped children which are considered to have determined their behavior of the mothers: the kind of disability, verbal expression ability, mouth rinsing ability and adaptation to dental care.

Adult↗
PubMed1989

Coping responses of adolescents with and without mild learning handicaps.

Five sentence completion stems about coping were administered to 60 adolescents (30 learning handicapped [mean IQ = 76], 30 nonhandicapped). Content analysis revealed that sources of everyday stress fell into four categories that reflected developmental concerns: frustrated efforts, direct conflict, social injustice, and performance issues. Coping responses were initially coded as active or passive and then further subcategorized into more specific coping behaviors. Analysis indicated that students with learning handicaps did not report any instances of performance issues as a source of stress and gave more passive coping responses than did students who were not handicapped. Sources of stress as well as coping responses revealed group differences in adolescents' perceptions of dependency and control.

Adaptation, Psychological↗
PubMed1989

Mainstreaming children with handicaps: implications for pediatricians.

The judicial precedents and legislative mandates passed during the past two decades to ensure full appropriate public education for all children have resulted in a movement toward mainstreaming children with a wide range of physical and developmental disabilities into regular education classroom settings. Although some child development and pediatric literature has addressed the effects of these initiatives on the children with handicaps, less attention has been paid to the effect that mainstreaming has on their nondisabled peers in the classroom. As knowledgeable community advocates, pediatricians should be informed about the specifics of the mainstreaming movement. This paper outlines the movement's historical underpinnings, discusses current definitions of "mainstreaming", and briefly reviews the literature on the effects of this policy on classrooms, teachers, and students with and without disabilities. The impact of mainstreaming children with handicaps in regular classroom settings is equivocal, with many studies lacking methodological sophistication to yield reliable and valid data. Results of the few well-designed studies do show, however, that academic and social outcomes for both the handicapped child and for his/her nondisabled peers are consistently better in mainstreamed classrooms where adequate resources have been made available to the child and teacher than in more segregated settings. Furthermore, the literature consistently points out the key role both regular and special education teachers play in successful mainstreamed classrooms. Pediatricians can help families with children with disabilities negotiate the educational system in order to achieve the appropriate classroom placement.

Child↗
PubMed1977

The needs of the intellectually handicapped.

There are about 10 000 intellectually handicapped people in New Zealand. Most are fit, healthy, mobile adults with individual needs and the same rights as other citizens. Most can be trained to live semi-independent lives, living within the community in family-type homes, flats or small hostels, provided properly organised and efficient community based support services are developed. A minority present major problems in behaviour, or lack mobility, or are multi-handicapped and require permanent institutional care. Such institutions should be small and located in the community that they serve. There is a need for action, not words, in developing the provisions for the intellectually handicapped in our community.

Adolescent↗
PubMed1989

Hepatitis B in a residential population with a mental handicap.

Hepatitis serology was used to assess the nature and extent of hepatitis B virus (HBV) infection in the population of a residential centre for people with a mental handicap comprising 56 with Down's Syndrome (DS) and 193 with other mental handicaps (OMH). Markers of HBV were present in 170 cases (68%), of which 25 (10%) were HBsAg positive and potential carriers and 145 IgG anti-HBc positive (58%) indicating exposure to but not necessarily immunity from the virus. Of 25 who were HBsAg positive five were HBeAg positive, 17 were anti-HBe positive, two were HBsAg positive only and one was anti-HBe plus IgM anti-HBc positive. Age and length of residence were significantly associated with HBsAg, IgG anti-HBc and total markers of infection but the degree of mental handicap was not and the DS/OMH ratio only with HBsAg. The results indicated widespread HBV infection, no acute disease cases, relatively few infectious cases and a pre-disposition of DS residents to retain HBsAg in their sera. Vaccination of staff and at risk residents is recommended.

Adolescent↗
PubMed1986

Depression and substance abuse in handicapped young men.

A group of 42 young men with self-reported handicaps was compared with a group of 991 demographically similar nonhandicapped men. The research instrument was a highly structured questionnaire that elicited information about alcohol and drug use and other psychopathology in the subjects and their families. The results revealed that the handicapped men had more alcohol-related problems, were more likely to have used drugs, and had more instances of depression requiring mental health care. The family histories revealed more alcohol-related problems in the mothers and more drug use in the fathers of the handicapped men than in the control families.

Adult↗
PubMedDate not supplied

Health and special education: a study of new developments for handicapped children in five metropolitan communities.

Since the implementation in 1977 of the Education for All Handicapped Children Act (Public Law 94-142), public school systems have provided special education and related services to students with a wide range of handicapping conditions, including some children served previously in hospitals or other institutions. Although the Federal law does not require physician participation in the special education process, it does imply an active new role for the medical care community, both public and private, in helping schools to identify and diagnose children with disabilities and in ensuring that those children have adequate access to health services. This study explores the experience of five nationally dispersed urban school systems in implementing P.L. 94-142, with particular reference to the interaction of physicians and the schools. The findings highlight continued problems with early identification of certain types of childhood handicaps, classification of children's functional disorders, and adequate participation of practicing physicians in the program, especially with regard to developmental and behavioral issues. In addition, inequities in community health services are documented for a substantial number of the children studied. Improved collaboration between the health and education sectors is needed to address these concerns in order to fulfill the intent of national special education policy and to maximize the potentialities of these children and their families.

Child↗
PubMed1986

Adolescent characteristics associated with acceptance of handicapped peers.

This study examined the relationship between characteristics of nonhandicapped adolescents and their attitudes toward the handicapped. Forty-one nonhandicapped youngsters completed sociometric evaluations of their physical education classmates. The class of eighty included eleven learning-handicapped students. Ratings were then analyzed with descriptive student data. Characteristics which were significantly associated with acceptance of the handicapped included gender, ethnicity, chronological age, school achievement, moral development, popularity, and overall peer acceptance. Socioeconomic status, physical ability, and length of association did not appear related to student attitude. Implications for placement and intervention are discussed.

Adolescent↗
PubMed1987

[Functionally adapted office furniture for handicapped patients].

Individually adapted, functional office furniture is not only capable of making physically or sensorily handicapped persons more independent but also enhances their performance. These effects combine to bring about greater personal freedom, making it unnecessary for the handicapped individual to ask for help ever so often. Different types of disability may require totally different technical solutions. The present contribution deals with various office furniture programmes adapted specifically to the needs of certain types of handicap, such as those of wheelchair users, visually impaired or blind persons, hand amputees, or cerebral palsied persons. Examples are described of disability-adapted office designs both for training purposes and workplaces, including CAD or a specifically designed arrangement for technical drawing with the feet. The main objective is to show that individual functional losses can already be compensated for to a large extent by proper selection of commercially available furniture and workplace design.

Computers↗
PubMed1987

Parental attitudes toward children with handicaps: new perspectives with a new measure.

Research on attitudes toward the disabled generally has focused on adult perceptions of disabled adults, or children's attitudes toward peers. In view of changing social practices, such as mainstreaming in education and community integration of children with special needs, measures of adults' attitudes toward disabled children are needed. This paper reports on the development and validation of a 30-item self-report questionnaire assessing parental attitudes toward children with handicaps, and presents information concerning several determinants of parental attitudes. The measure is easy to use, reliable, and shows good evidence of construct validity. It detects differences among parents by gender, by parental education and occupational status, by cultural background of parents, by parental familiarity with a handicapped person, and by stimulus (physically disabled vs. mentally retarded child referent). Results are discussed in relation to determinants of parental attitudes toward handicaps. Potential applications of this measure for evaluation of teacher attitudes are suggested.

Attitude↗