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PubMed1988

Pediatricians' perceptions of the effectiveness of early invention for at-risk and handicapped children.

To evaluate pediatricians' perceptions of the effectiveness of early intervention for handicapped and at-risk children, all board-certified pediatricians in the state of Ohio were surveyed. A detailed questionnaire was developed which included the use of brief but specific cases identifying eight different children with documented handicaps and two cases of children at developmental risk. Overall, the results indicated that pediatricians judged early intervention to produce at least a modest effect on children's general development and function. A more optimistic perspective was held for families in that involvement in early intervention was viewed as improving substantially the ability of families to cope with the problems of a handicapped or at-risk child and to provide a supportive and stimulating environment. However, perceptions of effectiveness did vary for specific disability and at-risk groups. The correspondence between perceived effectiveness and existing research findings also was discussed.

Adaptation, Psychological↗
PubMed1988

Prescribing requirements of the elderly mentally handicapped: future demands on primary health care teams.

The medication prescribed for 269 mentally handicapped hospital residents aged 60 years and over on 1 January 1987, including five with Down's syndrome, and for 31 residents aged 50 years or over with Down's syndrome was analysed.Fifty of the 269 elderly residents were receiving no medication but the mean number of prescriptions for the remaining 219 was four. Of the total sample of 269 residents, 32% were taking drugs for psychiatric and psychological disorders; 11% regular antiepileptic drugs; 62% long-term drugs for other problems (diuretics and laxatives were the most common); 29% had long-term prescriptions for topical preparations, enemata or suppositories; 23% were on shortterm prescriptions for other problems; and 17% had short-term prescriptions for topical preparations, enemata or suppositories. For the 31 Down's syndrome residents the commonest prescriptions were for skin preparations.Particular care is needed in making a diagnosis and monitoring the effects of treatment on mentally handicapped patients because a complete history and full cooperation on examination may not be forthcoming. These findings have implications for primary health care teams who will be responsible for the mentally handicapped when hospitals close and the residents live in the community.

Aged↗
PubMed1985

The behavioral development of physically handicapped children in the second year.

Studies of school-aged children with physical handicaps often report cognitive-linguistic deficits, passivity, and inhibition. This study has attempted to determine whether this pattern is anticipated in earlier developmental periods, by examining the functioning of toddlers with physical anomalies (but without CNS damage) compared to premature toddlers (who share some aspects of deviant early experience) and to normal toddlers. Fourteen infants in each group were videotaped, longitudinally, at 9, 12, 18, and 24 months, in interaction with their mothers and in various semistructured situations. Developmental level was assessed at 12 months (Bayley scales) and at 24 months (Stanford-Binet IQ). Both groups of at risk toddlers performed more poorly in measures of focused play, language production, social initiative, affective expression, and 2-year IQ. Handicapped toddlers were more distractible, less compliant, and less willing to separate from their mothers, than were prematures. Patterns previously described for older handicapped children can therefore be recognized as early as the second year of life.

Child Development↗
PubMed1985

[Pre-, peri- and postnatal factors in 419 handicapped children of a specific region].

A retrospective analysis was done in 419 children with handicaps, born 1966-1980 in a territory. In comparison with 419 children with normal development the following factors were found more often in the group with handicaps: Mother older than 30 years, brothers and sisters with handicaps, low birth weight, low placental weight, obstetric operations, vaginal labour in breech presentation, low Apgar score, neonatal reanimation, transfer in a children hospital, pathological reflexes in newborn, retardation of early development, bad social environment.

Abnormalities, Multiple↗
PubMed1988

The values and value stability of emotionally handicapped and normal adolescents.

This study addresses two basic questions: (1) Do the value rankings of conduct-disorder, anxiety-withdrawal, and normal adolescents differ? (2) Are the value rankings of the two groups of emotionally handicapped adolescents less stable than the value rankings of the normal group? Value stability was viewed in relation to the broader concepts of identity and psychopathology. While a number of studies have examined value differences among different groups of adolescents, few studies have examined the value stability of adolescents. A total of 148 15- to 18-year-old adolescents were administered the Rokeach Value Survey on two separate occasions (3-week interval) to measure value differences and value stability. The two groups of emotionally handicapped adolescents were classified using the Revised Behavior Problem Checklist. Results revealed that all three groups shared similar values; very few value differences across groups were found on both testings. All three groups shared moderate to low levels of value stability. The findings suggest that both types of emotionally handicapped adolescents are similar to normal adolescents in their stated values and the stability of those values. Results are discussed in terms of possible explanations of the findings, and implications for those who work with adolescents and for future research on adolescent values.

Adolescent↗
PubMed1988

Hearing loss and associated handicaps in preschool children.

In the Greater Stockholm area, 251 children born in 1976 to 1980 had hearing loss of such a degree that they needed hearing habilitation at the time of school entrance (prevalence rate 2.8/1,000). The prevalence rates of profound hearing loss (greater than 50 dB pure tone average) and monoaural deafness were both 1.0/1,000. The etiology of the hearing loss was heredity in 45%, unknown in 35%, sequelae of otitis media in 2% and related to high-risk histories in 18%. The high-risk history group includes the eight last known cases of congenital rubella. One associated handicap was present in 25%, two extra handicaps in 6.4% and three in 1.2%. Moreover, in 17% Swedish or Swedish sign language was not the vernacular. Nineteen different languages were represented among the children. Thus, an optimal habilitation program should not be based solely on the type of hearing handicap.

Child↗
PubMed1988

Exercise testing in patients with musculoskeletal handicaps.

To determine safe and effective exercise testing techniques for musculoskeletally handicapped individuals, 20 patients (mean age, 61 years) were studied. Types of handicaps included various degrees of paralysis of arms and legs, and leg amputations. Seventeen of the 20 patients had concurrent cardiovascular problems. All were currently hospitalized, engaged in various physical therapy exercises, and referred for exercise testing to increase rehabilitation therapy or for cardiovascular evaluation. Of 20 tests, arm ergometry was used in 15, leg or combination arm-leg ergometry in four, and treadmill in one. All patients completed testing with mean increases in heart rate (82 to 106 bpm arm, 88 to 125 other) and systolic blood pressure (114 to 127 mmHg arm, 118 to 146 other). Low-grade atrial and ventricular ectopy occurred in eight patients, decrease or plateauing of systolic blood pressure in three, increased diastolic blood pressure in two, and significant (greater than or equal to 1mm) ECG S-T segment displacement in one. With the use of appropriate equipment for each patient, exercise testing can be done safely and effectively in musculoskeletally handicapped individuals.

Adult↗
PubMed1988

Friendship patterns of mildly learning handicapped and nonhandicapped high school students.

Participant observation techniques were employed in a high school setting to document the friendship patterns of 32 mildly learning handicapped and 32 nonhandicapped adolescents. Three features of friendship were examined: intimacy, empathy, and stability over time. Handicapped adolescents were found to have fewer friendships than did their nonhandicapped counterparts and less stable friendships. There was less evidence of intimacy and empathy between pairs of handicapped peers. Variation in friendship behavior within both populations was noted, and factors contributing to difficulties in achieving fuller friendship were discussed.

Adolescent↗
PubMed1987

Adaptation of children to a chronically ill or mentally handicapped sibling.

The presence of a chronically ill or mentally handicapped child in a family can be a stress for the child's siblings, who often are ill informed about the nature and prognosis of the illness, may be uncertain what is expected of them in the caregiving role, may feel their own identities threatened, and may experience ostracism by their friends and misunderstanding at school. Although individual reactions vary widely, feelings of anger, guilt, resentment and shame are commonly reported. Excessive responsibility and concern about one's identity may add to these feelings and culminate in psychologic problems in the sibling. The physician caring for the family must be alert for symptoms of emotional disturbance or social maladjustment among the siblings of chronically ill or mentally handicapped children and should be prepared to counsel the family or refer them to a counsellor experienced in this area. In general, the first step is to be sure that the sibling is fully informed about the condition and to encourage frank discussion between the parents and the handicapped child's siblings.

Adaptation, Psychological↗
PubMed1986

Bereavement in the mentally handicapped.

There has been an upsurge of interest in bereavement and bereavement counselling but our knowledge of how bereavement relates specifically to mentally handicapped people is limited. This article reviews our current understanding of the grieving process, discusses how appropriate these models are for mentally handicapped people, examines how the mentally handicapped may be not receiving the necessary support following bereavement and puts forward suggestions to improve the situation.

Adolescent↗
PubMed1987

Facilities for the mentally handicapped in the Western Cape. Some pressing needs.

The proper management of mental handicap requires a carefully planned system of interlocking services. To implement such a system, accurate assessment of needs is essential. In 1984 the Western Cape Forum for the Mentally Handicapped undertook a survey incorporating information received from all existing centres (N = 37) within four economic regions of the Western Cape. The most glaring deficiency in services was in the black community with only 5.4% of the estimated needs being met, whereas in the coloured and white communities the figures were 36% and 86% respectively. However, serious deficiencies and imbalances for all three ethnic groups were identified. Certain basic principles which underlie a well-planned system of provision for the mentally handicapped are outlined. A survey to establish needs on a national level is suggested.

Black or African American↗
PubMed1985

A moment in human development: legal protection, ethical standards and social policy on the selective non-treatment of handicapped neonates.

Selective non-treatment decisions involving severely handicapped neonates have recently come under renewed judicial and legislative scrutiny. In this Article, the Author examines the legal, ethical and social considerations attendant to the non-treatment decision. In Part II of this Article the Author discusses the predominant ethical viewpoints relating to this issue and proposes a new moral standard based on personal interests. Part III presents a survey of the jurisprudence relating to selective non-treatment decisions. Parts IV and V of this Article provide a critical examination of the recently enacted Child Abuse Amendments of 1984, a federal legislative initiative designed to regulate treatment decisions relating to handicapped infants. The Author suggests that the ethical standards and treatment criteria proposed in this Article may prove useful to courts seeking to balance the handicapped neonate's constitutional right to privacy with the requirements of the new federal law.

Abnormalities, Multiple↗
PubMed1983

Stress over time: parents with young handicapped children.

Data from three research studies provided information about stress encountered by parents of young handicapped children as they sought services and information regarding diagnosis, treatment, and prognosis. In depth interviews were conducted with 115 families of children between the ages of 1 6/12 and 5 9/12 years, with mild to moderate handicaps. Three specific periods were considered: the initial diagnosis of handicapping condition, the first efforts at seeking help or intervention, and the transition from infant to preschool programs. Various child characteristics and community factors which seemed related to stress during these periods were considered. Problems encountered with professionals are identified, and implications for training and practice are offered.

Child, Preschool↗
PubMed1983

Auditory response behavior of severely and profoundly multiply handicapped children.

Severely and profoundly involved multiply handicapped children present special problems for the audiologist. Although a substantial amount of data is available on the behavioral responses of normal babies, there is a surprising dearth of similar information concerning handicapped children. In the present study, the responses of 31 severely and profoundly involved multiply handicapped children were studied by behavioral observation audiometry. Children's chronological age ranged from 7 to 153 months, while developmental age was estimated as 0 to 24 months. An experienced judge rated each of 9 specific behaviors either absent, strong, or weak on each trial. The stimulus types were a broadband noise, narrowband noises centered at .5 and at 2 kc/s, and speech either unfiltered or high-pass filtered at 1.2 kc/s, presented to S by a loudspeaker at 45 degrees azimuth, at 20, 40, 60, and 80 db re normal HTL. The interrelationships between stimulus variables, types of responses, and developmental level of the children were evaluated. Overall, the children responded differentially to the 5 stimulus types. Furthermore, the higher-functioning children responded much differently to the sounds than did the lower-functioning children. It was recommended that any behavioral technique be used together with objective tests in this most difficult population, and that testing be repeated over an extended period of time.

Audiometry↗
PubMed1982

Facilitating attitude change toward the handicapped.

Measurement in the shift of 424 normal children's perceptions of their handicapped peers was determined following their exposure to structured learning experiences of what it would be like to be handicapped. Attitude development and approaches used for attitude change are described. Significant positive shifts were found in children's perceptions of their handicapped peers' play capabilities, intelligence level, and self-concept. Attitudes toward mainstreaming remained unchanged. It is suggested that a viable receptivity exists in normal children's attitude development. The role of the occupational therapist in facilitating positive attitudes is discussed.

Attitude↗
PubMed1983

The handicapped in sports.

The first U.S.O.C. workshop on sports medicine for the handicaPped athlete led to several conclusions. First and foremost, the disabled athlete as an amateur athlete with a desire to participate must ever be uppermost in our minds, hearts, and planning. It appears that one of our chief objectives within the U.S.O.C. should be a central unifying force operating with joint support of the Sports Medicine Council and the Handicapped in Sports Committee, under the Sports Medicine Division. This arrangement will serve as an information and clearing center for the better understanding of each other and each organization of sports for the disabled athletes. We need to identify and classify for attention the common problems inherent among these groups and coordinate our various efforts. Fundamental to improvement in the application of sports medicine concepts is development of a definite plan for the education of voluntary coaches and trained or professionally prepared coaches, athletic trainers, physical therapists, and physicians. A variety of concurrent approaches are feasible with initiative and sharing of resources. An additional venture must be to begin pooling and computerizing our present and future information in this regard (professional articles and medical records) within the U.S.O.C. information retrieval system. This must be systematized so the pertinent information can then the disseminated and furnished nationwide to anyone or any group dealing with the disabled athlete in sports. Ultimately, our objective is to make this information available to all handicapped people.(ABSTRACT TRUNCATED AT 250 WORDS)

Athletic Injuries↗
PubMed1984

Some subjective and objective prerequisites to educational integration of handicapped children.

The success of educational integration of handicapped children is dependent upon, inter alia, the attitudes of social groups involved in the integration (subjective prerequisites) and from certain characteristics of the schools in which they are being integrated (objective prerequisites). In the latter case, an investigation was carried out on the attitudes of teachers at regular and special schools, of handicapped and non-handicapped school-children and the parents of both samples of children by means of the Lickert-type questionnaires, and the data processed by means of the multivariate analysis method. In the case of regular school teachers, an analysis was made also of the relationship between their concept of integration and their attitude towards the educational role of the school as an institution and towards their socioeconomic status. The objective prerequisites of integration were estimated by investigating in loco the conditions in regular schools, and through interviews with the responsible school staff. The factor analysis of the random samples investigated enabled factors to be extracted which, in respect to the integration, proved to be favorable to unfavorable. Some of these factors are of a general nature, in the sense that they refer to all the children, whereas other factors are specific, i. e. they refer to the type of disability. An examination of the objective prerequisites of integration produced findings which could lead to a suitable policy in preparing objective conditions for integration. The whole of this investigation was carried out within the framework of a research project of the Faculty of Defectology in Zagreb, lead by Prof. Dr. Franjo Tonković.

Adult↗
PubMed1983

[Siblings of a child with a motor handicap].

The siblings of children with motor handicaps have been only very infrequently studied, perhaps because of the fear of inducing additional disorders. From his personal experience, the author suggests that the siblings are more influenced by efficient parental guidance than by the presence of the handicapped child, whether this child is with it's family or in an institution. The risk for one of the parents of being appropriated by the handicapped child, who is thus over-protected, must be countered in order to avoid adverse reactions from the siblings.

Adult↗