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Visual screening of pre-school children.

In an attempt to reduce the incidence of persistent amblyopia and related disorders, routine screening of the visual function of pre-school children has been introduced in Ayrshire, the tests being carried out by orthoptists. A pilot study confirmed the feasibility of the screening. Under the definitive scheme, whose first three months' results are presented, the children are examined as near as possible to their homes and the average attendance rate has been 86%. Thirty-seven of 442 children were referred to an ophthalmic clinic with suspected abnormalities (only one of which was not confirmed) that had not been picked up by the GP or welfare clinic. It is concluded that visual screening of pre-school children is administratively feasible and welcomed by parents, and that it can detect abnormalities missed by traditional procedures-which according to these results may be more than half of the total.

Amblyopia↗

Health-related quality of life in parents of school-age children with Asperger Syndrome or High-Functioning Autism.

BACKGROUND: The estimated prevalence rate of Pervasive Developmental Disorders (PDD) in children is 6 per 1.000. Parenting children who are intellectually impaired and have PDDs is known to be linked to the impaired well-being of the parents themselves. However, there is still little available data on health-related quality of life (HRQL) in parents of children with Asperger Syndrome (AS) and High-Functioning Autism (HFA), or other PDD diagnoses in children of normal intelligence. The present study aimed to evaluate aspects of HRQL in parents of school-age children with AS/HFA and the correlates with child behaviour characteristics. METHODS: The sample consisted of 31 mothers and 30 fathers of 32 children with AS/HFA and 30 mothers and 29 fathers of 32 age and gender matched children with typical development. Parental HRQL was surveyed by the use of the 12 Item Short Form Health Survey (SF-12) which measures physical and mental well-being. The child behaviour characteristics were assessed using the structured questionnaires: The High-Functioning Autism Spectrum Screening Questionnaire (ASSQ) and The Strengths and Difficulties Questionnaire (SDQ). RESULTS: The mothers of children with AS/HFA had lower SF-12 scores than the controls, indicating poorer physical health. The mothers of children with AS/HFA also had lower physical SF-12 scores compared to the fathers. In the AS/HFA group, maternal health was related to behaviour problems such as hyperactivity and conduct problems in the child. CONCLUSION: Mothers but not fathers of children with AS/HFA reported impaired HRQL, and there was a relationship between maternal well-being and child behaviour characteristics.

Adolescent↗

The identification of high-school dropouts identified as learning disabled: evaluating the utility of a discriminant analysis function.

This study examined the utility of a linear discriminant function to distinguish between students identified as learning disabled (LD) who had either been released from high school under codes suggestive of school dropout (n = 213) or graduation (n = 92). The discriminant function was comprised of six variables--student ethnicity, reading ability, family intactness, family socioeconomic status, school transfers, and school-initiated interruptions. The analysis determined that differences between the LD dropout sample and LD graduate sample were sufficient to allow for a discrimination between the groups. On the basis of group differences the discriminant function that was constructed correctly classified 83% of the school dropouts and 46% of the school graduates, for an overall 73% accuracy rate. Those factors contributing most to the function were the number of district-initiated interruptions, school transfers, and family intactness. Based on the findings, implications for school districts and future research are noted.

Achievement↗

School-aged children with spina bifida in Western Australia--parental perspectives on functional outcome.

A questionnaire mailed to the parent(s) of all 86 school-aged children with spina bifida resident in Western Australia in 1992 who were attending a spinal dysfunction clinic or were members of the Spina Bifida Association was returned by 72 parents. All 72 of these children (55 with myelomeningocele, 17 with meningocele) lived at home with their parent(s). All but two children with meningocele were mobile without aids, whereas only 42% of the children with myelomeningocele were. Twenty one per cent of the children were naturally continent of urine day and night, and 36% were naturally continent of faeces. 76% attended a mainstream school although performance at school was rated below average for 40%. Nine children with meningocele (56%) and 42 with myelomeningocele (76%) were reported to have learning difficulties. This information will be useful in counselling parents of unborn and newborn children with spina bifida, and in allocating resources for children and young adults with spina bifida and their families.

Adolescent↗

[Evolutive neurologic evaluation and cortical functions in a sample of children from the 1st grade of an elementary school].

The authors observed 24 children that are studying for the first time in the first grade of the elementary school. They were observed through the classical neurological examination, the evolutive neurological examination and through tests for evaluation of cortical functions. It is analyzed the school performance in report to the evolutive neurological performance and to the tests for cortical functions. Results obtained are compared and discussed. The authors conclude that the usage of these two evaluation instruments is able to discriminate the good from the bad school performance.

Achievement↗

Health beliefs of the school-aged child and their relationship to risk-taking behaviours.

Health educators are frequently exhorted to encourage the development of functional lifestyles among school-aged children. Current efforts, however, often neglect consideration of the full spectrum of relevant age groups and the context imposed by the students' existing health beliefs. Interview data from a probability sample of children 6-17 years of age enable such assessment. Findings indicate that "health" is a meaningful concept and of concern to a majority of students, regardless of age or sex. However, a majority also report engaging in health-related risk-taking behaviours, and yet deny personal responsibility for poor health outcomes. Children of all ages were found to discriminate among illnesses, in terms of both their perceived personal vulnerability to the conditions and the extent to which they worry about them. Finally, by incorporating these attitudinal components as well as other social and demographic characteristics, regression analyses provide exploratory profiles of the current cigarette smoker and user of alcohol. Differences between each risk-taking behaviour are reviewed, as are areas for improving research into children's health beliefs and behaviours.

Adolescent↗

Improved disability population estimates of functional limitation among American children aged 5-17.

OBJECTIVES: This paper (a) creates and validates measures for population survey data to assess functional limitation in mobility, self-care, communication, and learning ability for school-age American children; (b) calculates rates of functional limitation using these measures, and provides population estimates of the number of children with limitations; and (c) examines these limitations as a function of socioeconomic factors. METHOD: The study is based on data for children aged 5-17 collected in the 1994 National Health Interview Survey on Disability. Ordinal values are assigned to survey items in the four functional areas and analyzed to produce scales of high reliability. These measures are used to identify within a 95% confidence interval the number of children with these limitations. Ordered logistic regression models measure the effects of functional limitations on disability and societal limitation. Socioeconomic differences are measured with an ordered logistic regression model that predicts severity and comorbidity. RESULTS: Limitations in learning ability (10.6%) and communication (5.5%) are the most common, with mobility (1.3%) and self-care (0.9%) occurring less often. Six percent of children have one serious functional limitation and 2.0% have two or more serious functional limitations. This corresponds to 4.0 million school-age American children with serious functional limitations. Functional limitation is strongly linked to socioeconomic disadvantage and to residence in single-mother households. CONCLUSIONS: Future population research should use multiple-item scales for four distinct areas of functional limitation, and a summary that takes into account both severity and comorbidity. The improved estimates of the number of school-age children with functional limitation in this paper may help contribute to a more informed scientific and policy discussion of functional limitation and disability among American school-age children. Future research on the disability process among children must consider the role of socioeconomic disadvantage and family structure.

Activities of Daily Living↗

Risk factors for childhood respiratory disease. Analysis of pulmonary function.

Four thousand elementary-school-age children from a rural area of western Pennsylvania participated in a cross-sectional survey that consisted of a standardized respiratory questionnaire completed by their parents and spirometric testing at school. Spirographic tracings were digitized to obtain the FVC, FEV0.75, FEF25-75, Vmax75, and Vmax90, which were standardized for height, age, and sex for the subsequent analyses. Independent associations of potential risk factors with the standardized pulmonary function measures were evaluated with multiple regression techniques. Asthma, persistent wheeze, and parental smoking habits, especially those of the mothers, were associated with lower flow rates. The effect of parental smoking was primarily due to smoking by the mother and was stronger in girls. In female children of currently smoking mothers, FEF25-75 was 96% of predicted, Vmax75 was 95% of predicted, and Vmax90 was 92% of predicted; each flow measure was 98% of predicted in male children of smoking mothers. Prolonged hospitalization at birth was independently associated with lower FEV0.75 and flow rates. Low socioeconomic status was associated with lower FVC and FEV0.75. Neither current gas stove use nor a history of severe chest illness before 2 yr of age were independently associated with lower levels of pulmonary function.

Adolescent↗