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PubMed1989

Test-retest reliability of the Hearing Handicap Inventory for the Elderly using two administration approaches.

Previous investigation with the Hearing Handicap Inventory for the Elderly demonstrated high test-retest reliability for face to face/face to face and paper-pencil/paper-pencil administration techniques. From a practical standpoint, a face to face administration followed by a paper-pencil readministration may be a preferable method. The present study evaluated the latter administration approach in a sample of hearing-impaired elderly men. The high test-retest reliability correlations which emerged suggest that the face to face/paper-pencil measurement technique can be adopted for quantifying changes in self-perceived hearing handicap following audiologic intervention especially when clients are unable to return for hearing aid follow-up.

Aged↗
PubMed1990

Discriminating and responsiveness abilities of two hearing handicap scales.

Several scales exist for screening handicap and assessing rehabilitation in elderly individuals with hearing loss. There are few comparative studies, however, to suggest which scales perform best. Using receiver-operating curves and responsiveness indices, we examined the relative discriminating ability and sensitivity to detect change of four scales: a long and short version of the Hearing Handicap Inventory in the Elderly (HHIE-L, HHIE-S), and a long and short version of the Revised Quantified Denver Scale of Communication Function (RQDS-L, RQDS-S). All scales were administered to 137 elderly veterans with hearing loss and 101 elderly veterans without hearing loss. Follow-up testing to determine relative ability to detect change was assessed in hearing impaired individuals only after they had used a hearing aid for 4 months. Discriminative accuracy for correctly identifying individuals with hearing loss were: HHIE-L 78%, HHIE-S 79%, RQDS-L 73%, and RQDS-S 74%. Overall differences between the HHIE-S and the RQDS-S were not statistically significant (p = 0.06). True positive results were greater with the HHIE-S compared to the RQDS-S (p = 0.03). Responsiveness indices were: HHIE-L 1.78, HHIE-S 1.86, RQDS-L 1.04, and RQDS-S 1.07. Differences between the HHIE-S and the RQDS-S were statistically significant (p less than 0.05). We conclude short versions of the HHIE and RQDS are as accurate and sensitive for detecting change as long versions, and the HHIE-S is a superior versatile instrument for screening and assessing rehabilitation in elderly individuals with hearing impairment.

Aged↗
PubMed1979

Ecological aspects concerning the rehabilitation of handicapped persons.

When drawing up demand-oriented plans and establishing a network of rehabilitation facilities covering all areas, it is advisable to make an ecological analysis of the area to be served. Such an analysis should take into account the natural physical and socio-geographical conditions as well as basic data relating to the population living in a particular area and its movement. A further step is the topographical determination of available data on chronic diseases and handicaps in the individual discernable areas; besides the various statistical data, one should investigate also the degree of severity and the care required by the individual forms of diseases or handicaps. These factors largely influence the needs in the fields of medical, educational, vocational and social rehabilitation for in-patient or out-patient facilities and the personnel requirements in the form of specialist staff. When performing such calculations, it is often necessary to find a compromise between the various alternatives in accordance with the corresponding, existing socio-political and national health system. On the basis of such data, it is possible to formulate a concrete single plan together with already functioning institutions; such a plan could take its lead from a model concept. Of assistance, in this case, would be an epidemiological assessment which , in a longitudinal section of time, can transform itself into interventionist research and improvement of the deficiencies thereby ascertained. Consideration should also be paid to allowing future actions to be accompanied by scientific measures.

Demography↗
PubMed1982

Mentally handicapped children in special schools in Israel: a focus on social behavior.

As a part of a needs-assessment study, done in Israeli special schools for the mentally handicapped, social skills and personality characteristics were assessed on the Adaptive Behavior Scale (Nihira, Foster, Shellhaas, & Lelans, 1974). Structured observations were done in the classrooms of the behavior of each child and classroom climate questionnaire was administered to the children. Social behavior was found to be multidimensional consisting of: independence skills, personal maladaptive behaviors and social maladaptation. Correlations done between the ABS dimensions and the observations and classroom's climate, indicated that the more active and agitated child was less successful in terms of "vocational activity" and "self direction" (ABS domains), which were the behaviors most valued by the teachers. The more active child was also characterized by exhibiting positive and negative social behaviors, as indicated by responses given to the classroom climate questionnaire. The general implications of the study to social learning programs are that any curriculum in this area should take into consideration the multidimensionality of social behavior while at the same time take into account the socio-cultural pattern of the society and the personality makeup of mentally handicapped children.

Adolescent↗
PubMed1983

Play activities of mentally handicapped children at home and mothers' perception of play.

Reviewers have frequently commented on the meagre literature that is available on the play of mentally handicapped children, especially play at home. This study involved 67 families with a moderately or severely handicapped child aged mainly between 2 and 12 years, living in Dublin city. Details were obtained on who the children played with; the activities they engaged in and aspects of the home environment conducive to play. Furthermore mothers' perception of play are reported along with their reactions to playing with their child. It was found that the children's play was immotive and lacking in variety and that it invariably occurred within the family. Mothers viewed play as very important and saw it as an enjoyable and beneficial experience for themselves as well as the child. It is argued that parents should be given opportunities to learn how best they could nurture their child's development through play.

Attitude↗
PubMed1987

Home-based learning programmes for mentally handicapped people in rural areas of Zimbabwe.

This paper describes the operation of a community-based rehabilitation programme specifically for mentally handicapped children and young adults living with their families in rural areas of Zimbabwe. Details are given of the clients enrolled in the programme and the teaching goals used with them. Evaluation data on the programme's effectiveness is also presented. Three features are identified as being central to the programme's success, 1) partnership with existing agencies in the area, 2) the training and monitoring that is provided by specialist staff in mental handicap, and 3) the provision of resource materials -- forms, cards, videos -- which are tailored to the cultural, linguistic and literacy needs of the recipients. The efficient use of specialist staff is highlighted as are future areas for research and development.

Activities of Daily Living↗
PubMed1987

Elderly handicapped persons in a primary care district: changes during a 5-8 year follow-up.

643 handicapped persons born in 1918 or earlier were found at an inventory in 1975-78. In a follow-up 5-8 years later the mortality was 46%, which was significantly higher compared to the general mortality in the same age groups. There was no relationship between social class and mortality. Based on data from the first study, the deceased showed, compared to the surviving, impaired ADL and they used more medical and social care. The surviving population showed impairments in primary and secondary ADL during the follow-up. Elderly handicapped persons constitute a group at risk as they have an increased mortality and a great need of medical and social care. They should therefore be known to the medical profession.

Activities of Daily Living↗
PubMed1990

Italian research on computers and the physically handicapped.

Many categories of handicapped people experience serious difficulties in communicating. Among these are the deaf, whose language development is retarded primarily on account of poor speech control, the deaf-blind, whose only means of communication is touch, and the motor disabled, who often lack speech control and/or the ability to make the movements required to write or type. These disabilities, often associated with neuropsychiatric disorders, negatively affect the learning and the socialization processes of handicapped children. The advent and ever-growing power of personal computers (PCs) has opened up new opportunities in providing tools through which the disabled can vastly improve their communication capabilities. This paper describes some of these developments in Italy.

Blindness↗
PubMed1991

A computer-based approach to measurement of employment handicap.

The need for a more systematic, objective and appropriate approach to determining the extent of employment handicap, resulting from a disability, is considered. A possible approach, that takes advantage of the computer's ability to process and store large qualities of relevant data is presented. An attempt to pilot this in a large public corporation is then described. The need for a less simplistic definition of employment handicap than that adopted here is identified. The paper concludes that the approach can nonetheless form the basis for significant advances in this area, that should not only make possible more effective legislation but also make it more feasible to introduce a partial disability benefit.

Computers↗
PubMed2004

Working with a chronic disorder--the development of the Work and Handicap Questionnaire.

The Work and Handicap Questionnaire (WHQ) was developed to improve the vocational perspectives of patients with a chronic disorder. The WHQ differs from similar instruments in its explicit linkage between disabilities in daily life and job demands. This is an important feature, which allows for the development of specific strategies to counter work problems of people with a chronic disorder. The WHQ makes an inventory of possibly harmful working conditions and of possible strategies to counter health-related work problems by means of the work adjustments. Results of the application of the WHQ are shown for three patient groups (neuromuscular disorders, multiple sclerosis and asthma) and a group of colleagues with no chronic disorder. Results show similarities and differences between labour conditions and labour experiences between the three patient groups. It also shows differences and similarities between those working with a chronic disorder and those without such a disorder. Acceptance of the consequences of a chronic disorder for the job performance and a focus on health-related work problems would prolong career opportunities for workers with a chronic disorder. The use of the Work and Handicap Questionnaire will hopefully further these aims in determining health-related work problems and offer solutions by means of adequate work adjustment.

Adult↗
PubMedDate not supplied

MR imaging of brain maturation in normal and developmentally handicapped children.

White matter myelination was assessed in the frontal, temporal, and occipital lobes and in the internal capsule in 91 neurodevelopmentally handicapped infants on T2-weighted images (spin echo 3,000/120 ms) and compared with myelination scores from 53 normal control subjects. Clinical diagnosis was birth asphyxia (34), seizures with delays of various causes (33), congenital infections (15), and intracerebral hemorrhages (9). Myelination in the total group of patients was generally delayed. However, we found distinct differences in myelin deposition between groups. Myelination of handicapped children with seizures or with intrauterine infections was retarded most severely at all ages. Children with intracerebral hemorrhages were almost never significantly different from normals in any part of the brain, whereas children with birth asphyxia had myelination scores in between. We conclude that magnetic resonance staging of developmental processes, such as myelination, in the infants' brain helps to recognize delays at an early age.

Asphyxia Neonatorum↗
PubMed2007

The dizziness handicap inventory and its relationship with functional balance performance.

OBJECTIVE: The purpose of this study was to describe the relation between the Dizziness Handicap Inventory (DHI) and balance performance measures. STUDY DESIGN: Retrospective case series. SETTING: Outpatient balance clinic in a tertiary referral center. PATIENTS: Patients referred with dizziness or imbalance of vestibular and nonvestibular origin. OUTCOME MEASURES: DHI, Romberg with Jendrassik maneuver, standing on foam, tandem Romberg, single-leg stance, the timed up and go test, the Dynamic Gait Index (DGI), tandem gait, and the 10-m walking test. RESULTS: The mean age of participants (n = 214) was 53.9 years. The mean DHI total score was 35.1, ranging from 0 to 96. Spearman rank correlation coefficients (rS) between DHI and the static balance tests were fair and ranged between -0.42 (p < 0.01) for single-leg stance with eyes closed and -0.51 (p < 0.01) for single-leg stance with eyes open. Only the Romberg test with Jendrassik maneuver correlated weakly (rS = -0.25; p < 0.01) with the DHI. Correlations with the walking tests were moderate, the connection with the DGI being the strongest one (rS = -0.69; p < 0.01). Forty-two percent of the variance in DHI scores in our patients was accounted for by the DGI score (r = 0.417). CONCLUSION: Functional balance tests involving locomotion correlate better with DHI scores when compared with static balance measures. The DGI explains a large component of handicap in dizzy and unsteady patients, which advocates its use in these patients.

Adult↗
PubMed2003

Measuring participation across impairment groups using the Craig Handicap Assessment Reporting Technique.

OBJECTIVE: To assess the efficacy, across a range of disability groups, of the Craig Handicap Assessment and Reporting Technique (CHART), a measure of societal participation. DESIGN: Cross-sectional analysis survey methodology. A total of 1110 community-based, nonhospitalized Coloradans with spinal cord injury, traumatic brain injury, multiple sclerosis, stroke, burn, or amputation were interviewed twice, 2 wks apart, using the CHART and a single administration of the FIM. RESULTS: Across all impairment groups, the intraclass correlation for the total score and the subscales of CHART-R were high. In addition, the CHART-R discriminated among the impairment categories in a direction that parallels increasing disability. CONCLUSIONS: CHART may be an appropriate measure of handicap for a range of physical or cognitive impairments.

Adult↗
PubMedDate not supplied

Surgical management of the severely multiply handicapped individual.

Thirty-four surgical procedures were performed over a 12-year period on a select population of severely multiply handicapped individuals. Heel cord lengthening, hamstring and adductor releases, as well as selected osteotomies, tenotomies, and arthrodeses (both wrist and foot) were performed. The objectives were improvement in sitting posture, care, and comfort. Independent evaluations of active function, passive function, cosmesis, self-esteem, limb posture, and ease of dressing and hygiene were assessed. Significant improvement was generally noted. No patient was made worse. Selected procedures in the severely multiply handicapped individual have a definite place in patient management.

Adolescent↗
PubMed2000

Testosterone, ticks and travels: a test of the immunocompetence-handicap hypothesis in free-ranging male sand lizards.

The immunocompetence-handicap hypothesis suggests that androgen-dependent male characters constitute honest signals of mate and/or rival quality because of the imposed costs through immune suppression associated with elevated testosterone levels. We demonstrate in a field experiment that male sand lizards (Lacerta agilis) exposed to elevated testosterone suffered from increased mass loss and tick load compared to control males. Although the first of these two results could be due to an elevated basal metabolic rate from increased plasma testosterone levels, the increased parasite load was statistically independent of the loss in body condition and is likely to be due to compromised immune function. Testosterone-treated males showed greater mobility than control males, and greater mobility resulted in higher mating success. Our experiment thus lends support to the immunocompetence-handicap hypothesis, suggesting that male testosterone levels have been moderated by balancing selection for reproductive success and sustained immune function.

Animals↗
PubMed1980

Dental treatment in young handicapped patients. An assessment of relative analgesia as an alternative to general anaesthesia.

A trial was undertaken to assess the suitability of oxygen/nitrous oxide sedation (relative analgesia) for dental treatment in unmanageable handicapped young patients. Fifty patients with chronological ages 5-22 years and mental ages 1 1/2-14 years participated in the double blind trial to see if premedication with diazepam 0.2 mg/kg would be a useful adjunct. After the trial, previous dental histories and behaviour at regular recall visits over the next 12-18 months were studied. Seventeen of 19 patients previously treated with general anaesthesia and 27 of 31 formerly untreated patients accepted treatment in the trial; of the 50 patients, 33 are continuing treatment with oxygen/nitrous oxide sedation, seven need general anaesthesia and 10 have moved from the district. It appears that the use of diazepam premedication improves patient demeanour and operating conditions although this improved effect is not carried over to recall visits. The results obtained indicate that routine dental procedures can be safely carried out by an experienced operator-sedationist in young handicapped patients using oxygen/nitrous oxide sedation. The frequency with which potentially hazardous techniques need to be used can be reduced, as can hospital admissions.

Adolescent↗
PubMedDate not supplied

The end of mentally handicapped childhood: problems of residential transfer and school leaving during adolescence.

The evolution of two hospital units for mentally handicapped children is contrasted with two special boarding schools which each have radically different discharge procedures at adolescence. Two communities organized so as to obviate the need for adolescent transfer are discussed. Problems at adolescence highlight the interdependence of educational and social services for the handicapped. It is shown how isolated developments in residential provision may create as many problems as they are intended to solve. The difficulty of reconciling expediency with educational and humanitarian aims is discussed.

Adolescent↗
PubMedDate not supplied

Special unit care of the preschool child with severe physical or mental handicaps.

The provision of special care units for the severely physically and mentally handicapped preschool child is discussed. Types of handicap and ethnic origin of the children passing through such a special care unit in a two year period are considered. Management of the special care unit is discussed and the need for a multidisciplinary approach to the care of the child emphasized.

Australia↗