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PubMedDate not supplied

Considerations in the provision of comprehensive care for children with severe visual handicap.

The medical and social characteristics of children attending day special schools for the partially sighted is described. This group is characterized by the large number of additional handicaps and a high rate of familial defect. One third have at least one member of the family handicapped and belong to families larger than average. One tenth of the children are living in anomalous family situations. Some of the implications for the provision of comprehensive care are discussed.

Child↗
PubMedDate not supplied

An experimental resource centre on handicap in children. 2. Results from one year's operation.

An experimental resource centre on handicap for professional workers in four London boroughs as well advertised through all the relevant social, health and education departments. It provided a wide range of reference and display material as well as a programme of 20 lectures from experts with different backgrounds. The response to the centre by the various professions is reported, both in respect of visits to use its resources and of attendance at seminars and lectures. The response was disappointing, particularly from social workers and teachers. The centre had to close from lack of support after one year. Possible causes for the lack of response are discussed, and suggestions are made as to how the quality of the service given to handicapped children and their families can be improved.

Attitude of Health Personnel↗
PubMedDate not supplied

An approach to the evaluation of early intervention projects with mothers of severely handicapped children: the attitude dimension.

This paper describes a research investigation currently being carried out into the changing attitudes of mothers of severely handicapped pre-school children. A summary is made of the most frequently cited emotional reactions following the birth of a handicapped child and this is followed by a detailed description of a Maternal Attitudes Battery designed to obtain quantitative measures of relevent maternal attitudes. This is presented within the framework of an evaluation model specifically chosen to investigate the effectiveness of the Honeylands Home Intervention Project.

Attitude↗
PubMedDate not supplied

Identification of severe mental handicap.

Parents of 212 severely educationally handicapped children ESN(S) were asked about the circumstances of the identification of their child's handicap. Findings for the group as a whole were similar to those quoted in other studies but varied significantly according to the clinical group of the child. The 'no specific pathology' group gives cause for most concern: identification of these children occurs later, and is further delayed from the time that parents become anxious, than it is for children in other groups. Since 'no specific pathology' children may benefit as much or perhaps more from early intervention as do children in the more easily identifiable groups, attention should be paid to means of recognition and of giving appropriate help and support to their parents.

Age Factors↗
PubMedDate not supplied

The Croydon workshop for parents of pre-school mentally handicapped children.

A multidisciplinary team of professionals met the parents of 25 pre-school handicapped children for a series of evening meetings to discuss how professionals and parents can help the development of the child. The workshop was exceptionally well-attended by parents who received practical advice from both the professionals and other parents. Multidisciplinary parents workshops appear to be an effective community service for the parents of handicapped children.

Child Behavior Disorders↗
PubMedDate not supplied

Use of play materials in treating a severely handicapped child.

A 4-year-old boy with a physical handicap severe enough to preclude his manipulating materials, participated in a play intervention designed to help him to deal with some of his limitations. His skill in communicating to the therapist and in utilizing vicarious experiences allowed him to participate fully and successfully in therapy, although several modifications had to be made in the usual play procedures. The basic techniques of play therapy may therefore be of use to other motorically handicapped children who are capable of verbalizing and fantasizing. During the course of the therapy, this child also evidenced some unusual perceptions of the world. The lack of opportunity to have the customary sensorimotor experiences had apparently delayed his development of object permanence. This finding is consistent with Piaget's theory, which emphasized early motoric behaviours as prerequisites to later intellectual operations.

Child, Preschool↗
PubMedDate not supplied

Psychological factors in feeding disorders occurring in mentally or multiply handicapped children.

This is a discussion of the psychological aspects of non-organic feeding problems occurring in infancy and early childhood. There are particular difficulties caused by parental responses to a handicapped child and these increase the likelihood of feeding problems. The temperament and personality of the child can pose additional problems. Early counselling for families of handicapped babies can facilitate normal mourning and the mobilization of practical help, and reduce the incidence of non-organic feeding problems.

Adaptation, Psychological↗
PubMedDate not supplied

A paediatric home therapy programme for developmental progress in severely handicapped infants.

An effort has been made to influence the development of severely handicapped infants and improve the quality of life for their families in one health care district. Weekly visits to the homes by a 'developmental therapist' for 2 years after the initial suspicion of major developmental delay have taken place. The visits have been carried out by senior professional staff in the therapeutic professions who normally deal with a young handicapped population working within a closely knit team directed by a paediatrician and a psychologist. Success and difficulties met by children, families, therapists and team are described. Appreciation of the child's individual characteristics and his family's particular accommodation to them has been the task of therapists, who appear to have successfully crossed the parent-professional barrier. Evaluation of maternal attitudes in this group and a comparison group from another health care district is being carried out. This paper is the first of three. The next two will describe the observed effects in the children and the families respectively.

Developmental Disabilities↗
PubMedDate not supplied

Play materials for mentally handicapped children.

A range of experimental play materials are described which were designed to aid the development of manipulative skills such as posting, threading, fitting and matching in mentally handicapped children functioning at the 1-2-year-old stage of normal development. The play materials are designed to withstand rough treatment and they can be securely mounted on adjustable frames so that they can be presented to children with physical handicaps. There are few detachable parts to be thrown or dropped out of reach, and appropriate manipulations produce "rewarding' auditory feedback. A preliminary assessment of the experimental play materials suggested that they prompted more developmentally productive kinds of manipulative play than did a selection of comparable conventional toys.

Acoustic Stimulation↗
PubMedDate not supplied

The effectiveness of parent workshops in mental handicap service.

Workshops designed to help parents teach their mentally handicapped children new skills and new habits were offered for 4 years as part of a wider service. This was the first time such a service had been available to any family within an area, population 250 000, and all families with mentally handicapped children under age 8 were invited to join the workshops. Workshops objectives were to teach parents skills in observation, selection and teaching of new skills and new behaviour, and to provide parents with confidence and support from other parents as well as professionals. workshops ran one evening/week for between 8 and 12 weeks, and nine workshops were held with a total of 40 families attending. Attendance was high and success was considerable with the problems tackled during the workshops. Nevertheless, the original objectives of the workshops were only fulfilled in part, as it is uncertain how much the methods taught during the workshop were applied to subsequent problems. The paper discusses the value of such workshops as a way of providing both practical help and support to families.

Activities of Daily Living↗
PubMedDate not supplied

The concept of interface related to services for handicapped families.

The Warnock Report (1978) concept that a "link person' was needed to liaise services to handicapped families was investigated with a one in three sample (n = 120) of parents with mentally handicapped children in a county in South Wales. The findings show that whilst almost half the parents considered a social worker to be in the best position to undertake this overall coordinating function, there remains a considerable gap between theory and practice.

Child↗
PubMedDate not supplied

A behavioural parent training programme for single mothers of physically handicapped children.

The single mothers of four children with congenital physical disorders participated in a 9-week parent training programme. The programme was developed to instruct them in the systematic utilization of behavioural techniques in order to enable them to teach their children self-help skills and to reduce behaviour problems. The mothers successfully taught their children seven self-help skills, with average self-help skill performance increasing from 18% correct during baseline to 99% correct during a 5-month follow-up period. In addition, the mothers provided one another with social support and practical suggestions related to psychosocial stresses facing single parents of handicapped children. The findings suggest the potential of behavioural parent training techniques in facilitating functional independence in physically handicapped children, as well as providing single parents with increased feelings of being able to systematically contribute to their children's physical and psychosocial development.

Behavior Therapy↗
PubMedDate not supplied

The Mary Sheridan Unit: an evaluation of the effects of a hospital unit on the development of visually-impaired multiply handicapped children.

The evidence in this study appears to indicate that adopting a goal-planning approach can provide demonstrable and clear improvements in the developmental functioning of multiply handicapped blind children. However, while the improvements in functioning for self-help and sensorimotor abilities are quite significant, those for communication and language skills are much less so. Three possible hypotheses have been advanced as to why this should be so. The hypothesis that the setting might be an institutionalizing one was rejected on the grounds that some of the evidence did not fit with that from other populations. The second hypothesis referred to the lack of formal speech and communication training on the unit. The best possible test of this hypothesis would be to employ a speech therapist to work on the unit and support for such a scheme is being sought. Finally, it was hypothesized that the way in which the staff interacted with the children was not being sufficiently modified to take account of the children's handicaps.

Activities of Daily Living↗
PubMedDate not supplied

The nature of interactions between nursing staff and profoundly multiply handicapped children.

The rate and content of naturally-occurring interaction patterns between nursing staff and profoundly multiply handicapped children were observed within a long-stay ward in a large mental handicap hospital. Child behaviours were recorded as appropriate, inappropriate or neutral and responses to the target child's behaviour were coded as positive attention, negative attention and no attention. It was found that for more than half of the time (54%) that the children were observed, they were doing nothing. Staff interacted with them for 16.2% of the total observation period. Most of the attention given by staff was positive, regardless of the appropriateness of the child's behaviour. A social learning framework suggests that given the low rate of interaction, potential therapeutic opportunities are being missed and the style of those interactions which occur may be anti-therapeutic. The implications of these findings for nurse training and hospital management are discussed.

Adolescent↗
PubMedDate not supplied

Similarities and differences in behaviour between mentally handicapped and normal preschool children during play.

When 12 normal preschool children and 12 mentally handicapped children of similar mental age were individually observed during peer group play, more similarities than differences were found in the incidence of 28 behaviours. However, the behaviours for which significant differences were found included those likely to be most relevant to social acceptance. Mutual social involvement of normal and handicapped children during integrated play may require not only attention to the constitution of the group but also manipulation of the conditions and environment.

Child Behavior↗
PubMedDate not supplied

Parent playfulness: a case study of infant twins with handicaps.

This longitudinal case study was designed to provide descriptive data on game playing between one mother and father and their infant twin sons, each of whom had handicaps. Specific issues addressed were the proportion of interaction time spent playing parent/infant games, the types and characteristics of the games played, whether these varied between the mother and father, and whether there was a relationship between parental game playing and the developing but different abilities of the infants. Results showed many parallels with existing literature on parent/infant games and on differences between mothers and fathers. Results also indicated variations in game playing in relation to the extent of handicap in the infant.

Attention↗
PubMed1992

Quantitative analysis of factors contributing to handicap and distress in vertiginous patients: a questionnaire study.

Statements encapsulating common beliefs, behaviour and difficulties associated with vertigo, derived from in-depth interviews, were used to construct a Vertigo Handicap Questionnaire (VHQ) which was completed by 84 patients referred for vestibular testing. Factor analysis identified four principal components of handicap in addition to 'Anxiety and Depression', (which was isolated prior to analysis): 'Restriction of Activities', both physical and social; concern that vertigo would adversely affect social relationships ('Social Anxieties'); 'Fear of Vertigo', both the attacks themselves and their possible significance; and 'Severity of Attacks' which was multiplied with frequency of attacks to give a measure of reported physical disability. Multiple regression revealed that Severity x Frequency of attacks contributed to patient distress only indirectly, through its influence on the mediating psychological and behavioural variables. Significant patient benefit may therefore result from counselling or behavioural therapy, whether or not the vertigo itself can be controlled.

Adolescent↗
PubMed1985

Behavioural training for nurses in mental handicap: an application of the EDY course.

The role of the nurse in the care of mentally handicapped people is increasingly one of teaching and training using behavioural methods, as witnessed, for example, by the new RNMS syllabus. Methods of providing suitable training to equip staff for this changing role are discussed and it is concluded that an economic and effective method may be through locally organized in-service training. One particular in-service course--the education of the developmentally young course for mental handicap practitioners--is described and its applications in two health authorities in the UK are discussed.

Behavior Therapy↗