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PubMed2004

Neurologic treatment strategies in autism: an overview of medical intervention strategies.

Child neurologists are likely to be caring for an increasing number of patients with autistic spectrum disorder (ASD). ASD may occur in as many as 1/100 to 1/200 births. It appears to be a multifactorial disease, with many phenotypes or subgroups. No simple treatment is currently approved for curing or managing core symptoms of autism. We rationally propose a symptom-based review of what treatments may offer relief to specific subtypes of clinical behaviors seen in autism. There is a lack of clinically based evidence on which to universally recommend a rational clinical algorithm for treatment; we suggest that rational pharmacotherapy may offer symptomatic relief to core areas of dysfunction in the autistic population. Future research into rational medical treatment options is desperately needed.

Aggression↗
PubMed2003

Reading emotion cues: social communication difficulties in pediatric populations.

Speech-language pathologists frequently address social communication difficulties in children with diverse linguistic profiles. Of consequence to effective management of social communication skills is that some children with language disorders may also have difficulty understanding emotional cues. The ability to recognize and comprehend the emotional meaning of messages is accomplished through integration of linguistic cues (e.g., what the speaker says), nonlinguistic cues (e.g., the speaker's facial expressions), and situational cues (e.g., predicting how the speaker is likely to feel about the particular topic). This article explores children's comprehension of emotion as expressed through facial expressions and situational cues. First, development of emotion comprehension in children with normal development is summarized. This is followed by a brief review of studies investigating emotion comprehension in clinical populations. Suggestions for assessment and intervention of children's emotion comprehension skills are presented.

Affect↗
PubMed2004

Owning up to complexity: a sociocultural orientation to attention deficit hyperactivity disorder.

To enrich our conception of attention deficit hyperactivity disorder (ADHD), it is necessary to take a wider orientation to this disability category than has been advocated traditionally. Over the past decade, there has been an emerging conception of ADHD from a sociocultural perspective, and this orientation, when linked to the traditional biomedical perspective, provides a more accurate and authentic construct of ADHD. In this article, we advocate that speech-language pathologists approach ADHD with a mindset that is open to the complexities of context-bound human functioning at all levels. Four sources of data demonstrating the richness of the sociocultural orientation are presented and clinical implications are detailed

Attention Deficit Disorder with Hyperactivity↗
PubMed2000

Computer play centres for children with disabilities.

For all children play is the leading and dominating activity in childhood and essential in child development. Many children with severe disabilities have limited opportunities to play and need support. Computer play can be a good support in habilitation/rehabilitation of children who have not earlier been able to play independently. Eight pilot computer play centres were started in Sweden in 1992 and since then the number of centres has increased. The target group was children with disabilities on the level before reading and writing. This brief report is a description of the computer play centres and the first three activity years.

Adolescent↗
PubMed2006

Perceived needs for geriatric education by medical students, internal medicine residents and faculty.

CONTEXT: Traditional methods of setting curricular guidelines using experts or consensus panels may miss important areas of knowledge, skills, and attitudes that need to be addressed in the training of medical students and residents. OBJECTIVE: To seek input from medical students and internal medicine residents ("trainees") on their perception of their needs for training in Geriatrics. DESIGN: Two assessment methods were used (1) focus groups with students and residents were conducted by professional facilitators and the transcripts analyzed for areas of agreement and divergence and (2) geriatric medicine experts and ward attendings were surveyed to examine training gaps raised by trainees during Geriatric Guest Attending Rounds. RESULTS: Trainees perceived training gaps in caring for elderly patients in the areas of (1) recognizing and addressing the complex, multifactorial nature of illness; (2) setting priorities and goals for work-up and intervention; (3) communication with families and with patients with cognitive disorders; (4) assessment of a patient for discharge from the hospital and the services at different sites in which patients may receive care. They recounted feeling overwhelmed by complex patients and social situations while acknowledging the special aspects of connecting with older patients. The gaps identified by trainees differ from and complement the curriculum guidelines set by expert recommendations. CONCLUSION: Trainees identified gaps in skills and knowledge leading to trainee frustration and potentially adverse outcomes in caring for elderly patients. Development of curriculum guidelines should include assessment of trainees' perceived learning needs.

Attitude of Health Personnel↗
PubMed1998

Autism and other pervasive developmental disorders: exploring the dimensional view.

OBJECTIVE: To examine empirical data on children with autistic disorder (AD), Asperger's disorder, and pervasive developmental disorder not otherwise specified (PDD-NOS) for continuities or distinguishing features between disorder and to see to what extent the Diagnostic and Statistical Manual of Mental Disorder (DSM-IV) diagnostic criteria-reflect observed data. METHOD: Studies were identified in 4 ways. 1)A Medline search from 1976 to the present of articles with the key words autism, pervasive developmental disorder, autistic spectrum disorder, and Asperger; of these articles, those with mesh headings or textwords "cluster," which identified cluster analyses deriving pervasive developmental disorder (PDD) subtypes, were retained 2) The Journal of Autistic and Developmental Disorder from 1990 to the present was hand-searched to identify other empirically derived studies on diagnosis, prevalence, classification, and validity of PDD subtypes. 3) Key review articles were searched for their references. 4) The references of all identified articles were searched. RESULTS: Eight cluster studies were retained for their relevance to diagnostic issues, as were 7 empirically derived studies delineating clinic characteristics of children will AD, Asperger's syndrome, or PDD-NOS. Data suggests that children with PDD may fit into 1 of 2 overlapping groups, including a lower-functioning group with greater developmental compromise, social aloofness, and a greater number of autistic symptoms and a higher-functioning group with higher IQ, fewer autistic symptoms, and more prosocial behavior. The PDD subtype resemble each other and can be seen as existing o a continuum, differing only by degree of impairment. CONCLUSION: Children exhibiting the triad of autistic impairments can be seen as suffering from disorders on a PDD continuum. While the DSM-IV does identify a lower-functioning autistic group (AD), the higher-functioning group is less well served. Asperger's disorder as defined in the DSM-IV is not clearly distinguishable from AD and PDD-NOS, and the PDD-NOS subcategory is not operationalized. Further research is required to elaborate criteria for the higher-functioning PDD group, and measures related to etiology, outcome, and treatment response may help determine which diagnostic criteria can meaningfully separate one disorder from another.

Autistic Disorder↗
PubMedDate not supplied

[Adaptation of the picture exchange communication system in a school context].

BACKGROUND: Alternative communication. AIM: To evaluate the efficacy of the adapted Pecs and Picture Communication Symbols (PCS) in the communication of a child with cerebral palsy. METHOD: The participant of this study was a 9 year and 10 months old girl, with athetoid quadriplegia. All stages of the adapted Pecs were applied (Walter, 2000), using the PCS pictures (Johnson, 1998), associated with the functional curriculum proposed by LeBlanc (1991). An experimental AB Design was used in order to test the procedures. RESULTS: The subject was able to pass through all of the adapted Pecs phases and to use her communication board in school activities. CONCLUSION: The adapted Pecs proved to be effective in improving the subject's communication abilities.

Adaptation, Psychological↗
PubMed2006

Analysis of factors that affect responding in a two-response chain in children with developmental disabilities.

A sequence of behaviors consisting of appropriate responses, inappropriate responses, or a combination of both can be linked together in a behavior chain. Several operant processes may disrupt behavior chains. For example, one or more members of the behavior chain may be affected when reinforcement is withheld for the last response in the chain (extinction), when the last response is reinforced even if it occurs without the other responses in the chain (unchaining), or when access to the terminal reinforcer is available independent of responding (satiation). However, few studies have examined the effects of these types of procedures on responding that occurs in the context of behavior chains. The purpose of this study was to examine the effects of three clinically relevant procedures and processes (i.e., extinction, satiation, and unchaining) on behaviors that occur as part of a behavior chain. Overall, extinction and satiation resulted in a decrease in both responses in the chain. During the unchaining procedure, decreases were observed in the first response in the chain but not in the second response.

Attention Deficit and Disruptive Behavior Disorder↗
PubMedDate not supplied

[The hard and the soft].

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Commitment of Persons with Psychiatric Disorders↗