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PubMed1992

Reliability and validity of three fitness tests for adults with mental handicaps.

To examine the reliability and validity of cardiovascular fitness tests, 10 untrained controls and 18 adults with mental handicaps (experimental group) completed five trials on each of four exercise protocols. VO2 max results (M +/- SD) averaged across trials were as follows: Maximal treadmill test, 27.2 +/- 6.2 for the experimental group (E) and 45.5 +/- 8.1 for the control group (C); Maximal shuttle run test, 19.7 +/- 3.4 (E) and 42.1 +/- 6.2 (C); Submax step test, 33.0 +/- 7.6 (E) and 44.5 +/- 7.6 (C); and Submax cycle ergometer test, 36.4 +/- 13.1 (E) and 42.0 +/- 7.1 (C). The four modes had similar VO2 max values across trials with intraclass correlations ranging from r = .90 to .97. To examine validity, the predictive tests were compared with the treadmill VO2 max test. Both the step and shuttle run tests correlated significantly with the treadmill test. The duration of the shuttle run test was unrelated to the exercise intensity. The stepping test is recommended over both the maximum shuttle run test and the submaximum cycling test when measuring the aerobic fitness of adults with mental handicaps.

Adult↗
PubMedDate not supplied

Providing for the severely handicapped: a case for competency-based preparation of occupational therapists.

Recent court decisions that mandate the development of new instructional alternatives for severely handicapped children will have significant implications for occupational therapists. Focusing on such issues as mainstreaming, accountability, and certification standards, this paper places in perspective the problems and trends that have led to this new challenge. It also provides suggestions for the development and disposition of training programs that can ultimately result in more appropriate programming for the handicapped children in the new population to be served in the public schools. Illustrated with examples of competency components and behavioral objectives, competency-based occupational therapy preparation programs are emphasized.

Child↗
PubMed1992

Traumatic dental injuries in normal and handicapped children in Nairobi, Kenya.

Two thousand, seven hundred and ninety one normal and handicapped children aged 5-15 years were examined for traumatic dental injuries. Twelve percent had traumatised teeth while three percent had soft tissue injuries. More handicapped children (18%) than normal children (11%) had injuries. This study indicates that children need to be educated on preventive measures regarding traumatic dental injuries.

Adolescent↗
PubMed1977

Predictive value of infant intelligence scales with multiply handicapped children.

The predictive value of infant intelligence scales with multiply handicapped children was investigated through the administration of a mental measure on two occasions to 28 children, divided into two age groups. A Pearson product-moment correlation coefficient of .69 (p less than .001) was obtained for the younger group and .83 (p less than .001) for the older group. When subjects were divided according to IQ level, a nonsignificant correlation coefficient was obtained for the high-IQ group and a significant correlation (r=.81, p less than .001) for the low-IQ group. These results indicated that infant intelligence tests are highly reliable predictors of later intellectual development when given to a population of multiply handicapped children.

Child↗
PubMed1992

A survey of the vision assessment of the developmentally disabled and multi-handicapped in University Affiliated Programs (UAPs).

In 1989 we conducted a survey to assess the availability of vision assessments (screening and complete eye/vision examinations) in University Affiliated Programs for Persons with Developmental Disabilities (UAPs). Analysis of the results suggests that although the UAPs are continuing to provide some services for eye/vision care, only 58 percent of these centers have facilities for the screening of vision problems. Ninety-six percent of the respondents, however, feel that vision screening is important. The developmentally disabled and multi-handicapped child is at high risk for vision/eye problems. Unless this difference between service availability and the perceived importance of vision services is addressed, there is an increased risk that the child may not reach his/her full potential. The UAPs need to increase the availability of eye/vision care within the UAPs and to expand training to providers in the community to deal with the developmentally disabled and multi-handicapped.

Child↗
PubMed1992

Educating students with mild handicaps in general classrooms: essential teaching practices for general and special educators.

This study was designed to identify and validate essential teaching practices needed by both general and special educators to successfully educate students with mild handicaps in general classrooms. An interdisciplinary panel of 105 experts, evenly divided into university-based and field-based participants from 35 states, identified 96 of 125 practices in six categories as being essential for effective teaching of mainstreamed students with mild handicaps. Based on a two-round Delphi procedure, a substantial majority (82%) of these teaching practices were seen as being essential for both general and special educators across all six rated categories. Panel ratings were significantly higher for special educators than general educators on four of the six categories. No significant differences in ratings were found for university-based versus field-based panelists, or for field-based panelists who were professionals directly involved in elementary or secondary teaching roles versus administrators, supervisors, and consultants. Based on essential teaching practices validated in this study, implications for preservice teacher preparation and staff development programs for general and special educators are discussed.

Persons with Disabilities↗
PubMedDate not supplied

Perceptions of parents of handicapped children concerning nurses and the health care system as it affects them.

Because of the change in mandate for Home Care Programs across Alberta, new cases of children with handicaps are now being assessed by nurses. Social workers, through the Handicapped Children's Services program, have traditionally been the ones to assess these children. This is a very new area for nurses and there is much to learn. Even less is known about the parents' perspective in working with families in community. As both a nurse working in the community and a parent of a child with special needs I see many of the issues from two sides. This study seeks to find out more about parents' feelings and views regarding nursing and the health care system. This knowledge is helpful to nurses working with these families as they strive to understand, communicate and build a helping relationship.

Alberta↗
PubMed1992

[A clinical course and autopsy results of an 8-year-old severely handicapped girl with marked periventricular leukomalacia].

We reported a clinical course and autopsy results of an 8-year-old severely handicapped girl with marked periventricular leukomalacia. She was well until 3 days prior to first admission in local hospital. Two days prior to admission, she began to vomit. Twelve hours later, she was noted to be lethargic and developed malaise with frequent vomiting. At physical examination on admission, she had frequent fits and her posture was decerebrate rigidity. Consciousness disturbance continued for two weeks. Thereafter, she became severely handicapped with spastic quadriplegia, mental retardation and intractable epilepsy. She was transferred to our hospital one month later. We cared her totally and carefully with our rehabilitation staff, but during her course several rare happening occurred; she suffered from subdural hemorrhage due to hypocupremia and received an operation for the release of contracture of her hips. She died of acute cardio-respiratory failure at 8 years and 5 months of age. Her autopsy findings were characteristic of the damage to an immature brain during development; cactus formation of cerebellar cortex and periventricular leukomalacia.

Acute Disease↗
PubMed1992

[Feeding problems in severely handicapped children].

Nineteen patients with severely handicapped children were divided into 3 groups; tube-fed patients (group 1, n = 8), oral-fed patients with dysphagia (group 2, n = 3) and oral-fed patients (group 3, n = 8). Clinical symptoms, past history, cranial CT, EEG, blink reflex and auditory brainstem response were evaluated in these patients. All patients of group 1 and 2 could not control head or sit by themselves. They needed naso-oral suction. However, nasal airway, intubation and tracheostomy were necessary only in group 1 patients. Five out of 8 patients of group 3 could control head and sit by themselves. No one needed naso-oral suction. CT revealed ventricular dilatation or prominent destructive lesions in group 1. However, patients of group 2 and 3 showed the lesions of mild to moderate degree. EEGs showed poorly developed background activities or electrical status epilepticus in group 1, while they showed relatively well-developed background activities with less prominent paroxysmal discharges in group 2 and 3. R2 component of blink reflex was absent bilaterally in 90% patients of group 1 and 2, while unilateral R2 at least was present in group 3. Feeding problems in severely handicapped children were affected by combination of cerebrum and brainstem involvements. Examination of cranial CT, EEG and blink reflex was useful to determine the method of feeding.

Adolescent↗
PubMed1977

[The possibility of oral rehabilitation of the handicapped under anesthesia].

In addition to technical and personnel requirements, clinical experience is necessary for oral rehabilitation of handicapped patients under general anesthesia. As our investigation has shown, the dental measures conceivable under legal aspects and theoretically feasible under general anesthesia, are almost exclusively limited to uncompromising, dental surgical reconstruction, if possible in one session. Conservative measures show a lasting success in few cases only, especially in occlusal acrylic and amalgam fillings of handicapped persons of sufficient intelligence and personal oral hygiene. Treatment under general anesthesia is inevitably indicated in imbeciles, the feeble-minded, spastics, epileptics, and sometimes in mongoloids. The patient's wish or that of his companion are not sufficient, nor the lack of will or obstinacy. Only after all other means failed, should oral rehabilitation be performed under general anesthesia.

Anesthesia, General↗
PubMed1992

[Consequences of handicaps following a cerebrovascular accident for patient's partner].

What is the influence of stroke on experienced burden, coping and well-being of the patient's spouse? To explore this problem we interviewed 22 spouses, living with their husband or wife at home. Stroke had occurred over 12 months ago. There appeared to be different consequences for the spouse, depending upon the kind of handicap: The physical handicaps in stroke-patients were associated with an increase of household tasks and caregiving, and with diminished opportunities for the spouse to relax. Mental deterioration after stroke was slightly associated with a lower level of well-being in the spouse. Spouses of patients with severely impaired communication had fewer opportunities to relax, reported more deterioration of the marital relationship and showed slightly more depression than spouses of patients with slightly impaired communication.

Aged↗
PubMed1992

[Expert assessment of hearing loss within the scope of the social compensation law and the law regarding severely handicapped patients].

Special problems are described concerning expert opinions on hearing disability and hearing loss with regard to the German Social Rights for Compensation and the laws for handicapped persons. In some aspects there are similarities to the rights of accident insurance, but disability programs question only the degree of handicap present and not the source of the hearing loss. The expert opinion on the subject's ability to work in his or any other profession must only determine the patient's ability to hear and the tasks needed to fulfill the profession. Special attention is given to the problems arising from tinnitus.

Deafness↗
PubMed1960

Work potential of the handicapped: the physician's role in evaluating it.

Even a severe physical defect may not be a handicap on some jobs; even a mild one may be a handicap on others. Physicians considering the employability of a disabled person must not only appraise the person but also must analyze the job. Job analysis must take into consideration the degree of exertion necessary, the emotional demands, working conditions (including accessibility of the place of work, of toilet facilities and the like) and job hazards. Appraisal of the person must include a medical examination, a review of the work history, consideration of socio-economic background, and psychological testing.

Disability Evaluation↗
PubMed1992

[Responsibilities of pediatric medicine in integrated rehabilitation of handicapped children in Bremen].

Integrated education of handicapped children in Bremen is both goal and method. In the case of infants (0-3 years old) integration means integrating the child into the family by working with and within the family; for pre-school children (3-6 years old) this means education with non-handicapped children in a pre-school setting; integration in school settings using various approaches is still a goal. Integrated education is understood as a multi-disciplinary approach with the necessary inclusion of sociopaediatric competencies. The contribution to the concept of integration by paediatricians in Bremen is presented in this article. The work described is viewed as a perfect fit for paediatricians in the Public Health Services if they have the necessary preliminaries in self-understanding and qualification.

Child↗
PubMed1977

Auditory reinforcement in profoundly retarded multiply handicapped children.

Profoundly retarded multiply handicapped children were placed in a situation where auditory stimulation was made contingent on a visually directed level-pulling response. Two experiments were performed. In the first, a technique for establishing an effective reinforcer from a range of possible reinforcing stimuli was evaluated. In the second experiment, a multiple schedule was used to compare the effectiveness of a reinforcer whose efficacy was established in Experiment 1 with a second auditory stimulus. The selection of auditory reinforcers and an evaluation of their relative potency was achieved using these techniques. The results show the feasibility of systematic measurement of operant-conditioning effects with very severely handicapped subjects in a laboratory situation. The information gained concerning the effectiveness of auditory reinforcers has implications for behavior-modification programs with these children.

Acoustic Stimulation↗
PubMed1978

Assessing the driving potential of the handicapped.

Proper and early assessment of the handicapped person's potential for driving a vehicle depends upon an understanding of the factors involved in a driver evaluation. The driver evaluation factors discussed in this paper are: driving aids and their application; the handicapped driver's physical, perceptive, and cognitive capabilities; and the psychosocial characteristics that influence a client's ability and need for driving.

Automobile Driver Examination↗
PubMed2003

Comparative research on substance abuse and self-perception among adolescents with physical handicap.

The research on substance (alcohol, tobacco and drug) abuse and on self-perception was done by comparing a test group of physically disabled adolescents and a test group of non-disabled adolescents. The respondents of the experimental group were students of the only special high school for physically handicapped persons in Croatia, Zagreb. The respondents of the control group were the students of two regular high schools in the capital of Croatia. The instrument used in this research was a self-reported, anonymous questionnaire. The respondents completed the questionnaire in the classroom. The data analysis regarding alcohol abuse indicated that physically disabled adolescents drink more often and out of quite different motives than their non-disabled peers. Regarding the prevalence, frequency, quantity and motives for smoking, no statistically significant difference has been found between the tested groups. On the contrary, significant differences between handicapped and non-disabled adolescents were evident regarding drug abuse. Only one physically disabled examinee used a drug--marijuana, only a few times a year. On the other hand, almost one quarter of the non-disabled adolescents use at least one, five at the most, type of drug sometimes or often. The results on the self-perception scale show that adolescent with physical disabilities have a much more negative attitude toward themselves than non-disabled controls. Their self-esteem and self-confidence are seriously diminished. Described findings could have a mighty impact on ways of preventing substance abuse, and on ways of increasing self-esteem among disabled and non-disabled adolescents.

Adolescent↗
PubMed1992

Grief elaboration in families with handicapped member.

Families with handicapped member seem to follow the same five stages (rejection and isolation, anger, dealing with the problem, depression, acceptance) of Kubler-Ross grief elaboration theory while dealing with the narcissistic wound of a handicapped child. Some of these families show a block in one of the stages. The effort of psychotherapy is to remove the block and let them reach the last stage. In this paper families under systemic psychotherapeutic treatment are analyzed, who had in common the birth of a child with low or modest invalidating signs and psychotic or autistic features. The families structure did not show the characteristics of a psychotic family. Nevertheless either one or both parents ignored the evidence of their child disease and they built a "disease-incongrous" wait around the child, trying to push away the painful reality. The authors explain the importance of this approach for the improvement of the autistic traits.

Child↗