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[A review of the alert and psycholinguistic intervention model in attention deficit hyperactivity disorder].

INTRODUCTION: In every class in our schools, teachers are faced with one or two children with attention deficit hyperactivity disorder (ADHD), a neurobiological disorder with three main clinical axes: lack of attention, hyperactivity and impulsiveness. Generally speaking, these children develop poorer psycholinguistic skills, although over 50% of these problems remain undetected because they are concealed by the child's behaviour. Most of the children will see some kind of adverse effect on their academic performance, chiefly in areas concerning reading and writing. DEVELOPMENT: The language disorders in ADHD are mainly related to the areas of semantics and pragmatics and, to a lesser extent, to phonetic-phonological aspects. They are discernible from the earliest months of life, during the preverbal stage, which is the time when the infant's character is being shaped. In this case, our experience shows that the character can be classed as difficult or inflexible and explosive in 56.5% of children diagnosed with ADHD. Moreover, we know that many children with this disorder find it difficult to engage in play, and 30% of them have retarded language development. A rather undefined percentage of children can have similar problems to those of children with autism spectrum disorders, which makes the differential diagnosis even more complicated. CONCLUSIONS: The mixed model of intervention in ADHD includes language work within the context of cognitive-behavioural programmes and the development of narrative skills and social competencies through a literary creativity workshop. This study offers a review of the psycholinguistic problems affecting children with ADHD in the light of our own experience, together with other clinical evidence.

Attention Deficit Disorder with Hyperactivity↗

Long-term outcomes of pediatric acquired brain injury.

Recent studies have shown that persisting deficits remain even in young children with mild brain injuries. Our 2-year study investigated patterns of recovery in children and adolescents with ABI over the past 10 years. In the first year, we retrospectively reviewed demographic information (e.g., age at injury, gender,severity, GCS, coma length, and LOS), medical status, academic and therapy interventions, psychological, emotional and cognitive,physical, social, and family issues reported by parents and clients and outcome data from an adapted version of the Mayo-Portland Adaptability Inventory. In the second year of the study, we prospectively collected in-depth information through the use of new outcome measures, questionnaires and structured interviews. We focused on the relationships between persisting limitations (academic performance, pragmatic communication, social interactions, and physical abilities) and restrictions on participation (i.e., school, social relationships, vocational,and quality of life) of children who are between 3 and 5 years post-injury.

Activities of Daily Living↗

Prevalence and factors related to smoking among secondary school students in Kota Tinggi District, Johor, Malaysia.

Smoking among adolescent is a public health concern in Malaysia. Multiple studies on smoking prevalence and its related factors have been conducted in Malaysia, however, they were specific to either urban or rural areas alone. Studies in mixed settlement areas (urban, rural, land development area) had not been intensively investigated. This study reports the prevalence, demographic and factors related to smoking amongst form four students in the district of Kota Tinggi, Johor. A cross-sectional study of 16-year old secondary school students in Kota Tinggi district was conducted using two-stage stratified, proportionate sampling in July 2005. The study instrument used was a validated structured questionnaire on smoking and its related factors. Smoking prevalence was found to be 29.7%. More than 50% of male students were smokers. Prevalence was highest in FELDA (Federal Land Development Authority) settlement areas. Smoking was associated with having a brother or friend who smokes and poor academic performance. The study revealed that smoking prevalence was high, especially among male students in land development schemes. This situation will contribute to high smoking-related health problems in the future if proper preventive measures are not taken accordingly.

Adolescent↗

Leadership and professionalism curriculum in the Gross Anatomy course.

INTRODUCTION: Today's physicians must demonstrate both professionalism and leadership skills in order to succeed in largely team-based healthcare environments. The purpose of this study was to determine if professionalism attributes, leadership style, and leadership style adaptability are associated with academic performance among first-year students early in their medical curriculum. MATERIALS AND METHODS: Students were divided into 4-member dissection groups for the duration of the Gross and Developmental Anatomy course. Leadership responsibility was randomly assigned to a team member on a rotating basis every 5 weeks. After each 5-week block, student performance was measured by written and practical examinations, and each student assessed their leader's or their own professionalism attributes and leadership style using validated survey instruments. RESULTS: Most students demonstrated either a "selling" only (57%) or "participating" only (30%) leadership style with low to moderate leadership adaptability. "Participating" and "delegating" leadership styles have the highest average group written exam scores (89.4%, P <0.008). "Telling" only or "selling" only leaders have the lowest average group exam scores (83.5%, P <0.001). "Selling" and "participating" leaders have significantly lower average group practical exam scores than other styles (81.5%, P <0.007). Positive associations were observed between the written and practical examination scores and the leader's integrity (P = 0.003, P = 0.002) and responsibility (P <0.001, P = 0.037). CONCLUSIONS: This study demonstrates that various situational leadership styles and aspects of professionalism are associated with written and practical examination scores in the Gross and Developmental Anatomy course. Furthermore, it demonstrates that first-year medical students are in need of leadership skill development.

Anatomy, Cross-Sectional↗

Factors related to medical school application and acceptance in minority summer enrichment program students.

Baylor College of Medicine has conducted a summer enrichment program for minority/disadvantaged premedical students since 1969. Follow-up data on medical school application and acceptance for participants from 1980 through 1984 were analyzed in relation to selected preprogram variables--cumulative college grade point average, total Scholastic Aptitude Test score, competitiveness of undergraduate college, sex, and ethnicity. Results of univariate and multivariate analyses indicated that: 1) females were significantly less likely to apply to medical school than males, 2) females had significantly lower mean MCAT scores (5.9 vs 7.2) even though their preprogram academic performance was comparable to that of the males, and 3) after controlling for MCAT scores, none of the preprogram variables were significant in predicting medical school acceptance. These findings suggest the need for research to explain the discrepancy between male and female MCAT performance and frequency of medical school application in summer program participants. The findings also have implications for the type of counseling provided to female participants in summer enrichment programs.

College Admission Test↗

Attention deficit disorder with and without hyperactivity: clinical response to three dose levels of methylphenidate.

The response of 23 children with attention deficit disorder (ADD) with hyperactivity (+H) and 17 children with ADD without hyperactivity (-H) to three doses of methylphenidate (5, 10, and 15 mg twice a day) was evaluated in a triple-blind, placebo-controlled cross-over design using parent and teacher ratings of behavior, laboratory tests of ADD symptoms, and behavioral observations during academic performance. Results indicated that the children with ADD+H were rated as having more pervasive behavioral problems at home and more pervasive and severe conduct problems at school than the children with ADD-H. Laboratory tests found the children with ADD+H to be impaired in behavioral inhibition and vigilance whereas children with ADD-H were more impaired in the consistent retrieval of verbally learned material Drug effects were noted on the parent and teacher ratings and on most laboratory measures, with all three doses typically producing significant changes but rarely differing among themselves in effectiveness. The groups were not found to differ significantly on any measures in their response to methylphenidate. However, more children with ADD-H were clinically judged as having either no clinical response (24%) or responding best to the low dose (35%) of medication. In contrast, most ADD+H (95%) children were judged to be positive responders and most were recommended to receive the moderate to high dose (71%).

Attention Deficit Disorder with Hyperactivity↗

[Evaluation of interests, experiences and chemistry knowledge among students admitted to the Lisboa Medical School en 1989/1990].

Selected medical students for undergraduate medical courses in Portugal exhibit each year substantial deficiencies in chemistry. The group of students admitted to the Faculty of Medicine of Lisbon in 1989/1990 were selected by admission criteria apparently more restrictive than before. The aim of this study was to evaluate the quality of the theoretical knowledge in chemistry showed by those students before learning biochemistry. Eight-four of the admitted students were invited to participate in the study, by replying to an anonymous questionnaire on chemistry. A second questionnaire to identify a variety of personal/social factors was completed by the same students some days later. The results obtained have confirmed a clearly insufficient chemical background, in spite of the high scores achieved by those students in chemistry and other science subjects on the application. The majority of the students here studied declared financial security, live with their families, study at home, and report scarce outside distractions. It may be concluded that the new admission criteria to the faculties of medicine do not select students with better academic performances on chemistry than before. Otherwise, the sociocultural characteristics of the entrants do not fulfill the expectations that could contrast them clearly with average groups of students.

Chemical Phenomena↗

Intellective functioning and strategy use in children with insulin-dependent diabetes mellitus.

The cognitive development of children with either early or late onset insulin-dependent diabetes mellitus (IDDM) was investigated with tasks measuring intellectual ability, memory, and academic progress. In addition, children's perceptions of their competence and parents' perspectives on family functioning and their children's behavior were compared. It was found that children with IDDM scored within the normal range on standardized measures of intelligence and academic performance but evidenced some school difficulties, as reflected in subscale performance as well as in their need of remedial education services. Further, evidence was found to suggest deficiencies in children's use of strategies to organize and recall information, particularly for those with early onset of disease. Children's perceived self-competencies and parents' reports of family functioning were strikingly similar across groups. However, parents of those children whose illness began prior to age 5 reported their children to have poor attention spans and difficulty completing tasks.

Achievement↗

Family study of Kenyan children with school refusal.

The problem of school non-attendance is an increasing one in our setting and yet its cause has not been established. This paper presents data of work done through interviews with parents and observations of the home environments of the sample cases in attempt to establish factors associated with school non-attendance. After the initial interviews, the children were seen periodically for follow-ups, usually at two to three monthly intervals for at least one year, by the team which consisted of a consultant psychiatrist, a clinical psychologist, a paediatric registrar and a psychiatric social worker. Out of the ten cases sampled for the study, nine were of school phobia and one of conduct disorder (truancy). Generally, family characteristics significantly associated with school non-attendance in this study were neuroticism in parents, unstable family relationships occasioned by marital discord, parental expectations of high academic performance by the child and, to some extent, poverty. The common management approaches used were family therapy, counselling and anti-depressant pharmacotherapy.

Adolescent↗

47,XXX: what is the prognosis?

Eleven unselected 47,XXX girls, now 15 to 22 years of age, have been observed from birth in a prospective study of children with sex chromosome anomalies. A description of their growth and development is presented. The 47,XXX infants were not generally distinguishable from chromosomally normal children in the first year of life, even though there was a slight delay in neuromotor development. By 2 years of age, developmental delays in speech and language often became evident, and speech therapy was often necessitated in the preschool years. Early school problems included speech and language deficiencies, lack of coordination, poor academic performance, and immature behavior; these persisted throughout the school years. By high school age, a 47,XXX girl was generally tall and often subject to somatic complaints. Sexual development was generally normal. Seven of the 11 propositae had a diagnosed psychiatric disorder or disturbance at some time during adolescence. Variability within this syndrome is great; one proposita is in college and another is mentally retarded. The frequency of the diagnosis of the 47,XXX karyotype by genetic amniocentesis is estimated to be 1/1000, the same incidence as in the newborn population. Expectant parents must be counseled as to the significance of this karyotype and prognostic information must be given. Suggested guidelines are included.

Adaptation, Psychological↗

A retrospective study of the profile of ESN children seen at the Child Psychiatric Clinic.

A retrospective study of 50 cases of educationally subnormal children seen at the Child Psychiatric Clinic was done. Almost half of the referrals were initiated by schools, the majority being picked up at Primary 1. Forty-six percent of fathers and sixty percent of mothers had no more than primary education. Eighty-two percent of fathers had unskilled or semi-skilled jobs. Besides being below average in academic performance in school, these children also showed some behavioural problems like restlessness, disobedience, bullying, quarrelling or fighting with other children. They tended to be solitary, unresponsive, inert or apathetic, and were not much liked by others. Although all the children were referred and registered for special education, only half the number of parents accepted the offer for their children.

Child↗

School and the in-center pediatric hemodialysis patient.

Life "on the machine" can significantly disrupt the social and academic school experience of preadolescent and adolescent renal failure patients because of their frequent absences. When hemodialysis patients were offered treatments after school and on Saturday mornings, patients, families, and staff reported significant improvement in the patients' social integration and academic performance.

Adaptation, Psychological↗

The continuing problem of youthful solvent abuse in New York State.

The major finding in the comparison of surveys of New York State secondary school students is the increasing use of solvents in this population over time. What in 1974-75 seemed to be limited use, by 1983 was found to be of widespread use. Very much like the survey of 1974-75 and the findings in the literature, age of first use together with the recentness of use appears to cluster in the preteens or the early teen years and tapers off during the teen years. Of interest is the fact that, along with the general upward rate of use over the surveys, those 18 years or older also show an upward trend. Some evidence in the recent literature indicates that adults, too, are found to have a problem with inhalants. Similar to the 1974-75 survey, but unlike findings in the literature, males and females continue to show similar rates of solvent use. Although males do generally surpass females in these use rates, the differences are usually not significant. In light of the literature on solvent abuse among Hispanic youth, the 1978 and 1983 surveys indicated mixed findings. Hispanic students in New York City consistently showed intermediate levels of solvent use; whereas, in 1983, Hispanic students residing in areas of the state outside of New York City showed excessive rates of solvent use. To the extent that the problem of acculturation among poor Hispanic youth may contribute to solvent abuse, an explanation may be found in the contrasts between living in New York City and living in the rest of the State. In New York City, which has an extremely large Hispanic population (about 20 percent of the population), feelings of isolation and cultural distance may not be so profound. In the rest of the state, where the proportion of Hispanics is quite small (about 2 percent of the population), these cultural problems may be more of a factor. Reasons, however, for the extraordinary increase in solvent use among those Hispanic youth, specifically between 1978 and 1983, are difficult to offer. Again, very similar to the 1974-75 findings, the 1978 and 1983 surveys found a strong relationship between solvent use and poor academic performance. Furthermore, the early findings relating to solvent use to a lack of family cohesion was supported by the 1978 survey where comparable information was gathered. The pattern of drug-using or polydrug use found among solvent users in the 1974-75 survey was underscored by the findings in the subsequent surveys.(ABSTRACT TRUNCATED AT 400 WORDS)

Administration, Inhalation↗

[Social compensation problems of children and adolescents suffering from epilepsy against a background of neural infection].

Five hundred individuals with a history of neural infection in childhood or adolescence have been followed-up. Lower indicators, in particular with regard to academic performance, have been found in persons with CNS pathology, risk factors of epilepsy, and especially in epileptic patients, as compared to clinically healthy subjects. This is explained by psychic and neurologic abnormalities, above all by the presence of the cerebral asthenic, hypertensive CSF syndrome and affective aberrations, as well as by the rate and severity of attacks. The factors contributing to the improvement of social compensation include above all psychoneurologic and pedagogical observation over children with a history of neural infection attended by residual abnormalities, intensification of health education of teachers and parents and adequate individual professional orientation and employment.

Achievement↗

The Hartnup phenotype: Mendelian transport disorder, multifactorial disease.

The Hartnup mutation affects an amino acid transport system of intestine and kidney used by a large group of neutral charge alpha-amino acids (six essential and several nonessential). We compared developmental outcomes and medical histories of 21 Hartnup subjects, identified through newborn screening, with those of 19 control sibs. We found no significant differences in means of growth percentiles and IQ scores between Hartnup and control groups (but all low academic performance scores were found in the Hartnup group, and various skin lesions occurred in five Hartnup subjects), no significant difference between means of the summed plasma values for amino acids affected by the Hartnup gene in Hartnup and control groups, two Hartnup subjects with clinical manifestations--impaired somatic growth and IQ in one, impaired growth and a "pellagrin" episode in the other--who had the lowest summed plasma amino acid values in the Hartnup group; the corresponding values for their sibs were the low outliers in the control group, and two tissue-specific forms of the Hartnup (transport) phenotype: renal and intestinal involvement (15 families) and renal involvement alone (one family), both forms having been inherited as autosomal recessives (the symptomatic probands had the usual form). Whereas deficient activity of the "Hartnup" transport system is monogenic, the associated plasma amino acid value (measured genotype) is polygenic. The latter describes the parameter of homeostasis and liability to disease. Cause of Hartnup disease is multifactorial.

Amino Acids↗

The effect of methylphenidate on school grades in children with attention deficit disorder without hyperactivity: a preliminary report.

Ten children, aged 7-12 years, were diagnosed by DSM-III criteria for attention deficit disorder (ADD) without hyperactivity. Each child was treated with methylphenidate for one academic grading period. School grades were obtained for the grading periods before, during, and after drug treatment. Correlated t tests revealed that academic performance during drug treatment was significantly superior to that during the preceding grading period (p less than .01) and the period following drug treatment (p less than .001). ADD without hyperactivity may represent a potentially drug-treatable disorder in children.

Achievement↗

A survey of parental opinions on corporal punishment in schools.

Forty-three states permit corporal punishment in schools. This practice continues despite the universal opposition of professional organizations, including the American Academy of Pediatrics. This study determines parental attitudes concerning the use of physical punishment in schools. The surveyed sample is drawn from parents of military dependents who brought their children to this clinic for routine physical examinations. One hundred and twenty-nine of 132 questionnaires were returned for a 98% response rate. Fifty-one percent of the parents supported the use of corporal punishment in schools, 37% disagreed (77% of these strongly), 11% had no opinion, and 1% did not respond to the question. Analysis of the responses displayed a relationship between parental attitudes on the use of corporal punishment and opinion of the positive effects of physical punishment on children's behavior (p less than 0.0001). No relationship was found between position on corporal punishment and the respondent (mother, father, or both), the age of parents, the military rank of the sponsor (the individual whose military service makes the child eligible for military medical care, i.e., father, mother, guardian, etc.), the sex of the children, the marital status of the parents, or the schools attended by the children (public or private). Thirty-four percent of parents believed corporal punishment would improve behavior, and 20% of parents felt that physical punishment would improve their child's academic performance.

Achievement↗