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Language screening as a factor in the management of the pediatric otolaryngic patient. Effectiveness and efficiency.

The Early Language Milestone Scale, a screening test for language in children from birth to 36 months of age, was applied to the total population of pediatric otolaryngic patients. Ninety-seven percent of the patients were found to have a completed screen. Thirty percent of the patients failed one or more portions of the Early Language Milestone screen. Practice management was modified by the results of the Early Language Milestone in all the patients who failed the screen. The Early Language Milestone was found to be efficient and effective in contributing to the management of the children with pediatric otolaryngic disorders and diseases.

Child, Preschool↗

Development of an eating disorder in a 40 year-old male lung transplant candidate: a case study.

This paper presents the treatment of a lung transplant candidate suffering from an eating disorder who refused communication between the Eating Disorders Clinic and the transplant team. The importance of psychiatric evaluation in transplantation and the need for the free flow of information among all health professionals working with the transplant patient are discussed. Explanations are proposed for the role of dieting in the development of the eating disorder and the patient's continued food restriction, vomiting, and laxative abuse after transplantation.

Adult↗

Would control of childhood infectious diseases reduce malnutrition?

Infectious diseases and especially diarrheal diseases have been noted to have an adverse effect on the growth of underprivileged children in developing countries. Diarrheal diseases have been estimated to account for 10-80% of growth retardation in the first few years of life, with the magnitude of effect possibly modified by other factors, such as the adequacy and source of dietary intake, treatment and feeding practices during and following illness and the opportunity for catch-up growth after illness. In the only study in which infectious diseases and routine dietary intake have been evaluated simultaneously, inadequate dietary intake rather than infectious diseases, was found to have the predominant role in growth faltering. Although reduction in infectious diseases is desirable for many reasons, the relative feasibility and cost of this approach to improve nutritional status must be compared with more direct nutrition interventions.

Child↗

Toe walking. A marker for language disorders in the developmentally disabled.

Toe walking unassociated with an autistic disorder or cerebral palsy generally has been considered a normal infant gait. The incidence of toe walking in various diagnostic subgroups of 799 developmentally disabled children presenting to a tertiary-level multidisciplinary assessment clinic was reviewed to investigate the authors' clinical impression that toe walking may be a marker for language dysfunction. Toe walking was found to be more frequent in those diagnostic subgroups with more severe language disorders. Toe walking also correlated with lower IQ scores (p less than 0.0001). The sensitivities, specificities, predictive validities and odds ratios all supported the hypothesized association between toe walking and language disorders. Further prospective studies of the neurodevelopmental outcome of children with toe walking are needed to determine whether this behavior can identify children at risk for language disorders.

Autistic Disorder↗

Understanding dysfunctional and functional family behaviors for the at-risk adolescent.

At-risk adolescents and their impact on families and society, as well as characteristics of both healthy and maladaptive families, are discussed. Cognitive distortions of dysfunctional adolescents and their effect on family members, along with methods for intervention and creating more healthy environments, are delineated from a systemic viewpoint.

Adult↗

Predicting length of service provision in school-based occupational therapy.

Parents and school administrators commonly ask how long a child is likely to need school-based occupational therapy services. In an effort to provide a statistically supported answer, a record review of 464 cases of students discharged from school-based occupational therapy services in the past 7 years was performed. This review demonstrated that some general statements about service patterns could be determined for this particular caseload. Of note was the significant variability in length of services for students with multiple disabilities as compared to the more discrete length of service provision for students with speech impairments, learning disabilities and those students without a specific classification. The applicability to other practice settings is limited, but this study serves as a beginning point for discussion on the topic.

Adolescent↗

Autism: current understanding and management.

Autism is now generally considered to be an organic neurodevelopmental disorder. This review considers the current understanding of genetic factors and associated medical conditions, together with a discussion of some aspects of management and treatment of affected children and adolescents.

Adolescent↗