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PubMed1985

Cerebral palsy and additional handicaps in a 1-year birth cohort from northern Finland--a prospective follow-up study to the age of 14 years.

In a 1-year birth cohort from the two northernmost provinces in Finland, Oulu and Lapland which comprised of 12 058 liveborn infants, the total number of children affected with cerebral palsy (CP) was 69. The cumulative incidence up to the age of 14 years was 5.7 per thousand. A prenatal aetiology was present in 32%, a perinatal aetiology in 36% and a postnatal aetiology in 19% whereas in 13.0% of the cases the cause remained untraceable. A total of 50 children (73%), had 1 or more additional handicaps. Mental retardation (IQ less than 85) was present in 70%, epilepsy in 48%, a visual defect in 19% and impaired hearing in 7%. The impact of the total handicaps is also illustrated by the fact that only 33% of the children were able to attend a normal school. The incidence of 5.7 per thousand recorded here is clearly higher than in studies from several other countries, as the cumulative incidence is usually reported to vary between 2 and 3 per thousand.

Abnormalities, Multiple↗
PubMed1985

The nutritional care of people with mental handicap.

An introduction to the changing field of mental handicap and to possible roles for the dietitian in this field illustrated with specific examples from clinical practice. The dietitian who specialises in mental handicap may work in both institutional and community settings and with all ages. Current views on prevention, treatment and rehabilitation are reviewed.

Adult↗
PubMed1969

The organically handicapped child. How can the family physician help?

The better his understanding of some of the ways in which an organic deficit might affect normal development of the handicapped child, the more able the family physician will be to offer guidance to the family aimed at preventing the development of secondary problems. He can thus be instrumental in helping a child achieve his maximal potential.First, it is important to take into account how the parents' emotional and intellectual responses to having a defective child may interfere markedly in normal parent-child relationship. Second, ways in which each deficit will limit a child's exposure to stimuli must not be over-looked. Third, one must consider how a deficit may indirectly distort the normal learning patterns when parents do not make age appropriate demands. Fourth, it is important to understand how specific interference in the area of language skills may cause further developmental retardation. Fifth, one must be aware of special problems that an organically handicapped child must face in the society outside of the family. Last of all, in an older child, one must consider the need for a full scale evaluation to sort out primary and secondary factors in the picture.

Blindness↗
PubMed1979

[The physician faced with the mentally handicapped and his family].

In his work in the field of mental retardation, the physician is exposed to his vivid emotive reactions. He risks either to withdraw in a scientific relation or to identify himself with either family's members. The physician must learn to join with a pluridisciplinary team, to build up his emotional impulses, to answer to the needs of the mental handicapped and his family and to estimate the evolutive potential rather than the deficits. He must be conscious that the handicapped and his family are called, in an imperative manner, to resolve many tasks: they must not only confront themselves with many specialists (doctors, teachers, educators, logopedists, physiotherapists) and many Services, but also overcome the shock of the diagnosis and build, on the existential plan, a new life.

Adaptation, Psychological↗
PubMed1979

[How to seize and rate a social hearing handicap caused by hearing disorders (author's transl)].

A psychological test to size the quantitative social hearing handicap was developed by High and Fairbanks as a normative anemnesis. The splitting of the social hearing handicap index (SHHI) in the components of deafness and selection ability shows the importance of the selection ability for social hearing. Comparing the pure tone audiogramm with the SHHI of 54 patients demonstrates the low correlation of the audiogramm with the SHHI and especially its selection component. Only when the hearing loss is severe the selection component will correspond to the threshold.

Audiometry↗
PubMed1979

The learning-disabled juvenile delinquent: a case for early intervention of perceptually handicapped children.

The relationship between learning disabilities and juvenile delinquency is examined from an historical perspective as well as from the author's investigations. The majority of studies suggest that learning disabilities occur with significant frequency in delinquent populations. Perceptual disorders can be a significant cause of academic underachievement and poor social adaptation among youthful offenders. Preliminary results of an investigation of the learning-disabled delinquent confirm that the perceptually handicapped child is at high risk for developing these behavioral problems. As one of the first professionals who may be involved in the evaluation and treatment of the perceptually handicapped child, the occupational therapist is a key person in effecting early intervention. Early intervention is considered of prime importance as one preventive measure of juvenile delinquency.

Adolescent↗
PubMed1975

[Programmed typing in a school for the physically handicapped - testing a new audiovisual learning system (author's transl)].

Within the framework of a test performed at a school for the physically handicapped, 10 pupils with disabilities varying in type and degree of severity completed a typing programme which was adapted to their individual physiological possibilities. The deliberate use of audiovisual media contributed both to an adaptation to the disability, motivation of the pupils and intensification of the learning process. The assessment of the test results illustrated the success rates which can be expected if such a learning programme is carried out with physically handicapped pupils.

Adolescent↗
PubMed1984

Low birthweight and neurodevelopmental handicap.

There appears to be no doubt that where there is supportive obstetric care and intensive neonatal care, the long-term outlook for the very preterm infant has improved dramatically since the 1950s. However, the rate of neurodevelopmental handicap in these children is still unacceptably high when compared with term infants. To improve their outlook, modifications of obstetric and neonatal care, particularly in relation to the prevention of hypoxic, traumatic and biochemical insults, must continue to be introduced and tested until more fundamental research determines the mechanisms underlying preterm labour, and makes more effective prevention and treatment of preterm labour possible. Those infants who have suffered IUGR, certainly when it has been severe, never achieve their full intellectual potential. It is already recognized that some of the associated problems of IUGR cause handicap. Intrapartum hypoxia/acidosis, neonatal hypothermia, hypoglycaemia, polycythaemia and hyperbilirubinaemia for example, should be identified and appropriate action taken to prevent their effects. Further research is required to determine what duration and character of IUGR alone influences intellectual development before intervention in these pregnancies can be investigated.

Acidosis↗
PubMed1982

Vaccinations and the physically handicapped child.

The vaccination status of 98 physically handicapped children was examined to identify factors associated with an inadequate vaccination status. Of the 98 children, 57 had cerebral palsy, 14 had myelomeningocele, 3 had muscular dystrophy and 24 had myelomeningocele, 3 had muscular dystrophy and 24 had other motor disabilities. According to the available vaccination records, only 17 children had received all the recommended injections on schedule; 26 had missed at least one injection, and 3 of them had never been vaccinated. The overall rate of vaccination in our study group (63%) was lower than expected. The children with moderate to severe limitation of function due to cerebral palsy were significantly less likely (P less than 0.05) than those with less severe limitations to have received a basic series of vaccinations. Health departments must ensure that physically handicapped children receive the preventive health measures viewed normal and appropriate for other children.

Adolescent↗
PubMed1982

Dental care for the handicapped adolescent.

A total of 932 physically, mentally and multiple handicapped children, including many adolescents, were examined at their special schools in a mobile dental unit, during a 4-year pilot period, and 744 were treated. Their dental needs were compared with those of 450 children at normal schools. Although a greater proportion of handicapped children were caries-free, more required extractions and periodontal treatment. In the group aged 12-16 years there were more decayed teeth, more missing teeth and fewer fillings than in the controls of the same age. Over 90 per cent of the 744 children were treated satisfactorily in the mobile clinic, cooperation being acceptable in 79 per cent. Only 2 per cent were totally uncooperative and required a general anaesthetic, even for an examination. In total, 8.5 per cent of the children received some treatment under general anaesthesia. Treatment should aim to create understanding by adolescent or parent of good dental health, to obtain oral health, to create the most pleasing appearance possible, to encourage acceptance of further treatment and, where possible, to involve adolescent patients by providing treatment along normal lines.

Adolescent↗
PubMed1983

Routine rehabilitation procedures in auditory communication handicap.

A well known fact and an established experience in all audiological units, handling large groups of hearing loss patients is, that in many of them (15% or more?) - mostly having severe, but occasionally moderate hearing loss - the conventional audiological rehabilitation programme (hearing aids, special devices, functional training etc.) cannot adequately compensate for their communication handicap, i.e. they constitute problem cases, and consequently also a challenge to research. This experience gained through many years, but certainly also, in addition, the cochlear implant discussion during the last decade, emphasizing the "deaf patient", have focused our interest on this large, but heterogeneous patient group, whose common basis is that the patients consider themselves "deaf" or "almost deaf". The handling of these patients, of course, requires a multidisciplinary approach with a broad program of diagnostic and therapeutic measures. The activities presented in this supplement is meant to be one step in the direction of finding a suitable structure in Stockholm to adequately handle patients with auditory communication handicap.

Communication Devices for People with Disabilities↗
PubMed1983

Motor assessment tools: their concurrent validity in evaluating children with multiple handicaps.

Three developmental motor assessment tools were administered concurrently to 17 children with severe multiple handicaps in an effort to examine the relationship of developmental age equivalent scores among the 3 tools. The Bayley Scales of Infant Development, a standardized and norm-referenced infant assessment tool, was used as criterion for concurrent validity in evaluating the other 2 tools, the Callier-Azusa Scale and the Fircrest Deaf-Blind Motor Assessment Tool. In spite of variations in quantity and type of behaviors assessed on each of these 3 instruments, highly significant positive correlations were shown between age equivalent scores on the Bayley and those on each of the other 2 tests. These findings support the application of objective, quantifiable measurement tools for determining developmental motor age levels of severely disabled children with multiple handicaps.

Adolescent↗
PubMed1984

[Damage pattern in 419 handicapped children in one region].

Report about 419 children with handicaps, born 1966-1980 in one territory. 9.8 per cent of these 419 children have a severe damage, not able for education. 11.9 per cent have a moderate damage and 78.3 per cent a mild one. The mental retardation is combined with damage of senses, cerebral palsy and seizures. Frequency of children with handicaps seems to decrease in the last years.

Adolescent↗
PubMed1983

[The mentally handicapped child and his family].

Three points concerning the mentally retarded child's family and the physician's attitude towards this family are addressed. The first concerns disclosure of the handicap to the parents, which can take place only once the diagnosis is established without equivocation. Genetic counseling, or more pragmatically the reproductiveness of the handicap, is the second point. A thorough investigation of possible etiologies is warranted in all cases in order to try to answer the distressing question: "are the children to be born at risk?". An attempt at a classification based on reproductiveness is proposed. The third point is the future. Should the child remain with it's family or be placed in an institution? This decision is the parents and not the physician's. However, the physician should discuss this problem with the parents to enable them to voice their desires and their anxiety.

Family↗
PubMed1980

Dentistry for physically handicapped children in the International Year of the Child.

The dental profession has responded to the challenge of the increasing number of physically handicapped children. Originally, the emphasis was on how the physical disability prevented the delivery of dental treatment. Now, it is recognized that preventive care is the only answer to the problem. It is suggested that eventually all children, irrespective of their handicap, will be best treated in general dental practice.

Child↗
PubMed1980

[Performance behaviour of the physically handicapped. Selected approaches and a comprehensive skeleton concept (author's transl)].

The article shows that psychology's current situation with its confusing variety of theories and methods and, accordingly, heterogeneous examination findings, is also reflected in the discussion about the performance behaviour of the physically handicapped. This fact made it necessary to apply different concepts of the so-called normal psychology to this particular field. On the basis of limited approaches which place organic impairments - perceptual disorders and motor disturbances due to organic brain damage - in the foreground, a description of other research lines is crried out, which not only permit the taking into account of the performance aspects, but also motivational, interpersonal and social viewpoints. The continuous expansion of this field of consideration results in a skeleton concept which encompasses the whole of the person-environment relations and not only individual and isolated fields. In this connection the methodical consequences of this concept, i.e., the attempt to create biotic study situations, are discussed. It is hoped that in the future such new psychological approaches will also assist in the practical study of problems of the physically handicapped.

Brain Damage, Chronic↗
PubMed1980

[Statistical studies on caries in handicapped children].

The prevalence of caries in 108 mentally and physically handicapped children between the ages of 6 and 16 was determined in a clinical study. The prevalence of caries in residual teeth was extremely high, 100% higher than in the healthy control group. Caries-free dentition was not observed. The oral hygiene was totally inadequate in 94% of the children examined. The state of dental care for these patients was unsatisfactory. It was shown that directed prophylaxis is a necessity with handicapped children.

Adolescent↗
PubMed1980

The physically handicapped child--is active management justified?

Deformities can either be congenital in origin or acquired after an accident or particularly after extensive surgery for malignant disease. Many congenital anomalies, especially if associated with Down syndrome, or when major residual handicaps are anticipated, raise the ethical question of whether or not to treat them initially. The effect of major handicaps on the child, family and society are discussed. Certain congenital anomalies can now be prevented by amniocentesis and termination of pregnancy in the high-risk group, and some of the acquired deformities can also be prevented to a certain extent. Lastly, some aspects of the legal situation are mentioned.

Congenital Abnormalities↗