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PubMed1981

[Current problems of rehabilitating the handicapped in childhood].

An overview of current problems is accompanied by a clarification of the concepts underlying the terms "handicapped" and "rehabilitation". The main lines of intervention in the rehabilitation of handicapped subjects during the age of growth are explained, with reference to the essential matters involved in diagnosis, organisational structures, rehabilitation methods, and the comprehensiveness of treatment, education and rehabilitation. Conclusions are drawn in connection with the problems still widely discussed in this period, described - for this very reason - a period of reflection and transition. Lastly, note is taken of the many difficulties that impede the solutions, emphasis being placed on the need to sensitize society and coinvolve not only the operators and members of the family, but also all citizens. Sensitisation and involvement of this kind require reciprocal integration between the structures, and control of their planning, establishment in structures, and management at the territory levels.

Adolescent↗
PubMed1981

Parents' experiences and views on being told they have a handicapped child: a survey.

This study examines the experiences of 152 parents of young children with special needs of when and how they were first told of their child's condition and their preferences for being told alone or together with their spouse. The point at which parents were first told differed according to the nature of the child's handicap. The medical profession and allied health services bear the brunt of informing parents. There were no significant variations in parents' experiences of who was told or their preferences for being told together or alone when the five independent variables of child's handicap, residence, child's age family size, and socio-economic status were taken into account.

Age Factors↗
PubMed1982

Denial of emotional needs to people with handicaps.

Much work today focuses on the issue of accessibility for those with a physical handicap of chronic disease. While this is necessary and just, its solution only makes more visible what society as a whole has done and needs to correct, in its dealing with people who have handicaps. As a result of our collective past, those of us with a disability spend much of our time in a continuing effort to reclaim what we have lost - the right to act sexy, get angry, be vulnerable, and have possibilities. While these do not seem like the kinds of things that one person can give to another, they are needs whose satisfaction the rest of society has helped impede and deny.

Anger↗
PubMed1982

Educational intervention with multiply handicapped preschool children.

A study was conducted to objectively measure changes in functioning of multiply handicapped children in a specialized nursery school program. The study population consisted of the 18 children who entered the program in the study year. A quantitative teacher rating scale was developed, tested, and found to be reliable. Significant improvements were demonstrated in interaction, communication, and task orientation after 3 months and in self-care after 6 months. There was no measurable change in motor performance, and the intellectual functioning of the children remained in the same diagnostic category as at the outset. The study documented improvement on social competence of multiply handicapped children enrolled in a preschool program with minimal parental involvement. The teacher rating scale was found to be useful in measuring social functioning in a school setting for a young population with a limited range of possible achievements. Teachers proved to be reliable evaluators of their pupils. To measure social and interactional parameters, it appears necessary to have both a standardized instrument and an informed observer who knows the child's daily functioning.

Child Behavior↗
PubMed1977

Approaches to management of the handicapped infant.

A form of management which has proven helpful in a developmental intervention program for handicapped infants is described. The use of ordinal rather than normative assessments when monitoring the infant's development and when teaching families about their infants is advocated. Two cases demonstrate ways to enhance the functioning of the handicapped infant and his family.

Blindness↗
PubMed1978

Custon handles of dental acrylic to promote self-sufficiency of handicapped patients.

Dental materials lend themselves to a multitude of applications outside the dental profession. The inherent physical properties of dental acrylic (autopolymerizing methyl methacrylate) provide the potential for practical adaptation to a variety of functional problems. A technique using dental acrylic is described, which is easily adapted to a variety of circumstances, enabling digitally handicapped patients to perform independent functions. Specific stepwise instructions are provided for the fabrication of an easily customized acrylic-handled toothbrush and an efficient one-handed knife. The combination of dental acrylic and this flexible technique provides a useful tool in the alteration of appliances for handicapped persons.

Humans↗
PubMed1995

Handicap versus impairment: an important distinction.

In this era of spiraling health care costs, audiologists are being held accountable for the rehabilitative interventions that they are uniquely qualified to deliver. Accountability data in the rehabilitative arena should address the efficacy of short- and long-term treatment. If a treatment such as a hearing aid is dispensed for the purpose of reducing the communicative and psychosocial handicap associated with hearing loss, efficacy data should demonstrate whether such a goal has been attained. Increased attention has been focused on the value of self-assessment questionnaires as instruments that are predictive of candidacy for hearing aids, intent to purchase hearing aids, and outcomes with a given hearing aid treatment. Case studies demonstrate the advantage of engaging the client in the rehabilitative process through the use of responses to self-assessment questionnaires. It is evident that the client's appraisal of the handicapping effect of a given impairment is associated with treatment efficacy.

Adult↗
PubMed1995

[Measurement of total body and leg bone mineral densities by dual energy X-ray absorptiometry in severely handicapped children and adults].

Total body and leg bone mineral densities (BMD) were measured in 42 severely handicapped children and adults using a dual energy X-ray absorptiometry (DEXA) (LUNAR Radiation Corp., DPX). Despite the differences in motor ability and nursing history, about 95% of patients, except for 2 cases, were diagnosed as having osteopenia. The degree of osteopenia was dependent on the motor disabilities of their original disease. Therefore we should bear in mind a precaution and therapy from early period. Because BMD of the legs in females were less than -3 SD of the age-matched control values, we should be careful for a possible fracture of femur. Since X-ray hazard of DEXA for patients is considerable to be negligible, this will provide an effective means for quantifying bone mineral in severely handicapped patients.

Absorptiometry, Photon↗
PubMedDate not supplied

Sexual problems in the psychiatric and mentally handicapped populations.

People with chronic mental disorder, mental handicap or personality disorders may experience difficulties in forming intimate relationships and responding sexually. This review discusses the impact of major psychiatric disorders, mental handicap and substance abuse on sexual maturation and functioning. The significant social, psychological and biological factors are described.

Humans↗
PubMed1994

Parents of children with cerebral palsy in Nordland (county in the north of Norway); factors connected to their quality of life and coping of the circumstances around the handicapped child.

Assessment of quality of life in parents of children with cerebral palsy. Nearly all parents of a group of children in the county of Nordland, Norway, were interviewed. We found their quality of life primarily related to the spouses satisfaction with each other, the degree of mutual openness and the partners (spouses) well-being. To a lesser degree quality of life was related to amount of care and worry for the handicapped child, or to "material factors". These findings should be taken even more into consideration when plans for habilitation are made. Giving parents better possibilities to have good, relating time together, and to give all important information about the handicapped child to them simultaneously seems important in addition to the training and treatment the child receives.

Adaptation, Psychological↗
PubMed1993

Endoscopic removal of foreign bodies in the mentally and physically handicapped.

Although foreign bodies of the gastrointestinal tract are common in children, they are rare in the adult. Complications of the foreign bodies are well recognized to be a cause of obstruction, bleeding and perforation of the intestine, or furthermore, they sometimes lead to death unfortunately. On the other hand, it is very difficult to diagnose and treat foreign bodies in the handicapped because of disability of complaining the symptoms. This paper reports a 31-year-old severe handicapped man suffering from foreign bodies in the esophagus and the small intestine, and was successful removed by endoscope.

Adult↗
PubMed1994

[The medicolegal aspects of informed consent in the dental treatment of the handicapped patient].

The authors reiterate the necessity of informed consent in medical and surgical care. The importance of patient's consent is represented by significance that law grants to the psychic and physical health of the citizen and to his right to be protected. This paper considers the problem of informed consent relatively to the dental therapy of handicapped patient, that can't always undergo an operation in ambulatory and that often needs to be cured with general anaesthesia. The patients causing more difficulties to the doctors, with regard to the acquisition of informed consent, certainly are persons of unsound mind and subjects with sensorial alterations. In fact, for the others, is admitted a volitive and cognitive capacity resembling to their age. Certainly, it's possible to obtain a sufficient management of this patient's category. Finally, the authors underline the importance of prevention to improve dental status of the handicapped, and to avoid increase of patients that come to medical observation when their pathology needs of treatment with general anaesthesia.

Dental Care for Persons with Disabilities↗
PubMed1994

[Penetration of the esophageal and gastric ulcers to the cardioaortic system following hiatus hernia: a lethal complication in the severely-handicapped].

Among the severely-handicapped, hiatus hernia (HH) and/or gastroesophageal regurgitation (GER) are not uncommon. We report here three patients with HH and/or GER. Two of them died of massive hemorrhage in the alimentary tract from the heart or the thoracic aorta due to penetration of the gastric or esophageal ulcer. The third patient died of pneumonia, but autopsy proved multiple esophageal ulcers, one of which reached the wall of the brachiocephalic artery without penetration. We propose that proper treatment for HH and/or GER is required for the severely-handicapped, including surgical intervention, before their general conditions become worse and decompensatory.

Adult↗
PubMed1994

[Psychiatric management of mentally handicapped patients. A systemic model].

The care for mentally handicapped subjects in a geographically, linguistically and socioculturally well defined region of Switzerland (the region "Oberwallis") is described. The care and the treatment are following a systemic model. The mentally handicapped live outside the psychiatric hospital in social integrated housing and working structures, which are established by an autonomous organized association. There exists a close cooperation between this association and the psychiatric hospital, which is integrated in a general hospital. Both institutions, the common theoretical basis and forms of cooperation are described.

Activities of Daily Living↗
PubMed1993

[Evaluation of an intensive therapy program for treatment of severe behavioral disorders in mentally handicapped patients with autistic or psychotic behavior].

The development of severely disturbed and socially accepted behavior in mentally handicapped persons with autistic or psychotic symptoms is documented before, during and after an intensive therapy program conducted in a residential institution for mentally handicapped persons. Seven single case studies were made as long term observation with a duration between 18 and 33 weeks, mostly with a multiple baseline design. One or two follow ups with at least four weeks length were conducted in six out of seven cases up to four years after the end of the intensive therapy. The main results show (1) the decrease of disturbed behavior and the increase of socially accepted behavior during the therapy program, and (2) the significant reduction of the disturbed behavior patterns taking place during the baseline phase before the beginning of the therapy in all cases but one. The results are discussed under the aspects of a possible explanation for the findings and their impact on the discussion about psychotherapy research.

Adolescent↗
PubMed1993

Hepatitis B virus prevalence in two institutions for the mentally handicapped.

A comparative study of the prevalence of hepatitis B virus infection in two institutions for the mentally handicapped was carried out between April and November 1989 and April and August 1991. The institutions were situated within 10 km of each other in north-eastern Johannesburg. One institution had a significantly higher prevalence of virus markers, 68% (139 of 203) compared with 23% (40 of 176), was in poorer condition and had more severely handicapped residents with more aggressive behaviour. However, the most important difference between the two institutions was that residents at the higher-prevalence institution were admitted at a considerably younger age. Younger individuals appear to be more susceptible to infection and are more likely to develop persistent infection, thus contributing to a greater pool of infection in the institution.

Adolescent↗
PubMed1993

[Natural killer cell activity in severely handicapped children: correlation with malnutrition and frequent infections].

We studied natural killer cell (NK) activity in 20 severely handicapped children and investigated the relationship between NK activity and malnutrition. We divided our patients into two groups with regard to frequency of infections: high frequency group (group 1) and low frequency group (group 2). NK activity in group 1 was low in comparison with group 2. Calorie intake and Rohrer's index were lower in group 1. Serum albumin (Alb) and iron (Fe) in group 1 were also lower than those in group 2, and serum zinc (Zn) and hemoglobin (Hb) were slightly lower in group 1. NK activity was positively correlated with calorie intake, Alb, Zn and Hb. Six patients with low NK activity were given supplementary diet; two patients were given protein-enriched diet; three patients were given protein-enriched diet and zinc sulfate; one patient was given increased diet. NK activity rose in 4 patients. These results indicated that the depression of NK activity was associated with frequent infections and correlated with nutritional conditions of the severely handicapped children.

Adolescent↗
PubMed1993

Has the prevalence of handicapped infants increased with improved survival of the very low birth weight infant?

Several methodologic issues affect the literature on the outcomes of very low birth weight children, making assessing trends difficult. A conservative estimate is that the proportion of handicapped survivors has remained stable, and with increasing survival, the absolute numbers will increase, but many studies suggest decreasing proportions with handicap. Suggestions for improving responses to the questions are proposed.

Persons with Disabilities↗