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PubMed1990

Education and epilepsy: assessment and remediation.

Learning difficulties in children with epilepsy may be caused by brain damage and should be investigated. In many cases, however, seizures and/or electroencephalographic (EEG) findings are the only signs of pathology. Frequency and type of seizures may be determining factors that should, if necessary, be evaluated by long-term EEG monitoring, preferably during school performance or in conjunction with neuropsychological assessment. This may prove that subclinical epileptiform discharges in the EEG can adversely affect the child's performance. Secondary psychological problems in epilepsy patients, combined with side effects of antiepileptic drugs, may cause or heighten learning problems. Prophylactic control of seizures with one appropriate drug may alleviate learning problems. Computerized neuropsychological testing with simultaneous EEG recording may reveal the influence of epileptiform discharges on cognitive function and also help to evaluate the effects of antiepileptic drugs. Objective assessment of subclinical epileptiform activity makes it easier to treat the pathology identified by the EEG with optimal dosage of the most appropriate drug. A balance is required because epileptiform discharges and even occasional seizures may be less disabling than side effects from large doses of several drugs. Information to the school and the parents concerning the patient's abilities and limitations may be as important as seizure control. Specialized teaching should be started early, when necessary, with the patient integrated into a normal school if possible. However, good functioning in a special school is preferable to marginal functioning in a normal school.

Attention Deficit Disorder with Hyperactivity↗
PubMed1985

Suicidal behavior at school: a systemic perspective.

This article delineates the interpersonal function of suicidal behavior in children. Children's suicidal attempts have a major impact on their immediate surroundings and can be perceived as a mode of controlling the family or school. In order to highlight this approach, a case of epidemic suicidal attempts in a special education high school is presented. A systemic mode of intervention, consisting of an adolescents' group and a teachers' group within the school system, is described. The importance of implementing systemic modes in preventing suicide is outlined.

Adolescent↗
PubMed2006

Childhood functional gastrointestinal disorders: neonate/toddler.

Recognizing the importance of childhood functional gastrointestinal disorders in understanding adult functional gastrointestinal disorders, and encouraging clinical and research interest, the Rome Coordinating Committee added a pediatric working team to Rome II in 1999. For Rome III, there was an increase from 1 to 2 pediatric working teams. This report summarizes the current consensus concerning functional disorders in infants and toddlers. Another report covers disorders diagnosed more often in school-aged children and adolescents. The symptoms from functional gastrointestinal disorders in children younger than 5 years depend on maturational factors in anatomy, gastrointestinal physiology, and intellectual and affective functioning. There has been little or no change for infant regurgitation, infant rumination syndrome, or infant dyschezia. Cyclic vomiting syndrome may be diagnosed after 2 rather than 3 episodes. The description of infant colic has been expanded, although there was consensus that infant colic does not reflect gastrointestinal malfunction. The greatest change was in functional constipation. Functional constipation and functional fecal retention in the 1999 report were merged into a single entity: functional constipation. Data-driven changes in diagnostic criteria for functional constipation appear to be less rigid and more inclusive than previous criteria.

Child, Preschool↗
PubMed2001

Zinc and cognitive development.

Cognition is a field of thought processes by which an individual processes information through skills of perception, thinking, memory, learning and attention. Zinc deficiency may affect cognitive development by alterations in attention, activity, neuropsychological behavior and motor development. The exact mechanisms are not clear but it appears that zinc is essential for neurogenesis, neuronal migration, synaptogenesis and its deficiency could interfere with neurotransmission and subsequent neuropsychological behavior. Studies in animals show that zinc deficiency during the time of rapid brain growth, or during the juvenile and adolescent period affects cognitive development by decreasing activity, increasing emotional behavior, impairing memory and the capacity to learn. Evidence from human studies is limited. Low maternal intakes of zinc during pregnancy and lactation were found to be associated with less focused attention in neonates and decreased motor functions at 6 months of age. Zinc supplementation resulted in better motor development and more playfulness in low birth weight infants and increased vigorous and functional activity in infants and toddlers. In older school going children the data is controversial but there is some evidence of improved neuropsychological functions with zinc supplementation. Additional research is required to determine the exact biological mechanisms, the critical periods, the threshold of severity and the long-term effects of zinc deprivation on cognitive development.

Adolescent↗
PubMed2005

Children with unexplained chronic pain: substantial impairment in everyday life.

AIMS: To describe and quantify impairment in an outpatient population of children with chronic pain of unknown origin (UCP). METHODS: A total of 149 children who presented with pain of at least three months' duration and without a satisfactory explanation at presentation were studied. Number of somatic complaints (Children's Somatisation Inventory, CSI), pain intensity (VAS, 0-10 cm), functional disability (Child Health Questionnaire (CHQ-CF) and clinical history), and general health perceptions (CHQ) were determined. RESULTS: Mean age of the children was 11.8 years; 73% were girls. Overall, 72% suffered impairment in sports activities, 51% reported absence from school, 40% experienced limitations in social functioning, and 34% had problems with sleeping. Mean number of somatic symptoms differed significantly between boys (8.4) and girls (10.7). The CHQ-CF scores for physical functioning, role/social functioning, and general health perceptions were 76.4, 70.7, and 57.5, respectively, indicating substantial impairment on all domains. The mean pain intensity was 4.7 for current and 7.1 for worst pain. Children solely evaluated by a general practitioner prior to referral reported less, though still substantial, impairment. Low general health perceptions, impaired role/social functioning, high pain intensity, and having headache or musculoskeletal pain were independent predictors of having significant impairment. CONCLUSIONS: Referred children with UCP show substantial impairment on multiple domains in daily life.

Activities of Daily Living↗
PubMed2007

Clarifying the associations between language and social development in autism: a study of non-native phoneme recognition.

Autism spectrum disorders (ASDs) are characterized by correlated deficiencies in social and language development. This study explored a fundamental aspect of auditory information processing (AIP) that is dependent on social experience and critical to early language development: the ability to compartmentalize close-sounding speech sounds into singular phonemes. We examined this ability by assessing whether close-sounding non-native language phonemes were more likely to be perceived as disparate sounds by school-aged children with high-functioning ASD (n = 27), than by unaffected control subjects (n = 35). No significant group differences were observed. Although earlier in autistic development there may exist qualitative deficits in this specific aspect of AIP, they are not an enduring characteristic of verbal school-aged children with ASD.

Asperger Syndrome↗
PubMed1966

Distribution and function of genes concerned with aromatic biosynthesis in Escherichia coli.

Pittard, James (School of Microbiology, University of Melbourne, Victoria, Australia), and B. J. Wallace. Distribution and function of genes concerned with aromatic biosynthesis in Escherichia coli. J. Bacteriol. 91:1494-1508. 1966.-A number of mutant strains of Escherichia coli K-12, which are blocked in the biosynthesis of the aromatic amino acids, were examined biochemically to determine their particular enzymatic deficiencies. The mutations carried by these strains were mapped by use of the methods of conjugation and transduction. Structural genes for five of the enzymes of the common pathway leading to chorismate and for the two enzymes converting chorismate to phenylpyruvate and p-hydroxyphenylpyruvate, respectively, were identified. Unlike the genes of the tryptophan operon most of these genes are distributed over widely separated regions of the chromosome.

Amino Acids↗
PubMed2005

A clinical rating scale for Batten disease: reliable and relevant for clinical trials.

BACKGROUND: Batten disease (juvenile neuronal ceroid lipofuscinosis [JNCL]) is an autosomal recessive neurodegenerative disorder characterized by blindness, seizures, and relentless decline in cognitive, motor, and behavioral function. Onset is in the early school years, with progression to death typically by late adolescence. Development of a clinical instrument to quantify severity of illness is a prerequisite to eventual assessment of experimental therapeutic interventions. OBJECTIVE: To develop a clinical rating instrument to assess motor, behavioral, and functional capability in JNCL. METHODS: A clinical rating instrument, the Unified Batten Disease Rating Scale (UBDRS), was developed by the authors to assess motor, behavioral, and functional capability in JNCL. Children with verified JNCL were evaluated independently by three neurologists. Intraclass correlation coefficients (ICCs) were used to estimate the interrater reliability for total scores in each domain. Interrater reliability for scale items was assessed with weighted kappa statistics. RESULTS: Thirty-one children with confirmed JNCL (10 boys, 21 girls) were evaluated. The mean age at symptom onset was 6.1 +/- 1.6 years, and the mean duration of illness was 9.0 +/- 4.4 years. The ICCs for the domains were as follows: motor = 0.83, behavioral = 0.68, and functional capability = 0.85. CONCLUSIONS: The Unified Batten Disease Rating Scale (UBDRS) is a reliable instrument that effectively tests for neurologic function in blind and demented patients. In its current form, the UBDRS is useful for monitoring the diverse clinical findings seen in Batten disease.

Adolescent↗
PubMed1999

School refusal: issues of conceptualisation, assessment, and treatment.

Developments in the assessment and treatment of school refusal have often been hampered by a failure to recognise its essentially heterogeneous nature. This paper provides a review of major conceptual complexities that have helped to undermine developments in clinical practice. In particular, it considers the distinction between school refusal and truancy, and school phobia and separation anxiety. Common approaches to the assessment and treatment of school refusal are outlined. Although behavioural and cognitive behavioural approaches are now widely accepted as central to treatment, it is increasingly recognised that individually tailored programmes, utilising a range of approaches, are most likely to prove successful. An approach focusing upon the functions, rather than the symptoms, of school refusal is advocated as having most promise for assessment and the subsequent formulation of individual prescriptive treatment.

Adolescent↗
PubMed1983

Vitamin and mineral supplementation in Down's syndrome.

The claim that large, nonspecific doses of vitamins and minerals improve the performance of mentally retarded children has recently reappeared in both the scientific literature and the public media. This hypothesis was examined in a double-blind, case-control study involving 20 home-reared children with Down's syndrome between 5 and 13 years of age. Children were randomly assigned by matched pairs to either a vitamin/mineral group or placebo group for an 8-month study period. No significant group differences or suggestive trends were found in any tested area of development or behavior, including intelligence (IQ), school achievement, speech and language, and neuromotor function. No group differences in appearance, growth, or health were seen. No support was found for the orthomolecular hypothesis in school-aged children with Down's syndrome.

Adolescent↗
PubMed2003

Neuropsychological functioning after surgery in children treated for brain tumor.

OBJECTIVE: To describe the neuropsychological functioning of children treated with surgery only for localized brain tumors in Dana-Farber Cancer Institute Protocol 92-077. Subsequent reports will describe the neuropsychological functioning of children treated with surgery and stereotactic radiation therapy on Dana-Farber Cancer Institute 92-077. METHODS: The intellectual functioning of 106 patients was evaluated within 3 months after surgery. An in-depth assessment of the neuropsychological functioning, including an impairment index, was conducted for a subset of 77 school-age children (6-16 yr old) across six functional domains. Descriptive statistics were generated; binomial distribution analyses were performed to assess whether the proportion of individuals with impaired performance on each measure exceeded normative expectations. The impairment index assessed whether poor performance was attributable to a few children or reflected the performance of the cohort as a whole. RESULTS: Although the Full Scale IQ was within normative expectations, the Verbal IQ was higher than the Performance IQ with 45% of individuals showing a significant discrepancy (P < 0.01) between these scales. There was an increased prevalence of poor performance for measures of motor output, verbal memory, and visuospatial organization. The distribution of the impairment index indicated moderate impairment across the school-age cohort rather than severe impairment in a few patients. CONCLUSION: The results document a moderate level of neuropsychological morbidity among children with brain tumors before stereotactic radiation therapy, presumably referable to the tumor itself and the surgery. The extent to which stereotactic radiation therapy may increase this burden will be assessed in follow-up studies evaluating the longitudinal neuropsychological data.

Adolescent↗
PubMedDate not supplied

The peer group as a context: moderating effects on relations between maternal parenting and social and school adjustment in chinese children.

This 2-year longitudinal study examined, in a sample of Chinese children (initial M age = 11 years), the moderating effects of the peer group on relations between maternal supportive parenting and social and school adjustment. Data were collected from multiple sources including peer assessments, teacher ratings, school records, and maternal reports. It was found that whereas group prosocial-cooperative functioning strengthened the role of supportive parenting in helping children develop social and school competence, group antisocial-destructive functioning undermined the contributions of supportive parenting to children's social and academic achievement. The results indicated the significance of the peer group as a social context for socialization and development in Chinese children.

Child↗
PubMedDate not supplied

[Cognitive evaluation in illiterate persons].

INTRODUCTION: Approximately a third of the world population is illiterate. The analysis of illiterate patients' performance in cognitive tasks is an important part of neuropsychology. OBJECTIVE: To show that cognitive evaluation tests, both psychological and neuropsychological, are extremely sensitive to the educational level of the subject. DEVELOPMENT AND CONCLUSIONS: It has been suggested that schooling may in some way modify the cerebral organization of cognitive activity. Although education does not alter the hemisphere dominance of language and other cognitive functions, there does seem to be increased lateralization of these functions in literate people. In neuropsychological testing, schooling is an even more significant variable than age. However, education does have a lineal effect on the scores obtained in neuropsychological tests. More precisely, the relationship between schooling and performance of neuropsychological tests shows an negatively accelerated curve.

Adolescent↗
PubMed2006

Recurrent abdominal pain: what determines medical consulting behavior?

Recurrent abdominal pain (RAP) is associated with increased health care visits and school absences. In adults suffering from functional pain, psychosocial factors determine illness behavior and we aimed to investigate its role among children. A community sample of 40 RAP consulters, 41 RAP nonconsulters, and 36 pain-free controls and their mothers completed questionnaires on GI and non-GI symptoms, school absences, psychological symptoms, coping, self-esteem, and behavioral and cognitive responses to RAP. T-tests showed significant differences between RAP and controls in (1) GI and non-GI symptoms and school absences, (2) child distress and passive coping, and (3) mother's IBS severity, somatization, and fears about RAP. RAP consulters reported the same levels of GI symptoms and psychological distress as nonconsulters but missed significantly more school and their mothers reported more fears about RAP. Severity of symptoms and psychological distress did not predict consulting behavior. Only maternal fears about abdominal symptoms differentiated consulters from nonconsulters.

Abdominal Pain↗
PubMed1997

Geroprosthodontics: The Nijmegen and Manchester Dental Schools approach.

If quality of care for elderly patients is to be achieved, thorough and realistic geroprosthodontic treatment planning is essential. This requires mature consideration, incorporating comprehensive patient assessment and selection of the most appropriate treatment option for each patient. The latter should be based on criteria which meet the demands of a healthy dentition and which enable a patient to achieve satisfactory oral function. The Nijmegen and Manchester Dental Schools have evolved simple patient-related treatment guidelines. These start with a problem-oriented approach which leads to a provisional treatment. The provisional treatment is intended to result in a healthy dentition that is monitored over an appropriate period. Evaluation of the provisional treatment leads to three options: extension of the monitoring time, preservation of the natural occlusion or loss of the natural occlusion. Definitive prosthodontic treatment plans are based on the second or third option. In the maintenance of good oral health after prosthodontic treatments, plaque and diet control are essential elements. Recall or maintenance programmes must be carried out if successful treatment is to be achieved and maintained.

Aged↗
PubMed1986

Respiratory function in aboriginal children.

One hundred and fifty-one Aboriginal school children and 246 non-Aboriginal children, all aged between 11 and 15 years, performed lung function tests with a Vitalograph spirometer. The results showed that the mean forced vital capacity was 20% larger in non-Aboriginal children of both sexes. Similar differences were found for the one-second forced expiratory volume, which was 15% larger for the non-Aboriginal boys and 17% larger for the non-Aboriginal girls. Comment is made on their smoking practices.

Adolescent↗
PubMed2001

Nursing inputs to special schools in N. Ireland.

Children attending special schools often have healthcare needs that require ongoing medical and nursing care. Two postal surveys were undertaken of 47 special schools in N. Ireland to determine the type of contact they had with nurses and the functions they fulfilled. Responses were received from 42 school principals and from the 11 Health and Social Service Trusts responsible for nursing services. It was found that nurses were based in nine of 42 schools while the remaining schools depended on a range of different visiting nurses. The nurses were involved in 'hands-on' tasks as well as giving advice and training to school personnel. Further research needs to define more closely the nursing needs of these pupils as well as evaluating the differential benefits of various nursing services to schools and how their inputs can be coordinated with those of other health professionals.

Attitude to Health↗
PubMed2003

Changing schools, changing health? Design and implementation of the Gatehouse Project.

PURPOSE: To describe the Gatehouse Project which addresses the social context of high school with an aim of changing students' sense of school connection and in turn, health risk behavior and well-being. METHODS: Distinguishing features of the project were its conceptual framework, implementation process, and evaluation design. The conceptual framework derived from attachment theory and focused on three aspects of the school social context: security, communication, and participation. Implementation was standardized around a survey of the school social environment, creation of a school-based action team, and the implementation of strategies matched to a school's profile of need. In addition, an early high school curriculum addressed the skills relevant to social functioning and emotional adjustment. The evaluation design was based on a cluster randomized trial involving 26 schools. It used follow-up of an individual cohort and repeat cross-sectional surveys to capture outcomes at an individual student and whole-school level. RESULTS AND CONCLUSIONS: The Gatehouse Project drew on both health and education research to develop and coordinate a broad-based school health promotion intervention. It represents a promising new direction for school-based preventive work.

Adolescent↗