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PubMed1979

[Psychological problems of parents and therapists in the early education of physically handicapped children].

The traumatic experience of the child's handicap creates psychological problems not only for the parents, but also for the therapists involved in early stimulation. Since successful stimulation can be hindered by these difficulties, it is importnat that they are recognized as early as possible, and minimized by appropriate responses from the personnel involved. A prerequisite to overcoming these difficulties is therefore the training of professional staff in the areas of psychodynamics and self-experience.

Child↗
PubMed1979

[Schooling of mentally handicapped children].

It is difficult to describe a living thing in such a way that it doesn't lose its life by the very description. The author tries to accomplish this by means of an unsystematic report of a case: Some fundamentals to the life in the special school for mentally handicapped in Biel are presented. Every human being is unique and can only be understood in his totality. His Ego is intact and can be addressed in every case. Therefore, categories appear as conventions rather than facts. They indicate the general rather than the unique and therefore, they are of secondary importance. Children in special schools have difficulties to adapt to the school. Therefore, their school has to adapt itself to them with much awareness and imagination. Language has a great potential to stimulate development; it plays an important part in the school. The teaching must be elementary and concrete, it must touch "head, heart, and hand" (Pestalozzi). The special school as a living space has to be rich and stimulating with respect to building, environment, and practical activities, because one has to bring the world to the child when his ability to reach the world is impaired. The situation for all children improves when the adults make efforts to develop forms of living together worthy of human beings. Too rigid rules paralyze the natural forces governing human interaction and make them useless.

Child↗
PubMed1978

[Health and handicaps in the population older than 65 years of age in Basel and Bern].

A preliminary communication is made about an epidemiological survey concerning the habits and problems of the elderly in Switzerland. Special interest is given the aspects of health and competence in the activities of daily life. Data about self-rated health status as well as degree of restriction in the activities of daily life are presented. No sex differences were found in these two dimensions. When looking at the different age groups, perceived health does not vary with age, whereas the frequency of self-rated dependency is nearly eight times higher among those aged 85 + (55.5%) compared to those aged 65--74 (7.4%). Further analyses will test hypotheses about selective mortality, sex role and adaptation to different types of handicaps.

Aged↗
PubMed1981

[Institutional care of severely handicapped - how does it happen? - or: can the patient's career be influenced?].

The project "Analysis of the placement of handicapped in institutions from a social point of view (example: multiple sclerosis); has the objectives to improve knowledge about the situation of institutionalized MS-patients and to analyse the patient's way towards institutionalization. As far as this way is concerned, numerous examples show that the evolution of social factors in a wider sense is at least as important as the evolution of the medical factors. With regard to these social factors, the problem solving processes both of the patients and of their aides, professionals or not, are of primary importance together with the problem of being in control of the situation. Repression of the illness and uncertainty about the future are both barriers towards the search for new aims of life. Often, help is asked for in a moment when a great number of possible solutions for the problem are not anymore feasible. Furthermore, the "unique" patient is confronted with the well-tested problem solving process of the aide and thus, his own initiative is reduced and his dependency increased. These mechanisms do also exist within an institution where they have a major impact upon quality of life and influence it much more than the visible structure of the institution, e.g. buildings and equipments.

Community Health Services↗
PubMed1999

Dietary zinc intake of a group of long-stay mentally handicapped women: some bioavailability considerations.

Dietary factors affecting zinc bioavailability were evaluated according to their relative distribution in the individual daily meals making up the basic diet of 17 institutionalized, mentally handicapped adult women. Mean intake values of zinc, phytate, nonstarch polysaccharides (NSP), calcium, protein, and energy were calculated from a dietary survey of 7 consecutive days, which also served to obtain values for the two zinc bioavailability predictor formulas, phytate/Zn millimolar ratio and [Ca][phytate]/[Zn][energy] ratio. Mean daily zinc intake was 8.5 +/- 1.8 mg, with noon and evening meals accounting for the highest contribution to this value (45% and 35%, respectively), whereas breakfast meals' contribution was 16%. The mean protein intake was 55 +/- 13 g, with noon and evening meals being the major contributors to total daily intake (42% and 38%, respectively). Breakfast meals accounted for 77% of daily phytate intake, giving a respective phytate/Zn millimolar ratio of 20.4 +/- 7.6 and a [Ca][phytate]/[Zn][energy] ratio of 336 +/- 127 mmol/Mcal. Values for both ratios based on noon and evening meals were negligible in comparison. The mean daily NSP intake was 9.8 +/- 4.2 g, with 53% of total daily intake supplied from breakfast meals, whereas noon and evening meals accounted for 30% and 14%, respectively. The results, while suggesting that zinc bioavailability is unlikely to be adversely affected, indicated that dietary fiber intake levels are probably inadequate, particularly in view of the nonambulant condition and low physical activity prevalent in such individuals, who may, as a consequence, be susceptible to health disorders associated with impaired bowel function and constipation.

Adult↗
PubMed2006

[Voice Handicap Index (VHI) in inpatient voice rehabilitation medicine].

BACKGROUND: The focus of this study was to determine if the Voice Handicap Index (VHI) is a valid tool for evaluating an inpatient voice rehabilitation program. PATIENTS AND METHODS: A total of 39 German-speaking patients were asked to complete a German version of the VHI questionnaire at the beginning and 3 months after attending a voice rehabilitation program on an inpatient basis at the Bad Gögging voice center. The data collected were documented and assessed using Microsoft Excel and MATLAB. RESULTS: A significant reduction of the VHI summary score was achieved by 10 of 39 patients. An increased number of voice therapy sessions before the program diminished (!) the VHI score 3 months after the program. Work disability because of the dysphonia before the beginning of the voice rehabilitation program showed no significant correlation with the VHI score. CONCLUSIONS: At present, the VHI cannot be regarded as a reliable measure to evaluate benefit derived from completing a voice rehabilitation program on an inpatient basis. Apparently, numerous prior treatment regimens constitute a negative prognostic criterion for rehabilitation success as measured subjectively by the VHI.

Adult↗
PubMed2002

Correlation between voice handicap index and voice laboratory measurements in dysphonic patients.

Factors underlying voice disorders can be categorized into three distinct domains: emotional, physical, and functional. The Voice Handicap Index (VHI) subjectively evaluates voice disorders in terms of these three factors. On the other hand, Voice Laboratory Measurements (VLM) use objective criteria to evaluate the severity of voice disorders. Use of these two different tests (VHI and VLM) on dysphonic patients has, however, tended to yield results that vary widely in their conclusions. This report reviewed 135 testing sessions on dysphonia patients. Seventy-nine of the tests were VHI, and 56 were VLM. All VHI and VLM parameters were entered into a statistical program and analyzed using a Pearson correlation. The results show that each VHI parameter provides a significant level of reliability (P < 0.01) when compared with other VHI parameters. Four VLM parameters also demonstrated significant reliability (P < 0.01) in comparison with other VLM parameters. However, when comparing across testing methods, VHI and VLM parameter reliability is shown to be poor (P > 0.05). With such a large discrepancy between the results of VHI and VLM testing, no objective parameter can yet be regarded as a definitive prognostic factor in a subjective evaluation of dysphonic patients.

Adolescent↗
PubMed2006

Initial validation of the Swedish version of the London Handicap Scale.

OBJECTIVE: To adapt and evaluate the unweighted version of the London Handicap Scale (LHS) for use in Sweden. MATERIALS & METHODS: Respondent burden, linguistic validity and patient perceived relevance was assessed in 16 neurologically ill patients. Internal consistency reliability and construct validity were evaluated among 89 stroke survivors six months after discharge. RESULTS: Patients perceived the LHS as relevant and easy to understand and complete. Mean time to complete the questionnaire was 10 min. Cronbach's alpha reliability was 0.85. The LHS differentiated between patients living at home and in special accommodations. As expected, scores correlated strongly and weakly with indices of related and more remote constructs, respectively. There were no floor-, but large ceiling effects. CONCLUSIONS: The observations reported here are in accordance with previous studies using the original British LHS and provide initial support for the reliability and validity of the instrument for use in Sweden. However, ceiling effects may limit its usefulness as an outcome measure.

Activities of Daily Living↗
PubMed1976

A handicapping malocclusion assessment study at West Virginia University.

1. The AAO Handicapping Malocclusion Assessment Record (HMAR) was tabulated using 100 before-treatment records and dental casts of patients presenting with permanent dentition. 2. The 100-patient sample exhibited scores ranging from 52 points to 11 points. A cut-off point was established at 30 points. This divided the sample into two groups of fifty patients each. This hypothetic situation accepted for treatment those with the fifty highest scores and did not accept those fifty with the lowest scores. 3. The accepted group had 70 per cent skeletal malrelationships (Class II and Class III), while the nonaccepted group presented with 32 per cent skeletal discrepancies. 4. Maxillary incisor interarch deviations were found in 48 per cent of the accepted group but in only 12 per cent of the group not accepted. 5. Mandibular incisor interarch deviation (overbite) occurred in 6 per cent of the nonaccepted group and in 54 per cent of the accepted group of patients. 6. Four patients who required rapid palatal expansion and one who had undergone a mandibular resection were in the nonaccepted group. It was shown that if these patients were examined clinically using the Supplementary Oral Assessment Record, 19 their dentofacial deviations would merit 16 additional points and all five would be promoted to the accepted group.

Child↗
PubMed1994

Social handicaps of multiple sclerosis and their relation to neurological alterations.

The social conditions of 73 patients with multiple sclerosis (MS) were studied in relation to the most common neurological disorders observed among them. The Environmental Status Scale (ESS) and Kurtzke's Neurological Functional System (NFS)--both included within the Minimal Record of Disability (MRD)--were used. Pyramidal alterations were the more frequent neurological findings, whereas the need for personal care was the most common social handicap. The chi 2 test applied to contrast each of the dicotomic ESS and NFS variables showed a significant relationship between pyramidal alteration (weakness) and the need for personal care (p < 0.001), the use of community services (p < 0.01), and transportation problems (p < 0.05). Cerebellar disorders were significantly related to the need for community services (p < 0.01) and transportation problems (p < 0.01). Vision disorders were significantly related to the need for personal care (p < 0.05), transportation problems (p < 0.05), and social activity (p < 0.05). In turn, spasticity was significantly related to the need for personal care (p < 0.001), financial (p < 0.001) and transportation problems (p < 0.001), laboral situation (p < 0.05), and the use of community services (p < 0.05). Contrasting the four NFS and 7 ESS nondicotomic variables showed a marked correlation between the pyramidal alterations and personal care (r = 0.71) and transport (r = 0.62). Pyramidal alterations influence the social situation of MS patients and may be the foremost alterations to be considered for the optimal social integration of these patients.

Activities of Daily Living↗
PubMed1984

The effects of contingent water mist on the stereotypic responding of a severely handicapped adolescent.

The reductive effects of the water misting procedure on the stereotypic responding of a severely handicapped adolescent were investigated by using a variation of the multiple baseline design across settings, with sequential interventions across settings and simultaneous interventions across teachers. The results indicated that the intervention was related to reduced rates of stereotypic responding in each setting. The effects of the intervention were also maintained across multiple administrators of the procedure and during follow-up. Instructional implications are discussed. Further research is suggested.

Adolescent↗
PubMed1994

Automatic cueing to reduce drooling: a long-term follow-up with two mentally handicapped persons.

A follow-up was carried out on two mentally handicapped persons to check whether automatic cueing remained effective for reducing their drooling. The follow-up data were collected through observation sessions which were spread over a period of 18 months. These sessions together with the posttraining sessions of the original study covered an interval of about 2 years. The results of the follow-up showed that cueing continued to be fairly effective with drooling remaining at relatively low levels.

Adult↗
PubMed1978

EEG asymmetry in educationally handicapped children.

Bilaterally homologous parietal and temporal EEGs were recorded from two groups of educationally handicapped children while the subjects (Ss) rested with eyes open or closed or performed in simple tasks designed to differentially activate the two hemispheres (reading by Ss, reading to Ss, draw a picture). A 'dyslexic' but not dysphasic group showed a reversal of theta asymmetry from eyes closed to eyes open (L less than R to L greater than R). This difference between groups was reflected most at the parietal placement. Theta in the parietal lead changed in accordance with expectations from reading to drawing (reduction of the R/L ratio), but that pattern did not occur at the temporal lead in 'dyslexics'. A discriminant analysis on theta power correctly classified 20 of the 22 children.

Adolescent↗
PubMed1986

Productive language of premature and physically handicapped two-year-olds.

Structural and functional features of the productive language of healthy and at-risk 2-yr-olds were compared. Subjects were normal, full-term toddlers (n = 15), toddlers with either cosmetic or orthopedic anomalies (n = 15), and premature toddlers (n = 15). Transcripts of the language of each child were compiled from 30-min videotapes of mother and child engaged in a variety of semistructured activities. Although premature and physically handicapped toddlers did not differ significantly from each other, both groups of medical risk toddlers were delayed in a variety of structural indices of their productive language. In comparison to normal children, they had a shorter MLU and upper bound, and a smaller vocabulary, including fewer verbs. On functional features of language usage, however, there were few differences between normal and high-risk toddlers. Results are discussed in the context of developmental and learning models that posit a relationship between maternal and child behavior.

Child Language↗
PubMed1989

Acquisition of American Sign Language versus Amerind signs in a mentally handicapped sample.

The differential acquisition of American Sign Language versus Amerind signs was investigated in a moderately to severely mentally handicapped sample. The subjects (n = 10) were selected from a residential training facility and each had a mental age within the range 3;0-5;0 years. Twenty signs were taught to each subject, 10 American Sign Language signs and 10 Amerind signs. An Alternating Treatments Design was selected to facilitate comparison of the relative efficacy of the two sign systems across single subjects. Five signs were presented per week (2 weeks) in each sign system. Results showed that a significantly greater (p less than .001) number of Amerind as compared to American Sign Language signs were acquired during Week 1, Week 2, and across both weeks. Retention results, after 1- and 2-week delays, showed that subjects continued to reproduce significantly more Amerind than American Sign Language signs. The results were thought to be due to the more concrete and less complex nature of the Amerind system. Implications of these results for this and similar samples are discussed.

Adolescent↗
PubMed1977

A new mouthstick prosthesis for handicapped patients.

Most mouthstick prostheses previously described in the literature have severely limited application or availability. They are either highly specific and sophisticated and difficult to fabricate or very crude and unifunctional. Most do not conform to basic functional and physiologic criteria as outlined, nor are they sufficiently flexible to meet the various needs and physical capabilities of of a wide spectrum of patients. The prosthesis described is adaptable, and with the basic bite-stick and the friction-grip lock, the patient can change the form and function of the device to perform various tasks independently. The prosthesis is simple, inexpensive, and easy to fabricate and repair, and it needs no specialized or sophisticated parts. It enables handicapped patients to attain a greater degree of self-sufficiency than was previously possible, which improves their mental outlook.

Adolescent↗
PubMed1982

Pattern recognition in tachographic gait records of normal and lower extremity handicapped human subjects.

The electromechanical behaviour of the tachographic gait recording system developed by earlier research scientists was analysed. Some alterations were incorporated and the resulting modified system was used to record the gait of 25 normal, healthy, able-bodied adult males with sedentary habits, and 67 subjects having different types of lower extremity handicap. Some of the findings obtained from analysis of these gait records are reported in this paper. Basic differences in the pattern associated with different types of subjects have been explored through analysis of basic gait characteristics e.g. cadence, consistency etc., whereas the existence of specific patterns for each group of subjects has been recognised by applying the multi-variate statistical tool of discriminant analysis.

Adolescent↗