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PubMed2000

Comparison of single and multiple functional communication training responses for the treatment of problem behavior.

Two functional communication training (FCT) conditions without extinction were compared to treat the problem behavior of a child with developmental disabilities. The individual was taught to emit a single FCT response to obtain one of six items delivered in a randomized order or multiple FCT responses that specified the exact item. Results showed that only the FCT-multiple condition reduced problem behavior and maintained alternative mands.

Child↗

PubMed1987

Family interaction and treatment adherence after stroke.

Caregivers of 60 stroke patients were assessed five months after patient discharge from a stroke care unit to determine the relationship between family function and poststroke treatment adherence. Areas of family interaction which were significantly related to ratings of treatment adherence included problem solving, communication, and affective involvement. Better functioning families were consistently high on signs of treatment adherence. Findings suggest that families with specific dysfunction may not be as capable of helping patients comply with rehabilitation efforts as families who function more effectively. Thorough family assessment to identify which areas of family interaction are most problematic in relation to adherence issues is recommended.

Cerebrovascular Disorders↗

PubMed1986

The future of communicable disease control: toward a new concept in public health law.

The exercise of compulsory public health powers for the common good of the community, though rooted in constitutional authority, involves a potentially massive infringement of individual liberty, autonomy, and privacy. Yet, public health statutes do not reflect modern conceptions in either science or law. Most are structurally obsolete and lack criteria for judicial oversight and impartial decision making. Guidelines for a model statute are proposed to protect both communal and personal interests.

AIDS Serodiagnosis↗

PubMed1998

Asymmetry of chimpanzee planum temporale: humanlike pattern of Wernicke's brain language area homolog.

The anatomic pattern and left hemisphere size predominance of the planum temporale, a language area of the human brain, are also present in chimpanzees (Pan troglodytes). The left planum temporale was significantly larger in 94 percent (17 of 18) of chimpanzee brains examined. It is widely accepted that the planum temporale is a key component of Wernicke's receptive language area, which is also implicated in human communication-related disorders such as schizophrenia and in normal variations such as musical talent. However, anatomic hemispheric asymmetry of this cerebrocortical site is clearly not unique to humans, as is currently thought. The evolutionary origin of human language may have been founded on this basal anatomic substrate, which was already lateralized to the left hemisphere in the common ancestor of chimpanzees and humans 8 million years ago.

Animals↗

PubMed1975

Communication for the aphasic stroke patient: assessment and therapy.

Loss of communicative ability is one of the most devastating handicaps associated with stroke. The goals of therapy require continuous adjustment. Early ambulation facilitates breathing, chewing and swallowing, which are important factors in voice control. Hearing and vision should also receive concentrated attention. Formal speech therapy should begin when the patient shows an interest in regaining speech. Even before that, however, family members and friends can be of great help in laying the foundation for a good prognosis.

Aged↗

PubMed1987

Prestroke family interaction as a predictor of stroke outcome.

The Family of Assessment Device and clinical data for 60 stroke patients were used to predict outcome at six months and one year poststroke. Ratings of behavior control and affective responsiveness of the family predicted number of days of rehospitalization during the study. Problem solving scores, family communication skills, and patient self-care ability predicted family-rated patient adjustment. Family function was a better predictor of hospital stay than baseline ratings of typical predictors of stroke outcome. Family function represents an area for potential stroke intervention that may have more relevance to efficient health care delivery and the clinical status of stroke patients than has previously been noted.

Cerebrovascular Disorders↗

PubMed1986

Communicable disease and mental health: restrictions of the person.

Laws for the protection of public health control either the environment, as in the case of sanitation or air pollution regulations, or human conduct. This Article deals with limitations imposed upon individuals in order to prevent the spread of communicable disease and the harm resulting from mental illness. The restraints discussed include compulsory examination and immunization, and forms of compulsory detention or commitment. This Article is a revised chapter of the author's Public Health Law Manual, first published by the American Public Health Association in 1965. The Manual is intended to help public health professionals to understand the law relevant to their practice, and to apply it more effectively.

Acquired Immunodeficiency Syndrome↗

PubMed2002

The Health Intervention Project: HIV risk reduction among African American women drug users.

OBJECTIVE: This article describes the Health Intervention Project, an intervention for African American women in Atlanta, Georgia, who are crack cocaine users. METHODS: A formative phase involved ethnographic mapping of the physical and social infrastructure of the study communities and in-depth interviews with women crack cocaine users. Key findings that were incorporated into the intervention program included the exchange of sex for money or drugs, the women's experience with trauma and abuse, the role of men and male partners, the women's roles as mothers and members of extended families, their identity as African Americans, and their desire to reduce their risk for HIV/AIDS related to their drug use and sexual behavior. Individualized intervention sessions were designed to meet the women's needs. The motivation intervention emphasized self-motivation for behavioral change with the assistance of the interventionist, who facilitated the women's goal identification, action plan, and problem-solving skills. The negotiation intervention focused on improving technical and assertive communication skills. An action plan was developed, and the women worked on negotiation skills, self-control regarding sexual and drug-use encounters, assertiveness in sexual and drug-use interactions, and conflict resolution. CONCLUSION: Effective prevention and intervention programs must be framed within an appropriate racial, ethnic, and cultural context. Future research is needed to better understand risk in its social context, including the impact of community factors.

Adult↗

PubMed2000

Neonatal muscle hypotonia--an early manifestation of cerebral palsy.

UNLABELLED: Cerebral palsy causes a number of diagnostic, therapeutic, organisational, and social problems. A timely diagnosis reduces the unfavourable effects of the disease and the resulting disability of the children. AIM: The aim of the present study was to evaluate the role of the neonatal muscle hypotonia as an early indicative symptom of cerebral palsy (CP). MATERIAL AND METHODS: Forty-two children with clinical and anamnestic data of muscle hypotonia (from the neonatal period to the age of 3) were enrolled in the study. An active and dynamic follow-up including specialized neurologic examinations was realised. RESULTS: The etiologic factors of utmost importance for CP were prematurity (40.5%) and perinatal asphyxia (26.2%). On the background of differently expressed muscle hypotonia, persisting from the neonatal period, the abnormalities in the psychoneurologic development during the first year after birth were characterized mainly by psychoemotional retardation. Motor deficit was marked from the 1st through 2nd year, and speech disorders appeared after the age of 2. CONCLUSIONS: The presence of partial or generalized muscle hypotonia in the neonatal age and its persisting in the subsequent stages of the child's life is an early indicative symptom of CP. The diagnosis is possible within the first two years of life, especially in children with perinatal pathology, by dynamic neurologic follow-up and prompt evaluation of the abnormalities in the psychoneurologic development.

Age Distribution↗

PubMed1976

Evaluation of stroke disability.

The disabilities resulting from a stroke are not well understood from the epidemiologic or functional point of view. The stroke may impair mental status, perception, sensation, communication and motor ability; the total resulting disability is related to the extent of impairment in each of these areas. A complete evaluation in all these areas has to be done to determine the degree of disability before any rehabilitation program is planned. A comprehensive approach to evaluating stroke disability is presented that includes correlating the degree of impairment in each of the above-mentioned areas with the overall functional ability of the patient.

Activities of Daily Living↗

PubMed2005

Health related quality of life in adults with repaired tetralogy of Fallot: psychosocial and cognitive outcomes.

OBJECTIVE: To assess the health related quality of life of patients who were operated on during childhood for total correction of tetralogy of Fallot, focusing on the psychosocial and cognitive outcomes. PATIENTS: 54 patients (24 men and 30 women, mean (SD) age 32 (4) years), operated on for total correction of tetralogy of Fallot at mean age of 8.2 years, underwent a cardiological examination, psychological assessment (semistructured interview, Minnesota multiphasic personality inventory), evaluation of quality of life (36 item short form health survey), and neuropsychological assessment with an extensive neuropsychological battery of tests. RESULTS: Psychological characteristics-(1) a lower than normal academic level, (2) a job inadequate for educational level, (3) a preference for an overprotective familiar setting, and (4) a difficulty communicating own corporal image. Denial of the cardiopathy was found to be a common behaviour to normalise functioning. Very few patients had a deficit in memory, learning, or attention functions; rather, patients had a deficit in the executive functions, problem solving, and planning strategies. CONCLUSIONS: Despite a satisfactory health related quality of life, there are residual psychological and social problems in addition to impaired cognitive outcomes in the presence of a normal intelligence quotient.

Adult↗

PubMed2003

Psychoanalysis as a creative shaping process.

The author first explains the concepts of creativity, play and aesthetic experience. He then outlines the psychoanalytic process as a creative one that shapes reality. Making a link between psychoanalysis and the humanities, he demonstrates that creative play is a fundamental aspect of the human experience of reality. Aesthetic experiences during the psychoanalytic process are comparable to the play by which children structure their world and artists' activity in following their urge to shape. Furthermore it is shown that creative actualisation testifies to a quasi-biological need for coherence and structure. Through modern hermeneutics, the truth claims of aesthetic shaping can be established in epistemological terms. The basic principles of hermeneutics--historicity, linguisticity and communicative experience--find their psychoanalytic counterparts in memory, representational shaping and transference-countertransference. Psychoanalysis is demonstrated to be simultaneously a science and an art. On the basis of a case history, aesthetic experience is shown to constitute a specific and unique form of access to psychic reality. Aesthetic experience and creativity do not only aid recovery from 'bad psychological states', they are also indispensable for the entire understanding of internal and external reality. It is possible to develop this understanding through a creative psychoanalytic attitude.

Attitude↗

PubMed2001

Parent-adolescent conflict in teenagers with ADHD and ODD.

Eighty-seven male teens (ages 12-18 years) with ADHD/ODD and their parents were compared to 32 male teens and their parents in a community control (CC) group on mother, father, and teen ratings of parent-teen conflict and communication quality, parental self-reports of psychological adjustment, and direct observations of parent-teen problem-solving interactions during a neutral and conflict discussion. Parents and teens in the ADHD/ODD group rated themselves as having significantly more issues involving parent-teen conflict, more anger during these conflict discussions, and more negative communication generally, and used more aggressive conflict tactics with each other than did parents and teens in the CC group. During a neutral discussion, only the ADHD/ODD teens demonstrated more negative behavior. During the conflict discussion, however, the mothers, fathers, and teens in the ADHD/ODD group displayed more negative behavior, and the mothers and teens showed less positive behavior than did participants in the CC group. Differences in conflicts related to sex of parent were evident on only a few measures. Both mother and father self-rated hostility contributed to the level of mother-teen conflict whereas father self-rated hostility and anxiety contributed to father-teen conflict beyond the contribution made by level of teen ODD and ADHD symptoms. Results replicated past studies of mother-child interactions in ADHD/ODD children, extended these results to teens with these disorders, showed that greater conflict also occurs in father-teen interactions, and found that degree of parental hostility, but not ADHD symptoms, further contributed to levels of parent-teen conflict beyond the contribution made by severity of teen ADHD and ODD symptoms.

Adolescent↗

PubMed1982

Prevalence of autism and related conditions in adults in a mental handicap hospital.

The proportions of subjects with severe social impairment and those retaining the features of childhood autism were investigated in a population of mentally retarded adults in a long-stay hospital. The results confirmed the findings of an earlier study of mentally retarded children (Wing & Gould, 1979) that the administrative category of mental retardation includes a substantial minority of people with severe impairment of two-way social interaction. Such social impairment occurred in 38% of the adult population and was very significantly associated with abnormalities of communication and imaginative activities. Muteness, repetitive stereotyped behaviour, including repetitive speech, and a range of behaviour problems also occurred more frequently in the socially impaired group. Two methods of sub-classifying the socially impaired were compared. Classification based on the severity of social impairment gave more statistically significant associations with behavioural and psychological variables than did a method based on the presence or absence of typical autism. The implications of these findings and their relevance for management and planning of services for the mentally retarded were briefly discussed.

Adolescent↗

PubMed1987

Communication deviance in adolescence and adulthood: a longitudinal study.

Measures of communication deviance (CD) on the TAT were obtained for a sample of nonpsychotically disturbed adolescents and repeated 15 years later. For both males and females, total amount of CD significantly increased from adolescence to adulthood. The proportion of certain types of CD in an individual's speech was relatively stable across time, but further analysis indicated that the phenomenon was significant only for the females. Low amounts of CD in adulthood were associated with absence of any psychiatric disturbance throughout the 15-year follow-up period.

Acting Out↗

PubMed1985

Survivors of severe traumatic brain injury in childhood. II. Late residual disability.

36 survivors of very severe traumatic childhood brain injury have been followed for a median period of 48 months after injury. One remains in a vegetative state and 35 have been discharged. 34 regained ambulation, and motor function became essentially normal in 14 of them. Ataxia and movement disorders were as common among the residua as was spasticity. Only one child remained aphasic, but 14 showed dysarthria. Six of the 36 showed major dementia and most of the rest showed very significant new impairment of cognitive and social function. This impairment was greater than expected from changes in the I.Q. Motor and speech function showed prolonged recovery while learning ability and social function did not. The overall degree of recovery seems not much better in these children than in adults.

Adolescent↗

PubMed1997

What should be the focus of emotion regulation in children? A nonlinear dynamic mathematical model of children's peer interaction in groups.

This paper questions the assumption that children's social and emotional competence be placed within the developing child, rather than in the interaction of the child with the range of peer social ecologies in which the children might function. This paper presents a new nonstatistical mathematical approach to modeling children's peer social interaction in small groups using nonlinear difference equations in which both an uninfluenced and an influenced regulatory set point of positive minus negative interaction can be separately estimated. Using this model and the estimation procedure, it is possible to estimate what a focal child and the group initially brings to the group interaction and also how these regulatory set points are influenced by the interaction to determine two influenced regulatory set points. Six-person mainstreamed and specialized groups were established involving three types of unacquainted preschool boys: children with and without developmental delays and a language disordered but intellectually normally functioning group, using a methodology that ensured appropriate matching of child and family characteristics. For each 2-week play group, the social interactions of each child were observed during a designated free play period. Handicapped children were observed in either a specialized or mainstreamed setting. The application made of this modeling process in this paper is generating theory to attempt to understand influence processes. Parameters are introduced that reflect uninfluenced target child and group set points, emotional inertia, and influence functions.

Child, Preschool↗

PubMed1978

Effects of speech therapy on aphasics' responses to Functional Communication Profile.

Protocols of the Functional Communication Profile were compared for 17 treated and 18 untreated aphasic patients. All subjects were post-CVA, right-handed, right hemiplegic native speakers of English representing fluent, non-fluent and global aphasics. All treated patients received a minimum of a half hour of individual and an hour of group speech therapy daily, for 8 wk. during a period between 4 and 12 wk. post-onset. Statistical comparisons of treated and untreated groups did not yield significant differences. Patients who received traditional speech therapy could not be differentiated from untreated control patients.

Adult↗