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PubMed1993

Creating satisfaction: a psychological perspective on stress and coping in families of handicapped children.

This paper briefly reviews the literature on stress and coping in families of developmentally handicapped children and proposes an alternative way for conceptualizing some of the psychological processes involved. The approach specifies how threats to certain human needs lead to predictable patterns of appraisal and coping. The usefulness of this alternative is demonstrated for families of autistic children and the theoretical and clinical implications are discussed.

Adaptation, Psychological↗

PubMed1976

Handicapped children under National Health Insurance.

This paper describes the services for the care of handicapped children and young people in the United Kingdom and Sweden--two countries which have a system of a national health service and national health insurance. The author discusses the implications for the United States, which is now moving towards a national health insurance scheme. The future of existing programmes, the need for a national plan, and the choice of priorities are considered.

Adolescent↗

PubMed1984

Compliance in the community with consultants' recommendations for developmentally handicapped children.

A cross-sectional analytical survey was carried out to determine the extent and associations of compliance with consultants' recommendations for developmentally handicapped children to parents and front-line community professionals. Non-compliance was found to be a substantial problem. Several significant associations were found between clients' attitudes and beliefs about the recommendations and their compliance with them. These findings may prove useful in identifying clients at risk for non-compliance, and in developing strategies to enhance compliance among clients of developmental disability consultation services.

Adolescent↗

PubMed1984

A parent-centred approach to physiotherapy for their handicapped children.

A study was made of a parent-centred model for physiotherapy for a group of handicapped children in a sparsely inhabited region in northern Sweden. The parents were responsible for daily therapy, supervised by physiotherapists and occupational therapists. A questionnaire sent to all the parents showed that in 26 of the 39 families who responded the child was receiving daily therapy. Both parents took part in all but three cases, but eight families reported difficulties with the training. The authors conclude that the parents were not overstrained by their high degree of involvement, provided there was close supervision and adequate economic and emotional support.

Cerebral Palsy↗

PubMed1984

Physiological cost index of walking for normal children and its use as an indicator of physical handicap.

Seventy-two normal children aged between three and 12 years were assessed to establish their walking function. Speed of walking and heart rate were monitored continuously, both barefoot and in shoes, over eight consecutive lengths of a 25m walkway. Since heart rate is affected by speed, the physiological cost index (PCI)--which combines the two parameters--was calculated for each child, both barefoot and in shoes. Speed tends to increase and walking heart rate to decrease with age. However, resting heart rate also decreases with age, so the PCI has the same range for all ages. The mean PCI in shoes was 0.4 and barefoot was 0.38. The PCI for children with pathological gait is appreciably greater than that for normal children, so the PCI is a valuable quantitative indicator of the level of handicap.

Child↗

PubMed1985

Kinesthetic recall of children with athetoid and spastic cerebral palsy and of non-handicapped children.

Twenty-four children with spastic or athetoid quadriplegic cerebral palsy were paired according to severity of motor disability and age, then matched with 12 non-handicapped children of similar ages. The children were tested with a standard kinesthesiometer and two kinds of scores were recorded. Absolute Error scores reflected the children's deviation from the target and Total Movement scores reflected their over-all range of movement. There were significant differences between groups in Absolute Error scores, with the cerebral-palsied children performing worse than the controls and the spastic children worse than the athetoid children. All three groups tended to underestimate the targets and there were no significant differences in Total Movement scores.

Adolescent↗

PubMed1988

Hidden handicap in school-age children who received neonatal intensive care.

A group of 347 children who had been classed as 'at risk' in the neonatal period were examined by means of academic attainment tests and teacher ratings at the end of their first year in primary school. Matched classroom controls were also examined to estimate the prevalence of reading, spelling and mathematics difficulties. Preterm birth and low birthweight appeared to be significant antecedents of poorer outcome in all three subjects. The attributable risk of low birthweight to academic handicap was estimated to be 29 per cent. There was no additional effect of time to spontaneous respiration (short and long) on academic outcome for the preterm low-birthweight group. In contrast, poor outcome for the low-birthweight children who had not been preterm was associated with longer time to spontaneous respiration. Graduates of neonatal intensive care with normal birthweights performed comparably with their low-risk controls. These results are discussed in relation to other longitudinal studies of the outcome for 'at-risk' infants.

Child↗

PubMed1988

The basic care needs of profoundly mentally retarded children with multiple handicaps.

The ability profiles, aetiological patterns and basic care needs for a small minority of the most seriously multi-impaired and profoundly mentally handicapped children were analysed. The analyses were based on (1) a care-load study (1980-81) of a population-based series of 53 children and adolescents born in 1966-76, representing the most profoundly retarded third of those with and IQ less than 50 in the city of Gothenburg, and (2) 10 years clinical experience of a paediatric multi-impairment unit, including a cross-sectional consensus evaluation of the children being cared for in August 1986. It is concluded that these children represent a long-term paediatric care-group in need of continuous and life-long baby-care, with access to medical support and service. When it is not possible to care for these children in their own homes, it cannot be realistically expected that they can be included in a normalisation scheme, implying that they can become integrated residentially and socially in society and participate in traditional training-school programmes.

Abnormalities, Multiple↗

PubMed1996

The role of the old and the new antiepileptic drugs in special populations: mental and multiple handicaps.

Epilepsy is common in individuals who are mentally retarded and/or otherwise multiply handicapped. These patients often display several seizure types. Seizure control may be difficult and drug interactions common because of polytherapy. Cognitive, behavioral, affective, and motor problems in these patients often confound accurate diagnosis and effective management. Treatment often requires not only antiepileptic drugs (AEDs) but also psychoactive drugs and/or environmental and personal support. To minimize unwanted drug effects, therapeutic strategies should focus on the administration of the fewest possible drugs at the lowest effective dose. The new AEDs may be of special value at times in these populations because they offer potential for improved efficacy, but especially because many of them provide better safety profiles and fewer pharmacokinetic interactions with other drugs.

Acetates↗

PubMed1998

Cross-cultural adaptation of the hearing handicap inventory for the Elderly-Screening Version (HHIE-S) for use with Spanish-speaking Mexican Americans.

OBJECTIVE: To cross-culturally adapt the Hearing Handicap Inventory for the Elderly-Screening Version (HHIE-S) for use with older Spanish-speaking Mexican Americans. SUBJECTS AND SETTING: Two different samples were used. First, a convenience sample of 100 older community-dwelling Mexican American men and women in San Antonio, Texas, was used to test technical equivalence of the Spanish and English language versions of the HHIE-S. Second, a neighborhood-based sample of older Mexican Americans was used to establish conceptual (n = 433) and criterion equivalence (n = 381) of the two HHIE-S language versions. METHODS: Independent forward and back translations were done to create a Spanish language version of the HHIE-S. In the convenience sample, subjects were administered the English and Spanish HHIE-S in random order on separate days. In the neighborhood sample, the HHIE-S was given on one occasion in the language of the subject's preference. Depressive symptoms were assessed using the Geriatric Depression scale to see if the two language versions of the HHIE-S were similarly associated with depression (conceptual equivalence). Hearing impairment was assessed using the Welch-Allyn Audioscope to see if the two language versions were similarly associated with an audiometric measure for hearing loss (criterion equivalence). RESULTS: In the convenience sample, the overall mean (SD) Spanish and English HHIE-S scores were 6.2 (8.7) and 6.2 (9.3), respectively (P = 1.00). Total scores of the English and Spanish versions were highly correlated (r = .89), and regression analysis indicated that the two language versions gave nearly identical results. In the neighborhood-based sample, men had higher HHIE-S scores than women (OR 2.0, 95% CI = 1.3-3.5). Having depressive symptoms (OR 3.2, 95% CI = 1.9-5.5) or hearing impairment (OR 6.1, 95% CI = 3.5-10.5) was associated with higher HHIE-S scores. After adjustment for gender, depressive symptoms, and/or hearing impairment, the language of interview was not associated with HHIE-S score. CONCLUSION: We have developed and tested a Spanish translation of the HHIE-S that yields equivalent results to those obtained with the English version in bilingual Mexican Americans. The Spanish HHIE-S presented here is suitable for clinical use and research studies involving older Mexican Americans.

Aged↗

PubMed1990

From handicap to handy capable: training systemic therapists in use of self.

This article describes and discusses the rationale for an experiential methodology to help trainees expand their repertoire of behaviors in clinical situations. The goal in addressing the trainee's personal, "handicapping" responses is to pay attention to "how" a therapist is perceived, "why" a therapist has certain blindspots, and "what" the therapist does to co-create a therapeutic impasse. In addition, experientially considering the impact of self encourages therapists to "learn to learn" that they are an active, resourceful participant in the evolutionary process of the therapeutic system.

Ego↗

PubMed1995

Correlating preferential looking visual acuity and visual behavior in severely visually handicapped children.

We developed a series of questions that reflects the functional abilities of severely visually handicapped children. The study population comprised 100 patients aged 30 to 60 months (mean 43.23), mostly afflicted with retinopathy of prematurity. Visual acuity was measured by preferential looking. Preferential looking acuities of the patients ranged from 20/25 (0.8) to 20/6400 (0.003) (mean 20/470 (0.04)). Ten activities were analyzed and correlated with preferential looking acuity. Among the selected visual activities, when children are not interested in television (p = 0.0001), toys (other than those that make sounds (p = 0.0001), and people (p = 0.001)), their preferential looking acuities were very low. For example, 73 out of 100 patients who were visually interested in television had preferential looking acuities (mean 20/245 (0.082)) that were significantly higher (p = 0.001) than 21 patients not interested in television (mean 20/2806 (0.007)). Patients with nystagmus (n = 79) had significantly lower preferential looking acuities (p = 0.0001) (mean 20/1114 (0.018)) than patients with no nystagmus (mean 20/57 (0.35)). When evaluating visual function in young, severely visually impaired patients, in addition to preferential looking testing, analyzing visual behavior within the environment is important to accurately evaluate their remaining visual abilities.

Child, Preschool↗

PubMed1983

Psychotic behaviour in children and young adults in a mental handicap hostel.

One hundred and twelve children and young adults living in a long-stay hostel for the mentally handicapped were examined with regard to problems of social relationships, speech and language, and behaviour. Exactly half of the population showed severe impairment of social interaction. The socially impaired persons very often had severe speech/language and behavioural difficulties as well. A small number of classically autistic persons were identified. The results lend support to the view that infantile autism is but one behavioural syndrome along a continuum of triads of language and social impairments as outlined by Lorna Wing.

Adolescent↗

PubMed1987

Tardive dyskinesia in neuroleptic medicated mentally handicapped subjects.

Sixty-seven neuroleptic medicated mentally handicapped subjects in a hospital were rated on two occasions for abnormal involuntary movements on three scales: Abnormal Involuntary Movements (AIMS), Rockland and Parkinsonism scales, with 6 months between each assessment. Inter-rater and test-retest reliabilities were high. The data from the second assessment was analyzed. Prevalence of tardive dyskinesia (TD) was 21% on AIMS, 42% on the Rockland scale; 60% had parkinsonism. Multiple stepwise regression analysis revealed that age, sex, current neuroleptic and anticholinergic dose, antiepileptic medication, psychosis, cumulative anticholinergic dose were not significant predictors of TD as determined by AIMS. Parkinsonism and cumulative neuroleptic dose were significant predictors of and correlated positively with AIMS score. TD subjects formed 35% of the parkinsonian group. Overt brain damage was not a significant predictor of AIMS score and the difference between the neuroleptic medicated and neuroleptic free group on AIMS scores was highly significant.

Adult↗

PubMed1996

Variability in recording and grading the need for orthodontic treatment using the handicapping malocclusion assessment record, occlusal index and dental aesthetic index.

This investigation evaluates three malocclusion treatment need indices, the Handicapping Malocclusion Assessment Record (HMAR), the Occlusal Index (OI) and the Dental Aesthetic Index (DAI), for reliability and inter-index correlation. Pretreatment study models of 30 cases (mean age 12.9 years, SD 1.2) were assessed using each index. All the indices demonstrated a high level of reliability and non could be selected over the other with regards intra-examiner differences. The DAI, however, was more time-saving (2.68 mins, SD 0.41) and simple to use. The highest correlation was between HMAR and OI (r = 0.87, P < 0.001) which is a reflection of the similarity in their design. This study also discusses the limitations of the three indices.

Adolescent↗

PubMed1979

Effect of caries in mentally handicapped children of addition of fluoride and bicarbonate-phosphate to dietary sugar products.

Mentally handicapped children, aged 5--15 years and living in institutions, received fluoride supplement in several sugar products of their diet; in candies, marmalades, jams, fruit juices and in sweet desserts corresponding to 10 mg F as NaF per kg of the sugar (sucrose or glucose) of each product. To two of the four daily candies was also added a NaHCO3 + KH2PO4 mixture (mole ratio 9.8/l, resp.) to substitute for 2.5% of the sugar of the candy. The control children received the respective products without the additives. After stepwise exclusions of subjects for various reasons, e.g. for the absence of permanent teeth, low initial caries activity, strong medication, Down's syndrome, etc., the mean DMFS-increment in the remaining 43 control subjects was 4.5 and in the 41 test subjects 2.6 lesions/100 surfaces at risk, i.e. 42% reduction. Caries arrestment had occurred in these test subjects after the first year, while in the respective controls it was continuously increasing. Among numerous oral and body parameters studied, only surface enamel fluoride in primary teeth was increased by the fluoride supplements and urinary phosphate and calcium excretion decreased.

Adolescent↗

PubMed1984

Utilization of general case programming for teaching health education behaviors to students with severe handicaps.

Students with severe handicaps are acquiring safety behaviors through the implementation of systematic instruction. Absent from this instruction is the inclusion of generalization strategies. Included in this article is a procedure for selecting representative teaching examples to promote optimal generalization. This procedure is referred to as general case programming. The steps of this strategy are delineated using an example of applying an adhesive bandage to a cut.

Curriculum↗

PubMedDate not supplied

Oral hygiene for the severely handicapped: clinical evaluation of the University of Mississippi dental care system.

The study reported here was a clinical evaluation of an automatic toothbrushing device for persons with severe handicapping conditions. This device, the University of Mississippi dental care system, is designed for patients who are unable to control their arms and hands. The effectiveness of this device was compared to routine (ordinary, manual) regimens of oral hygiene through use of gingival (Loe-Silness) and plaque (Turesky) indexes (GIs, PIs). Plaque indexes for patients under routine care averaged 2.11; PIs for patients under the dental care system averaged 1.47. Based on Ebbutt's extra period changeover design model, the t-test for difference in plaque scores is significant (P less than .001). The results indicate that the University of Mississippi dental care system improves the patients' ability to independently control plaque.

Persons with Disabilities↗