Biomedical subjects
D C Harper
Publications and source records attributed to D C Harper.
Children's attitudes to physical differences among youth from Western and non-Western cultures.
Children with visible physical impairments (cosmetic and orthopedic) are known to experience difficulties in social interaction with peers. Some of these social difficulties are related to attitudes toward visible physical features of children. Several research studies from Western and non-Western countries are reviewed, focusing on children's attitudes toward children with facial disfigurement. Specific social preferences for particular disabilities are noted which are related to cultural and economic factors. Children's attitudes toward facial disfigurement reflect generally low preference for social interaction in the majority of cultures studied. Children's attitudes reflect both positive and negative attributions toward facial disfigurement.
The social needs of adolescents with cerebral palsy.
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Behavioral problems and medication utilization.
Although psychotropic medications are commonly used with older adults who have mental retardation, patterns of medication use for this group are not easily determined. Our objective was to explore relations between prescribed psychoactive treatments and rated behavioral difficulties. Adults with moderate mental retardation living in congregate and group care settings were rated by care providers using a standard behavior rating instrument. Older adults demonstrated a tendency toward higher medication utilization. Results indicated higher drug utilization in the larger setting despite the fact that behavior problems and cognitive level was matched across all settings. Medication utilization appears to be related to multiple factors, not only the behavioral or cognitive characteristics of adults with mental retardation.
Correlates of concern in parents of high-risk infants at age five.
Parents whose children have experienced a high-risk birth may be in double jeopardy due to the biomedical effects of the birth trauma as well as parent perceptions and feelings regarding medical vulnerability and the subsequent impact on caregiving. The present study determined whether the developmental, social, and medical concerns reported by 223 parents of high-risk infants at age 5 were congruent with the child's medical history and developmental performance at age 5. Results indicated that parents with the highest levels of developmental, social, and medical concerns had children with lower birth weights who were born earlier and spent longer periods of time in the hospital at birth. These children also had lower outcomes on the cognitive ability measures at age 5, and were more likely to demonstrate potential behavior problems. Present findings suggest the degree of concern reported by parents of high-risk infants is congruent with the birth history and the developmental status of their child.
Paradigms for investigating rehabilitation and adaptation to childhood disability and chronic illness.
Significant research perspectives in investigating chronic illness and disability are presented. Historical research conceptualizations in childhood disability are reviewed and newer contexts for evaluating disorder are presented. Future research in childhood illness and disability is directed toward basing investigations on theoretical models and promoting prospective longitudinal programs. Pediatric psychologists are encouraged to consider more collaborative efforts to move the field forward systematically.
Training health care professionals to communicate with patients with mental retardation.
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NP unity impossible without reorganization of NANP.
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Dementia and depression in elders with mental retardation: a pilot study.
A preliminary investigation of cognitive decline and depressive symptomatology is presented with older adults who have mental retardation. A series of different assessment instruments are reviewed and tested in a pilot study. A review of dementia and depression with respect to elders with mental retardation is presented to place the study in perspective. Findings reveal decreasing cognitive ability is associated with higher rates of observed depression and reported behavioral problems. Trends suggested those more elderly displayed more depressive behaviors, psychotropic medication was a common treatment, and cognitive decline was associated with lower initial intellectual levels. Dementia and depression is a complicated symptom complex to identify in aging adults with mental retardation.
Enhancing the management of secondary encopresis by assessing acceptability of treatment: a case study.
This clinical case study utilized a behavioral treatment sequence to assist an 11-year-old encopretic male who had been refractory to prior treatments. The sequence included: (1) positive reinforcement of bowel movements and the non-occurrence of soiling accidents; (2) self-evaluation; (3) positive practice; (4) milk of magnesia; (5) diet modifications; and (6) a numbered underwear strategy. The treatment was initiated on a pediatric inpatient unit and then generalized to the child's home environment. Parental acceptability of treatment was assessed during a three-day home visit while the procedure was implemented by the parents. The combination of behavioral treatment with milk of magnesia eliminated soiling accidents and increased the frequency of appropriate bowel movements. Results were maintained throughout a one-year follow-up.
Psychotropic drug use in older developmentally disabled with behavioral difficulties.
Use of psychotropic medications with elders who are mentally retarded is a very common procedure. However, patterns of medication usage in this group are not easily determined. Objectives were to explore relationships between prescribed psychotropic treatments, the types of reported behavioral difficulties, and the size/type of living settings where these difficulties were exhibited. Subjects were moderately mentally retarded elders who were living in Congregate and Group care settings who were observed and rated by caretakers using a standard behavior rating instrument. Comprehensive medical (drug) and demographic data was obtained on each person. The study revealed that psychotropic use was more frequent in congregate care settings for these older clients. Those more elderly demonstrated a tendency toward higher utilization. Little differences were evident in the general characteristics (sex, IQ, reality orientation) of elders living in the two settings despite differences in drug use rates. Future research needs to focus on differences in behavior problems and setting factors to more fully understand drug utilization rates in elders with mental retardation.
Journal of Pediatric Psychology: another stage of development.
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Residential assessment of adults with moderate mental retardation.
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Long-term surveillance of high-risk children.
We followed a group of high-risk children, both those who passed early developmental screenings and those who did not. Three hundred sixty-two children who had previously passed screenings were evaluated at 5 years of age. Significant differences were found between this group and a comparison group in mean scores on verbal, perceptuomotor, and preacademic tests. Children who had previously failed screenings at or before 30 months of age were followed up through telephone interviews with referral agencies and records review. Ninety percent proved to have significant problems, and 67% were in special education programs at 5 years of age. This study demonstrates the need for long-term follow-up of high-risk children at least to the age of school entry.
Implementation of the model in the University of Maryland RN-to-BSN program.
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"Mental imbalance" and the prediction of recurrent delinquent behavior.
Cognitive and personality patterns of 84 court-referred adolescents were examined to identify predictors of recurrent delinquent behavior. Continued behavioral problems at follow-up were more likely in adolescents with discrepancies between Verbal and Performance IQ or large differences between "neurotic" and "psychotic" scale elevations on the MMPI. Positive outcomes were most likely for adolescents who could be described as "mildly neurotic." Combining the discrepancy scores from the intelligence and personality tests with other background variables in a Bayesian conditional probability model resulted in accurate predictions of later behavior for 81% of the sample. These findings suggest that imbalances in cognitive and personality development may limit a delinquent adolescent's ability to interact appropriately with the environment.
Children's social preferences toward peers with visible physical differences.
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Environmental influences and perinatal risk factors in high-risk children.
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