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Biomedical subjects

D Drotar

Publications and source records attributed to D Drotar.

At least 91 records · Page 5Linked to original sources

Intellectual and emotional sequelae of Reye's Syndrome.

Previous reports on survivors of Reye's syndrome have indicated a high proportion of significant neurological and intellectual sequelae. However, increasingly sophisticated monitoring and therapeutic techniques have diminished both the mortality and morbidity of this disease. Our present study documented the relatively good intellectual and neurological prognosis for recent survivors of Reye's at our institution and explored the emotional impact of this illness on survivor's families. The significant emotional problems of the children and their families were in striking contrast to the relatively good intellectual and academic recovery. Nine of the 16 survivors showed emotional disruption (primarily somatic complaints, anxiety, and depression). Fourteen of 16 mothers interviewed continued to suffer from anxiety, depression, and overprotective behavior as long as 5 years after their child's illness. In many respects, the parents endured more prolonged and profound suffering than did the children. These findings have implications for the delivery of follow-up care to families of survivors.

Adolescent↗

Psychosocial functioning of children with cystic fibrosis.

The adjustment of children with cystic fibrosis as rated by parents and teachers was compared to that of physically healthy siblings, normal children, and other chronically ill children. The findings indicated that children with cystic fibrosis achieved an age-adequate level of adjustment at home and school. Adjustment was largely unrelated to the severity of cystic fibrosis. As a group, chronically ill children had less adequate adjustment as rated by parents. However, severe adjustment problems were relatively rare. These findings are consistent with a growing body of literature which suggests that children with cystic fibrosis can cope reasonably well with life tasks and that emotional disturbance is not an inevitable consequence of the disease. Future studies of the cystic fibrosis population should study factors which differentiate adjusted from maladjusted children.

Adolescent↗

Personality adjustment of children and adolescents with hypopituitarism.

Sixteen children and adolescents with extreme short stature secondary to hypopituitarism were compared to a matched group of physically healthy peers on a variety of psychological tests assessing general adjustment, body image, sex role development, sex-related fantasy, and reactions to frustration. With the exception of their reactions to frustrations, the psychological adjustment of children with hypopituitarism compared favorably with that of normal children. Children with hypopituitarism typically perceived less adaptive, mature solutions to frustrating situations than did peers of average stature. Anticipatory guidance for children with extreme short stature might help facilitate more adaptive responses to the difficult and inevitable frustrations imposed by short stature. Evaluations of intervention directed toward the enhancement of coping skills and life adjustment of children with small stature due to hypopituitarism is seen as a focus for future research with this population.

Adaptation, Psychological↗

The developmental case conference as a method of teaching pediatricians about child development on an inpatient service.

Teaching pediatricians about child development on an inpatient service can pose difficult problems for the psychologist-consultant. This paper describes the evolution of a weekly case conference devoted to teaching child development to the pediatric staff on a hospital division devoted to the care of young infants. A format involving live demonstration of developmental assessment is seen as a stimulating and effective way to convey information about child development to pediatricians. A case example illustrates the advantages of this conference to facilitating pediatric observations, and early recognition of developmental problems.

Child Development↗

The adaptation of parents to the birth of an infant with a congenital malformation: a hypothetical model.

To determine the course of parental reactions to the birth of a child with a congenital malformation and the process of parental attachment, the parents of 20 children with a wide range of malformations including mongolism, congenital heart disease, and cleft palate were interviewed. Structured interviews took place 7 days to 60 months after birth. Despite the wide variation of malformations, analysis of the interviews demonstrated five stages of parental reactions--shock, denial, sadness and anger, adaptation, and reorganization--in dealing with a congenitally malformed child during the course of his development and care. Observations of these patients suggest that early crisis counseling in the first months of life may be particularly crucial in parental attachment and adjustment.

Adaptation, Psychological↗

Low level lead exposure in the prenatal and early preschool periods: intelligence prior to school entry.

The hypothesis that low level lead exposure in the fetal and early preschool years is related to neuropsychological deficit is being examined in a prospective study of development through the preschool years. Clear and consistent support for the hypothesis was not obtained in previously reported findings relating maternal and cord blood lead level (PbB) and PbB from venous samples through age three years to a series of developmental tests. It was concluded the relationship of lead level and cognitive development was primarily a function of the dependence of each on the quality of the caretaking environment. The cohort has now been examined at age four years, ten months, an age selected to assess development just prior to school age. The test used was the Wechsler Preschool and Primary Scale of Intelligence. We found statistically significant correlations between most of the PbB measures and the intelligence test scores, but these were attenuated, not statistically significant and not consistent in direction when relevant confounding variables were considered. Possible biases or threats to validity were reviewed. Effect sizes relating both prenatal and preschool lead exposure to intellectual development were small, not statistically significant, and not consistent in direction.

Cohort Studies↗

Problem-solving abilities among mothers of infants with failure to thrive.

OBJECTIVE: Maternal problem-solving abilities, as they related to specific child-rearing situations, were examined and compared among mothers of infants with failure to thrive (FTT) and a matched group of comparison mothers. METHODS: Participants were 37 mothers of children diagnosed with FTT and 37 mothers with normally growing children matched on three child variables and five maternal variables. Participants were administered a means-ends problem-solving measure specific to parents of young children and measures of language ability, depression, negative affect, and stressful life events. RESULTS: Multivariate analysis of covariance results supported our main study hypotheses that mothers of infants with FTT would generate fewer problem-solving strategies that would be judged of poorer quality (i.e., less likely to result in positive outcomes) than mothers of healthy, normally growing infants. There were no significant associations obtained among problem-solving variables and individual difference variables (e.g., depression, negative affect, and stressful life events). CONCLUSIONS: Limited maternal problem-solving abilities may contribute to FTT by interfering directly with the quality of nurturance, feeling, and caloric intake the child receives. Recommendations are made for future research and interventions with mothers of children with FTT.

Adolescent↗