PubMed Health⌕ Search

Biomedical subjects

E C Perrin

Publications and source records attributed to E C Perrin.

At least 37 records · Page 2Linked to original sources
PubMed1994

Children of gay or lesbian parents.

There are no data to suggest that children who have gay or lesbian parents are different in any aspects of psychological, social, and sexual development from children in heterosexual families. There has been fear that children raised in gay or lesbian households will grow up to be homosexual, develop improper sex-role behavior or sexual conflicts, and may be sexually abused. There has been concern that children raised by gay or lesbian parents will be stigmatized and have conflicts with their peer group, thus threatening their psychological health, self-esteem, and social relationships. These fears and concerns have not been substantiated by research. Pediatricians can facilitate the health care and development of these children by being aware of these and their own attitudes, by educating themselves about special concerns of gay or lesbian parents, and by being a resource and an advocate for children who have homosexual parents.

Adolescent↗
PubMed1994

What do minority elementary students understand about the causes of acquired immunodeficiency syndrome, colds, and obesity?

Elementary school-age children's conceptual understanding and factual knowledge about the causes of acquired immunodeficiency syndrome (AIDS), colds, and obesity are poorly understood, particularly among black children living in low-income, urban neighborhoods. We examined minority children's conceptual understanding about the causes of these illnesses. In addition, children's knowledge and misconceptions about the causal agents of AIDS, colds, and obesity were investigated. A developmentally based, semistructured interview was developed to measure children's level of understanding about the causes of each condition. Interviews were conducted with 239, predominately black, first, third, and fifth grade students attending two public elementary schools in a low income city in northern California. Interviews were verbally administered and tape recorded for later verbatim transcription. Children's responses to questions about causality first were scored based on their level of conceptual sophistication. Responses then were assigned to thematic categories reflecting the children's factual knowledge about the causes of AIDS, colds, and obesity. Increases in grade level were associated with higher scores for causality of AIDS (p < .0001), colds (p < .0001), and obesity (p < .01). In all three conditions, causality scores increased between first and fifth grades, but did not significantly vary between third and fifth grades. Gender, socioeconomic status, and number of adults living in the household were not significantly associated with causality scores. Within each grade, the finding of lower causality scores for AIDS, as compared to colds and obesity, points out the need for developmentally appropriate explanations to children about the causes of AIDS.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1993

Understanding of acquired immunodeficiency syndrome by elementary school children--a developmental survey.

OBJECTIVES: The developmental process by which young children acquire an understanding of the concepts of causality, treatment, and prevention of illness as related to acquired immunodeficiency syndrome (AIDS) is poorly understood. Previous studies have focused on adolescent populations and have measured the facts that children seem to know rather than their understanding of relevant concepts. Such approaches are likely to overestimate the child's true level of understanding and obscure significant misconceptions. The aims of this project are to measure directly the level of understanding of the concepts of causality, treatment, and prevention of AIDS in healthy, elementary school children and to assess the sociodemographic variables associated with their conceptual understanding. METHODS: Using a new, developmentally based, semistructured interview protocol (ASK, AIDS Survey for Kids), 361 children (57% black, 24% Hispanic, 19% white) in kindergarten through sixth grade at four public schools in New Haven, CT were interviewed. Responses to questions about causality, treatment, and prevention were scored for each of three illnesses (AIDS, and for comparison, colds and cancer) based on the level of conceptual sophistication of the response, irrespective of its factual accuracy. RESULTS: Scores for each of the concepts were highly intercorrelated and were correlated most strongly with grade level (R = .31 to .50, P < .0001 for each of these correlations, with the exception of the treatment of AIDS). Gender, race, and socioeconomic status did not contribute significantly to the variance observed for any of the concept scores in a linear regression model. Over-all, children's level of understanding of causality was significantly less sophisticated for AIDS than for colds (P < .0001); their level of conceptual understanding for the causality of AIDS was not significantly different from that of cancer (P = .9). CONCLUSIONS: Children's understanding of causality, treatment, and prevention of AIDS, as measured by the ASK, follows the same developmental sequence reported for children's understanding of general physical illness. Sociodemographic variables, such as race, gender, and socioeconomic status do not affect children's level of sophistication of these developmental concepts. These results have implications for the creation of developmentally appropriate and effective AIDS education curricula for primary and elementary grades. They also offer guidance to health care providers in their efforts to educate parents and young children about this important topic.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Issues involved in the definition and classification of chronic health conditions.

The need for a widely applicable definition of chronic conditions for research, policy, and program development has led to an extensive review of the development of such definitions, the considerations involved in their use, and some recommendations for a new approach. This paper examines some of the methodologic and conceptual issues related to defining and classifying chronic conditions and describes some consequences resulting from decisions made about these issues. While most examples are taken from child health applications, the basic concepts apply to all age groups. The dominant method for identifying and classifying children as having a chronic condition has relied on the presence of an individual health condition of lengthy duration. This condition-specific or "categorical" approach has increasingly seemed neither pragmatically nor conceptually sound. Thus, the development of a "generic" approach, which focuses on elements that are shared by many conditions, children, and families, is recommended. Such a definition might reflect the child's functional status or ongoing use of medical services over a specified time period. In addition, it is suggested that conditions be classified based on the experience of individual children, thus emphasizing the tremendous variability in expression of seemingly similar conditions.

Child↗
PubMed1993

Development in children's causal theories of their seizure disorders.

Despite the prevalence of seizure disorders in children, little is known about how youngsters with epilepsy understand the cause of their disorder. Fifty children and adolescents with idiopathic seizure disorders, between 5- and 16-years-old, were questioned about the etiology of seizure episodes and of seizure disorders, as well as their understanding of physical causality, general illness causality, and brain functioning. Responses were scored for their conceptual complexity according to scales paralleling Piaget's stages of cognitive development. Older children had more cognitively sophisticated concepts of epilepsy than did younger children. Overall, however, children scored significantly lower on questions about their seizure disorders than on questions assessing their understanding of physical causality, general illness causality, and brain functioning. Many children had misconceptions about seizure disorders and lacked disease-related information; only 41% of the children identified epilepsy as a disease involving the brain. These findings underline the need for including educational intervention in the comprehensive care of pediatric seizure disorders.

Adolescent↗
PubMed1993

In the eyes of the beholder: family and maternal influences on perceptions of adjustment of children with a chronic illness.

Investigation of the adjustment of children with a chronic illness has been complicated by an imprecise definition of adjustment, immense diversity in the kinds of chronic illnesses studied, and multiple instruments and sources of measurement of the child's behavior. In this study we have used a composite construct of adjustment, looked separately at reports from three separate observers of children's behavior, and limited our investigation to a few discrete types of illnesses. The investigation explores the contribution of selected characteristics of mothers and of families to children's adjustment as reported by children, their mothers, and their teachers. Family interactions were important to the psychological adjustment of all children (healthy or with a chronic illness and independent of age and socioeconomic status) as reported by all three observers. The mother's self-esteem and reported size of her social network were not associated with children's adjustment, but the mother's health locus of control beliefs interacted with the child's intelligence to predict children's adjustment. The pattern of these associations was different for different illness groups and for each of the three observers.

Adaptation, Psychological↗
PubMed1991

Cautions in using the Child Behavior Checklist: observations based on research about children with a chronic illness.

The Child Behavior Checklist (CBCL) and the related instruments, the Teacher's Report Form (TRF) and Youth Self-Report (YSR), are frequently used in research assessing the behavioral adjustment of children. This paper describes some issues relevant to children with a chronic physical illness that should be considered when using these instruments. Salient problems include (a) possible bias in interpreting data concerning physical symptoms; (b) limited sensitivity to identify mild adjustment problems of the sort most often encountered in children with chronic physical illnesses; and (c) incomplete and potentially misleading assessment of social competence. When using these instruments investigators should also be aware of several general methodologic issues before collecting, analyzing, and interpreting data regarding children with chronic illnesses.

Adaptation, Psychological↗
PubMed1991

Sticks and stones may break my bones ... reasoning about illness causality and body functioning in children who have a chronic illness.

Children's concepts about illness causality and bodily functioning change in a predictable way with advancing age. Differences in the understanding of these concepts in healthy children vs children with a chronic illness have not been clearly delineated. This study included 49 children with a seizure disorder, 47 children with an orthopaedic condition, and 96 healthy children, all with normal intelligence and ranging in age from 5 to 16 years. It demonstrates systematic differences in children's general reasoning skills and in their understanding of concepts about illness causality and bodily functioning, as a function of their age and experience of illness. At all ages, children who had a condition with orthopaedic involvement reported less sophisticated general reasoning and concepts about illness than did healthy children; children with a seizure disorder reported similar general reasoning skills to those of healthy children, but considerably less sophisticated concepts about illness. Children's concepts about body functioning did not differ as a function of the presence of a chronic illness. When their different levels of general cognitive reasoning were statistically controlled, children with a chronic illness had somewhat more sophisticated concepts about bodily functioning than did healthy children. Differences in conceptual development among children with different types of illnesses lead to interesting speculations with regard to the effects of particular illness characteristics on children's cognitive development.

Adolescent↗
PubMed1990

Assessing psychosocial adjustment of children with chronic illnesses: a review of the technical properties of PARS III.

Four groups of investigators in the Research Consortium on Chronic Illness in Childhood have used the Personal Adjustment and Role Skills Scale (PARS) III to assess the psychosocial adjustment of children with chronic physical illnesses and no mental impairment. The PARS III consists of 28 items that measure psychosocial functioning in six areas: peer relations, dependency, hostility, productivity, anxiety-depression, and withdrawal. Analyses of the measure's reliability and validity, using a total combined sample of 450 school-age children (ages 5-18 years) with a variety of chronic illnesses and three comparison samples of healthy children, provide evidence that the PARS III can be used successfully to assess psychosocial adjustment of children with chronic illnesses and no cognitive impairments.

Adolescent↗
PubMed1989

Listening carefully. Improving communication about behavior and development. Recognizing parental concerns.

A simple checklist was developed for completion by parents prior to their regular meetings with their pediatricians for health supervision. Its efficacy in improving communication between pediatricians and parents about behavioral and developmental concerns was evaluated. Without the checklist, 30 percent of parents' concerns were discussed. More items overall, and more items that were concerns of the parent, were discussed with the use of the checklist than without it (p less than 0.05). An intermediate but statistically significant effect was observed even when the pediatrician did not see the completed checklist (43% of concerns were discussed); this effect was increased when he did (53% of concerns discussed). There were marked differences among pediatricians in the number of concerns that were discussed both with and without use of the checklist. Items regarding patterns of family life and child care, death or illness, siblings, and other stresses of modern families were frequently indicated as concerns on the checklist but were less frequently discussed. The data demonstrate the effectiveness of a simple and efficient method to improve communication about childrens' behavior and development between their parents and their pediatricians.

Child↗
PubMed1989

Parental perceptions of health status and psychologic adjustment of children with asthma.

The relationship between severity of illness and psychologic adjustment was evaluated in 46 children with asthma. Two measures of the severity of asthma were used: the first, a composite objective measure based on clinical history and the second, parental estimates of the severity of their child's illness. Psychologic adjustment was measured by the Health Resources Inventory, a parental report of childhood behavior. Parental estimates of severity were correlated significantly with the objective measure of severity (r = .39; P less than .01), although a concordance value of 54% indicated marked lack of agreement between parental and objective ratings. As a group, children in this study achieved apparently normal adjustment scores, although scores ranged widely across all categories of severity. Children whose parents ranked their asthma as mild or severe had significantly lower adjustment scores (F = 3.28; P less than .05) than did those children rated by their parents as having moderate asthma. Children's ranks on the composite objective measure of severity were not associated with their adjustment scores, although children with greater use of medication had lower adjustment scores than did children with little or moderate medication use (P less than .05). The relationship of severity of illness to psychologic adjustment is complex. Children at all levels of severity may demonstrate problems of adjustment, suggesting that attention to psychologic risk should not be limited only to children with severe asthma.

Adolescent↗
PubMed1989

Is my child normal yet? Correlates of vulnerability.

There are some children whose parents believe them to be unusually susceptible to medical or developmental problems--"vulnerable"--despite a lack of objective evidence of any difficulty. The "vulnerable child syndrome" refers to a constellation of behaviors that are thought to develop as a result of this excessive parental anxiety and subsequent difficulties in limit setting. In this study, the sense of vulnerability expressed by mothers concerning their healthy 3-year-old children is explored; children born prematurely and with considerable neonatal morbidity are compared with children born at full-term. Sense of vulnerability is assessed through the use of a simple instrument, the use and validity of which are described. Mothers of premature infants described a significantly greater sense of vulnerability concerning their children than did mothers of full-term infants. Mothers with more education described a greater sense of vulnerability than did less well-educated mothers, although mothers who claimed greater well-being and marital satisfaction described a lesser sense of vulnerability. Mothers with a greater sense of vulnerability concerning their children also reported more behavior problems, especially in the sphere of discipline, peer relationships and self-control, and in internalizing and somatic symptoms. Pediatricians can intervene in the development of the vulnerable child syndrome by recognizing those children at special risk and helping their parents to nurture their health and independence.

Attitude to Health↗
PubMed1989

The awareness of primary physicians of the psychosocial adjustment of children with a chronic illness.

This study compared primary care physicians' ratings of psychosocial adjustment of their chronically ill pediatric patients with parents' and children's reports. A series of measures of psychosocial adjustment were administered to 63 children with either a seizure disorder or a visible orthopedic condition, and their parents. Each child's physician was asked to rate the presence and severity of psychological adjustment problems in the child, as well as to rate six specific psychosocial domains. Forty-one physicians responded, and relationships between their ratings and child and parent psychosocial measures were determined using Pearson product-moment correlation coefficients. Ratings by physicians correlated with children's reports and parents' judgments about the children, but not with mothers' self-concept or the impact that the illness had on the family. However, physicians' ratings were interdependent. When congruence of physician ratings with child or parent reports was examined for each disease group, we found significant results for the seizure disorder group; however, congruence among ratings for the orthopedically handicapped group was poor. Student's t-tests revealed no statistically significant differences between the two disease groups in any of the demographic variables of the children or physicians, nor in their scores on the criterion measures. Hierarchical multiple regression analysis identified factors that contributed to physicians' significantly different congruence with parents regarding the adjustment of children in the two subsamples. The findings of this study suggested that primary care physicians were moderately aware of the presence and severity of psychosocial adjustment problems in some categories of their pediatric patients with chronic illness.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗
PubMed1988

Concepts of illness and perception of control in healthy children and in children with chronic illnesses.

Healthy children, children with seizure disorders, and children with orthopedic conditions, ranging in age from 5 to 16 years old, were questioned about their knowledge of disease etiology, treatment, and prevention, and their health locus of control beliefs, to explore the relationship between illness-related concept attainment and perceived control over health. Children who perceived greater personal control over health demonstrated a more sophisticated conceptual understanding of disease than did children with a more external orientation. Healthy children scored significantly higher on the illness concepts questions and expressed significantly more internal health locus of control beliefs than did their peers with a chronic physical illness. Perceived control over health appears to be one factor that mediates the relationship between illness experience and understanding.

Adaptation, Psychological↗
PubMed1985

Health locus of control beliefs of healthy children, children with a chronic physical illness, and their mothers.

Scales to measure health locus of control beliefs have been developed for both adults and children to assess the degree to which individuals believe their health to be the result of self-actions, the actions of "powerful" adults in their environment, or random events or fate. We have investigated how these locus of control beliefs differ at different ages and in relation to different illness experiences. Health locus of control beliefs vary consistently according to age and illness experience. Beliefs in the control of their health by chance and by powerful others are stated to be significantly stronger by younger than by older children, by children with certain chronic physical illnesses than by healthy children, and by parents of children with certain chronic physical illnesses than by parents of healthy children. The developmental trend suggested here confirms previously reported data regarding locus of control beliefs in children. The differences among children with and without a chronic physical illness, and especially among their parents, suggest that learning occurs from the experiences related to illness, resulting in an increased external orientation in locus of control beliefs. Health care professionals should be aware of the tendency for young children and for children with a chronic illness and their families to rely heavily on providers, perhaps to the detriment of their learning effective skills for independent health-related decision making.

Adolescent↗
PubMed1984

Development of children with a chronic illness.

About 5 to 10 per cent of all children have sometime during childhood a moderately to severely handicapping long-term illness or disability. These children are at risk, not only medically, but for complex social, educational, and emotional difficulties. The potential interferences with normal development imposed by a chronic illness are varied but pervasive, and depend on the specific characteristics of the illness, the child, and the child's family. There are known psychological effects of illness on a child, which can best be understood within a developmental framework such as that outlined above. Optimal health care of these children and families depends on a knowledge of the risks to normal development that are regularly faced by these children at each stage of their development. Physicians, nurses, and other health care providers have the opportunity to be powerful advocates for children with a chronic illness. We thus have a responsibility to facilitate these children's negotiation of the challenges and crises of childhood, so they may enter their adult years with strength and security. Such guidance requires an understanding of children's development and the impact of illness on that process, and effective communication with both children and families.

Adolescent↗