Biomedical subjects

G B Landman

Publications and source records attributed to G B Landman.

12 recordsLinked to original sources

PubMed1989

Language development from six to twelve.

This article has shown that the elementary school years are vital for the growth of linguistic skills. During this period children go from a relatively rudimentary understanding of syntax and grammar to a very sophisticated appreciation of the complexities of language. Syntactic skills also are increasing during these years, particularly the ability to understand factitive verbs and complicated prepositions and conjunctions. Additionally, the child is developing a greater awareness of what language is and how to manipulate and use it. This allows the youngster greater flexibility in dealing with metaphors, poetry, and linguistic interpretation. A child's expressive skills improve during the elementary years; both the ability to narrate events and to provide appropriate information is increasing dramatically. The child progresses from learning to write sentences to producing long term papers and sophisticated reports. Also, it has been shown that children who have problems in these areas are at risk for academic failure and social isolation. Pediatricians play a significant role in identifying children with such problems. Often children are not discovered by teachers who are overwhelmed by large classes or encumbered with a complicated curriculum. Fortunately, physicians come in contact with children regularly and, by asking the right questions and inquiring about school progress, they can often determine if a child needs further assessment. In addition, instruments have been specifically designed to enable physicians to assess the age-appropriateness of a child's linguistic skills. By using specific subtests physicians can quickly determine whether a child's receptive, expressive, or syntactical skills are intact.(ABSTRACT TRUNCATED AT 250 WORDS)

Auditory Perceptual Disorders↗

PubMed1988

Neurodevelopmental assessment of behaviorally disordered inner city boys.

The purpose of this study was to assess the usefulness of a recently developed neurodevelopmental instrument (Pediatric Early Education Exam "PEEX") for evaluating inner city boys thought to be "hyperactive" by their teachers. Thirty-nine boys (age x = 102.5 months, sd = 11.9; IQ x = 98, sd = 10; 97%, black) were evaluated. No relationship was found between overflow movements and neurodevelopmental subtest performance, intelligence, or educational functioning. The development of laterality was positively related to success in reading (t = 2.21, p less than 0.05). A sentence-copying task was related to success in reading (r = .38 p less than 0.01). The ability to answer questions about complex sentences was related to mathematical success (r = .32 p less than 0.05). A task involving the ability to follow verbal directions proved most sensitive to educational, intellectual, and social functioning.

Child↗

PubMed1987

Accidental injuries in children in day-care centers.

A telephone survey of all licensed group day-care centers serving 2- to 6-year-old children in Maryland was conducted to determine the rate of injuries, their nature, and the circumstances of occurrence. Eighty-two percent of the 523 operating centers were contacted. Two centers declined to participate. Twenty-nine injuries were reported. A total of 18,728 children were surveyed (children who attended half a day were given half credit per day) or 92,640 child-days. Yearly injury rates of 7.02% for medically attended injuries, 4.29% for injuries limiting activity, and a total yearly injury rate of 11.30% were calculated. This general injury rate was similar to incidence figures from a non-day-care center injury study. This lack of improvement in injury rates in licensed day care is of concern and deserves increased attention from pediatricians.

Accidents↗

PubMed1987

An evaluation of the effects of being regarded as "unmotivated".

To designate someone as unmotivated or lazy has consistently been shown to affect behavior towards that person. A prospective study evaluated the relationship between such a designation and events at school. The subjects included 164 school-aged children who presented to the Johns Hopkins School Problems Clinic and, prior to their evaluation, had extensive forms completed by their teachers and parents. Lack of motivation was seen as the primary cause of school difficulties in 80 children (49%). Testing revealed that 69 percent were more than one year behind academically; 48 percent were more than two years behind. Fifty-one percent had been retained in grade, and 8 percent of those had been retained twice. Only 16 percent were receiving remedial help. A comparison between children seen as unmotivated and those not perceived as such showed that sex, race, and socioeconomic status (SES) were not distinguishing factors. Children seen as unmotivated were further behind academically (Chi 2 = 7.02 p less than 0.05), had been retained more often (51% versus 25%, Chi 2 = 11.6 p less than 0.001), and were receiving less intensive remedial help at school (Chi 2 = 6.14 p less than 0.05). There was a trend for children seen as unmotivated to be older (mean = 129 m SD = 38 m versus mean = 103 m SD = 33 m, t = 1.47 p = 0.1).

Child↗

PubMed1987

A five-year chart review of children biopsied to rule out Hirschsprung's disease.

A 5-year chart review of all children biopsied to rule out Hirschsprung's disease was conducted at Johns Hopkins Hospital. A total of 150 (90%) charts of the 160 children who were biopsied were obtained and reviewed. Twenty-four children (16%) had aganglionosis by surgical pathology report. All had the onset of symptoms in the neonatal period. Ninety-seven percent of children without Hirschsprung's disease and who were biopsied after the neonatal period did not have symptoms during the first 4 weeks of life. Despite having severe symptoms from birth, nine (37.5%) of the children with Hirschsprung's disease were not biopsied until an average age of 15 months. Data indicate that using the presence of bowel symptoms from the neonatal period as criteria for referral for biopsy would have missed none of the children with Hirschsprung's disease. Children with symptoms dating from the neonatal period should be considered for biopsy to avoid potential morbidity and mortality from the complication of enterocolitis.

Age Factors↗

PubMed1986

Increasing the 'show rate' in a school problems clinic.

Appointment keeping was studied at a hospital-based clinic that evaluated children with school problems. Interventions aimed at improving the "show rate" included telephone reminders and withholding appointments until a parental form had been returned. Results indicated that telephone reminders did not improve appointment keeping. Requiring parents to return forms prior to being given an appointment did significantly increase the show rate (88% vs 57%). This increase could not be attributed to a change in patients' socioeconomic status or race, which remained constant during the entire study period. This intervention also reduced the clinic's waiting period and increased the number of patients seen each month. Data indicated that requiring parents to fill out forms prior to being given appointments resulted in improving the show rate, reducing the waiting period, and increasing the number of patients seen each month.

Adolescent↗

PubMed1986

Preventing school failure: the physician as child advocate.

Attending school heralds the end of the relative protection and nurture of home life. During the school day, a child experiences successes and failures that portend future feelings of self-worth and self-esteem. Usually children experiencing difficulty at school are identified by teachers, however, children are overlooked. When they are and subsequently experience chronic failure and frustration, long-term morbidity may ensue. Ideally, methods to identify potential learning problems should be available. Unfortunately, the state of the art does not allow accurate identification of problems before they occur. After any number of screening tests, we can accurately predict school successes, but predicting failure is elusive. Early school failure, however, like many maladies, can be diagnosed, particularly if a physician has a high index of suspicion and looks for signs and symptoms of ongoing failure and frustration. Family history, neonatal course, presence of minor congenital anomalies and soft neurological signs, attention problems and lack of age-appropriate processing skills in the preschool period should place a child at risk. Close observation should designate those children who fail to mobilize associated strengths that maintain development. Early intervention will reduce morbidity associated with academic difficulty. Longitudinally, reduction of chronic failure may be the most crucial intervention. The unfortunate cycle of developmental dysfunction leading to school failure and lowered self esteem with subsequent social pathology and delinquency is well known. To the extent that physicians are able to ensure appropriate school services for children experiencing failure, this cycle can be short circuited, adding significantly to the physician's traditional armamentarium.

Adolescent↗

PubMed1986

Minor neurological indicators and developmental function in preschool children.

An attempt was made to determine whether neuromaturational indicators (soft neurological signs) were associated consistently with specific areas of developmental function in 5-year-old children. Fifty-eight children were assessed over two diagnostic sessions. One involved administration of the Pediatric Exam of Educational Readiness (PEER) by pediatric fellows; the other consisted of administration of the McCarthy Scales of Children's Abilities (MSCA) by trained psychoeducational specialists. Data indicate that children who exhibited a greater number of minor neurological indicators had a high likelihood of experiencing difficulty with visual-perceptual, fine motor, and gross motor tasks of the PEER and the MSCA. What is more important, no relationship was found between aggregates of minor neurological indicators and performance on linguistic, memory, sequencing, quantitative, verbal, or preacademic sections of these diagnostic instruments. This information suggests that physicians should limit their interpretation of such signs when evaluating young children with academic difficulties. Additional data must be accumulated before the role of neuromaturational signs can be fully understood.

Child, Preschool↗

PubMed1986

Locus of control and self-esteem in children with encopresis.

Children with encopresis were compared to children with other "high prevalence low-severity" disorders on measures of locus of control and self-esteem. Children with encopresis tended to feel less in control of positive life events, had lower self-worth, and were more apt to want to change and be different than children with other chronic symptoms. Data tend to contradict traditional interpretations of encopresis as a system of unconscious motives involving independence and control. Also, this information adds to the clinical impression culled from experience that active intensive remediation is the appropriate clinical response when treating children with encopresis.

Child↗

PubMed1986

Pediatric management of nonpervasively "hyperactive" children.

Sixty-five children viewed by their teachers as hyperactive were evaluated as to whether they would benefit from stimulant medication. All underwent extensive neurodevelopmental and educational testing. Additional information was obtained from school and parent questionnaires and interviews. Children were not placed on medication unless they demonstrated characteristic impulsive, inattentive, and/or overactive behavior in two of three environments (home, school, clinic). Fifty-two children (80%) were not placed on medication. Follow-up was completed in 80 percent, and 93 percent of these children were doing well with nonpharmacologic interventions. Initial comparison of children not placed and placed on medication revealed that age, race, SES, amount of resource help and retention could not distinguish groups. Children placed on medication had difficulties earlier in school (chi 2 = 4.88, p less than 0.05), weren't as delayed academically (chi 2 = 6.30, p less than 0.05) and had less neurodevelopmental disorders (chi 2 = 9.01, p less than 0.01). If a careful psychosocial history does not reveal impulsive, inattentive, and/or hyperactive behavior outside of school, a child should be evaluated to rule out neurodevelopmental and educational problems.

Attention↗

PubMed1985

Pediatric management of severe treatment-resistant encopresis.

Chronic fecal soiling is a distressing condition that often is associated with inappropriate psychological symptoms. This case report illustrates that a medical approach focusing on intensive "demystification" of the symptom and careful follow-up can successfully treat a child who initially might have been referred for psychiatric or even surgical consultation.

Child↗

PubMed1984

A study of treatment resistance among children referred for encopresis.

This study reports on some of the distinguishing characteristics of children with persistent encopresis who have proven, at long-term follow-up, to be resistant to intensive pediatric-based treatment at a referral outpatient clinic. Resistant children differed from responsive children primarily in two respects: they tended to have less stool retention at initial presentation, and their accidents occurred at all hours of the day. Additional information suggested that early success or failure did not presage long-term resistance and that parents' attributions of the cause of their child's soiling were related to outcome. Discussion centered on enumerating important high-risk factors that signal the need for more intensive intervention and follow-up.

Child↗