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Biomedical subjects

H L Broder

Publications and source records attributed to H L Broder.

8 recordsLinked to original sources

Learning disability, school achievement, and grade retention among children with cleft: a two-center study.

OBJECTIVE: This study examined the prevalence of learning disability (LD), level of school achievement; and prevalence of grade retention by type of cleft and gender at two craniofacial centers. SETTING: The setting included two university-based craniofacial centers. DESIGN/PATIENTS: Participants included 84 consecutively evaluated patients from one center who were matched by cleft type, age, and gender with 84 patients evaluated at the second center. OUTCOMES: The outcomes included learning disability, school achievement, and grade retention. RESULTS: The results revealed that 46% of subjects with cleft had LD, 47% had deficient educational progress, and 27% had repeated a grade (excluding kindergarten) in school. Males with cleft palate only (CPO) had a significantly higher rate of LD than any other subject group. Males with CPO and females with cleft lip and palate (CLP) were more likely to repeat a grade in school than were females with CPO and males with CLP. CONCLUSIONS: Children with cleft are at risk for learning disability, low school achievement, and grade retention.

Adolescent

Dentofacial disharmony: motivations for seeking treatment.

Patients whose skeletal disharmony was severe enough to warrant a surgical treatment option completed a 24-item Motives for Treatment questionnaire. Each item was rated from (1) not at all a reason to (4) very much a reason. Items were grouped to form six dimensions. An average score of 3.0 or greater on a given dimension was considered a strong motivation. Of the 135 patients who completed the questionnaire, 16% of the patients had primarily a self-image motivation, 4% primarily an oral function motivation, and 6% strong dual self-image/oral function motivations. Males and females differed significantly on the social well-being and temporomandibular joint (TMJ) dimensions. A strong social motivation occurred 4.5 times more frequently among males than among females, while a higher proportion of females than males reported TMJ concerns. Patients older than 25 scored higher on oral function, future health, and TMJ dimensions. Patients who elected surgery had higher scores on oral function, nasal function, and TMJ dimensions. Approximately 1.5 times as many patients who elected surgery scored on average of 3.0 or higher on the self-image and oral function dimensions.

Adolescent

Implementing and evaluating a patient instructor program.

A Patient Instructor (PI) program designed to improve students' data-gathering and interpersonal skills is evaluated. Each student in two consecutive classes of third-year students (class of 1996, n = 60; class of 1997, n = 72) interviewed four patient instructors (PIs) during a three-hour rotation. Each PI portrayed one of six scenarios. PIs assessed students using content checklists and an abbreviated Arizona Clinical Interview Rating Scale (ACIR). After the interview, each PI gave student constructive feedback regarding interpersonal behavior and ability to identify salient content items from the patient's history. Significant improvement was observed on content checklists (p < 0.01) between the first and second rounds. Significant improvement was also noted on the ACIR (p < 0.01) between rounds one, two and three. The results indicate that data-gathering and interpersonal skills can be enhanced by using patient instructors. Student evaluation of the program was positive.

Education, Dental

Self-concept, Class II malocclusion, and early treatment.

Increased overjet has been associated with teasing, negative stereotyping, and low self-concept. Early treatment for children with Class II malocclusion is often recommended under the assumption that an improved dental appearance may benefit a child by increasing his or her social acceptance and hence self-concept. The self-concept of 208 patients, age 7 to 15 years and with increased overjet, was measured before treatment using the Piers-Harris self-concept scale; a subset of 87 of these children were measured again after 15 months of early growth modification. The mean self-concept score for these children was above the population norm, and there was no association between the child's score and the magnitude of his or her overjet or age. Although some significant associations were found between Class II malocclusion features and self-concept scores, the explained variation in self-concept scores was low (R2 from 5% to 8%). There was no change in the mean self-concept score of these children during early treatment, nor was there any association between reduction of Class II malocclusion features and improved self-concept. These findings suggest that children with Class II malocclusion do not generally present for treatment with low self-concept and, on average, self-concept does not improve during the brief period of early orthodontic treatment.

Adolescent

Effects of visible and invisible orofacial defects on self-perception and adjustment across developmental eras and gender.

Self-ratings of satisfaction with appearance and accomplishment of psychosocial tasks were examined by age and gender among school aged children with visible defects (cleft lip and/or palate, n = 272), or invisible defects (cleft palate only, n = 159), and dental patients (n = 128) without clefts. Using weighted least squares ANOVA and logistic regressions, the results revealed that subjects with visible defects expressed greater dissatisfaction with their appearance than those subjects with invisible defects (p < .001). Subjects with invisible defects consistently expressed lower problem solving ability than subjects with visible defects (p < .001) and dental patients with no defects (p < .05). Both groups with clefts expressed less social independence (p < .001); and subjects with clefts reported having more friends than other children (p < .01). Implications for clinicians and further research are discussed.

Adolescent

Habilitation of patients with clefts: parent and child ratings of satisfaction with appearance and speech.

This study examined ratings regarding satisfaction with facial appearance and speech performance from 495 parent-child pairs. Data were obtained from school-aged children (5-18 years old) and their parents using standardized independent interviews. Results revealed that 54 percent of the children with cleft lip (CL) or cleft lip and palate (CLP) were very pleased with their appearance, and 62 percent of the cleft palate or CLP subjects were very pleased with speech. Low, but statistically significant correlations exist between the female subjects and their parents in satisfaction with appearance. Although older cleft lip and/or palate patients reported increased satisfaction with speech, no age differences in patient satisfaction with appearance were observed in subjects with CL/CLP. Parents of females expressed more concern about their daughters' appearance than parents of males, while parents of males were more concerned about speech. Implications for craniofacial habilitation teams and research suggestions are discussed.

Adolescent