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Biomedical subjects

H R McConachie

Publications and source records attributed to H R McConachie.

9 recordsLinked to original sources
PubMed2003

Parent-mediated early intervention for young children with autism spectrum disorder.

BACKGROUND: Recent estimates concerning the prevalence of autistic spectrum disorder are much higher than those reported 30 years ago, with at least 1 in 400 children affected. This group of children and families have important service needs. The involvement of parents in implementing intervention strategies designed to help their autistic children has long been accepted as helpful. The potential benefits are increased skills and reduced stress for parents as well as children. OBJECTIVES: The objective of this review was to determine the extent to which parent-mediated early intervention has been shown to be effective in the treatment of children aged 1 year to 6 years 11 months with autistic spectrum disorder. In particular, it aimed to assess the effectiveness of such interventions in terms of the benefits for both children and their parents. SEARCH STRATEGY: A range of psychological, educational and biomedical databases were searched. Bibliographies and reference lists of key articles were searched, field experts were contacted and key journals were hand searched. SELECTION CRITERIA: Only randomised or quasi-randomised studies were included. Study interventions had a significant focus on parent-implemented early intervention, compared to a group of children who received no treatment, a waiting list group or a different form of intervention. There was at least one objective, child related outcome measure. DATA COLLECTION AND ANALYSIS: Appraisal of the methodological quality of included studies was carried out independently by two reviewers. Differences between the included studies in terms of the type of intervention, the comparison groups used and the outcome measures were too great to allow for direct comparison. MAIN RESULTS: The results of this review are based on data from two studies. Two significant results were found to favour parent training in one study: child language and maternal knowledge of autism. In the other, intensive intervention (involving parents, but primarily delivered by professionals) was associated with better child outcomes on direct measurement than were found for parent-mediated early intervention, but no differences were found in relation to measures of parent and teacher perceptions of skills and behaviours. REVIEWER'S CONCLUSIONS: This review has little to offer in the way of implications for practice: there were only two studies, the numbers of participants included were small, and the two studies could not be compared directly to one another. In terms of research, randomised controlled trials involving large samples need to be carried out, involving both short and long-term outcome information and full economic evaluations. Research in this area is hampered by barriers to randomisation, such as availability of equivalent services.

Autistic Disorder↗
PubMed1999

Conceptual frameworks in evaluation of multidisciplinary services for children with disabilities.

Child disability services are under pressure to evaluate what they provide. Evaluation encompasses both the procedures they adopt and the outcomes for their clients, that is, for children and families. This paper presents practical frameworks for service evaluation, with examples from experience and from published literature. Individual services cannot carry out evaluation of the clinical effectiveness of particular interventions, but they can clarify their goals, institute regular audit projects, develop guidelines for their practice through participatory evaluation, and sample parents' views of the quality of the services they provide. Practical suggestions are made for the measurement of outcomes for individual children and families.

Child↗
PubMed1999

How do Child Development Teams work? Findings from a UK national survey.

The area of child disability is the 'Cinderella' of community child health services. It lacks a clear commissioning model, agreed quality standards or guidance on the level of resources required. In this climate of uncertainty, a national survey of Child Development Teams was undertaken in order to describe their basic structure and processes. The paper reports information from 242 multidisciplinary teams providing local services, with statutory funding, to children with neurodevelopmental disability and their families. The picture presented is encouraging in part. For example, 79% of teams operate from a Child Development Centre, which may be expected to enhance team communication. In terms of the initial assessment process for a developmentally delayed child, most teams (91%) report that they would hold a case discussion afterwards, although only 74% would always include parents, and only 70% always give their report(s) to parents. The impression of management practices is weak, with only 62% giving a clear answer about who manages the team, and less than half having a written policy or contract for the team's work. The survey findings provide a sampling framework from which further evaluative research can be generated.

Child↗
PubMed1994

Early expressive language of severely visually impaired children.

This paper presents a comparison of the early language of nine blind and nine severely visually impaired children, with no other impairments, who were recruited from paediatric vision clinics in London and assessed in the second and third year of life using the Reynell-Zinkin Developmental Scales. Further information on milestones and content of early expressive language was obtained from parents' diary recordings of their children's emerging words. It is concluded that severely visually impaired children's expressive language tends to develop later than that of sighted children. The effect of children having even a small amount of vision could be discerned in their early words. The developmental course appears to be particularly variable for blind children, with implications for parental counselling.

Blindness↗
PubMed1994

Developmental setback in severe visual impairment.

Developmental setback in children initially thought to be of normal cognitive potential is a serious complication of severe visual impairment; the prevalence, diagnostic specificity, clinical presentation, and factors that contribute to its genesis require systematic investigation. The findings are reported of a retrospective case review over a 15 year period of children attending the developmental vision clinic at the Wolfson Centre of the Institute of Child Health. One hundred and two children met the inclusion criteria of a period of normal development confirmed at initial assessment when aged less than 16 months, absence of additional disabilities, and follow up to at least 2.5 years of age. Developmental setback in their second or third year occurred in 10 (31%) of 32 children who were totally blind throughout (minimal perception of light or less), one (4%) of 25 who, though blind at first assessment, showed visual improvement, and none of 49 children with better vision throughout (awareness for near, large objects). This represents a significantly greater risk for totally blind children than for the other groups. The course and characteristics of the affected children varied, but all had visual diagnoses involving the nervous elements of the visual system, and 60% had major social adversity factors. The role of primary maldevelopment of the central nervous system, the degree of visual impairment, the developmental and emotional climate, and the stage of attentional and behavioural development in the causation of adverse developmental outcome are discussed.

Autistic Disorder↗
PubMed1991

What parents think about parenting and teaching.

What parents of young mentally handicapped children think about parenting and teaching can affect their response to services offered, particularly programmes of advice on how to boost their child's rate of development. The paper presents a descriptive study of 40 mothers' and fathers' perceptions of their role in their child's activities, and how these relate to daily patterns of family interaction. The individual variations have implications for intervention strategies.

Activities of Daily Living↗
PubMedDate not supplied

The emotional experience of multiple handicap: issues in assessment.

Guidelines for good practice in the assessment of children with multiple disabilities are presented. These arose from working groups of parents and professionals, drawn from a variety of theoretical orientations, who met together during a workshop sponsored by the Mary Kitzinger Trust.

Child↗
PubMedDate not supplied

Home-based teaching: what are we asking of parents?

Professional services for young children with disabilities generally expect parents (usually mothers) to carry out teaching or therapy exercises at home. Their advice often implies structuring the work into special daily sessions. In this study, parents were asked to carry out play sessions, and managed 62% of the available days. Reasons for missing sessions were primarily shortage of time or child illness. Mothers were more likely to carry out sessions where their child was of lower ability, and fathers less likely. Discussion concentrates on the need for professionals to vary their expectations and approach with individual parents' philosophies and energies.

Adult↗