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Biomedical subjects

J Deitz

Publications and source records attributed to J Deitz.

18 recordsLinked to original sources
PubMed1999

The grant portfolio of the National Center for Medical Rehabilitation Research: the first five years.

OBJECTIVE: To relate grant funding activities of the National Center for Medical Rehabilitation Research (NCMRR) with the Center's mission, priorities, and terminology for disability classification. STUDY DESIGN: Retrospective review by the National Advisory Board on Medical Rehabilitation Research (NABMRR). DATA: Abstracts of 153 research proposals and one contract funded by the NCMRR from 1992 through 1996. METHOD: A six-member research group participated in the development of a rating form and related instructions used to evaluate each abstract. The form was piloted and revised, and interrater agreement was monitored. RESULTS: Funded proposals reflected each of the NCMRR priorities evaluated, with the highest proportion in the areas of assistive technology and whole body system, and the lowest in the area of behavioral adaptation. Although some proposals were funded in each of the domains of the disability classification system, proportionately fewer addressed the domains of disability and societal limitations. Findings also indicated that few funded proposals addressed more than one domain in the disability classification system and that most abstracts did not address consumers' perspectives on quality of life. RECOMMENDATIONS: The NABMRR recommended that the NCMRR (1) encourage more research in the areas of disability and societal limitations and in behavioral adaptation, (2) examine funded proposals in light of a recent Institute of Medicine report, and (3) explore quality-of-life measurements. Further, members of the rehabilitation community are encouraged to e-mail their responses to this review to NCMRR staff at (1q2n@nih.govA) and to suggest areas of research emphasis.

Financing, Government↗
PubMed1998

Test-retest reliability of the evaluation tool of children's handwriting-manuscript.

OBJECTIVE: This study examined the test-retest reliability of the legibility portion of the Evaluation Tool of Children's Handwriting-Manuscript (ETCH-M). METHOD: The sample consisted of 31 first-grade and second-grade students with handwriting dysfunction. The ETCH-M was administered two times, 1 week apart, to participants. The primary investigator acted as sole rater and followed standard scoring procedures. RESULTS: The reliability coefficients were .63 for total numeral legibility .77 for total letter legibility, and .71 for total word legibility. Individual task reliability coefficients were generally lower and ranged from .20 (near-point copy) to .76 (alphabet uppercase). CONCLUSION: Total letter, total word, and uppercase letter legibility were more stable than total numeral legibility scores and other individual tasks scores. When evaluating handwriting for a child, it is important to consider ETCH legibility scores as only one aspect of a comprehensive evaluation.

Child↗
PubMed1998

A comparison of two computer access systems for functional text entry.

OBJECTIVE: Functional written communication, an important goal in the rehabilitation of persons with tetraplegia, frequently is met through the use of personal computers and alternative computer access systems. To make informed decisions about alternative access systems, the therapist needs information on the efficacy of the available choices. The purpose of this study was to investigate the effectiveness of two commercially available systems for text entry, the traditional mouthstick and the Prentke Romich HeadMaster. METHOD: Participants were a 25-year-old man and 76-year-old woman who both functioned at a C5 neurological level. Neither participant had previous experience with either system for text entry. A single-subject research design was used whereby Participant 1 experienced six phases of treatment (i.e., CBCBCB, where C = mouthstick and B = HeadMaster), and Participant 2 experienced four phases of treatment (i.e., BCBC). RESULTS: Participant 1 achieved a maximum rate of text entry of 5.85 wpm with both the HeadMaster and the mouthstick, whereas Participant 2 achieved a maximum rate of 7.15 wpm with the mouthstick and 4.85 wpm with the HeadMaster. Results from this study were similar to the results from previous comparison studies of persons with severe disabilities who had no experience with alternative computer access systems. CONCLUSION: Both participants were able to use both systems successfully; however, their respective rates of text entry were too slow to be functional in most employment situations.

Adult↗
PubMed1994

The effect of oral support on sucking efficiency in preterm infants.

OBJECTIVE: The purpose of this study was to determine the effectiveness of oral support on feeding efficiency in preterm infants who were identified by the medical team as poor feeders. METHOD: Thirteen premature infants between 34 and 40 weeks' postconceptional age were selected from a group of infants at Children's Hospital and Medical Center in Seattle, Washington. They were fed twice within a 26-hr period, once with oral support and once without. The order of occurrence of these two conditions was randomly selected without replacement to assure that an equal number of both conditions occurred during the first feed. Only the first 2 min of the feed were used in data analysis. RESULTS: A statistically significant difference (z = -2.62, p < .01, two-tailed) in volume intake occurred between the oral support condition (M = 10.9 cc) and the no oral support condition (M = 4.8 cc). CONCLUSION: This study validates the use of oral support as an effective treatment technique to enhance sucking efficiency in preterm infants.

Bottle Feeding↗
PubMed1993

Single-switch computer access for infants and toddlers.

Computer access was studied with children between the ages of 6 months and 18 months with no known handicapping conditions. The research focused on determining at what age young children can access a computer using a single-switch system to run a simple cause-and-effect program. The sample consisted of 80 children divided into four groups (6 to 8 months, 9 to 11 months, 12 to 14 months, and 15 to 17 months). Results demonstrated that some children as young as 6 months of age could control a computer-based, cause-and-effect program using a single-switch access system. Therefore, professionals who work with children with disabilities may consider introducing computers to children at this age or to children who are functioning near this cognitive developmental level.

Association Learning↗
PubMed1993

Motor performance in children after traumatic brain injury.

Traumatic brain injury can result in persistent impairments of motor performance that interfere with functional activities. This study compared the gross and fine motor performance of 14 traumatically brain-injured children (five to 15 years old, with loss of consciousness for at least 24 hours) to 14 normal children group matched for age and sex. All subjects had normal intelligence and no prior history of cognitive or motor delays. Subjects were assessed with the Bruininks-Oseretsky Test of Motor Proficiency at least 16 months after injury. Results were compared using the Wilcoxon rank sum test. Highly significant differences were found between groups on the Gross Motor Composite. Although no significant differences were found on the Fine Motor Composite, a highly significant difference also was found on one of the fine motor sub-tests, Upper-Limb Speed and Dexterity. Subtest analysis revealed that when speed was a component of either fine or gross motor tasks, a pattern of significant differences was found. This is consistent with previous research in neuropsychology, which has demonstrated problems in speeded motor performance of children with brain injuries. These findings provide direction for further research, clinical assessment, and treatment of this at-risk population.

Adolescent↗
PubMed1992

Self-psychological approach to posttraumatic stress disorder: neurobiological aspects of transmuting internalization.

This essay presents the case of a young man with severe posttraumatic stress disorder (PTSD) in order to demonstrate how a self-psychological orientation and psychotherapeutic approach enables acute symptoms to be relieved, while concomitantly addressing vulnerability in character structure. The self-psychological conceptualization of the psychodynamics of PTSD is discussed, along with a recently proposed neuropsychological theory of PTSD. After viewing the pertinent neurobiological research, an integration of the self-psychological concepts of transmuting internalization (a purported curative factor in psychotherapy) with neurobiological data and behavioral observations is presented.

Adult↗
PubMed1991

Pediatric power wheelchairs: evaluation of function in the home and school environments.

The purpose of this study was to compare the performance of four power wheelchairs when used by children to perform a variety of indoor activities. Eight boys and eight girls performed a series of 11 functional tasks when positioned in each of four different power wheelchairs reflecting different design classes. There were no significant differences for many of the dependent variables. However, the Everaid Turbo was significantly better for functional positioning at a standard kitchen table and at school desks and for accessing objects at different heights. By contrast the Invacare Jaguar was better for straight-line driving speed. Other findings include children's subjective impressions of the four power wheelchairs.

Activities of Daily Living↗
PubMed1990

Spasticity in spinal cord injured persons: quantitative effects of baclofen and placebo treatments.

Spasticity commonly occurs after a spinal cord injury and is characterized by increased resistance to passive movement of peripheral joints. This study examined the effect of an antispasticity medication on stiffness from the myotatic reflex response generated by passive sinusoidal ankle motion. A repeated measures, multiple base-line, single-subject, double-blind design was employed. The independent variable was spasticity medication treatment, where the levels were 40 mg/day and 80 mg/day of baclofen v placebo treatment. Viscous and elastic stiffness measurements were taken at the ankle joint during a placebo base-line phase and during treatment with baclofen for five adult males with traumatic spinal cord injuries. Ankle sinusoidal oscillation frequencies were from 3 to 12 Hz during test sessions. Mean viscous and elastic stiffness scores for all frequencies were calculated for each phase of the study. Randomization tests of mean changes in stiffness measurements between each treatment phase of the study failed to provide any convincing evidence of a significant treatment effect for reduction of spasticity in the traumatic spinal cord injured subjects studied. Further testing is needed to exclude potential confounding factors before this conclusion can be confirmed. The results suggest that baclofen is not a universal treatment of choice for all individuals with spasticity resulting from traumatic spinal cord injury.

Adult↗
PubMed1989

The evolution of the self-psychological approach to depression.

This paper traces the evolution of the self-psychological view of depression from its roots in classical psychoanalytic theory and technique. Self psychology differs significantly from classical psychoanalysis in its theoretical understanding and its technical handling of the transferences and aggressive tendencies of depressed patients in psychotherapy or psychoanalysis.

Aggression↗
PubMed1988

Self-psychological interventions for major depression: technique and theory.

Cases of significantly depressed and regressed patients, where functional impairment necessitated psychiatric hospitalization, are presented to show the effects of a style of psychotherapeutic intervention whose goal is rapid mobilization of preexisting self-representations linked to positive affects. After defining the relevant self-psychological terms, we discuss the factors influencing emergence into consciousness of these positive affects and effects on the patient's vegetative symptoms of depression during self-psychologically oriented psychotherapy.

Aged↗
PubMed1988

A description of grip strength in preschool children.

The purpose of this research project was to provide occupational therapists with preliminary descriptive data on the spherical grip strength of 3- to 5 1/2-year-old children using the Martin Vigorimeter. Three hundred and eighty boys and girls were tested. Standardized positioning and instructions were followed. The mean of three trials was used as the grip strength score for each hand. The right and left hands were alternated during testing to allow a 20-second rest between trials. A repeated measures design multiple analysis of variance was used to analyze the data. The findings indicated that the mean grip strength scores increased linearly with an increase in age (p less than .001) and that the right grip strength score was greater than the left (p less than .001). The descriptive data were reported separately for the right and left hands by age increments of 6 months. Two tables of mean grip strength scores and their standard deviations were generated for clinical use.

Age Factors↗
PubMed1986

A ventilator for magnetic resonance imaging.

Breathing motion severely degrades the quality of magnetic resonance images (MRI) of the thorax and upper abdomen and interferes with the acquisition of quantitative data. To minimize these motion effects, we built an MRI compatible ventilator for use in animal studies. Solid state circuitry is used for controlling ventilation parameters. The ventilator can be triggered internally at frequencies of 0.1 to 30 Hz or it can be triggered externally such as by the MRI pulse sequence. When triggered by the scanner, ventilation is synchronized to occur between image data acquisitions. Thus, image data are obtained when there is no breathing motion and at a minimum lung volume when hydrogen density is maximum. Since the ventilator can be adjusted to operate at virtually any frequency from conventional to high frequency, ventilation can be synchronized to all commonly used repetition times (100 ms to 2000 ms or more; 600 to 30 breaths/min). Scan synchronous ventilation eliminates breathing motion artifacts from most imaging sequences (single and multiple spin echo and inversion recovery). Best image quality is obtained when scan synchronous ventilation is combined with cardiac gating. These methods are also useful for quantitative research studies of thoracic and abdominal organs.

Abdomen↗
PubMedDate not supplied

The effect of switch control site on computer skills of infants and toddlers.

OBJECTIVE: The purpose of this study was to determine whether switch control site (hand vs. head) affects the age at which children can successfully activate a computer to play a cause-and-effect game. METHOD: The sample consisted of 72 participants randomly divided into two groups (head switch and hand switch), with stratification for gender and age (9-11 months, 12-14 months, 15-17 months). All participants were typically developing. After a maximum of 5 min of training, each participant was given five opportunities to activate a Jelly Bean switch to play a computer game. Competency was defined as four to five successful switch activations. RESULTS: Most participants in the 9-month to 11-month age group could successfully use a hand switch to activate a computer, and for the 15-month to 17-month age group, 100% of the participants met with success. By contrast, in the head switch condition, approximately one third of the participants in each of the three age ranges were successful in activating the computer to play a cause-and-effect game. CONCLUSION: The findings from this study provide developmental guidelines for using switches (head vs. hand) to activate computers to play cause-and-effect games and suggest that the clinician may consider introducing basic computer and switch skills to children as young as 9 months of age. However, the clinician is cautioned that the head switch may be more difficult to master than the hand switch and that additional research involving children with motor impairments is needed.

Age Factors↗
PubMedDate not supplied

Current practice of occupational therapy for children with autism.

OBJECTIVE: The purpose of this study was to examine the current practice patterns of occupational therapists experienced in working with children with autism spectrum disorders. METHOD: Occupational therapists experienced in providing services to 2-year-old to 12-year-old children with autism completed a mail questionnaire describing practice patterns, theoretical approaches, intervention techniques, and preferred methods of preparation for work with children with autism. RESULTS: Of those contacted, 72 occupational therapists met the study criteria and returned completed questionnaires. Practice patterns included frequent collaboration with other professionals during assessment and intervention. Intervention services were typically provided in a one-to-one format with the most common techniques being sensory integration (99%) and positive reinforcement (93%). Theoretical approaches included sensory integration (99%), developmental (88%), and behavioral (73%). Evaluations relied heavily on nonstandardized tools and clinical observations. Educational methods identified as most helpful were weekend workshops (56%) and on-the-job training (52%). CONCLUSION: This study clarified the nature of current occupational therapy practice patterns for 2-year-old to 12-year-old children with autism. Additional studies are needed to examine the efficacy of current evaluation and intervention methods, as well as to explore the relevance of available standardized assessments for this population.

Attention↗
PubMedDate not supplied

Children with burn injuries: purposeful activity versus rote exercise.

OBJECTIVE: This study was designed to compare measures of pain when children with burn injuries were engaged in a purposeful activity, specifically a play activity, versus rote exercise. METHOD: Two 6-year-old children participated in a study using a single-subject, randomized multiple treatment design to compare two conditions: purposeful activity and rote exercise. Data were gathered for each session on four dependent measures: number of repetitions of therapeutic exercise completed, number and type of overt distress behaviors displayed, scores on self-report scales of pain intensity, and overall enjoyment of the activity. RESULTS: Visual inspection of the graphed data suggested that, early in the rehabilitation process, the use of a play activity in comparison to rote exercise yielded better outcomes in terms of all four dependent measures. Additionally, the data implied that there may be a point later in the rehabilitation of a child with a burn injury when rote exercise may be as effective as play activities in meeting therapeutic goals. CONCLUSION: This study supports the belief that purposeful activity can yield results equal to or better than those achieved using rote exercise. Replication of this study is warranted, and the development is indicated of a measure of overt behavioral distress that is more appropriate than those currently available for children with burn injuries.

Burns↗
PubMedDate not supplied

Comparison of Sensory Profile scores of young children with and without autism spectrum disorders.

OBJECTIVES: The purpose of this study was to describe the sensory-based behaviors of young children with autism as reported by their parents on the Sensory Profile. Factor scores of children with autism were compared with those of children without autism. METHOD: The Sensory Profile questionnaire was completed by parents of 40 children with autism 3 through 6 years of age and parents of 40 children without autism 3 through 6 years of age. RESULTS: The performance of children with autism was significantly different from that of children without autism on 8 of 10 factors. Factors where differences were found included Sensory Seeking, Emotionally Reactive, Low Endurance/Tone, Oral Sensitivity, Inattention/Distractibility, Poor Registration, Fine Motor/Perceptual, and Other. CONCLUSION: Findings from the study suggest that young children with autism have deficits in a variety of sensory processing abilities as measured by the Sensory Profile. Further research is needed to replicate these findings, to examine the possibility of subgroups on the basis of sensory processing, and to contrast the sensory processing abilities of children with other disabilities to those of children with autism.

Autistic Disorder↗