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Biomedical subjects

J E Fischel

Publications and source records attributed to J E Fischel.

11 recordsLinked to original sources
PubMed1994

Practitioner review: early developmental language delay: what, if anything, should the clinician do about it?

Early developmental language delay is characterized by slow development of language in preschoolers. The condition is frequent among two- and three-year-olds, causes concern among parents, and generates differences of opinion as to significance among informed professionals. Poorer long-term outcomes are much more likely if language delay persists until the later preschool years, and if the delay is not specific to language and/or includes problems in understanding. Specific language delay in the preschool period is better characterized as a risk factor than a disorder; most children with specific language delay recover to the normal range by five years of age.

Child↗
PubMed1992

Painful defecation and fecal soiling in children.

Fecal soiling is a common complaint among school-age children. The fecal soiling is often accompanied by chronic constipation and so-called "idiopathic," "functional," or "psychogenic" megacolon, the cause of which is undetermined. The records of all children presenting to a pediatric gastroenterology clinic between 1981 and 1990 with difficult defecation were reviewed to determine the incidence of painful defecation and its relationship to chronic impaction and fecal soiling. There were 227 children; 74 were younger than 36 months of age and 153 were older than 36 months. Of the younger children, 86% presented with pain, 71% with impaction, and 97% with severe withholding. The younger children had painful defecation for a mean of 14 +/- 9 (SD) months before presentation. Of the older children, 85% presented with fecal soiling, 57% with pain, and 73% with fecal impaction, and 96% exhibited withholding; the older children had difficult defecation for a mean of 56 +/- 42 months before presentation. Sixty-three percent of the children presenting with fecal soiling had a history of painful defecation beginning before 36 months of age. Painful defecation frequently precedes chronic fecal impaction and fecal soiling in American children. Early, effective treatment of painful defecation in infancy might reduce the incidence of chronic fecal impaction and fecal soiling in school-age children.

Adolescent↗
PubMed1991

The continuity of babble and speech in children with specific expressive language delay.

A natural language sample of babble and words was obtained for 37 two-year-olds with severe specific expressive language delay. Variables derived from this sample were used to predict individual differences in expressive language scores 5 months later. The rate of word use was positively related to language outcome, whereas rate of vowel babble was negatively related to outcome. Together, these two variables accounted for 41% of the variance in language outcome test scores. The addition of one nonlinguistic variable, a measure of behavior problems, allowed the prediction equation to account for over 50% of the variance in expressive language outcome. The single strongest correlate of language outcome was the proportion of consonantal to vowel babble. The degree of social responsiveness of babble and the length of babble were not related to later language scores. These findings indicate that for children with specific expressive language delay, vowel babble competes with expressive language, consonantal babble facilitates expressive language, and the length and social responsiveness of babble are independent of expressive language. The continuity between babble and speech is multidimensional and multidirectional.

Child Language↗
PubMed1991

Family history in developmental expressive language delay.

Familial aggregation of language deficits has been demonstrated in previous studies. However, researchers have typically failed to differentiate subgroups of language-impaired children. The present study used questionnaire data to assess the family history of speech, language, and school problems in a group of young children with developmental expressive language delay (ELD) and in a sample of normally developing children. In contrast to previous studies of language and speech problems, no strong familial component of ELD was found. Further, family history was not predictive of later language development in ELD children. These findings argue against genetic and familial causes of ELD and attest to the importance of differentiating subtypes of early language problems.

Chi-Square Distribution↗
PubMed1989

Behavioral correlates of developmental expressive language disorder.

The association of behavior problems with preschool language disorders has been documented extensively. However, researchers have typically failed to differentiate subgroups of language-impaired children, to use observational data in documenting the behavior disorders, or to study children at the youngest ages. Using a multimodal assessment, this study examined parent-child interaction and behavior problems in a clearly defined subgroup of language-impaired children, those with developmental expressive language disorder (ELD). These children exhibit a delay in expressive language compared with receptive language and nonverbal cognitive skills. Subjects were identified and studied at the youngest age at which the disorder can be assessed. A group of ELD children, averaging 27 months of age, was contrasted with a group of normally developing children, matched for age, sex, and receptive language ability. Groups were compared on observed parent-child interactions as well as maternal responses on the Parenting Stress Index, the Eyberg Child Behavior Inventory, and a behavior-related structured interview. ELD children, when compared with normally developing children, exhibited higher levels of negative behavior and were perceived as different by their parents.

Child Behavior Disorders↗
PubMed1989

Language growth in children with expressive language delay.

Developmental expressive language disorder is a frequently occurring condition in children, characterized by severe delay in the development of expressive language compared with receptive language and cognitive skills. Opinions differ regarding whether expressive language delay is a disorder worthy of active intervention or an indication of normal variation in the onset of expressive language. The purpose of this research was to follow for 5 months 26 2-year-old children in whom expressive language disorder had been carefully diagnosed to discover the rate of improvement and its predictors. Improvement was variable, with approximately one third of the children showing no improvement, one third showing mild improvement, and one third in the normal range at posttest. Nearly two thirds of the variance in improvement could be accounted for by three child variables measured by the pretest: parentally reported vocabulary size, parentally reported problems with having regular meals, and observed frequency of quiet activity not requiring the parent's management. A screening procedure involving only one of those variables, reported vocabulary size, was 81% accurate in identifying children's improvement status. The implications of these results for the management of children with expressive language disorder are discussed.

Child Behavior Disorders↗
PubMed1986

Effect of "wet nights" on daytime behavior during concurrent treatment of enuresis and conduct problems.

The case study reported in this paper focuses on the relationship between bedwetting and misconduct after the implementation of behavior therapy for both problems. A 6 1/2-year-old girl was treated for enuresis and subsequently for conduct problems (lying, aggressiveness). After both bedwetting and misconduct displayed substantial and stable improvement, it was found that occasional nightly relapses in bedwetting were strongly associated with the occurrence of misconduct the following day. Implications of this finding are discussed.

Behavior Therapy↗
PubMed1983

Acute otitis media in children: are decongestants or antihistamines necessary?

This study was designed to investigate the efficacy of a decongestant-antihistamine preparation in combination with antibiotic treatment of acute otitis media. The effectiveness of a new Dimetapp (DIM) preparation was assessed in comparison with each of its components (brompheniramine maleate [BPM] and phenylephrine hydrochloride [PEH] as well as a placebo (PL) vehicle in the treatment of acute otitis media. In a randomized double blind study, 98 children were treated in the emergency department or outpatient medical clinics at Children's Hospital of Michigan with amoxicillin and either DIM, BPM, PEH, or PL. They were evaluated at two weeks by clinical examination, pneumatoscopy, and tympanometry. Fifty-eight patients (59%) continued to have evidence of fluid in the middle ear. These patients were continued on the test medications for another two weeks and then reevaluated. There were significant differences between the treatment groups (DIM, BPM, and PEH) and the control PL group; the patients receiving Dimetapp or placebo fared better than those receiving BPM or PEH. However, there was no difference in the overall response between Dimetapp and placebo. Antihistamine-decongestant therapy does not appear to be necessary in the treatment of acute otitis media in children.

Acute Disease↗