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Biomedical subjects

J W Varni

Publications and source records attributed to J W Varni.

At least 55 records · Page 3Linked to original sources
PubMed1990

Cognitive functioning in long-term survivors of childhood leukemia: a prospective analysis.

Treatment-related cognitive impairments have been reported for survivors of childhood leukemia following prophylactic central nervous system (CNS) treatment with 2400 cGy craniospinal irradiation and intrathecal chemotherapy. The present study was designed to prospectively evaluate cognitive functioning of 24 children prior to CNS prophylaxis of 1800 cGy of craniospinal irradiation and intrathecal drugs, and at intervals of 1 and 4-5 years. At diagnosis, prior to CNS treatment, all 24 subjects performed in the average range of intelligence, as measured by the Wechsler Intelligence Scales. Subjects continued to perform in the average range with no significant declines at the 1-year follow-up. Significant declines in cognitive functioning, however, were found at the 4- to 5-year follow-up period, with five subjects (21%) performing in the low average or borderline levels of intelligence. Of the 19 subjects performing in the average range, five showed significant discrepancies between Verbal and Performance IQ scores. Nine subjects exhibited poor performance on a subtest cluster assessing perceptual and attentional processes. With regard to school experiences, 50% of the subjects had received some type of special education services. The findings indicate the need for annual evaluations of cognitive functioning in long-term survivors of childhood leukemia who received 1800 cGy craniospinal irradiation, to identify potential cognitive late effects of treatment requiring appropriate special education services.

Adolescent↗
PubMed1989

Social support and adjustment in chronically ill and handicapped children.

The relationship between social support and adjustment was investigated in children with a chronic physical illness or handicap. Mothers of 153 children with juvenile diabetes, juvenile rheumatoid arthritis, chronic obesity, spina bifida, or cerebral palsy reported on these children's family support, peer support, externalizing behavior problems, and internalizing behavior problems. Children reported as having high social support from both family and peers showed a significantly better adjustment than those with high social support from only one of these sources. Chronically ill or physically handicapped children without high support from both family and peers were reported to have significantly more behavior problems than children in general. Both family and peer support contributed negatively and independently to the variance in externalizing behavior problems, whereas only peer support did so for internalizing behavior problems. There were no interactions between type of support and either sex or age in predicting adjustment.

Adaptation, Psychological↗
PubMed1989

Disability parameters, chronic strain, and adaptation of physically handicapped children and their mothers.

Investigated the contribution of disability parameters and chronic disability-related strain to the adaptation of 50 congenitally physically handicapped 6- to 11-year-old children and their mothers. Multiple dimensions of adaptation, disability status, and chronic disability-related strain were assessed with a variety of procedures. The mothers reported their children and themselves to display significantly worse adaptation than expected for a general sample. The adaptation of these children and their mothers, however, was not significantly related to the children's disability status nor the chronic strain thereto related. An exception was that the children's social functioning could be significantly explained by both of these factors. The inability to explain most dimensions of adaptation in the children and their mothers as it relates to the conceptual model guiding this research is discussed.

Adaptation, Psychological↗
PubMed1989

Physical status and psychosocial adjustment in children with spina bifida.

Investigated the relationship between the physical status and psychosocial adjustment of chronically physically handicapped children. The status of 61 children with spina bifida regarding six specific disease or disability parameters was determined from medical charts. Their mothers completed the Child Behavior Checklist as a measure of the children's psychosocial adjustment. Children with spina bifida were reported to display on the average significantly more behavior and social competence problems than expected for children in general. However, children with differing degrees of physical problems and disability did not differ significantly in their psychosocial adjustment. The general lack of relationship between physical status and adjustment as it relates to a conceptual model guiding this research is discussed.

Adolescent↗
PubMed1989

Family resources as resistance factors for psychological maladjustment in chronically ill and handicapped children.

The hypothesis that their psychological adjustment is related in part to resources present in their families was investigated in 153 children, age 4-16, who had one of five chronic physical disorders: juvenile diabetes, juvenile rheumatoid arthritis, chronic obesity, spina bifida, or cerebral palsy. Their mothers completed standardized psychometric instruments to measure specific dimensions of family psychological and utilitarian resources and of child adjustment. Variation in children's psychological adjustment was related both to their psychological and utilitarian family resources. Psychological family resources contributed uniquely to the prediction of adjustment beyond that provided by utilitarian family resources. These results are discussed as having implications for the identification of chronically ill and handicapped children at risk for adjustment difficulties.

Adaptation, Psychological↗
PubMed1989

The social environment and the adaptation of mothers of physically handicapped children.

Evaluated relationships between social environmental characteristics and adaptation in 50 mothers of congenitally physically handicapped 6- to 11-year-old children. Mothers reported on utilitarian resources, child adjustment, psychosocial family resources, service utilization, and three dimensions of adaptation. Analyses of the concurrent correlational design indicated significant proportions of the variance in mental and social functioning were explained by features of the social environment. Mother's physical health could not be significantly predicted. Consistently strong contributions were made by psychosocial family resources in all adaptation domains.

Adaptation, Psychological↗
PubMed1989

Stress, social support, and depressive symptomatology in children with congenital/acquired limb deficiencies.

Ongoing chronic strain of living with limb deficiencies and normal daily hassles may interact to produce a negative impact on adjustment. Degree of limb loss, daily hassles/microstressors, and classmate, parent, teacher, and friend social support were investigated as predictors of depressive symptomatology in 27 children with congenital/acquired limb deficiencies. Hierarchical multiple regression analyses were utilized to test the main effects and buffering interactions effects models of the stress-social support-depressive symptomatology relationship. Degree of limb loss was not a significant predictor. Microstressors and classmate, parent, and teacher social support were all significant predictors of depressive symptomatology. None of the Stress X Social Support interaction terms were statistically significant. The overall model of stress and social support predicted 73% of the variance in depressive symptomatology.

Adolescent↗
PubMed1989

Assessment and management of chronic and recurrent pain in children with chronic diseases.

This paper provides an overview to the assessment and management of chronic and recurrent pain in children with chronic diseases. Relevant clinical research studies are cited, and practical guidelines are provided for the differential assessment and management issues inherent in the comprehensive care of chronic and recurrent pain in children and adolescents with hemophilia, juvenile rheumatoid arthritis, sickle cell disease, and cancer.

Child↗
PubMed1989

Family functioning, temperament, and psychologic adaptation in children with congenital or acquired limb deficiencies.

Family functioning and child temperament variables were investigated as predictors of psychologic and social adaptation in 42 children with congenital or acquired limb deficiencies. Higher psychologic and social adaptation were seen when there was more family cohesion and moral-religious emphasis and organization, in combination with less family conflict. With regard to child temperament, more emotionality predicted greater internalizing and externalizing behavior problems and less social competence. In addition to the main effects of the family functioning and child temperament predictor variables, the interaction between family cohesion and child emotionality significantly predicted both internalizing and externalizing behavior problems. The findings are discussed in terms of the risk and protective effects of family functioning domains and temperament on the psychologic and social adaptation of children with visible physical handicaps.

Adaptation, Psychological↗
PubMed1989

Determinants of self-esteem in children with congenital/acquired limb deficiencies.

Social support, family functioning, self-perceptions of appearance, school, behavior, athletics, and social competence, as well as daily hassles/microstressors, were investigated as determinants of general self-esteem in 41 children with congenital/acquired limb deficiencies. Classmate, parent, teacher, and friend social support all were significant predictors of self-esteem. Family conflict and organization were also significantly associated with self-esteem, as were microstressors. The overall model of significant predictor variables accounted for 66% of the variance in general self-esteem. General self-esteem also was significantly predictive of depressive symptomatology. The findings suggest a number of factors which are potentially modifiable and which might enhance general self-esteem in children with visible physical handicaps.

Adaptation, Psychological↗
PubMed1988

Mediating effects of family social support on child psychological adjustment in juvenile rheumatoid arthritis.

This study assessed the mediating effects of social support on psychological adjustment in children having to cope with the ongoing chronic strain of juvenile rheumatoid arthritis. Disease activity, family social support, and peer social support were entered into hierarchical multiple regression analyses to statistically predict internalizing and externalizing behavior problems. Family social support was a statistically significant predictor of child psychological adjustment for both internalizing and externalizing behavior problems, accounting for 22% of the variance in each. These findings are consistent with the stress-social support-psychological adjustment relationship that has received empirical attention in studies on physically healthy children. The results are discussed in terms of their implications for primary and secondary prevention efforts for those chronically ill and handicapped children who are at increased risk for psychological adjustment problems.

Adaptation, Psychological↗
PubMed1987

Behavioral treatment of adherence to therapeutic exercise by children with hemophilia.

Behavioral treatment of adherence to therapeutic exercise by ten children (aged 8 to 15) with hemophilia was investigated during a one-year period. During a one-week baseline phase, adherence to exercise performance was 55%. A 12-session behavioral physical therapy program was then implemented emphasizing individualized instruction in progressive strengthening exercises with weights. Endurance activities such as stationary bicycling and swimming, as well as noncontact sports (which provide optimal musculoskeletal conditioning without potentiating a joint or muscle bleed), were also included. Within a contingency contract format, designated points were given for adherence and exchanged for reinforcers. Adherence parameters included the percentage of prescribed therapeutic exercises performed, the percentages of exercise record forms returned, and the percentage of sessions attended. During the treatment phase, therapeutic adherence averaged 94% across the three parameters. Adherence declined during the follow-up phases from 84% to 66% across these parameters, as explicit reinforcement decreased.

Adolescent↗
PubMed1986

Psychostimulant medication and perceived intensity in hyperactive children.

Adult ratings of children's activity, based on impressionistic scales, are good indicators of psychostimulant medication effects. These ratings seldom correlate with objective indicators, however, and their behavioral referents are poorly understood. Two separate studies tested the hypothesis that intensity of child behavior, as perceived by others, would differentiate medicated and unmedicated states. College student subjects assessed randomized videotaped segments of children's behaviors. The perceived intensity of hyperactive children's responses decreased with medication. while there were no medication-related changes in either gross motor locomotion of off-task behaviors. In a test for observer sensitization or expectancy, the results for subjects who were looking for medication effects did not differ from those for uninformed subjects.

Attention Deficit Disorder with Hyperactivity↗