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Biomedical subjects

M D Levine

Publications and source records attributed to M D Levine.

At least 19 recordsLinked to original sources

The wrath of math. Deficiencies of mathematical mastery in the school child.

Mastery of mathematics involves the interactions of multiple developmental pathways. Children with mathematics disabilities often experience profound feelings of intellectual inadequacy that can erode self-esteem and academic motivation. This article delineates 16 interactive subcomponents that students who underachieve in mathematics can encounter. The article also discusses assessment and management issues for children with mathematics disabilities.

Child

Neurodevelopmental study of writing disorders in middle childhood.

This study investigated patterns of neurodevelopmental dysfunction in children with writing disorders (WD). Records of children, ages 9 to 15 years, referred to a school problems clinic were examined. Using teacher questionnaire information, including ratings of writing legibility, mechanics, rate, linguistic sophistication, and spelling, 99 cases of WD were found. Sixty-three children without WD served as clinic controls. A cluster analysis revealed four discrete subtypes of WD and two non-WD control clusters. The four WD clusters were found to have different patterns of writing and reading characteristics. Neurodevelopmental tests discriminated among the clusters (F = 2.8, p less than .0001), and an examination of neurodevelopmental performance characteristics among the clusters showed different patterns of strengths and weaknesses. An empirically derived subtyping of WD is proposed: WD with fine motor and linguistic deficits, WD with visual-spatial deficits, WD with attention and memory deficits, and WD with sequencing deficits. This subtyping, if confirmed in a population study, may have important diagnostic and therapeutic implications.

Achievement

A study of the cognitive aspects of sexual decision making in adolescent females.

A comprehensive sexuality questionnaire was administered to 37 females, ages 13 through 16 years, who attended clinics for routine health care. Subjects completed standardized scales of self-concept, locus of control, and future orientation. They also were given a short battery of standardized cognitive tests. Three groups were identified: Group 1 was sexually active and using contraception reliably, Group 2 was not using contraception reliably, and Group 3 had not been sexually active. Group 1 adolescents had higher scores on the vocabulary subtest of the WISC-R (F = 3.4, p less than .05) than did Group 2 adolescents, over and above the effect of socioeconomic status (SES). Group 1 subjects had higher scores on knowledge of sex and contraception than did Group 2 (F = 3.3, p less than .05). Group 1 had more internal locus of control (F = 7.0, p less than .005) than did Group 2 over and above the effect of SES. Mean scores for Group 3 adolescents were intermediate and not significantly different. The findings suggest that cognitive factors may influence contraceptive behavior in adolescent females.

Adolescent

Neurodevelopmental readiness for adolescence: studies of an assessment instrument for 9- to 14-year-old children.

The Pediatric Examination of Educational Readiness at Middle Childhood (PEERAMID) is a neurodevelopmental examination for 9- to 14-year-old children. The examination was designed largely for use by developmental-behavioral pediatricians as a way of assessing certain critical developmental functions, including attention, memory, language, and motor coordination in children with school problems. Preliminary field testing of the PEERAMID was carried out in one community, and subsequently a revised version was standardized on randomly selected subjects from three communities near Boston, Massachusetts, and on groups of children from those towns said to be having significant problems at school. Additionally, the examination was used for the evaluation of 106 consecutive patients referred to the School Function Program at The Children's Hospital in Boston. Statistically significant performance differences discriminated between children with normal academic performance and those with school problems in the community as well as in the referral setting. It was discovered that children with school problems tended to have clusters of dysfunction, whereas normally achieving youngsters more often harbored no developmental dysfunctions or perhaps one or two areas of difficulty. It is believed that the PEERAMID can be a useful instrument in serving as part of a pediatric contribution to a multidisciplinary assessment in children in this age group.

Adolescent

Targeted early childhood programming. The promise half fulfilled.

A group of 169 children was followed up from birth to second grade in a community-based early identification and early intervention project. Periodic assessments of health and function yielded profiles of concerns. Over the first five years of life, 39% of the children had health concerns, 20% had cognitive concerns, 25% had motor concerns, 15% had social adjustment problems, and 12% had early attentional problems. Children at the highest risk of having reading and behavioral problems in second grade were those with early attentional disability. At the second-grade level, 31% of the children with early attention concerns were one full grade behind in reading and 38% had behavioral problems; among the youngsters without early attentional concerns, 6% demonstrated a reading delay and 8% had behavioral problems. In addition, children of highly educated mothers were more likely to benefit from the multidisciplinary program than were children of less educated mothers, for whom the intervention effected only a modest improvement when contrasted with randomly selected comparison children. For instance, among children with early cognitive problems and whose mothers had little education, 31% of these children had reading problems in second grade as opposed to 10% of those whose mothers had high educational attainment. Similarly, 39% of children with the combined risks of low maternal education and early attentional problems had reading problems in second grade compared with none of the attention-problem children of highly educated mothers. This study shows that while early identification of health and developmental problems can be carried out in a community-based project, strategies for the early intervention of developmental concerns among children of low socioeconomic status remain less than completely effective.

Boston

A follow-up study of preschool children evaluated for developmental and behavioral problems.

Parents and teachers of preschool children evaluated for developmental and behavioral problems in a tertiary pediatric clinic were surveyed an average of 15 months after the initial visit to determine whether they thought the original presenting problem(s) were still present. In 46 percent of cases in which there was an initial concern about behavior, parents continued to be concerned. In contrast, only 24 percent of responding parents continued to be concerned about developmental problems. In more than half of the cases in which parents were no longer concerned, especially about behavior, teachers indicated that there continued to be problems. Age and sex of children were not related to outcome. The higher the socioeconomic status of parents, the more likely the parents were to report persistent developmental problems. Children with persistent problems tended to have difficult temperament characteristics. This study suggests that it is difficult to predict which problems will persist and that there are varying viewpoints as to the nature and existence of these problems.

Child

Locus of control as predictor of compliance and outcome in treatment of encopresis.

We examined the effectiveness of instruments that describe a child's locus of control and perceived self-competence as predictors of outcome in the treatment of encopresis. Fifty children 9 to 12 years of age completed such instruments prior to clinical interview. Clinicians were blind as to the results of these questionnaires and administered a standard encopresis protocol to all patients. Six to 17 months later, 45 (90%) of the patient's parents were interviewed to assess compliance and treatment outcome. Children who significantly improved had a more internal locus of control (P less than 0.05) and better compliance (P less than 0.05) as determined by two separate outcome variables. Locus of control and compliance were not, however, significantly correlated with each other; each appeared to have an independent association with outcome. There was no association between perceived self-competence and outcome. The positive association between locus of control and outcome was not mediated by socioeconomic status, age, duration of encopresis, severity of encopresis, gender, or time between initiation of treatment and follow-up. Measurement of locus of control in children with encopresis appears to be helpful in identifing a group at high risk for resistance of treatment.

Child

The prevention of constipation and encopresis: a developmental model and approach.

This article proposes a developmental model for understanding the evolution and treatment of bowel problems in infancy and childhood. It focuses on anticipatory guidance to maximize parental understanding of the normal variations of bowel function and specific interventions to limit the long-term effects of mild bowel problems.

Child

Minor neurological indicators and developmental function in preschool children.

An attempt was made to determine whether neuromaturational indicators (soft neurological signs) were associated consistently with specific areas of developmental function in 5-year-old children. Fifty-eight children were assessed over two diagnostic sessions. One involved administration of the Pediatric Exam of Educational Readiness (PEER) by pediatric fellows; the other consisted of administration of the McCarthy Scales of Children's Abilities (MSCA) by trained psychoeducational specialists. Data indicate that children who exhibited a greater number of minor neurological indicators had a high likelihood of experiencing difficulty with visual-perceptual, fine motor, and gross motor tasks of the PEER and the MSCA. What is more important, no relationship was found between aggregates of minor neurological indicators and performance on linguistic, memory, sequencing, quantitative, verbal, or preacademic sections of these diagnostic instruments. This information suggests that physicians should limit their interpretation of such signs when evaluating young children with academic difficulties. Additional data must be accumulated before the role of neuromaturational signs can be fully understood.

Child, Preschool

Locus of control and self-esteem in children with encopresis.

Children with encopresis were compared to children with other "high prevalence low-severity" disorders on measures of locus of control and self-esteem. Children with encopresis tended to feel less in control of positive life events, had lower self-worth, and were more apt to want to change and be different than children with other chronic symptoms. Data tend to contradict traditional interpretations of encopresis as a system of unconscious motives involving independence and control. Also, this information adds to the clinical impression culled from experience that active intensive remediation is the appropriate clinical response when treating children with encopresis.

Child

Estimating personal performance: a problem for children with school dysfunction.

Children with school dysfunction typically do limited planning and fail to use potentially beneficial mediational strategies on cognitive tasks. This study tested the hypothesis that these children are poor at assessing their own performance capabilities, a deficit which might contribute to this passive learning style. Thirty children, 9-12 years old, attending a multidisciplinary clinic in a pediatric setting for school underachievement, and 30 age, grade, and socioeconomic status (SES)-matched controls were asked to predict their performance in four domains of function before they were given the opportunity to perform the tasks. Clinic subjects overestimated their performance to a greater degree than controls in two domains. This performance resembles the performance of younger children on related tasks and may be amenable to therapeutic or educational intervention.

Child