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Biomedical subjects

O Chadwick

Publications and source records attributed to O Chadwick.

17 recordsLinked to original sources
PubMed2005

Handicaps and the development of skills between childhood and early adolescence in young people with severe intellectual disabilities.

BACKGROUND: While a number of studies have examined the development of skills in children with intellectual disabilities (ID), most have been cross-sectional, most have been concerned with particular syndromes such as Down's syndrome or autism and few have attempted to identify factors associated with improvements in skills. METHODS: From a sample of 111 children with severe ID who had been identified from the registers of six special schools at 4-11 years of age, 82 were traced and reassessed 5 years later at the age of 11-17 years. On both occasions, information on the children's handicaps and skills was collected by interviewing their main carers using a shortened version of the Vineland Adaptive Behaviour Scales and the Disability Assessment Schedule. RESULTS AND CONCLUSIONS: There were small but statistically significant improvements in Vineland age-equivalent communication and daily living skills scores, but not in Vineland Socialization scores, over the 5-year period of follow-up. This pattern of improvement was observed in most aetiological subgroups. Improvement in skills was greatest in younger children, and was associated with reductions in behaviour problems and in levels of parental stress. In spite of the improvements in age-equivalent scores, Vineland standard scores showed significant declines over the same period of time, indicating that the improvements observed were smaller than would be expected in a general population sample of children of the same age. The dangers of using standard scores or quotients to quantify the level of functioning of children with severe ID are highlighted.

Activities of Daily Living↗
PubMed2000

A natural history of hyperactivity and conduct problems: self-reported outcome.

At the age of 16-18 years, outcome was prospectively assessed in a general population sample of four behavioural groups, defined at 6-7 year old: a pure pervasively hyperactive group (N = 31), a mixed hyperactive conduct problem group (N = 20), a pure conduct problem group (N = 18) and a normal control group (N = 29). The objective of the present paper is to describe outcome in those domains for which self-report is recognised as a valid source of information. Differential effects for hyperactivity and conduct problems on outcome were studied. It was found that early hyperactivity and conduct problems predicted different patterns of conduct problems in adolescence. Drug use in adolescence was not predicted by either type of behavioural problem in childhood. Overall social adjustment was worse in the hyperactive groups, whereas no differences in self-esteem were found. Hyperactivity was a strong predictor of relationships problems in adolescence. The results suggest that hyperactivity and conduct problems in childhood are differential predictors of outcome in adolescence.

Adolescent↗
PubMed2000

Factors affecting the risk of behaviour problems in children with severe intellectual disability.

In order to examine the importance of a range of potential risk factors for behaviour problems in children with severe intellectual disability, a sample was identified by the administration of a screening version of the Vineland Adaptive Behaviour Scales (VABS) to the parents of children aged 4-11 years attending six special needs schools in three adjacent inner London boroughs. Parents whose children had a VABS standard score of < or = 50 were interviewed using the Disability Assessment Schedule and both parents and teachers completed the Aberrant Behaviour Checklist. Most behaviour problems were more common in ambulant children, but problems less dependent on the ability to walk, such as sleeping difficulties, screaming and self-injury, were equally common in ambulant and non-ambulant children. Among ambulant children, there were few significant associations between the severity of the child's behaviour problems and the age or sex of the child, the presence or absence of epilepsy, and various indices of socio-economic disadvantage. Sleeping difficulties, overactivity, self-injury, destructive behaviour and autistic features, such as social withdrawal and stereotypies, were strongly associated with skills deficits, but aggression, temper tantrums and general disruptive behaviour were not. Limitations in daily living skills were better predictors of behaviour problems than were poor communication skills.

Child↗
PubMed1999

Hyperactivity and reading disability: a longitudinal study of the nature of the association.

In order to investigate the possible causal relationships between hyperactivity and educational underachievement that might account for their frequent co-occurrence, four groups of boys, defined by the presence or absence of hyperactivity and specific reading retardation, were identified in an epidemiological study of 7 8-year-old children. They were examined in detail by means of parental interviews and psychological tests and reassessed 9 years later at the age of 16-18 years on a similar range of measures. The findings provided little support for the idea that persistent reading disabilities either lead to the development of hyperactivity de novo or increased the likelihood that hyperactivity, when present, would persist. Similarly, although features of hyperactivity persisted to follow-up, there was little evidence that they either lead to the development of reading disabilities or increased the likelihood that reading disabilities, when present, would persist. Socioeconomic adversity and a history of speech therapy were more common in the group with both hyperactivity and reading disability, but the strength of these associations made it unlikely that these factors could account for the frequent co-occurrence of the two conditions.

Adolescent↗
PubMed1996

Hyperactivity and conduct problems as risk factors for adolescent development.

OBJECTIVE: To clarify the developmental risk associated with hyperactive behavior, especially the relationship between hyperactive and conduct problems, in a longitudinal epidemiological design. METHOD: A follow-up study of children who were identified, by parent and teacher ratings in a large community survey of 6- and 7-year-olds, as showing pervasive hyperactivity or conduct problems or the comorbid mixture of both problems or neither problem. They were later investigated, at the age of 16 to 18 years, with detailed interview techniques as well as parental and self-report ratings and cognitive tests. RESULTS: Hyperactivity was a risk factor for later development, even allowing for the coexistence of conduct problems. Its sequelae included a high likelihood of psychiatric diagnosis, persisting hyperactivity, violence and other antisocial behaviors, and social and peer problems. CONCLUSIONS: The results suggested a developmental pathway through which hyperactivity raised the likelihood of impaired social adjustment, including the development of psychiatric disorders, independently of the existence of conduct problems.

Adolescent↗
PubMed1990

The examination attainments of secondary school pupils who abuse solvents.

A sample of 105 adolescents who had abused solvents and an equal number of controls matched for school, school year and sex were identified by means of a two-stage screening procedure involving (a) administration of a self-completed questionnaire to approximately 5,000 third, fourth and fifth year pupils in 16 secondary schools, and (b) individually conducted interviews. These two groups were followed up at the end of their final year of compulsory education when details of their fifth year public examination entries and results were obtained from their schools. The examination attainments of the solvent abusers were generally lower than those of the controls. They were more likely to leave school at Easter of their fifth year and a much higher proportion of them were not entered for any examinations. Those who were entered for exams were less likely to pass at O level and, regardless of the type of exam, much less likely to obtain higher examination grades. Poor examination attainments among the solvent abusers were associated with adverse domestic circumstances, frequent self-reported behaviour problems and low scores on educational tests administered at the time of transfer from primary to secondary school. After controlling for these factors, the difference between groups in examination attainments was no longer statistically significant.

Absenteeism↗
PubMed1989

Neuropsychological consequences of volatile substance abuse: a population based study of secondary school pupils.

OBJECTIVE: To examine the effects of volatile substance abuse on neuropsychological functioning. DESIGN: A sample of index children and matched controls were identified by a two stage procedure. Firstly, over 5000 secondary school pupils completed a screening questionnaire, and, secondly, a sample of those who acknowledged volatile substance abuse and a matched sample of those who denied the practice were assessed in detail by means of (a) individually conducted interviews and (b) toxicological examination of breath samples (to exclude those intoxicated at the time of testing). SETTING: 16 Local education authority secondary schools in London. SUBJECTS: 160 Pupils aged 13-16: 80 index children who had abused volatile substances to the point of intoxication at least once (confirmed by interview) and 80 controls (confirmed by interview) matched for school year, sex, and ethnic background. MEASUREMENTS AND MAIN RESULTS: Neuropsychological functioning tests provided 35 main outcome measures and were administered blind. Data on educational test performance before substance abuse began were obtained retrospectively. Information on potentially confounding social factors, such as number of siblings, tenure of housing, and parents' socioeconomic and employment state was also obtained. The index children performed significantly less well than the controls in tests of vocabulary, verbal intelligence quotient, full scale intelligence quotient, and a measure of impulsivity. When background social disadvantage was taken into account these differences were no longer significant. There were no significant associations between performance on psychological testing and frequency of abuse, and relations with other aspects of the children's history of abuse were generally weak or unsystematic. Comparisons between the results of these tests and of educational tests taken before substance abuse produced equivocal findings. CONCLUSION: Volatile substance abuse, as commonly practised by secondary school pupils, is unlikely to result in neuropsychological impairment.

Adolescent↗
PubMed1983

Airway and ventilator management.

The employment of a ventilator adds flexibility to the treatment of hypoventilation and hypoxia in the emergency department. Understanding the advantages of spontaneous respiration, the effects of positive pressure ventilation and the use of CMV, IMV, and PEEP allows for optimal care for emergency respiratory problems.

Anesthesia↗
PubMed1981

A prospective study of children with head injuries: II. Cognitive sequelae.

A 2 1/4-year prospective study of children suffering head injury is described. Three groups of children were studied: (a) 31 children with 'severe' head injuries resulting in a post-traumatic amnesia (PTA) of at least 7 days; (b) an individually matched control group of 28 children with hospital treated orthopaedic injuries; and (c) 29 children with 'mild' head injuries resulting in a PTA exceeding 1 hour but less than 1 week. Individual psychological testing was carried out as soon as the child recovered from PTA, and then again 4 months, 1 year, and 2 1/4 years after the injury. A shortened version of the Wechsler Intelligence Scale for Children (WISC), the Neale Analysis of Reading Ability and a battery of tests of specific cognitive functions were employed. The mild head injury group had a mean level of cognitive functioning below the control group, but the lack of any recovery; during the follow-up period indicated that the intellectual impairment was not a consequence of the injury. In the severe head injury group, the presence of cognitive recovery and a 'dose-response' relationship with the degree of brain injury showed that the intellectual deficits were caused by brain damage. Some degree of cognitive impairment was common following head injuries giving rise to a PTA of at least 2 weeks. Conversely no cognitive sequelae, transient or persistent, could be detected when the PTA was less than 24 hours. The results were less consistent in the 1-day to 2-week PTA range, but the evidence suggested that a broadly defined threshold for impairment operated at about that level of severity of injury. Timed measures of visuo-spatial and visuo-motor skills tended to show more impairment than verbal skills but otherwise there was no suggestion of a specific pattern of cognitive deficit. Recovery was most rapid in the early months after injury, but substantial recovery continued for 1 year with some improvement continuing n the second year in some children, especially those with the most severe injuries. Age, sex and social class showed no significant effects on the course of recovery.

Achievement↗
PubMed1981

A prospective study of children with head injuries: III. Psychiatric sequelae.

A 2 1/4-year prospective study of children suffering head injury is described. Three groups of children were studied: (a) 31 children with 'severe' head injuries resulting in a post-traumatic amnesia (PTA) of at least 7 days; (b) an individually matched control group of 28 children with hospital-treated orthopaedic injuries; and (c) 29 children with 'mild' head injuries resulting in a PTA exceeding 1 hour but less than 1 week. A retrospective assessment of the children's pre-accident behaviour was obtained by parental interview and teacher questionnaire immediately after the accident and before the behavioural sequelae of the injury could be known. Further psychiatric assessments were undertaken 4 months, 1 year and 2 1/4 years after the initial injury. The mild head injury group showed a raised level of behavioural disturbance before the accident but no increase thereafter. It was concluded that head injuries resulting in a PTA of less than 1 week did not appreciably increase the psychiatric risk. By contrast, there was a marked increase in psychiatric disorders following severe head injury. The high rate of new disorders in children with severe head injuries who were without disorder before the accident, together with the finding of a dose-response relationship with the severity of brain injury, indicated a causal relationship. However, the development of psychiatric disorders in children with severe head injuries was also influenced by the children's pre-accident behaviour, their intellectual level, and their psychosocial circumstances. With the exception of social disinhibition and a slight tendency for the disorders to show greater persistence over time, the disorders attributable to head injury showed no specific features.

Amnesia↗
PubMed1981

A prospective study of children with head injuries: IV. Specific cognitive deficits.

Twenty-five children with a head injury resulting in a posttraumatic amnesia of at least one week were compared with an individually matched group of 25 children with orthopedic injuries. Both groups were studied a few weeks after the accident and the again at 4 months, 1 year and 21/4 years after the injury. The head injury group showed a persistent deficit on the WISC Performance IQ scale; the deficit on the Verbal IQ scale was more transient. An extensive battery of neuropsychological tests was employed to identify specific deficits not shown on the WISC. On the whole, these tests showed a pattern of results similar to that found with the WISC, and in most cases children without deficits on the Performance IQ scale of the WISC also did not show deficits on the battery of specific tests. However, in a few cases, tests of speed of visuo-motor or visuo-spatial functioning picked up deficits attributable to the head injury which occurred in children with normal scores on the WISC.

Adolescent↗
PubMed1980

A prospective study of children with head injuries: I. Design and methods.

The main unresolved issues with respect to the psychological sequelae of brain damage in childhood are noted, and the previous studies of children suffering head injury are critically reviewed. A new prospective study is described. Three groups of children were studied: (a) 31 children with "severe" head injuries resulting in a post-traumatic amnesia of at least 7 days; (b) an individually matched control group of 28 children with hospital-treated orthopaedic injuries; and (c) 29 children with "mild" head injuries resulting in a post-traumatic amnesia exceeding 1 hour but less than 1 week. The children were studied as soon as possible after the accident and then again 4 months, 1 year, and 2 1/4 years after the injury. The parents were interviewed, using systematic and standardized interview techniques; both parents and teachers completed behavioural questionnaires; and the children were seen for individual psychological testing the WISC, the Neale Analysis of Reading Ability and a battery of tests of more specific cognitive functions. At the final follow-up, the severe head injury group (but not the other 2 groups) received a systematic neurological examination and the school teacher who knew the child best was personally interviewed. The findings are given on physical handicap, neurological abnormality, school placement and psychiatric referrals. All types of disabilities were both more frequent and more persistent in the children with severe head injuries.

Amnesia↗
PubMed1975

Psychiatric outcome of localized head injury in children.

Previous studies have shown a high prevalence of psychiatric disturbance in children with brain injury. Studies on localized lesions have suggested that injury to the young organism carries a better prognosis for recovery of function than injury at a later age. The present study was designed to investigate these phenomena systematically. A representative sample of children (n = 98) who had been hospitalized for treatment of a compound depressed fracture, associated with a dural tear and visible damage to the underlying cortex, was identified from the records of neurosurgical units throughout the United Kingdom. The children were aged between 3 months and 12 years at the time of injury and between 5 and 15 years at the time of examination. The interval between injury and examination varied but the sample was designed to include only children who had been injured at least two years before examination. The children were examined neurologically and psychometrically, a detailed account of their current psychiatric state was obtained from one or both parents, and their mental state was assessed in a standard psychiatric examination. Preliminary data are presented which relate psychiatric, educational and intellectual status at the time of examination to site and severity of injury, age at injury, and to a number of psychosocial variables.

Adolescent↗
PubMedDate not supplied

Self-report of attention deficit and hyperactivity disorder in adolescents.

The validity of self-report measurement varies widely according to the type of behaviour investigated. For behaviour of overactivity and inattention, adolescents seem to underestimate their problems. Well validated instruments for self-report of attention deficit and hyperactivity disorder (ADHD) are lacking yet, and research on ADHD beyond childhood relies quite heavily on self-report. In this study, an attempt is made to validate an adolescent interview scale for DSM-based ADHD symptoms. Results show that the measure has a high inter-rater reliability and is a good predictor of general outcome. However, adolescents do not validly report on symptoms specifically of ADHD. Possible implications for research and clinical practice are formulated.

Adolescent↗