Eye exercises and learning disability.
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Child↗
Biomedical subjects
P M Leary
Publications and source records attributed to P M Leary.
The ambulatory electro-encephalogram as a diagnostic tool in a children's hospital.
The neurophysiology laboratory at the Red Cross War Memorial Children's Hospital provides a diagnostic electro-encephalogram (EEG) service for the hospital and surrounding community. In selected cases ambulatory EEG monitoring is undertaken. The present study is a review of the findings in 55 children thus investigated using the Oxford monitor. Indications included unexplained aberrant behaviour outbursts, erratic school performance, atypical absence episodes and the need to distinguish between real and simulated seizures in children with epilepsy. During reporting, correlations were noted between EEG appearances and the child's behaviour. Abnormalities were noted in 35 of the records. These included paroxysmal spike and wave discharge, focal cortical abnormalities and unequivocal seizure episodes. It is felt that the investigation made a significant contribution to correct diagnosis in 32 cases, and that ambulatory monitoring should be available in all laboratories which offer a diagnostic EEG service for children.
Ambulatory Care↗
The effect of maternal employment during preschool years on school readiness.
Many children referred because of 'learning disability' have mothers in full-time employment. This study was undertaken to examine the effect of maternal employment on school readiness. One hundred and seven children were studied. Forty-six were the offspring of women who had not gone out to work since the birth of the child (group A). The mothers of the other 61 had worked for 1 year or more during the lifetime of the child (group B). The mother of each child completed a detailed questionnaire. Each child was subjected to standardized tests of reasoning, numerical ability, Gestalt, verbal comprehension, eye-hand co-ordination, visual and auditory perception and IQ. Groups A and B were compared with regard to marital status of parents, their educational attainments, family size, ordinal position of the index child and years of nursery school experience. Educational attainments of both fathers and mothers were significantly higher in group A and children had spent significantly longer at nursery school. Group B (working mothers) had a predictably higher incidence of single parents. Comparison of results showed no significant difference between groups A and B for 6 of the 8 tests administered. Group B results did not differ significantly when divided into categories according to years of maternal employment. The study suggests that there is no direct relationship between maternal employment and maturity at school entry.
Aptitude Tests↗
The development of a microcomputer system for poisons information retrieval.
The Poisons Information Centre at the Red Cross War Memorial Children's Hospital in Cape Town makes use of a microcomputer for information retrieval. An outline is given of the data base design and the manner in which data were collected and collated. User operation of the system is described and its effect on the efficiency of the service noted.
Data Collection↗
Cortical dysfunction as an aetiological factor in learning disability.
This study examines the relationship between learning disability, EEG changes, and events in the life history of the individual child which could cause cortical damage or dysfunction. One hundred children with learning disability were compared with 100 age- and sex-matched normal children identified by random selection. Each child underwent routine EEG studies. Abnormalities were detected in 71 of the learning-disabled group and in 29 of the controls. The incidence of abnormal pregnancy was 31% in children with learning disability and 10% in controls. Neonatal complications occurred in 29 learning-disabled children as opposed to 13 controls. Seventeen learning-disabled children had experienced seizures and 5 had a history of meningitis; comparable figures in the control series were 7 and 2 respectively. Nine learning-disabled children had a history of severe illness as opposed to 3 children in the control series. The results of this study indicate that a significant relationship exists between learning disability and a variety of circumstances associated with insults to the immature brain. These insults may account for the cortical dysfunction suggested by psychometric and EEG studies.
Adolescent↗
Liver function in children receiving treatment with the anticonvulsant sodium valproate.
Alanine aminotransferase and alkaline phosphatase levels were studied in 49 children who had received the anticonvulsant sodium valproate (Epilim; R & C) for at least 6 months. No significant deviation from accepted normal was detected.
Alanine Transaminase↗
Electroretinography and visual evoked responses in paediatric practice.
Electroretinography an the recording of visual evoked responses are of considerable value as ancillary investigations in clinical ophthalmology, paediatric neurology an developmental paediatrics. The techniques used are non-invasive and yield objective results without any need for patient co-operation. In this study 159 children were examined using a system constructed from apparatus available in South Africa. Indications for the investigations included developmental delay, acute intracranial disease, eye disease and cerebral degenerative disorders. Information obtained made possible distinctions between retinal dysfunction and lesions of optic pathways, the occipital cortex and higher cortical centres.
Adolescent↗
DOes the child with a learning disability have a biochemical defect?
SInce the brains of children with learning disabilities are not available for direct study, neurobiochemical explanations for the characteristic features exhibited by these children must necessarily be hypothetical. There is considerable evidence to show that the catecholamines, noradrenaline and dopamine, play a major role in the function of areas of the brain which mediate mood, emotional response and state of arousal. Physiological evidence of underarousal in some learning-disabled children and the dramatic effect of stimulant medication suggest that there may be a fundamental defect in catecholamine metabolism. Support for this hypothesis is provided by certain pathological studies and comparative neurochemical studies, while familial clustering of cases suggests an underlying genetic mechanism to account for the biochemical defect. However, learning-disabled children are a heterogeneous group and the postulated neurobiochemical model must be regarded merely as heuristic, for it does not have universal application.
Animals↗
The role of the EEG in the investigation of the child with learning disability.
Electro-encephalograms were recorded in 94 children who presented with learning disability. Abnormalities were found in 71%. Records obtained from age- and sex-matched controls showed a 29% incidence of abnormality. In the learning-disabled group no significant correlation could be demonstrated between abnormalities on the EEG and abnormal perinatal history, behaviour, concentration, perceptual function, co-ordination or 'soft sign'. Routine EEG recording is not recommended in the assessment of a learning-disabled child, but it is of value if the clinical history suggests a seizure disorder.
Child↗
Hyperactivity.
'Hyperactivity' has many causes in childhood, and an analytical approach is necessary before management can be applied. In order to be effective, management must be individually tailored. It may take the form of simple adjustments in the child's environment, the treatment of physical illness, emotional support, counselling of parents, or, in selected cases, drug therapy.
Adolescent↗
Clinical experience with sodium valproate in children.
Good control was achieved with sodium valproate (Epilim) in 44 (71%) of a sample of 62 children with severe recurrent epileptic seizures. The medication was most effective in the control of petit mal; good results, however, were also achieved in some patients with previously poorly controlled grand mal epilepsy and psychomotor and myoclonic seizures. Twenty children required no other anti-convulsant and 28 required only one other. Side-effects were infrequent and mild. Only the high cost of sodium valproate in South Africa precludes its more general use in childhood epilepsy.
Adolescent↗
Childhood convulsions.
An outline is given of the incidence and aetiology of childhood convulsions. Aspects of diagnosis and drug therapy are discussed.
Adolescent↗
The effect of remedial teaching on children with learning disabilities.
A study of questionnaires completed by the parents and class teachers of 70 children with learning diabilities revealed evidence of considerable parental satisfaction with scholastic progress and improved behaviour. These advances were attended by a significant reduction in domestic tension and concern about the children's future. However, teacher ratings indicate that despite prolonged remedial teaching more than half of the group remained at a scholastic level below the average class performance.
Adolescent↗
Changes in the electro-encephalogram related to the menstrual cycle.
A comparison has been made between the electro-encephalograms (EEG) recorded in the premenstrual phase and those recorded at mid-cycle in 25 healthy young women. In only 5 could no difference be discerned visually between the two records obtained from each subject. Eight premenstrual records showed a significant increase in mean alpha frequency and 17 showed an increase in mean alpha amplitude. Theta activity and mild paroxysms were twice as common in premenstrual records, as was an abnormal response to hyperventilation. These findings may correlate with subjective mood changes commonly experienced in the premenstrual phase and in the well-recognized tendency of certain epileptic women to have seizures only at the time of their menses. It is suggested that when reporting on the EEGs of female subjects, cognizance should be taken of the stage reached in the menstrual cycle at the time of recording.
Adult↗
Clinical experience with methylphenidate.
The indications for the use of methylphenidate in 250 children are reviewed, and the effect of the drug is examined. Concentration was improved or hyperactive behaviour diminished in 89% of the children with normal intelligence and with no gross physical defect, in 72% of the children with cerebral palsy, and 68% of the children with subnormal intelligence. In children with emotional disturbance, response to methylphenidate was seldom satisfactory. Significant side-effects occurred infrequently and only 2 children lost weight during the period of medication.
Adolescent↗
Beasties in jam jars.
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Child, Preschool↗