Biomedical subjects

R Manikam

Publications and source records attributed to R Manikam.

4 recordsLinked to original sources

PubMed2000

Pediatric feeding disorders.

Pediatric feeding disorders are common: 25% of children are reported to present with some form of feeding disorder. This number increases to 80% in developmentally delayed children. Consequences of feeding disorders can be severe, including growth failure, susceptibility to chronic illness, and even death. Feeding disorders occur in children who are healthy, who have gastrointestinal disorders, and in those with special needs. Most feeding disorders have underlying organic causes. However, overwhelming evidence indicates that abnormal feeding patterns are not solely due to organic impairment. As such, feeding disorders should be conceptualized on a continuum between psycho-social and organic factors. Disordered feeding in a child is seldom limited to the child alone; it also is a family problem. Assessment and treatment are best conducted by an interdisciplinary team of professionals. At minimum, the team should include a gastroenterologist, nutritionist, behavioral psychologist, and occupational and/or speech therapist. Intervention should be comprehensive and include treatment of the medical condition, behavioral modification to alter the child's inappropriate learned feeding patterns, and parent education and training in appropriate parenting and feeding skills. A majority of feeding problems can be resolved or greatly improved through medical, oromotor, and behavioral therapy. Behavioral feeding strategies have been applied successfully even in organically mediated feeding disorders. To avoid iatrogenic feeding problems, initial attempts to achieve nutritional goals in malnourished children should be via the oral route. The need for exclusive tube feedings should be minimized.

Child↗

PubMed1990

Training nonverbal and verbal play skills to mentally retarded and autistic children.

Two mentally retarded boys with autism and one mentally retarded girl with Down syndrome were taught to initiate and play a ball game with an adult confederate. The program targeted both nonverbal responses related to the actual execution of the ball game as well as verbal responses for play initiation and providing compliments for the confederate's behavior. Training sessions provided ample practice in all aspects of the game from initiation to termination through use of brief play cycles. Instruction was provided using a combination of physical and verbal prompts as well as reinforcement and time-out. All three children learned the game and by the study's completion executed multiple play cycles each session. The implications of combining play and social skills training in programming for developmentally handicapped children are discussed.

Autistic Disorder↗

PubMed1988

Training social skills to severely mentally retarded multiply handicapped adolescents.

Three severely mentally retarded, multiply handicapped, adolescents were treated in a classroom setting for social skills deficits. Two of these children exhibited symptoms of autism including periods of echolalia, and fascination with tactile and visual stimulation. One of the pair was deaf. The third child was profoundly mentally retarded and had minimal expressive language skills. All had received sign language training to facilitate communication. Treatment focused on increasing the frequency of eye contact, in seat and response to verbal prompt behaviors, skills deemed necessary to facilitate use of sign language communication and to increase social interaction. Baseline and treatment were evaluated in a multiple baseline, alternating treatment design across children. Baseline was taken on responses to 10 standard questions, asked by the teacher, based on verbal presentation and sign language. This same procedure was then continued during the initial treatment phase following training sessions. During training, the children received social reinforcement, performance feedback and edible reinforcement, in the form of candy, for appropriate performance. Physical and verbal prompts as well as pictorial cues were employed to shape appropriate behavior. In the second treatment phase, training was implemented in the classroom in which baseline data had been collected. Improvement in target behaviors, via training sessions held four days a week, was noted. These data suggest that use of a combination of visual stimuli, operant and social learning methods can remediate social skills deficits in children with multiple psychological and physical deficits. The implications of these findings for current and future research are discussed.

Achievement↗

PubMedDate not supplied

Adolescent depression: relationships of self-report to intellectual and adaptive functioning.

Self-report measures of depression, general psychopathology, and social skills were administered to adolescents ranging from moderate mental retardation to above normal intelligence. Adolescents with mental retardation reported more depression and general psychopathology symptoms. Variance and regression analyses demonstrated distinctions on the basis of mental retardation status for individual measures. Additional analyses identified differences between individuals with above normal intelligence and individuals with mild mental retardation on the basis of depression specifically. Adaptive behavior functioned as a moderator variable, mediating the relationship between depression and intellectual functioning.

Activities of Daily Living↗