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Biomedical subjects

W E MacLean

Publications and source records attributed to W E MacLean.

35 records · Page 2Linked to original sources
PubMed1989

The importance of parents' concerns about their child's development.

Parents are often concerned about their child's development, but it is unknown whether concerns indicate actual developmental problems. Pilot studies within 96 families showed that parents' concerns about their children's development took the form of value judgments, could be classified into commonly accepted developmental domains, and related to performance on screening tests. In our study, 100 families seeking pediatric care were asked to list any concerns about their child's development while their children received developmental screening. Eighty percent of the children who failed screening had parents with concerns about articulation, language, fine-motor skills, or global development. Ninety-four percent of the children who passed screening had parents with no concerns or concerns in other developmental areas. The types of concerns parents raised did not vary significantly with level of education, experience in child rearing, or other demographic variables. These results suggest that parental concerns may be a helpful adjunct to standardized developmental screening.

Child Development↗
PubMed1989

The effects of exercise and cardiovascular fitness on stereotyped bodyrocking.

A severely mentally retarded person residing in a large state institution participated in a 16-week cardiovascular conditioning program. The participant engaged in a high rate of stereotyped bodyrocking. Cardiovascular fitness was estimated by a measure of heart recovery rate obtained during the exercise periods. The amount of bodyrocking was measured prior to, during and following the implementation of the conditioning program. Increased fitness and decreased rates of bodyrocking were noted. These results are encouraging with regard to the implementation of fitness training programs for persons with severe retardation who reside in institutions.

Adult↗
PubMed1989

The effects of stereotyped behaviour on orienting and tonic cardiac activity.

The relationship of cardiac activity to stereotyped behaviour was studied in profoundly mentally retarded persons, using both inter-group comparisons. The first intra-group comparison involved examining the relative magnitude of an orienting response to an auditory stimulus during the occurrence or nonoccurrence of stereotyped body rocking. While no differences were found between periods of rocking and non-rocking when behavioural measures of orienting were used, smaller changes in post-tone heart rate were observed during periods of stereotyped rocking. A second intra-group comparison found that stereotyped behaviour was associated with a significant increase in heart rate but no change in heart rate variability when compared to periods of no stereotyped activity. Finally, using an inter-group comparison, individuals who displayed stereotyped body rocking exhibited higher tonic heart rates and lower heart rate variability during periods of no stereotyped behaviour than was observed in matched control subjects. This result suggests that stereotyped behaviour may be correlated with reduced vagal tone.

Acoustic Stimulation↗
PubMed1989

Parental perceptions of health status and psychologic adjustment of children with asthma.

The relationship between severity of illness and psychologic adjustment was evaluated in 46 children with asthma. Two measures of the severity of asthma were used: the first, a composite objective measure based on clinical history and the second, parental estimates of the severity of their child's illness. Psychologic adjustment was measured by the Health Resources Inventory, a parental report of childhood behavior. Parental estimates of severity were correlated significantly with the objective measure of severity (r = .39; P less than .01), although a concordance value of 54% indicated marked lack of agreement between parental and objective ratings. As a group, children in this study achieved apparently normal adjustment scores, although scores ranged widely across all categories of severity. Children whose parents ranked their asthma as mild or severe had significantly lower adjustment scores (F = 3.28; P less than .05) than did those children rated by their parents as having moderate asthma. Children's ranks on the composite objective measure of severity were not associated with their adjustment scores, although children with greater use of medication had lower adjustment scores than did children with little or moderate medication use (P less than .05). The relationship of severity of illness to psychologic adjustment is complex. Children at all levels of severity may demonstrate problems of adjustment, suggesting that attention to psychologic risk should not be limited only to children with severe asthma.

Adolescent↗
PubMed1988

Children with chronic illness. The prevention of dysfunction.

Children with long-term illnesses are at risk of developing problems in psychological adjustment and in functioning in activities of daily life. Their families face increased risks of marital and economic dysfunction, and siblings too face special tasks living with a chronically ill child. A variety of interventions can help children and families to cope effectively with the tasks of chronic illness. Pediatricians should be alert to effects on the family. Children respond to family stress in very predictable ways. Inasmuch as the stress of chronic illness may affect the marital relationship, there is a likelihood of concurrent behavioral and school problems. Relatively sudden changes in behavior may signal family issues that require professional attention. Drotar et al. maintain that professionals should serve as guides or advocates for children with chronic illness and their families. The relationship that develops between families and professionals is based on trust. They believe that "trust appears to evolve from the following principles: (1) continuity of relationship, (2) active participation by professional caregivers, (3) mutual participation of child and family, (4) advocacy, (5) a focus on coping and competence, (6) a developmental perspective, and (7) a family-centered focus." Cadman et al. identified a similar set of elements that characterizes an efficacious preventive intervention approach. In addition, they propose specific programmatic efforts that are associated with less morbidity. These include ongoing education and counseling for the child, family, and community regarding chronic illness and its management, use of stress management techniques to promote mastery and reduce the impact of stressful life events, and facilitation of social support mechanisms for families with chronically ill children. We have added consideration of the child's performance in school.

Adaptation, Psychological↗
PubMed1988

Does stress affect bleeding in hemophilia? A review of the literature.

Many bleeding episodes in hemophilia are thought to be related to ambient stress. The evidence in support of this hypothesis comes from a variety of anecdotal and clinical reports. Whether or not stress leads to bleeding has had little direct study in a prospective way, however, and methodological problems affect most of the studies in this field. This paper examines the evidence in support of this hypothesis and suggests ways to improve research relating stress to bleeding.

Child↗
PubMed1988

Critique of sensory integration therapy and its application in mental retardation.

Studies on the use of sensory integration therapy with mentally retarded persons were critically reviewed. Experimental design and statistical procedures were found inadequate to support the use of this therapy on an empirical basis. In addition, certain methodological and design problems seriously cloud interpretation of research results on this topic. Alternative explanations of positive outcome as well as equivocal findings among studies appear related, in part, to the conceptual foundation of sensory integration therapy. Recommendations for future directions in research and restraint in application were discussed.

Child↗
PubMed1984

Deceleration of self-injurious and stereotypic responding by exercise.

A jogging exercise program was implemented for two severely retarded adults who exhibited high rates of self-injurious behavior and stereotyped mannerisms. Exercise was increased from one mile per day to three miles per day over a six-week period. Baseline measures were taken on the self-injurious behavior, stereotyped body rocking and pacing, sitting, and social interactions. Aberrant responding gradually decreased over the six weeks. Daily response rates were lower after the exercise as contrasted with before. When the program was terminated aberrant responding again increased.

Adult↗
PubMed1984

Time-series analysis of stereotyped movements: relationship of body-rocking to cardiac activity.

The pathological stereotypies frequently observed among severely mentally retarded and autistic persons are highly rhythmical in nature. Most attempts to quantify such behavior, however, have not analyzed stereotypy in terms of its cyclical properties. In the present paper we have detailed a method for electronically transducing stereotyped body-rocking and analyzing its frequency and amplitude characteristics with a standard polygraph and microprocessor. The relationship between stereotyped body-rocking and cardiac activity was also described using time-series analysis. The method described should provide a sensitive index of various experimental manipulations and treatment effects.

Adult↗
PubMed1982

Effects of vestibular stimulation on motor development and stereotyped behavior of developmentally delayed children.

Four developmentally delayed babies were given semicircular canal stimulation in an effort to facilitate their motor and reflex development. Each of the children also exhibited abnormal stereotyped movements. The theory was advanced that these movements are related to motor development and that significant improvements in motor abilities will produce changes in the intensity and/or form of stereotypic responding. Semicircular canal stimulation was provided by rotating the children in a motor-driven chair at a velocity of about 17 rpm for 10 minutes daily over a period of 2 weeks. Standard motor and reflex measures were taken before, during, and after the rotation treatment period. Daily observations were made of the children's stereotyped movements. Over the course of the study all of the children showed motor and/or reflex changes that were attributable to the vestibular stimulation. In addition, some evidence was obtained linking changes in stereotypic responding to the vestibular stimulation.

Arousal↗
PubMed1981

Ultradian rhythms in stereotyped and self-injurious behavior.

Institutionalized profoundly mentally retarded persons who exhibited stereotyped motor movements, including self-injurious behavior, were observed continuously in their typical environments for periods of 8 to 14 hours on each of several days. In addition to targeting stereotyped responses, we collected data pertaining to activities, settings, other behavioral states, and social interactions. Spectral and cross-spectral analyses were conducted on data from each daily session. Power spectra indicated a marked ultradian or less than 24-hour rhythm for each subject on each day. Spectral density estimates were thought to reflect the influence of rhythmic changes in the institutional environment and, to a less degree, the influence of an endogenous rest--activity rhythm.

Adolescent↗
PubMed1980

Observational studies of retarded children with multiple stereotyped movements.

Stereotyped movements, such as body rocking and hand gesturing, are common among developmentally delayed children. However, very little is known concerning the naturally occurring circumstances that produce variability in this type of responding. Three relatively long-term observational studies, involving seven preschool children, each of whom exhibited multiple stereotypies, were conducted to determine the extent to which the type of activity or setting had any effect upon the rates of these responses. Repeated observations were made of each child during a variety of school activities. In two studies, adult-child interactions were also recorded. The results showed that, in general, the particular activity greatly affected rates of stereotyped behavior, although there were some marked individual differences. Moreover, in two studies variability was apparent across sessions within a particular setting. For some of the children, there was evidence that their multiple stereotypies were functionally interrelated. Adult interactions, as recorded in one study, appear to be both quantitatively and qualitatively different for stereotyping as contrasted with nonstereotyping children. An environmental analysis employing a sequential model indicated that there were teacher behaviors that affected the frequency and/or conditional probability of the child's aberrant behavior.

Child↗
PubMed1977

Developmental analysis of outerdirectedness in noninstitutionalized EMR children.

Outerdirectedness has been found in nonretarded and institutionalized retarded children to be related inversely to cognitive level and directly to history of failure experiences. The developmental nature of outerdirectedness was investigated among noninstitutionalized EMR children using two independent measures of outerdirectedness. Forty subjects, comprising two MA levels, were given a block-design task that was equally difficult for both MA groups. Glancing from the task was found to be related inversely to MA. On a task in which subjects were scored for the amount of imitation of the experimenter's behavior, imitation was also found to be related inversely to MA. However, imitation and glancing were not correlated, suggesting that they may tap different aspects of outerdirectedness.

Adolescent↗
PubMedDate not supplied

Stress and coping with scoliosis: psychological effects on adolescents and their families.

The psychological, functional, and family impact of brace treatment for idiopathic scoliosis was assessed in a cross-sectional follow-up study. Eighty-four percent of parents described the initial bracing period in stressful terms. Establishing a daily routine facilitated coping with bracewear treatment. While bracewear did not necessarily affect participation in many common activities, subjects perceived limitations in sports, physical activities, and social events. There was no evidence of overt psychopathology among the subjects, although the initial bracewear period was associated with lower levels of self-esteem. Recommendations that can minimize the stresses attendant to bracewear treatment are given.

Adaptation, Psychological↗