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The motor control assessment: an instrument to measure motor control in physically disabled children.

The Motor Control Assessment has been developed as a research tool for the assessment of motor skills in physically disabled children. In tests of concurrent validity it was found to be highly correlated with the results of the Physical Abilities Chart (Pearson coefficient = .96), and satisfactorily correlated with ranking of motor ability assigned using the clinical judgment of physiotherapists (Spearman rank coefficients = .63 to .97 in diagnostic subgroups). Estimates of both interrater and intrarater reliability were also high, with intraclass coefficients above .95.

Adolescent↗

Relationship between intellectual status and reading skills for developmentally disabled children.

The relationship between WISC-R Full Scale IQ and scores on the Woodcock Reading Mastery Tests were explored for 80 developmentally disabled children. While the children's reading skills correlated moderately and significantly with intellectual status, abstract reading skills, e.g., word comprehension, correlated more highly with Full Scale IQ than did concrete ones, e.g., word identification. The development of concrete learning patterns by such children was discussed, with an emphasis on the emotional importance of these learning styles to the children and their families.

Child↗

Seeing the same doctor: determinants of satisfaction with specialty care for disabled children.

The effect of continuity of physician on satisfaction with medical care was examined in a sample of 370 families of disabled children receiving care from four specialty clinics of teaching hospitals. Families of children with myelodysplasia, cystic fibrosis (CF), cerebral palsy and multiple physical handicaps were included. A comparison of scores on the eight scales of the Patient Satisfaction Questionnaire across the four clinics revealed marked and consistent differences: patients of cystic fibrosis clinic scored significantly higher than patients of other clinics on most scales. Multiple regression analysis in which source of care (CF clinic versus other clinics), continuity of care, waiting time and patient and family characteristics (income, race, education, level of disability) were used as predictors indicated that continuity of care accounted for a large part of the association between source of care and satisfaction. Further, when continuity of physician and waiting time in the clinic were held constant, patients of the CF clinic were indistinguishable from patients of other clinics in their satisfaction with doctors and with medical care. Further analysis revealed that continuity of care contributed to patient satisfaction not only in a clinic that constitutes a patient's principal source of care, but also in a clinic in which only specialized care is given, excluding care for intercurrent illnesses or immunizations.

Adolescent↗

Postoperative morbidities following dental care under day-stay general anesthesia in intellectually disabled children.

PURPOSE: The objective of this study was to compare the postoperative morbidities for 24 hours following dental care under day-stay general anesthesia using sevoflurane or halothane in intellectually disabled children. MATERIALS AND METHODS: Eighty-six premedicated patients with intellectual disabilities underwent general anesthesia for their dental treatment. They were randomly given anesthesia maintained with sevoflurane (2% to 3%) or halothane (1% to 1.5%) after receiving inhalation induction either with sevoflurane (8%) or halothane (5%) and nitrous oxide in oxygen (50:50). The patients' age, gender, weight, ASA Class, type of dental treatment, and duration of anesthesia and operation were recorded as well as the time required for recovery (Aldrete Scale) and the length of time taken before they were discharged (postanesthetic discharge scoring system) from the hospital. Pain and agitation were recorded using a visual analog scale (0 to 10). Other postoperative morbidities, which include crying, nausea and vomiting, bleeding, and drowsiness, were also noted for 24 hours after the operation. RESULTS: The most common morbidities during the postoperative 24 hours were agitation and pain, and their occurrence was significantly more common in the sevoflurane group than in the halothane group (P < .05). The recovery time was shorter in the sevoflurane group, but it was not statistically significant. There was no difference between the groups in the discharge time. CONCLUSIONS: Apart from more postoperative agitation and pain after awakening from sevoflurane, the quality of recovery was similar for both sevoflurane and halothane.

Ambulatory Surgical Procedures↗

Attitudes towards disability amongst Pakistani and Bangladeshi parents of disabled children in the UK: considerations for service providers and the disability movement.

It has sometimes been assumed that religiously based explanations for and attitudes to having a disabled child have led to the low uptake of health and social services by ethnic minority families in the UK. A series of semi-structured interviews were held between 1999 and 2001 with 19 Pakistani and Bangladeshi families with a disabled child as part of an evaluation of an advocacy service. The families' understandings of the causes of their child's impairment, whether they felt shame and experienced stigma, and whether these factors influenced service uptake and their expectations of their child's future are reported. While religious beliefs did inform the ways in which some families conceptualised their experience, the families' attitudes were complex and varied. There was little evidence that religious beliefs and associated attitudes rather than institutional racism had resulted in the low levels of service provision which the families experienced prior to the advocacy service. There was also no evidence that the families' attitudes had been informed by the disability movement. The implications for service providers and the movement are considered.

Adolescent↗

Communication breakdowns in normal and language learning-disabled children's conversation and narration.

The frequency and type of communication breakdowns occurring in the speech of 7 language learning-disabled children (LLD), aged 9:10-11:1 (years:months), were examined in two conditions, conversation and narration, and compared to a group of 7 normal peers matched for chronological age and 7 peers matched for mean length of communication unit in conversation. Types of communication breakdowns examined included stalls, repairs, and abandoned utterances. The LLD group incurred a significantly greater rate of communication breakdowns per communication unit in narration than conversation compared to control group differences. Mean length of communication unit was also significantly greater in narration than conversation for the LLD group compared to controls. For all groups, across both speech sample conditions, longer communication units contained more breakdowns than shorter ones. The groups did not differ in the types of breakdowns. Communication unit length and the nature of the narrative task may account for the increased dysfluencies in LLD children's speech.

Child↗

Can WISC-R IQ values be computed validly for learning-disabled children?

Prior research demonstrated that the relationships between age and neuropsychological test scores are much weaker in brain-damaged adults and children than in non-brain-damaged subjects It appears that the effects of brain damage on test scores are sufficiently strong to diminish the influence of age and education Similar results have been found with learning-disabled children The present study evaluated the effect of age adjustments on WISC-R IQ values and subtest scores The results suggest that conventional scoring of the WISC-R, which requires an age adjustment to obtain the IQ, underestimates the IQs especially of older LD children, apparently reflecting the learning-disabled child's limited rate of acquisition of intellectual abilities with advancing age.

Journal Article↗

Service needs of parents with motor or multiply disabled children in Dutch therapeutic toddler classes.

OBJECTIVE: To determine parents' service needs at the start of therapeutic toddler class treatment, to analyse determinants and to investigate received help after a period of 10 months. SUBJECTS: Parents with motor or multiply disabled children in therapeutic toddler classes. SETTING: Sixteen out of 17 Dutch rehabilitation centres. DESIGN: A sample of 84 parents, stratified according to toddler class size. MAIN OUTCOME MEASURES: A questionnaire of 33 items, divided into five categories, was designed to assess parents' needs and to evaluate the amount of received help. Several measures were used to assess child, parent and family characteristics. RESULTS: Based on factor analysis, five need subscales were distinguished which only partially corresponded to the initial categories. The initial category concerning needs for help in family functioning did not come out as a factor. Needs expressed most frequently belonged to the three subscales of needs for information concerning the child. The average level of needs generally did not differ for mothers and fathers across the subscales. However, we found large variation in needs for both mothers and fathers on each subscale. The most important, positively correlated determinant of parents' needs was social isolation of the family. After 10 months a considerable level of unmet needs was found. CONCLUSIONS: A systematic and periodic assessment of individual needs of parents as well as the services offered is recommended. Professionals of the therapeutic toddler classes should especially focus on providing parents with information on their child's disability and therapy, community services and parenting.

Adult↗

ACTH4-10: cognitive and behavioral effects in hyperactive, learning-disabled children.

A single dose of 30 mg i.m. ACTH4-10 or placebo was given to a sample of 20 hyperactive, learning-disabled children. No significant drug effects were obtained on measures of visual and auditory memory, new learning, impulsivity, attention, perceptual motor skills, anxiety, or behavior during testing. There was a slight increase in pulse rate for drug compared with the placebo group. These findings are in keepeing witth other recent reports of limited or insignificant cognitive effects in adults of a single dose of this peptide.

Adolescent↗

Nursing research and the care of chronically ill and disabled children.

This is a review of a group of studies comprising the nursing research literature concerning the care of chronically ill and disabled children and their families. Six purposively selected nursing journals were examined for articles published over an 8-year period (1980 to 1987), in order to investigate the scientific potential of this research in building a knowledge base for practice. The descriptive studies provide many areas for consideration in nursing assessments, particularly psychosocial aspects. However, the relatively few experimental studies of nursing interventions provide only fragments of research findings for direct application into practice. It was concluded that this body of research is in its early stages of development. Current gaps and possible future directions for nursing research are wide-ranging.

Child↗

Sources of EEG activity in learning disabled children.

The sources of different EEG frequencies were studied in 25 normal children and 46 learning disabled (not otherwise specified) children between 7 and 11 years old. The EEG sources were computed using Frequency-domain Variable Resolution Electromagnetic Tomography which produces a three dimensional picture of the currents at each EEG frequency. Significant differences between groups were observed. LD children showed more theta activity (3.5 to 7.02 Hz) in the frontal lobes and control children more alpha (9.75 to 12.87 Hz) in occipital areas. These results may support the maturational lag hypothesis, as the neurobiological cause of learning deficiencies not otherwise specified.

Alpha Rhythm↗

Laterality preference patterns of learning disabled children.

This study concerned the prediction of group membership of 40 learning disabled and 40 normal children on the basis of preference for laterality of the children and of their parents. A stepwise discriminant analysis showed maternal and paternal lateral preferences could correctly identify approximately 85% of the cases. Orthogonal contrasts showed that, although children themselves did not differ in the degree of laterality, parents of learning disabled children were significantly more bilateral in their preference patterns than normals.

Child↗

Gender differences in the psychological adjustment of parents of young, developmentally disabled children.

Psychological distress, as expressed through symptoms of depression, was studied in a cross-sectional sample of parents providing homecare to developmentally disabled children. Mothers and fathers were interviewed separately in 73 households. The intent of the study was to explore predictors of symptoms of depression to better understand what child, family and life circumstances might be differentially related to psychological stress in the cohorts of men and women. Hierarchical regression analyses showed similar levels of variance explained in depression of mothers (42%) and fathers (40%). Mothers with younger children, and fathers with male children, appeared to be at higher risk for depression. Personal or intra-psychic coping resources (self-esteem), and strong-tie social support resources (spousal relationship) were found to be significant predictors of depression in both mothers and fathers. Informal respite resources were related to mothers' well-being.

Adaptation, Psychological↗

The use of the Staggered Spondaic Word and the competing environmental sounds tests in the evaluation of central auditory function of learning disabled children.

Children aged 6 to 12 years with intelligence and pure-tone hearing within the normal range (91 functioning academically within the middle 50% and having uneventful hearing health histories and 76 demonstrating learning disabilities) were evaluated with dichotic central auditory listening tasks. Auditory response patterns were established and analyzed for normal and learning disability-specific performance. Children with learning disability-specific performance. Children with learning disabilities performed more poorly than "normal" peers on verbal and nonverbal listening tasks, suggesting learning disabled children may be identified by auditory performance on dichotic listening skills.

Age Factors↗

Studies on nutrition in severely neurologically disabled children in an institution.

Severe neurological handicaps in children are frequently accompanied by growth retardation. We have studied 13 severely neurologically impaired children in an institution to see if their poor growth was related to a low intake of energy and nutrients, if this was reflected in biochemical nutritional parameters, and to modify their diet according to the results. The investigation showed low dietary intakes of energy and of several of the nutrients, with corresponding low Hb values and serum values of ferritin, selenium and vitamins E and D in some of the children. All the children were initially light for age, with catch-up growth after intervention. We conclude that severely disabled children are at high risk for under- and malnutrition, and that this may partly explain the growth retardation in the study group. To avoid the potential detrimental effects of malnutrition, it is important to aim at providing an optimal diet.

Adolescent↗

Nonverbal visual short-term memory as a function of age and dimensionality in learning-disabled children.

A serial recognition task was used to compare performance of 2 learning disability age groups with 2- and 3-dimensional representations of nonlabeled 8-point random shapes. Age-related increases in short-term memory (STM) performance for both dimensions were found. No significant differences were found between 2- or 3-dimensional stimuli. Contrary to reports of STM performance with normal children, learning-disabled children showed no primacy effect for the 2-dimensional treatment, and second choices were not consistently correct when the first choice was incorrect, These findings were interpreted according to Flavell's notions of mediational inefficiencies.

Age Factors↗

A study of behavior modification for developmentally disabled children.

A tape-slide series, using a desensitization and modeling approach, was developed in order to prepare three- and four-year-old developmentally disabled children for an initial dental examination. The tape-slide series pleasantly describes what to expect during the first visit to the dental office. A clown and a four-year-old girl were used as models. Twenty-eight children participated in the study, divided into two groups: control and experimental. A requirement for qualification as a patient was that the child not have had any previous dental experience. Three techniques for measuring behavior were used: heart rate, a modified Melamed's scale, and a dentist's subjective evaluation. The results demonstrated that: a) The experimental group was in a high state of arousal when starting the dental procedures; b) Children exposed to the tapeslide series showed worse behavior and a higher heart rate than children not exposed to the series; c) Heart rate was sensitive and objective in measuring anxiety and arousal in the dental setting; d) Modified Melamed's scale was not sensitive enough to measure microbehavior in this study; e) The subjective dentist's evaluation showed the impossibility of preventing a biased interpretation of behavior by the evaluator.

Analysis of Variance↗

Hair element content in learning disabled children.

Hair samples from 31 learning disabled and 22 normal children were analyzed for content of 14 elements. Significant group differences were determined and a discriminant function was completed which separated the groups with 98 per cent accuracy. Elevated lead and cadmium content in the learning disabled group is viewed as being of particular importance.

Cadmium↗