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Results for “school functioning”

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PubMed1992

Substance abuse among adolescents with chronic mental illnesses: a pilot study of descriptive and differentiating features.

Twenty-six adolescents with a chronic mental illness (schizophrenia or schizoaffective disorder of at least 1.5 years' duration) were assessed for the presence or absence of comorbid substance abuse. The two groups were compared on a number of variables believed to identify or predict substance abuse. The substance abusing subgroup were significantly different in levels of social functioning, school achievement, premorbid substance abuse, having parents or siblings who abused substances, dysfunctional families, cigarette smoking, number of hospital admissions, and emergency room visits. These findings are discussed in the context of clinical issues regarding the management of adolescents with chronic mental illnesses.

Adolescent↗

PubMed2005

Developmental and functional outcomes at school age of preschool children with global developmental delay.

The later developmental trajectory of young children diagnosed early with global developmental delay was determined. Using a prospective study, preschool children diagnosed with global developmental delay were systematically reassessed during the early school years with standardized developmental and functional outcome measures (Battelle Developmental Inventory and Vineland Adaptive Behavior Scale). Of an original cohort of 99 children assessed and diagnosed at a mean age of 3.4 +/- 1.1 years, 48 were reassessed at a mean age of 7.3 +/- 0.9 years. Group performance on the Battelle Developmental Inventory overall was 66.4 +/- 4.3 (mean 100 +/- 15). Between 75% and 100% of the cohort performed at least 1.5 SD below the normative mean on the individual domains of the Battelle Developmental Inventory. Similarly, the group mean on the Vineland Adaptive Behavior Scale overall was 63.5 +/- 20.8 (mean 100 +/- 15), with between 61% and 76% of the cohort scoring more than 1.5 SD below the mean on each of the domains. Univariate and multivariate analyses on potential predictor variables identified a lack of an underlying etiology as predictive of poorer performance on the Battelle Developmental Inventory fine motor and motor domains and increasing severity of initial delay as predictive of poorer performance on the Vineland Adaptive Behavior Scale communication domain and overall score. Similarly, maternal employment and paternal postsecondary education improved Vineland Adaptive Behavior Scale communication scores, whereas paternal postsecondary education alone predicted better socialization and total scores on the Vineland Adaptive Behavior Scale. Children with early global developmental delay demonstrate persistent and consistently poor performance across all developmental and functional domains. Few variables are apparent at intake to predict later performance.

Child↗

PubMed2006

Clinical phenotype of South African children with neurofibromatosis 1.

Forty-eight children with neurofibromatosis 1 presenting between 2000 and 2004 were reviewed for their clinical phenotype, and data were compared with published reports. The median age at presentation was 4 years (range 10 days to 12 years). The male to female ratio was similar (22 male:26 female). There were frequencies of café au lait spots, axillary freckling, Lisch nodules, and new mutations comparable to those cited in the literature. Fewer patients had neurofibromas (4%), but more patients had plexiform neurofibromas of the head and neck (16%). Three patients of the 22 who had neuroimaging had optic gliomas (14%). The most consistent disability, with maximum impact, related to the patient's cognitive level of functioning. School problems, defined as learning and behavioral problems observed in the classroom, were reported in 70% of school-aged children (n = 21), compared with international figures of 29.8% to 45%. This high prevalence has reinforced the clinic service policy of formal neuropsychology assessments in all children with reported school problems. In addition, earlier referral of children to the service (preschool n = 18) has enabled formal developmental assessments and planning of specific educational placement to optimize learning. This is the first description of the neurofibromatosis 1 phenotype from the African continent. The multidisciplinary approach to management has proved beneficial in the South African context. The combined clinic has resulted in a holistic approach to patient care, early detection of pathology, consistent therapies across the specialties, and better patient attendance and compliance. (J Child Neurol 2006;21:63-70).

Brain↗

PubMed2002

Further evidence for the diagnostic continuity between child and adolescent ADHD.

OBJECTIVE: To determine if there are differences in the clinical expression and correlates of ADHD between children and adolescents. METHOD: Subjects were 811 boys and girls aged 6 to 17 with ADHD, and 132 gender- and age-matched controls. Blind raters, using DSM-III-R structured diagnostic interviews and psychometric measures, assessed psychiatric diagnoses, intellectual performance, social disability, and school failure. RESULTS: Children and adolescents with ADHD had very similar patterns of outcome in multiple domains of assessment, including comorbidity with conduct, mood and anxiety disorders, and school functioning. There was some evidence that the rate of ODD was greater in adolescents compared to children, and that this difference was greater in the control sample. CONCLUSIONS: These findings document the diagnostic continuity of ADHD between childhood and adolescence and support the inclusion of adolescent samples in ADHD research protocols.

Adolescent↗

PubMed2006

The PedsQL as a patient-reported outcome in children and adolescents with Attention-Deficit/Hyperactivity Disorder: a population-based study.

BACKGROUND: Attention-Deficit/Hyperactivity Disorder (ADHD) is the most common chronic mental health condition in children and adolescents. The application of health-related quality of life (HRQOL) as a pediatric population health measure may facilitate risk assessment and resource allocation, the identification of health disparities, and the determination of health outcomes from interventions and policy decisions for children and adolescents with ADHD at the local community, state, and national health level. METHODS: An analysis from an existing statewide database to determine the feasibility, reliability, and validity of the 23-item PedsQL 4.0 (Pediatric Quality of Life Inventory) Generic Core Scales as a patient-reported outcome (PRO) measure of pediatric population health for children and adolescents with ADHD. The PedsQL 4.0 Generic Core Scales (Physical, Emotional, Social, School Functioning) were completed by families through a statewide mail survey to evaluate the HRQOL of new enrollees in the State of California State's Children's Health Insurance Program (SCHIP). Seventy-two children ages 5-16 self-reported their HRQOL. RESULTS: The PedsQL 4.0 evidenced minimal missing responses, achieved excellent reliability for the Total Scale Score (alpha = 0.92 child self-report, 0.92 parent proxy-report), and distinguished between healthy children and children with ADHD. Children with ADHD self-reported severely impaired psychosocial functioning, comparable to children with newly-diagnosed cancer and children with cerebral palsy. CONCLUSION: The results suggest that population health monitoring may identify children with ADHD at risk for adverse HRQOL. The implications of measuring pediatric HRQOL for evaluating the population health outcomes of children with ADHD internationally are discussed.

Activities of Daily Living↗

PubMed2005

Profile of daily life in children with brain tumors: an assessment of health-related quality of life.

PURPOSE: The survival of children with CNS tumors approaches 70%, yet health-related quality of life (HRQOL) has not been investigated rigorously in this population. We aimed to show that universal assessment of HRQOL could be obtained easily by using the PedsQL 4.0 and to provide a composite profile of their daily lives. PATIENTS AND METHODS: The PedsQL was administered to all patients seen in the neuro-oncology clinic at Lucile Packard Children's Hospital (Palo Alto, CA) from December 2001, to September 2002. Patients were compared with healthy controls by using two-sided t tests to evaluate statistically significant differences. RESULTS: One hundred thirty-four patients (73 male; mean age +/- standard deviation, 11.8 +/- 5.4 years; 55 had low-grade glioma, 32 had medulloblastoma/primitive neuroectodermal tumor/embryonal tumor, 17 had malignant astrocytoma, nine had germ-cell tumor, and 21 had other types of tumors) were assessed, each in less than 20 minutes. Scores on both child and parent-proxy reports for the total HRQOL, psychosocial, physical, emotional, social, and school-functioning scales were all significantly lower than controls (P < .01). Patients with low-grade glioma were reported to have the highest total HRQOL. Children receiving radiation therapy (XRT) but no chemotherapy had significantly lower total, psychosocial, emotional, and social functioning than those receiving other treatments, including XRT plus chemotherapy. CONCLUSION: The PedsQL can be used to assess HRQOL rapidly and easily in children with CNS tumors, who have significantly worse HRQOL than healthy children. Children receiving XRT fare worse overall; chemotherapy added to XRT does not seem to worsen HRQOL. Assessment of HRQOL should be included as an outcome in future clinical trials.

Adolescent↗

PubMed1999

Competence and adjustment of siblings of children with mental retardation.

Adjustment and competence of siblings who had a brother or sister with mental retardation were compared to those of control siblings who had brothers or sisters with no disabilities. Results indicated no overall differences for internalizing disorders, externalizing disorders, or for self-esteem and competence based on group membership, gender, or gender match. However, boys with a brother or sister with mental retardation had difficulty in school functioning. In addition, a greater number of girls with brothers and sisters with mental retardation expressed their distress through internalization.

Achievement↗

PubMed2000

Poorer behavioral and developmental outcome more than 10 years after treatment for iron deficiency in infancy.

OBJECTIVE: To determine the long-term effects of iron deficiency in infancy. DESIGN: Longitudinal follow-up study of children who had been tested and treated for iron deficiency as infants. SETTING: Periurban community near San Jose, Costa Rica. PARTICIPANTS: Of the original 191 participants, 87% were reevaluated at 11 to 14 years old (average age: 12.3 years). The children were free of iron deficiency and growing normally by US standards. Those who had chronic, severe iron deficiency in infancy (n = 48) were compared with those who had good iron status before and/or after iron therapy in infancy (n = 114). OUTCOME MEASURES: Comprehensive set of cognitive, socioemotional, and motor tests and measures of school functioning. RESULTS: Children who had severe, chronic iron deficiency in infancy scored lower on measures of mental and motor functioning. After control for background factors, differences remained statistically significant in arithmetic achievement and written expression, motor functioning, and some specific cognitive processes (spatial memory, selective recall, and tachistoscopic threshold). More of the formerly iron-deficient children had repeated a grade and/or been referred for special services or tutoring. Their parents and teachers rated their behavior as more problematic in several areas, agreeing in increased concerns about anxiety/depression, social problems, and attention problems. CONCLUSIONS: Severe, chronic iron deficiency in infancy identifies children who continue at developmental and behavioral risk >10 years after iron treatment.

Adolescent↗

PubMed1996

Effects of teacher assistance teams on special education referrals in elementary schools.

School-based problem-solving teams recently have received much attention as a possible support for children who are at risk for school failure and for over-referral to special education. However, no controlled studies of the effects of such teams on numbers of referrals for special education or for proportion of appropriate referrals for special education have been conducted. The lack of adequate research concerning school-based problem-solving teams, coupled with the widespread promotion of their use, suggests that further study of such teams is important. In this study, we investigated the effect of one team model, Teacher Assistance Teams, on special education referrals in elementary schools of a large urban district. To address limitations of previous research, schools with such teams were compared with those without across several years of implementation. Analysis yielded a significant decrease in referrals in both groups of schools but no significant differences between groups. These findings may be explained by the context in which both groups of schools functioned.

Child↗

PubMed1987

A younger aged reference group for the WISC-R.

The present study obtained WISC-R scores for a younger aged sample. Standard scores for this sample are presented along with an adequate three factor solution reflecting verbal, general performance, and auditory-attention-perceptual-performance dimensions. Furthermore, coefficients of concordance are reported for the present sample with a three factor solution for the normative WISC-R 6 1/2 year old group. Problems with the skewness of some of the subsets are discussed in light of a possible psychometrically guided approach to constructing early infant intellectual assessment measures. Implications of finding a different, from traditional, third factor are considered with respect to early school functioning.

Child↗

PubMed1996

Development of critical paths for post-acute brain injury rehabilitation: lessons learned.

One important tool for case management is critical path analysis. This article explains four critical pathways developed by an interdisciplinary team for a post-acute brain injury rehabilitation program. The heterogeneity of the brain injury population mandates the need for systematic coordination of direct care services. Yet, variations in the neurobehavioral consequences of brain injury necessitate differing goals and treatment tracks for individual clients. The critical pathways in this setting define and describe the procedures and services to be rendered from admission to discharge to achieve optimal goals for four treatment program tracks: Return to Work, Return to School, Functional Independence, and Neurorehabilitation. The tracks reflect a hierarchy of expectations for information processing and functional performance. Critical pathways provide a tool for enhancing communication among service providers and external case managers and for determining the extent to which a client's course of treatment compares with a clinical standard considered to be ideal. This article compares the four critical pathways, provides representative case samples, and discusses lessons learned in the development and implementation process.

Activities of Daily Living↗

PubMed1993

Treatment Issues in Adolescent Substance Use and Addictions: Options, Outcome, Effectiveness, Reimbursement, and Admission Criteria.

Cost-reduction strategies and a lack of overall perspective have created a potentially dangerous climate for the treatment of the various forms of adolescent substance abuse. The authors argue for a holistic approach that focuses on demographics, family issues, school functioning, and other related problems as well as on careful evaluation of treatment outcome and criteria for admission, continued stay, and discharge from treatment programs.

Journal Article↗

PubMed2002

[Cruel and violent children].

Three to 4% of parents are regularly battered by their children, at the adolescence. Before the appears of violence, there is an escalation of pathologic interaction between parents and child. Comorbidity is usual: problem behavior, impairments in school functionning, antisocial disorders, etc.... Sometimes violence seems to appear at the adolescence in families without any problem. Very often there are many family conflicts and discrepancy between parents about education of their children. Prevention is the better treatment with an early intervention as soon as possible.

Adolescent↗

PubMedDate not supplied

Longitudinal parental perceptions of spinal fusion for neuromuscular spine deformity in patients with totally involved cerebral palsy.

Retrospective surveys of caregivers of patients with totally involved cerebral palsy who are undergoing arthrodesis for spine deformity have demonstrated satisfaction with results but are subject to retrospective bias. The Pediatric Orthopaedic Society of North America outcomes questionnaire was prospectively administered to parents of patients with consecutively presenting, totally involved cerebral palsy before spinal fusion, 6 months after spinal fusion, and 1 year after spinal fusion. Review of medical records determined complication rates. Parents of 20 consecutive patients completed preoperative questionnaires. Ten of these completed questionnaires 6 months and 1 year postoperatively, and seven more completed only 1-year postoperative questionnaires. There were no significant changes between preoperative and postoperative assessments of physical function, school absence, comorbidities, and parental health. Patient pain, happiness, frequency of feeling sick and tired, and parental satisfaction improved significantly by 1 year postoperatively. All but pain and happiness were significantly improved by 6 months postoperatively, also. The presence of complications did not significantly affect questionnaire results. This prospective study substantiates the subjective gains noted in previous retrospective studies of spinal fusion for neuromuscular spine deformity in cerebral palsy.

Adolescent↗

PubMed2005

Quality of life of children with attention-deficit/hyper activity disorder.

OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) has an impact on children and families. The purpose of this study was to assess the health-related quality of life between school-age children with ADHD compared with those without physical or mental disorders. MATERIAL AND METHOD: Self- and parent-reports describing the quality of life, covering 4 domains: physical, emotional, social, and school functioning, were obtained from 46 children with ADHD and 94 control children. At the time of the study, 17 of 46 children reported receiving medication for ADHD. RESULTS: After controlling for age and demographic background, both children with ADHD and their parents reported having a significantly lower quality of life score than controls and their parents. Children with ADHD also reported themselves to have a significantly low physical score, despite their physically healthy status. CONCLUSION: Children with ADHD had impairment of their quality of life in the physical and psychosocial domains. Improvement of health-related quality of life should be integrated in the overall planning of the treatment goals.

Attention Deficit Disorder with Hyperactivity↗

PubMed1989

[Psychosocial aspects of the so-called short-bowel syndrome in children].

In a retrospective study of 16 patients with (congenital) bowel pathology, aged 2 to 12, attention was paid to the psychosocial aspects of the short bowel syndrome. Parents were interviewed and parents' and teachers' reports of children's behavioural and emotional problems were obtained. Parents as well as children appeared to have reached a reasonable level of adjustment. Parents' emotions concerning the period of hospitalisation still appeared to be strikingly strong. Although most children did not show obvious psychopathology, problems were observed in the areas of behaviour and attention, interfering with optimal school functioning in the case of some children.

Adaptation, Psychological↗

PubMed1981

Developmental output failure: a study of low productivity in school-aged children.

Children with low academic productivity in late elementary and junior high school present a vexing problem to parents and schools. A subgroup of these youngsters may have underlying subtle handicaps that result in reduced productivity and chronic underachievement. Such children may be clinically characterized as exhibiting "developmental output failure." Using parent and teacher questionnaires, educational achievement tests, and pediatric neurodevelopmental assessments, a group of 26 children was selected according to predetermined criteria from among the clinic population seen in The School Function Program at The Children's Hospital Medical Center. Common findings among the group included problems with expressive language, fine motor tasks, finger agnosia, attention, and retrieval memory. It is suggested that clinicians be aware of the possibility that a child in this age group with low academic work output may have underlying developmental dysfunctions, whose manifestations may not have been evident earlier in life.

Achievement↗

PubMed1977

[Dislocation of the elbow as a clinical problem with reference to rehabilitation].

In the period from 1970 till 1974, 106 patients with the clean luxation without the injury of the bone supstrate were treated. From that number there were 68 men and 38 women. In the total anaesthesia the reposition and imobilisation in the upper arm longeta were performed. This longeta was removed after three weeks and then the rehabilitation was continued (medical school). Functional results are neat.

Adolescent↗