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[Medicosocial problems of the health status of disabled children in a large city].

A specially designed chart of medico-social examination of a handicapped child is proposed which has been used in Ufa city for examination of invalid children. This elucidated essential factors of childhood invalidity which served the basis for two programs for a city--Children's Invalidity Prevention Program and Medical and Social Care Program for Children-Invalids.

Adult↗

[Effects of tizanidine for refractory sleep disturbance in disabled children with spastic quadriplegia].

Tizanidine is a centrally acting alpha-2 adrenoreceptor agonist widely used in the treatment of spasticity in patients with cerebral or spinal injury, and it is causing drawsiness in some of them. Based on these drug actions, we administered tizanidine to 21 spastic quadriplegic children with severe sleep disturbance not improved by conventional therapies. All these patients were showing abnormalities of both the induction and maintenance of sleep. The dosage of tizanidine was 0.1 to 0.2 mg/kg/day, divided into two or three doses. If daytime drowsiness was severe, tizanidine admistration was restricted to just prior to bedtime. In 13 patients (61.9%), we found improvement in sleep induction and/or maintenance. Moreover, patients' families were satisfied with the treatment. There were no detectable side effects except facial pallor in two patients (9.5%) whose treatment was discontinued. Severe muscle hypertonia causes severe pain, which generates strong sympathetic nerve activity and subsequent sleep disturbance. We consider that tizanidine has direct effects on the induction of sleep, and promotes muscular relaxation bringing about good sleep. We conclude that tizanidine is useful for the treatment of refractory sleep disturbance in spastic quadriplegic patients.

Adolescent↗

Perceptual consequences of a temporal processing deficit in reading disabled children.

Recent research suggests that some children who are reading disabled exhibit sensory deficits associated with poor temporal processing. The performance of disabled readers on various perceptual tasks is consistent with a temporal processing deficit hypothesis. Visual masking paradigms were utilized to obtain direct measures of the temporal aspects of processing in normal and disabled readers, and showed that the visual processing of disabled readers is characterized by a longer integration time and a slower processing rate for both simple and word-like stimuli. Image blurring, which reduces the contrast of high spatial frequencies, reestablished normal temporal processing of words in disabled readers.

Child↗