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PubMed2003

Psychometric properties of the Mid-Range Expanded Trail Making Test. An examination of learning-disabled and non-learning-disabled children.

By systematically varying the stimuli within the Mid-Range Trail Making Test (MTMT), it may eventually be possible to isolate the cognitive demands of this test. Toward this end, the Mid-Range Expanded TMT (METMT) was developed by adding five new forms to the original forms A and B. To insure its appropriateness for clinical and experimental use, the current study sought to quantify the psychometric properties of this new test. The results indicate that the METMT is reliable and has adequate construct, criterion, and factoral validity. The results also cross-validated the findings of Davis et al. [J. Clin. Psychol. 45 (1989) 423.], suggesting that brief neuropsychological evaluations can effectively differentiate normal learners from learning-disabled children. The present study suggests that the MTMT is robust to alterations of its stimulus dimensions. Preliminary METMT normative data are presented.

Adolescent↗
PubMed1992

[Problems and disability pension in back and spinal diseases in occupational disability insurance].

In the German disability insurance, exclusion clauses are the dominating approach to the underwriting of low back pain. This is due to a lack of clear prognostic factors, the nonexistence of severity classifications and the strong impact of individual and psychological circumstances. Considering various clinical, individual and psychological indicators, a new system is introduced to allocate the prognosis of lower back pain to four levels of severity. This approach makes it possible to use extra ratings instead of exclusion clauses of mild and moderate low back pain.

Back Pain↗
PubMed2004

Disability plans--treating physician rule. Black & Decker Disability Plan v. Nord.

ERISA does not require the administrator of an employee welfare plan to give special deference to a claimant's treating physician's opinion for purposes of determining eligibility for disability benefits. Nevertheless, administrators may not arbitrarily refuse to credit a claimant's treating physician's opinion or any other reliable evidence.

Eligibility Determination↗
PubMed1995

[Clinical studies of learning disability. Part I: Two-axial diagnosis of learning disability using the Pupil Rating Scale Revised (PRS) and WISC-R].

We investigated the correlation between intelligence quotient and school performance evaluated by PRS (the Pupil Rating Scale Revised) to assess an adequacy of two-axial diagnosis of learning disabilities (LD). The subjects were 37 children, including 31 cases with developmental or school problems and 6 normal children. The Japanese Wechsler Intelligence Scale for Children-Revised (WISC-R) was employed for an estimation of intelligence quotient (IQ) and, PRS was used to evaluate school performance. We defined 'LD risk child' as a child whose IQ was no less than 70 and PRS score was no more than 65. A statistical evaluation of IQ and PRS was done in this group separately. Ten children were diagnosed as 'LD risk' using this criterion. Fourteen children had normal IQ, and thirteen children were mentally retarded. There was a significant correlation (r = 0.68, P < 0.001) between IQ and the PRS score in these 37 children. On the other hand, no significant correlation was found between IQ and the PRS score of the 'LD risk child'. This result suggests that we can expect high PRS score in proportion to their IQ level. Because LD children generally tend to demonstrate deviated IQ-school performance correlation, we conclude that the WISC-R and PRS are appropriate for two-axial screening of LD.

Adolescent↗
PubMed1996

The role of the pediatrician in prescribing therapy services for children with motor disabilities. American Academy of Pediatrics Committee on Children With Disabilities.

Pediatricians are often called upon to prescribe physical and occupational therapy service for children with motor disabilities. This statement defines the context in which rehabilitation therapies should be prescribed, emphasizing the identification and enhancement of the child's function and abilities. The statement encourages the pediatrician to work with teams including the parents, child, teachers, therapists, and other physicians.

Arthrogryposis↗
PubMed1996

[Work capacity, severe disability and needs for disability services in Thüringen with respect to demographic change].

Considerable changes are taking place in germany in respect of age groups (fewer youngsters, more old people), and this is bound to be reflected by the demography of the working population (15 to 64 years) during the next 50 years. It is shown in this contribution how the expected changes in age distribution in Thuringia will probably be reflected by the number of pensioners who are incapable of gainful employment or of exercising their original job for which they were trained. The proportion of younger persons who had to be pensioned because of inability to work or major disablement or severe need of nursing care, will decrease until 2040 A.D., these persons being in most cases about 10 years younger than the usual pensioning age. This entails a great need for medical, social and job rehabilitation in tremendous measure: a major challenge both in sociomedical and labour market policy respects.

Adolescent↗
PubMed1996

Practice guidelines for the clinical assessment and care management of Alzheimer's disease and other dementias among adults with intellectual disability. AAMR-IASSID Workgroup on Practice Guidelines for Care Management of Alzheimer's Disease among Adults with Intellectual Disability.

The AAMR/IASSID practice guidelines, developed by an international workgroup, provide guidance for stage-related care management of Alzheimer's disease, and suggestions for the training and education of carers, peers, clinicians and programme staff. The guidelines suggest a three-step intervention activity process, that includes: (1) recognizing changes; (2) conducting assessments and evaluations; and (3) instituting medical and care management. They also provide guidance for public policies that reflect a commitment for aggressive care of people with Alzheimers's disease and intellectual disability, and avoidance of institutionalization solely because of a diagnosis of dementia.

Activities of Daily Living↗
PubMed1997

[Clinical studies of learning disability. Part III: Prevalence of children with suspected learning disabilities].

The prevalence of children with suspected learning disabilities (LD) was investigated. One thousand and eight-hundred-eighty-nine pupils at ordinary elementary classes were evaluated by class teachers. We defined suspected LD as a condition with normal IQ (not less than 70) and low PRS score (not more than 65). Eighteen children (12 boys, 5 girls, and 1 with sex unknown) were considered as suspected LD with this criterion. The prevalence of suspected LD at elementary schools was 0.95%, the lowest figure as compared to those in previous reports. The suspected LD children were studied for the LD type and school grade. Verbal LD was not found, non-verbal LD was found in 6 children, and mixed type in 11. In the study of their school grades, the third grade suspected LD children were the largest. There was a significant decrease in number at higher school grades.

Age Factors↗
PubMed1997

[Clinical studies of learning disability. Part IV : A prospective study of children with risk factors for learning disability at three year-old screening--clinical examinations in 1995].

We are following children with risk factors for learning disability (LD) at three year-old screening prospectively. In 1995, one child reportedly as normal in 1994 was considered to have a possibility of LD. The complaints of their parents had shifted to underachievement. In several children, their poor social skill in school and family was considered to be more serious in 1995 than in 1994. All children who were clumsy in early childhood showed non-optimal motor co-ordination on minor neurological examinations by Touwen. This suggested that non-temporary neurological impairments led them to LD.

Child↗
PubMed1998

Learning disabilities, dyslexia, and vision: a subject review. Committee on Children with Disabilities, American Academy of Pediatrics (AAP) and American Academy of Ophthalmology (AAO), American Association for Pediatric Ophthalmology and Strabismus (AAPOS).

Learning disabilities are common conditions in pediatric patients. The etiology of these difficulties is multifactorial, reflecting genetic influences and abnormalities of brain structure and function. Early recognition and referral to qualified educational professionals is critical for the best possible outcome. Visual problems are rarely responsible for learning difficulties. No scientific evidence exists for the efficacy of eye exercises ("vision therapy") or the use of special tinted lenses in the remediation of these complex pediatric developmental and neurologic conditions.

Adolescent↗
PubMed2003

Time to disable DALYs? On the use of disability-adjusted life-years in health policy.

The concept of disability-adjusted life years (DALYs) has rapidly gained in popularity in health policy, and considerable research resources are being allocated to this field. Proponents of DALYs suggest that the measure can be used both as a "gross domestic product of health" and to help in setting priorities in health policy. This study investigates the usefulness of DALYs and contends that DALYs, as the measure is currently understood, cannot be used for either of these two purposes. The DALYs procedure does not produce a useful measure of population health, and its use in priority setting is ethically questionable.

Journal Article↗
PubMed2000

Screening for learning disabilities in preadolescents using psychosocial disability markers-a pilot study.

PURPOSE: Learning disabilities (LD) are among the most common developmental and psychiatric disorders encountered by pediatricians, yet many children are not adequately diagnosed or treated in elementary school when intervention is most effective. Because of the well-known co-morbidity between psychosocial problems and LD, this pilot study sought to utilize psychosocial "markers" to screen for unidentified LD among all fifth graders in three urban/suburb Connecticut elementary schools.METHODS: 115 fifth graders, representing a 71% response rate, agreed to participate in the study and were screened using standardized psychosocial questionnaires administered to parents (Child Behavior Checklist), students (Youth Self Report), and teachers (Teacher Report Form). Psychosocial symptom scores and associated t-scores were obtained for three types of problems; "internalizing," "attention" and "externalizing." 28 students with high levels (t > 60) of internalizing or attention problems, were selected along with a sample of 22 "normal" students with no evidence of psychosocial impairment. These 50 students were given an individually administered battery of ability, performance and cognitive processing tests to determine the presence of unidentified LD. Performance tests included standardized tests of reading, writing and mathematics. All test scores were normed with a mean of 100 and a SD of 15. LD was determined to be present if the student had a 1.5 SD or greater discrepancy between ability and performance in any of the three academic areas, and evidence of a cognitive processing deficit.RESULTS: The results indicated that 14 of the 50 students tested (28%) had evidence of undiagnosed LD. No significant difference was found in the proportion of undiagnosed LD among psychosocially impaired versus normal students. However regression analysis suggested that this finding was misleading. Controlling for ability, attention problems reported by the parent, were found to be significant (p < 0.05) predictors of lowered test scores, whereas internalizing problems were found to be predictive of increased test scores. Students with both internalizing and attention problems did not differ significantly from psychologically unimpaired students.CONCLUSIONS: This pilot study indicates that better screening methods are needed to identify the likely high proportion of elementary school children with undiagnosed learning difficulties and co-morbid psychosocial problems.

Journal Article↗
PubMed1991

Federal old-age, survivors and disability insurance (1950- ); determining disability and blindness; extension of expiration date for cardiovascular system listing--Social Security Administration. Final rule.

We are extending the expiration date of the cardiovascular system listing found in appendix 1 of part 404, subpart P, from June 6, 1991, to June 6, 1992. We have made no revisions in the medical criteria in the cardiovascular listings; they remain the same as they now appear in the Code of Federal Regulations. We are presently considering revisions to update the medical criteria contained in part A and part B of the listing, and any revised criteria will be published as a proposed rule when we have completed our review. Insofar as Medicare eligibility is based on entitlement to disability insurance benefits under title II of the Act, this proposed regulation affects the Medicare program. To the extent that Medicaid eligibility is based on title XVI eligibility, this proposed regulation affects the Medicaid program.

Aged↗