Access to health care for disabled children.
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Hospitalization and use of outpatient health care services during a 1-year period by 369 pediatric patients with cystic fibrosis, cerebral palsy, myelodysplasia, or multiple physical handicaps and 456 randomly selected children without congenital conditions from the Cleveland area were examined. Use of hospitalization and outpatient services by the average chronically ill or disabled child was 10 times that of the average comparison child. Physician specialists, occupational and physical therapists, and school nurses were the major outpatient categories used disproportionately by children with chronic illnesses or disabilities. The major share of health care used by children with chronic conditions was attributable to a small subset of children: All hospital care was accounted for by one third of the children, and three quarters of all outpatient care was accounted for by one quarter of that sample. Hospital care was used at similar rates by the four diagnostic groups. However, amount and type of outpatient care varied by diagnosis, level of functional impairment, race, and income. Estimated average expenditure for health services used by the chronically ill or disabled sample was 10 times that of the comparison sample. Relative distribution of estimated expenditures across types of services differed for the two samples as well as among diagnostic categories.
This study investigated the effects of rewards and practice on the attentional task performance of learning-disabled (LD) and normally achieving children. Contingent feedback and rewards resulted in faster but less accurate performance by the LD children. Despite the speed-accuracy trade-off, the LD children still responded more slowly than the controls. However, limited practice on the tasks resulted in significantly improved performance, such that the groups performed similarly. Poorer performance of LD children on their first encounter with laboratory measures of attention may be due to inefficient strategies rather than to actual deficits in ability to attend.
Fifty 8-year-old children, 25 classified as normal and 25 as learning disabled, participated in a study to determine whether they could be differentiated into their respective groups by using four tasks from the Devereux Test of Extremity Coordination: opposition, foot patting, finger wiggling, and heel-toe walking with the eyes closed. Each chilld received numerical scores based on the number of times he could perform a task in 10 seconds. A stepwise discriminant function analysis revealed that two tasks, opposition and foot patting, were significant discriminating variables. A resulting discriminant function prediction equation showed that, according to the results of the tasks tested, 78 percent of the sample had been correctly classified by previous methods.
Four commonly used measures of academic achievement were administered in counterbalanced order to 32 elementary and middle school-aged children enrolled in exceptional education programs for the learning disabled. Measures chosen were the Kaufman Test of Educational Achievement, KeyMath-R, Test of Written Spelling 2, and the Gray Oral Reading Test-Revised. Analysis suggested corresponding measures of reading, mathematics, and spelling were highly correlated, although in some instances generated significantly different mean standard scores. Implications for practitioners are discussed.
Pediatric Rehabilitation is starting a new section in the journal. 'Voices from the Past' will combine two forms of articles. The first will be reviews of, and where possible, republication of the 'classic' articles in the field of paediatric rehabilitation. Summaries and discussions of these seminal contributions will at least be presented. The second will be scholarly studies of historical topics within the fields of paediatric rehabilitation, childhood and disability. Recent research in the histories of childhood and disability is reviewed in this essay.
The problem-solving ability of 18 learning-disabled high school students was increased by instructions to verbalize overtly, but not by instructions to verbalize their actions covertly. This suggests that Vygotsky's 1962 "internalization-of-speech" perspective may be as useful in understanding the limitations of disabled learners as it has been in understanding the limitations of young learners.
The knowledge of 9-10 years old disabled pupils and the knowledge of not-disabled pupils of the same age about the respective other group does not only differ with regard to its extent but also to its contents from the knowledge of 11-12 years old disabled and not-disabled pupils, respectively.
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