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Changing diagnosis of childhood psychosis.

The case findings of thirty-three children given a diagnosis of psychosis during hospitalization in the '50s and '60s were reviewed and rediagnosed in 1973. Childhood schizophrenia was the original diagnosis in 58% of the cases but was the rediagnosis in only 18% of those same cases. Chronic brain syndrome with various reactions (psychotic reaction, nonpsychotic behavioral reaction, and mental retardation and autism) was the diagnosis in 27% of the cases, originally, but was given to 67% of the cases on rediagnosis. One-third of the children originally diagnosed as psychotic were rediagnosed as nonpsychotic. Approximately two-thirds of the children were nonpsychotic according to the DeMyer-Churchill guidelines.

Autistic Disorder↗

A seroepidemiologic study of hepatitis A in Spanish children. Relationship of prevalence to age and socio-environmental factors.

Three child population groups from the Madrid area were studied for anti-HAV antibodies. Analysis was carried out with respect to age and socio-environmental factors. The population understudy was composed of 156 children, with ages ranging from 1 to 14 years; they were stratified in three socio-environmental groups (white-family unit, gypsy-family unit and orphanage), and also divided into subgroups according to age. As a whole, an age-related increase in prevalence was found. The overall seroprevalence by socio-environmental groups was: gypsy-family unit 63%, orphanage 46%, and white-family unit 23%. Significant differences between groups appeared from seven years on, being more marked among the eldest subgroups. Among the factors evaluated, hygienic-sanitary conditions and overcrowding influenced the high prevalence rate found in the gypsy-family unit subjects, whereas overcrowding appeared to be responsible for the higher prevalence in orphanage residents, as compared to white-family unit children.

Adolescent↗

Enterovirus infection in a semi-closed community.

Infection with enteroviruses was studied over a 61-week period (during 1960-61) in a semi-closed child community in the Detention Home of the Allegheny County Juvenile Court in Pittsburgh, Pennsylvania. While most of the viruses isolated were known adeno- and enterovirus types, three apparently represent new enterovirus types or 'prime strains'. Viruses were isolated in all but 6 weeks of the 61-week study period from the gastro-intestinal tracts of 110 children out of a total population of 514 (21%); of these 110, 24 children (22%) excreted virus at the time of admission. The population averaged 37 children (more than half of whom were under 5 years of age), with a turnover of about nine per week. Spread of infection in this community on introduction of a new virus was demonstrated, with virus shedding of variable duration after infection. Thirteen of the 110 positive children (12%) showed mixed virus infections. During the entire study period, no clinical diarrheal illness was found associated with the viral infections detected.

Adenoviruses, Human↗

Institutional child abuse in Greece: some preliminary findings.

A long-term study on child abuse and neglect in Greece is being carried out at the Institute of Child Health, Athens. A multidisciplinary team is investigating the nature of the problem in Greece, is trying a system of therapeutic intervention to families, is evaluating the adequacy of child protection as it is used in child abuse and neglect, and is examining the efficacy of the law. During a one year period, 5 children cared for in institutions were referred to the program. All were boys. All were children with minor or major handicaps. Two of died from the abusive incident. A study of the circumstances of the injury, and of the conditions in Greek institutions, supports the idea that institutional and family child abuse share many common characteristics. Special mention is made of the Greek circumstances pertaining to child protection and the law.

Adolescent↗

How much of a problem is resident mistreatment in child welfare institutions?

The purpose of this article is to provide information developed since 1980 by the Institutional Child Protection Project about the size and significance of the problem of mistreatment in child welfare residential institutions. In the 1,700 facilities surveyed, there are about 69,000 children and youths. Rates of utilization vary among Health and Human Services (H.H.S.) regions from 8 per 10,000 to 19 per 10,000 children and youths in the population. The average rate is 12 per 10,000. In 1961 this rate was estimated at 10 per 10,000. About 2,700 complaints were reported by facilities to the survey for 1979. Complaint rates range by H.H.S. region from 25 per 1,000 to 55 per 1,000 children and youth in care. The average complaint rate per 1,000 residents in care was 39. Observations of site visitors suggest that only one out of five complainable situations may be reported to child protection agencies. A list of complainable occurrences that came to the attention of site visitors is included to document the problem. An additional effort to assess the significance of this issue is made by comparing intrafamilial complaint rates with rates reported by child welfare facilities. The authors believe residential complaint rates may be twice as large as intrafamilial complaint rates.

Adolescent↗

[Violence and negligence to children and adolescents in institutions].

Institutional abuse comprises a structural aspect directly bound to the institutional area itself as well as direct abuses of all kinds which are committed by members of the staff. Such direct abuses can be felt by those who enact them or by observers as being legal in their context or as illicit and therefore concealed. Information about violence in institutions is rarely found in scientific literature. Some books, usually underground, and newspapers deal with the problem. Testimony from professionals working within institutions may not be justified or may be flawed by ulterior motive. However, when correctly decyphered and interpreted, it is absolutely necessary. Enquiries are difficult and not always conclusive. The paper presents a typology of "violent" institutions and proposes some recommendations to make this problem better known.

Adolescent↗

A study to define and assess severity of institutional abuse/neglect.

The purpose of this paper is to examine results of an empirical study of judgments about the seriousness of situations of institutional child maltreatment. This study furthers the development of operational definitions of institutional abuse and neglect by examining the following issues: What is the relative seriousness of institutional child maltreatment events? Are judgments of seriousness made on the basis of caregiver behavior or negative consequences to the child? Are incidents of child maltreatment which occur in institutions judged differently than similar incidents which occur in an intrafamilial context? This paper presents data gathered on judgments made by 630 respondents regarding 24 situations of child maltreatment. Respondents in the study represented: children in care, direct caregivers, managers in institutions, public child welfare workers, facility board members, and foster parents. Respondents judged the situations to be harmful more readily than they judged them to be abuse/neglect. For the majority of events in this survey, the setting (out-of-home care vs. intrafamilial) did not appear to significantly affect the judgments of respondents in their assessment of harm or judgment as abuse/neglect. The presentation of a negative consequence for the child significantly (p less than .05) increased the respondents' assessment of harm in 12 out of 24 events. The presentation of a consequence for the child significantly (p less than .05) increased the respondents' assessment of harm in 12 out of 20 events. The presentation of a consequence for the child significantly (p less than .05) increased the judgment of abuse/neglect in 8 out of 24 events.

Adolescent↗

The Solomuna Orphanage: a historical survey.

The social-emotional status and behavioral symptoms of Eritrean war orphans were compared before and after a major social reorganization of the institution had been implemented. The comparison was based on direct clinical observations and behavior checklist questionnaires. Two years after the orphanage was restructured, the emotional state of the orphans had improved dramatically. The findings suggest that even when financial and technical resources are severely limited, it is possible to provide humane group care for severely traumatized orphans by applying basic clinical principles of child development.

Child↗