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Results for “Child, Institutionalized”

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PubMed1990

[Therapeutic methods used in psychiatric departments and homes for children and adolescents in Norway].

In November 1988 a point prevalence questionnaire study was carried out to evaluate which methods of treatment were given to child and adolescent psychiatric inpatients in Norway. Special emphasis was laid on to what extent psychotropic drugs are prescribed. All child and adolescent psychiatric institutions participated in the study and completed questionnaires on every inpatient on one particular day, 295 patients in all. The study confirms the family-oriented approach within child psychiatry and discredits the notion that children are drugged by psychiatrists. The study raises the question of how the chain of treatment should be organized to optimalize the available resources, and how methods should be differentiated in regard to the different diagnostic groups. It also emphasizes the need for continuous evaluation of the therapeutic activity.

Adolescent↗

PubMed1991

[Assistance work in Romania. A multidisciplinary study of institutionalized children].

In October/November 1990 a health team worked in an institution for mentally retarded children in Rumania. The team diagnosed 154 children and encountered children with undernourishment, retarded growth, skin infections, injuries and untreated physical deformities. 11 children were in need of acute medical attention. Cerebral palsy and motoric, auditive and visual handicaps were not attended to. The children showed signs of deprivation, anxiety and behavioural maladjustment. They were mentally retarded, but receptive to stimulation. To conclude, the children suffered from physical, psychological, pedagogic and social neglect. The article provides information on the needs for further assistance to children in institutions in Rumania.

Adolescent↗

PubMedDate not supplied

Spinal bracing in the institutionalized person with scoliosis.

Twenty institutionalized children with scoliosis were treated with a spinal bracing program for an average of two years. The Boston brace with or without superstructure was employed. These children generally had neuromuscular disease and were often functional sitters only. Seizure disorders were common. Fifteen thoracolumbar curves were improved from a prebracing mean curvature of 4.25 degrees to a postbracing mean curvature of 31 degrees. The three lumbar curves improved from 39 degrees to 30 degrees. On patient was termed a failure. The program is considered to be of definite benefit.

Adolescent↗

PubMedDate not supplied

The Mary Sheridan Unit: an evaluation of the effects of a hospital unit on the development of visually-impaired multiply handicapped children.

The evidence in this study appears to indicate that adopting a goal-planning approach can provide demonstrable and clear improvements in the developmental functioning of multiply handicapped blind children. However, while the improvements in functioning for self-help and sensorimotor abilities are quite significant, those for communication and language skills are much less so. Three possible hypotheses have been advanced as to why this should be so. The hypothesis that the setting might be an institutionalizing one was rejected on the grounds that some of the evidence did not fit with that from other populations. The second hypothesis referred to the lack of formal speech and communication training on the unit. The best possible test of this hypothesis would be to employ a speech therapist to work on the unit and support for such a scheme is being sought. Finally, it was hypothesized that the way in which the staff interacted with the children was not being sufficiently modified to take account of the children's handicaps.

Activities of Daily Living↗

PubMed1998

A three year follow-up of attachment and indiscriminate friendliness in children adopted from Romanian orphanages.

Attachment and indiscriminately friendly behavior were assessed in children who had spent at least 8 months in a Romanian orphanage (RO) and two comparison groups of children: a Canadian-born, nonadopted, never institutionalized comparison group (CB) and an early adopted comparison group adopted from Romania before the age of 4 months (EA). Attachment was assessed using 2 measures: an attachment security questionnaire based on parent report, and a Separation Reunion procedure that was coded using the Preschool Assessment of Attachment. Indiscriminately friendly behavior was examined using parents' responses to 5 questions about their children's behavior with new adults. Although RO children did not score differently from either CB or EA children on the attachment security measure based on parent report, they did display significantly more insecure attachment patterns than did children in the other 2 groups. In addition, RO children displayed significantly more indiscriminately friendly behavior than both CB and EA children, who did not differ in terms of indiscriminate friendliness. RO children's insecure attachment patterns were not associated with any aspect of their institutional environment, but were related to particular child and family characteristics. Specifically, insecure RO children had more behavior problems, scored lower on the Stanford-Binet Intelligence Scale, and had parents who reported significantly more parenting stress than RO children classified as secure.

Adoption↗

PubMed1985

Prediction of developmental attainments of institutionalized mentally retarded children.

Two regression equations using chronological age and either IQ or the Fisher and Zeaman K score were developed to predict Developmental Record ratings of institutionalized mentally retarded children over a 2-year interval (N = 200), a 4-year interval (N = 165), and an 8-year interval (N = 95). Although the correlations between predicted and obtained scores for both equations were quite high even over an 8-year interval, analysis of mean differences revealed that the equation using IQ yielded more accurate predictions. If future studies support the use of such equations with other subjects in other settings, they should be useful in estimating later developmental attainments of mentally retarded children.

Activities of Daily Living↗

PubMed1980

A study of institutionalized mentally retarded patients in Manitoba. I: Classification and preventability.

This preliminary report concerns the types, and the possibility of prevention, of mental retardation found among 406 patients less than 20 years of age and with IQs less than or equal to 50 who had been admitted to institutions for the retarded in Manitoba prior to 1977. The retardation appeared to be of genetic origin in 27.8 per cent of cases, and acquired in a further 30.3 per cent. 31 per cent of the genetic and 55 per cent of the acquired, or 25.4 per cent of the total group, are considered to have been avoidable, given the full application of current techniques and knowledge.

Adolescent↗

PubMedDate not supplied

[The parameters of the immune function in the evolution of HIV-1 infection in institutionalized children in Romania].

OBJECTIVE: To describe the evolution of HIV-1 + horizontal infected children nursed in closed community. METHOD: The biological status of 26 HIV-1 + children nursed in Iaşi Orphanage was assessed in dynamic during April. 1993-Feb. 1994. The income age ranged among 1 month-3 years. RESULTS: The following progressive stages could be drawn accordingly to the biological status parameters dynamic: stage 1 ("oligosymptomatic"), stage 2 ("multiform, medium or severe symptomatology"), and stage 3 ("severe immunodepression, with predominant infectious symptomatology, waves evolution"). These stages could not be assimilated to the currently CDC or WHO classifications. The following thresholds of the immunologically parameters separate the stages 1 and 2, and respective stages 2 and 3: CD4% lymphocytes (27% respective 20%); absolute CD4+ lymphocytes (1150/microliter respective 700 + 750/microliter), CD4/CD8 ratio (0.75 respective 0.45), beta 2-microglobulin (1.5 mg/1000 respective 2.5 mg/ 1000). Lymphocytes lacking the markers CD4, CD8, CD19, CD3, ranging between 15 + 20% were also detected by flow-cytometry; these cells could be attributed to the immature subpopulations (typically for dystrophy) or to down-regulation of membrane expression of some markers. Also, a dichotomy in the distribution of the CD2/CD3 surface markers was recorded in the case of lymphocytes. CONCLUSIONS: Immunological features demarcate this epidemiological group versus the current described models for the HIV-1 + child.

Biomarkers↗

PubMed2004

Emotion understanding in postinstitutionalized Eastern European children.

To examine the effects of early emotional neglect on children's affective development, we assessed children who had experienced institutionalized care prior to adoption into family environments. One task required children to identify photographs of facial expressions of emotion. A second task required children to match facial expressions to an emotional situation. Internationally adopted, postinstitutionalized children had difficulty identifying facial expressions of emotion. In addition, postinstitutionalized children had significant difficulty matching appropriate facial expressions to happy, sad, and fearful scenarios. However, postinstitutionalized children performed as well as comparison children when asked to identify and match angry facial expressions. These results are discussed in terms of the importance of emotional input early in life on later developmental organization.

Adaptation, Psychological↗

PubMed1978

A study of object concept development in institutionalized and home-reared infants.

Institution- and home-reared infants were tested in five areas: language development, object concept development, play, social responsiveness, and social maturity. The sample consisted of 104 infants ranging in age from six months to two years, thus broadly encompassing object concept stages 3 to 6 described by Piaget. The relationship of each of the five functions to IQ and background was examined. This paper describes the specific nature of the object concept function as reflected by the investigation. It was found statistically that object concept scores, as measured by Piagetian tests, were relatively unaffected by the background variable but were significantly related to IQ. The other measures were sensitive to both IQ and background variables. The fact that the object concept score was relatively independent of the background variable suggested that it represents the most stable developing function and provides the most accurate reflection of the cognitive potential of the infant.

Child Development↗

PubMed1976

Dimensions of adaptive behavior in institutionalized mentally retarded children and adults: developmental perspective.

Factor analyses were performed utilizing the subscale scores of the AAMD Adaptive Behavior Scale, Part One, for 3,354 institutionalized mentally retarded children and adults. Eight different age groups were studied to determine (a) the underlying dimensions of adaptive behavior measured by the scale, (b) similarity of factor structure across ages, (c) whether there were developmental changes revealed by factor scores, and (d) the extent to which the above findings would be related to level of retardation. Three salient factorial dimensions--Personal Self-Sufficiency, Community Self-Sufficiency, and Personal-Social Responsibility--appeared across a wide span of age ranges from childhood through senility. The implication of these factors was discussed in terms of the critical period of development, rate of growth, and maximum level of growth of subjects grouped by level of retardation.

Activities of Daily Living↗

PubMed1981

Primary care of previously institutionalized retarded children.

Medical care of retarded children is a responsibility of pediatricians that is seldom discussed. Past practices of isolating these children in institutions and caring for them in special multidisciplinary clinics are fading. The medical experience with 48 retarded children, the problems that they present, and the system of care that was developed to meet their special needs are described. Previous medical care was often found to be lacking or inappropriate. The spectrum of morbidity resembles that of a general pediatric population although chronic conditions are much more prevalent. Utilization of primary care and consultative services is much higher than for a nonretarded population. Much time is required for their care; a great deal of time is devoted to advising caretakers and schools and to coordinating health services. A prepaid system of care using a health associate as the primary provider was developed, and has been an effective means of providing health care to these children.

Acne Vulgaris↗

PubMed1976

Plasma vitamin A levels--a diagnostic indicator of hepatitis in an institutionalized mentally retarded population.

Based on hepatitis-associated antigen carrier status as a model liver disease, level of vitamin A can be a useful diagnostic indicator in mentally retarded individuals. It was found that vitamin A levels and age were linearly related by the equation A = (B + CD), where A is the plasma vitamin A in mugms per 100 mls of plasma, B is the sex dependent constant of 25.9 for males and 28.4 for females, C is a sex dependent constant of 0.64 for males and 0.77 for females, and D is age in years. Above age 20, D becomes a constant with a value of 20. With this equation, if the observed vitamin A value is less than 79 percent of the predicted value, then liver damage should be suspected. This information presented graphically allows one to predict liver damage by observing the plasma vitamin A levels and then locating the point on the appropriate graph.

Adolescent↗

PubMedDate not supplied

Circulation flow of enteropathogenic bacteria in institutionalized children. I. An epidemiologic study.

The circulation flow and maintenance of enteropathogenic bacteria were studied from May 1982 to April 1983 in a population of institutionalized children and adult staff contacts in the city of Rio de Janeiro, Brazil. Subjects were assigned to three groups: A and B, included, respectively, 105 and 46 children with diarrhea who were admitted in the institution in different periods, and group C with 82 adult contacts. Faecal cultures were positive in 35.2%, 39.1% and 19.7% of subjects of groups A, B, and C, respectively. It suggests that the transmission was probably fostered by the environment because of as high as 30% of faecal contamination was found in environmental samples. Higher rate of isolation and elevated antibodies levels pointed out that Escherichia coli (EPEC) was the prevalent agent. Shigella predominated in the serological tests. These findings suggest that the institution itself may play an important role in the epidemiology and transmission of enteric infections in the community.

Adult↗

PubMed1995

[Nutritional and disease diagnosis in institutionalized children. Day care center Elisio Teixeira Leite, Perus, SP 1993].

As a part of one survey about health conditions in institutionalized children, the nutritional status were evaluated. Data were obtained through antropometric assessment in a sample of 111 pre-school children matriculated in a small official day-care center in Perus-SP. According to Gomez, 50.0% of all that children were classified as malnourished, 23.4% of them in the I degree; 22.4% in II degree and only 4.3% in III degree. Taking into account the Waterlow's classification there was a highest frequency of cronic-actual malnutrition (30.8%) concentrated in children between 12-48 months of age. Additionally, these children presented highest incidence of infective-respiratory and intestinal diseases. These evidences lead on to the improvement of the follow-up of children growth and food consumption, specially that under 24 meses, to attempt for an early identification of malnutrition, thus increasing the chance of nutritional recuperation.

Brazil↗

PubMed1984

A five-year immunological follow-up study of the institutionalized handicapped children vaccinated with live varicella vaccine or infected with natural varicella.

Twenty-two institutionalized handicapped children who were susceptible to varicella were vaccinated with live varicella vaccine of the Oka strain and their immune status was followed for 5 years under conditions without exposure to natural varicella. Simultaneously, 7 children infected with natural varicella were followed. Of the 22 vaccinees, 16 showed sero-positive conversion by the fluorescent antibody to membrane antigen (FAMA) test, the other 6 remaining seronegative during 5 years of observation period. All the 16 cases showing seroconversion had detectable antibody for 5 years after vaccination, and 14 of them gave a positive reaction in the varicella skin test. All the 7 cases after natural varicella gave positive reactions in both the FAMA and skin test. These results suggest that immunity conferred by the vaccination would persist long even in the absence of exposure to natural varicella, though further follow-up studies are needed.

Adolescent↗

PubMedDate not supplied

[The clinico-epidemiological aspects of HIV infection in 167 children nonmaternally infected who have died with a diagnosis of AIDS].

The aim of this study was to evaluate the clinical and epidemiological particularity of pediatrics nosocomial HIV infection. Our study group consists of 167 HIV serum-positive nonmaternally infected children who died of AIDS in 1990-1997 (inclusive) in Colentina Hospital of Infections Diseases--Bucharest. Fifty per cent of institutionalized children and 28% of family children died in the first two years of life. About 80% of children were revealed too late as HIV infected. It has been observed a relatively high prevalence values for: multiple or recurrent pneumonia--74.8%, recurrent or chronic diarrhea--87.4%, encephalopathy--65.8%, weight-growth deficiency--100%, disseminated or extrapulmonary tuberculosis--13.8%, HBsAg carriage--59.8%; and low prevalence values for: lymphoid interstitial pneumonia--16.5%, Pneumocystis carinii pneumonia--11.4%, cytomegalovirus diseases--1.8%, cryptosporidiosis--1.8%. The evolution of HIV infection (weight-growth deficiency and encephalopathy) were aggravated in hospitalised children (especially, in the first two years of life). Nutrition and hygiene care factors positively influence the evolution of HIV infection. Multiple or recurrent pneumonia are out of an important prognostic value in the appreciation of SIDA evolution. The incidence and severity of tuberculosis increased at older children. The too late diagnostic of HIV infection had unfavourable influence upon the life expectancy of children.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Hypercalciuria in chronically institutionalized bedridden children: frequency, predictive factors and response to treatment with thiazides.

Calcium and creatinine concentrations were analyzed in urine samples of 42 chronically institutionalized bedridden children, with neurologic disorders. Their ages ranged from 2 to 16 (mean 8.7) years. Hypercalciuria, defined as UCa/UCr ratio greater than 0.21, was recognized in 18 children (42.8%), the mean UCa/UCr ratio of this group was 0.40 +/- 0.18. Twenty-four children were normocalciuric, with a mean UCa/UCr ratio of 0.08 +/- 0.03. There were no significant differences between the two groups with regard to age, sex, length of institutionalization, the basic neurologic disorder, diet, anticonvulsive medications, exposure to sunlight and weekly hours of physiotherapy. Age- and sex-matched percentiles for fat and muscle areas were similar in both groups. Seven limb fractures had occurred in the hypercalciuric group during the last three years, but only in one of the normocalciuric patients (p less than 0.02). The hypercalciuric children were treated with a hydrochlorothiazide-amiloride preparation for three weeks, which resulted in reduction of their mean UCa/UCr ratio by 57.7%, to 0.17 +/- 0.13 (p less than 0.005); only four children remained hypercalciuric. We conclude that resorptive hypercalciuria is common among chronically immobilized bedridden children. Hypercalciuria in such children should be specifically looked for, because of its association with deranged bone metabolism and increased frequency of limb fractures. Treatment with thiazides was found to be efficient in reducing urinary calcium excretion in our hypercalciuric patients. This therapeutic modality for the reduction of morbidity in bedridden chronically immobilized children should be further explored.

Adolescent↗