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Results of oral health and hygiene education in an institution for multiple handicapped children in Indonesia.

In a collaboration between the Dutch and Indonesian Dental Associations a system for oral health care for multiple handicapped children was initiated in a large care and rehabilitation institution in Jakarta, Indonesia. Part of the project was to develop a programme for oral health and hygiene education (OHE), with a specific plaque control component. This programme was aimed not only at the handicapped children but also at their parents and the teaching and (para) medical staff of the institution. A study to investigate the feasibility, acceptability and effectiveness of the OHE programme was carried out over a period of 2 1/2 years. The programme was well accepted, effective and of clinical significance. It is probably one of the first of its kind in a developing country.

Adolescent↗

Transformational deficits in cognition of schizophrenic children.

This study examined schizophrenic children for cognitive deficits in logical thinking, symbolic imagery, and conservation. Evaluation revealed persistent failure of the aberrant subjects to achieve at the level of age expectancy. Comparison with nonpsychotic, institutionalized children demonstrated no effect due to institutionalization. By mid-teens not one of the subjects had accomplished formal operations and very few were able to master concrete operations. Implications for development and treatment were discussed.

Adolescent↗

Sexual knowledge and attitudes of institutionalized and noninstitutionalized retarded adolescents.

Sixty-one noninstitutionalized and 60 institutionalized mentally retarded adolescents were psychometrically assessed on three measures: sexual knowledge, sexual attitudes, and self-concept. The two groups differed on total score on sex knowledge only, with the non institutionalized group being more knowledgeable. With regard to sexual attitudes and self-concept, the two groups did not differ in terms of total correct statements. Internal consistency demonstrated on all the measures ranged from .50 to .90. Intercorrelations of relevant variables for each group (10 for the noninstitutionalized, 13 for the institutionalized) produced several significant correlations. Results were discussed with reference to the development of a standardized instrument for assessing sex-education programs for mentally retarded persons.

Age Factors↗

Language differences between institutionalized and noninstitutionalized retarded children.

The linguistic performances of 15 noninstitutionalized and 15 institutionalized retarded children were compared on usage of grammatical categories and structure of spoken language (Length--Complexity Index) and for underlying subskills (Illinois Test of Psycholinguistic Abilities). Differences were not found between the groups for usage of grammatical categories or structures but were found for subskills of Auditory Reception. Auditory Sequential Memory, Verbal Expression, and Auditory Closure. Further analysis by multiple stepwise regression indicated that noninstitutionalized and institutionalized retarded children may be differentiated by examining a number of linguistic variables. The grammatical structure of language appeared less affected by environment than were the semantic and auditory elements.

Adolescent↗

Predictors of parent involvement with institutionalized retarded children.

A multivariate discriminant function analysis was used to explore 22 biographical and psychological variables which were thought to have some possible bearing on frequency of family visits to the institution and attendance at parent conferences. The analysis identified 6 of the variables as significant predictors, although the factors related to the 2 measures of parental involvement were not identical. The 6 major predictors of lack of involvement were: presence of physical anomalies, high disparity between CA and social maturity, greater distance from the institution, low occupational level of the father, maintenance payments not being required, and the parent having custody being divorced and remarried.

Child, Institutionalized↗

Hepatitis and Down's syndrome.

Data obtained concerning Hepatitis B as a possible couse of Down's syndrome, neonatal hepatitis, and the occurrence of Hepatitis A and B in institutionalized Down's syndrome and matched non-Down's syndrome retarded patients was summarized. The results of our studies indicated that Hepatitis B infection during pregnancy was not related to the genetic changes associated with Down's syndrome. It was further indicated that in institutionalized patients the incidence of Hepatitis B infection in both Down's syndrome and other mentally retarded patients was similar. Within the institition we studied, the incidence of Hepatitis B varied among wards. This ward variation seemed to be related to age at time of institutionalization and degree of mental retardation. Those patients with most retardation and those institutionalized at an early age were placed on wards with highest incidence of Hepatitis B antigenemia.

Age Factors↗

[Severely mentally and physically disabled in Gunma Prefecture].

We studied severity, causes of the disabilities, complications due to disabilities, and past histories of the severely mentally and physically disabled whose guardians or parents were residents in Gunma prefecture on September 1, 1991. This survey was made on severely disabled schoolboys and girls aged 6 to 15 years with IQ of 35 or less who could not stand or walk, even if they were supported. The number of them was 133 at the moment of this survey. Asphyxia at birth and congenital but unknown etiology were the major causes in the institutionalized cases, but cerebral palsy of unknown etiology and "no information" were frequent in the cases cared at home. The institutionalized patients showed severer mental retardations, palsies and disabilities on activities of daily lives, though not with statistically significant difference, and contained significantly larger number of cases fed by gastric tube or having meals as blended foods and significantly smaller number of cases having conventional meals than cases cared at home. Furthermore, epilepsies or constipations as complications were found more frequently in institutionalized cases than in cases cared at home with significant difference. On past history, relatively large numbers of the disabled suffered from various infectious diseases, especially from measles, varicella, mumps and pneumonia. Histories of measles, varicella and mumps showed higher frequency in institutionalized cases than in cases cared at home, though not with significant difference. On the cases cared at home, some of them did not have their home doctors, though in small numbers.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

An investigation to determine the health status of institutionalised street children in a place of safety in Durban.

This study determines the health profile of institutionalized street children in a Place of Safety in Durban. Fifty black street children who had been institutionalized for a period of not more than fourteen days were interviewed and health assessments were carried out. The children's weights and heights were recorded on growth charts and structured interviews were held. Generally the children were found to be deprived, both socially and physically. Minor health problems were common and some had more serious problems. Recommendations for effective primary health care are put forward.

Adolescent↗

[Periodontal status of institutionalized mentally retarded patients].

The periodontal (PI) and the oral hygiene (OHI-S) indexes of 109 institutionalised mentally handicapped children were compared to PI and OHI-S indexes of 94 institutionalised healthy children. Both indexes showed significantly higher values at the handicapped group. Sex differences manifested only in the control group to the advantage of females.

Adolescent↗

Dimensions of problem behavior in institutionalized retardates.

A factor analysis of teacher ratings of 55 items of deviant behavior in a sample of 252 institutionalized retardates resulted in the emergence of three interpretable factors. Two factors clearly represented the broad-band dimensions of conduct disorder and anxiety-withdrawal, while the third reflected psychotic behavior. Only conduct disorder was related to age, sex, race, or intellectual level.

Adolescent↗

The effects of family structure on institutionalized children's self-concepts.

This study examined the effects of family structure (intact, stepparent, and single parent) on children's self-concepts, using Parish and Taylor's Personal Attribute Inventory for Children. One hundred sixty-six institutionalized children in Grades 5 through 12 participated in the study. Although a trend was noted for students from single-parent families to check fewer positive adjectives, they did not differ significantly (.05 level) from children from intact families or stepfamilies.

Child↗

Psychoneurotic disturbance and drug-taking in Borstal boys.

Their own accounts of their use of drugs, together with a detailed description of psychiatric history and present mental state, were obtained from a sample of institutionalized delinquents, Subjects reporting extensive involvement in drug abuse were found to be disturbed on a number of psychiatric variables; however, those reporting some limited abuse were less disturbed than subjects reporting no experience of drug taking. The results and their implications are discussed.

Adolescent↗

[Oral findings of institutionalized handicapped children].

In this study, we investigated the oral conditions of 77 handicapped children (57 boys and 20 girls) and backgrounds of living in an institution. The results were as follows. Among 73 children having permanent dentition, the percentage of subjects with one or more DMF teeth was 94.52%, while DMFT was 7.45. The percentage of teeth treated for dental caries was 57.35%. GI (Gingival Index) was 1.7, and OHI-S was 3.50. The other features observed were attrition of posterior teeth in 25 subjects and crowding in 39. According to the degree of mental retardation, severely retarded children had a lower percentage of teeth treated for dental caries than moderately and mildly retarded children. Additionally, the severely retarded handicapped children who were long-time institutionalized and taking antispastic drugs, had the higher incidence of gingivitis and poor oral hygiene. This study indicated the necessity of a scheduled and active practice in order to improve oral hygiene status and gingival condition, and raise the percentage of teeth treated for dental caries of severely retarded children in an institution.

Child↗

Adaptation to childhood parental loss: the experience of growing up in an "orphanage" and its meaning over time.

Intrigued by a newspaper ad in the Argus Leader, placed by The Sioux Falls Children's Home Society in their hope of reuniting adults formerly institutionalized there as children, I wondered what we might learn from the experiences of people having grown up as "orphans." After exploration, I was invited to attend their reunion to facilitate some of the discussion of former residents who were "welcomed home" from various parts of the country. The participants expressed a wide range of emotions as they rediscovered one another--sometimes from childhood memory, sometimes contrasting childhood faces in old photos with the faces of people now present in middle or old age. As the group reminisced, one man told of his calling out the home's upper-story window each evening to his older sister who lived a floor below. He recalled his sadness on the day when there was silence in response, as she had been sent to a foster home. A woman "alumni" sang word for word, with others joining in, an old Christian hymn that they had sung decades before. And, an elderly woman described how the church across the street from the original children's home facility on tenth street, had a large stain glass window depicting the outstretched arms of God. She told how every night, when it was time for her to go to bed, the window would be lit up. Movingly, she related how she would lie in her bed and look through the window of her room, feeling "held" until she fell asleep. Over the many months that followed, men and women who had been institutionalized there throughout childhood entrusted to me their life stories. This article is a summary of their narratives. In general, it seemed that the participants were set apart by the enormity of the poverty of their early years, the enduring quality of their losses, and by a certain tenacity, decency, and striving for restoration.

Adolescent↗

Adolescent Rorschach responses as a function of age at first institutionalization.

To test the hypothesis that age of first separation from a home environment is a factor in the emotional health of institutionalized boys, Rorschach protocols of 82 residents of Saint Francis Vocational School, a facility for deprived nondelinquent nonretarded youth aged 10 to 18, were examined. Seven Rorschach variables were used as dependent variables of emotional status. It was found that boys who had first been institutionized before age 10 gave more color-dominant and pure color responses (p less than .005), and more responses with pathological overtones (p less than .005), than did youth first placed at ages 10 to 13 or ages 14 to 17. Fixation was proposed as the basis for the group differences.

Adolescent↗

Some considerations concerning institutional placement of retarded children.

The question whether retarded children should be institutionalized is discussed in the light of how, on the one hand, children can be successfully cared for at home and, more extensively, the serious problems that often arise at home. Institutions are not seen as the dreaded places they are often believed to be, and the frequent advantages to the retarded children of institutional care are discussed.

Adolescent↗

Concepts of emotion in institutionalized children.

Institutionalized children of 7, 11 and 15 years of age were interviewed with regard to their concept of emotion. Questions were posed pertaining to the identification of emotion, the effects of emotion on other psychological processes, and the strategies by which both the display and experience of emotion may be regulated. The results of this study were analysed together with those from an earlier study conducted by Harris, Olthof and Meerum Terwogt (1981) in which non-institutionalized schoolchildren were interviewed. The institutionalized children show the same general (development) shift in their conception of emotions, albeit in a delayed fashion in some cases, as was found in the earlier study for the non-institutionalized schoolchildren. That is to say, whereas the youngest children focus on the publicly observable components of an emotion, the older children also take the hidden mental aspect of an emotion into consideration. The institutionalized children differ from the non-institutionalized children in that they claim to be less attentive to their own emotions as well as those of others; they do not consider it feasible to actually change an emotion; and they consider the effect of emotions to be more detrimental. These results are discussed in terms of a learned helplessness explanation.

Adolescent↗

An innovation in an undergraduate paediatric teaching programme.

The reasons for removal of children into care and the effects of institutionalization are described. Medical students were attached to children's institutions and played various roles in befriending individual children, caring for groups of children, undertaking health education, and monitoring growth and development. The majority of students became committed to assisting the children and, simultaneously, the learning objectives were fulfilled. The programme has potential as a learning experience and a community service.

Child↗