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PubMed1990

Psychosocial aspects of disability in children.

General psychosocial issues must be considered in facilitating the development of children with chronic illnesses and disabilities. A coping model and the developmental stages can be used as a framework to regard the impact of disabling conditions on children and the interventions that encourage psychosocial growth. Health professionals are encouraged to recognize the key role that they can play in promoting effective coping and growth for disabled children and members of their families and to incorporate psychosocial interventions into their practice.

Adaptation, Psychological↗

PubMed2003

Childhood functional status, family stressors, and psychosocial adjustment among school-aged children with disabilities in the United States.

BACKGROUND: During the last 30 years, several studies have indicated that children with disabilities are at increased risk for emotional and behavioral morbidity. Population-based studies are needed to understand the relationship between functional status, family stressors, and the psychosocial adjustment of children with disabilities. METHODS: Using data from the 1994 and 1995 National Health Interview Surveys, Disability Supplement, this study examines the associations between children's functional status, family stressors, and the psychosocial adjustment of school-aged children with disabilities. RESULTS: Regression analyses indicate that children's functional impairments in the areas of communication or learning, poor maternal health and mental health, family burden, and poverty are significantly and positively associated with psychosocial maladjustment among children with disabilities. CONCLUSIONS: Children's functional activity limitations and family stressors are significant correlates of psychosocial adjustment among children with disabilities. These data indicate a need for routine screening for mental health problems among children with disabilities, as well as a family-oriented approach to their medical care.

Adaptation, Psychological↗

PubMed2000

Training of pediatricians in care of physical disabilities in children with special health needs: results of a two-state survey of practicing pediatricians and national resident training programs.

OBJECTIVE: One goal of the American Academy of Pediatrics' Future of Pediatric Education II Project is to establish guidelines in training physicians to care for children with special health care needs (CWSN). Assessment of current practices in prescribing therapies and devices is necessary to meet this goal. Although much has been written about CWSN, there is a paucity of literature describing pediatricians' preparedness in prescribing such therapies and devices to children with physical disabilities. In an effort to assess physician preparedness, we surveyed pediatric residents nationwide and practicing pediatricians from 2 states, 1 urban and 1 rural. METHODS. A questionnaire aimed at identifying areas of concern regarding preparedness of physicians in practice and in training was prepared and mailed to prospective participants in Ohio and Mississippi. After follow-up mailings to nonresponders, approximately 59% responded. Summary statistics were reported as proportions with 95% confidence intervals. RESULTS: Among those polled, >70% reported no training in prescribing certain durable medical equipment and over 50% reported no training in prescribing certain therapies. In addition, at least 20% reported no training in treating some of the more common childhood physical disabilities. Nearly three fourths of the respondents indicated that they did not believe that they were adequately prepared to take an active role in prescribing therapies and durable medical equipment. Fewer respondents believed that they should be the sole providers of these therapies and durable medical equipment. CONCLUSIONS: The results of the survey indicate a lack of specific training and physician confidence in prescribing therapies and devices to CWSN, establishing the necessity of expanding training programs to better ensure quality health care for special needs children. Although additional ongoing research is necessary to fully evaluate the preparedness of physicians in caring for CWSN, this survey does help to identify areas of physician training that require improvement to provide quality health care for CWSN.

Child↗

PubMed2005

Nonfatal injuries among US children with disabling conditions.

OBJECTIVES: We investigated the risk of nonfatal injury in US children with disabilities. Disability was defined as a long-term reduction in the ability to conduct social role activities, such as school or play, because of a chronic physical or mental condition. METHODS: Among 57 909 children aged 5-17 years who participated in the 2000-2002 National Health Interview Survey, we identified 312 children with vision/hearing disabilities, 711 with mental retardation, 603 with attention-deficit/hyperactivity disorder (ADD/HD), and 403 with chronic asthma. We compared nonfatal injuries in the past 3 months between children with disabling conditions and those without using injury rates and logistic regression analyses. RESULTS: Compared with children without a disability, a higher percentage of children with disabilities reported nonfatal injuries (4.2% for vision disability, 3.2% for mental retardation, 4.5% for attention-deficit/hyperactivity disorder, and 5.7% for asthma vs 2.5% for healthy children). After we controlled for confounding effects of sociodemographic variables, children with disabilities, with the exception of mental retardation, had a statistically significantly higher injury risk than those without disabling conditions. CONCLUSIONS: Children with a disabling condition from vision/hearing disability, ADD/HD, or chronic asthma had a significantly higher risk for nonfatal injuries compared with children without a disabling condition. These data underscore the need to promote injury control and prevention programs targeting children with disabilities.

Adolescent↗

PubMed2007

Risk factors for psychiatric disturbance in children with intellectual disability.

BACKGROUND: Children with intellectual disability (ID) have a higher risk for psychiatric disturbance than their peers with normal intelligence, but research data on risk factors are insufficient and partially conflicting. METHOD: The subjects comprised 75 children with ID aged 6-13 years. Data were obtained from case files and the following four questionnaires completed by their parents or other carers: Developmental Behaviour Checklist, American Association of Mental Deficiency (AAMD) Adaptive Behavior Scale, a questionnaire on additional disabilities, and a questionnaire on family characteristics and child development. RESULTS: The risk of psychopathology was most significantly increased by moderate ID, limitations in adaptive behaviour, impaired language development, poor socialization, living with one biological parent, and low socio-economic status of the family. CONCLUSIONS: The risk of psychopathology in children with ID is increased by factors related to family characteristics and child development. Identifying these factors will help diagnose and possibly prevent psychiatric disorders in these children.

Activities of Daily Living↗

PubMedDate not supplied

[Work with parents of children with chronic illness or developmental disability].

INTRODUCTION: It is more and more important to work with parents of disabled children or children with chronic illness. PURPOSE: The goal of this study was to investigate mother's presence during hospitalization in regard to the child's handicap. We also wanted to establish if parents were trained to work with children with developmental disabilities. MATERIAL AND METHODS: In order to learn if parents of disables or chronically ill children were trained to help them, parents of 99 children hospitalized at Principovac Hospital were asked to fill out a questionnaire. RESULTS AND DISCUSSION: It was established that parents of children with multiple disabilities were best trained, whereas parents of mentally handicapped children were the least trained. Parents of physically handicapped children (63.6%) and children with multiple disability (63%) were mostly present during hospitalization.

Adolescent↗

PubMed1992

Fading teacher prompts from peer-initiation interventions for young children with disabilities.

This study examined a system for fading teacher prompts to children who served as peers in peer-initiation interventions for young children with disabilities. A teacher taught peers to direct social initiations to children with disabilities, provided verbal prompts for those initiations, and introduced a system that provided peers with visual feedback about the social interactions of the children with disabilities. She then systematically withdrew the verbal prompts to peers, and subsequently faded the visual feedback system. Peer initiations increased when the intervention began and resulted in increases in social interaction for the children with disabilities. As the teacher systematically faded the prompts and visual feedback to the peers, social interaction continued at the levels found during intervention and was maintained during a short maintenance period.

Behavior Therapy↗

PubMed2006

Nonverbal social interaction skills of children with learning disabilities.

Many children with learning disabilities (LD) face problems in their nonverbal communication, which constitutes an important component of their social skills. This study explores the frequency of nonverbal initiations and responses of 36 children with LD and 36 children without LD matched for age and gender, who were observed for 40 min during the break. Younger and older children with and without LD did not differ significantly in their nonverbal responses, but there was a statistically significant difference in terms of younger children's nonverbal initiations. Younger children with LD exhibited significantly fewer nonverbal initiations than younger children without LD. Findings are discussed and suggestions are made for further research.

Adaptation, Psychological↗

PubMed1988

Energy cost of ambulation in healthy and disabled Filipino children.

The energy expenditures (Ee) for locomotion by nondisabled and disabled Filipino children aged 7 to 13 were determined and compared using indirect calorimetry. Forty-one controls (20 boys and 21 girls) ambulated at a comfortable pace; 16 children (eight boys and eight girls) with lower extremity poliomyelitis of varying severity ambulated by (1) wheelchair propulsion, (2) bilateral axillary crutches, (3) unilateral lower extremity ankle-foot orthoses or knee-ankle-foot orthoses, and (4) unassisted. Disabled children, regardless of their mode of ambulation, had to expend significantly more energy to ambulate than normal children (p less than 0.05). Wheelchair propulsion cost 16% more energy than the normal gait; crutch ambulation cost 41% more than the control. Children using unilateral braces sacrificed speed to attain near-normal Ee. When they ambulated without orthoses, their Ee increased by 109% over the control. In ascending order, the least energy was expanded by normal ambulation followed by disabled ambulation with unilateral brace, disabled propelling a wheelchair, disabled ambulation with bilateral axillary crutches, and disabled ambulation without brace. Efficiency of locomotion was reflected in the values obtained for Ee in terms of kcal x 10(-3)/kg/m, as demonstrated by the lower Ee but slower ambulation of children with braces, as compared to the nondisabled children.

Braces↗

PubMed1976

Selective attention in children with learning disabilities.

49 children, aged 11 to 14 yr., a learning disabled group and a normal group, performed a primary, reading-like, card-sorting task. After they completed the primary task, they were tested for memory of incidental materials presented during learning. While the normal children showed better recall of incidental materials related to the primary task, 24 children with disabilities showed superior recall of material irrelevant to the primary task. The results were discussed in terms of alternative "motivational" and "developmental lag" interpretations.

Achievement↗

PubMed2006

Registered childminders and children with disabilities.

This article describes the role of the registered childminder in caring for children with disabilities. It explains the community childminding networks that help put parents in touch with appropriate childminders and then provide continuing support to the parents and the childminder. These networks help provide additional tailored training for childminders to enable them to meet the special needs of a particular child. The networks link in with other local authority and health services and may sometime help to fund placements.

Adult↗

PubMedDate not supplied

Spiritual experiences of parents and caregivers who have children with disabilities or special needs.

Despite the fact that faith has been described as a universal concern, and despite the realization that the presence of social supports is an essential element in successful coping, there has been no systematic examination of the quality of spiritual networks important to families impacted by childhood disability. There is also little understanding of how spirituality in children influences the lived experience of faith in the adults who care for them. Findings reported here come out of a larger existential phenomenology study that examined the lived experience of parents or caregivers who sought to obtain formal religious education for their children with special needs. Participants included 26 parents/caregivers representing 44 children with special needs and 15 different faith traditions. Narratives indicated that many clergy and members of faith communities either devalue or fail to recognize the spiritual lives of disabled children. This lack of recognition was associated with participant disillusionment or crises of faith and a sense of alienation from potential sources of emotional support. In contrast, those participants whose children were welcomed reported feeling sustaining support and strengthened faith. No parent or caregiver perceived nurses as having an awareness of or interest in spirituality within families of children who have special needs.

Adaptation, Psychological↗

PubMed1998

Implications for estimates of disability in children: a comparison of definitional components.

OBJECTIVE: To test how prevalence estimates and characteristics of children vary by the way that disability is defined. Specifically, to determine 1) the proportions of children identified as disabled by one particular operationalization of disability based on parental reports of three types of consequences (i.e., functional limitations [FL]), dependence on compensatory mechanisms (CD), and service use or need beyond routine [SU/N]), and 2) whether children identified as disabled by these three types of consequences differ by type of disorder or condition, age, socioeconomic status, or race. METHOD: We analyzed a national dataset representing a random sample of 712 households with 1388 children. The Questionnaire for Identifying Children with Chronic Conditions (QuICCC) was used to identify children with disabling conditions. We divided the QuICCC items into three discrete sets, reflecting three definitional components of disability, and compared the proportions and characteristics of children fitting these components separately and in combination. RESULTS: Using the QuICCC definition of disability, SU/N identified the largest proportion of children (72%), followed by CD (55%) and FLs (49%). Forty-four percent of children were identified by only one component, 36% by two components in any combination, and 20% by all three components. The type of disorder or condition generally did not vary by the three definitional components, although the FL component may be more effective at identifying children with sensory impairments. Children identified by two or more components were more likely to have multiple conditions and had more pervasive disorders than those identified by only one component. The youngest children (0 to 3 years old) may be less likely to be identified as disabled than children of other ages, especially by FLs. FLs also were more likely to identify children from the poorest and least educated families. CONCLUSIONS: Although the specific findings reported here pertain to a single definitional approach (the QuICCC), the data highlight that who will be classified as disabled (and who will not) may be dependent on how disability is defined. The implications of using different definitions and definitional components on both the prevalence and the characteristics of children with disabilities need to be considered before data can be applied responsibly and appropriately.

Adolescent↗

PubMed1996

Psychological characteristics of mothers of children with disabilities.

The purpose of this study was to investigate the psychological characteristics of mothers of children with disabilities. This study was performed under the hypotheses that, at the initial diagnosis of the children's disabilities, (1) the mothers suffered from serious psychological distress; (2) the more severe the child's disability was, the more serious the mother's psychological distress was; and that (3) the mother's psychological distress might be resolved within 8 weeks of rehabilitational interventions. The results were as follows: 1) mothers of children with disabilities showed significant (p < 0.05) somatization, depression, anxiety, hostility, and phobic anxiety more so than the control group; 2) there was no significant difference in T scores of 9 dimensions of the Symptom Checklist-90-Revision (SCL-90-R) of the mothers at the initial diagnosis of children's disabilities according to severity of child's disability; 3) there was no significant difference in T scores of 9 dimensions of SCL-90-R in mothers of children with disabilities between at initial evaluation and after 8 weeks of rehabilitational interventions. In conclusion, : 1) mothers of children with disabilities suffered from serious psychological distress at the initial diagnosis of their child's disability; 2) the severity of the child's disability had little influence on the degree of the mother's initial psychological distress; 3) this distress did not resolve with only 8 weeks of rehabilitational interventions. Therefore, effective rehabilitational programs should provide sufficient opportunities for repeated follow-up interviews which offer not only adequate information on the children's disabilities but also psychological support for the mothers.

Adult↗

PubMed1994

Use of substitute food textures for standard eating assessment in children with cerebral palsy and children without disabilities.

OBJECTIVE: Eating assessment is the first step toward amelioration of eating problems in children. A quantitative evaluation tool with three standard textures of food has been developed to determine the severity of an eating problem. However, children occasionally refuse some of the standard textures. Much time and effort could be saved if substitute textures could be used for testing. The purpose of this study was to examine the feasibility of using substitute food textures. METHOD: Twenty children (10 without disabilities, 10 with cerebral palsy and eating impairments) with a mean age of 8.2 years (SD = 4.1) years were tested with three standard and three substitute textures of food (solid viscous, puree. Eating time (in seconds) and chewing cycles were compared between standard and substitute textures as well as between children without disabilities and children with eating impairments. RESULTS: Substitutes for pureed and viscous, but not solid textures could be used for children without disabilities; in children with eating impairments, substitutes for viscous and solid, but not pureed textures could be used. CONCLUSION: Children with eating impairments may be more sensitive than children without disabilities to small changes in food consistencies or other characteristics of the food. Thus, in standardized testing, food textures should not be arbitrarily interchanged.

Adolescent↗

PubMed2001

Disabilities in children with Duchenne muscular dystrophy: a profile.

Proper assessment of disabilities is essential for rehabilitation of patients with Duchenne muscular dystrophy. The aim of this study was to identify and quantify the disabilities in children with Duchenne muscular dystrophy and correlate them with impairment. Thirty-one patients with Duchenne muscular dystrophy of age four years and above were studied. The motor functions were evaluated using total motor score, upper and lower extremity function grades and timed function tests. Disability was quantified with Barthel index. The mean scores of motor scales were: total motor score -52 +/- 7.8, total functional grade -4.4 +/- 1.9 and timed function score -12.5 +/- 5.8. Barthel index scores ranged from 45-95 with a mean of 70.8 +/- 12.7. Motor scales correlated with each other and with Barthel index. Thirty children had disabilities in multiple spheres of life, which were significantly influenced by the motor power. Barthel index was useful in identifying and quantifying specific areas of disabilities in these children. Evaluation of disabilities using specific measures may be crucial for planning comprehensive management.

Activities of Daily Living↗

PubMedDate not supplied

Welfare reform: loss of supplemental security income (SSI) for children with disabilities.

PURPOSE: To describe the changes the new welfare reform legislation, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, makes in children's eligibility for Supplemental Security Income (SSI) and the implications of the changes for low-income children with disabilities and their families. POPULATION: Low-income children and youth, 18 years of age and younger, who have one or more limitations in physical or mental function in performing age-appropriate skills. CONCLUSIONS: The tightened federal standards for determining whether children are disabled place thousands of children at risk for losing SSI cash benefits. This loss of necessary financial support has the potential to adversely affect the physical and psychological health of low-income children with disabilities and their families. The new law represents a step backward from the long awaited gains the 1990 Zebley v. Sullivan U. S. Supreme Court decision legislated for children with disabilities. PRACTICE IMPLICATIONS: Knowledge of the legal changes in children's SSI enables nurses to implement interventions that help low-income families maintain SSI eligibility for their children with disabilities and to advocate with the public and policymakers on behalf of this vulnerable population.

Child↗

PubMed2003

Jurors' perceptions of adolescent sexual assault victims who have intellectual disabilities.

Children and adolescents with intellectual disabilities are especially likely to be sexually abused. Even so, their claims are not likely to be heard in court, possibly because people assume that jurors will not believe them. We tested this assumption in a mock-trial study in which 160 men and women watched videotaped excerpts from an actual trial. As predicted, when the 16-year-old sexual assault victim was portrayed as "mildly mentally retarded" instead of as "having average intelligence," jurors were more likely to vote guilty and had more confidence in the defendant's guilt; considered the victim to be more credible and the defendant to be less credible as witnesses; and rated the victim as more honest, less capable of fabricating the sexual abuse accusation, and less likely to have fabricated the sexual abuse accusation. Men and women were affected similarly by the disability manipulation, but women were generally more pro-prosecution in their case judgments and perceptions than were men. Finally, jurors who had more liberal views toward persons with disabilities were more likely than other jurors to make pro-prosecution judgments on measures of guilt. Implications for psychological theory and the law are discussed.

Adolescent↗