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The effect of concurrent manual activity on the dichotic listening performance of boys with learning disabilities.

Three groups of learning-disabled children, defined according to their Wechsler Intelligence Scale for Children (WISC) profiles, and one normal control group, were given both a standard dichotic listening task and a dichotic listening task performed concurrently with a manual tapping task. Learning-disabled children who showed no disparity in their verbal and performance subscale scores on the WISC demonstrated a right ear preference under standard testing and when tapping with the left hand, but not the right, which was nearly the same pattern as that obtained by the control group. Learning-disabled children whose verbal WISC score was at least 15 point lower than their performance demonstrated a right-ear preference only when tapping with their left hand. Finally, learning-disabled children who had high verbal, low performance WISC profiles showed no ear preference under any conditions. These results were interpreted as indicating that these three types of learning-disabled children are differentially lateralized and differentially affected by the facilitory-inhibitory effects of concurrent hemispheric activities.

Adolescent↗

Comparison of attitudes of teachers of physical and musical education toward inclusion of children with disabilities.

56 elementary teachers of physical education and 54 teachers of elementary music education responded to the Teacher Integration Attitudes Questionnaire which assesses teachers' attitudes regarding inclusion of children with disabilities into regular education settings. Analysis indicated that children with emotional and behavioral disorders were perceived less favorably by teachers of music education and children with orthopedic handicaps were perceived less favorably by teachers of physical education. The type and severity of disability appeared to influence teachers' attitudes towards including children with disabilities in regular education classrooms.

Adaptation, Psychological↗

Enhancing participation for children with disabilities: application of the ICF enablement framework to pediatric physical therapist practice.

PURPOSE: This paper describes how pediatric physical therapists can utilize the enablement framework, embraced by the World Health Organization in the current International Classification of Functioning, Disability, and Health (ICF). The ICF can guide clinical reasoning related to enhancing participation in desired activities for children with disabilities. In the ICF framework, participation reflects the person's engagement in important life situations. By emphasizing what the person can do in valued contexts, the enablement framework is a positive complement to a focus on functional limitations and disability of the disablement model. SUMMARY OF KEY POINTS: Current conceptual frameworks and policies advocate attention to children's participation. Legislation (Individuals with Disabilities Education Act, Amendments of 1991 and 1997 and the Americans with Disabilities Act of 1990), the Guide to Physical Therapist Practice, and motor control and action perspectives all support the inclusion of children with disabilities in natural environments. These frameworks and laws can guide therapists' clinical reasoning to focus on children's participation in desired activities during the evaluation, goal-setting, and intervention process. A case study of a child with spastic diplegia illustrates how pediatric physical therapists can apply the enablement framework to develop meaningful goals and interventions focused on enhancing the child's participation in desired activities. CONCLUSIONS: Adoption of an enablement perspective may help pediatric physical therapists to focus their evaluations and interventions on promoting children's participation as well as the specific functional activities that enhance participation.

Journal Article↗

An examination of the measurement properties of the pediatric volitional questionnaire.

The Pediatric Volitional Questionnaire (PVQ) is a 15- item play-based assessment of a child's motivational strengths and weaknesses in various settings based on the Model of Human Occupation. A previous study examined the PVQ's ability to provide a valid measure of volition in ten non-disabled children. This study combined data from the previous study with data on eight children with disabilities to further test the instrument's psychometric properties. Data on 36 observations of the 18 participants were observed by a total of 20 raters. Each rater was randomly assigned to rate videotapes. Data were analyzed using the Rasch Measurement Model. Results indicate that the 15 items of the scale work well together to measure volition and were well matched to the volitional levels of the sample group. Nineteen of the twenty raters used the scale in a valid manner, though scores were affected by the extent of severity/leniency of the rater. All eighteen participants were validly rated and the scale items effectively differentiated levels of volition among the eighteen children. These findings supported the conclusion that the PVQ provides a valid and sensitive measure of volition. The study also found that the 4-point rating scale operated as a 3-point scale in this study and that raters differentiated in their severity/ leniency. These latter findings indicate the need to further clarify the rating scale.

Child↗

An assessment of the cognitive abilities of multiply handicapped children: adaptations of the Uzgiris and Hunt scales and their use with children in Britain and Singapore.

Educational achievement is measured by many forms of assessment. The assessment of some children, and disabled children, has elicited much concern and debate. In particular, problems have arisen with test design, construction, administration and recording. In the West, legislation and public opinion have drawn attention to the need to provide more suitable measuring instruments. The purpose of this paper is to illustrate the use of an adapted assessment procedure for monitoring educational achievement and progress. A study is discussed where the major aim is to use situations which are both stimulating and which most closely resembled the children's natural settings, in order to elicit communication and language skills. The study is being carried out in Singapore with a group of multiply handicapped children. The adaptations to the administration of the test enable the examiner to note the behaviour as it occurs rather than look for expected behaviours. It is possible then to record behaviours at a later stage. The results of the study show that it is possible to elicit the required responses from a group of children who are diagnosed as multiply handicapped and whose competencies are difficult to assess. In the original research in Britain, with a large group of multiply handicapped children, there was evidence of reliability, validity and ordinality in the children's responses. Analysis of these children's scores showed patterns of responses inconsistent with a popular view of development. This paper describes the Singapore study and the original study upon which it is based.

Child↗

Concurrent validity of the Functional Independence Measure for Children (WeeFIM) and the Pediatric Evaluation of Disabilities Inventory in children with developmental disabilities and acquired brain injuries.

The Functional Independence Measure for Children (WeeFIM) and the Pediatric Evaluation of Disability Inventory (PEDI) are the most commonly used measures of functional performance in children. The purpose of this study was to determine the concurrent validity of the instruments when used with children with developmental disabilities and acquired brain injury. The subjects were 41 children, age 1.3 to 9.5 years, who were receiving inpatient or outpatient services at a pediatric rehabilitation unit in Brisbane, Australia. Spearman correlation coefficients between the two tests were greater than 0.88 for self care, transportation/locomotion, and communication/social function. The high correlations indicate that the two tests measure similar constructs. Choosing between the tests depends on situational requirements and depth of information required.

Brain Injuries↗

Objective test of the quality of motor function of children with cerebral palsy: preliminary study.

An objective test of motor function would enable better evaluation of various treatment programmes for children with cerebral palsy. The use of tri-axial accelerometry was investigated in 36 children with cerebral palsy and in 53 children without disabilities. Variables discriminated well between able-bodied and disabled children, and there was a high level of retest reliability. The technique requires further development, but shows promise of providing the ability to gather objective data about the quality of motor function.

Cerebral Palsy↗

Children with disabilities.

The purpose of this article is to provide the clinician with a comprehensive review of the influence of temperament on the social and cognitive development of children with disabilities. Research concerning the interaction of temperament and cognition and the temperament characteristics of children with disabilities is reviewed. Also discussed are issues relevant to clinical practice, including assessment of temperament characteristics and interventions with parents.

Child↗

Implementing the right to community integration for children with disabilities in Russia: a human rights framework for international action.

Human rights organizations have documented a widespread pattern of abuse in Russia's orphanages and institutions for children with disabilities. Community integration is critical to attack the underlying causes of discrimination and abuse of children in institutions. While there is an immediate need to protect children in institutions, investment in improving orphanages may inadvertently strengthen an outmoded system of segregated services, delaying long-term reform. This article describes a response to abuses in institutions based on the internationally recognized right to community integration for all children, including children with mental and physical disabilities. While tailored to Russia, the framework for action described here applies to many countries in which children and adults with disabilities are similarly segregated from society in closed institutions.

Child↗

Disability in children with myelomeningocele. A Nordic study.

This study was carried out to evaluate the medical impairments and disability among 527 children with myelomeningocele living in four Nordic countries. The information was extracted form questionnaires and data based on case records. The level of intellectual functioning was fairly high with 76% within normal range (IQ greater than 90). Shunt operations were performed in 68% of the children and 1/3 had had four or more shunt revisions. Twenty-three per cent walked without support. Bladder incontinence was found in 60% of the children whereas 4% were entirely continent. Intermittent catheterisation was used in 36% with higher frequency among girls (48%) than boys (24%). We found a higher incidence of bacteriuria among those who used catheterisation than among those who used manual compression. Bowel control was experienced by 112 (21%) of the children. The overall disability is classified according to Lorbber's 5-graded handicap scale and Lagergren's 3-graded scale. According to Lagergren's scale, 70% suffered form severe overall disability.

Adolescent↗

[Congenital hearing disability among children in Copenhagen].

The survey describes the detection, identification and aetiology of congenital/early acquired (i.e. neonatal period) hearing disability in a well-defined cohort of children, living in the Copenhagen area (Copenhagen City and County). The effect of intervention programmes is also mentioned. The children's age at identification can be considered as an evaluation of the quality of hearing screening aimed towards the detection of children with congenital/early acquired hearing disability, while the results of the aetiological evaluation reflects the quality of the diagnostic evaluations performed within paediatric audiology. The prevalence rate of 1.5/1000 of congenital/early acquired hearing disability for children born during 1980-1990 is unchanged in comparison to the period 1970-1980. An improvement in the detection of children with congenital/early acquired hearing disability is found, the identification is, however, still delayed in both children at risk and not-at-risk of hearing disability. The parents are most frequently the first to raise suspicion of their child's hearing disability, but very seldom apply to the audiological department without a referral from the primary health care sector. A change in the aetiology of congenital/early acquired hearing disability has taken place within 1980-1990, which can be ascribed to the reduced frequency of foetal rubella infection, while the frequency of inherited hearing disability has increased. The outcome of intervention programmes, evaluated by means of type of school, education, and employment situation is briefly described in relation to the social consequences of a hearing disability.

Child, Preschool↗

Foot pressure distribution: methodology and clinical application for children with ankle rheumatoid arthritis.

INTRODUCTION:: Foot pressure measurements furnish information about distribution of pressures, forces, time and contact areas under the foot during standing and walking. Foot pressure measurement has been used in a number of rehabilitation and athletic applications in adults, however, little has been published regarding the clinical usefulness of this technology for children with disabilities. Children with juvenile rheumatoid arthritis (JRA) are reported to have various foot deformities and gait deviations and clinicians report that the children may have foot pain such as metatarsalgia. These may be treated with specially fitted shoes, shoe modifications or ankle foot orthoses. The purpose of this preliminary study was to describe the methodology used to quantify foot pressure distribution patterns and, further, to describe the patterns seen in individual children with JRA compared to aged matched typical children without JRA. METHODS:: Pressure, area and force were measured using the EMED-F system including a platform with 2048 capacitive pressure sensors and a computerized data collection and analysis system. Children were asked to walk comfortably and normally across the platform while time, pressure and area measurements were automatically taken. Other data collected were height and weight, observational gait analysis and lower extremity range of motion measurements. Data are reported for the entire foot, as well as particular areas of the foot that are of interest. For this study, eight discrete areas or masks were identified (medial and lateral heel, medial and lateral midfoot, first metatarsal, lateral four metatarsals, great toes and four lateral toes) for description. Information reported for each area and the total foot included force, peak pressure, total area, pressure time integral and force time integral. Data from three pairs of children were analysed and differences were described. RESULTS:: Several differences in the descriptive data were noted and will be highlighted. Children with JRA had striking asymmetries in several variables, higher peak pressures and in increased total foot pressure time integrals and force time integrals. This information is presented to improve our understanding of the patterns under the foot so that (1) appropriate treatment strategies for foot impairments may be better prescribed for children with JRA and (2) to assist in planning for treatment of gait abnormalities. This preliminary work will also form the basis for determining the clinically meaningful variables to consider in a larger study and statistical analysis.

Journal Article↗

Associated medical disorders and disabilities in children with autistic disorder: a population-based study.

A population-based survey was conducted among 152,732 Finnish children and adolescents aged under 16 years and living in northern Finland. Diagnoses and associated medical conditions were derived from the hospital and institutional records of this area. One hundred and eighty-seven children with DSM-IV autistic disorder were identified. Associated medical disorders or associated disorders of known or suspected genetic origin were found in 12.3 percent, including tuberous sclerosis, Down syndrome, fragile X syndrome, Klinefelter syndrome, XYY syndrome, chromosome 17 deletion, chromosome 46, XX, dup(8) (p) and mitochondriopathy. Other associated medical disorders identified were epilepsy, hydrocephalus, foetal alcohol syndrome and cerebral palsy. Hearing impairments were found in 8.6 percent and severe impairment of vision in 3.7 percent of the individuals with autistic disorder. Medical disorders seem to have a special impact on the genesis of autistic disorder and need to be thoroughly examined in each child with autistic disorder.

Adolescent↗

[Health status of disabled preschool children and determining factors].

Children's invalidism is a serious social, moral and financial problem in Russia. Approaches to its solving are not fully formulated now and need further study. The paper reports the results of the original trial of social and health status, life style of invalids of preschool age. The system of measures is proposed to improve rehabilitation of handicapped children.

Adolescent↗