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Allergic children suffering from learning disabilities, hyperactivity, fatigue, incoordination and irritability who were treated by conventional allergic methods showed a marked improvement in ability to learn, reduction of hyperactivity and incoordination, and ability to perform intelligence tests. The objective neurological studies showed no consistent changes as a result of one year of allergy therapy.
In this statement, the American Academy of Pediatrics reaffirms the importance of the Americans With Disabilities Act (ADA), which guarantees people with disabilities certain rights to enable them to participate more fully in their communities. Pediatricians need to know about the ADA provisions to be able to educate and counsel their patients and patients' families appropriately. The ADA mandates changes to our environment, including reasonable accommodation to the needs of individuals with disabilities, which has application to schools, hospitals, physician offices, community businesses, and recreational programs. Pediatricians should be a resource to their community by providing information about the ADA and the special needs of their patients, assisting with devising reasonable accommodation, and counseling adolescents about their expanded opportunities under the ADA.
Reading-disabled children's language skills have long been implicated in their poor school performance. This study is a cross-sectional and longitudinal examination of the narrative language skills of both reading-disabled and normally achieving children in an attempt to understand more clearly the language processes involved in these skills and how these processes relate to reading achievement over time. Children were read scriptlike narratives and asked to demonstrate their knowledge of the story by a nonverbal enactment of the narrative. After perfect enactment of the story was assured, the children were asked to paraphrase the narratives. Results from both the cross-sectional and longitudinal study indicated that reading-disabled children comprehended the narratives in a comparable fashion to normal peers, but they performed more poorly on a variety of content and complexity measures derived from their paraphrases. The study indicates that reading-disabled children's language problems are persistent over time in the area of verbally expressing information, even when they have demonstrated nonverbal comprehension.
Esophagitis is common in children with cerebral palsy. Because histamine2-receptor antagonists such as ranitidine have not been uniformly effective, we treated disabled children with esophagitis with greater than usual doses. Endoscopy and pH monitoring were used to monitor dose and response to treatment. A dose of 9.3 +/- 0.9 mg/kg/day did not improve visual or microscopic esophagitis after 3 months. A dose of 14.8 +/- 3.9 mg/kg/day resulted in only slight microscopic improvement, but symptoms were improved. There was no correlation between esophageal reflux index at enrollment and either severity of esophagitis or response to treatment. Elevation of gastric pH by ranitidine was infrequent. These results affirm that pH monitoring does not reliably identify disabled children with reflux esophagitis nor does ranitidine reliably heal this disorder.
Three learning disabled children, selected on the basis of peer sociometric ratings and teacher referral, received social skills training. A group training procedure consisting of coaching, modeling, behavior rehearsal, and feedback was used to teach children the target, behaviors of eye contact and appropriate verbal responses. The multiple baseline analysis across target behaviors was used to demonstrate treatment effectiveness on role-play scenes trained during treatment sessions. Duration of speech was measured as an untrained, corollary measure. The following measures were also obtained during baseline, posttreatment, and 1-mo follow up for experimental subjects and three control subjects: (a) performance on role-play scenes not trained during treatment sessions; (b) behavioral observations in a free play setting, and (c) sociometric ratings. In addition, the trained and untrained role-play scenes were administered by novel experimenters following treatment. The results indicated that socially unskilled, learning disabled children can be taught to respond appropriately to role-play situations. However, improved performance did not generalize to the natural school setting and treatment did not effect ratings of peer acceptance. The implications of these findings for future social skills training with children are discussed.
OBJECTIVE: To investigate the self-reported health status of mothers of school-age children with disabilities. METHOD: Seventy-four mothers in the Northern Metropolitan and Eastern Sydney regions completed the MOS 36-item Short Form Health Survey (SF-36). The survey was readministered 11 to 15 months later and completed by sixty-two mothers. RESULTS: On average, the mothers reported significantly poorer mental health by comparison with population norms for women in New South Wales and for mothers with partners Australia wide. CONCLUSIONS: In the absence of population data, the results of this study substantiate the findings of earlier studies based on clinical assessment and small group comparison designs.
A distinction among reading disabled children based on whether phonetic or semantic deficits predominate has important implications for remediation. Two kinds of reading disability are related to two distinct aspects of the indirect phonological approach used in the vast majority of reading instructions. This approach to determining the meaning is a conversion of the written form of a word to its phonetic counterpart, making the comprehension auditory. Phonetic reading disabled children have a difficulty with the first step in the process, converting the written word to its sound. Semantic reading disabled children can convert the word to its sound, but this does not lead to determining meaning. Significant gains in performance, may occur by using a direct access to meaning, rather than through the intermediary of sound. The Direct Access approach to reading has one premise: Do not use a "word to sound to meaning" approach. The results of a demonstration project indicate the Direct Access approach to reading can be very useful for many reading disabled children.
This study examines parental perceptions of the importance of grandparents as providers of routine care to children with disabilities and the impact of such assistance on parental well-being. Data are drawn from a survey and follow-up interactive interviews. Findings of the survey indicate that: 1) grandparents are a common source of weekly assistance-significantly more common than other relatives or friends and neighbors; 2) where grandparents participate, the number of other sources of support is also higher; and 3) help from grandparents has a positive, while the number of other sources of help has a negative, relationship to parental ability to maintain a positive emotional outlook and to avoid physical exhaustion. Findings of the interactive interviews suggest that: 1) grandparent participation can promote pride and "normalized attitudes" by helping grandparents to get to know the child with a disability on an intimate basis; 2) when grandparents do not participate, parents may feel the need to manage the information given to and the emotional responses experienced by grandparents who have not had a chance to get know and love the child through frequent, direct contact; and 3) parents are very concerned that if grandparents themselves begin to need help due to increased age and disability, they will not ask for it because of fear that parents are already overburdened by the unusual demands of their parenting roles.
Visible persistence duration for sine-wave gratings was measured in 9-year-old normal and specific-reading-disabled children. Experiment 1 investigated the influence of stimulus duration on visible persistence. The results demonstrated a Reading Group X Spatial Frequency interaction with disabled readers showing a smaller increase in persistence duration with increasing spatial frequency than controls. This interaction was greatest with stimulus durations longer than 80 msec. In Experiments 2a and 2b persistence was measured across a range of contrasts from .1 to .5. The stimulus durations employed were 100 msec in Experiment 2a and 300 msec in Experiment 2b. In both experiments, increasing contrast decreased persistence duration at 2 and 12 cycles per degree (c/deg) for the control group. In the specific-reading-disabled group, however, contrast had little effect on the persistence of 2-c/deg gratings in either experiment. In Experiment 2a the persistence of the 12-c/deg grating decreased with increasing contrast for both groups. In Experiment 2b contrast had significantly less effect on persistence duration in the specific-reading-disabled group, however, contrast had little effect on the persistence of 2-c/deg ratings in either experiment. In Experiment 2b contrast had significantly less effect on persistence duration in the specific-reading-disabled group than in the control group at 12 c/deg. Consequently, contrast had less effect on persistence in specific-reading-disabled children than in normal readers, especially at durations longer than the "critical duration" for each spatial frequency. Experiment 3 extended this finding to gratings with spatial frequencies of 4 and 8 c/deg. These results indicate a difference between normal and specific-reading-disabled children in cortical visible persistence. Two scores of visual processing were derived from the above experiments. On these scores the reading-disabled children were divided into Visual Disabled Readers (approximately 70%--eight subjects) and Nonvisual Disabled Readers (approximately 30%--four subjects). The percentages of disabled readers in each category remained constant when the sample size was increased to 61 normal and disabled readers.
The intent of this statement is to describe the breadth of issues that have special pertinence to pediatricians who care for children and families affected by genetic disorders and other chronic health conditions. The Committee on Children With Disabilities believes that because these children are leading healthier and longer lives, pediatricians are the more highly qualified to serve them, by virtue of their training and experience, and to provide them a "medical home." This statement is designed to assist pediatricians in the treatment of these patients by describing their potential roles in relationship to their patients' changing needs, as they work with various members of the health care team and as they respond to the requirements of government agencies and various third-party payers.
The authors present findings from a study of State Medicaid managed care enrollment and benefit policies in 1995 and 1996 for children with disabilities. During this time the number of States serving children through fully capitated plans grew by more than one-third, and enrollment of children receiving Supplemental Security Income (SSI) payments and children in subsidized foster care increased. Most States required plans to provide all mandatory and most optional Medicaid services. Although States have begun to make noticeable improvements in their contract language concerning medical necessity and the early and periodic screening, diagnosis, and treatment (EPSDT) benefit, overall State guidance in these areas remains weak.
This article is based on a secondary analysis of a random sample of 512 Israeli parents of children with disabilities (ages 3-17) regarding their consideration of out-of-home placement. Major findings showed that Arab parents reported greater levels of personal and family burden compared to Jewish parents. Despite that fact, Arab parents rarely considered out-of-home placement. In addition, parents whose children utilized more services reported a greater burden of care than those who utilized fewer services. Findings are discussed with respect to future research and policy implications.
OBJECTIVES: The Training and Support Programme (TSP) is an 8-week programme in which carers of children with disabilities receive instruction in simple massage techniques to use with their child. The aims of the present study were firstly to compare, adherers and non-adherers on measures of psychological well-being and self-efficacy and secondly, to examine whether, for adherers, the positive benefits of attending the TSP reported immediately after the Programme were maintained at 12-month follow-up. DESIGN: Eighty-two carers took part in the study. Data were collected 12-months after completion of the TSP by self-report questionnaires mailed to carers. For comparisons between adherers and non-adherers at 12-month follow-up a between-groups design was used. For comparisons over time, a within-subjects design was used. RESULTS: Adherers had significantly higher levels of self-efficacy for managing their child's psychosocial well-being, self-efficacy for carrying out the massage, and significantly better psychological well-being at follow-up compared to non-adherers. Furthermore, there were no significant differences over time on self-efficacy for managing their child's psychosocial well-being, self-efficacy for giving massage and levels of anxiety and depression at 12-month follow-up for adherers, suggesting that their improvements noted immediately post-programme were maintained at follow-up. Significant decreases on self-efficacy and depression were noted for non-adherers and there was a trend towards deterioration in anxious mood. CONCLUSION: In conclusion, the present study suggests that the positive benefits the TSP has for carers of children with disabilities can be maintained if carers continue to practise the massage at home with their child.
In order to determine the experiences with health services of caregivers of children with disabilities (CWDs), and the attitudes of health care workers (HCWs) towards CWDs and their caregivers, a survey was conducted of 26 caregivers of clients of 3D Projects, St. Mary, Jamaica, using a checklist, and of 113 HCWs in St Mary and Kingston who completed a questionnaire. Half of the 19 CWDs referred by HCWs to hospitals in Kingston because of the lack of facilities in St Mary eventually defaulted because there was no apparent improvement. 10 caregivers said that the cause of the disability was not explained, three others did not understand the explanation given, and only 4 understood the instructions of HCWs. These problems led to unrealistic expectations about the outcome of rehabilitation. 13 caregivers attributed disability of their CWDs to negligence, carelessness or poor treatment by HCWs during pregnancy or the early neonatal period. 87% of the HCWs, particularly Community Health Aides (CHAs), acknowledged at least some responsibility for the care of CWDs; but 10%, notably some nurses and midwives, denied responsibility. 90% referred patients for further care and 90% thought that they had made an impact on caregivers' 'beliefs'; but more than half the CHAs, and 25 to 30% of the other groups, expressed dissatisfaction with their management of CWDs. This study has highlighted inadequacies in the care of CWDs in St Mary and indicates that more appropriate preparation of all health staff for this important aspect of their work is required.
Alternative care arrangements are often necessary when children enrolled in day-care centers experience illness or temporary disability. To meet this need, a new facility named Health House was established by the Child Development Program of the Pomona (Calif) Unified School District. This report describes the organization, operation, and costs of the program, and reviews the management of 179 episodes of illness or temporary disability in 99 children served by the program during the 1983-1984 school year. The medical conditions of patients cared for were comparable with those seen in physicians' offices as reported in a national survey. The daily cost of care per child for the sponsoring agency was $38. The service enabled an average daily salary saving of $39.80 for the working parent. Health House may serve as a model for the management of illness or temporary disability in children enrolled in day-care centers.
OBJECTIVES: To examine the potential association between disability and risk of vehicle-pedestrian and vehicle-bicyclist collisions among children. METHODS: Data from the 2002 National Transportation Availability and Use Survey for Persons with Disabilities (NTAUSPD) were analyzed. RESULTS: Among 5019 persons who completed the survey, there were a total of 687 children between 5-17 years of age, including 299 respondents with and 388 without disabilities. After controlling for potential confounding variables, children with disabilities were more than five times more likely to have been hit by a motor vehicle as a pedestrian or bicyclist than children without disabilities (adjusted OR = 5.53, 95% confidence interval (CI): 1.43-21.41). For all children, regardless of their disability status, children who reported having some difficulty with traffic had a significantly higher risk of collisions (adjusted OR = 50.71, 95% CI: 7.35-349.86). The most commonly reported traffic difficulties for all children with and without disabilities were "Too few or missing sidewalks/paths," "Do not know when it's safe to cross," and "Insensitive/unaware drivers." CONCLUSIONS: Existing effective transportation safety interventions should be effective in reducing the risk of vehicle-pedestrian and vehicle-bicyclist collisions in children with disabilities. Future research and safety interventions should focus on how to promote the use of existing effective transportation safety interventions among children with disabilities and their families.
The dominant epistemological model in Western special education, the medical model, is imbedded with assumptions about the meanings of disability that may conflict with alternative beliefs held by non-Western families of children with disabilities. This paper argues the need for professional awareness of these imbedded assumptions towards culturally responsive service delivery.