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PubMed1995

Nonverbal perceptual organization output disability and schizophrenia spectrum symptomatology.

Patients with neurodevelopmental syndromes often receive numerous psychiatric diagnoses before the true nature of their disorder becomes apparent. We present a case in which the neuropsychological evaluation played a significant role in reconceptualizing a patient who had received, at various times, diagnoses of schizotypal personality disorder, schizoaffective disorder, and schizophrenia. The identification of specific cognitive deficits in executive functioning, perceptual organization, visual-spatial problem solving, and abstraction led to: 1) a diagnosis of nonverbal perceptual-organization-output disabled; 2) the adoption of a rehabilitative treatment model; and 3) a greater understanding of the way in which the patient's social deficits represented adaptations to her cognitive impairments. Research data and theoretical models relating cognitive deficits to psychiatric symptoms are discussed, and evidence is presented that schizophrenia and certain neurodevelopmental syndromes may share commonalities of pathophysiology. Diagnostic issues arising from similarities between these disorders are discussed. It is suggested that direct comparisons between these groups can aid in clarifying the specific nature of cognitive deficit-symptom relationships, as well as leading to improvements in the understanding, diagnosis and treatment of schizophrenic and neurodevelopmental syndromes.

Achievement↗
PubMed1997

Prospective study of New Zealand very low birthweight infants: outcome at 7-8 years.

OBJECTIVE: To determine the survival and sensorineural outcome at 7-8 years in very low birthweight (VLBW) infants born in New Zealand in 1986. METHODOLOGY: In 1986 all VLBW New Zealand infants admitted to neonatal units were enrolled in a prospective study of acute retinopathy of prematurity. Surviving infants were traced and were assessed at a home visit. Parents were asked a comprehensive questionnaire, and children underwent a visual assessment including photorefraction and were tested with the Revised Wechsler Intelligence Scale for Children (WISC-R). RESULTS: Four hundred and thirteen VLBW infants were admitted to neonatal units in 1986, 338 (81.8%) surviving to discharge, 12 children died after discharge, 17 were traced to overseas, seven declined to participate and four were untraced, leaving 298 (96% survivors resident in New Zealand) who were assessed at a mean age of 7.6 (+/- 0.4 years, 15 children (5.0%) had severe disability, 14 (4.7%) moderate disability, and 46 (15.4%) mild disability. Blindness (vision worse than 6/60) occurred in eight children (2.7%), deafness requiring aids in four (1.3%), any form of cerebral palsy in 17 (5.7%), and an JQ score on the WISC-R > 1 SD below the mean in 62 (20.8%). There was no significant difference in outcome for children with birthweight < 1000 g and 1000-1499 g. CONCLUSIONS: Long-term (7-8 year) survival and disability rates in this national cohort of VLBW infants is comparable with that reported from other populations. Although a majority of children have no disability a sizeable proportion do perform poorly on the WISC-R. This may relate in part to problems such as a short attention span and poor visual-motor integration.

Blindness↗
PubMed1997

Suicidal thoughts and associated factors in an elderly population.

This study examined the prevalence of suicidal thoughts and associated factors in an elderly population. Data for 969 elderly subjects from a population-based study were used, and examinations by physicians, including psychiatric examination and informants' interview, were assessed. In total, 13.3% of the subjects had had suicidal thoughts during the last 2 weeks (10.8% fleetingly and 2.5% frequently). Of those who had had fleeting suicidal thoughts, 26.7% also had major depression, while 50% of those who had frequent suicidal thoughts were depressed. In addition, suicidal thoughts were associated with increased disability in daily living, institutionalization, visual problems and the use of psychotropic drugs. It is concluded that a careful psychiatric assessment is necessary when suicidal thoughts are expressed by an elderly person.

Activities of Daily Living↗
PubMed1996

Sensory impairments and physical disability in aged women living at home.

BACKGROUND: Studies of the impact of visual or hearing impairments on physical disability in older people have provided conflicting results. Furthermore, the consequences of the loss of such visual functions as depth perception or contrast sensitivity have rarely been studied. We examined the relationship of visual acuity, depth perception, contrast sensitivity, and hearing difficulty to the ability of older women living at home to accomplish instrumental activities of daily living independently. METHODS: Data on self-reported physical disability and hearing impairment, as well as objective measures of functional vision and physical ability were collected from a sample of 1210 community-dwelling women aged 75 years and older. Multivariate logistic regression modelling was used to assess the strength of the association between physical disability and sensory impairments, controlling for age, education level, motor limitations, and prevalent chronic diseases. RESULTS: Women with low visual acuity or low contrast sensitivity were significantly more likely to be physically dependent than women with good vision. Contrast sensitivity was, however, a better predictor than functional acuity, after controlling for age, education level, motor limitations and chronic medical conditions (adjusted odds ratio: 5.1; 95% confidence interval: 2.0-12.9). Depth perception was not related to physical disability. Women with serious hearing difficulty had significantly increased odds of dependency (4.1; 1. 4-12.1). CONCLUSIONS: Severe sensory impairments are strongly related to physical dependency in older women. It may be useful to add a test of contrast sensitivity to the traditional acuity test to predict better which elderly individuals may have difficulty carrying out routine daily activities.

Activities of Daily Living↗
PubMed1990

Perception of figure orientation by nonambulatory children with profound mental retardation.

An habituation-dishabituation procedure was used to study perception of changes in figure orientation by nonambulatory children with profound mental retardation. On each of 3 days, 16 participants were given familiarization trials with either a vertical or an horizontal pattern, followed by test trials with the familiarized stimulus and one of three novel stimuli--a 90 degree or 45 degree rotation of the pattern, or a rearrangement of the pattern elements into a square. Visual fixation times decreased over familiarization trials. Fixation times on test trials were longer for novel than for familiar stimuli, indicating that these children discriminated changes in form and orientation.

Adolescent↗
PubMed2005

Effect of visual perception, visual function, cognition, and personality on power wheelchair use in adults.

The purpose of this study was to determine to what extent visual perception, visual function, cognition, and personality traits affect power wheelchair use in adults. It also proposes to establish baseline information to help clinicians determine or predict power wheelchair driving performance and to develop service plans to address those driving skills that need improvement or compensation. Sixty-two adult power wheelchair users were recruited. Standardized instruments were used to evaluate visual perceptual skills, visual function, cognitive skills, and personality traits. The results of these evaluations were then correlated with participants' scores on a power wheelchair performance test. Strong correlations were found between power wheelchair driving performance and visual perception (p = .000), ocular motor function (p = .000 and p < or = .001), stereodepth perception (p < or = .001), and alertness to the environment (p < or = .001). No significant correlations were found between personality traits and power wheelchair driving performance. These results indicate that good visual perceptual skills, visual function, and various aspects of cognition are necessary for proficient power wheelchair use. These data will assist clinicians in identifying significant factors to consider when evaluating and training clients for power wheelchair use.

Activities of Daily Living↗
PubMed1983

[Sailing with the handicapped].

The sailing schooner Jachara makes one-week turns in the Western Baltic Sea with the youth groups on board serving as crew members. Numerous changes and adaptions have since 1979 been introduced so that, today, ship is suitable for young people with hearing, and visual impairments, as well as for wheelchair users.

Persons with Disabilities↗
PubMed1993

Functional assessment scales: a study of persons after stroke.

The purpose of this study was to investigate disability in persons after stroke by using combinations of functional assessment item, subscale, domain, and full-scale scores, to predict (1) the burden of care measured in minutes of assistance provided per day by another person in the home, and (2) the subject's level of satisfaction with life in general. The Functional Independence Measure (FIM) and the Sickness Impact Profile (SIP) each contributed to prediction of the subject's physical care needs. A change in total FIM score of one point (range, 61 to 126) was equivalent to an average of 2.19 minutes of help from another person per day and a change in one point in the SIP physical dysfunction (SIPPHYS) score (range, 4.0% to 57.4%) was equivalent to an average of 3.32 minutes. Along with the Brief Symptom Inventory and a measure of visual ability, the FIM contributed to predicting the patient's general satisfaction as well. The burden of care and subjective satisfaction with life in general are important standards by which functional assessment instruments may be compared to reflect, in pragmatic terms, the impact of disability on the lives of individuals and on the human and economic resources of the community.

Activities of Daily Living↗
PubMed2002

Is vision function related to physical functional ability in older adults?

OBJECTIVES: To assess the relationship between a broad range of vision functions and measures of physical performance in older adults. DESIGN: Cross-sectional study. SETTING: Population-based cohort of community-dwelling older adults, subset of an on-going longitudinal study. PARTICIPANTS: Seven hundred eighty-two adults aged 55 and older (65% of living eligible subjects) had subjective health measures and objective physical performance evaluated in 1989/91 and again in 1993/95 and a battery of vision functions tested in 1993/95. MEASUREMENTS: Comprehensive battery of vision tests (visual acuity, contrast sensitivity, effects of illumination level, contrast and glare on acuity, visual fields with and without attentional load, color vision, temporal sensitivity, and the impact of dimming light on walking ability) and physical function measures (self-reported mobility limitations and observed measures of walking, rising from a chair and tandem balance). RESULTS: The failure rate for all vision functions and physical performance measures increased exponentially with age. Standard high-contrast visual acuity and standard visual fields showed the lowest failure rates. Nonstandard vision tests showed much higher failure rates. Poor performance on many individual vision functions was significantly associated with particular individual measures of physical performance. Using constructed combination vision variables, significant associations were found between spatial vision, field integrity, binocularity and/or adaptation, and each of the functional outcomes. CONCLUSIONS: Vision functions other than standard visual acuity may affect day-to-day functioning of older adults. Additional studies of these other aspects of vision and how they can be treated or rehabilitated are needed to determine whether these aspects play a role in strategies for reducing disability in older adults.

Activities of Daily Living↗
PubMedDate not supplied

Effect of photorefractive keratectomy on visual functioning and quality of life.

The authors present the results of the psychosocial outcomes of 45 patients undergoing excimer laser photorefractive keratectomy (PRK). The patients were evaluated by means of self-report questionnaires preoperatively and 6 months after surgery to determine the effect of uncorrected vision change on the patients quality of life. The measurements include the following variables: clinical end points (spherical equivalent refraction); visual function (night driving, day driving, near vision, far vision, glare disability); functional status (physical, social, and role functioning, mental status); general well-being (health perceptions, personal well-being, overall quality of life); and satisfaction with surgery (expectations, satisfaction with medical staff, postoperative pain, satisfaction with treatment outcomes). Preliminary results indicate that changes of uncorrected vision after PRK are reflected by improvement in each of the quality-of-life functions.

Activities of Daily Living↗
PubMed1983

The coloured elderly in Cape Town--a psychosocial, psychiatric and medical community survey. Part III. A survey of physical disorders and disabilities.

A representative sample of elderly Coloured persons (over the age of 65 years) in the community underwent a medical and psychosocial assessment of prevalent physical disorders and resultant disability. This revealed that hypertension, visual impairment, osteo-arthritis and chronic lung disease were the most prevalent and disabling conditions, while hearing impairment and major neurological disorders played a lesser role. Most of the individuals claimed that they had little or no disability, while 10 felt they were only moderately disabled and 21 (14,9%) that they were severely disabled. The number of disorders ranged from 2,08 in those claiming no disability to 3,28 in those who were severely disabled. Profiles of the results of biochemical investigations resembled those of other aged populations, serum cholesterol, creatinine and alkaline phosphatase levels being raised. The pattern of medical care was also examined, including medication and the use of local facilities.

Black or African American↗
PubMed1983

Stimulus overselectivity in autistic, trainable mentally retarded, and non-handicapped children: comparative research controlling chronological (rather than mental) age.

Much of the comparative research on stimulus overselectivity has been flawed by either failure to control for chronological age and language ability of the subjects or reliance on the controversial technique of matching on mental age. The present study investigated the prevalence of overselectivity in autistic, trainable mentally retarded, and nonhandicapped children demonstrating some expressive speech. The ages of the children were between 6 years-6 months and 9 years-3 months. Thus, chronological age and language ability were controlled, rather than allowed to vary unsystematically. Results indicated no significant differences between the autistic and TMR samples, but significant differences between the handicapped samples and the non-handicapped group. Some, but not all, of the handicapped children displayed overselectivity.

Attention↗
PubMed1988

Stimulus equalization: temporary reduction of stimulus complexity to facilitate discrimination learning.

Learners with limited behavioral repertoires often have difficulty discriminating complex, multidimensional stimuli. Procedures that use gradual stimulus change have been developed to facilitate such discrimination, but these procedures are often difficult to implement and costly in terms of teacher time and expertise. This study investigated the effectiveness of stimulus equalization, an error reduction procedure involving an abrupt but temporary reduction of dimensional complexity. A microcomputer was used for stimulus presentation, data collection, and response analyses. Preschool children's responding to groups of four stimuli differing along several dimensions was analyzed on four discrimination tasks under several conditions. On each task, one element from a different dimension was programmed as correct. When trial-and-error training failed to establish the discrimination, equalization training began in which differences in the irrelevant dimensions were eliminated. When correct responding developed, the differences were reinstated, and correct performance was maintained in all but one instance. In a repeated acquisition design, stimulus equalization was found to be generally effective and superior to the trial-and-error method. Implications for computer-assisted instruction are discussed.

Attention↗
PubMed1989

Establishing sound blending in moderately mentally retarded children: implications of verbal instruction and pictorial prompting.

The present study evaluated a program for establishing blending of consonants (C) and vowel-consonant (VC) syllables in moderately mentally retarded children. The study consisted of two experiments. Experiment 1 assessed whether the subjects' failure to blend was due to the task requirements per se, or to the inadequacy of the instructional terminology ("Say together"). Experiment 2 evaluated the implications of using pictorial prompts in the acquisition and generalization of C-VC blending. The data revealed that (a) adequate verbal instruction had a modest but significant effect on the subjects' blending performance (Experiment 1), and (b) training without pictorial prompts resulted in better blending of trained and untrained C-VC items than training with pictorial prompts (Experiment 2).

Adolescent↗
PubMed1986

The effects of sensory changes in older persons.

An increasing proportion of persons encountered in professional nursing practice are older. This paper discusses the effects of sensory changes in older persons, specifically, the visual, auditory, olfactory, and gustatory effects. Nursing interventions aimed at assisting older persons to cope with or more effectively adapt to these potentially disabling alterations are explained, and some guidelines for nursing care are discussed.

Aged↗