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1.
Because the cerebral-palsied child is also a growing person whose development should be encouraged along as normal a course as possible, the pediatrician may well take the lead in coordinating orthopedic, psychiatric, educational and vocational services for such children. In El Centro this policy has been followed in a school for handicapped children serving 30 with cerebral palsy, 15 of them pupils at the school. Those with sufficient intelligence and milder physical handicap attend a regular public school, while others are unable to attend even the special school.Emphasis has been placed on working with children who are less seriously affected. As to children with severe neuromuscular and intellectual handicap, the chief effort is to prevent contractures and maintain function. The pediatrician confers monthly with all workers concerned with the child, and maintains liaison with the family physician who treats acute illnesses, including palsy seizures. Special effort has been made to investigate family circumstances such as foreign background which make it more difficult to evaluate the palsied child''s true capabilities. 相似文献
2.
Under California Assembly Bill 464, special classes may be provided by school districts for children designated as educationally handicapped. An educationally handicapped child is not mentally retarded or physically disabled. He may have neurological handicap or emotional disorder, but he must show impaired achievement in relation to his tested abilities.A physician may be asked to participate in the program, either as a specified member of the admissions committee of the school district or to provide a medical clearance for entrance of one of his own patients into the program.He does a thorough history and physical examination but adds special examination of attention, activity, coordination and attitudes.The educationally handicapped child is helped most by the physician who does not reject the idea of educational handicap even if the medical examination is negative; who treats his minor ills; who medicates, when it is indicated, for hyperactivity, distractibility or extreme anxiety; who cooperates with parents and school personnel. 相似文献
3.
Barbara H. Fiese Amber Hammons Diana Grigsby-Toussaint 《Economics & Human Biology》2012,10(4):365-374
There has been a growing interest in the role that shared family mealtimes may play in promoting the health and well-being of children. Families that regularly eat their main meal together four or more times a week are more likely to have children who do better in school, are of average weight, less likely to use drugs and alcohol at an early age, and consume more fruits and vegetables. The mere fact that families eat together does not address the process by which shared family mealtimes may protect children from unhealthy weight gain. Just as there is no simple explanation for the rising rates of obesity, the link between shared family mealtimes and childhood obesity is a complex one including socioeconomic and cultural context. In this paper, we provide an overview of how shared family mealtimes are embedded in a socio-cultural context that may either support or derail healthy eating patterns for children and youth. Evidence from an observational study of 200 family mealtimes demonstrates the complex interplay between socio-economic factors, family mealtime behaviors, and child obesity status. Families who had a child of healthy weight spent more time engaged with each other during the meal, expressed more positive communication, and considered mealtimes more important and meaningful than families who had a child who was overweight or obese. Using a cumulative risk model, it was found that the combination of family level and neighborhood risk factors predicted child overweight status. Recommendations are made for future research directions and policies directed toward families living in diverse economic circumstances. 相似文献
4.
FRIEDMAN DB 《California medicine》1957,86(1):25-28
Today's parents tend to be overwhelmed with advice from many sources. In his role as family counselor, the pediatrician must understand and consider the emotional development of parents in relation to their child's development; otherwise, his advice and counsel do not "take" and he becomes tired and frustrated and angry. PARENTS PROGRESS THROUGH DEFINITE STAGES OF DEVELOPMENT: Stage 1: Learning the cues-the struggle of the parents to interpret the infant's needs. Stage 2: Learning to accept growth and development-the parent learning to accept some loss of control of the toddler. Stage 3: Learning to separate-the parent learning to allow the child to develop independently. Stage 4: Learning to accept rejection, without deserting-the struggle of the parents not to intrude and yet to be there when needed. Stage 5: Learning to build a new life having been thoroughly discredited by one's teenager-the parent learning to live independently while the teenager struggles to develop his own identity.The pediatrician who is accepting, sensitive and a good listener and who keeps in mind that parents as well as children have capacities for growth and development, will be a potent factor in promoting good parent-child relationships and many times more effective in dealing with the child in health and disease. 相似文献
5.
The total population of 11,865 children of compulsory school age resident on the Isle of Wight was studied to determine the prevalence of epilepsy, cerebral palsy, and other neurological disorders. With the use of reliable methods, children selected from screening of the total population were individually studied by means of parental interviews and questionaries, neurological examination and psychiatric assessment of each child, information from school teachers, and perusal of the records of hospitals and other agencies. The association between organic brain dysfunction and psychiatric disorder was studied by comparing the findings in the children with epilepsy or with lesions above the brain stem (cerebral palsy and similar disorders) with those in (1) a random sample of the general population, (2) children with lesions below the brain stem (for example, muscular dystrophy or paralyses following poliomyelitis), and (3) children with other chronic physical handicaps not involving the nervous system (for example, asthma, heart disease, or diabetes).Psychiatric disorders in children with neuro-epileptic conditions were five times as common as in the general population and three times as common as in children with chronic physical handicaps not involving the brain. It was concluded, on the basis of a study of factors associated with psychiatric disorder, that the high rate of psychiatric disorder in the neuro-epileptic children was due to the presence of organic brain dysfunction rather than just the existence of a physical handicap (though this also played a part). However, organic brain dysfunction was not associated with any specific type of disorder. Within the neuro-epileptic group the neurological features and the type of fit, intellectual/educational factors, and socio-familial factors all interacted in the development of psychiatric disorder. 相似文献
6.
Skeletal maturation of children in Shiraz, Iran 总被引:1,自引:0,他引:1
Hand-wrist radiographs were made of 4,551 Shiraz school children and well babies of known age who were also weighed and measured. Medical examinations were not made and selection was biased in favor of the advantaged child because the urban standard of living is higher than the rural in Iran and because the poorest children may not attend elementary school and never attend high school. Nevertheless, height, weight and bone age fell rapidly below the tenth Iowa percentile by the age of two years and did not begin recovery until the age of six years. The distribution of the bone ages in each group was symetrical, not bi-modal. Bone age offered no advantage over height age as an index of development but analysis of the radiographs provided evidence that the retardation was pathologic rather than genetic. Ossification of individual epiphyses was recorded in 3,333 hands and a marked discrepancy between carpal and phalangeal bones, with the carpal bones most retarded, was documented. A high incidence of pseudoepiphyses was noted. 相似文献
7.
Evidence that the learning gains of preschool fade as children transition into elementary school has led to increased efforts to sustain preschool advantages during this key transitional period. This study explores whether the observed benefits of sustainability practices for a range of child outcomes are explained and/or moderated by family and school mechanisms selecting children into experiencing these practices. Analyses of the Early Childhood Longitudinal Study-Birth Cohort revealed that both family and school factors predicted children’s exposure to several PK-3 sustainability practices. PK-3 sustainability practices were associated with reading (but not math) gains and better interpersonal skills (but not fewer externalizing behaviors) following the transition into kindergarten. These links were not conditioned by the selection mechanisms. The findings highlight who is more likely to seek out (at the family level) or offer (at the school level) sustainability practices and how relevant they are to fighting preschool fadeout. 相似文献
8.
When a child is born with a mental handicap, his or her parents are usually confronted with a complicated and demanding process of adaptation and emotional coping, as well as with profound restructuring of their family life. Professional experts, including physicians and psychosocial specialists, can support the parents in terms of supplying them with information, but they inherently lack the experience of parents who have equally affected children and who have learned to master everyday problems and challenges. Filling that gap is the main purpose of self-support groups, whose number and importance have continuously grown since the 1970s. Internet databases are valuable signposts to self-support groups concerning particular, and even rare, types of handicaps. A study on Down syndrome exemplifies the self-support group experiences of parents of mentally retarded children. We conclude with suggestions for better conjunction of professional and self-support activities. 相似文献
9.
Dickinson HO Rapp M Arnaud C Carlsson M Colver AF Fauconnier J Lyons A Marcelli M Michelsen SI Parkes J Parkinson K 《BMC research notes》2012,5(1):300
ABSTRACT: BACKGROUND: SPARCLE is a study across nine European regions which examines the predictors of participation and quality of life of children with cerebral palsy. Children and their families were initially interviewed in 2004/2005 when the children were aged 8-12 years (SPARCLE1); they were approached again in 2009/2010 at age 13-17 years (SPARCLE2). The objective of this report is to assess potential for bias due to family non-response in SPARCLE2. Logistic regression was used to assess whether socio-demographic factors, parental stress and child impairment were related to non-response, both overall and by category (failure to trace families, death of child, traced families declining to participate). RESULTS: Of the 818 families who participated in SPARCLE1, 224/818 (27%) did not participate in SPARCLE2. 51/818 (6%) were not traced. Among the 767 traced families, 32/767 (4%) children with cerebral palsy had died, seven children had been incorrectly diagnosed as having cerebral palsy, thirteen families had moved out of the region and one family had language problems. Of the remaining 714 families, 120/714 (17%) declined to participate. Drop-out between SPARCLE1 and SPARCLE2 varied significantly between regions; families were more difficult to trace and more likely to decline to participate if the parents' educational qualifications, as recorded in SPARCLE1, were lower; they were also more likely to decline to participate if SPARCLE1 recorded that they were more stressed or if they had not completed a SPARCLE1 stress questionnaire. CONCLUSIONS: To reduce the risk of bias, all SPARCLE2 analyses should allow for factors (region and walking ability) which determined the sampling strategy, either by adjusting for these factors or by using sampling weights. Further analyses should be performed, adjusting for additional factors that were associated with non-response: parents' educational qualifications, family structure and parental stress. To allow for differential non-response in studies which sample from population registers, such registers should routinely record socio-demographic information. 相似文献
10.
Robert Krell 《CMAJ》1972,107(9):867-872
Case reports on single-parents families demonstrate some unique problems with which such a family unit must cope. Single mothers frequently present children to the family physician, pediatrician or child psychiatrist with specific symptom complaints. There exists a need to recognize that these symptoms may reflect the special problems of the single-parent family or unresolved issues which led to the formation of the unit.To meet the needs of these parents the physician must explore the specific circumstances of such a family in some depth. Nonjudgmental recognition of their problems may decrease the tendency to view these problems as “psychiatric”. Increased awareness of this entity as a new social unit will help the physician choose proper techniques and appropriate resources to provide support. 相似文献
11.
Brief admission of the new diabetic child and of a parent to an enlightened hospital for stabilisation, preliminary education, and familiarisation with hospital and community staff is well worth while. The greater the demand for constant control of the highest quality, the greater the need for a close understanding of the psychosocial factors concerned and for clinical skill. The nature of the home and the family relationships should in theory be available from the child''s general practitioner at the time of the first referral since he has so much information about the whole family. With the virtual disappearance, however, of mutual consultation in the patient''s home in many places, the opportunity for oral communication has declined, and availability on the telephone is not always easy. The busy general practitioner (far less an unknown physician from a deputising service without access to the records) has little time to write a comprehensive letter. In practice a relatively small hospital-based mobile team of specially experienced sisters who are keen to communicate in the home, the GP''s surgery, and the school makes a major contribution to the diabetic care of a young population vulnerable to major handicap in what should be the prime of life. Their cost effectiveness may be difficult to prove but it is not at all in doubt--especially when the sisters as in this area deal in the community with a wider range of chronic illnesses and handicaps in children. 相似文献
12.
In a sample of 61,829 US families, the probability of having an additional child is higher in those families with all the children the same sex as compared to those families with children of both sexes. Data are from families of American high school students who took the National Merit Scholarship Qualifying test in 1965. All families with 3 or 4 children were selected. Families with only boys were more likely to have an additional child than families with all girls. Less than 1% of the variance in family size is explained by family configuration. Although the sample size makes these results unequivocal for the population involved, the population is clearly biased in favor of white middle class families. 相似文献
13.
Since November 1961 it became apparent that the administration of thalidomide to pregnant women was associated with the occurrence of severe congenital anomalies. These deformities are frequently symmetrical, involving the limbs, particularly the proximal part, and associated with an absent external ear, mid-line facial hemangioma with saddle nose, atresia of the bowel and other congenital anomalies. Care of these children is a complicated problem requiring a team of specialists of many disciplines, particularly a pediatrician, an orthopedic surgeon, a prosthetic specialist and a social worker. Treatment by such a team ideally would commence immediately after delivery of the infant and continue until the child has been totally habilitated. Such care ideally should be provided within existing services in the country for the habilitation and rehabilitation of handicapped children. 相似文献
14.
Warnock M 《Bioethics》1987,1(2):141-155
Warnock, chair of Britain's Committee of Inquiry into Human Fertilisation and Embryology, discusses the implications of the "artificial family" for children born through the use of reproductive technologies. She considers both treatment of infertility and the possible use of assisted reproduction to enable persons other than infertile couples, such as single persons and homosexuals, to have children. Warnock has found that emphasis has been placed on the wants and well-being of the adult(s) involved, and that the "good of the child" is a "wide and vague concept, widely invoked, not always plausibly." She is particularly concerned about children born as a result of the delayed implantation of frozen embryos, AID children who are deceived about their origins, and children born of surrogate pregnancies. She recommends that a detailed study of existing "artificial family" children be conducted to aid public policy decisions on assisted reproduction. 相似文献
15.
David Belais Friedman 《The Western journal of medicine》1957,86(1):25-28
Today''s parents tend to be overwhelmed with advice from many sources. In his role as family counselor, the pediatrician must understand and consider the emotional development of parents in relation to their child''s development; otherwise, his advice and counsel do not “take” and he becomes tired and frustrated and angry.Parents progress through definite stages of development: Stage 1: Learning the cues—the struggle of the parents to interpret the infant''s needs. Stage 2: Learning to accept growth and development—the parent learning to accept some loss of control of the toddler. Stage 3: Learning to separate—the parent learning to allow the child to develop independently. Stage 4: Learning to accept rejection, without deserting—the struggle of the parents not to intrude and yet to be there when needed. Stage 5: Learning to build a new life having been thoroughly discredited by one''s teenager—the parent learning to live independently while the teenager struggles to develop his own identity.The pediatrician who is accepting, sensitive and a good listener and who keeps in mind that parents as well as children have capacities for growth and development, will be a potent factor in promoting good parent-child relationships and many times more effective in dealing with the child in health and disease. 相似文献
16.
《Biodemography and social biology》2013,59(3-4):223-232
Abstract Data on women with at least two children are used to examine how the breastfeeding experience with the first child affects whether subsequent children are breastfed. Our results indicate that women most often repeat with later children the feeding decision they made with their first child. That is, those who breastfed their first child are very likely to breastfeed a later child and those who did not breastfeed their firstborn are unlikely to breastfeed a later‐bom. Among those who did not breastfeed their first child, education beyond high school increases the likelihood that they will switch to breastfeeding with a later‐born. Those who breastfed their first child are less likely to breastfeed a later‐born if the first breastfeeding experience was of short duration or was perceived to be unsuccessful or unsatisfactory or if the woman had not gone beyond high school or received anesthesia at the later birth. Hence, educational differences are greater at higher parities than at first parity. 相似文献
17.
A total of 400 children with neurological disorders were studied to ascertain whether they had been immunised against pertussis, the reasons for non-immunisation, and the "validity" of these reasons, as judged by interpretation of the recommendations of the Department of Health and Social Security. The results for this group were compared with those for a group of 400 aged matched controls. The study group had a significantly lower rate of immunisation than controls (p less than 0.01); rates for both groups fell sharply after 1975. A total of 192 study patients and 186 controls were not immunised. Those children with cerebral palsy had the lowest rate of immunisation (19%) and the highest number of valid reasons for non-immunisation (63%). Paediatricians apparently advised against immunisation in 61 (32%) of the index group but in only four (2%) of the controls. The risk of serious neurological handicap after pertussis immunisation is small and there is little evidence to support the view that underlying neurological disease predisposes a child to increased risk. The advice currently given by paediatricians may need to be reconsidered. 相似文献
18.
The socioeconomic gradient in child health and noncognitive skills: Evidence from the Czech Republic
We investigate the presence of a socioeconomic status (SES) gradient in children’s health and noncognitive skill development, and its evolution with child age using cohort data from the Czech Republic. We show that family SES are positively associated with better child health. These effects start to emerge at age 3 and are persistent for all subsequent ages. We find a modest strengthening of the gradient as the children grow older. Similarly, at the lowest distribution of average family income, children lag in their noncognitive skills. We find evidence that children enter school with substantial differences in noncognitive skill endowments based on family SES. This correlation persists when controlling for poor health at birth, the roles of specific and chronic health problems, housing conditions, and partner characteristics. Maternal health status explains some of the association between family income and child noncognitive skills. We account for the endogeniety of SES and non-linearities in measures. 相似文献
19.
S. J. Koegler 《CMAJ》1963,89(20):1009-1014
The management of the retarded child in general practice is discussed. The necessity of a thorough medical and psychological assessment is stressed. The problem of the parents is described from the point of view of the emotional stages through which they pass and the defence mechanisms they commonly use. The factors involved in planning the future program for the retarded child are enumerated and depend on the degree of mental and physical handicap, the socio-economic and emotional climate of the family and the available services in the area. Since a large proportion of retarded children remain at home, a systematic follow-up program by the practising physician should be encouraged. 相似文献
20.
S.M. Côté J.-B. Pingault M. Boivin C. Japel D.S. Nagin Q. Xu M. Zoccolillo M. Junger R.E. Tremblay 《PSN》2010,8(2):77-87