摘要:

A community-based multiagency and multidisciplinary clinic was developed to perform comprehensive evaluations of preschool children in foster care. One hundred thirteen children, ages 1 month to 6 years old, were seen during the first 2 years. Forty-seven percent of the children were known to the social service agency from birth; however, the mean age at placement was 19 months. Fifty-seven percent of the children were in their first foster home at the time of their initial evaluation, but 17% had already been placed in three or more homes. Behavioral problems were found in 39% of the children, and chronic medical problems in 35%. Sixty-one percent of the children were delayed in one or more portions of the developmental assessment. Developmental delay was associated with older age. Sixty percent of the children with developmental delays were not involved in any community educational or therapeutic program, although they had been in foster care for a mean of 6 months. Because of the high mobility of this population, continuity of care by social workers, foster parents, and physicians is hard to achieve. The evaluation model developed by the clinic appears to facilitate the identification of children in need of additional services, enhances cooperation between various community agencies, and provides a constant site for monitoring the status and progress of children in foster care.

ISSN:0196-206X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Thirty-five infants with cystic parenchymal lesions detected by ultrasonography during the neonatal period were evaluated via periodic neurologic and developmental assessments. Long-term neurologic status (abnormal, normal, and isolated motor deficit) was assigned at 2 years of age. Abnormal neurologic status was strongly associated with bilateral cystic lesions as well as hydrocephalus during the neonatal period. Microcephaly at 6–8 months of age also correlated with abnormal status at 2 years of age. The neurologic exam at discharge and at 6–8 months of age added further negative predictive value for the infants with isolated motor delays. A literature review was conducted to determine the incidence of motor and mental delays in a large series of infants with cystic intracranial lesions.

ISSN:0196-206X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The purpose of this study was to evaluate the effectiveness of the Pediatric Symptom Checklist (PSC) as a psychosocial screening instrument. Using the PSC, the researchers screened 212 patients, ages 6–12 years, at a military outpatient pediatric clinic. Twenty-one children with scores in the “high-risk” range were randomly selected and matched with children scoring in the normal, “not-high-risk” range. Two trained interviewers, blind to individual PSC scores, independently interviewed and rated each subject's level of psychosocial functioning on the Children's Global Assessment Scale (CGAS). The Child Behavior Checklist (CBCL), a standardized psychosocial measure, was also completed by each subject's mother. PSC scores were compared to the CGAS and CBCL scores in terms of sensitivity and specificity. Additional analyses compared data from the study sample with that of previous studies. Results suggest that the PSC is a valid pediatric psychosocial screening instrument for multiethnic patient populations.

ISSN:0196-206X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Maternal perceptions of infant health are strongly associated with the use of health services and may influence the child's future health and development. The extent to which such perceptions reflect infant health problems or a response to environmental stress in the mother's life is unclear. Because this issue may be especially important in disadvantaged groups for which both high levels of infant morbidity and environmental stress are common, we have explored the correlates of maternal perceptions of infant health among 367 mothers of 12-month-olds in central Harlem. Lower ratings of infant health were associated with such indicators of morbidity as problems in the neonatal period, hospitalization, and one or more episodes of illness. They were also associated with lower family income and the mother's rating of her own health in the bivariate analyses, but not in multivariate analyses. Neither maternal mental health, social support, nor enviromental stress appeared to influence maternal rating of child health. These findings indicate that a mother's ratings of her infant's health relate specifically to the child's morbidity, independent of her own health and environmental stress. Moreover, within disadvantaged communities, infants of the poorest mothers may experience greater levels of morbidity.

ISSN:0196-206X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

A brief parent-assisted treatment for children's nighttime fears is described. Five children, ages 4–5 years, and their parents participated in the study, which was designed as a multiple baseline across-subjects experiment. The children were taught relaxation skills, pleasant imagery, and self-instructions to reduce anxiety; the parents were trained to positively reinforce compliance and reductions in their children's fearful behavior. Nightly ratings of the children's bedtime behavior (e.g., crying spells, getting out of bed, the time it took to fall asleep) were completed by the parents. Relative to baseline scores, the mean reduction in fearful behaviors at the end of the 3-week treatment phase was 40%. Six weeks later, it increased to 48%. Telephone interviews with the parents at a 6-month follow-up suggested continued improvement. Pre- and post-ratings on the Child Behavior Checklist showed significant improvement in the children's behavior at the end of treatment, as well as at a 6-week follow-up. This suggests that the beneficial effects of the intervention went beyond the presenting problem. The results of this study extend the generalizability of previous research to a younger population of nighttime fear sufferers.

ISSN:0196-206X    

出版商:OVID    

年代:1989

数据来源: OVID

ISSN:0196-206X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The judicial precedents and legislative mandates passed during the past two decades to ensure full appropriate public education for all children have resulted in a movement toward mainstreaming children with a wide range of physical and developmental disabilities into regular education classroom settings. Although some child development and pediatric literature has addressed the effects of these initiatives on the children with handicaps, less attention has been paid to the effect that mainstreaming has on their nondisabled peers in the classroom. As knowledgeable community advocates, pediatricians should be informed about the specifics of the mainstreaming movement. This paper outlines the movement's historical underpinnings, discusses current definitions of “mainstreaming,” and briefly reviews the literature on the effects of this policy on classrooms, teachers, and students with and without disabilities. The impact of mainstreaming children with handicaps in regular classroom settings is equivocal, with many studies lacking methodological sophistication to yield reliable and valid data. Results of the few well-designed studies do show, however, that academic and social outcomes for both the handicapped child and for his/her nondisabled peers are consistently better in mainstreamed classrooms where adequate resources have been made available to the child and teacher than in more segregated settings. Furthermore, the literature consistently points out the key role both regular and special education teachers play in successful mainstreamed classrooms. Pediatricians can help families with children with disabilities negotiate the educational system in order to achieve the appropriate classroom placement.

ISSN:0196-206X    

出版商:OVID    

年代:1989

数据来源: OVID

ISSN:0196-206X    

出版商:OVID    

年代:1989

数据来源: OVID

ISSN:0196-206X    

出版商:OVID    

年代:1989

数据来源: OVID

ISSN:0196-206X    

出版商:OVID    

年代:1989

数据来源: OVID