摘要:

SummaryWith a dramatic decrease in infant mortality, an emerging challenge facing modern medicine in China is chronic disabling conditions in infants and young children. According to the results of a national sampling survey in 1987, it is estimated that there are over 51 million people of all ages with disabilities, which accounts for 4·9% of the total population. One out every five families in China has a member who is disabled. For children under 14 years of age, the overall prevalence rate of disability is 2·66%. The prevalence rate of mental retardation is 1·8% which accounts for 66% of all disabled children. Mental retardation is the most frequent childhood disability. Research on factors contributing to disability indicates the complexity of the problem. The etiology of 47% of cases is unknown, 21% of cases result from damage prenatally, 3% are due to perinatal factors, 29% are acquired during infancy and early childhood. Efforts to prevent developmental disabilities among children can be classified in terms of primary, secondary and tertiary activities. The most important primary prevention activities consist of genetic counselling, immunization programmes, improved prenatal, perinatal and postnatal health care, and legislation. On the secondary preventive level, focus is primarily on prenatal diagnosis and newborn screening. Tertiary preventive efforts include special education and comprehensive rehabilitation services. While these prevention efforts have been established, they are insufficient to meet the the needs of disabled children and their families. In the context of the one child per family policy in China, much more is needed, much more can be done to reduce childhood disability. In addition to strengthening prevention efforts at all 3 levels, special emphasis should be placed on (a) intervention programmes remains an essential issue for the future’ (Guralnick&Bennett 1987). At one level, the need for professionals having the clinical skills of their own discipline and the specialist knowledge of children with disabilities, continues to increase with the growing number of disabled children and diversity of service programmes. At another level, training teachers in early childhood and special education is particularly pressing and there is a need to establish the credentials and training programmes for professions in this field. Health professions at all levels should be trained to identify developmental disabilities in individual children. Early diagnosis and management of disabilities is crucial to maximize the full growth potential of disabled children. The basic techniques of developmental surveillance and screening should be incorporated into the training curriculum of health workers. Courses for early intervention at the college level or graduate level should be developed. An underlying consideration in regard to training, however, is to balance the need for speciality preparation with the need for widely available services. This is a concern for any country but which may vary in its expression depending upon whether it is a western country such as Germany (Schindele 1985) or an eastern country such as C

ISSN:0305-1862    

DOI:10.1111/j.1365-2214.1993.tb00715.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SummaryThe Finnish version of the Portage Assessment Scale was used with 114 aspartylglucosaminuria (AGU) persons aged between 1 and 56 years. Ninety‐three persons with AGU were also given psychological tests, mainly SB (Finnish), WISC‐R and WPPSI, but also Merrill‐Palmer, Bayley, Leiter and WAIS tests. The data also include for the reliability assessment a sample of 30 normal pre‐school children. The internal consistency reliability was calculated for the areas of socialization 0·80, language 0·81, self‐help 0·73, cognitive 0·70, motor 0·‐75 and for the whole scale 0·80. The factor analysis produced one very strong factor. The results of the Portage assessment were compared to the developmental levels provided by the tests. Both methods gave almost identical cross‐sectional descriptions of the skills of patients with AGU, which was interpreted as providing a cross‐validation for Portage in clinical use and to mean that Portage can be used as a reasonable assessment method. The advantages of Portage include easy use by non‐psychologists, concrete descriptions of the skills, the 5 areas, and the close rel

ISSN:0305-1862    

DOI:10.1111/j.1365-2214.1993.tb00716.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SummaryInformation was collected in relation to 1133 children, aged 4–11 years, regarding methods of travel to and from school, together with distances involved. Ninety‐seven per cent of the children walked, travelled by car or alternated between these 2 methods of travel. Some 584 children (51·5%) walked to school every day with an average one‐way‐distance of less than half a mile. It would seem therefore that few primary school children are walking far enough to gain heart health benefits from their journeys to school. Reasons are given, however, as to why it is important for young children to be encouraged to walk to school providing adequate safety considerations are taken into

ISSN:0305-1862    

DOI:10.1111/j.1365-2214.1993.tb00717.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SummaryFeeding difficulties, vomiting and recurrent chest infections associated with poor growth and nutrition are common in children with cerebral palsy (CP). However, the role of gastrooesophageal reflux as a possible cause has been little studied. We therefore investigated 23 children with cerebral palsy (median age 2–3 years, range 0–6‐11‐8) whose symptoms were consistent with gastrooesophageal reflux (severe feeding difficulties 70%, failure to thrive 52%, anaemia 31% and recurrent chest infections 31%). Using 24‐hour ambulatory oesophageal pH monitoring, we determined the relationship between gastrooesophageal reflux and: (a) developmental age (Griffith's scales); (b) feeding behaviour skills score; (c) nutritional status and (d) clinical assessment of cerebral palsy (type and severity). Abnormal gastrooesophageal reflux (i.e. reflux index>5%) was detected in 16 (70%) patients (median reflux index 11–4%; range 5·4–59%).Reflux was unrelated to chronological or developmental age, but there was a significant, unexplained association with male gender (P<0·01). No correlation was found with feeding behaviour skills score, malnutrition (which was commonly severe) and type and severity of cerebral palsy. We conclude that gastrooesophageal reflux is common and should be sought in symptomatic, neurologically handicapped children as effective treatment is likely to improve

ISSN:0305-1862    

DOI:10.1111/j.1365-2214.1993.tb00718.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SummaryThe Charter for Children in Hospitals, drawn up by professional and women's groups from a number of European countries at the First Conference for the Care of Children in Hospital (Netherlands 1988) presents many fine guidelines for. protecting the rights of children and their parents before, during and after hospitalization. The development of these guidelines, their current acceptance in Europe and the psychological principles underlying them, are outlined here.

ISSN:0305-1862    

DOI:10.1111/j.1365-2214.1993.tb00719.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SummaryThe ‘Mesker test’, an experiment devised after the psycho‐motor dominance test described by the Dutch paediatrician Mesker, was evaluated as a method for testing writing handedness in 145 children at school entry in Crewe Health Authority. Also included in the assessment was if, and how these children know their laterality.Positive outcome was measured as Mesker test result corresponding to spontaneous hand‐preference in symbol copying. The correct indication of right arm or leg was evaluated in relation to the outcome by chance.The Mesker test could not confirm hand‐preference in children at school entry. There was no significant relation to the child's maturity and no significant consistency in test performance. The sub‐group of right‐handed writers who confirmed their handedness showed an almost significant level of consistency.No more children who thought they knew the right side indicated the correct limb then could have been arrived at by chance. This was not significantly related to having been taught, writing handedness or maturity. It is concluded therefore, that at school entry age children don't have a good knowledge of their body's laterality.Although the Mesker test does not confirm writing handedness at school entry, it may be useful in older children with inconsiste

ISSN:0305-1862    

DOI:10.1111/j.1365-2214.1993.tb00720.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Book review in this article:A Pocket Book of Social and Community Paediatrics, by Jo Sibert.Congenital, Perinatal&Neonatal Infectionsedited by Anne Greenough, John Osborne and Sheena Sutherland, Churchill LivingstoneClinicalpragmatics: unravelling the complexities of communicativefailureby Benita Rae Smith and Eeva Leinonen.Comprehensive child andfamily nursing skillsby Smith D. P., Nix K. S., Kemper J Y., Liguori R., Brantly D. K., Rollins J. H., Stevens N. V. and Clutter L. B.

ISSN:0305-1862    

DOI:10.1111/j.1365-2214.1993.tb00721.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY