摘要:

This study compared primary care physicians' ratings of psychosocial adjustment of their chronically ill pediatric patients with parents' and children's reports. A series of measures of psychosocial adjustment were administered to 63 children with either a seizure disorder or a visible orthopedic condition, and their parents. Each child's physician was asked to rate the presence and severity of psychological adjustment problems in the child, as well as to rate six specific psychosocial domains. Forty-one physicians responded, and relationships between their ratings and child and parent psychosocial measures were determined using Pearson product-moment correlation coefficients. Ratings by physicians correlated with children's reports and parents' judgments about the children, but not with mothers' self-concept or the impact that the illness had on the family. However, physicians' ratings were interdependent. When congruence of physician ratings with child or parent reports was examined for each disease group, we found significant results for the seizure disorder group; however, congruence among ratings for the orthopedically handicapped group was poor. Student'st-tests revealed no statistically significant differences between the two disease groups in any of the demographic variables of the children or physicians, nor in their scores on the criterion measures. Hierarchical multiple regression analysis identified factors that contributed to physicians' significantly different congruence with parents regarding the adjustment of children in the two subsamples. The findings of this study suggested that primary care physicians were moderately aware of the presence and severity of psychosocial adjustment problems in some categories of their pediatric patients with chronic illness. Physicians may focus their attention more accurately on individual children rather than on parents and the larger family unit of which each child is a part.

ISSN:0196-206X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Mothers of 30 infants who had experienced an emergency apnea episode and were placed on a home apnea monitor were studied longitudinally, using measures of mood disturbance (anxiety, depression, hostility, fatigue, vigor and confusion). Mothers were assessed at the time of hospitalization immediately following the apnea episode, after approximately one month of home monitoring, and after three months of home monitoring. Measures of family resources, health locus of control, and coping style, involving preference for information under situations of threat, were obtained as predictor variables. A high level of mood disturbance was seen initially, but this was transient, diminishing significantly after the first month of monitoring. Level of family resources was highly predictive of mood disturbance throughout the study period, while health locus of control beliefs were predictive of changes in mood disturbance over time. These findings suggest a means for identifying families at higher risk for maladaptive responses, and in need of more intensive psychosocial support.

ISSN:0196-206X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Social support, family functioning, self-perceptions of appearance, school, behavior, athletics, and social competence, as well as daily hassles/microstressors, were investigated as determinants of general self-esteem in 41 children with congenital/acquired limb deficiencies. Classmate, parent, teacher, and friend social support all were significant predictors of self-esteem. Family conflict and organization were also significantly associated with self-esteem, as were microstressors. The overall model of significant predictor variables accounted for 66% of the variance in general self-esteem. General self-esteem also was significantly predictive of depressive symptomatology. The findings suggest a number of factors which are potentially modifiable and which might enhance general self-esteem in children with visible physical handicaps.

ISSN:0196-206X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

An in vitro flooding package was used to treat the posttraumatic stress disorders of two adolescents. Traumatic scenes were identified through nonstructured interviews, and stimulus response imagery cues were presented according to a multiple baseline across traumatic scenes design. Posttreatment and 6-month follow-up assessments revealed meaningful improvements in the patients' affective, behavioral, and cognitive parameters.

ISSN:0196-206X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

A study was undertaken to develop activity sheets that can be given to parents at the time of child health maintenance visits. A series of 200 activities for parents to undertake with their children were arranged into 11 age groups and four areas: self-care and socialization, speech, small muscle skills, and large muscle skills. A national field test involved 53 private and public practices already using a parent-answered developmental questionnaire. The practices gave the Denver Developmental Activities and survey questionnaires to parents, and completed professional survey questionnaires. Fifty-one professional questionnaires and 79 parent questionnaires were returned. The professionals liked the Activities and did not feel that they slowed their practices. Parents found the Activities enjoyable and easy to understand. Less educated parents reported that the Activities increased their knowledge and prompted them to discuss child development issues with their child's health provider. This survey is considered preliminary, since it was limited to health practices already manifesting interest in child development, and it is not known what percent of parent questionnaires were returned. The latter point precludes one from making generalizations to a larger population.

ISSN:0196-206X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Failure-to-thrive (FTT) is categorized as organic (OFTT) or nonorganic (NFTT). Traditionally, it has been taught that children with OFTT are unable to grow well in spite of adequate care (calories, nurturance, medical supervision), whereas NFTT children will grow well when given adequate care. We undertook this study to determine whether NFTT and OFTT children could grow at similar rates when treated by a specialized multidisciplinary team that provided concerete, individualized therapies including psychosical support, medical care, and hypercaloric diets. Eighty-six children were enrolled on referral to our outpatient FTT consultative clinic; 64 had NFTT and 22 had OFTT. Growth quotient analysis was used to determine growth outcomes over a 6-month follow-up period. Growth at a rate paralleling the growth curve produces a GQ equal to 1. Growth 2 times as rapid as expected gives a GQ = 2. Children in both groups grew extremely well. For NFTT, GQ = 1.67 ± 0.56 (SD); for OFTT, GQ = 1.81 ± 0.37 (SD),p= NS. OFTT children grew just as well as NFTT children when given adequate calories for catch-up growth. Our data indicate that weight gain alone cannot reliably differentiate OFTT from NFTT, as has been traditionally taught. They suggest that we make every attempt to maximize caloric intake in FTT children. They also suggest that a multidisciplinary team consisting of a pediatrician, child psychiatrist, nutritionist, nurse clinician, and social worker may be successful in managing FTT children.

ISSN:0196-206X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Children born at very low birth weights (VLBW) (≤1500 g) who were beneficiaries of modern neonatal intensive care are reaching middle childhood, and their school achievement can be evaluated. We compared 65 9-year-old children born in 1976, who were very low birth weight and who were free of neurological impairment, with 65 children of normal birth weight who had been matched for race, sex, age, and social class on measures of IQ, cognitive, visuo-motor, and fine motor abilities, and academic achievement. VLBW children scored significantly lower than controls on the WISC-R, Bender-Gestalt, Purdue Pegboard, subtests from the Woodcock Johnson Cognitive Abilities Battery, and reading and mathematics (math) achievement. Exploratory analysis of a subset of 43 VLBW and matched controls with IQ scores ≤85 yielded a similar trend, except that, on achievement tests, differences were significant only in math. Further analyses revealed that the differential in math achievement between VLBW and control children is not fully attributable to differences in IQ.

ISSN:0196-206X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Blood pressure reactivity to stress in childhood has predicted development of hypertension 45 years later, so it is important to understand the characteristics of blood pressure reactivity in childhood. The present study assessed the 1-week and 6-month stability of systolic blood pressure reactivity to a 40-meter run stressor in preschool children. Sixty-three low-income children (mean age, 3.9 years) were assessed on four different days over a 6-month period. One-week stability (r= 0.39 to 0.50) and 6-month stability (r= 0.56) of reactive systolic blood pressure levels were highly significant. Reactive systolic blood pressure level was more stable than resting systolic or diastolic blood pressure in this sample. Sex, body mass index, family cardiovascular disease history, and child Type A behavior all were unrelated to systolic blood pressure reactivity. Systolic blood pressure reactivity to exercise appears to be an enduring characteristic that emerges in early childhood.

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:

Studies of behavioral diagnosis in children with nonorganic failure-to-thrive (NOFTT) are critically reviewed. Prior studies have been based on several problematic assumptions: (1) specific behavioral abnormalities are associated with NOFTT, (2) NOFTT is a homogeneous population, and (3) a strict dichotomy between organic and environmental influences on physical growth is a valid distinction. An alternative way to organize data from behavioral assessment is presented which emphasizes the heterogeneity of NOFTT and the consequences of environmental and biologic risk factors on psychological development. A comprehensive approach to behavioral assessment can facilitate the clinical management of NOFTT and encourage research concerning the developmental processes which affect the psychological outcomes of NOFTT children.

ISSN:0196-206X    

出版商:OVID    

年代:1989

数据来源: OVID