Epilepsy in mainstream and special educational primary school settings.
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This population based study compared the prevalence, nature and management of epilepsy between primary school children in mainstream education and those attending a special educational placement (children with special needs). The overall prevalence of epilepsy was 4.3/1000, but was 30 times higher in children with special needs, many of whom also had severe physical disabilities. Seizure types and the proportion of subjects with multiple seizures were similar in mainstream children and those with special needs. Epilepsy syndromes were identified in 74% of children. Although seizures were better controlled in children at mainstream school, 44% of these children did not have well controlled seizures. Children with epilepsy are an educationally vulnerable group and both education and health staff need to be aware of the additional support that many of these children require in all types of primary educational settings. (+info)
Functional outcome at adolescence for infants less than 801 g birth weight: perceptions of children and parents.
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OBJECTIVE: To compare functional, emotional, and academic status of adolescents who had been extremely low birth weight (ELBW) with those who were full term. STUDY DESIGN: Twenty-six adolescents who were born in 1983 to 1984 at less than 801 g birth weight were compared with 26 adolescents born at term. Adolescent-perceived status was assessed using the Behavior Assessment System for Children (BASC-SR) and the Self-Perception Profile. Parents' perceptions were assessed using BASC Parent Report, Family Impact Questionnaire, and Functional Status Measure. Health status was obtained through written requests to primary care providers and parent interviews. Academic and attendance information was obtained through school records. RESULTS: Compared to the term adolescents, the ELBW group had significantly lower function related to health status, increased need for special education, and tended to score lower on academic performance measures. However, ELBW adolescents' perceptions regarding their scholastic, athletic, or social competencies did not differ from the term group or national normative data. Parents of ELBWs reported lower adaptive skills, but no other behavioral differences from the term group. CONCLUSION: ELBW survivors and their parents perceived outcome at adolescence positively in spite of evident limitations. Mechanisms that ELBW families use to cope may be important determinants for successful, long-term outcome. (+info)
Utilization of special education services and educational attainment among long-term survivors of childhood cancer: a report from the Childhood Cancer Survivor Study.
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BACKGROUND: The objective of the current report was to compare the self-reported rates of special education (SE) and educational attainment among specific groups of childhood cancer survivors and a random sample of sibling controls. METHODS: The Childhood Cancer Survivor Study is a retrospective cohort of individuals who were diagnosed with a cancer in childhood and survived at least 5 years postdiagnosis. This analysis includes 12,430 survivors and 3410 full siblings. Reported use of SE services and educational attainment were analyzed within subgroups defined by type of cancer, age at diagnosis, and type of treatment. RESULTS: The use of SE services was reported in 23% of survivors and 8% of siblings, with the greatest differences observed among survivors who were diagnosed before age 6 years, most notably survivors of central nervous system (CNS) tumors (odds ratio [OR], 18.8; 95% confidence interval [95%CI], 15.01-23.49), leukemia (OR, 4.4; 95%CI, 3.75-5.16), and Hodgkin disease (OR, 4.4; 95%CI, 2.64-7.24). It was found that intrathecal methotrexate (IT MTX) and cranial radiation (CRT), administered alone or in combination, significantly increased the likelihood that a survivor would use SE (IT MTX only: OR, 1.3; 95%CI, 1.09-1.78; CRT only: OR, 7.2; 95%CI, 6.14-8.39; IT MTX and CRT combined: OR, 2.6; 95%CI, 2.30-2.95). A positive dose response was identified between higher doses of CRT and use of SE. It was determined that survivors of leukemia (OR, 1.6; 95%CI, 1.23-2.16), CNS tumors (OR, 2.7; 95%CI, 1.92-3.81), non-Hodgkin lymphoma (OR, 1.8; 95%CI, 1.15-2.78), and neuroblastoma (OR, 1.7; 95%CI, 1.14-2.61) were significantly less likely to finish high school compared with siblings; however, when survivors received SE services, risk estimates approximated those of the sibling SE population. CONCLUSIONS: Children who are diagnosed with cancer should be followed closely during and after treatment to identify early signs of learning disabilities and to maximize intervention strategies for the successful completion of scholastic goals. (+info)
Long term follow up after meningitis in infancy: behaviour of teenagers.
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AIMS: To determine the effects of meningitis in infancy on subsequent teenage behaviour. METHODS: A national postal survey of parents and teachers using an established standard behavioural questionnaire. Subjects were 739 of the surviving children from the national incidence study of infantile meningitis in England and Wales carried out between 1985 and 1987, together with a group of 606 matched controls that had been recruited when the index cases were 5 years old. RESULTS: 46% of parents of children who had had meningitis with complications in infancy, compared with 21% of parents of control children rated their children as having behavioural problems. When the children were rated by their teachers, 37% and 23% respectively, were scored as having behavioural problems. There was no significant difference in behaviour between the 103 children who had had meningitis during the first month of life and the 634 who had had postneonatal meningitis. Eight of the index children had been excluded from school compared to none from the control group. CONCLUSIONS: The behaviour of teenage children who had meningitis in infancy is worse than that of control children who did not have infantile meningitis when rated by parents and teachers. (+info)
Effects of teacher-directed versus student-directed instruction on self-management of young children with disabilities.
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In this study, students worked independently by setting goals, selecting assignments, and recording and evaluating their results after receiving one of two different types of self-management training. During teacher-directed training, the teacher set goals, assigned work, and recorded and evaluated results for students. During student-directed training, students performed those tasks themselves. The results indicated that students engaged in the self-management behaviors more frequently during independent work following student-directed instruction than following teacher-directed instruction. (+info)
Decreased access to health care and social isolation among young adults with cerebral palsy after leaving school.
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OBJECTIVE: To examine if leaving special schools has a negative impact on the health care and social isolation of young adults with cerebral palsy. METHODS: Young adults with cerebral palsy, aged between 15 and 22 years, were divided into 2 cohorts: current students, who were still receiving services from special schools, and school-leavers, who had since been discharged from care. A questionnaire and physical examination were administered to assess the extent of disability, health care received by, and social isolation of these young adults. RESULTS: School-leavers had a greater degree of dissability than did students, although the results were not statistically significant. Health care exposure to specialists, general practitioners, therapists physiotherapists, occupational therapists, and/or speech therapists), and medical social workers decreased after leaving school; with the exception of contact with general practitioners, these results were significant (p<0.05). The entire cohort was more socially isolated than a control cohort. School-leavers participated in fewer activities outside their homes, but showed less concern about their disability than did current students. CONCLUSIONS: Young adults with cerebral palsy continue to have health care and lifestyle needs after leaving school, which are currently not being adequately met. (+info)
Causes and temporal trends of blindness and severe visual impairment in children in schools for the blind in North India.
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AIMS: To describe the causes of severe visual impairment and blindness (SVI/BL) in children in schools for the blind in north India, and explore temporal trends in the major causes. METHODS: A total of 703 children were examined in 13 blind schools in Delhi. A modified WHO/PBL eye examination record for children with blindness and low vision which included sections on visual acuity, additional non-ocular disabilities, onset of visual loss, the most affected anatomical part of the eye concerning visual impairment, and the aetiological category of the child's disorder based on the timing of insult leading to visual loss was administered in all children. RESULTS: With best correction, 22 (3.1%) were severely visually impaired (visual acuity in the better eye of <6/60) and 628 (89.3%) children were blind (visual acuity in the better eye of <3/60). Anatomical sites of SVI/BL were whole globe in 27.4% children, cornea 21.7%, retina 15.1%, and lens 10.9%. The underlying cause of visual loss was undetermined in 56.5% children (mainly abnormality since birth 42.3% and cataract 8.3%), childhood disorders were responsible in 28.0% (mainly vitamin A deficiency/measles 20.5%), and hereditary factors were identified in 13.4%. Study of temporal trends of SVI/BL by comparing causes in children in three different age groups-5-8 years, 9-12 years, and 13-16 years-suggests that retinal disorders have become more important while childhood onset disorders (particularly vitamin A deficiency) have declined. CONCLUSIONS: Almost half of the children suffered from potentially preventable and/or treatable conditions, with vitamin A deficiency/measles and cataract the leading causes. Retinal disorders seem to be increasing in importance while childhood disorders have declined over a period of 10 years. (+info)
Promoting interaction during sociodramatic play: teaching scripts to typical preschoolers and classmates with disabilities.
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We investigated the effects of teaching sociodramatic scripts on subsequent interaction among three triads, each containing 2 typical children and 1 child with autistic characteristics. The same type and rate of teacher prompts were implemented throughout structured play observations to avoid the confounding effects of script training and teacher prompting. After learning the scripts, all children demonstrated more frequent theme-related social behavior. These improvements in social-communicative interaction were replicated with the training of three sociodramatic scripts (i.e., pet shop, carnival, magic show) according to a multiple baseline design. These effects were maintained during the training of successive scripts and when the triads were reconstituted to include new but similarly trained partners. Results provided support for the inclusion of systematic training of scripts to enhance interaction among children with and without disabilities during sociodramatic play. (+info)