Manipulation In Children Research Articles

Cancer in children. Clinical management

is still a relatively rare disease in children. Nevertheless, physicians need to have a general knowledge of the possible aetiology, symptoms, treatment, complications and outcome of cancer in their young patients. This book offers useful information for physicians in a clear presentation of the practical problems of paediatric oncology. The third edition of Cancer in Children has been completely updated. It shows how today's fast-moving research is already improving our understanding of oncogenesis and how it can be used in new treatment techniques such as genetic manipulation in children. Other new information regarding epidemiology, radiotherapy, drug treatment and even bone marrow transplantation is also included. The paediatric oncologist, the paediatrician and the general practitioner should all find this book useful.

THE IMPACT OF CHILDHOOD SEXUAL ABUSE ON WOMEN'S Healthcare

Prevalence studies show that between 15 and 30% of women have been sexually abused by a man by the age of 16. Child abuse survivors rarely spontaneously reveal this history to a doctor yet they are more likely than non‐abused patients to suffer multi‐system medical complaints and to indulge in high‐risk behaviours. This of course may make them more likely to appear in gynaecology or colposcopy clinics. It seems sensible that gynaecologists should be well informed about CSA and in particular the impact it may have on their patients so that they can offer the required sensitive treatment in an appropriate environment for these women in particular. Just as with rape the sexual component of child sexual abuse is of secondary importance to power over and manipulation of children, therefore psychological damage to children is much greater if the abuser is a parent or parent figure. Incest is most commonly between father or stepfather and daughter, with stepfathers being the worst offenders. The peculiar difficulties that follow sexual abuse of a child by a family member and which place the child in a seemingly impossible position in the family have been well‐described by Summit (1983). He uses the term CSA accommodation syndrome to describe a reaction, which allows for the immediate survival of the child within the family.There are 5 components to this syndrome:‐(1) Secrecy(2) Helplessness(3) Entrapment and Accommodation(4) Delayed, Conflicted and Unconvincing disclosure(5) RetractionUnfortunately these children develop multiple psychological and emotional disorders in the process e.g. depression, high anxiety and panic attacks, obsessional concerns, eating disorders and abuse of self. They may also develop physical manifestations of emotional pain such as pseudo‐seizures or chronic pelvic pain. Not surprisingly, sexual problems are also common e.g. low sex drive or vaginismus. Despite the fact that abuse of children is very variable in severity, the treatment of abused women follows a recognised process which is similar in each case. Disclosure – therapy starts from this moment so it is important that it is handled well. She is encouraged to talk about the abuse as she remembers it and it is important that her therapist lets her know that her story is believed. Responsibility for the abuse is addressed. Almost without exception, victims of abuse feel responsible in some way for what happened so again her therapist must point out where the blame really lies i.e. with the abuser. Current family relationships have to be reviewed as she may still in fact be living with the abuser and part of the healing process may involve his confrontation. Finally moving from victim to survivor the woman addresses the damage that has been done. Many women attending colposcopy or gynaecology clinics will have suffered sexual abuse. They may find the experience traumatising and will be greatly helped to cope if the environment in which they are treated is sensitive and caring.

Object/wrist movements during manipulation in children with cerebral palsy

The kinematics of the wrist and a manipulated object were studied in a posting task in 30 control, eight hemiplegic and 10 diplegic children. Statistical analyses using 'mixed' models examined the effects of subject group, hand, object shape and repeated trials, together with all possible interaction terms. During transport to the posting hole, the number of significant peaks/troughs in the velocity/time profile of the wrist in the transport ('z') direction were increased in subjects with cerebral palsy, as were adjustment error and the distances moved by the object relative to the wrist, reflecting more unpredictable object movement. In the placing phase, relative object/wrist normalized 'z' distances and number of wrist 'z' velocity peaks increased with increasing object complexity, reflecting the need for more adjustment movements. The number of wrist 'z' velocity peaks/troughs and adjustment error were increased in cerebral palsy subjects, reflecting ineffective adjustment. Relative object/wrist distances and number of wrist 'z' velocity troughs were reduced in both phases with repeated trials. It is suggested that such variables may provide a quantitative measure of poor movement 'quality' in children with Cerebral Palsy and that these findings reflect reduced mechanical stability of the hand and arm during movement.

The use of dietary manipulation by parents of children with atopic dermatitis.

In 1989 we demonstrated that 71% of children referred to our paediatric dermatology clinic with atopic dermatitis (AD) had been subject to dietary manipulation by their parents in order to manage their disease. We have re-examined our clinic population to determine whether the documented rise in the use of complementary therapy in children with skin disease has been accompanied by a rise in dietary manipulation. To qualify and quantify the usage of dietary manipulation in children with AD in secondary care. A face-to-face structured questionnaire study of 100 children with AD. The mean age of the children interviewed was 7.3 years (median 5.9, range 0.6-17.1) and ethnic origin was 59% white, 35% Indo-Asian, 3% Afro-Caribbean and 3% mixed race. Seventy-five per cent of patients (75 of 100) had tried some form of dietary exclusion; the most common foods omitted were dairy products in 48% (36 of 75), eggs in 27% (20 of 75) and cow's milk in 25% (19 of 75). Forty-one per cent of patients (41 of 100) had tried some form of dietary supplementation. The most common dietary supplement was evening primrose oil in 59% (24 of 41), of whom 13% (three of 24) felt this had helped their skin. Only 51% (38 of 75) had consulted a doctor or dietician before commencing any dietary change, but 39% (29 of 75) felt that their skin had improved as a result of this dietary manipulation. In comparison with our previous study, the proportion of patients excluding foods from their diet had increased from 71% to 75%. The proportion of these dietary changes that are unsupervised has remained the same, as have the food types avoided. The proportion of patients who report that unsupervised dietary manipulation is beneficial has increased from 10% to 39%.

Adjustable sutures in children using a modified technique

Purpose Adjustable-suture techniques are commonly used to decrease the reoperation rate in adults undergoing strabismus surgery, but they are infrequently used in children because of the difficulty of performing adjustments on a conscious child. The purpose of this study is to evaluate a new technique for using adjustable sutures in children, which makes the second stage of the procedure unnecessary if no adjustment is needed. Methods This was a retrospective study of children who underwent surgery for exotropia or esotropia. The technique used was a variation of the standard fornix-based adjustable suture with a separate slipknot. The pole sutures were buried within the sclera and tied; then the incision of the conjunctiva was closed to cover the adjustable sutures. The patients were then measured 4 to 6 hours after the initial surgery. The decision of whether to adjust was based on predetermined criteria. Those children not adjusted were discharged with no further manipulation needed because the conjunctiva was already closed. For those children who were adjusted, the adjustment was made with the patient under intravenous propofol sedation or laryngeal mask anesthesia. Results A total of 61 consecutive children ages 12 months to 14 years underwent surgery using this technique. Patients were followed-up after surgery for a minimum of 6 weeks (median 19.4). Fifty-four of the 61 patients (88%) were within 10 prism diopters ( PD) of orthophoria on their final postoperative visit. Of the 22 patients who underwent an adjustment, 20 (91%) were within 10 PD of orthophoria at their final postoperative visit. The median follow-up was 19.4 weeks (range 6 to 45.9). Conclusions This new adjustable-suture technique was associated with excellent short-term eye alignment. It is particularly suited for pediatric surgery because it eliminates the necessity of further manipulation of children who do not require adjustment.

Quantification of object manipulation in children with cerebral palsy.

A shape-posting task was studied in 30 control, eight hemiplegic and 10 diplegic children, to determine how differences in object manipulation between such children could be quantified. Conical, cylindrical and triangular-shaped objects were posted through a hole in a perspex screen, three times each with both preferred and non-preferred hands. Four variables were defined to describe kinematic aspects of the task: adjustment inefficiency, mean transport velocity, adjustment distance to be completed in the placing phase and adjustment velocity in the placing phase. As expected, total task time was increased in subjects with cerebral palsy and with more complex shapes, and reduced by repetition. The four kinematic variables reduced the variation in task time between individual children by 79%, between sets of like objects by 62%, and the residual variation by 63%. Adjustment inefficiency was increased and mean transport velocity reduced in subjects with cerebral palsy, whereas repetition had the opposite effect. It is suggested that combined alterations in adjustment inefficiency and transport velocity reflect changes in the intrinsic uncertainty of a movement and that this quantity is decreased by repetition and increased in cerebral palsy.

I Show You How I Like You: Human-Robot Interaction through Emotional Expression and Tactile Stimulation

We report work on a LEGO robot capable of displaying several emotional expressions in response to physical contact. Our motivation has been to explore believable emotional exchanges to achieve plausible interaction with a simple robot. We have worked toward this goal in two ways. <p>First, acknowledging the importance of physical manipulation in children's interactions, interaction with the robot is through tactile stimulation; the various kinds of stimulation that can elicit the robot's emotions are grounded in a model of emotion activation based on different stimulation patterns.</p><p>Second, emotional states need to be clearly conveyed. We have drawn inspiration from theories of human basic emotions with associated universal facial expressions, which we have implemented in a caricaturized face. We have conducted experiments on both children and adults to assess the recognizability of these expressions.</p>

Fingertip Forces During Object Manipulation in Children with Hemiplegic Cerebral Palsy. II

Pediatric Physical Therapy is the first and only peer-reviewed journal devoted to this discipline. The Journal provides a forum for scientific and professional exchange among researchers and practitioners throughout the world that represent subspecialties of the discipline, including early intervention, neonatology, pediatric sports and fitness, school physical therapy, acute care for seriously ill children, and the prevention of primary and secondary conditions that lead to disabling conditions. Official Journal of APTA Pediatrics, an Academy of the American Physical Therapy Association, The Dutch Association for Pediatric Physical Therapy, Physiotherapia Paediatrica, The New Zealand Society of Physiotherapists Pediatric Special Interest Group, and The Pediatric Division of the Canadian Physiotherapy Association.

Fingertip Forces During Object Manipulation in Children with Hemiplegic Cerebral Palsy. II

The present study examines the coordination of fingertip forces during object manipulation in both the involved and non-involved hand of 14 children with hemiplegic cerebral palsy (CP) aged between 8 and 14 years. While no impairment could be observed in the non-involved hand, subtle deficits in the sequencing of the grip–lift movement were observed in all children tested in this hand. However, they were able to scale the fingertip force output of the non-involved hand in advance (use anticipatory control) based on the object's weight. In the second experiment in this paper, we tested whether the anticipatory control can be generalized across hands. The results indicate that sensory information from the non-involved hand can be used for anticipatory scaling of isometric force increase during subsequent lifts with the contralateral involved hand. These findings suggest that the initial lack of anticipatory control usually observed in the involved hand of children with hemiplegic CP is likely to be based on disturbed sensory input.

Fingertip forces during object manipulation in children with hemiplegic cerebral palsy. I: Anticipatory scaling

Previous studies of grasping and object manipulation in children with cerebral palsy (CP) have suggested a dichotomy in the ability to use anticipatory control (planning) of the fingertip force output, depending on the type of sensory information (tactile or proprioceptive) on which it is based. The present study further explores this issue by testing the ability of 15 children with hemiplegic CP aged between 8 and 14 years to scale the fingertip force output in advance during the lifting of small objects whose weight and surface texture are varied. The results indicate that children with hemiplegia can use anticipatory control based on both the weight and texture of the object, but require a greater number of trials than age‐matched children without CP (control children) before they can do so. We suggest that the initial lack of anticipatory control results from an indistinct internal representation of the object's physical properties due to disturbed sensory mechanisms, which may have direct implications for therapeutic intervention.

Fingertip forces during object manipulation in children with hemiplegic cerebral palsy. II: Bilateral coordination

The present study examines the coordination of fingertip forces during object manipulation in both the involved and non‐involved hand of 14 children with hemiplegic cerebral palsy (CP) aged between 8 and 14 years. While no impairment could be observed in the non‐involved hand, subtle deficits in the sequencing of the grip–lift movement were observed in all children tested in this hand. However, they were able to scale the fingertip force output of the non‐involved hand in advance (use anticipatory control) based on the object's weight. In the second experiment in this paper, we tested whether the anticipatory control can be generalized across hands. The results indicate that sensory information from the non‐involved hand can be used for anticipatory scaling of isometric force increase during subsequent lifts with the contralateral involved hand. These findings suggest that the initial lack of anticipatory control usually observed in the involved hand of children with hemiplegic CP is likely to be based on disturbed sensory input.

Vocabulary of grips in children with hemiplegic cerebral palsy

Children with hemiplegic cerebral palsy are affected in their motor function on one side more than the other. Our focus here is on the functions of the hand, specifically examining grasp and manipulation in children with hemiplegic cerebral palsy. We concentrate on manipulation in functional settings across a range of tasks based on the classification of hand movements by Elliott and Connolly (1984) and a selection of the tasks from Brown et al (1987). The children were filmed performing the tasks, providing both qualitative and quantitative data, from which detailed information on the functional ability of each child was obtained. The value of such assessment procedures for physiotherapists and remediation in general is discussed.

幼児の手指操作における機能的左右非対称性

To examine functional asymmetry in children's manipulation, 103 right-handed subjects (4, 5 and 6-year-olds) were given the unimanual task which included both sequential and spatial factors. The main results were as follows: (a) Subjects performed better with their right hands for the sequential factor, and with their left hands for the spatial factor. (b) Left-hand predominance was observed in correct responses of both sequential and spatial factors. (c) Though all subjects were right-handed, different performances were shown by the groups of latent handedness measured by the Crossing-arms test. These results were interpreted as a reflection of functional asymmetry of the brain, and it was suggested that the developmental process of manipulation was different from that of handedness.

The Psychogenic Theory of History

With Archimedean exuberance, Lloyd de Mause and his colleagues in the Institute of Psychohistory are convinced that they have found place to stand-the Theory of History. They hope to move the earth by explaining how the unfolding of history can be related directly to the evolution of childhood acting through adult intrapsychic configurations. They see evolution (for the better) in both childhood and history illuminated by their theory which combines Darwinian and Freudian models. Their grand schematization posits six modes of childhood spanning recorded Western history: the Infanticidal, Abandoning, Ambivalent, Intrusive, Socializing, and Helping modes which are supposed to reflect the history of projection upon and manipulation of children by parents. Davis' book is an application of these ideas to American history from 1840 to I965. Drawing upon childrearing books published during this I25-year period and upon personal memoirs, diaries, and autobiographies of ordinary persons as well as the eminent, the book attempts to explicate four psychogenic submodes within the Socializing mode-Psychic Control, Aggressive Training, Vigorous Guidance, and Delegated Release. After an introduction to the Psychogenic Theory of History, Davis' book takes up, chapter at time, these four submodes. Psychic Control, lasting roughly from 1840 to 1880, is illustrated by Bronson Alcott's records of the upbringing of his daughters, and by the writings of Francis Wayland, an early nineteenthcentury president of Brown University. Psychic Control is a

Effect of Manipulation of Children's Affect on Their Family-Drawings

Summary Drawing pattern changes elicited following experimental manipulation of young children's self-esteem lent support to the notion that dynamic defensive processes are reflected in drawings. Some global drawing patterns previously identified were used to score drawings because of the primitive drawing skills of the 4- and 5-year-old Ss. Criticism of Ss' toy building capacity elicited drawing patterns of constriction-impoverishment; supportive comments during a play therapy session elicited expansion-improvement. Findings and observations were related to theory of cognitive-defensive style.

Children's Manipulation of Illusory and Ambiguous Stimuli, Discriminative Performance, and Implications for Conceptual Development

Children's Manipulation of Illusory and Ambiguous Stimuli, Discriminative Performance, and Implications for Conceptual Development

Differential Manipulation in Children

Differential Manipulation in Children