Multiple Physical Disabilities Research Articles

개별차원의 긍정적 행동지원이 중복지체장애학생의 수업 관련 행동에 미치는 효과

개별차원의 긍정적 행동지원이 중복지체장애학생의 수업 관련 행동에 미치는 효과

ATHLETE IDENTITY AND COMMON BENEFITS AND BARRIERS TO SPORT PARTICIPATION AMONGST ADOLESCENT SLED HOCKEY PLAYERS

Background:The physical, psychological, and social benefits of sports participation in adolescents have been well reported in the able-bodied population. However, those with physical disabilities encounter many barriers to participating in sports, which limits access to these benefits. Additionally, due to their disabilities, these individuals are often not viewed as athletes by the general population and therefore may not identify as one themselves. Purpose:Our study seeks to use qualitative research techniques to identify the themes influencing adolescents’ participation in sled hockey and determine their identity as athletes. Methods:Cross-sectional qualitative interview. Our IRB approved study recruited athletes at sled hockey practices and tournaments where interviews were moderated and transcribed. Transcriptions were coded according to common themes mapped in Figure 1. Results:We surveyed 19 youth sled hockey players (range 10-24 years old, mean 15.3) with multiple physical disabilities, the most common diagnosis being spina bifida (14) (Table 1). Our qualitative analysis identified the most prevalent themes that influence participation in adaptive sports to be: social factors, intrapersonal factors, motivators to start sport, access, physical and mental health, and athletic identity (Figure 1).Initial motivators to start involvement included encouragement from parents, role models, adapted sports organizations, healthcare providers or personal interest in the sport itself. Despite the perceived medical and financial barriers, support from teammates and funding assistance in purchasing equipment facilitated continued involvement.Our population also reported many perceived benefits to continued participation in adaptive sports, each reporting “having fun” while playing a sport they “love”. Other benefits were connecting with friends of similar disabilities and capabilities, who encourage them, serve as role models, and make them feel included. Furthermore, the mentorship the coaches provide, pushing the athletes to achieve, creates an atmosphere of competitiveness and a feeling of physical and mental wellbeing. Ultimately, this competitive environment allows for formation of an athletic identity, reported by 18 out of the 19 interviewees. Conclusions:Despite encountering barriers to participating in a team sport that requires expensive equipment and travel and negotiating the limitations of physical disabilities requiring frequent medical procedures and time away from sport, the overpowering benefits of participation allow majority of our adolescent population to thrive and to identify as athletes. Among the main facilitators to continued involvement are mentorship and support from coaches and parents, comradery and competition, all which lead to physical and mental wellbeing and feeling of inclusiveness and accomplishment.Figure 1:Coding map illustrating the results of analysis: Themes and subthemes that influence participation in adaptive sports.

Nutrition assessment and geriatric associated conditions among community dwelling Iranian elderly people

BackgroundAlthough malnutrition risk is well documented in elderly care institutions, few studies have been conducted to address concerns regarding community-dwelling elderly people. This study has been aimed to describe the nutritional status and its related socioeconomic and geriatric factors in community-dwelling elders with malnutrition.MethodFor this study, a randomized sampling among people aged 60 has been done (n = 326). Information on nutrition status (full MNA) and health information, like cognitive status (MMSE), daily functional status (ADL and IADL scales) and frailty was obtained. Multiple logistic regression analyses have been carried out, in order to identify the association of demographical and clinical factors with malnutrition.Results28.1% of the participants suffered from poor nutrition. In the binary analysis, low MNA scores were associated with increasing age, female gender, lower education level, financial dependence, solitary life, poor self-rated health, multiple physical disabilities and chronic disease, polypharmacy, smoking, functional and cognitive decrease and frailty. In the final model of the multivariate analysis, living alone (OR:1.249,CI:1.105–2.620), multiple physical disabilities (OR:2.183,CI:1.246 ± 3..250) and chronic disease (OR: 2.148,CI:1.167–2.879) were independently associated with malnutrition. Also financial independency (OR:0.625,CI:0.233–0.938), functional ability on ADL (OR:0.536,CI:0.327–0.976) and IADL (OR:0.319,CI:0.194–0.856), normal cognitive (OR:0.456,CI:0.293–0.934) and no frailty (OR:0.253,CI:0.117–0.729) independently were inversely associated with malnutrition. The model was adjusted for all socio- demographic and health variables that were significantly related in the previous models.ConclusionsOur results indicated a strong correlation between malnutrition and health status. Identifying predictive factors can potentially improve prevention and management strategies used for malnutrition in elderly.

Independent walking and balance in children with CHARGE syndrome

Children with CHARGE syndrome (CWCS) are born with multiple physical disabilities, several of which impair balance and the onset of motor milestones. Early motor development problems can include delayed independent walking, which has been found in CWCS. In addition, few studies have examined balance in CWCS and these studies have been limited in scope, necessitating a more comprehensive examination of balance in this population. Motor development occurs as a progression of stages as represented by Seefeldt’s conceptual model. As such, it is essential to examine the association of early development of foundational skills, such as balance, with the onset of motor milestones as they are building blocks to motor competence. The aims of this study are to (1) examine the differential effects of children with and without CHARGE syndrome on balance and (2) examine the association of age of walking to these balance measures. In this study, 27 CWCS and 22 children without CHARGE syndrome, aged 7 to 16 years, were assessed on four components of balance including anticipatory control, reactive postural control, sensory orientation, and dynamic gait using the shortened version of the Balance Evaluation Systems Test (mini-BESTest) and parental reported age of independent walking. Their balance and age of walking were compared to 22 typically developing peers of similar age and gender distribution. Results revealed that CWCS walked three times later than their peers without CHARGE syndrome and had significant deficits on all balance systems assessed with the largest difference occurring in anticipatory control. Anticipatory control is critically important in maintaining static and dynamic postural control. These results indicate a critical need for early functional balance training and compensatory strategies in CWCS.

A Study of Switch Skills Instructional Model for Students with Severe and Multiple Physical Disabilities

A Study of Switch Skills Instructional Model for Students with Severe and Multiple Physical Disabilities

A Qualitative study on school curriculum implementation for students with severe and multiple physical disabilities - Focused on elementary schools -

A Qualitative study on school curriculum implementation for students with severe and multiple physical disabilities - Focused on elementary schools -

Effects of combined special education treatment and occupational therapy on upper extremities motor skills in adult patients with hemiplegia

Background/Aim. Stroke is the most common single cause of severe and multiple physical disabilities, and rehabilitation that reduces functional deficits is the most effective treatment. The aim of this study was to determine the effect of special education treatment as a supplement to occupational therapy on upper extremities motor skills in adult patients with post stroke hemiplegia. Methods. Standard education tests for motor function evaluation of the upper extremities: O`Connor, Ring and Hand grip test, were applied on a sample of 64 patients who were in the process of rehabilitation in the Clinic for Rehabilitation ?Dr. Miroslav Zotovic? in Belgrade. After the evaluation, all the participants were included in occupational therapy and divided in two intervention groups per 32 subjects each. The patients from the first experimental group received individually dosed special education treatment which was performed for at least 12 weeks as a supplement together with occupational therapy, while patients from the second experimental group were only in the process of occupational therapy without special education treatment. At the end of the study the same tests were used to re-evaluate the level of motor abilities of the patients in both groups. Results.The patients from the first experimental group with individually dosed special education treatment as a supplement showed significantly better scores after applying the treatment in all tested variables ? explosive, static and dynamic muscular strength grip fist, as well as oculomotor skills at the level of the elbow and shoulder for both healthy and paretic hand. Conclusion. On the basis of the obtained results, it can be concluded that special education treatment added to occupational therapy lead to better performing of upper extremities motor skills and that it can be a good supplement to conventional occupational therapy methods and techniques.

The Effects of AAC Intervention Using Eye Tracking for Students with Multiple Physical Disabilities

The Effects of AAC Intervention Using Eye Tracking for Students with Multiple Physical Disabilities

Problématique de la tenue de tête chez l’enfant polyhandicapé avec hypotonie globale : proposition de différentes modalités d’appareillage à partir d’un cas clinique

General hypotonia in children with multiple physical disabilities leads to difficulties in postural head control, of which risks are orthopaedic and functional (food ingestion in the bronchial system, respiratory disorders, etc.). Based on clinical observation we will reflect on the features and indication of the equipment to best reduce cervical hypotonia. By means of a clinical case, we will describe several methods of postural head control with their respective benefits and drawbacks, in order to improve the function: dynamic headrest, partial head hanging, helicoidal headrest and chin strap.

Respecting Children with Disabilities—and Their Parents

In 2004, the parents of six-year-old Ashley, who has profound cognitive disabilities, asked Seattle Children's Hospital to provide three unusual procedures that aimed, not at treating an illness, but at improving the child's and her parents' quality of life. The parents argued that by attenuating Ashley's growth with high-dose estrogen, they would keep her easy to lift and move, and thus readily integrated into their loving family life. By removing Ashley's uterus, they would spare her the distress associated with monthly bleeding that girls with cognitive disabilities can experience especially intensely, as well as remove the possibility of impregnation by a sexual predator. And by removing her breast buds, they would reduce the chances of breast cancer, which runs in the family, and minimize discomfort from the harness needed to lift her in and out of bed. (1) The Ashley case prompted heated debate about acceding to parental requests for medical treatment to cope with non-medical problems. Children like Ashley cannot share in decision-making. The parents have to choose, relying on their understanding of what is best for their child and family. To gain a sense of how various their views can be, it helps to listen to competent children with physical disabilities talk about their experiences. The more I have listened to them, the more I have come to grasp the (in retrospect unsurprising) diversity of views they have about using medical means to achieve social purposes. It has made me ever more committed to the boring but fundamental ideal of truly informed decision-making. Refusing and Requesting Interventions Over the years, many of the people I have spoken with have said things much like what therapist and disability rights activist Harilyn Rousso said when she described growing up with multiple physical disabilities: [My mother] made numerous attempts over the years of my childhood to have me go for physical therapy and to practice walking more normally at home. I vehemently refused all her efforts.... My disability, with my different walk and talk and my involuntary movements, having been with me all of my life, was part of me, part of my identity. With these disability features, I felt complete and whole. My mother's attempt to change my walk, strange as it may seem, felt like an assault on myself, an incomplete acceptance of all of me, an attempt to make me over. (2) (emphasis added) Ms. Rousso argued powerfully that her disabling features were part of her identity. She was not going to change her body to reduce anyone else's discomfort. I am not proud to confess that when I first heard people with disabilities say such things, I practiced some armchair psychoanalysis: Yes, yes, that's very nice. You say that the problem is social responses to your disability, not your disability. But let's be honest; you're in denial. The more I heard people like Ms. Rousso say that the most difficult thing about having a disability was the way temporarily able-bodied people like me treated them, however, the more I began to take them at their word. I became convinced that if, after a process of truly informed decision-making, someone with a disability refuses the use of medical means to improve her social experience, then there is no good alternative to respecting her decision, no matter how surprising I might find it. Frankly, however, showing respect in this way didn't turn out to be a stretch. I love the idea of learning to let healthy bodies be. I'm naturally inclined to prefer changing minds with words to changing bodies with scalpels. Using social means like words requires us to engage each other and reminds us that we are the sort of animals whose minds can change with the giving and taking of reasons. As wonderfully efficient as they can be, medical means can emphasize our growing understanding of ourselves as mechanisms to be fixed. …

The Inclusive City: Design Solutions for Buildings, Neighborhoods and Urban Spaces

Children, Youth and Environments Vol. 18 No. 2 (2008) ISSN: 1546-2250 The Inclusive City: Design Solutions for Buildings, Neighborhoods and Urban Spaces Goltsman, Susan and Iacofano, Daniel (2007). Berkeley, CA: MIG Communications; 493 pages. ISBN 9780944661314. The Inclusive City is a guide to creating public buildings, green spaces, streets and neighborhoods with positive social impacts, edited by two founding principals in the firm of MIG, which has a long history of designing and facilitating projects of this kind. With text, drawings and many color photographs, it shows how cities can be inclusive for all ages, all abilities, all income levels, and how the people who use and inhabit places can participate in their design and creation. An opening chapter by the editors on “The Challenge of Our Cities” gives a brief history of the idea of “cities for people” and presents a vision of how cities can function as healthy and inclusive habitats for all community members. It is followed by 14 case studies which demonstrate how this vision can be realized, with detailed information on the design and planning process as well as outcomes in the form of new buildings, transformed parks and streets, and revitalized neighborhoods. It closes with an 80-page section on “Inclusive Design Guidelines,” which distills lessons from the case studies and other projects. This section by itself is worth the purchase of the book, but the book as a whole is a useful and attractive celebration of buildings and places that enhance the lives of all people who use them. Because the book’s topic is inclusive cities, every chapter is relevant for the creation of multigenerational community settings. In addition, a number of chapters focus on settings for children. Susan Goltsman describes the design of three institutions that serve children: Edelman Children’s Court in Los Angeles in the chapter “Helping Children Heal,” Tule Elk Park Child Development Center in “Bringing Nature into the 290 Urban School,” and St. Coletta of Greater Washington, D.C., a school for children with mental retardation, autism and multiple physical disabilities, in “Expanding the Learning Environment.” In “Combining Community Facilities,” she writes with Susan McKay about the design and program of the Edison School in Glendale, California, an elementary school that functions as a community focal point, open 15 hours a day and seven days a week. In “Growing Caring Children,” Robin Moore describes Explore! A Child’s Nature—the renovated and reinvented children’s zoo at the Brookfield Zoo in metropolitan Chicago, which has become a model for promoting connection with the natural world among young children and their families. All of these chapters demonstrate how institutions’ philosophies, policies, programs and places function can together to treat children as full-fledged community members whose comfort, engagement and inclusion matters. Reviewer Information Chawla, Louise Louise Chawla is a professor in the College of Architecture and Planning at the University of Colorado. ...

Working with Clients with Learning Disabilities and Multiple Physical Handicaps: A Comparison between Hospital and Community Based Therapists

This comparative study looked at hospital and community based occupational therapists who worked with clients with learning disabilities and multiple physical handicaps. The factors that were examined were the time spent by occupational therapists with this group, the interventions that were used, and the learning support that was needed for the therapists. Information was gathered from questionnaires and semistructured interviews. The results showed a distinct difference between the two groups of occupational therapists, with remedial activities being the focus in the hospital setting and functional activities in the community. Most of the respondents felt that they had not had either sufficient education at college or sufficient support when they started their service. A change in role from therapist to consultant was found in those working in the community and this group also placed more emphasis on keeping up to date with developments in this specialist field.

The search for molecular defects in genetic disease.

In most wealthy industrialized countries, socioeconomic circumstances, hygiene and medical care have improved to such an extent that perinatal complications and congenital disorders have become the major causes of infant mortality and of chronic handicap in children [1].In the past four decades, we have made impressive advances understandig the cytogenetic and molecular basis of congenital disorders. Dozens of syndromes associated with multiple physical handicaps and mental retardation have been related to specific numerical or structural chromosome aberrations. In situ hybridization and the development of a rapidly increasing number of DNA probes enable the detection of chromosomal abnormalities with a resolution down to the level of a single gene. The discovery of tumor-associated chromosomal aberrations, microdeletions, more than a hundred oncogenes, and the cloning of tumor suppressor genes are illustrations of the importance of molecular cytogenetics.When I started my scientific career at the end of the fifties, some 1,000 syndromes were proven or suspected to be subject to Mendelian inheritance and this number has now increased to more than 6,600 [2]. Progress in elucidating the protein defects responsible for these single gene disorders has been much slower and currently about 400 protein defects have been delineated [3]. This knowledge has been important not only for basic research on biochemical pathways and cell biology, but has also provided new perspectives for early laboratory diagnosis of index patients, carrier detection, genetic counseling and in some instances, such as phenylketonuria, for newborn screening and early treatment [4]. In those instances where a protein defect is also expressed in cultured skin fibroblasts, amniotic cells or chorionic villi, prenatal diagnosis becomes possible for couples at increased risk [5, 6].

Personal health record for school children with multiple needs.

Children with severe learning difficulties in special schools often have multiple physical disabilities. Their case notes are frequently bulky. Many professionals are involved in their care and information on the child is seldom readily available or accessible. A concise, regularly updated Personal Health Record given to the child or carer would overcome these problems and allow for timely and appropriate care to be provided.

Book Reviews

Counselling in Child Disability: skills for working with parents Implementing the Whole Curriculum for Pupils with Learning Difficulties Supporting Visually Impaired Students in Further Education Children's Gardening Taking Control: Enabling People with Learning Difficulties Autism: a guide for parents and professionals Learning for Life: A pack to support learning opportunities for adults who have profound intellectual and multiple physical disabilities

The provision of ophthalmic services for a rehabilitation day care centre population with multiple physical handicaps

The provision of the wide variety of support services necessary for patients with multiple handicaps is often poorly coordinated. In this study a group of 108 adults, aged from 19 to 90 years, who suffered from multiple physical handicaps and attended a rehabilitation day care centre, had their visual functions and requirements assessed by a multidisciplinary team. The programme consisted of five stages. Each patient was initially screened and subsequently referred for more detailed optometric, ophthalmological, low vision or rehabilitation assessments, where appropriate. Results indicated that many of the patients had not been receiving regular ocular assessments and would benefit from the provision of an optical appliance or ophthalmological treatment. The survey provided staff at the rehabilitation centre with information on the visual status of individual patients and enhanced general eye-care awareness.

The provision of ophthalmic services for a rehabilitation day care centre population with multiple physical handicaps

The provision of ophthalmic services for a rehabilitation day care centre population with multiple physical handicaps

The provision of ophthalmic services for a rehabilitation day care centre population with multiple physical handicaps

The provision of ophthalmic services for a rehabilitation day care centre population with multiple physical handicaps

Computers Star in New Communication Concepts for Physically Disabled People

WORKING HAND in glove, some engineers and scientists concerned with the communication problems of people with multiple physical disabilities have come up with innovative solutions to the challenge posed by persons who are both deaf and blind. Other creative individuals have thought of a way to help people who retain hearing and vision but are incapable of movement. Tapping the functions that remain is what scientists and engineers attempt to do when they design devices for use by persons with physical losses. This is difficult enough when a sensory loss, sight or sound, is involved; when people have multiple disabilities, finding a way to help them compensate is an even more daunting task. At the recent meeting of the American Association for the Advancement of Science, in San Francisco, Calif, researchers described new approaches to meeting these input-output challenges through computer-assisted technology. Here is what the developers of Dexter, the

Neuro-developmental Problems in Children in Riyadh, Saudi Arabia: 1-Year's Experience in a Family Practice Centre

Neurological and developmental problems were diagnosed in 100 children aged from 1 month to 11 years during 1984 and 1985, out of 1716 children who presented for pediatric consultation. The total number of children seen at the centre by the physicians for that year was 28401 out of 75600 patients of all ages. The ethnic groups and nationalities were varied; 73 per cent were natives; 23 per cent were non-natives mostly from the Middle East, North Africa, and Asia, usually of social classes III–IV. The 100 children included 65 per cent females and 35 per cent males. The diagnostic problems were the following: 23 per cent had cerebral palsy; 18 per cent had psychological and/or psychosomatic problems and disorders of vegetative functions; 17 per cent had non-organic failure to thrive (FTT); 14 per cent presented with congenital malformations; 8 per cent with hydrocephalus; 2 per cent with epilepsy; 20 per cent with miscellaneous conditions. The aetiology of cerebral palsy was prenatal in 21.7 per cent, perinatal in 8.6 per cent; postnatal in 21.7 per cent; mixed factors in 4.3 per cent; unknown in 43.4 per cent In 16 patients (69.5 per cent), there was a positive family history and/or consanguinity; 12 of these patients were natives: 4 per cent had multiple physical handicaps and/or mental retardation. Cerebral palsy was of the spastic type in 69.5 per cent, with a higher incidence in females 56.5 per cent. Except for the higher incidence in females, the high incidence in consanguinity and the positive family history, the findings are similar to those described in the literature.