Stigmatizing effects of a child''s wheelchair in successive and simultaneous interactions

In Experiment I, each of 28 boys age 7 to 9 years was observedin two successive 15-minute playroom sessions. In each sessiona second boy (a confederate) was already in the room. This confederatewas either in a wheelchair (simulating handicap) or seated inan ordinary chair. The boys engaged in significantly more cooperativeplay in the session with the "nonhandicapped" peer and in apostexperimental interview significantly preferred this child.In the second session only, they spent significantly more timelooking at the "handicapped" peer. In Experiment 2, each of20 boys was observed in a single playroom session in the simultaneouspresence of the two confederates, one of whom was in the wheelchair.In this study boys spent significantly more time in cooperativeplay with the "nonhandicapped" child and significantly moreoften preferred this child. They spent significantly more timelooking at the "nonhandicapped" child, more time talking tohim, and made more movements toward this child. The resultsof both studies were interpreted in terms of Coffman 's conceptof stigma.     

The Assessment of Child and Adolescent Personality (Book)

Evaluated the psychometric properties of the Spanish version of the Parenting Stress Index (PSI), based on the responses of 223 Hispanic mothers. Alpha coefficients were comparable to those for the original PSI. A factor analysis of the 13 PSI subscales indicated that three factors rather than the original two-factor solution more meaningfully described the Hispanic data. This study is consistent with recent research with Anglo-American mothers suggesting that the dimensions of the PSI are better described by three factors: Child Characteristics, Parent Characteristics, and Child-Parent Interaction. Multivariate analysis of variance (MANOVA) indicated that in a Hispanic sample, mothers of handicapped children reported more parenting stress than mothers of nonhandicapped children. This study supports the cross-cultural utility of the PSI.     

Intelligence and achievement in children with myelomeningocele

Intelligence and achievement test scores for 89 children with myelomeningocele (MM), ages 4 to 14 years, were obtained from medical records. These children scored below the population average but within the normal range on most tests. The greatest deficits occurred on Performance IQ, arithmetic achievement, and visual-motor integration (copying geometric designs). With increasing age, these children fell further behind age-peers on tests of arithmetic and visual-motor performance while keeping pace on reading and spelling tests. We speculate that these findings may reflect a developmental difference between MM children and nonhandicapped children in a visual-perceptual-organizational cognitive function such as Rourke (1987) has proposed.     

Two families with Wilson disease in which siblings showed different phenotypes

We investigated two families with Wilson disease in which siblings showed different clinical phenotypes and different ages at onset. In Family 1, the second and fourth male children demonstrated onset of the neurological type of Wilson disease at 16 and 28 years of age, respectively, and the first female child developed the hepatic type at 38 years of age. In Family 2, the second male child showed neurological symptoms at 32 years of age and was diagnosed as having the hepatoneurological type of Wilson disease; then the 35-year-old first female child was found to have the hepatic type by familial screening. We performed mutation analysis of the ATP7B gene for these patients, and found that the mutation was a compound heterozygote in both families. Previous reports of siblings with Wilson disease have shown an identical clinical phenotype and similar ages at onset. In addition, hepatic-type cases generally occur at lower ages compared with the neurological type. In the present investigation, however, younger patients showed neurological symptoms earlier than their older siblings, and clinical phenotypes differed among siblings in both families. These cases appear to be rare. Individual differences in copper accumulation in hepatic cells and intolerance to copper toxicity might be the reason for this phenomenon. Furthermore, there might be a difference in the dominance of the allele expressing ATP7B protein among these cases, resulting in different clinical phenotypes, because all patients of both families were found to be compound heterozygotes. Received: May 9, 2002 / Accepted: July 19, 2002     

Fecal excretion of a novel human circovirus, TT virus, in healthy children

The role of TT virus (TTV) as a human pathogen is unclear, as is the mode of TTV transmission. To determine the prevalence of TTV infection and the possible fecal-oral route of transmission, we analyzed fecal specimens from 67 healthy, nontransfused children for TTV DNA sequences by heminested PCR, using the NG and T primer sets. The overall prevalence of TTV fecal excretion was 22.4% (15 of 67), with the T primer set (19.4%) being more sensitive than the NG primer set (10.4%). TTV prevalence based on gender or ethnicity showed no significant differences. None of seven children in the 0- to 6-month age group had detectable TTV in feces. Of three sets of siblings, two unrelated sets of twins, ages 33 and 37 months, were negative for fecal TTV DNA, while the third set of siblings, ages 99 and 35 months, was positive. The absence of TTV in the feces of children younger than 6 months and the high prevalence (40%) in children 7 to 12 months of age is consistent with age-specific acquisition of TTV infection by the nonparenteral route. TTV genotypes 1, 3, 4, and 5 were represented in our study population. TTV-positive siblings had TTV genotypes 1 and 4, suggesting unrelated environmental sources of TTV infection. This observation suggests a possible time frame for TTV acquisition in children which coincides with increased interaction with their environment and increased susceptibility to infectious agents.     

Dopamine transporter polymorphism associated with externalizing behavior problems in children

Early childhood externalizing behavior is a stable and heritable pattern of aggressive and delinquent behavior that often leads to the development of serious psychiatric disorders such as conduct disorder and attention deficit hyperactivity disorder. We examined the relationship between parent reported externalizing behavior (assessed at ages 4, 7, and 9 years) and the VNTR polymorphism of the 3' untranslated region of SLC6A3 (DAT1) in a community sample of 790 children ascertained as part of our longitudinal twin and adoption studies. We applied the sibling-based methodology developed by Fulker et al. [1999: Am J Hum Genet 64:259-267] for estimating allelic association with quantitative traits, while controlling for population stratification. An extension of these methods allowed for the inclusion of monozygotic twins, dizygotic twins, siblings, and singletons. We have demonstrated that the 9-repeat variant of the DAT1 is a significant risk allele for externalizing behavior at ages 4 (P=0.001) and 7 years (P=0.02). Although the effect size was negligible at age 9 (P=0.92), a formal test of the developmental decrease in effect across the three ages was non-significant (P=0.70).     

Fecal Excretion of a Novel Human Circovirus, TT Virus, in Healthy Children

The role of TT virus (TTV) as a human pathogen is unclear, as is the mode of TTV transmission. To determine the prevalence of TTV infection and the possible fecal-oral route of transmission, we analyzed fecal specimens from 67 healthy, nontransfused children for TTV DNA sequences by heminested PCR, using the NG and T primer sets. The overall prevalence of TTV fecal excretion was 22.4% (15 of 67), with the T primer set (19.4%) being more sensitive than the NG primer set (10.4%). TTV prevalence based on gender or ethnicity showed no significant differences. None of seven children in the 0- to 6-month age group had detectable TTV in feces. Of three sets of siblings, two unrelated sets of twins, ages 33 and 37 months, were negative for fecal TTV DNA, while the third set of siblings, ages 99 and 35 months, was positive. The absence of TTV in the feces of children younger than 6 months and the high prevalence (40%) in children 7 to 12 months of age is consistent with age-specific acquisition of TTV infection by the nonparenteral route. TTV genotypes 1, 3, 4, and 5 were represented in our study population. TTV-positive siblings had TTV genotypes 1 and 4, suggesting unrelated environmental sources of TTV infection. This observation suggests a possible time frame for TTV acquisition in children which coincides with increased interaction with their environment and increased susceptibility to infectious agents.     

Spina Bifida Children and Their Parents: A Population Prone to Family Dysfunction?

Spina bifida children of normal intelligence and their parentswere compared with a carefully matched control group of nondisabledchildren and their parents in a hierarchically oriented assessmentof individual, marital, and family functioning. Contrary topopular hypotheses that families with a handicapped child areespecially vulnerable to stress and psychological problems,results across all measures revealed no differences betweenthe two groups. Further, no differences were found between mothersand fathers on the various measures. These results support theview that nonretarded spina bifida children and their parentshave no special psychological characteristics that distinguishthem from nonhandicapped children and their parents. The findingsalso underscore the strengths and coping skills of handicappedchildren and their families. The tendency of researchers andclinicians to focus on the deviant aspects of these populationsmay obscure the fact that many may be adapting successfully.     

Physical work capacity and daily physical activities of handicapped and non-handicapped children

Summary In this study physical work capacity, mechanical efficiency on the bicycle ergometer and daily physical activities were compared between 24 physically handicapped and 24 non-handicapped children. As a measure of mechanical efficiency and physical work capacity, the oxygen uptake per kg body weight at 0.5 watt·kg^–1 and oxygen uptake per kg body weight at a heart rate of 150 beats·min^–1 were used. The daily physical activities were recorded during a 24-h period by means of a scoring list. The load imposed by the daily physical activities was investigated by registration of heart rate.The mean value of the physical work capacity of the group of handicapped children was found to be lower compared with the non-handicapped children. The mechanical efficiency of 7 of the 24 handicapped children was lower when compared with the mechanical efficiency of 23 of the 24 non-handicapped children. A significant correlation between mechanical efficiency and nature of the handicap (spastic hemi-, di-, tetraplegic) was found (p<0.05). During light daily physical activities the handicapped children showed the same mean heart rate as the non-handicapped children, but the mean heart rate during heavy daily physical activities was lower for the handicapped group than for the non-handicapped group. The non-handicapped children spent more time in physical activities with relatively high heart rates.From the results obtained of oxygen uptake and heart rate measurements it is to be expected that non-handicapped children are able to maintain a higher state of training by means of their daily physical activities than are handicapped children.     

Brief report: family-based group intervention for young siblings of children with chronic illness and developmental disability

OBJECTIVE: To evaluate the impact of a family-based group intervention for young siblings of children with chronic illness and developmental disability (CI/DD). METHODS: Forty-three healthy siblings (ages 4-7 years) of children with CI/DD and their parents participated in an intervention designed to address sibling challenges that cut across types of diagnostic conditions. The intervention consisted of six sessions of collateral and integrated sibling-parent groups. Measures of sibling knowledge, sibling sense of connectedness with other children in similar family circumstances, and sibling global functioning were collected before and after intervention. A subsample of 17 families completed a 3-month follow-up. RESULTS: Siblings' knowledge of the child's disorder and sibling connectedness increased significantly from pre- to posttreatment for both boys and girls, regardless of the nature of the brother or sister's condition. Sibling perceptions of self-competence increased from pre- to posttreatment, whereas parent reports of sibling behavioral functioning remained within the normal range. Improvements in sibling knowledge and connectedness maintained at follow-up. Parent satisfaction with the program was high. CONCLUSIONS: Results support more controlled evaluations of family-based intervention to improve young sibling adaptation to CI/DD.     

The cyclical nature of prepubertal growth

We have examined the complete longitudinal height velocity (HV) data of 135 (80 male and 55 female) chromosomally normal children from the edinburgh Longitudinal Growth Study who were measured six-monthly between age 3 years and the onset of the adolescent growth spurt. Individual HV curves appeared to consist of a regular series of accelerations and decelerations in a cyclical fashion. After excluding variations due to measurement error, and basing the analysis on the pattern of acceleration, we were able to identify a number of spurts of regular occurrence. The mid-childhood spurt was clearly identified at ages 7·0 in boys and 6·7 years in girls, and could be identified in all children except one girl. Other spurts were also apparent; a pre-school spurt at ages 4·8 and 4·6, a late-childhood spurt at ages 9·2 and 8·6, and in children with an average-to-late onset of puberty, a prepubertal spurt at ages 10·8 and 10·0 years in boys and girls respectively. Synchronization at peak HV was performed for each spurt as described by Shuttleworth (1937) for the adolescent growth spurt. The overall pattern of growth appeared to be cyclical with a mean peak interval of 2·2 years in boys and 2·1 years in girls, the cycles appearing to continue until interrupted by the onset of the adolescent growth spurt. Sitting height velocity (SHV) and leg length velocity (LLV) curves also showed a cyclical pattern, but each varied independently. The magnitude of the HV spurts in an individual was dependent on the synchrony between the phases of SHV and LLV spurts.

The cyclical pattern of prepubertal growth with its rapid changes in HV should be taken into account when assessing the growth of any child and in the response to any treatment offered.     

Secular changes in height and weight of Stockholm schoolchildren born in 1933, 1943, 1953 and 1963

Secular growth changes of Stockholm schoolchildren born in 1933, 1943, 1953 and 1963 were studied through samples of about 2500 children in each year. Heights and weights at the ages 7, 10 and 13 years were obtained from school health records stored in the Stockholm city archives. The increase in height and weight at these ages was more marked between the children born in 1933 and 1943 than later, except for the girls aged 7, who had no increase in height. The increase in height between the later samples was at age 7 years practically none, at age 10 years about 1 cm/decade and at age 13 years 1–2 cm/decade. The body mass index (BMI) indicated a continuous trend towards a slimmer body build for Stockholm schoolchildren at the age of 7 years. At the ages of 10 and 13 years the BMI remained fairly stable for the cohorts born from 1943 to 1963.     

Secular changes in height and weight of Stockholm schoolchildren born in 1933, 1943, 1953 and 1963.

Secular growth changes of Stockholm schoolchildren born in 1933, 1943, 1953 and 1963 were studied through samples of about 2500 children in each year. Heights and weights at the ages 7, 10 and 13 years were obtained from school health records stored in the Stockholm city archives. The increase in height and weight at these ages was more marked between the children born in 1933 and 1943 than later, except for the girls aged 7, who had no increase in height. The increase in height between the later samples was at age 7 years practically none, at age 10 years about 1 cm/decade and at age 13 years 1-2 cm/decade. The body mass index (BMI) indicated a continuous trend towards a slimmer body build for Stockholm schoolchildren at the age of 7 years. At the ages of 10 and 13 years the BMI remained fairly stable for the cohorts born from 1943 to 1963.     

Assessing Social Behaviors in the Visually Handicapped: The Matson Evaluation of Social Skills with Youngsters (MESSY)

The present investigation was divided into three studies aimed at establishing the reliability and validity of the Matson Evaluation of Social Skills with Youngsters (MESSY) with a visually handicapped population. Age, sex, and related variables also were evaluated. In Study 1, 75 severely visually impaired persons (ages 9-22) who were receiving services for the visually handicapped were evaluated. A number of adaptations to the scale (providing the in formation in large print and on audio cassettes) were made to insure that self-report as well as teacher-report data could be obtained. Internal reliability were all .78 or above on either the teacher- or self-report versions. Study 2 used the same population but aimed at evaluating the differences on various demographic variables of this visually handicapped sample. Age differences were not apparent but six differences and groupings by placement classroom showed significant differences. Visual acuity did not markedly effect differences in social behavior but this may have been due to the relatively severe visual impairments of all the persons studied. The final study compared children and youth matched on age and sex with a total sample of 45 visually handicapped and 45 non-handicapped persons. Analyses of variance showed several differences between these groups on social behavior. The implications of these findings and future directions for research are discussed.     

Examining the Effects of Chronic Disease and Disability on Children's Sibling Relationships

Research on siblings of children with a variety of developmentaldisabilities and major chronic illnesses was reviewed withinthe context of literatures on typical sibling relationshipsand family adaptation. Assumptions, questions, and methods guidingcurrent research were analyzed and critiqued. To date, studieshave addressed a narrow range of variables and issues-the detectionof maladjustment being the primary concern. Further, predominantreliance on more subjective and anecdotal research methods andfailure to control for confounding factors limit the value ofinvestigations. Certain popular beliefs and perceptions havegained support but others have not, in particular the assumptionthat siblings of handicapped and ill children experience morefrequent psychological disturbance. A variable matrix is proposedthat may help investigators identify relevant factors, avoidpotential confounds, and generate productive hypotheses andresearch designs.     

Networks of attention in children with the 22q11 deletion syndrome

The 22q11 chromosomal deletion syndrome (22q11 DS) is associated with learning disabilities and a complex neuropsychological profile. Previous findings have suggested that executive attention deficits might underlie other neurocognitive anomalies. We administered the child Attention Network Test (ANT) to 52 children ages 5.0 to 11.5, 32 22q11 DS children (19 girls) and 20 controls (13 girls) and assessed the efficiency of segregated executive, orienting, and alerting networks. We hypothesized that 22q11 DS children have impaired executive network efficiency as compared to control siblings. The internal validity of the child ANT was confirmed for this population. Analysis of variance results showed significant main effects for flanker and cue types and no interaction effect in either 22q11 DS children or control siblings. Compared to control siblings, 22q11 DS children had significantly larger (less efficient) executive network scores, significantly increased errors on only incongruent trials, and a significant correlation between executive network scores and accuracy. The implications of these findings for future neurocognitive studies of 22q11 DS children are considered.     

Incidence and case-fatality rates resulting from the 1998 enterovirus 71 outbreak in Taiwan

In 1998, an epidemic of hand-foot-and-mouth disease and herpangina caused by enterovirus 71 occurred in Taiwan, leaving many fatalities and severely handicapped survivors in its wake. The reasons this rather common pathogen would cause such a large-scale epidemic remain unknown. A seroepidemiological survey to elucidate the epidemiological characteristics of this outbreak, including its incidence and case-fatality rates was undertaken. Microneutralization tests for antibodies against enterovirus 71 were used to screen four collections of serum samples: 1) 202 specimens taken from individuals > or = 4 years old in 1994; 2) 245 specimens collected from individuals of all ages in 1997; 3) 1,258 specimens collected from individuals of all ages in 1999; and 4) sera samples from a birth cohort of 81 children who had yearly blood samples taken from 1988-98. After the maternal antibody had declined, the seropositive rates began to increase with age. Approximately half of all children aged 6 years or older were enterovirus 71 seropositive. Significantly higher seropositive rates were noted in 1999 than in 1997, in children aged 0.5-3 years. The incidence of enterovirus 71 infection during the epidemic was estimated to be 13-22%, with the higher rates in younger children. The case-fatality rate was highest (96.96 per 100,000) in infants aged 6-11 months, and declined in older children. The results showed that enterovirus 71 is endemic in Taiwan. The apparent lack of large-scale enterovirus 71 activity in the 3 years before 1998 might have been the prelude to the epidemic's appearance in 1998, and might suggest that enterovirus 71 infection will reappear every few years. The lack of a protective antibody in younger children may account for the high incidence and case-fatality rate in this age group.     

Networks of Attention in Children With the 22q11 Deletion Syndrome

The 22q11 chromosomal deletion syndrome (22q11 DS) is associated with learning disabilities and a complex neuropsychological profile. Previous findings have suggested that executive attention deficits might underlie other neurocognitive anomalies. We administered the child Attention Network Test (ANT) to 52 children ages 5.0 to 11.5, 32 22q11 DS children (19 girls) and 20 controls (13 girls) and assessed the efficiency of segregated executive, orienting, and alerting networks. We hypothesized that 22q11 DS children have impaired executive network efficiency as compared to control siblings. The internal validity of the child ANT was confirmed for this population. Analysis of variance results showed significant main effects for flanker and cue types and no interaction effect in either 22q11 DS children or control siblings. Compared to control siblings, 22q11 DS children had significantly larger (less efficient) executive network scores, significantly increased errors on only incongruent trials, and a significant correlation between executive network scores and accuracy. The implications of these findings for future neurocognitive studies of 22q11 DS children are considered.     

Reality Perceptions of Television: A Comparison of School-Labeled Learning-Disabled and Nonhandicapped Children

We administered the Stony Brook Videotest (SBV), a measure of reality perceptions of television programs and commercials, to 104 school-labeled learning-disabled (LD) children in self-contained classes and to 229 nonhandicapped elementary school children. The LD children scored significantly lower than the comparison group, even when IQ was controlled, indicating that LD children are less able to distinguish between reality and fantasy on television. The clinical implications of these findings and possible remedial actions are discussed.     

A t(1;22)(p13;q13) in four children with acute megakaryoblastic leukemia (M7), two with Down syndrome

We report four children with acute megakaryoblastic leukemia (AML-M7) and t(1;22)(p13;q13), two of them with Down syndrome; their ages were 7 months, and 6, 7, and 10 years. These findings differ from those reported in children with M7 and t(1;22) at the age of presentation (exclusively under 1-year-old) and in the two cases associated with Down syndrome (t[1;22],+21c) that may be due to the high heterogeneity of the chromosomal changes in children with AML. We cannot disregard ethnic difference distribution of chromosomal changes and age of presentation in Mexican children with AML.