The relationship between form and space perception, constructional abilities, and clumsiness in children.

The Sensory Integration and Praxis Tests (SIPT) (Ayres, 1989) were administered to 21 children with learning disabilities and 18 children without learning disabilities, aged 5 to 8 years. The children with learning disabilities were divided into two groups, clumsy and nonclumsy, on the basis of their scores on the Test of Motor Impairment (Stott, Moyes, & Henderson, 1984). It was hypothesized that the learning-disabled children in the clumsy group would score significantly lower than the learning-disabled children in the nonclumsy group on the six SIPT subtests that measure form and space perception and visual construction and that the nonclumsy learning-disabled children, in turn, would score significantly lower than the non-learning-disabled children. It was further hypothesized that there would be a significant correlation between the degree of clumsiness and the degree of visual-perceptual and constructional deficits. An analysis of the data indicated that both groups of learning-disabled children scored lower than the non-learning-disabled children on four of the six SIPT subtests. The clumsy and nonclumsy children with learning disabilities, however, differed from each other on only two subtests. The degree of clumsiness correlated significantly with three of the six subtests. The results are discussed in terms of variations in perceptual and motor skills related to subtypes of learning disabilities.     

Nystagmus and ocular fixation difficulties in learning-disabled children

The visual fixation ability of learning-disabled children was evaluated after sensory integrative therapy had been administered for short or long periods of time. Children with hyporesponsive postrotary nystagmus displayed reduced oculomotor control skills, but the deficit was apparent only in those who had been in therapy for a shorter interval. These results present further support for the hypothesis that the learning disabled can be differentiated according to their nystagmus characteristics. In addition, very tentative evidence suggested that sensory integrative therapy may have been successful in ameliorating the fixation deficiency; however, further research into this possibility is needed. The data also indicate that oculomotor control dysfunction may be a mediating mechanism for at least part of the learning disabilities experienced by some learning-disabled children.     

Neuropsychological Assessment Following Concussion: an Evidence‐Based Review of the Role of Neuropsychological Assessment Pre- and Post-Concussion

Neuropsychological evaluation is one component of a comprehensive and multifaceted assessment following concussion. Although some neuropsychologists use a “hybrid” assessment approach integrating computerized neurocognitive testing batteries with traditional paper and pencil tests, computerized neurocognitive test batteries are the predominant testing modality for assessment of athletes from the youth to professional level. This review summarizes the most recent research supporting the utility of neuropsychological evaluation and highlights the strengths and weaknesses of both computerized and traditional neuropsychological testing approaches. The most up to date research and guidelines on baseline neurocognitive testing is also discussed. This paper addresses concerns regarding reliability of neuropsychological testing while providing an overview of factors that influence test performance, both transient situational factors (e.g., pain level, anxiety) and characteristics of particular subgroups (e.g., age, preexisting learning disabilities), warranting the expertise of an experienced neuropsychologist for interpretation. Currently, research is moving forward by integrating neuropsychological evaluation with emerging assessment approaches for other domains of brain function (e.g., vestibular function) vulnerable to concussion.     

The relationship between visual-perceptual motor abilities and clumsiness in children with and without learning disabilities

One visual-perceptual test, four visual-motor tests, and a test of motor impairment were administered to 22 children with learning disabilities and 22 children without learning disabilities, aged 5 to 8 years. The children with learning disabilities were divided into two groups--"clumsy" and "nonclumsy"--based on their scores on the motor impairment test. It was hypothesized that the clumsy children with learning disabilities would score significantly lower on visual-perceptual and visual-motor tests than the nonclumsy children with learning disabilities who, in turn, would score significantly lower than the children without learning disabilities. It was further hypothesized that there would be a significant correlation between the degree of clumsiness and the degree of visual-perceptual and visual-motor deficit. Analysis of the data indicated that, as expected, the clumsy children with learning disabilities scored significantly lower than the children without learning disabilities (the control group). There was no significant difference between the clumsy and nonclumsy children with learning disabilities or between the nonclumsy children with learning disabilities and the control group. Degree of clumsiness significantly correlated with scores on four of five tests. Results are discussed in terms of subtypes of learning disabilities and sample size.     

Religion and disability: clinical, research and training considerations for rehabilitation professionals

Purpose. This article (i) reviews existing research on the relationships that exist among spirituality, religion, and health for persons with disabilities; and (ii) compares different theoretical coping models (i.e., spiritual vs. psychoneuroimmunological).

Background. Over the past decade interest has increased in relationships among spirituality, religion, and health in both the mainstream media (e.g., Newsweek) and scientific literature (e.g., Koenig). In general, research has concluded that religion and spirituality are linked to positive physical and mental health outcomes. Most religion and health research has focused on populations with life-threatening diseases (e.g., cancer, cardiovascular disorders, AIDS) with minimal attention to persons with chronic, life-long disabling conditions such as brain injury, spinal cord injury, and stroke. However, religion is used by many individuals with disabilities to help them adjust to their impairments and to give new meaning to their lives.

Conclusions. Religion and spirituality are important coping strategies for persons with disabilities. Practical suggestions for rehabilitation professionals are provided regarding: (a) strategies to enhance religious coping; (b) methods to train rehabilitation professionals about religious issues; and (c) issues to consider regarding future research on rehabilitation and religion.     

Religion and disability: Clinical,research and training considerations for rehabilitation professionals

Purpose. This article (i) reviews existing research on the relationships that exist among spirituality, religion, and health for persons with disabilities; and (ii) compares different theoretical coping models (i.e., spiritual vs. psychoneuroimmunological).

Background. Over the past decade interest has increased in relationships among spirituality, religion, and health in both the mainstream media (e.g., Newsweek) and scientific literature (e.g., Koenig). In general, research has concluded that religion and spirituality are linked to positive physical and mental health outcomes. Most religion and health research has focused on populations with life-threatening diseases (e.g., cancer, cardiovascular disorders, AIDS) with minimal attention to persons with chronic, life-long disabling conditions such as brain injury, spinal cord injury, and stroke. However, religion is used by many individuals with disabilities to help them adjust to their impairments and to give new meaning to their lives.

Conclusions. Religion and spirituality are important coping strategies for persons with disabilities. Practical suggestions for rehabilitation professionals are provided regarding: (a) strategies to enhance religious coping; (b) methods to train rehabilitation professionals about religious issues; and (c) issues to consider regarding future research on rehabilitation and religion.     

Crossing the body midline in learning-disabled and normal children

The SVCU scores of 179 learning-disabled children, ages 5 to 8, were compared with the scores of 120 normal children, using both the actual Space Visualization Contralateral Use (SVCU) score, and the SVCU category of "normal, suspect, or possible deficit," in order to evaluate whether using guidelines to interpret the SVCU as a function of age enabled differentiation between normal children and children with learning disabilities. The SVCU measure clearly differentiated between groups at the younger ages, although the difference was not as clear for the older age groups. It was suggested that the SVCU score be used in conjunction with other observations of midline crossing. Alternative interpretations of the SVCU score are discussed.     

Reliability of the Southern California Postrotary Nystagmus Test with learning-disabled children

The Southern California Postrotary Nystagmus Test (SCPNT) provides an objective assessment of nystagmus. Although depressed nystagmus duration as measured by the SCPNT is considered a major sign of vestibular dysfunction in learning-disabled children, the reliability of the SCPNT with this population has not been established. To study reliability of nystagmus duration in this population, 89 learning-disabled children were evaluated with the SCPNT. The results demonstrated that this sample had significantly depressed scores and more variability in scores than normal children. Intrascorer and test-retest reliabilities, although statistically significant, were lower than those established with normal children. A test-retest study of the reliability of placing a child in a deviant duration range over time significantly reduced reliability estimates. Clinicians using nystagmus duration scores in the evaluation of vestibular dysfunction in learning-disabled children should be sensitive to the variation in this measure in this population.     

The effect of phonotactic constraints in German-speaking children with delayed phonological acquisition: Evidence from production of word-initial consonant clusters

In this study the effect of phonotactic constraints concerning word-initial consonant clusters in children with delayed phonological acquisition was explored. Twelve German-speaking children took part (mean age 5;1). The spontaneous speech of all children was characterized by the regular appearance of the error patterns fronting, e.g., Kuh“cow” /ku:/ →[tu:], or stopping, e.g., Schaf“sheep” /a:f/ →[ta:f], which were inappropriate for their chronological age. The children were asked to produce words (picture naming task, word repetition task) with initial consonant clusters, in which the application of the error patterns would violate phonotactic sequence constraints. For instance, if fronting would apply in /kl-/, e.g., Kleid“dress”, it would be realized as the phontactically illegal consonant cluster /tl-/. The results indicate that phonotactic constraints affect word production in children with delayed phonological developments. Surprisingly, we found that children with fronting produced the critical consonants correctly significantly more often in word-initial consonant clusters than in words in which they appeared as singleton onsets. In addition, the results provide evidence for a similar developmental trajectory of acquisition in children with typical development and in children with delayed phonological acquisition.     

The Neuropsychological and Neurobehavioral Consequences of ADHD Comorbid with LD and Otitis Media

The purpose of this study was to identify a possible subtype of attention deficit hyperactivity disorder (ADHD) comorbid with learning disabilities (LD) and otitis media (OM). Data collected from children with ADHD, LD and otitis media included: Wechsler Intelligence Scale for Children—III, Intermediate Visual and Auditory continuous performance test, neurobehavioral rating, neuropsychological testing, neurophysiological function, and school grades. Findings included deficits in: auditory processing, interpersonal relations, increased social stress, external locus of control, and academic impairment. Parents rated ADHD as mild despite high theta to beta ratios along with neuropsychological dysfunction. Increased severity of ADHD and LD was associated with OM. There may be a unique ADHD subtype with phonological processing deficits. Implications for auditory vs. visual information transmission are discussed. The data collected was obtained from the author’s dissertation completed at The Union Institute & University.     

Patterns of Time Processing Ability in Children with and without Developmental Disabilities

Background Children with developmental disabilities, e.g. intellectual disability or autism, are reported to have problems in time perception, time orientation or time management, i.e. in time‐processing ability (TPA). The aim was to investigate whether the problems described are diagnosis specific or reflect differences in age or in level of TPA. Methods Using a cross‐sectional design, this study investigated if there were different patterns of TPA in 5‐ to 10‐year‐old children with (n = 77) and without disabilities (n = 89). The results indicated that the patterns of TPA mainly follow the chronological age of children without disabilities, all clusters differing as regards levels of TPA. Daily time management (as estimated by the parents) and children’s self‐rated autonomy differed between clusters and was related to TPA. Conclusions The level of TPA seems to be a more valid overall base than the type of diagnosis for the planning of interventions in daily time management.     

基于ICF构建学习障碍儿童功能分析与运动康复方案研究

目的 应用《国际功能、残疾和健康分类》(ICF)对学习障碍儿童的整体功能特点进行分析,并制定个别化运动康复方案。方法 基于ICF的理论架构和ICD-11的疾病诊断,从儿童发展和成长的角度,对学习障碍儿童的认知、理解、注意和思维等功能进行分析,并根据“生物-心理-社会”的健康模式及身体活动的身心交互理论,构建针对学习障碍儿童以功能为导向的个别化运动康复方案。结果 学习障碍儿童的身体功能障碍集中表现在精神功能方面,在活动和参与方面体现为学习和应用知识、完成一般任务、与人交流等的活动受限和参与局限,且学校环境中的教育用品和技术及其服务、政策和体制等因素也都会影响学习障碍儿童。运动康复有利于学习障碍儿童改善精神和运动功能,并有效提升智力、认知、注意力、沟通、活动等能力,促进儿童全面发展。根据《WHO关于身体活动和久坐行为的指南》以及相关国家身体活动指南中针对儿童的部分,选取适合学习障碍儿童的运动方案,进行中等强度到高强度的身体活动至少每天60 min,以及每周不少于3次的高强度训练,配合适宜的体育游戏和休闲体育活动可有效改善学习效果,降低学习障碍影响。结论 运用ICD-11和ICF对学习障碍儿童的疾病、功能障碍和运动特点进行系统分析,基于身心交互作用理论和ICF的生物-心理-社会的健康模式,建立了整体康复和功能导向的运动康复方案,这些方案推荐每天进行至少60 min的中等强度身体活动,包括有氧运动和体育游戏等,以及每周至少3次且时长不低于30 min的高强度身体活动,包括肌力训练和体育竞赛等。结合儿童的学习障碍和运动功能特点,制定基于功能的个别化运动康复方案,可有效改善学习障碍儿童认知、注意和思维等功能,改善学习障碍,促进儿童的全面发展。     

儿童学习障碍原因及早期表现

目的儿童学习障碍是基本学习技能获得障碍,常常表现为学习困难和情绪行为异常,未经及时干预矫治者,易出现品行障碍、抑郁,甚至人格障碍、反社会行为.为此,回顾了儿童学习障碍原因及早期表现,阐明引起儿童学习障碍的常见原因、主要表现,进而寻求有效的方法进行早期诊断、早期干预.资料来源应用计算机检索PubMed数据库1985-01/2003-12期间的相关文章,检索词"Learning disabilities,Children,Survey documents",限定文章语言种类为英文,同时计算机检索中国期刊全文数据库、万方数据库1990-01/2003-12期间的相关文章,检索词"学习障碍,儿童,综述文献",限定文章种类为中文.资料选择对资料进行初审,纳入标准包括儿童学习障碍原因,学习障碍早期表现的随机对照实验以及关于学习障碍儿童的预后及矫治方法的文献.资料提炼共收集到25篇关于儿童学习障碍原因及早期表现的文献,其中16篇符合标准,其余9篇系重复实验.资料综合16篇包括3 132例学习障碍儿童均符合诊断标准.其中10篇文章调查了2 081例儿童学习障碍,发现其原因有遗传因素、脑功能失调、脑结构异常、脑损伤、外部环境影响;6篇文章分析1 051例学习障碍儿童的主要表现为阅读障碍、拼写和书写障碍、计算技能障碍、情绪和行为问题,提出学习障碍儿童的预后及矫治方法.结论儿童学习障碍迄今为止原因不明确,可能是内因和外因多种因素共同作用的结果,具体分为阅读障碍、拼写和书写障碍、计算技能障碍、情绪和行为问题,矫治关键在于早期诊断、早期治疗.     

The performance of learning-disabled and normal young men on the test of visual-perceptual skills

The present study explored the discriminative validity of the motor-free Test of Visual-Perceptual Skills (TVPS) as an assessment for adults. The subjects were 26 learning-disabled and 26 normal young men. Overall, the subjects with learning disabilities made significantly more errors and took significantly more time on the total TVPS than did the normal subjects. The group with learning disabilities demonstrated significantly lower accuracy scores on four of the seven subtests and longer time scores on five subtests. Discriminant analysis revealed that the time score for Visual Sequential Memory and the accuracy score for Visual Closure were the two subtest scores that best discriminated between groups and, together, were able to correctly classify 84.6% of the subjects. The TVPS total accuracy score for the subjects with learning disabilities significantly correlated with their overall performance IQ but not with their verbal IQ. Their TVPS total accuracy scores also correlated with scores on Block Design, but not with scores on the Object Assembly or Picture Completion subtests of the WAIS-R. The results seem to indicate that the TVPS is valid as an assessment of visual-perceptual functions for young adult subjects. Recommendations for further study were made.     

The relationship between occupational therapy and physical therapy test scores in children with learning disabilities.

Twenty-seven children with learning disabilities associated with perceptual deficits were studied in order to determine what relationship might exist between occupational therapy and physical therapy test scores. Intercorrelations were computed and multivariate models were developed for the occupational therapy test items. Numerous positive relationships were demonstrated between the two groups of test items, consistent with previous clinical and experimental data. One test, however, did not duplicate the other, and both are essential in the evaluation of the learning-disabled child with perceptual deficits. Negative correlations also emerged, which might have been caused by compensation for deficits.     

Evaluation of children with reading difficulties

Reading difficulties are common and are associated with poor long-term academic achievement. Evaluation of a child's developmental, educational, and family histories in conjunction with standardized screening tests (e.g., Ages and Stages Questionnaires, Parents' Evaluation of Developmental Status, Safety Word Inventory and Literacy Screener) can increase recognition of risk factors for reading difficulties. Validated, office-based, standardized screening tests and school-administered standardized achievement tests (e.g., California Achievement Tests, Iowa Tests of Basic Skills, Metropolitan Achievement Tests, Stanford Achievement Test) can be used to assess school-age children with reading difficulties. Reading difficulties in children often are caused by environmental and organic risk factors. However, many children have reading or learning disabilities and will have lifelong difficulties with reading despite adequate intervention. Children with substantial reading difficulties should receive a full educational assessment. There is good evidence that individualized instruction emphasizing increased phonologic awareness can have a favorable long-term effect on academic achievement.     

Systematic Review of Vocational Preferences on Behavioral Outcomes of Individuals with Disabilities

Assessing performance of individuals with disabilities in relation to their preferences is a method of determining the social validity of practices. The benefits of using vocational preferences on related behavioral outcomes of individuals with disabilities such as task completion, challenging behavior, and indices of happiness, have been explored through several studies. The purpose of this systematic review was to assess the effects of preference for certain vocational activities on performance outcomes for individuals with disabilities. A comprehensive search resulted in a total of 16 included studies. Studies were analyzed according to (a) participant characteristics (e.g., diagnosis, age), (b) setting, (c) work tasks, (d) service provider, (e) experimental design or observational method, (f) preference assessment method, (g) independent variable, and (h) outcomes. Studies were appraised with quality indicators for single-case research. While outcomes were primarily positive in support of incorporating preferred vocational conditions, quality indicators were generally lacking and there are numerous areas calling for future research.     

Self-Esteem of Children and Adolescents with Physical Disabilities: Quantitative Evidence from Meta-Analysis

Previous studies on self-esteem of young people with physical disabilities have yielded discrepant results. There is a need for the succinct synthesis of the studies to understand the relationship between physical disabilities and self-esteem. This study aimed to examine the effects of minor physical disabilities (e.g., clumsiness, developmental coordination disorder) on different domains of self-esteem, and major physical disabilities (e.g, cerebral palsy, spina bifida) on general self-esteem in children and adolescents. A total of 1984 young people from 13 studies were included in meta analyses. The effect of minor physical disabilities on the self-esteem of physical competence was large. Although the effects of minor physical disabilities on the global self worth, physical appearance, and social acceptance were moderate, the effect of major physical disabilities on the general self-esteem of young people was mild. Major physical disabilities do not seem to affect general self-esteem as much as minor physical disabilities do.