Social/sexual awareness of persons with autism: A parental perspective

A parental survey that addressed the social sexual awareness, sex education, and sex behaviors of persons with autism, a developmental disability is provided. Questionnaires from 100 caregivers of persons with autism 9 years of age and older and with the DSM-III-R diagnosis were analyzed. Eighty-five percent of respondents were mothers, 8% both parents, 5% fathers, and 2% others; 32% of the persons with autism were female and 68% male with an age range of 9.1 to 38.9 years. The verbal level of the person with autism related to parents' beliefs about the relevance of sex relations (² = 6.99, p < 0.05) and sex education (² = 22.91, p < 0.001). No relationship between parents' report of the verbal level of the individual and the display of inappropriate sexual behaviors was found (² = 2.56, ns). Parents of males were more concerned about their son being taken advantage of by a same-sex person (² = 15.90, p < 0.001); parents of females were worried about an opposite-sex person (² = 4.06, p < 0.05). Parental concerns and beliefs regarding sexuality varied and could not be generalized. The nonsignificant finding regarding verbal level and display of inappropriate sexual behaviors suggests that the need for sex education is best determined by the behaviors of the person rather than the functioning or verbal levels.     

Heparin-induced extracorporal low-density-lipoprotein precipitation (H. E. L. P.) to improve the recovery of hearing in patients with sudden idiopathic hearing loss

The pathogenesis of sudden hearing loss (SHL) is still not well understood. Possible causes include increased blood viscosity, microthrombosis or altered blood flow. Hypercholesterolemia, hyperfibrinogenemia and increased platelet aggregation are frequently observed in patients with SHL. The aim of this study was to investigate whether drastic lowering of plasma cholesterol and fibrinogen by selective extracorporal apheresis could have a beneficial effect on hearing recovery in these patients. Seven patients with SHL were treated with an extracorporal procedure removing fibrinogen and cholesterol from plasma. Six of the seven patients showed an immediate improvement in auditory thresholds following a single treatment of heparin-induced low-density lipoprotein precipitation. These findings indicate for the first time that acute and drastic removal of plasma fibrinogen and low-density lipoproteins may be an effective clinical method for the treatment of patients with SHL. Received: 19 February 1999 / Accepted: 6 May 1999     

Guidelines on the diagnosis of noise‐induced hearing loss for medicolegal purposes

These guidelines aim to assist in the diagnosis of noise‐induced hearing loss (NIHL) in medicolegal settings. The task is to distinguish between possibility and probability, the legal criterion being ‘more probable than not’. It is argued that the amount of NIHL needed to qualify for that diagnosis is that which is reliably measurable and identifiable on the audiogram. The three main requirements for the diagnosis of NIHL are defined: R1, high‐frequency hearing impairment; R2, potentially hazardous amount of noise exposure; R3, identifiable high‐frequency audiometric notch or bulge. Four modifying factors also need consideration: MF1, the clinical picture; MF2, compatibility with age and noise exposure; MF3, Robinson's criteria for other causation; MF4, complications such as asymmetry, mixed disorder and conductive hearing impairment.     

Etiology of individual differences in reading performance: A test of sex limitation

To test the hypothesis that the etiology of individual differences in reading performance differs in males and females, reading performance data from twin pairs tested in the Colorado Learning Disabilities Research Center were fitted to structural equation models of sex limitation. The sample included 513 pairs of twins in which at least one member of each pair has a positive school history of reading problems [228 monozygotic (MZ), 176 same-sex dizygotic (DZ), and 109 opposite-sex DZ pairs] and 302 matched control pairs [148 MZ, 98 same-sex DZ, and 56 opposite-sex DZ pairs]. Estimates of the genetic correlation between performance in males and females were obtained by analysis of data from both same-sex and opposite-sex twin pairs (Neale and Cardon, 1992). The full model fit the data well ²=17,74, df=16,p=0.340), and the resulting genetic parameter estimates were highly similar in males and females in both the proband and the control samples. The correlations between genetic influences in males and females do not differ among groups (change in ²=0.95, df=1,p0.25), and the resulting pooled estimate is about .5. Thus, results of this analysis suggest that the etiology of individual differences in reading performance may differ to some extent in males and females.     

人眼眩光失能测定及其临床意义

目的:观察国产仪器测定眩光失能的性能与规律,并讨论其临床意义。方法:采用MGT—1多功能视觉眩光测试仪(海军医学研究所研制),按规定方法操作。测定正常人30名56眼(矫正视力全部≥1.0,晶体透明,无其他明显眼病),晶体混浊患者15人27眼。测定目标亮度及眩光亮度设置为中—中及弱—中两档分别模拟白天及夜间眩光失能。结果:中—中状态下,眩光失能值正常人均值为9.22%(全距0～31),低于晶体混浊者(24.05%,全距9～67),两者差异显著。正常眼在弱—中状态眩光失能值较中—中状态明显(均值20.12%,全距0～56)。不同频率条件对正常及晶体混浊眼眩光失能的影响不同,低频及中频较高频区的影响明显。结论:作为视功能评论指标,眩光失能检查是一种实用方法。在眼科临床及人体工效学上具有重要的意义。     

The functional restoration approach for chronic spinal disability

The functional restoration approach to treating chronic spinal disability consists of a medically directed, interdisciplinary team approach to physical reconditioning and a cognitive-behavioral crisis intervention procedure for dealing with related psychosocial problems. One- and two-year follow-up studies have demonstrated the clinical efficacy of this approach. The present article describes this approach and summarizes the research documenting its success in treating patients with chronic spinal disability. This article also highlights the pitfalls in misunderstanding and misrepresenting the components of the functional restoration approach when evaluating treatment efficacy.     

Thoughts about encounters between nondisabled and disabled peers: Situational constraints,states-of-mind,valenced thought categories

This study explores three issues: thoughts and feelings of individuals with and without physical disabilities concerning encounters in different situations, ways of grouping self-statements into valenced categories, and use of states-of-mind (SOM) ratios as an alternative to positive and negative thought frequencies. Data from 127 able-bodied and 46 physically disabled college students indicate that, in everyday social encounters, nondisabled individuals' thoughts and feelings were more negative, while those of disabled individuals were more negative when helping was involved and when encounters centered on the impairment. Thus, problematic encounters between people with and without disabilities may be due to the reactions of individuals with disabilities in situations which involve help, and to reactions of able-bodied persons in everyday contexts. The data also confirm the utility of SOM ratios as an alternative to valenced frequencies in cognitive assessment: SOM scores discriminated groups when situational demands were manipulated and scores were linearly related to criterion measures. However, SOM ratios differed dramatically, depending on the attentional focus of thoughts. The findings illustrate types of thoughts which occur during interaction between people with and without disabilities, demonstrate a simple technique for grouping thoughts into valenced categories on an empirical basis, and highlight the relative contribution of cognitive and affective elements to overall valenced scores. Implications for research on assessment of self-statements are discussed and recommendations are made concerning programming to facilitate the social integration of people with disabilities.This research was supported by grants to the first author from the Social Sciences and Humanities Research Council of Canada and from Fonds F.C.A.R. pour l'aide et le soutien à la recherche. Thanks are due to Meribah Aikens, Maria Barile, Leo Bissonette, Bosco Daude, Jim Dubois, Lillian Fox, Evelyn Gold, Naomi Goodz, Darlene Judd, André Leblanc, John Martos, Sue McKenzie, Irwin Slopak, and Joan Wolforth for their assistance with various stages of this investigation.     

Synaptic connections of the auditory nerve in cats: relationship between endbulbs of held and spherical bushy cells

This report focuses on a class of large synaptic endings, the endbulbs of Held. These endings are located in the anteroventral cochlear nucleus and arise from the axons of type I spiral ganglion neurons. Axons were stained with horseradish peroxidase (HRP) using intracellular injections of single fibers or extracellular injections into the auditory nerve. Individual endbulbs or pairs of endbulbs that converged onto the same spherical bushy cell were examined with the aid of a light microscope and subjected to morphometric analyses. Endbulbs of fibers having low spontaneous discharge rates (SR, less than or equal to 18 spikes/sec) have a more complex shape than those of high SR fibers (greater than 18 s/s), a feature represented by systematic differences in endbulb silhouette perimeter without differences in endbulb silhouette area. Consequently, the ratio, silhouette area divided by silhouette perimeter, yields a "form factor" separating endbulbs of high SR from those of low SR. High SR fibers had ratios greater than 0.52 (mean = 0.63 +/- 0.09), whereas low SR fibers had ratios less than 0.52 (mean = 0.45 +/- 0.06). Pairs of endbulbs with unknown physiological properties had similar form factor values, despite the wide range of values observed in the endbulb population. These data imply that endbulbs converging upon the cell body of a spherical bushy cell arise from fibers of the same SR group. Electron microscopic examination was conducted on the endbulb of one physiologically characterized and intracellularly stained auditory nerve fiber (CF = 1.4 kHz; SR = 55 s/s) and its unstained endbulb mate with the aid of serial ultrathin sections. In addition to the well-known axosomatic synapses, these endbulbs formed axodendritic synapses: 11.7% for the HRP-labeled endbulb and 13.3% for the unlabeled endbulb. The axodendritic synapses appear to occur on dendrites of nearby spherical bushy cells and may represent a mechanism whereby single endbulbs can disperse activity to multiple neurons in the cochlear nucleus. We propose that axosomatic synapses preserve fiber SR groupings, whereas axodendritic synapses may not.     

Unusual presentation of a giant glomus tumor

Giant glomus tumors pose a challenge to the Otologist by virtue of their location and vascularity. A vast majority of them present with tinnitus, conductive hearing loss and cranial nerve palsies. We report the case of a 16-year-old male patient who presented with sudden right-sided sensorineural hearing loss. This is an unusual presentation of a giant glomus tumor. We present the clinical features and management of this unusual case.     

Objective assessment of auditory thresholds in noise‐induced hearing loss using steady‐state evoked potentials

Objective assessment of auditory thresholds in noise‐induced hearing loss using steady‐state evoked potentials The purpose of this study is to evaluate whether steady‐state evoked potential (SSEP) can be used for objective estimation of auditory thresholds in patients with noise‐induced hearing loss (NIHL). Eleven subjects (22 ears) with a characteristic audiometric notch between 3000 and 6000 Hz participated in this study. Both pure‐tone thresholds and SSEP thresholds were obtained for each ear of all subjects. The correlation of SSEP thresholds and pure‐tone thresholds was assessed. The results show that SSEP thresholds predicted pure‐tone thresholds with correlation coefficients (r) of 0.86, 0.92, 0.94 and 0.95 at 500, 1000, 2000 and 4000 Hz respectively. Typically, the SSEP thresholds overestimate the pure‐tone thresholds by 10–20 dB, but they closely reflect the configuration of the audiogram. The strength of the relationship between SSEP and pure‐tone thresholds increased with increasing frequency and increasing degree of hearing loss. In conclusion, SSEP can be used as a reliable and objective tool to assess auditory thresholds in patients with noise‐induced hearing loss with high‐frequency dips.