Pediatric rehabilitation最新文献

Introduction: Use of a tracheostomy speaking valve allows the expiratory flow of air to exit over the vocal folds promoting phonation. The purpose of this retrospective review was to determine: (1) what percentage of trial candidates tolerated a speaking valve; (2) whether candidates achieved phonation with a valve; and (3) which secondary benefits (coughing ability, secretion management, swallowing/feeding and oxygenation) could be clinically observed.

Methods: Twelve cases of children and youth (ages 8 months to 21 years) evaluated for a tracheostomy speaking valve at an inpatient rehabilitation hospital were reviewed. A speech-language pathologist and respiratory therapist evaluated the children for valve tolerance and candidacy for ongoing use. Clinical observations were used to determine phonation ability and to examine potential secondary benefits.

Results: All 10 subjects who tolerated the valve achieved phonation. Vocalizations included audible crying, non-specific vocalizations, word approximations, single words and short phrases. Minimal-to-no improvement was noted for coughing, secretion management, swallowing and oxygenation with clinical assessment.

Discussion: With supervision and training, speaking valves can enhance communication options for children and youth with tracheostomies and oxygen and ventilator dependence. Physiological and functional secondary benefits were observed but were more difficult to assess.

Intrathecal baclofen is a cornerstone in the treatment of spasticity in children. However, further research is required to set criteria for treatment. This paper offers insight into the national act on baclofen and the experience at the Nottingham University Hospital.

It may take many years for published clinical research findings to be found, understood, adopted and applied in practice. In recognition of this delay, many jurisdictions and agencies are now promoting a stronger link between research and its dissemination in useable forms that will enable practitioners to access, understand and use new ideas. The purpose of this paper, first presented as a keynote address at the 15th Annual Meeting of the European Academy of Childhood Disability in Oslo in October 2003, is to share experiences of the author and his colleagues at a childhood disability system-linked research centre in Ontario, Canada. The lessons learned include the value of striving to describe one's findings in plain language; writing study reports for parents and children who are involved in research studies; using multiple methods to disseminate one's work; and making explicit the potential importance and applicability of the findings to readers of the work. Engaging end users at many stages of the development and field testing of one's work will enhance buy-in and lend added credibility to the work, as well as influencing content and process as the research unfolds. The result is likely to be greater recognition of 'familiar' aspects of the research and the adoption of relevant findings.

Marc-Hector Landouzy (1812-1864) was one of the first to describe facial paralysis in newborn, through a series of case studies. By examining these four cases in the context of Landouzy's life, publications and professional circumstances, this study shows how case studies were an important part of the scientific revolution within medicine in the 19th century. Landouzy, soon followed by others, used the growing clinical populations of Parisian hospitals, patho-anatomy and cutting-edge physiologic techniques to help describe a previously ignored disease among newborns. His case studies, in particular, are a valuable example of the emerging interest in children as a clinical population and of early interest in child neurology.

This paper provides a review of several critical issues and directions for research and practice, centred on children with multiple and severe disability, with special attention to the recent study of individual behaviour states as a measure of arousal and involvement. It notes several areas for future research and discusses educational interventions designed to improve the engagement of children, focusing on the central role of early intervention and human ecologies in supporting the achievement of positive educational outcomes for this population.

This paper describes an intervention aimed at empowering parents of child survivors of acquired brain injury (ABI) in their interaction with teachers and other professionals involved in their child's education. The particular characteristics of the late morbidity of child ABI led to the design of an intervention in the form of a video and informational booklet that is the property of the family. Early response to the intervention has been extremely positive, although formal evaluation has been unexpectedly challenging.

There is a need to understand the difficulties faced by those with autistic spectrum disorders (ASD) in educational settings if one is to manage and help them manage their learning. This paper explores some of the most pertinent problems that arise. It analyses perceptual, social, conceptual, emotional and memorizing barriers to learning and shows how difficulties in communication are exacerbated by educational language, which gives a poor model for those who have no prior understanding of inter-personal communication. The notion of an 'autism-friendly' environment is examined as is the process of how schools and other learning institutions might be helped to create such an environment. Education as entitlement is distinguished from education as therapy and the implications for inclusion are examined. It is argued that the best teaching arises from an empathetic understanding and a willingness to be flexible, the worst, from rigidity and an expectation that it is the child who must change. There is no single approach that can meet all the needs of those with ASDs, but nor are needs entirely determined by individual behaviour. It is the understanding of ASD that enables the teacher to correctly identify the child's learning needs and begin to meet them.

The aim of this study was to investigate the relationship between participation in school activities of students with disabilities and their school environment. Children and youths with disabilities rated their own participation in school activities while teachers and special education counsellors rated the student's school environment. Statistical methods used in this study were the Pearson's correlation coefficient and one-way-ANOVA. The results revealed that neither the amount of support given nor the general school environment was statistically related to students' participation. Further, the individual's specific environment, especially when rated as availability to activities by the students themselves, was related to students' participation. This might indicate that when investigating important environmental factors related to participation, students' own perceptions of his/her niches is important to investigate. The support students were given related more to type and number of disabilities than to students' participation.

Children with traumatic brain injury (TBI), regardless of the severity of the injury, often face challenges when living in home, school and community. Their needs are often overlooked and recognition of the long-term consequences is not always central to the management of the child in the school or community. This article provides references to pertinent literature and suggestions for intervention from the clinical experiences of four individuals with extensive experience of the family stresses, educational, cognitive-communicative and behavioural challenges that occur after TBI in children. It provides information regarding these issues, particularly educational situations, and suggests methods that may be useful for service providers and family members.