- Email: [email protected]
Educational achievement in non-verbal children: Are they learning disabled?
284 of detection, referral, first appointment and hearing-aid fitting and of the severity of their hearing impairments on spoken language and communication were the foci of the study. Children were aged between 27 and 80 months with hearing threshold levels ranging from 32 to 98 dB in the better ear. All were audio- and video-taped in their own homes, in an unstructured play setting with the mother. Measures of expressive language ability were extracted including mean length of utterance, vocabulary size, words per min., total utterance attempts per min., proportion of non-verbal utterances and the proportion of questions asked by the child. No significant correlations were found between the children’s hearing impairments and their scores on the language measures once age at interview had been statistically controlled. However, significant correlations were found between the language measures and the ages at which the children received intervention for their hearing impairments, in particular for vocabulary and those language measures denoting the rate and quality of the child’s interaction during the episode recorded. This finding is consistent with some of the arguments to be found in the small body of data addressing the question of early intervention.
Educational achievement in non-verbal children: Are they learning disabled? Fisher W.; Burd L. BRAIN DEVELOP. (1991) 13/6 (428-432) From a data-base of all nonspeaking children in North Dakota we analyzed the data on those children functioning above the retarded range to determine the prevalence of children meeting the main inclusion criteria for learning disabilities (LD), a severe discrepancy between IQ and achievement. The mean IQ for this group of 38 nonspeaking, nonretarded children of 104.0 was significantly higher than IQ equivalent scores in the academic subjects of reading (66.4), math (70.4), written language (65.2), and spelling (71.2). Using a stringent criterion for an IQ-achievement discrepancy of 2 standard deviations, 27 of 38 (71%) met this criterion in at least one subject. Academic subjects dependent upon higher linguistic functioning, written language and reading, were more affected than spelling and math. While the vast majority (73%) of these 38 children were deaf, the prevalence of IQ-achievement discrepancies was also found in 57% of the nonspeaking children without hearing impairments. These data suggest the common practice of excluding a diagnosis of a learning disability in a deaf child on the basis of the child’s hearing impairment may not be appropriate. Further research is needed on the role of speech in academic achievement.
Controversies in the management of pediatric facial fractures Bartlett S.P.; DeLozier J.B. III CLIN. PLAST. SURG. (1992) 19/l (245-258) The treatment of pediatric maxillofacial fractures demands consideration of different factors than those in the adult and, therefore, a different therapeutic approach. We currently believe that certain principles in the management of these injuries can be outlined, recognizing that they may require modification as additional experience accumulates. These management principles are as follows: 1. Maintain a high index of suspicion for maxillofacial injury in the pediatric patient, especially when multiple trauma exists. 2. In addition to careful physical examination, utilize CT scanning on a routine basis, even for apparently trivial injuries. 3. Give consideration to observation only for minimally displaced fractures. 4. Respect the functional matrix and employ the least invasive surgical approach that will access the fracture and allow stable reduction. 5. Employ methods of fixation that adequately stabilize the facial skeleton without rigidly immobilizing long segments. 6. If rigid internal stabilization is necessary, in the form of conventional plate and screw fiiation, give consideration to interval removal. 7. Microplates appear to provide enough stability so that their use can be advocated whenever possible. 8. Avoid the use of alloplastic materials, especially in the very young patient. 9. Use bone grafts sparingly, except in instances in which inlay reconstruction is necessary and onlay reconstruction is required to maintain soft-tissue support. 10. Be aware of the pediatric dentition and avoid iatrogenic injury to evolving teeth and tooth buds. Perhaps the most important principle of all is to document injuries and their method of treatment and to follow patients serially. This will allow further definition of fracture patterns and the effects of injuty and its treatment on growth, thereby giving the surgeon a better understanding and ability to develop more concise treatment philosophies for the future.
Educational achievement in non-verbal children: Are they learning disabled? Fisher W.; Burd L. BRAIN DEVELOP. (1991) 13/6 (428-432) From a data-base of all nonspeaking children in North Dakota we analyzed the data on those children functioning above the retarded range to determine the prevalence of children meeting the main inclusion criteria for learning disabilities (LD), a severe discrepancy between IQ and achievement. The mean IQ for this group of 38 nonspeaking, nonretarded children of 104.0 was significantly higher than IQ equivalent scores in the academic subjects of reading (66.4), math (70.4), written language (65.2), and spelling (71.2). Using a stringent criterion for an IQ-achievement discrepancy of 2 standard deviations, 27 of 38 (71%) met this criterion in at least one subject. Academic subjects dependent upon higher linguistic functioning, written language and reading, were more affected than spelling and math. While the vast majority (73%) of these 38 children were deaf, the prevalence of IQ-achievement discrepancies was also found in 57% of the nonspeaking children without hearing impairments. These data suggest the common practice of excluding a diagnosis of a learning disability in a deaf child on the basis of the child’s hearing impairment may not be appropriate. Further research is needed on the role of speech in academic achievement.
Controversies in the management of pediatric facial fractures Bartlett S.P.; DeLozier J.B. III CLIN. PLAST. SURG. (1992) 19/l (245-258) The treatment of pediatric maxillofacial fractures demands consideration of different factors than those in the adult and, therefore, a different therapeutic approach. We currently believe that certain principles in the management of these injuries can be outlined, recognizing that they may require modification as additional experience accumulates. These management principles are as follows: 1. Maintain a high index of suspicion for maxillofacial injury in the pediatric patient, especially when multiple trauma exists. 2. In addition to careful physical examination, utilize CT scanning on a routine basis, even for apparently trivial injuries. 3. Give consideration to observation only for minimally displaced fractures. 4. Respect the functional matrix and employ the least invasive surgical approach that will access the fracture and allow stable reduction. 5. Employ methods of fixation that adequately stabilize the facial skeleton without rigidly immobilizing long segments. 6. If rigid internal stabilization is necessary, in the form of conventional plate and screw fiiation, give consideration to interval removal. 7. Microplates appear to provide enough stability so that their use can be advocated whenever possible. 8. Avoid the use of alloplastic materials, especially in the very young patient. 9. Use bone grafts sparingly, except in instances in which inlay reconstruction is necessary and onlay reconstruction is required to maintain soft-tissue support. 10. Be aware of the pediatric dentition and avoid iatrogenic injury to evolving teeth and tooth buds. Perhaps the most important principle of all is to document injuries and their method of treatment and to follow patients serially. This will allow further definition of fracture patterns and the effects of injuty and its treatment on growth, thereby giving the surgeon a better understanding and ability to develop more concise treatment philosophies for the future.