RESUMEN
Autism is a neurobiological disorder that compromises ability to communicate and can be accompanied by anxiety, particularly for those in unfamiliar settings with unknown people. To improve communication, children with autism often relate well to pictures; however the literature describes no studies of picture schedules for patients with autism in medical settings. Our pilot project demonstrates how picture schedules for medical settings can relieve anxiety in children with autism and suggests that this approach should be employed as an innovative way to interact with patients with autism.
Asunto(s)
Ansiedad/prevención & control , Recursos Audiovisuales , Trastornos Generalizados del Desarrollo Infantil/enfermería , Cooperación del Paciente , Educación del Paciente como Asunto/métodos , Niño , Trastornos Generalizados del Desarrollo Infantil/terapia , Pruebas Diagnósticas de Rutina/psicología , Estudios de Factibilidad , Humanos , Iowa , Simulación de Paciente , Fotograbar , Examen Físico/psicología , Proyectos PilotoRESUMEN
BACKGROUND: The prevalence of childhood obesity in the US has increased considerably over the last few decades and continues to increase. To monitor the progress of patients enrolled in weight management programs, clinicians need accurate methods of detecting changes in body composition (percent body fat) over time. The gold standard method, hydrodensitometry, has severe limitations for the pediatric population. OBJECTIVE: This study examines the reliability of air-displacement plethysmography (ADP) in detecting percent body fat changes within obese children over time. METHODS: Percent body fat by ADP, weight, and body mass index (BMI) were measured for eight obese children aged 5-12 years enrolled in a weight management program over a 12-month period. These measurements were taken at initial evaluation, 1.5 months, 3 months, 6 months, and 12 months to monitor the progress of the subjects and detect any changes in these measures over time. Statistical analysis was used to determine the reliability of the data collected. RESULTS: The reliability estimate for percent body fat by ADP was 0.78. This was much lower than the reliability of BMI, 0.98, and weight measurements, 0.99. The low reliability estimate of ADP indicates a large standard error of measurement by this method. CONCLUSION: The measurement error of ADP is large, and in our study, ADP measured changes in percent body fat that far exceeded levels of true change that would have been clinically useful and important to detect. Hence, this method yielded change measures that did not allow meaningful clinical interpretations and often did not reflect true differences in status across time. ADP is not a reliable method for detecting changes in percent body fat over the time intervals employed within this study of obese children.
RESUMEN
PURPOSE: To describe the routine health maintenance needs of individuals with Down syndrome who have specialized health needs associated with the multi-system impact of the diagnosis. DATA SOURCES: Review of scientific literature including peer-reviewed articles, books, and online resources. CONCLUSION: In addition to the routine health maintenance needs of all persons, those with Down syndrome have specialized needs. Failure to address these specific health maintenance concerns may lead to misdiagnoses and failure to reach the highest level of function possible. IMPLICATIONS FOR PRACTICE: Patients with Down syndrome who have legitimate, treatable diagnoses may be misdiagnosed as having behavior problems or dementia. Failure to identify abnormalities such as cardiac problems or sleep apnea may shorten life and interfere with ability to live life to the fullest.
Asunto(s)
Síndrome de Down/terapia , Manejo de Atención al Paciente , Adolescente , Adulto , Niño , Preescolar , Susceptibilidad a Enfermedades , Síndrome de Down/complicaciones , Femenino , Humanos , Lactante , Recién Nacido , Discapacidad Intelectual/rehabilitación , Salud Mental , Guías de Práctica Clínica como Asunto , EmbarazoRESUMEN
It can be very difficult to get a complete history and review of systems for children with developmental disabilities and poor communication skills. In addition, many children with developmental disabilities may engage in self-injurious or aggressive behavior. Although the causes of inappropriate behavior are frequently environmental, physiologic components may exist as well, particularly pain or discomfort. History taking must be focused and specific and may need to focus on the child's behavioral patterns, because the child may not have sufficient communication skills to describe his or her problem and parents or guardians may not realize the relevance of certain behaviors. Gastrointestinal problems in particular may be a source of discomfort and should be reviewed with particular care. Referral to a psychologist who is able to perform a functional analysis of behavior may be necessary to treat problem behavior, especially if medical causes have been ruled out.