[Family development conditions of autistic children before foster home care: a comparison with families of hyperkinetic, emotionally disturbed and antisocial children]. / Familiale Entwicklungsbedingungen von autistischen Kindern vor Heimaufnahme: Ein Vergleich mit Familien von hyperkinetisch, emotional und dissozial gestörten Kindern.

With reference to psychogenetic autism models a retrospective study investigates, if autistic children more frequently than children with other disturbances grow up in a family-environment, which is characterized (a) by deficits in emotional warmth and (b) by a relatively high educational and occupational status of parents. The parallel group study is based upon a sample of 112 children, who had been referred to a residential facility for psychiatric care. The hypothesis concerning deficits in emotional warmth is not confirmed. As to occupational status of parents however, comparative findings meet hypothetical expectations. Supplementary comparisons show, that autistic children had been exposed to parental overprotection more often and also not infrequently to ineffective behavior control.

[Differential results of treatment in pedagogic-therapeutic long-term intervention in residential treatment centers for children]. / Differentielle Behandlungsergebnisse bei pädagogisch-therapeutischer Langzeitintervention im Kinderheim.

In a longitudinal evaluation study the developmental progress of 223 children, who have been treated between 1968 and 1987 in a residential facility for psychiatric care, was explored from referral until time of discharge. Initial state and state at discharge were defined multidimensionally according to MAS. Comparisons between children with different initial clinical diagnosis met expectations, that introversive disturbances recover more frequently than autistic as well as conduct disorders or hyperactivity. Associations between recovery and initial cognitive-intellectual state did not reach statistical significance, when type of disorder was controlled for. But rate of recovery appeared to be throughout higher for children with learning disabilities than for children without such deficits. Age at onset and age at referral were apparently rather irrelevant for the state at discharge. But rate of recovery was in general clearly reduced, when length of time between onset and referral had been above average. The relation between duration of treatment and state at discharge depended on the type of disorder. For children with conduct or autistic disorders the rate of recovery increased with longer duration of treatment, whereas for children with introversive disturbances the contrast was true. This could suggest confounding effects of severity of disorder. When the treatment in the facility had been precociously terminated, rate of recovery in general was remarkably lower than in case of a planned termination. Analysis on effects of alternative methods of treatment was only with restrictions possible and did not suggest a general or differential superiority of a special type of treatment.

Indication of different forms of therapy in long-term in-patient treatment.

The contribution presented attempts to demonstrate disturbance characteristics in children who are used in practice as differential indication criteria in the choice between medical-pedagogical and psychotherapeutic methods of treatment. 171 of a total of 238 children in a medical-pedagogical/psychotherapeutic children's home were examined; these children were discharged between the foundation of the institution in 1968 and July 1987. Apparently, the presence of a partial performance weakness, a hyperkinetical/development-dependent or dissocial disturbance as well as a disturbance of the central nervous system can be regarded as indicators for medical-pedagogical measures, the diagnosis of a neurotic/emotional disturbance as well as at least average intelligence level as indication criteria for an analytical child therapy. The disturbance conditions found correspond with the indicators for a medical-pedagogical and/or psychotherapeutical treatment described in specialist literature. Moreover, the success quota was compared with the remission rate known in child psychiatric practice.

[Relation of intelligence and the pathogenesis of various psychological disorders in children]. / Beziehungen zwischen Intelligenz und Pathogenese unterschiedlicher psychischer Störungen im Kindesalter.

In a study on 5- to 13-year-old children referred to a residential facility for psychiatric care we explored the interrelations between intelligence on the one hand and onset of manifest behavior problems and clinical diagnosis on the other. We controlled statistically for confounding effects of parental occupational status and the children's sex. There was a statistically significant association between type of disorder and level of intelligence. When intelligence was above average, neurotic and emotional disturbances as well as some other syndromes that are generally considered to have a good prognosis dominated. In contrast, average or below-average intelligence frequently coincided with more enduring types of syndromes such as conduct disorders. The level of correlation between age at onset and IQ depended on the type of disorder. For the children with neurotic/emotional syndromes or conduct disorders, the lower the IQ the earlier the age of onset and initial referral. But this did not hold for children with autism, hyperactivity or certain developmental disorders. The results are tentatively interpreted as supporting the position that cognitive competence acts as a protective factor in emotional development.

Termination of long term treatment in a residential home: quotas, conditions and additional comments.

The method of discharge of 235 children from a pedagogic-psychotherapeutic children's home between 1968 and 1987 was examined. The centre of interest were the terminations by the parents (13% of all discharges) and those brought about by the home itself (8%). The latter were partly those falsely admitted, some of these developed complications during a later stage in the treatment. The results indicate that the terminations by the parents were independent of age on admission, sex of the child and the type of disturbance involved. It was, however, noticible that parents of children with autistic disturbances and multiple partial performance deficiencies did not require early termination. An increase in parental termination was shown where individual limitations of parent-child contact were implemented. Terminations by the home showed a systematic relationship to certain contraindications to institutionalized conditions of treatment. The introduction of parental participation in particular lead to a dramatic decrease in the total of all terminations.

[Comparative description of the clientele of an educational psychotherapeutic home for children with behavior disorders]. / Vergleichende Klientelbeschreibung eines heilpädagogisch-psychotherapeutischen Heimes für verhaltensauffällige Kinder.

Two groups of children who were taken in care during two different periods (each of five years) by a psychotherapeutic institution are compared in respect to the multi-axial classification system and demographic variables. Each group consists of 80 children. Comparisons were made to check propagated preconceived ideas about aggravation of clientele. The number of social behavior disorders, of specific developmental retardation, social and familial adversities, age by residential placement, level of intelligence did not change. Significant decrease was found in the number of earlier non-familial placement, significant increase in the number of children with minimal brain dysfunction. The findings are discussed and the necessity of basic documentation accentuated.