ABSTRACT
KIE: Two doctors urge the use of transplant procedures in the treatment of end stage renal disease in children for those children and families whose quality of life is apt to be improved by it but suggest restraint in those whose psychosocial status has demonstrated deterioration. They recommend that parents and physician work together with a child psychiatrist to explain medical problems to children and to translate their responses into the medical system of decision making; the option of no further treatment other than supportive care should be offered to children with extremely poor quality of life.^ieng
Subject(s)
Kidney Transplantation , Risk Assessment , Adaptation, Psychological , Child , Child, Preschool , Family , Humans , Marriage , Parental Consent , Quality of Life , Renal Dialysis , Stress, Psychological , Withholding TreatmentABSTRACT
Disorders of the gastrointestinal tract are common in children. Fortunately, many are short-lived, related to infection, food intolerance, or specific etiology. Those that persist or recur require greater attention on the part of the physician and can require psychiatric consultation. The frequency of consultation will depend in large part on the psychosocial sophistication and philosophy of care of the referring physician. When consulted, the child psychiatrist can complement the medical care by examination in greater detail of the psychosocial environment of the child, the family, and by psychiatric evaluation of the child. Formulation of these factors may then point the way to more helpful management of the child and treatment. The most serious problems, such as regional ileitis and ulcerative colitis, require not only collaboration of pediatricians and child psychiatrist, but surgeons as well if patients are to receive optimum care.
Subject(s)
Gastrointestinal Diseases/psychology , Anxiety, Separation/complications , Child , Child Psychiatry , Child, Preschool , Colitis, Ulcerative/psychology , Crohn Disease/psychology , Family , Female , Humans , Male , Peptic Ulcer/psychology , Peptic Ulcer/therapy , Pregnancy , Prenatal Exposure Delayed Effects , Psychotherapy/methods , Pyloric Stenosis/etiology , Referral and Consultation , Stress, Psychological/complications , Vomiting/psychologyABSTRACT
Recent research has highlighted the complexity of the battered child syndrome. Clinical experience suggests that treatment of troubled families is a long-term process, draining financial resources of agencies and emotional resources of professionals. The need to provide support and case consultation to professionals working in the area of child abuse and neglect evolved in the establishment, in 1968, of the Suspected Child Abuse and Neglect (SCAN) Program at Children's Hospital, Pittsburgh, Pennsylvania. This program provides an effective method of intervention through identification, consultation, referral and follow-up of at-risk families. Weekly meetings offer multi-disciplinary case coordination, treatment recommendations, and a channel of communication for representatives of community agencies. This paper traces the history and present status of the SCAN Program, as well as the role of SCAN as a force for change of community attitudes.
Subject(s)
Child Abuse/prevention & control , Community Health Centers/organization & administration , Family Therapy , Child , Humans , Male , Patient Care Team , Pennsylvania , Professional-Family RelationsSubject(s)
Toilet Training , Age Factors , Attitude of Health Personnel , Child Rearing , Child, Preschool , Humans , Infant , Infant, Newborn , Mother-Child Relations , PediatricsABSTRACT
The phonemic substitution errors of ten apractic speakers were analyzed to investigate the effects of markedness on speech production patterns. Results revealed that: more errors were produced on phonemes high in markedness; more changes in markedness were from marked to unmarked than unmarked to marked; and errors and directional changes in markedness were positively correlated with ease of articulation. The findings were interpreted as a systematic effort by the apractic speakers to reduce the complexity of articulatory gestures required to produce phonemes.
Subject(s)
Apraxias/complications , Articulation Disorders/diagnosis , Phonetics , Aged , Articulation Disorders/etiology , Child Language , Child, Preschool , Humans , Middle AgedSubject(s)
Phobic Disorders , Adult , Emotions , Environment , Female , Humans , Infant , Male , Phobic Disorders/therapySubject(s)
Accidents , Child Abuse , Child Rearing , Adoption , Child , Child Advocacy , Child Development , Child, Preschool , Child, Unwanted , Family Characteristics , Female , Foster Home Care , Humans , Infant , Infant Nutrition Disorders/etiology , Male , Psychotherapy , Stress, Psychological , SyndromeABSTRACT
Sixteen patients have been seen since 1956 at the Children's Hospital of Pittsburgh with a disgnosis of cyclic vomiting. Five of these patients were reverred for psychiatric consultation or treatment. Four of the 16 had laparotomies and no specific pathological condition was found; seven of the patients did not have surgery or psychiatric intervention. Descriptive follow-up is given for all patients, as well as various methods of handling the problem. The psychological conflicts were found to be parental anxiety, a prolonged symbiotic relationship with the mother, and the failure of the child to separate and individuate.
