Objective. To develop and validate a self- or parent-administered instrument for measuring functional status in children with juvenile rheumatoid arthritis (JRA).

Methods. We adapted the Stanford Health Assessment Questionnaire (HAQ) for use in children ages 1–19 years, by adding several new questions, such that for each functional area, there was at least 1 question relevant to children of all ages. The face validity of the instrument was evaluated by a group of 20 health professionals and parents of 22 healthy children. The questionnaire was then administered to parents of 72 JRA patients (mean age 9.1 years, onset type systemic in 16, polyarticular in 21, pauciarticular in 35).

Results. The instrument showed excellent internal reliability (Cronbach's α = 0.94), with a mean inter-item correlation of 0.6. The convergent validity was demonstrated by strong correlations of the Disability Index (average of scores on all functional areas) with Steinbrocker functional class (Kendall's tau b = 0.77, P 8 years) was 0.84 (n = 29; P 0.9 by paired t-test; Spearman's correlation coefficient = 0.8, P < 0.002).

Conclusion. The Childhood HAQ, which takes less than 10 minutes to complete, is a valid, reliable, and sensitive instrument for measuring functional status in children with JRA.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/art.1780371209

Measurement of health status in children with juvenile rheumatoid arthritis

Purpose : This review article examines the development of individualized meanings assigned to assistive technology and how these personal meanings influence the integration of assistive technology into daily activities. Methods : A review of the published literature regarding assistive technology use and abandonment was conducted by performing two independent searches using 26 search terms and three databases. Publications were reviewed for whether they addressed device use, device abandonment, coping, adjustment, adaptation, values, outcomes and/or cultural issues; 81 publications met these criteria. Results : The evidence suggests that psychosocial and cultural issues influence the shaping of individualized meanings assigned to assistive technology. Theoretical arguments suggest that the process of adapting to disability is another influential factor. Conclusions : The synthesis of evidence and theories suggests that successful integration of assistive technology into daily lives requires potential devi...

The shaping of individual meanings assigned to assistive technology: a review of personal factors.

This paper focuses on the identification and testing of potential psychosocial factors contributing to an integrated multivariate predictive model of occupational low back disability. Psychosocial predictors originate from five traditions of psychosocial research: psychopathological, cognitive, diathesis-stress, human adaptation and organizational psychology. The psychosocial variables chosen for this study reflect a full range of research findings. They were investigated using 253 subacute and chronic pain injured workers. Three outcome measures were utilized: return-to-work status, duration of disability and disability costs. The key psychosocial predictors identified were expectations of recovery and perception of health change. Also implicated, but to a lesser degree, were occupational stability, skill discretion at work, co-worker support, and the response of the workers' compensation system and employer to the disability. All psychosocial models were better at predicting who will return than who will not return to work.

Psychosocial factors predictive of occupational low back disability: towards development of a return-to-work model.

/pdf/on-the-origins-of-negative-attitudes-toward-people-with-30gekrlyju.pdf

On the Origins of Negative Attitudes toward People with Disabilities.

Little is known about the handicapping effect of epilepsy without other neurological deficits on an epileptic individual's life. The purpose of this study was to collect information on the occurrence of disabilities and handicaps in an unselected population sample of children, 4-15 years of age, and to compare the results with matched controls. The prevalence of epilepsy in the study population was 0.68% (143/21, 104). Time elapsed from last seizure was at least 1 year in 62.1% of the cases. There was marked neurologic comorbidity in the children with epilepsy; an accessory neurological deficit was found in 39.9%, the most frequent neurological impairments being mental retardation (31.4%), speech disorders (27.5%), and specific learning disorders (23.1%). A handicap was experienced in 20.7% of children with epilepsy only; i.e., with no other neurologic impairments, compared to 0.9% of matched controls. This means a 21.7-fold (95% CI, 6.3-74.5) risk of the occurrence of a handicap in children with epilepsy compared to controls. Orientation and social integration handicaps were significantly more frequent in children with epilepsy only compared to controls. Occurrence of communication disability, situational disability, or satisfactory to poor economic status of the family were the independent predictors of the occurrence of a handicap in children with epilepsy only.

Epilepsy in Children: Prevalence, Disability, and Handicap

Physical Disability and Human Behavior

Perceptual-motor Efficiency in Children

Movement and Spatial Awareness in Blind Children and Youth

Children with minor motor problems are often referred for evaluation of these problems to physical therapists who work in educational environments. Measures that therapists use to assess seriously disabled children are often inappropriate for these children. The Basic Gross Motor Assessment was developed after analyzing research on minor motor dysfunction. Standard procedures were outlined and a sample of 1,260 randomly selected children aged 5 years 6 months to 12 years 5 months served for norming purposes. Validity and reliability studies were completed with an additional 285 subjects. The Basic Gross Motor Assessment is presented as a useful tool for evaluating minor motor problems in children and identifying those children who require further physical therapy assessment and perhaps direct treatment.

Jeanne E. Hughes

Papers

Physical Disability and Human Behavior

Perceptual-motor Efficiency in Children

Movement and Spatial Awareness in Blind Children and Youth

Basic gross motor assessment. Tool for use with children having minor motor dysfunction.

Concept Development for Visually Handicapped Children: A Resource Guide for Teachers and Other Professionals Working in Educational Settings