Clinical Utility of CERAD neuropsychological battery in elderly Jamaicans

Information on the clinical utility of neuropsychological tests in non-North-American samples is limited. We examined the diagnostic efficacy of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropsychological battery in Jamaican men and women age 65 and older. A total of 72 elders were diagnosed as normal and 12 were demented based on history, physical, and neurological examination, participants were tested with the CERAD battery. Normal controls scored significantly better than dementia patients on all tests in the CERAD battery. A discriminant function found that a combination of Word List Learning Sum Recall and Boston Naming Test correctly classified a total of 81 percent of the cases (83 percent of the dements and 81 percent of the normal controls). This study is the first to demonstrate thr clinical utility of the CERAD neuropsychological battery in the differential diagnosis of memory disorders of the aged in a non-North-American sample.(Au)

The prevalence of childhood disability and related medical diagnosis in Clarendon Jamaica

In a population-based survey in a defined area in the parish of Clarendon, Jamaica, the prevalence of six types of childhood disabilities was sought. All children aged 2-9 years who screened positive for disability, with 8 per cent of children screening negative (out of a total of 5,468 children), were assessed by a physician and a psychologist. Disabilities were categorised by types and levels of severity. The estimated prevalence rate for all types and levels of disabilities was 93.9 per 1,000 children and for serious disability was 24.9 per 1,000. The rates for specific disabilities showed wide variation (cognitive, 81/1,000; speech, 14/1,000; visual, 11/1,000; hearing, 9/1,000; motor, 4/1,000; seizure, 2/1000). Of the disabled children, 70 per cent had only one disability, 23 per cent had two and 6 per cent had three or four disabilities. If disability is to be seen as a major outcome of a range of interacting factors, then these prevalence rates, taken with the specific aetiologies, would provide a framework for planning preventive and rehabilitative interventions. (AU)

A comparison of efficacy of the key informant and community survey methods in the identification of childhood disabilities in Jamaica

A comparison of the efficacy of the key informant and the community survey methods for identifying children with disability was carried out in the Jamaican component of an international epidemiological study of children disability. Approximately 130 key informants were exposed to a two-day workshop giving information on sign of disability, aspects of the project, and available services. Questionnaires were given to enable the informants to refer children and they were reminded six months later. In the survey method, eight community workers completed a house-to-house survey of all families and administered the 10-question screen with probes on 5475 children, 2 to 9 years old. Seventeen referrals were made by the key informants; of these, two were found to have disabilities. Of the 821 children who tested positive on the 10-question screen on the house-to-house survey, 193 had disabilities. We concluded that the key informant method would not be a satisfactory way of identifying cases of childhood disability. (AU)

Psychologically disturbed children: a comparative analysis of three clinic populations

This paper has focused attention on the large proportion of school-age children who are at risk of developing psychological/psychiatric problems which require immediate action on a nation-wide basis. The data presented suggested that certain factors have been operative in contributing to the client population of child guidance clinics. These factors are (a) a possible shift in parental attitude towards the understanding of mental ilness,(b) a decrement in threshold tolerance to the child's psychological problems, and (c) a comparatively better school guidance service in the Kingston area. It would seem, therefore, that separation experience per se is not sufficient to explain the size of the Child Guidance population. The UHWI data did not support the findings of feldman and Marriott (1967) in that more females than males showed anti-social behaviour. However, Greenfield (1974) pointed out that preliminary data from CRH Child Psychiatry Clinic indicated that more females than males expressed anti-social behaviour. This trend seen in Jamaica, is different from that observed in the United States and Great Britain. The question arises as to whether Jamaican parents, in respect to certain behaviour patterns, are less tolerant towards their pre-adolescent and adolescent female children than males. The answer to this will have to await further investigation. As for the diagnostic categories represented in the sample, the major problem is not one of assessment and diagnosis, but of treatment and prognosis. It is of interest to note that psycho-therapy as compared with pharmaco-therapy was more significantly utilized at the UHWI Child psychiatry Clinic Xý = 23.17;d.f = 1; p<0.01). This trend was also observed at the two other Clinics. However, the acute shortage of staff time available for each client at the Comprehensive Clinic at CRH is such that successive appointments may be two or more weeks apart. Therefore, the intensity of treatment may fall below optimal levelc