Post-traumatic stress symptoms in childhood brain tumour survivors and their parents.

OBJECTIVES: This study aimed to investigate post-traumatic stress symptoms (PTSS) in childhood brain tumour survivors and their parents. A further aim was to explore the relationship between objective illness parameters, parent-child interactions, coping styles and PTSS. METHODS: A cross-sectional correlational design was employed. Fifty-two childhood brain tumour survivors, aged 8-16, and 52 parents completed a battery of questionnaires designed to assess quality of parent-child interactions, monitoring and blunting attentional coping styles and PTSS. RESULTS: Over one-third (35%) of survivors and 29% of their parents reported severe levels of PTSS (suggestive of post-traumatic stress disorder 'caseness'). Increased parent-child conflict resolution for survivors and number of tumour recurrences for parents independently predicted the variance in PTSS. CONCLUSIONS: For a substantial proportion of brain tumour survivors and their parents the process of survivorship is a considerably distressing experience.

Behaviour problems in retarded children with special reference to Down's syndrome.

Data were collected, using interviews with parents and teachers and rating scales, concerning the behaviour of two groups of mentally retarded children: 193 children with Down's Syndrome (DS) and 154 children with a similar degree of handicap were identified in the same schools. The proportions of children who had high scores on the Rutter or an additional behaviour check list, were similar in the two groups. Deviant behaviour was markedly more common in both sets of retarded children than in their siblings next in age; 31% of the children with DS and 29% of controls were judged to be well adjusted, while 38% of the DS children and 49% of the controls had significant behaviour disorder. Conduct disorders were most common in the children with DS. 'Psychosis' was the most common diagnostic label in the control group, but was also found in the children with DS.

Family background of children with Down's syndrome and of children with a similar degree of mental retardation.

The families of Down's Syndrome children and another group with a similar degree of retardation were compared using data collected at interview. Differences in social class distribution were explained by the maternal age effect in the Down's group. Divorce was more common in the control group but the quality of marriage in those parents still together and the health of parents were similar. No close associations were found between behaviour disorders in the children and family factors, except that behaviour disorders were likely to be associated with similar disturbance in siblings next in age and to be more common in the less happy marriages.

Retarded children and their siblings.

One hundred and eighty-three retarded children and their nearest-in-age siblings were investigated. Ninety-five of the retarded children had Down's syndrome and 88 were retarded for other reasons. Interviews with the parents were carried out at home. Questionnaires on behaviour and educational attainment were completed for the retarded child, the sibling and a classroom control for the sibling. The retarded children had more behaviour problems than their siblings, as expected. The behaviour problems in the sibling were more often found if the retarded child had much-disturbed behaviour, especially when the retarded child had Down's syndrome. The siblings in the non-Down's group had more reading problems and more behaviour disturbance in school than either the controls or the siblings of Down's syndrome group.

Down's syndrome and the family: follow-up of children first seen in infancy.

Twenty-three survivors of a prospective study of infants with Down's syndrome were followed up at eight or nine years of age. All but three lived at home, and those three came home for weekends or school holidays. IQs varied from less than 20 to 80 (mean 48). IQ and adaptive behaviour scores were related to birthweight and muscle tone in infancy. Difficult behaviour was common, but differed from that of normal children. More of the parents had minor degrees of psychiatric disability than parents in the control families. Marital problems arising in the earlier years of the child's life persisted, but without further deterioration. The findings indicate that the priorities for these families are to help the parents deal with emotional repercussions, to teach communication skills to the child, and to diagnose and treat difficult behaviour.

Controlled trial of oligoantigenic treatment in the hyperkinetic syndrome.

76 selected overactive children were treated with an oligoantigenic diet, 62 improved, and a normal range of behaviour was achieved in 21 of these. Other symptoms, such as headaches, abdominal pain, and fits, also often improved. 28 of the children who improved completed a double-blind, crossover, placebo-controlled trial in which foods thought to provoke symptoms were reintroduced. Symptoms returned or were exacerbated much more often when patients were on active material than on placebo. 48 foods were incriminated. Artificial colorants and preservatives were the commonest provoking substances, but no child was sensitive to these alone.