Psychological disturbance in children with physical disabilities: Continuity and change in a 5-year follow-up

Measured continuity in behavioral disturbance of a 5-yr period among 255 6–18 yr old children with physical disabilities, including cystic fibrosis, cerebral palsy, myelodysplasia, and multiple physical handicaps that involved neurological and brain damage in most cases. Psychological functioning was measured by the Psychiatric Screening Inventory, which assessed Ss' self-destructive tendencies, mentation problems, conflict with parents, regressive anxiety, fighting, delinquency, and isolation. Ss showed little stability in aggression, an area in which stability over time has been reported for the general child population. Furthermore, differences were observed between Ss with cystic fibrosis and Ss with cerebral palsy, myelodysplasia, or multiple physical handicaps, all conditions involving brain abnormality. Ss with cystic fibrosis followed the trend toward better adjustment seen among the general population. In contrast, among Ss with conditions involving the brain, the majority of those who had been classified as psychologically severely impaired remained at this level of impairment 5 yrs later. In 2 behavioral domains—mentation problems and isolation—Ss with conditions involving the brain maintained, on the average, the same high score they had initially. Results suggest that, among children with physical conditions involving the brain, mentation problems and isolation signify persistent problems that do not subside with maturation. (19 ref)