Autism is a perplexing condition because of its unique presenting signs and high degree of variability. Evidence is presented that the basic underlying information processing disorder is a dysfunction of the appreciation of the emotional significance of incoming stimuli and attaching motivational value to the stimuli. It is proposed that this dysfunction occurs when the amygdaloid nucleus and/or its connections are disrupted, resulting in the variability of the presentation of this syndrome among individuals. Herpes simplex encephalitis sometimes results in signs of autism. The virus has a predilection to attack specific areas of the brain, which provides information on the probable underlying neurological dysfunction in autism.
The information patients require in order to provide informed consent is very variable. Many appear to make a judgement about the need for information depending on the perceived severity of the complication, but some want information about all complications, irrespective of risk and severity. The level of risk at which they require this information is likely to be higher than the level used by doctors who are obtaining consent from patients. The process may be improved by providing procedure-specific information leaflets that offer information regarding common and serious complications.
SummaryJets issuing from rectangular slots cut in thin plates exhibit some unusual features, including unequal spreading rates in the spanwise and transverse directions, the appearance of velocity peaks near the “ends” of the jet and changing rates of centreline velocity decay in the downstream direction. This study examines the effects of aspect ratio on such flows. The flow field has been investigated using both total head tubes and hot wire anemometry. The results are presented in the form of three-dimensional plots of total pressure and contour maps of constant velocity, streamwise turbulence intensity and the Reynolds shear stresses. The decay of mean velocity and stream-wise turbulence intensity along the centreline are presented. The rates of spanwise spreading and the location of the velocity peaks at various downstream stations are discussed. If the aspect ratio is small enough, spanwise peaks in the mean velocity distribution are suppressed.
A case is presented of an individual with Down's syndrome and multiple personality disorder. No such cases were found in a review of the literature. Three other individuals with Down's syndrome are also discussed whose symptoms range from experiencing imaginary friends to experiencing borderline multiple personality disorder. In all these cases the imaginary friends became more evident and resistive of diversion as the levels of stress increased. We speculate that experiencing imaginary friends progresses to experiencing multiple personality disorder in some individuals as personal stress increases. These cases also indicate that limited cognitive development does not preclude individuals from presenting with imaginary friends or multiple personality disorder.
This study conceptualizes the presence of a retarded child within a family as constituting a stress which the family attempts to cope with by bringing its resources to bear on the problem. If the stress proves too great for the family's coping mechanism institutionalization may be sought. The Institutional Sample families did not appreciably improve over the year following the removal of their child; while the Community Sample showed signs of deterioration, particularly in the areas of sibling functioning. The follow-up findings could be interpreted in two ways to support alternate biases with regard to hospitalization. Those who are generally against institutionalization for the retarded, believing that young children should remain in their own homes if possible, may view the lack of improvement in the functioning of the institutional families after the child was removed as an indication that these families should be encouraged to remain intact. In order to achieve this goal every effort would need to be made to strengthen, shore up and assist these families to cope with their retarded member or, where necessary, to supply the child with a new home (a foster or adoptive family). Those who generally favour institutionalization for the retarded may interpret the evidence of the decreased functioning of the community families who kept their child at home as supporting the need for the wholesale hospitalization of retarded persons. This was advocated by Goddard in his study of the Kallikaks (10). In the former approach the focus is on the welfare of the retarded child and in the latter the emphasis is on the welfare of the family and society. Is it not possible to stop playing ‘either/or’ and consider both? There are frequent occasions when a child needs to be separated from his family for their benefit or his and where an alternate family (foster or adoptive) cannot be found. Must the choice be between forcing the family to keep him and allowing the family functioning to deteriorate, or removing the child to a large impersonal institution? Lorimer Lodge, which has cared for young retarded women for over a hundred years and also the Harold Lawson Residence for trainable retarded children aged 6–12 years (both operated by the Metropolitan Toronto Association for the Mentally Retarded), the work of Jean Vanier in France and Glen Lowther in Winnipeg on community homes for retarded adults all demonstrate viable alternatives to institutionalization. It is becoming imperative that more adequate and humane alternatives be found than the present impersonal and huge institutions for those retarded persons who require, or could benefit from, an out-of-home living arrangement. This will require a major shift in emphasis, planning and responsibility. At present in Ontario the local Association for the Mentally Retarded is the main moving force in the building of community residences. Considering the magnitude of the need, progress has been slow and such agencies as the Children's Aid Society need to set up residences, possibly in conjunction with the local Association for the Mentally Retarded. This study may be interpreted as supporting the contention that to have a retarded child in the home is an added stress on the family. Follow-up of families who responded to this stress by institutionalizing their retarded children suggests that in many instances this is not the ideal answer to the problem for the family or for the child, but that a more complex variety of solutions is needed.
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