The development of the medical examination as a tool in diagnosing child sexual abuse is discussed. The role of the medical professional in promoting conservative and appropriate diagnosis and treatment and in providing a scientific base for the recognition of child sexual abuse is reviewed. (CR)

A response is presented to commentaries (EC 232 375-377) on two papers (EC 232 373 and EC 232 374), focusing on research methodology on stuttering, the impact of improving intrajudge and interjudge agreement, the importance of studying stuttering as a private experience rather than an acoustical event, and speakers' experience of loss of control…

The importance of early identification of hearing loss in children and progress toward newborn screening is discussed, along with consequences of delayed identification. The history and status of early screening at national and state levels and specific types of screening methods for bilateral and unilateral sensorineural hearing loss are…

Research and clinical data regarding concomitant speech and language problems in children who stutter are reviewed, along with theoretical models explaining this interrelationship. A framework is presented for the differential evaluation of children who stutter, involving four areas of assessment: case history, fluency assessment, language skills…

This review of instruments for assessing psychopathology and behavior problems in people with mental retardation characterizes evaluation tools in such terms as age groups encompassed, levels of mental retardation, number of domains, and types of raters used. The structure of maladaptive behavior is described, and several instruments are…

This article discusses the history of revisions to the category of "attention deficit hyperactivity disorder" (ADHD) in the Diagnostic and Statistical Manual of Mental Disorders (DSM); results of field trials for the forthcoming fourth edition of the DSM; and the relevance, functions, and limitations of DSM-IV diagnosis for educational…

A mother writes of her early years with her son as a single parent and the difficult years with twin younger siblings when she was trying to find a diagnosis and help for her son. Her son is 9 years old now, and she reflects on her experiences. (Author/CR)

The mother of a 13-year-old boy with autism discusses the symptoms of autism from birth through 18 months and 18 through 36 months and her journey out of denial. The dreaded validation of the diagnosis and the support of other parents are addressed. Her husband shares some suggestions for stepfathers. (CR)

The mother of a 10-year-old boy with high functioning autism discusses her shock at the diagnosis, her denial, her feelings of guilt, her sense of isolation, the panic she felt in trying to stay on top of things, her anger, bargaining with herself, and her final feelings of acceptance and hope. (Contains three references.) (CR)

The original authors of an article proposing a new medical model of special education for children with emotional or behavioral disorders respond to comments by considering: (1) the role of psychiatric diagnosis in special education, (2) the relative efficacy of behavioral versus psychopharmacologic treatment, and (3) the nature of…

Proposals have been developed to clarify physician responsibility in withholding treatment to terminally ill patients. These proposals seek to provide a legal shield against malpractice proceedings and to reduce confusion over how to resolve high medical costs through standardizing procedures for withholding treatment. When first published,…

Suggests using the paradigm of qualitative research, consistent with the bio-psycho-social perspective, rather than the "rule out" decision-tree method of diagnosis for training in geriatrics. Argues that this paradigm would provide clinicians with the broadest picture of the presented problem. (Author/ABB)

Describes the Brazelton Neonatal Behavioral Assessment Scale, which is used to assess infants' competence in organizing their states of consciousness, interactive capacities, physiological responses, and environmental responsiveness. Various projects which have used the scale are reported. The predictive value and clinical uses of the scale are…

If the family physician is to focus on the family as a unit of diagnosis and treatment, new knowledge with practical applications for the health care provided is required. Producing this knowledge is the responsibility of the family medicine researcher who will need to use new tools, strategies, and innovative research design. (JMD)

As an illustration of cases where existing programs and facilities do not meet individual special needs, the article traces the chronology of a behavior disordered male from special class placement in elementary school through his eventual incarceration in the Nebraska penal system. (JW)