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Biomedical subjects

B Whitman

Publications and source records attributed to B Whitman.

10 recordsLinked to original sources

Toe walking and language development.

Neurodevelopmental markers that are present early in childhood may identify children at risk for later developmental disabilities. This paper attempts to clarify the relationship between one such proposed marker, toe walking, and language development in a general pediatric population. One hundred sixty-three children being seen for well-child visits were included in the study. Information from each child's caretaker was obtained for language development and a history of toe walking; observation of toe walking during the visit was also included. The frequency of toe walking was 24%. Language quotients were calculated and compared for toe walkers (n = 39) and non-toe walkers (n = 127). The mean language quotient for toe walkers tended to be consistently lower than that for non-toe walkers. The specificity of toe walking for low language scores was 85% but had a sensitivity of only 32%. Although an association between toe walking and language delay is supported by the present data, the association does not appear to be clinically significant.

Age Factors

Toe walking. A marker for language disorders in the developmentally disabled.

Toe walking unassociated with an autistic disorder or cerebral palsy generally has been considered a normal infant gait. The incidence of toe walking in various diagnostic subgroups of 799 developmentally disabled children presenting to a tertiary-level multidisciplinary assessment clinic was reviewed to investigate the authors' clinical impression that toe walking may be a marker for language dysfunction. Toe walking was found to be more frequent in those diagnostic subgroups with more severe language disorders. Toe walking also correlated with lower IQ scores (p less than 0.0001). The sensitivities, specificities, predictive validities and odds ratios all supported the hypothesized association between toe walking and language disorders. Further prospective studies of the neurodevelopmental outcome of children with toe walking are needed to determine whether this behavior can identify children at risk for language disorders.

Autistic Disorder

Excessive water drinking. A marker of caretaker interaction disturbance.

In children examined at a child development clinic the incidence of excessive water drinking was almost exclusively confined to the foster care population. A series of 11 patients is compared with other reports of excessive water drinking as a marker for parent-child problems and inadequate nurturance. The parent-child interaction patterns were characterized as rejecting and both overprotective and overindulgent. The family adaptational styles tended to be chaotic and rigid, and the family cohesion styles disengaged or separated. Excessive water drinking can be considered a marker for problems in parenting.

Child

The learning-disabled medical student.

Developmental pediatricians are being consulted by medical school promotion committees with regard to the course of action to be taken with learning-disabled medical students experiencing academic difficulties. Faculty attitude, a difficulty understanding the nature of learning disabilities, appears to be a major contributor to poor medical school performance on the part of learning-disabled adults. Utilizing the sequential-simultaneous information processing model as a simplified introduction to learning disability patterns, the authors argue that recommending intensive remediation of rote spelling and writing skills in students engaged in graduate education represents both a waste of time and a further emotional trauma to these young professionals.

Achievement

Autism and plumbism. A possible association.

Six cases of inner city black children with both infantile autism and lead poisoning are reviewed. In three cases, developmental deviance seems to have been present before the possible impact of lead toxicity. In two cases the lead poisoning may have contributed to the onset or acceleration of developmental symptomatology. In one case the temporal sequence remains unclear. Possible patterns of interaction and the implications for clinical practice are discussed.

Black or African American

Acute leukemia. Learning disabilities following CNS irradiation.

Thirteen elementary school age children with acute leukemia who had received cranial irradiation with dosages between 1,800 and 4,800 rads a mean of 6.3 years earlier were evaluated for the presence of learning disorders. The authors utilized both psychometric and educational tests. The results were analyzed according to a graduated regressed standard score procedure and yielded the following diagnoses: mental retardation, two (15%); learning disability in reading and mathematics, two (15%); learning disability in mathematics, five (39%); no psychoeducational diagnosis, four (31%). Of the nine children (69%) who qualified for a specific psychoeducational diagnosis, only three were receiving any special educational services. The failure of a previous assessment of this same group of children at our center and of other research reports to uncover a similarly high incidence of neurodevelopmental pathology may be due to the specific tests employed or to the later onset of measurable difficulties in these patients.

Brain

Chemosensitivity of human neoplasms with in vitro clone formation. Experience at the University of Southern California - Los Angeles County Medical Center.

We analyze experience with 600 specimens for in vitro chemosensitivity assessment of human neoplasms utilizing a soft agar colony-forming technique. Good test reproducibility is demonstrated. Disaggregation with collagenase enhances yield and does not alter chemosensitivity profiles. Therapeutic exposure to chemotherapy prior to biopsy reduces in vitro sensitivity to the specific agents used in vitro. The cyclophosphamide derivatives 4-hydroperoxycyclo phosphamide (4-HC) and phosphoramide mustard are active in vitro, and produce comparable rank order sensitivities among tested tumors. There is marked reduction of in vitro 4-HC sensitivity in patients with prior therapeutic cyclophosphamide exposure, supporting the use of this derivative in test systems. Rank order of test results among specimens is compared at 0.1 microgram and 10 microgram drug/ml. Substantial differences in rank order at these two dose levels are demonstrated, indicating that the in vitro test dose selected is an important variable.

Antineoplastic Agents