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PubMed2006

[Differences in serum retinol level between the breastfed and non-breastfed children aged 0 to 23 months].

OBJECTIVE: Some recent studies found that high prevalence of vitamin A deficiency in the breastfed children. This study aimed to understand the differences in serum retinol level between breastfed and bottle-fed children aged 0 to 23 months and the possible causes of low level of serum retinol for the breastfed children. METHODS: Data for children aged 0 to 23 months were extracted from a population-based cross sectional study for vitamin A nutrition status. Fluorescence method was used to measure the serum retinol. Mothers or caregivers were asked to answer a pre-designed questionnaire and socioeconomic status, peri-natal care, breastfeeding status, morbidity histories and other related factors were collected. Semi-quantitative food frequency questionnaire was used to investigate the child's dietary intake one week prior to the survey. Data were analyzed using SAS 8.1. RESULTS: Of 401 children aged 0 to 23 months, the breastfeeding rate was 50.37%. The means of the serum retinol level between bottle-fed (30.67 +/- 0.57) microg/dl and the breastfed children (27.60 +/- 0.56) microg/dl was significantly different (P < 0.01). The corresponding figures were (31.82 +/- 0.98) microg/dl and (29.46 +/- 0.96) microg/dl after adjustment for confounders, which also showed significant difference (P < 0.01). After stratified by age groups, the breastfeeding rates in the 0-, 6-, 12- and 18-months groups were 92.1%, 70.1%, 32.0% and 17.1%, respectively. We calculated the difference in means of the serum retinol level between the bottle-fed and breastfed children for each of four age groups, and the 95% confidence limits of the differences. The differences in means and the 95% confidence limits for 0-, 6-, 12- and 18-months group were 4.70 microg/dl (-2.52-1.92), 0.82 microg/dl (-2.32-3.95), 2.95 microg/dl (-0.68-6.58) and 6.05 microg/dl (2.34-9.77), respectively. After adjustment for confounders and covariates, the adjusted figures were 0.00 microg/dl (-7.18-7.19), 1.35 microg/dl (-1.76-4.45), 2.92 microg/dl (-0.82-6.65) and 4.26 microg/dl (0.71-7.81), respectively. The significant difference in means of serum retinol level was only found in the 18-months group before or after adjustments (P < 0.01 for both). The Cochrane-Atmitage chi square trend test showed that the breastfed children tended to have lower frequencies of complementary dietary intakes than that of the bottle-fed aged 12 months and above. CONCLUSIONS: The breastfed children aged 0 to 23 months had relative low serum retinol level while compared with the bottle-fed. However, the significant differences seemed to be only confined to those aged 18 months and above. Low level of vitamin A in breast milk and low frequent complimentary food supplements might have served as the potential for the differences.

Breast Feeding↗

PubMed2005

Prevalence of anti-hepatits A antibodies in children of different socioeconomic conditions in Vila Velha, ES.

This report describes the prevalence of anti-HAV antibodies in children from elementary school in the Municipality of Vila Velha, ES, Brazil. Anti-HAV antibodies were investigated by ELISA method in the serum of 606 children (four to fourteen years old) from three elementary schools, located in neighborhoods with varying household monthly income levels: São José School, 200 children, household income higher than US$700; São Torquato School, 273 children, US$200 to 300; and Cobi School, 133 children, less than US$200. From each children data on age, gender, skin color, sanitary conditions, frequency of contact with sea or river water and family history of hepatitis were recorded. Anti-HAV antibodies were present in 38.6% of all children, 9% in São José School, 49.1% in São Torquato School and 61.7% in Cobi School. Logistic regression analysis demonstrated a positive correlation of positive anti-HAV test with age, non white color of the skin, absence of sewage treatment and domestic water filter, and a past history of hepatitis. The prevalence of anti-HAV antibodies in school children in Vila Velha, ES, was lower than that observed in the same age group in North and Northeast Brazil and was significantly higher in children from families with low socioeconomic status. In addition the results indicate a changing epidemiologic pattern of hepatitis A in our country, with an increasing number of children and adolescents with high risk for HAV infection, mainly in high socioeconomic class. A consideration must be given to the feasibility of vaccination programs for children and adolescents in our country.

Adolescent↗

PubMed1987

[The value of respiratory function tests in the surveillance of asthmatic children].

The purpose of pulmonary function testing in children with asthma is to search for obstructive airway disease. We examined the charts of 169 asthmatic children during intervals between acute exacerbations. The severity of asthma was determined according to VIALATTE classification, with the Tiffeneau ration FEV1/VC (1) and the MMFR/VC ratio serving as obstructive indices. According to these data, children were classified into three groups: normal children (normal FEV1/VC and MMFR/VC), children with probable obstruction of the distal airways (normal FEV1/VC and decreased MMFR/VC), and children with both proximal and distal airway obstruction (decreased FEV1/VC and MMFR/VC). Since suggested normal values vary in the literature, we compared FEV1 and MMFR to determine as accurately as possible the number of children with obstructive disease. The relationship between the degree of clinical involvement and pulmonary function testing results was studied. Clinically, asymptomatic children with suspected normal respiratory function had evidence of obstructive disease in two out of three cases, and would benefit from drug therapy.

Adolescent↗

PubMed1995

Parental stress and growth outcome in growth-deficient children.

OBJECTIVE: In order to examine the relationship between parental stress, child psychosocial factors, anemia, lead poisoning, and growth deficiency (GD), 48 children attending a GD referral program were recruited consecutively and matched with 50 comparison subjects from a primary care program. METHOD: Parents completed the Parenting Stress Index (PSI) with subscales and provided demographic data. Children received developmental screening, hemoglobin levels, Pb levels, and growth evaluation. They also received medical evaluation for GD. T tests were used to evaluate group differences. Spearman Rho correlation analyses were computed between group coefficients and PSI scales, Pb, and hemoglobin levels. RESULTS: No differences were found on the PSI with regard to overall parental stress. GD parents perceived themselves as less competent (P < .001), and their children as less adaptable (P < .006). They also reported more social isolation (P < .05). The GD group had more anemia and Pb poisoning (P < .002 and P < .001, respectively); however, these variables were not related to differences in child adaptability or growth outcome. A high sense of parental competence and high child adaptability were associated with improved growth outcomes (P < .001 and P < .02, respectively). CONCLUSIONS: We conclude that parents of GD children seen in an outpatient referral setting show no difference in overall perceived stress levels versus comparison subjects. Increased parental competence and child adaptability are strongly associated with improved growth outcome. Decreased child adaptability may contribute to GD pathology. These findings challenge the traditional view of GD etiology.

Adaptation, Psychological↗

PubMed2002

Drug management for acute tonic-clonic convulsions including convulsive status epilepticus in children.

BACKGROUND: Tonic-clonic (grand mal) convulsions and convulsive status epilepticus (currently defined as a grand mal convulsion lasting at least 30 minutes) are medical emergencies and demand urgent and appropriate anticonvulsant treatment. Diazepam, lorazepam, phenobarbitone, phenytoin and paraldehyde may all be regarded as drugs of first choice. OBJECTIVES: To review the evidence comparing diazepam, lorazepam, phenobarbitone, phenytoin and paraldehyde in treating acute tonic-clonic convulsions and convulsive status epilepticus in children. SEARCH STRATEGY: We searched the Cochrane Epilepsy Group's specialized register (4 July 2002); the Cochrane Controlled Trials Register (Cochrane Library Issue 2, 2002); MEDLINE (28 May 2002) and EMBASE (January 2002). SELECTION CRITERIA: Randomized controlled trials comparing lorazepam and other anticonvulsant drugs used for the treatment of convulsive status epilepticus in children. DATA COLLECTION AND ANALYSIS: This was a review of published, aggregate data. The main outcome measures included cessation of the presenting tonic-clonic convulsion/episode of convulsive status epilepticus; the number of additional drugs required to stop the convulsion; people demonstrating respiratory depression and people requiring admission to the intensive care unit because of respiratory depression. MAIN RESULTS: Only one trial was found, in which children were allocated lorazepam or diazepam. The main results are as follows. (1) One or two intravenous doses stopped the convulsion in 19 of 27 (70%) lorazepam and 22 of the 34 (65%) intravenous diazepam-treated children. The relative risk (RR) with 95% confidence intervals (CIs) was 1.09(95% CI 0.77 to 1.54). A single dose of rectal lorazepam stopped the convulsion in six of six, compared to six of 19 children treated with rectal diazepam, RR 3.17(95% CI 1.63 to 6.14). (2) Six of the 27 (22%) intravenous lorazepam and 12 of the 34 (35%) intravenous diazepam-treated children respectively, experienced a further convulsion within 24 hours after presentation RR 0.63(95% CI 0.27 to 1.46). (3) Only one of 27 children (4%) who received intravenous lorazepam compared to five of 34 children (15%) who received intravenous diazepam required additional antiepileptic drugs to terminate the presenting seizure RR 0.25(95% CI 0.03 to 2.03). (4) A lower incidence of respiratory depression occurred in the lorazepam-treated group: one of 27 (4%) children compared to seven of 34 in the diazepam-treated group (21%), RR 0.21(95% CI 0.02 to 1.37). REVIEWER'S CONCLUSIONS: This review provides no evidence to suggest that intravenous lorazepam should be preferred to diazepam as the first-line drug in treating acute tonic-clonic convulsions including convulsive status epilepticus in children. There was some evidence from this review that rectal lorazepam may be more effective and safer than rectal diazepam, but the data were insufficient to indicate that lorazepam should replace diazepam as the first choice rectal drug in treating acute tonic-clonic convulsions and convulsive status epilepticus.

Administration, Rectal↗

PubMed1991

Psychosocial adjustment and physical growth in children with imperforate anus or abdominal wall defects.

Pediatric surgeons have the unique responsibility of performing surgical procedures that will enable their patients to function normally throughout a lifetime. Good anatomic results may not ensure that this goal will be achieved. Using a battery of psychological testing instruments, we evaluated the academic achievement and psychosocial status of 56 children (mean age, 10.6 years) with imperforate anus (IA) and abdominal wall defects (AWDs). Physical growth was assessed by measurement of standard anthropometric parameters, and a parent questionnaire was used to define clinical status. As a group, the children presented with average intellectual ability. Achievement in both reading and math was in the normal range. In 12.5% of the children a reading learning disability was noted and 10.7% had a disability in math. On the basis of parental assessments, 25% of the children demonstrated externalizing behavior disorders (eg, conduct problems) and 29% displayed internalizing symptomatology (eg. withdrawal, anxiety). Social competency deficits were described in 23% of the children. Data obtained from the teachers were consistent with the parental assessments. No major differences between the IA and AWD patients in academic achievement, psychosocial status, or physical growth were discovered. Routine screening of these children for learning disabilities and behavior problems is recommended.

Abdominal Muscles↗

PubMed1985

Immigrants and a public oral health care service for children in Denmark.

The present study was conducted to compare level of dental caries, treatment pattern and contact patterns with the Child Oral Health Care System of children of immigrants. The study comprised 239 Turkish, 117 Pakistani and 91 other immigrants and a control group of 359 Danish children. Data were extracted from the dental records in the clinic where they were treated. All groups of immigrants showed more caries in the primary dentition and less caries in the permanent dentition than Danish children of comparable age. For preschool children a higher number of broken appointments were found for the immigrants as well as a higher number of appointments which were interrupted due to management problems. The consequences for planning preventive and restorative programs for children of immigrants are discussed.

Adolescent↗

PubMed1996

Ischaemic stroke in infancy and childhood: role of the Arg506 to Gln mutation in the factor V gene.

Dahlbäck et al. recently described in vitro resistance to the anticoagulant response of activated protein C (APC), in the majority of cases associated with the Arg506 to Gln point mutation in the factor V gene in thrombophilic patients. To determine to what extent this common gene mutation affects the risk of childhood stroke, its occurrence was prospectively investigated in a population of children with ischaemic stroke. Over a 2-year period the Arg506 to Gln mutation, factor V, protein C, protein S, antithrombin, antiphospholipid antibodies and lipoprotein (a) [Lp(a)] were measured in 14 infants and children with acute ischaemic stroke. Heterozygous factor V Leiden mutation (n = 4), homozygous factor V Leiden mutation (n = 1), protein C deficiency type I (n = 3) and increased Lp(a) (n = 2) were diagnosed in the children investigated. Seven of 14 patients showed an underlying disease and additionally risk factors were present in nine of 14 children. Data of this study indicate that deficiencies in the protein C anticoagulant pathway play an important role in the aetiology of childhood stroke. However, additional triggering factors may promote early manifestation of thromboembolism in children with inherited defects of clotting inhibitors.

Adolescent↗

PubMed2004

Clotting parameters and thromboelastography in children with neuromuscular and idiopathic scoliosis undergoing posterior spinal fusion.

STUDY DESIGN: An unblinded comparison of laboratory values between patients with idiopathic and neuromuscular scoliosis. OBJECTIVES: To compare standard tests of coagulation and thromboelastography (TEG) parameters between two groups of patients undergoing posterior spinal fusion (PSF). SUMMARY OF BACKGROUND DATA: Children with neuromuscular scoliosis such as cerebral palsy have more intraoperative blood loss than children with idiopathic scoliosis during PSF. Various reasons suggested for this include nutritional deficiencies, altered tissue integrity, hepatic dysfunction, and use of antiepileptic medications that can cause poor hemostasis and altered coagulation. We have observed alterations in coagulation factor levels in patients with cerebral palsy due to spastic quadriplegia with moderate blood volume loss (25% estimated blood volume). METHODS: In a prospective analysis, we compared standard tests of coagulation (prothrombin time [PT], partial thromboplastin time [PTT], platelet count, fibrinogen levels) and TEG at baseline and at a blood loss of 15% estimated blood volume in patients with idiopathic scoliosis and cerebral palsy undergoing PSF. RESULTS: There were no differences between the groups in terms of gender distribution and age. There was a significant difference between the baseline PT and PTT values, although both groups were within laboratory norms. After 15% blood volume loss, there were differences seen in the PT, PTT, maximum amplitude on the TEG, ionized calcium, and serum magnesium levels (P < 0.05). CONCLUSIONS: Children with cerebral palsy undergoing PSF have increased bleeding that starts earlier in the procedure than it does for patients with idiopathic scoliosis undergoing PSF. We found that, even though children with spastic quadriplegia had baseline PT and PTT values within normal limits, they were significantly different when compared with normal patients.

Adolescent↗

PubMed1997

Omeprazole for severe reflux esophagitis in children.

BACKGROUND: Severe esophagitis is a rare complication of gastroesophageal reflux in children. In adults, omeprazole therapy of severe erosive esophagitis has become the gold standard short-term treatment of the disease. In children, data on its use are limited, and problems about the dosage are unresolved. The aim of this study was to evaluate the efficacy of a simplified, body-weight-based daily dosage of omeprazole in children with severe esophagitis. METHODS: Ten children (median age 75.6 months; range 25-109 months) with severe esophagitis were prospectively investigated. All patients were evaluated by endoscopy, histology, and 24-h pH-metry study before and after 3 months of omeprazole. The starting dose of omeprazole was 20 mg as a single daily dose in children weighing less than 30 kg, and 40 mg daily for those weighing over 30 kg. RESULTS: A significant improvement in all the children was demonstrated after 3 months of treatment by clinical, endoscopic, and pH-metry assessment. However, histologic study failed to show significant improvement of both inflammatory and hyperplastic findings. Relapse occurred in six of 10 patients after discontinuation of therapy. CONCLUSIONS: Omeprazole is effective in the short-term treatment of severe oesophagitis in children. The daily dose of the drug could be easily based on the body weight. The persistence of histologic features of esophagitis in spite of clinical and endoscopic healing could be an indicator of poor outcome.

Anti-Ulcer Agents↗

PubMed2003

Provision of pneumococcal prophylaxis for publicly insured children with sickle cell disease.

CONTEXT: It is recommended that children younger than 5 years with sickle cell disease (SCD) take daily prophylactic antibiotics to prevent pneumococcal infections; however, how much prophylactic medication they actually are dispensed is unclear. OBJECTIVES: To measure the amount of prophylactic antibiotics dispensed to young children with SCD and to investigate factors associated with increased delivery of medication. DESIGN, SETTING, AND PATIENTS: Retrospective longitudinal study conducted January 1995 through December 1999 using Tennessee and Washington State Medicaid administrative claims and encounter data. Children (N = 261) who had 1 inpatient or 2 outpatient claims or encounters listing an International Classification of Diseases, Ninth Revision, Clinical Modification code for SCD, were younger than 4 years at study entry (mean age, 1.4 years), and were continuously enrolled in Medicaid for a 1-year period. MAIN OUTCOME MEASURE: Number of days during a 365-day period covered by prescription fills for a penicillin or macrolide antibiotic, or for trimethoprim-sulfamethoxazole. RESULTS: In a 365-day period, patients were dispensed a mean of 148.4 (SD, 121.3; median, 114; interquartile range [IQR], 39-247) days of prophylactic medication. The total amount of medication dispensed varied widely: 10.3% of patients received none and 21.5% received more than 270 days of medication. In a 365-day period, a mean of 12.7 (SD, 10.5; range, 0-40) prophylactic prescriptions were filled per patient. The median prescription duration was 10 days. In a multivariate linear regression model adjusting for state, sex, age at study entry, inclusion year, residence in urban community, outpatient inclusion encounter, required prescription co-payment, and number of outpatient visits for nonpreventive care, each preventive visit was associated with 12.0 (95% confidence interval [CI], 2.3-21.7) additional days of prophylactic antibiotics, and each emergency department visit was associated with 10.0 (95% CI, 1.2-18.8) additional days. CONCLUSIONS: Publicly insured children with SCD may receive inadequate antibiotic prophylaxis against pneumococcal infections, placing them at increased risk of morbidity and mortality; however, increased numbers of outpatient visits for preventive care are associated with improved provision of prophylactic antibiotics.

Anemia, Sickle Cell↗

PubMed1982

The stress of a family move as a precipitating factor in children's burn accidents.

The present study focuses on the stress of a family move as a precipitating factor in children's burn accidents in a group of 330 burned children. Data on the type of burn injury (flame versus scald) and the age and sex of the child were related to the amount and type of family stress which the child and his/her family had experienced. Children in the study sample were found to have moved at approximately three times the rate of children in the general population. It was found that children under five, who were scalded, were more likely to have moved than older children who had sustained a flame burn. A critical period at 2-5 months after the move was identified where the child seemed to be especially vulnerable to burn accidents. Possible explanations for this critical period are suggested.

Adaptation, Psychological↗

PubMed2006

Child health and the environment: the INMA Spanish Study.

The INMA (INfancia y Medio Ambiente [Environment and Childhood]) is a population-based cohort study in different Spanish cities, that focuses on prenatal environmental exposures and growth, development and health from early fetal life until childhood. The study focuses on five primary areas of research: (1) growth and physical development; (2) behavioural and cognitive development; (3) asthma and allergies; (4) sexual and reproductive development; and (5) environmental exposure pathways. The general aims of the project are: (1) to describe the degree of individual prenatal exposure to environmental pollutants, and the internal dose of chemicals during pregnancy, at birth and during childhood in Spain; (2) to evaluate the impact of the exposure to different contaminants on fetal and infant growth, health and development; (3) to evaluate the role of diet on fetal and infant growth, health and development; and (4) to evaluate the interaction between persistent pollutants, nutrients and genetic determinants on fetal and infant growth, health and development. Extensive assessments will be carried out on 3100 pregnant women and children. Data will be collected by physical examinations, questionnaires, interviews, ultrasound and biological samples. Pregnant women are being assessed at 12, 20 and 32 weeks of gestation to collect information about environmental exposures and fetal growth. The children will be followed until the age of 4 years.

Anthropometry↗

PubMed2006

Oral or topical nasal steroids for hearing loss associated with otitis media with effusion in children.

BACKGROUND: Otitis media with effusion (OME) is common and may cause hearing loss with associated developmental delay. Treatment remains controversial. OBJECTIVES: To examine evidence for or against treating children with hearing loss associated with OME with systemic or topical intranasal steroids. SEARCH STRATEGY: We searched the Cochrane Ear, Nose and Throat Disorders Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library Issue 4 2005, MEDLINE (1966 to 2006), EMBASE (1974 to 2006), and the CINAHL, LILACS, Zetoc, IndMED, SAMED, KoreaMed, MEDCARIB and Cambridge Scientific Abstracts databases in January 2006. SELECTION CRITERIA: Randomised controlled trials of oral and topical intranasal steroids, either alone or in combination with another agent such as an antibiotic, were included. EXCLUSIONS: publications in abstract form only; uncontrolled, non-randomised or retrospective studies; studies reporting outcomes with ears (rather than children). DATA COLLECTION AND ANALYSIS: Data were extracted from the published reports by the authors independently using standardised data extraction forms and methods. The methodological quality of the included studies was independently assessed by the authors as described in the Cochrane Handbook. Dichotomous results were expressed as an odds ratio using a fixed-effect model together with the 95% confidence intervals. Continuous data were analysed using the weighted mean difference in a fixed-effect model. Tests for heterogeneity between studies were performed using a Mantel-Haenszel approach. In trials with a cross-over design, post cross-over treatment data were not used. MAIN RESULTS: No study prospectively documented hearing loss associated with OME prior to randomisation. Follow up was mainly short term. The odds ratio for OME persisting after short-term follow up in children treated with oral steroids compared to control was 0.22 (95% CI 0.08 to 0.63). The odds ratio for OME persisting after short-term follow up for children treated with oral steroids plus antibiotic compared to control plus antibiotic was 0.37 (95% CI 0.25 to 0.56). However, there was significant heterogeneity between studies included in the latter comparison (P < 0.01). Trends favoured steroids for most other comparisons, but confidence intervals included unity. There was no evidence of benefit for steroid treatment for OME or hearing loss associated with OME in the longer term. AUTHORS' CONCLUSIONS: Both oral and topical intranasal steroids alone or in combination with an antibiotic lead to a quicker resolution of OME in the short term, however, there is no evidence of longer term benefit.

Administration, Intranasal↗

PubMed2006

The influence of the training and support programme on the self-efficacy and psychological well-being of parents of children with disabilities: a controlled trial.

The purpose of the study was to examine the effectiveness of an intervention for parents of children with disabilities in a controlled study focusing on parents' self-efficacy, psychological well-being and perceptions of change in children's sleeping, eating and mobility. The Training and Support Programme (TSP) was designed to equip parents with a simple massage skill that they could use with their children in the home environment. Parents were trained in massage by therapeutic massage therapists in 8-weekly sessions, each lasting 1h. The sample comprised 95 parents (49 in the Intervention Group, 46 in the Waiting-list Control Group) who attended the TSP with their children. Data were collected by self-administered questionnaires at baseline (before commencing the TSP), and at 8-week follow-up. The TSP demonstrated statistically significant positive effects on parents' anxious mood, self-efficacy for managing children's psychosocial well-being, self-efficacy in giving massage therapy, and perceptions of children's sleeping and eating. Relatively high levels of psychological distress were found among parents, particularly mothers. Overall, findings suggest that wider implementation of the Programme is warranted, and greater attention needs to paid to the psychological well-being of parents caring for children with disabilities.

Adaptation, Psychological↗

PubMed1993

The effects of lead levels on the growth of word recognition in middle childhood.

The relationship between dentine lead levels and the development of word recognition abilities from 8 to 12 years of age was studied in a sample of 636 children drawn from a birth cohort of 1265 New Zealand children. Data were analysed by growth curve modelling methods to characterize the relationship between early lead levels and subsequent development of word recognition abilities. The results of this analysis showed: i) Before adjustment for confounding and other factors children who had lead levels of > or V 8 p.p.m. had mean test scores which were consistently 5 points lower than children with levels of 0-3 p.p.m. There was no evidence to suggest either catch-up or deterioration in the performance of those with levels of > or = 8 p.p.m. ii) After adjustment for both confounding covariates and potential sample selection bias these differences reduced to about 3 points between those with levels of > or = 8 p.p.m. and those with levels of 0-3 p.p.m. These differences, however, remained statistically significant (P < 0.05) or marginally significant (P < 0.10). It was estimated that the 3-point difference in word recognition skills amounted to approximately 4-6 months' delay in the word recognition abilities of those with mildly elevated lead levels. The results of this study are generally consistent with the view that early exposure to lead results in very small, statistically detectable but apparently enduring deficits in cognitive abilities.

Child↗

PubMed1984

Psychomotor development in the first year and mental retardation--a prospective study.

The psychomotor development of mentally retarded children (IQ less than or equal to 85) in their first year is compared here with that of healthy children on the basis of a 1-year birth cohort (1966) from northern Finland which comprised a total of 12 058 live-born children. Data on the age of reaching the main developmental milestones in the first year, standing without support, walking with and without support and speech at 12 months were obtained by means of information collected prospectively in the children's welfare centres for this purpose. Detailed information on mental retardation covering the age group 0-14 years was obtained from the school health authorities, the national hospital discharge register and other regional or national registers. The results show that mental retardation is associated with subnormal motor development in the first year, as this finding persists even after the exclusion of children with a CP syndrome. Children who could neither walk with support nor speak by the age of 12 months constituted a high-risk group for mental retardation, the risk being 14-fold higher in this group than among the other children. Even so, only 65.2% of the children with severe mental retardation and 38.2% of those with mild mental retardation fulfilled these criteria, demonstrating that psychomotor development in the first year can be apparently normal in these groups.

Child Development↗

PubMed1995

Stability and change in temporal distance between the elderly and their children.

Drawing on a developmental model of late-life migration, this paper investigates how older people's health and social characteristics influence stability and change in their temporal distance from their children. Data from the Longitudinal Study of Aging are used to examine both discrete transitions and continuous change in distance over a four-year period. Decline in older parents' physical health increased the propensity of parents and children to become temporally closer to each other. Among those parent-child pairs who had become closer, the conjunction of declining health and widowhood increased both the degree of non-coresident proximity and the likelihood of transition to coresidence. The findings portray a geographically resilient family that adjusts to the changing needs of its older members.

Activities of Daily Living↗