Search PubMed⌕ Search

Biomedical subjects

B K Shapiro

Publications and source records attributed to B K Shapiro.

35 records · Page 2Linked to original sources
PubMed1986

The Clinical Linguistic and Auditory Milestone Scale (CLAMS). Identification of cognitive defects in motor-delayed children.

The Clinical Linguistic and Auditory Milestone Scale (CLAMS) and Bayley Scales of Infant Development (BSID) were independently administered to 43 children with mild-to-moderate motor delay at 15, 21, and 27 months of age. Highly significant correlations were noted for each examination. Sex, race, and age at time of examination did not significantly influence the relationship between a CLAMS quotient and a Bayley ratio quotient (BRQ). On the first examination gestational age exerted an effect that carried over to the total population. The initial CLAMS quotient also correlated with the results of the CLAMS and BSID administered 12 months later. The CLAMS identified children with a delayed BRQ (less than 70) as follows: sensitivity, 0.66; specificity, 0.79; predictive value of a positive test, 0.80; and predictive value of a negative test, 0.65. The CLAMS provides the pediatrician with a language assessment instrument that adequately detects cognitive deficits in motor-delayed children.

Child Language↗
PubMed1986

Growth of severely impaired children: neurological versus nutritional factors.

Nineteen children with cerebral palsy who have had gastrostomies since 1981 and who have been followed for at least six months postoperatively were reviewed to assess the effects of gastrostomy feeding on their growth and to determine whether growth failure was due to neurological or nutritional dysfunction. The children's ages ranged from five to 168 months (mean 60.4 months) and follow-up extended from six to 41 months (mean 23.1 months). All were profoundly handicapped, with involvement of all four limbs. 11 also had seizures and all 19 were severely to profoundly retarded. Heights and weights were recorded during the visit immediately before surgery and at most recent follow-up. Data were recorded as a standard deviation score (Z-score). Before surgery the mean weight/height was -2.71 Z. Postoperatively this improved to -1.18 Z. 16 of the 19 children increased their weight/height ratio. Three children had a weight/height ratio greater than 10th percentile preoperatively. 11 achieved this on follow-up. Seven children were greater than 25th percentile for weight/height. Improvement in weight/height did not correlate with length of follow-up. For severely neurologically impaired children, nutritional factors play a major rôle in growth. By ensuring adequate caloric intake via gastrostomy, a significant number of children achieved adequate growth and better nutritional status.

Adolescent↗
PubMed1986

Clinical linguistic and auditory milestone scale: prediction of cognition in infancy.

At each well-child examination between birth and two years, parents of 448 infants were questioned about their child's age at attainment of 25 linguistic and auditory milestones. Parental reports were compared with the results of independently administered Bayley Mental Developmental Index (MDI) at one year of age. Parental recall of information was high, ranging from 70 to 99 per cent for 21 of the 25 milestones. The milestone performance of infants with normal MDI scores showed an orderly, sequential progression of expressive and receptive language. Across the entire population studied, the correlation between milestone attainment and MDI was statistically significant for 24 of the 25 milestones, and later attainment of milestones correlated with lower MDI. As a group, 'delayed' infants (MDI less than 68) attained milestones significantly later than 'average' infants (MDI 85 to 116) for 20 of 25 items. Attention to linguistic and auditory milestones early in infancy can contribute to the early detection and diagnosis of mental retardation and disorders of communication.

Auditory Perception↗
PubMed1986

Age of presentation in developmental disability.

It has not been determined whether severity of handicap or other associated factors are more important in determining the age of presentation for developmental disabilities. The relationship between age at presentation and referral source, presenting complaint, diagnosis, and associated factors (medical illness, motor signs, or behavioral disturbances) was examined in 738 consecutive children referred for developmental evaluation during 1982-1983. The nature of the complaint or diagnosis (motor, language, behavioral, or educational) was a far better predictor of age of presentation than the severity of the disorder. The degree of mental retardation did not affect age of presentation. Behavior problems did not affect the age of presentation for school failure or learning disability, but were associated with later presentation for motor delay, language delay, communication disorder, and within all IQ groups. The association of topography of handicap rather than severity with age of presentation should be considered when establishing or evaluating efforts at early identification of developmental disability.

Black or African American↗
PubMed1985

The motor quotient. A method for the early detection of motor delay.

A motor quotient was calculated by dividing the age of a child's best motor achievement by his or her chronologic age. A quotient less than 50 was said to predict gross motor delay (walking at or later than 24 months). Applying the quotient to 144 8- to 18-month-old children yielded a sensitivity of 87%, specificity of 89%, and overreferral and underreferral rates of 12%. By viewing motor development as a ratio, one is able to forecast motor delay.

Age Factors↗
PubMed1985

Normal gross motor development: the influences of race, sex and socio-economic status.

The ages at attainment of 12 gross motor milestones were obtained prospectively during well-baby visits in the first two years of life for 381 children. All had been born at term and were judged to be normal at one year. A longitudinal analysis, using an index summarizing each child's progress for eight selected milestones, is reported for the 284 children for whom data were complete. A high percentage of parents were able to report the age at attaining milestones with an acceptable degree of variability. The children attained milestones at earlier ages than traditionally reported. There were only minor sex differences in age at attainment, but black children attained milestones earlier than white children.

Analysis of Variance↗
PubMed1985

The diagnostic value of the neurodevelopmental examination.

The neurodevelopmental examination is a pediatric approach to developmental diagnosis that relies on evaluation of multiple streams of development. The value of the neurodevelopmental examination for the early diagnosis of cerebral palsy and mental retardation was studied by a retrospective analysis of prospectively (longitudinally) collected data. Both conditions were found to be accurately diagnosed in the first year of life. For cerebral palsy, sensitivity was 0.81 and specificity 1.00; for mental retardation, sensitivity was 0.56 and specificity 0.96. The trained pediatrician can make early diagnoses of developmental disabilities.

Cerebral Palsy↗
PubMed1985

Cognitive-motor interactions. The relationship of infant gross motor attainment to IQ at 3 years.

The relationship of gross motor development to later cognitive status was assessed by comparing the ages of attainment of four early milestones to later performance on the Stanford Binet. The ages of rolling supine to prone, sitting alone, crawling, and walking were collected in a prospective fashion via parental report for 213 Caucasian children. Stanford Binet IQ was measured at 3 years. Significant but low-order correlations were noted for age of milestone and Stanford Binet IQ. Stratifying the sample by IQ standard deviation groups revealed significant relationships, but this was largely the result of the difference between the extreme groups (117 vs. 85). Children with earlier ages of milestone attainment did not have higher IQs on average. The association of gross motor development and cognition is not strong enough to allow the use of one to predict the other.

Child Development↗
PubMed1984

Primitive reflex profile: a quantitation of primitive reflexes in infancy.

This report describes quantitative standardization data on nine primitive reflexes for a cohort of 381 normal infants evaluated longitudinally at each visit between birth and two years of age. Normality was confirmed by the use of the Bayley Scales of Infant Development at one year of age. The standardization of this new examination technique complements the traditional infant neurological examination and may allow primitive reflexes to become a useful adjunct to the prediction of motor disability in early infancy.

Brain Damage, Chronic↗
PubMed1984

Computers in rheumatology practice: implications for clinical research.

We conducted a survey to determine the current and potential uses of computerized information systems in clinical rheumatology. One in 3 rheumatologists currently uses an office based computer, primarily for administrative functions, and at least one in 5 is likely to acquire a computer in the near future. Survey responses indicate that the increased use of office based computers will increase the willingness of community practitioners to participate in clinical research. This development will provide an opportunity to broaden the scope of clinical research participation and to increase the pool of patients available for cooperative clinical trials in rheumatology.

Computers↗
PubMed1984

Issues in the early identification of specific learning disability.

Currently the diagnosis of Specific Learning Disability (SLD) requires the demonstration of academic underachievement relative to cognitive potential. However, if the focus is shifted from academic underachievement to the detection of the deviant neurologic substrate, then the potential exists for diagnosing SLD prior to school. Circumstantial evidence from a variety of sources--studies of historical risk, the newborn examination, assessment of newborn behaviors, combination of newborn and subsequent examination, retrospective assessment of early development in SLD children, and aspects of infant development (motor or language) and SLD-suggests that the neurologic substrate for SLD can be identified in infancy. Early identification of SLD will permit early intervention when indicated, aid the assessment of therapeutic efficacy, and facilitate the evaluation of other interventions (e.g., neonatal care).

Child↗
PubMed1983

Age of walking in the cognitively impaired.

Age levels for independent walking were compared for groups of children with varying degrees of intellectual impairment, but without other neurologic handicaps. All walked independently, save for 13.5 per cent of the profoundly retarded. Although mental retardation was associated with a delay in walking, subgroups existed at all levels that walked at a normal age. This suggests that the cognitive level is not the sole determinant for the achievement of this milestone.

Age Factors↗
PubMed1982

A prospective study of three postural reactions.

In order to assess the evolution of postural reactions in the prone position, a group of 149 normal infants were followed from birth to two years of age. The Landau reflex was present in 44 per cent of two-month-old infants, and in 95 per cent at four months. The tonic labyrinthine response (grades 2 to 4) was seen in 80 per cent of infants at two weeks, with a marked diminution by the age of 24 months. In contrast, the symmetrical tonic neck reflex was detected in fewer than 30 per cent of the infants: the maximum prevalence was at four to six months of age. These findings are consistent with the hypothesis that the Landau is an early righting reflex which emerges after, and is independent of, the tonic labyrinthine response in prone and the symmetrical tonic neck reflex.

Female↗
PubMed1982

Motor functions: associated primitive reflex profiles.

The results of reflex/motor activity interactions in 177 normal infants are evaluated. The asymmetrical tonic neck reflex, tonic labyrinthine reflex-supine, and Moro reflexes were assessed for each child at birth and at intervals up to 12 months. Ages of rolling prone to supine, rolling supine to prone, and sitting alone were elicited from parents. The effects of the primitive reflexes on early motor activity were assessed, and statistically significant correlations were demonstrated between decreased reflex activity and the emergence of motor milestones. The distinctive association of reflex activity with motor function suggests the interaction of several reflexes (a primitive reflex profile) rather than the influence of isolated reflex activity. Such patterns support the hypothesis that decreasing primitive reflex activity is associated with the onset of volitional motor activity in normal infants.

Developmental Disabilities↗
PubMed1981

Spectrum of developmental disabilities: continuum of motor dysfunction.

The spectrum of developmental disabilities encompasses a diverse group of interrelated disorders with multiple manifestations resulting from brain dysfunction. Motor disability has been highlighted, as it is the most frequent presenting sign of developmental disability. Such disability may vary from severe to minimal. Severe disability, or cerebral palsy, is well appreciated, as are the additional associated disabilities that affect habilitation. Mild to minimal motor disability (mild to minimal cerebral palsy), because it is usually nonhandicapping, is less frequently appreciated as a marker of brain dysfunction. Further delineation of the child's nonmotor abilities is necessary in order to define the scope of the disability. Cognitive limitation is not an important cause for the gross motor delay seen in children with mental retardation. It is our postulation that the motor deficit is on the basis of mild to minimal cerebral palsy. This diagnosis is frequently obscured by the mental retardation.

Humans↗
PubMed1979

Factors affecting walking in a profoundly retarded population.

A total of 127 children with profound mental retardation were reviewed to determine the age at which walking began. 53 per cent of the children walked at a median age of 30 months. Further sub-classification revealed that both the number of ambulatory children and their age at walking varied with degree of neurological handicap, children with additional neurological problems having a higher median age for beginning to walk. The minimal cognitive level required for walking remains unknown, but is probably less than generally accepted. In this profoundly retarded population, the existence of neurological factors was associated with both increased age at walking and with decreased ability to walk.

Brain Damage, Chronic↗