PubMed · 1513706
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G Duff. Respite choice.. https://pubmed.ncbi.nlm.nih.gov/1513706/
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A 2.5-year-old child presented with a sleep disturbance initially diagnosed as a behavioral problem. The child had several atypical symptoms of gastroesophageal reflux disease (GERD). The sleep disturbance resolved quickly after treatment of GERD. GERD is a disease with protean manifestations which is becoming of greater interest to the pediatric otolaryngologist. We discuss diagnosis of this entity.
Nonretentive encopresis refers to inappropriate soiling without evidence of fecal constipation and retention. This form of encopresis accounts for up to 20 percent of all cases. Characteristics include soiling accompanied by daily bowel movements that are normal in size and consistency. An organic cause for nonretentive encopresis is rarely identified. The medical assessment is usually normal, and signs of constipation are noticeably absent. A full developmental and behavioral assessment should be made to establish that the child is ready for intervention to correct encopresis and to identify any barriers to success, particularly disruptive behavior problems. Successful interventions depend on the presence of soft, comfortable bowel movements and addressing toilet refusal behavior. Daily scheduled positive toilet sits are recommended. Incentives may be used to reinforce successful defecation during these sits. A plan for management of stool withholding should be agreed on by the parents/caretakers and the family physician before intervention.
OBJECTIVE: To determine whether preterm children born at </=32 weeks' gestation who did not cooperate for developmental testing at 3(1/2) to 4(1/2) years old were more likely to have school problems at 7 to 10 years old than preterm children who completed developmental testing. STUDY DESIGN: The McCarthy Scales of Children's Abilities were administered to a cohort of 118 preterm children at 3(1/2) to 4(1/2) years old when they were seen in the neonatal follow-up clinic. When these children were 7 to 10 years old, their parents completed the Child Behavior Checklist, and the child's teacher completed the Teacher's Report Form. RESULTS: Parents returned questionnaires on 105 (89%) children. On the Teacher's Report Form, children who were untestable had more somatic complications and more attention problems and scored higher on the Total Problems Scale and the Internalizing Scale than children who had completed testing. Children who were untestable were twice as likely to receive help in school than were children who completed developmental testing. CONCLUSIONS: Preterm children born at </=32 weeks' gestation who do not cooperate for developmental testing at 3(1/2) to 4(1/2) years old should be examined at school age for evidence of school and behavior problems.