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Variation and correlation of clinical tests of accommodative function in a sample of school-age children.

Accommodative facility, lag of accommodation, accommodative response, and relative accommodation were measured in 244 school-age (7.9 to 15.9 years of age) children. The tests studied included monocular estimate method (MEM) dynamic retinoscopy, Nott dynamic retinoscopy, low neutral dynamic retinoscopy, the binocular cross cylinder test, lens accommodative rock (facility), distance (near-far) accommodative rock, negative relative accommodation (NRA), and positive relative accommodation (PRA). The mean, standard deviation, and range of test findings of each test are presented. Coefficients of correlation among the various tests are presented.

Accommodation, Ocular↗

Maternal smoking during pregnancy, environmental tobacco smoke exposure and childhood lung function.

BACKGROUND: Exposure to environmental tobacco smoke (ETS) during childhood and in utero exposure to maternal smoking are associated with adverse effects on lung growth and development. METHODS: A study was undertaken of the associations between maternal smoking during pregnancy, exposure to ETS, and pulmonary function in 3357 school children residing in 12 Southern California communities. Current and past exposure to household ETS and exposure to maternal smoking in utero were assessed by a self-administered questionnaire completed by parents of 4th, 7th, and 10th grade students in 1993. Standard linear regression techniques were used to estimate the effects of in utero and ETS exposure on lung function, adjusting for age, sex, race, Hispanic ethnicity, height, weight, asthma, personal smoking, and selected household characteristics. RESULTS: In utero exposure to maternal smoking was associated with reduced peak expiratory flow rate (PEFR) (-3.0%, 95% CI -4.4 to -1.4), mean mid expiratory flow (MMEF) (-4.6%, 95% CI -7.0 to -2.3), and forced expiratory flow (FEF(75)) (-6.2%, 95% CI -9.1 to -3.1), but not forced expiratory volume in one second (FEV(1)). Adjusting for household ETS exposure did not substantially change these estimates. The reductions in flows associated with in utero exposure did not significantly vary with sex, race, grade, income, parental education, or personal smoking. Exposure to two or more current household smokers was associated with reduced MMEF (-4.1%, 95% CI -7.6 to -0. 4) and FEF(75) (-4.4%, 95% CI -9.0 to 0.4). Current or past maternal smoking was associated with reductions in PEFR and MMEF; however, after adjustment for in utero exposure, deficits in MMEF and FEF(75) associated with all measurements of ETS were substantially reduced and were not statistically significant. CONCLUSIONS: In utero exposure to maternal smoking is independently associated with decreased lung function in children of school age, especially for small airway flows.

Adolescent↗

The contribution of executive functions to emergent mathematic skills in preschool children.

Mathematical ability is related to both activation of the prefrontal cortex in neuroimaging studies of adults and to executive functions in school-age children. The purpose of this study was to determine whether executive functions were related to emergent mathematical proficiency in preschool children. Preschool children (N = 96) were administered an executive function battery that was reduced empirically to working memory (WM), inhibitory control (IC), and shifting abilities by calculating composite scores derived from principal component analysis. Both WM and IC predicted early arithmetic competency, with the observed relations robust after controlling statistically for child age, maternal education, and child vocabulary. Only IC accounted for unique variance in mathematical skills, after the contribution of other executive functions were controlled statistically as well. Specific executive functions are related to emergent mathematical proficiency in this age range. Longitudinal studies using structural equation modeling are necessary to better characterize these ontogenetic relations.

Aptitude↗

School dysfunction: evaluative aspects.

Inability of a child to function in a formal school setting necessitates a review of potential physical, mental, emotional, and behavioral etiologies. A thorough, systematic history and examination is expected; the time of onset, age, and grade of the patient helps to narrow the differential diagnosis. A careful assessment should determine the work-up, correct diagnosis, and treatment. Additional primary care physician responsibilities in school dysfunction cases include patient education, family support, and specialist referral, if necessary.

Adolescent↗