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Design factors in the assessment of intelligence.

The use of intelligence tests to assess the effects of otitis media on the development of children is discussed in this article. An overview of the development of intelligence tests is provided and some of the limitations and central issues of controversy concerning intelligence testing and the IQ are reviewed. Basic intelligence tests are described in terms of their characteristics and uses; the questions which an investigator must ask about any given intelligence test measure are posed and answered. Finally, cautions concerning the applicability of intelligence tests for evaluating the effects of otitis media are offered.

Humans↗

Predictability as an index of impaired verbal communication in schizophrenic and affective disorders.

The cloze procedure was used to examine predictability in speech samples from schizophrenic, depressive, manic, schizoaffective and normal subjects. Each speech sample was also rated for particular indices of thought disorder using the Andreasen Scale for the Assessment of Thought, Language and Communication. Schizophrenics were found to be less predictable than other patient groups or normals. Depressives were found to be the most predictable. Correlational analyses of cloze scores and specific thought disorder ratings suggest that reduced predictability is associated with traditional indicators of thought disorder.

Adolescent↗

Language development in a child with left hemispherectomy.

A longitudinal study of a left hemispherectomized boy (AB) was conducted to document linguistic evolution and maturation and determine the extent to which right hemisphere processes allow development of language. Resection of the left hemisphere occurred at age 5 years 6 months, following intractable epilepsy. Tests of language comprehension (pointing, understanding of prepositions, understanding of narratives) and production (naming, repetition, lexical diversity, grammatical production) were administered at ages 6:2, 6:4, 6:6, and 6 years 9 months. Observations showed little progress, if any, in most aspects of linguistic performance. In contrast to studies with left-hemispherectomized children, AB showed only a modest expansion of the semantic lexicon and the phonological repertoire more than a year after the surgical intervention. These observations indirectly suggest (1) poor functional involvement of the right hemisphere in the development of adequate linguistic abilities, (2) the necessary integrity of the LH for adequate development of language, or (3) that variations in individual brain maturation rates may account for AB's linguistic progress.

Brain↗

The pediatric early elementary examination: studies of a neurodevelopmental examination for 7- to 9-year-old children.

The Pediatric Early Elementary Examination (PEEX) is a neurodevelopmental assessment designed to evaluate children with learning problems between the ages of 7 and 9. The current study of this procedure focused on a sample of youngsters from two middle-class communities and a group of children referred for learning problems to the School Function Program, a specialty clinic at The Children's Hospital in Boston. During prior pilot testing, diagnostic criteria had been established for specific areas of development assessed on the Pediatric Early Elementary Examination. Findings were expressed as "areas of concern" or developmental weaknesses suggesting the need for further monitoring or referral. It was found that nearly half of the children in the community had at least one such finding. These areas of concern were spread fairly evenly over the seven developmental areas of concern correlated with results of the revised Wechsler Intelligence Scale for Children (WISC-R) and the California Achievement Test in the community. Youngsters referred to the School Function Program with learning problems also were more likely to have multiple areas of developmental concern. Results suggest that the Pediatric Early Elementary Examination shows promise as a reliable and valid system of observation for use by health care professionals.

Achievement↗

Severe permanent encephalopathy in acute lymphoblastic leukemia.

As survival rates for childhood acute lymphoblastic leukemia have increased, concerns over improved quality-of-life have also increased. Although 3-10% of children may experience acute transient neurotoxicity during induction chemotherapy, they are felt to be at low risk for late sequelae. We report three previously healthy boys with newly-diagnosed acute lymphoblastic leukemia who presented with obtundation and severe seizures during late induction with a standard four drug chemotherapy regimen. While all three are disease-free survivors, they unexpectedly have persistent and medically intractable partial complex seizures, broad-based neuropsychological impairment and striking neuroimaging abnormalities. These findings suggest that children with leukemia who develop an acute encephalopathy during induction chemotherapy are at risk for long-term neurological and neuropsychological sequelae, despite the cessation of further potentially neurotoxic therapy.

Antineoplastic Combined Chemotherapy Protocols↗

[Evaluation of a German version of WOMAC (Western Ontario and McMaster Universities) Arthrosis Index].

The WOMAC (Western Ontario and McMaster Universities) Osteoarthritis Index is a tested questionnaire to assess symptoms and physical functional disability. We adapted the WOMAC for the German language and tested its metric properties, test-retest reliability and validity in 51 patients with knee and hip OA. All WOMAC scales (pain, stiffness, function) were internally consistent with Cronbach's coefficient alpha ranging from 0.80 to 0.96. Test-retest reliability was satisfactory with intraclass correlation coefficients ranging from 0.55 to 0.74. All scales and the global index calculated as the mean of scale scores had a bimodal distribution and a slight ceiling effect. As hypothesized the WOMAC scales were associated with radiological OA-severity and limitations of range-of-motion. Patients with more severe symptoms and functional disability perceived more limitations in their roles at home and at work. The presented German version of the WOMAC is a reliable and valid instrument for the assessment of symptoms and physical functional disability in patients with knee and hip OA.

Activities of Daily Living↗

Neuropsychological verbal tests may lack "hold" properties in occupational studies of neurotoxic effects.

OBJECTIVES: In epidemiological studies of neurotoxic effects neuropsychological tests are often applied to assess possible functional changes. In these studies tests presumed to be resistant to neurotoxic effects, "hold tests", are often used to adjust performance in tests presumed to be sensitive to neurotoxic effects, "nonhold tests", in assessment of pre-exposure ability. This conception is based on experience from the examination of patients with organic brain disorders. For this adjustment to be valid hold tests should change comparatively little over time and should not change differently in groups of people with different exposures to neurotoxic agents. METHODS: These assumptions were examined in 71 carpenters and 135 painters divided in three subgroups according to level of cumulative exposure to organic solvents. The results were noted from two verbal tests (test A, which involved following verbal instructions and test C, word comprehension), which were performed at conscription (age 18-20). The tests resemble hold tests used in occupational studies. The same tests were performed again at the age of 45-60 together with a conventional synonym test (SRB 1), often used in occupational studies. RESULTS: In the three tests given at the time of the investigation some differences were found between the carpenters and the subgroups of painters. The painters with low exposure tended to perform better than the carpenters in all three tests and the heavily exposed painters tended to perform less well in the tests. These differences were not present at the age of 18-20. In one of the conscription tests painters with different cumulative exposure to organic solvents developed differently over time. There was little improvement among painters with heavy and intermediate exposure and obvious improvement among painters with low exposure. The results in the other conscription test showed similar tendencies. CONCLUSIONS: The results indicate that the hold tests examined do not meet basic criteria for hold tests used in occupational studies. Thus adjustments for conventional verbal tests seem inappropriate in such studies. It is possible that other presumed hold tests may meet the criteria but our results suggest that such tests also should be evaluated before being used as hold tests in working populations.

Adolescent↗

Screening for perceptual skills dysfunction: an up-date.

The paper argues that the primary-care practitioner has an obligation to screen the visual and auditory perceptual skills of all his/her elementary school-aged patients. Two easy-to-administer tests are described, along with guidelines for interpreting and making decisions on the basis of test outcomes.

Auditory Perceptual Disorders↗

Once-weekly and 5-days a week iron supplementation differentially affect cognitive function but not school performance in Thai children.

Many studies have reported comparable hemoglobin response in subjects given intermittent and daily iron supplements. However, the effect of intermittent iron supplementation on impaired cognitive function, one of the serious consequences of iron deficiency among children, has not been studied. We investigated the effects of 1 d/wk (weekly) and 5 d/wk (daily) iron supplementation on changes in results of intelligence quotient (IQ), Thai language, and mathematics tests among Thai primary schoolchildren. A double-blind, randomized, placebo-controlled trial was conducted. Primary schoolchildren (n = 397) were randomly assigned to receive iron supplements daily or weekly or placebo. Ferrous sulfate (300 mg) or placebo tablets were given under direct observation by the researcher for 16 wk. Changes in IQ, and Thai language and mathematics scores were then compared. The increases in hemoglobin concentration were comparable in the weekly and daily iron supplementation groups but serum ferritin increased more in the children supplemented daily. Children receiving daily iron supplements, however, had a significantly lower increase in IQ (3 +/- 12 points) than those receiving the supplement weekly (6 +/- 12 points) or placebo (6 +/- 12 points), whereas the last-mentioned two groups did not differ. Z-scores of Thai language and mathematics test results did not differ among the groups. We conclude that weekly iron supplementation is the regimen of choice in this study community.

Child↗

Results of psychological testing of patients aged 3-6 years.

Cognitive development of early treated PKU children (132) was investigated by intelligence tests, tests for visual perception, motor and language development. Deviations from test norms occurred at 5 years of age concerning performance IQ, mathematical thinking, and visual perception. With the exception of mathematical thinking, "normal" results were obtained at the age of 6 years. Correlation with levels of plasma Phe revealed a relation between quality of dietary control and performance IQ. Results are discussed in light of methodological aspects and with respect to treatment consequence.

Child, Preschool↗

Physical growth and neurodevelopmental outcome of nonhandicapped low-risk children born preterm.

BACKGROUND: Outcome studies on the effects of prematurity are increasingly restricted to extremely immature infants with birth weight below 1000 g or gestational age below 26 weeks. In contrast, studies comprising low-risk preterm infants are rare. AIM: To examine growth and neurodevelopmental outcome, 70 low-risk low birth weight (LBW) children without neurological impairment were followed from birth to 7 years of age. At 7 years of age, LBW children were compared to a matched control group born at term. METHODS: Postnatal growth was measured at 20 months in the LBW group and at 7 years in LBW and control children. At 20 months, the LBW group was assessed with the Griffiths Scales. At 7 years, LBW and control children were assessed with a neuropsychological test battery comprising tests for language, visual-perceptual, visual-motor, fine and gross motor abilities. RESULTS: At 7 years of age, the frequency of children with low (3rd-9th percentile) or subnormal (<3rd percentile) growth parameters was increased in the LBW group. The Mean Griffiths Developmental Quotient (DQ) of the preterm group was normal (102.3+/-8.4), and there were only two results below DQ 85. There was no difference between 49 children appropriate for gestational age and 21 small for gestational age (SGA) children. At 7 years of age, reduced mean test results in the range of -0.5 SDS were observed for language and visual-motor abilities in the preterm group. This was due to an increased frequency of LBW children with moderately (SDS -1.0 to -2.0 SDS) subnormal test results. Even for the slightly LBW group (2000 to 2499 g), poorer language abilities were confirmed. CONCLUSION: All LBW infants, including low-risk populations, should be included in a follow-up program in order to detect deficits early in life and begin treatment before school entry.

Adult↗