E. David Mellits

Identification of language-impaired children on the basis of rapid perception and production skills

Discriminant function analysis was used to determine whether performance on temporal perception and production tasks alone could correctly classify children as language-impaired or normal. The analysis identified six variables, all of which assessed temporal perceptual and production abilities, which taken in combination correctly classified 98% of participating subjects. None of these variables assess the higher-level linguistic abilities (semantic, syntactic, pragmatic) that have classically been considered to be deficient in language-impaired children, or have been used to diagnose them clinically.

A double-blind controlled trial of anti-Pseudomonas chemotherapy of acute respiratory exacerbations in patients with cystic fibrosis

A double-blind controlled trail of anti-Pseudomonas chemotherapy was carried out in 24 exacerbations of pulmonary disease in patients with cystic fibrosis. Fifteen exacerbations were treated with oxacillin plus sisomicin and carbenicillin (treatment group); nine were treated with oxacillin alone (control group). The planned length of treatment was 14 days. The difference between the failure rate in the treatment group (3/15) and the control group (7/9) was statistically significant (P less than 0.015). The difference in improvement of forced expiratory volume in 1 second was also significant (P less than 0.025). At the end of the study, Pseudomonas aeruginosa was still present in the sputum of all nine patients in the control group, but was not isolated from six of the 15 patients in the treatment group. The data suggest a beneficial role for anti-Pseudomonas chemotherapy in the treatment of acute pulmonary exacerbations in patients with cystic fibrosis.

Increase in functional bladder capacity and improvements in enuresis

A follow-up study of 83 children with enuresis demonstrates a relationship between increased bladder capacity and improvement in enuresis. The effect of age on functional bladder capacity and the wide variability among children even of the same age are stressed.

A simple protoporphyrin assay-microhematocrit procedure as a screening technique for increased lead absorption in young children

A simple screening technique for measuring protoporphyrin (PROTO) in acidified acetone extracts of capillary blood is described. A statistically significant linear relationship was found between blood lead concentration and log e PROTO concentration. The relationship is sensitive to mild degrees of anemia. The hematocrit may be used to compensate for concurrent anemia when screening for increased lead absorption. When this PROTO assay-microhematocrit procedure was was used prospectively as a screening technique for increased lead absorption, 95 per cent of children with ⪖50 μg Pb were identified, while 90 per cent of those with

Intravenous immunoglobulin in minimal change nephrotic syndrome: a crossover trial

To determine whether intravenous immunoglobulin (IVGG) would be an efficacious adjunct in the treatment of childhood minimal change nephrotic syndrome (MCNS), we enrolled ten patients with frequently relapsing or steroid-dependent MCNS in a double-blind crossover clinical trial. At the time of relapse of the nephrotic syndrome, patients were assigned to treatment with a single outpatient infusion of IVGG (800 mg/kg) or intravenous albumin as a control. The relapse was treated concurrently with standard doses of oral prednisone. At the time of the next relapse, patients who had first received IVGG were treated with albumin, and vice versa. There were no significant differences in the length of remission between the IVGG and albumin treatments. The study had a power of 0.72 to detect a true difference of 45 days between the two therapies. We conclude that in the dose of drug used in this trial, administered at the time of relapse in conjunction with prednisone therapy to children with frequently relapsing or steroid-dependent MCNS, IVGG does not lead to a clinically important extension of the period of remission.

Neonatal screening for phenylketonuria: III. Altered sex ratio; extent and possible causes

In many infants with phenylketonuria (PKU) the concentration of blood phenylalanine rises only minimally during the first three days of life and infants of both sexes may be missed by screening. During this period the rate of rise of blood phenylalanine is slower in females than in males and, on the fourth day of life, significantly more males than females are discovered by screening. The ratio of males to females who are screened on the fourth day is not higher than on the previous days. The large proportion of all infants who were screened on the fourth day of life probably accounts for the previously described excess of males; females are being missed. In 12 states providing data 44.4% of all infants were screened on one of the first three days of life and 25% on the fourth day.

Pitfalls in the Measurement of Intelligence: Are Standard Intelligence Tests Valid Instruments for Measuring the Intellectual Potential of Urban Children?

Summary Selected questions from the Wechsler Intelligence Scale for Children (WISC) were readministered to 200 inner-city seven-year-olds after completion of the standard protocol. The readministration was specifically structured to ascertain the reasoning by which children arrived at their answers. A system was developed for the classification of errors. Four categories of error, in addition to basic lack of knowledge, were demonstrated. The categorization of errors, by type, permitted examination of the reasoning underlying responses. It was apparent that some reasonable alternative answers existed which received no credit or only partial credit when the standard WISC protocol was applied. These results may suggest modifications to compensate for some of the limitations imposed by standardized test procedures.

Quantification of Language Abilities in Children

Publisher Summary This chapter presents the approaches for quantification of language abilities in children. There is, at present, a widely felt need for a standard approach to the assessment of language abilities in children. Although clinical judgment and review of intelligence test data and of the childs communicative skill provide important insights, there is no substitute for language measures per se. A variety of language tests have been developed for the purposes of measuring receptive and expressive language functioning, or some combination of the two, in children of 4 to 8 or 9 years. Some of these texts are styled as screening tests only; others are more exhaustive and are used interchangeably to identify language impairment in children and/or to design intervention programs for the children who are so identified. The same tests are sometimes used to design intervention and to assess its effectiveness, with the unfortunate result that children have sometimes been taught to take language tests, not to understand or to use language