Eddie Keir

A Longitudinal Study of Very Low-birthweight Infants. IV: An Overview of Performance at Eight Years of Age

A cohort of 169 very low‐birth weight infants (800 to 1500g) was followed prospectively to the age of eight years. Information on 159 of the children was available at that age, and for a further five to the age of six years. A comparison group of 67 normal‐birthweight children was also followed, but only 43 of these children were seen at the age of eight years.

Risk factors for adverse outcomes of bacterial meningitis

Objective: To identify risk factors for adverse outcomes from bacterial meningitis.

Auditory function at 14 years of age of very-low-birthweight children

The aim of the study was to determine audiological function at 14 years of age of very-low-birthweight (VLBW < or = 1500 g) children compared with a cohort of normal birthweight (NBW > 2499 g) children. Participants were consecutive surviving preterm children of birthweight < 1000 g born between 1977 and 1982 (n=86) and of birthweight 1000 to 1500 g born between 1980 and 1982 (n=124) and randomly selected NBW children born between 1981 and 1982 (n=60). Audiometric tests included pure tone audiometry, tympanometry, stapedius muscle reflexes, and measures of central auditory processing. Psychometric tests included measures of IQ, academic achievement, and behaviour. There were no significant differences in rates of hearing impairment, abnormal tympanograms, figure-ground problems, or digit recall between VLBW children and NBW control children. VLBW children had higher rates of some central auditory processing problems, which in turn were associated with poorer intellectual, academic, and behavioural progress.

A longitudinal study of very low-birthweight infants. II: Results of controlled trial of intensive care and incidence of handicaps.

Between 1966 and 1970, infants with birthweights between 1000 and 1500g entered a randomized controlled trial to determine the short‐term and long‐term results of neonatal intensive care. Of 158 long‐term survivors, five were lost to follow‐up, but the multidisciplinary research team prospectively followed 143 children up to the age of eight years. Useful data were available for the other 10 children. Of the long‐term survivors 74 had received routine, and 84 had received intensive nursery care.

A longitudinal study of very low-birthweight infants. I. Study design and mortality rates.

A group of 238 infants, weighing between 1000g and 1500g and born consecutively in one hospital between 1966 and 1970, were entered in a controlled trial in an attempt to determine whether intensive care of very low‐birthweight (VLBW) infants affects long‐term survival and the incidence of severe handicap. The infants were allotted on an alternate basis to either intensive care or routine care. The methods of intensive and routine care are described in detail. All the VLBW infants received the same basic nursery care.

Electroencephalographic abnormalities during sleep in children with developmental speech-language disorders: a case–control study

Earlier research has suggested a link between epileptiform activity in the electroencephalogram (EEG) and developmental speech‐language disorder (DSLD). This study investigated the strength of this association by comparing the frequency of EEG abnormalities in 45 language‐normal children (29 males, 16 females; mean age 6y 11mo, SD 1y 10mo, range 4y–9y 10mo) and 54 community‐ascertained children (35 males, 19 females; mean age 5y 7mo, SD 1y 6mo, range 4y–9y 11mo) with a diagnosis of severe DSLD, defined as a score at least 2 SD below the mean on at least one speech‐language measure, and a performance IQ of at least 80 points. All participants underwent sleep EEGs after sedation. Children with DSLD also had detailed speech‐language, hearing, and psychological assessments. Results failed to support the previously identified strong association between abnormal EEG and DSLD. There was a weak, non‐significant relationship between DSLD and epileptiform EEG. Epileptiform EEG was significantly associated with low performance IQ (p=0.04). This study draws into question previously reported associations between epileptiform activity and DSLD probably because it examined a purer cohort of children with more severe language difficulties who did not have seizures.

Auditory Dysfunction In Children with School Problems

One hundred thirty-three children with school problems referred to a hospital-based multidisciplinary clinic were screened audiologically to determine the frequency of auditory problems, and to determine whether one could predict auditory problems from clinical data. Ninety-three (69.9%) failed one or more parts of the screening procedure. Twenty-two children (7.9% of the total group) had abnormal hearing acuity, 33 (30.6%) abnormal speech discrimination in noise, and 73 (62.4%) abnormal short term auditory memory. These figures are significantly higher than those found in a representative sample of school children. Not one of 16 items from parent and teacher questionnaires and neurodevelopmental findings predicted auditory acuity or speech in noise problems; there were correlations between short term auditory memory items and parental and teacher rating of a language problem, teacher rating of reading and sequencing problem, and neurodevelopmental finding of auditory sequencing problem. In view of this inability to clinically predict auditory processing deficits, the authors suggest that a full audiological assessment, including short term memory and speech in noise testing, is warranted as part of the evaluation of children with learning difficulties.

The association of thyroid dyshormonogenesis and deafness (Pendred syndrome): Experience of the Victorian Neonatal Thyroid Screening Programme

Abstract Between 1977 and 1989, the Victorian Neonatal Thyroid Screening Programme detected five subjects with thyroid dyshormonogenesis and sensorineural deafness. These patients have been diagnosed as having Pendred syndrome. In two of the children, thyroid function tests which were initially abnormal at birth returned to normal spontaneously without treatment. However, hypothyroidism subsequently recurred and the children required thyroxine therapy. These two children could have been mistakenly diagnosed as having transient hypothyroidism. The detection of five patients with Pendred syndrome illustrates the importance of audiological assessment in all babies with thyroid dyshormonogenesis in whom there is increased uptake of isotope on thyroid scanning. In our experience, hearing loss in patients with Pendred syndrome may be progressive over time, so that repeated audiological assessments are necessary.