Margareta Dahl

Feeding problems in an affluent society. Follow-up at four years of age in children with early refusal to eat.

Twenty‐four children, previously investigated at 3–12 months of age for refusal to eat during at least four weeks with no apparent medical cause, were followed up prospectively and reinvestigated at four years of age. Comparisons were made with 38 controls, selected from the same child health care districts. Information was obtained from parental interviews, medical records and assessments by a speech therapist. At four years of age, 17 of the 24 children with early refusal to eat (71%) were reported by the parents to still have feeding problems and 10 (42%) were reported as hyperactive. Compared to the controls, the children with early refusal to eat seemed to have an equally good prognosis with respect to health, growth and development, but were at risk of later problems with their eating patterns and behaviour.

Characteristics of School Children who are Choosy Eaters

Choosiness, manifested in refusal of foods, eating little, and disinterest in food, was studied with regard to prevalence, stability, sociodemographic characteristics, health problems, weight, and associated problem behaviors in a sample of 240 Swedish primary school children. Questionnaires were used, and data on sociodemographic variables, health problems, weight, and height were collected from child health-care and school health records. Choosiness was present in one third of the children, but only 8% showed choosy behavior both at home and in school. The choosy children had no more health problems than others, nor were they significantly thinner. Choosiness was not related to gender, social class, or ethnic background. The choosy children had modestly elevated levels of externalizing, hyperactive, and internalizing behavior. The choosy children with a history of refusal to eat in infancy or preschool age had more pronounced choosy behavior and had more problem behaviors than the other choosy children. Choosiness can not easily be categorized within an eating disorders or main problem syndromes of childhood frame of reference.

Children with early refusal to eat: follow-up during primary school.

Dahl M, Rydell A‐M, Sundelin C. Children with early refusal to eat: follow‐up during primary school. Acta Paediatr 1994;83:54–8. Stockholm. ISSN 0803–5253

Medical problems in adolescents with myelomeningocele (MMC) : an inventory of the Swedish MMC population born during 1986-1989.

Aim: To describe the prevalence of myelomeningocele (MMC) and the medical needs of adolescents, 15–18 years, with MMC in Sweden, at a time when they are on the threshold of adulthood, leaving paediatrics.

Self-esteem in children and adolescents with mobility impairment: impact on well-being and coping strategies

Aim: The first aim was to investigate dimension‐specific and global self‐esteem in children and adolescents with mobility impairment and to analyse the relation between self‐esteem and demographic data and disability characteristics. The second aim was to identify the impact of five self‐esteem dimensions on well‐being and coping strategies.

Well-being among children and adolescents with mobility impairment:In relation to demographic data and disability characteristics

AIM To describe the well-being of children and adolescents with mobility impairment in relation to demographic data and disability characteristics. METHODS The present study is based on interviews with 141 subjects aged 7 to 18?y with impaired mobility. Perceived overall well-being was measured by a nine-grade visual scale, the Snoopy scale. Independence or dependence was evaluated by the Index of Independence in Activities of Daily Living. Motor capacity was assessed with an instrument including active movements, rapidity, locomotion and balance as well as the presence and localization of pain. RESULTS Since there were no significant differences in well-being regarding the diagnostic-related group, additional disorder/disability or the degree of disability, the impairment per se did not necessarily influence well-being negatively. Even though the majority of the children and adolescents in the study indicated a high level of well-being, several risk factors for a lower level of well-being were identified: greater age, not living with both parents, being a first-generation immigrant, having an acquired disease/injury and experience of pain. CONCLUSION These findings increase our limited knowledge of well-being among children/adolescents with mobility impairment and provide a basis for effective care and future research.

Well-being among children and adolescents with mobility impairment in relation to demographic data and disability characteristics: Well-being among children and adolescents with mobility impairment

Aim: To describe the well‐being of children and adolescents with mobility impairment in relation to demographic data and disability characteristics. Methods: The present study is based on interviews with 141 subjects aged 7 to 18 y with impaired mobility. Perceived overall well‐being was measured by a nine‐grade visual scale, the Snoopy scale. Independence or dependence was evaluated by the Index of Independence in Activities of Daily Living. Motor capacity was assessed with an instrument including active movements, rapidity, locomotion and balance as well as the presence and localization of pain. Results: Since there were no significant differences in well‐being regarding the diagnostic‐related group, additional disorder/disability or the degree of disability, the impairment per se did not necessarily influence well‐being negatively. Even though the majority of the children and adolescents in the study indicated a high level of well‐being, several risk factors for a lower level of well‐being were identified: greater age, not living with both parents, being a first‐generation immigrant, having an acquired disease/injury and experience of pain.

Children with early refusal to eat: Follow‐up in adolescence

AIM To describe the adolescent outcome of infant refusal to eat (RTE) and to investigate early predictors of adolescent outcomes. METHODS 19 of 25 children with RTE and 35 of 42 controls were assessed at age 16. The participants rated eating attitudes and self-perceptions with a Swedish version of the Childrens Eating Attitudes Test (ChEAT) and a Swedish self-perception measure. Weight and height were assessed through self-reports, and body mass index (BMI) was computed. Child and family variables measured from infancy through age 4 were used as predictors. RESULTS RTE and controls did not differ with regard to disturbed eating attitudes, BMI or self-perceptions. There were no relations between early predictors and adolescent disturbed eating for the whole sample, but breastfeeding problems and social adversity in the early years predicted negative self-perceptions, and weight at 4 y predicted adolescent BMI. For the RTE group, low birthweight predicted higher levels of disturbed eating attitudes and less positive self-perceptions. For the control group, social adversity predicted high BMI. CONCLUSION RTE does not seem to constitute a risk factor for adolescent disturbed eating. Further, there may be different risk factors for adolescent disturbed eating for children with and without RTE.

Coping strategies among Swedish children and adolescents with mobility impairment in relation to demographic data, disability characteristics and well-being

Aim: The first aim of the present study was to evaluate the applicability of a four‐dimensional model of coping strategies, which includes ‘active coping’, ‘distraction’, ‘avoidance’ and ‘support seeking’ strategies, on children and adolescents with mobility impairment. The second aim was to identify coping strategies in this group. Finally, we analysed the relation between coping strategies and demographic data, disability characteristics and well‐being.

Increased perinatal intracranial pressure and brainstem dysfunction predict early puberty in boys with myelomeningocele

Background:  Children with myelomeningocele (MMC) run an increased risk of developing early or precocious puberty (E/PP).