Thomas E. Frothingham

Toxocara canis Infestation: Clinical and Epidemiological Associations with Seropositivity in Kindergarten Children

We studied a cohort of 333 children in kindergarten to determine the prevalence of seropositivity to Toxocara canis, and to detect and measure chronic health effects that might be attributable to past infection. We found that 23.1% of the children had serologic evidence of infection (antibody titer greater than or equal to 1:32), assayed by means of an enzyme-linked immunosorbent assay. Black children were more frequently infested than white children, as were children of parents who did not graduate from high school. In a subsample of seropositive and seronegative children, we found associations between seropositivity and both pica and puppy ownership; we did not find differences in the symptoms and signs that occur in toxocaral visceral larva migrans nor differences in measures of growth and nutrition. No child had ocular toxocariasis although 31.8% (106) of the children had antibody titers greater than or equal to 1:16. In a population in which approximately 20 to 30% of the children show serologic evidence of Toxocara infestation, care must be taken in differentiating toxocariasis-like ophthalmic lesions, due to the potential for the coincidental occurrence of retinoblastoma in a child who is seropositive for the Toxocara parasite.

Child development knowledge, childrearing attitudes, and social support among first- and second-time adolescent mothers

This paper compares the parenting characteristics of first- and second-time adolescent mothers. Using a case control design, immediately after delivery and at two months postpartum we administered a pretested questionnaire to 51 second-time adolescent mothers, 47 first-time adolescent mothers, and 25 second-time adult mothers. The questionnaire measured the subjects social support system, contraceptive use, and education level. Scales measuring stressful life events, knowledge of child development, and childrearing attitudes were included. The adolescent groups were similar except that significantly more second-time adolescent mothers dropped out of school (p less than or equal to 0.05). Greater maternal education and higher infant five-minute Apgar scores were associated with less negative childrearing attitudes immediately after the birth (p less than or equal to 0.05). At two months postpartum, the age of the father and the time he spent with the child were associated with positive childrearing attitudes (p less than or equal to 0.05). Increased paternal involvement and completion of high school may enhance adolescent attitudes toward childrearing and improve mother-child relations.

DISPROPORTIONATE INTRA-UTERINE HEAD GROWTH AND DEVELOPMENTAL OUTCOME

The authors examined the relationship between disproportionate intra‐uterine head growth, or a relatively small head, and later development, using data collected as part of the Collaborative Perinatal Project of the National Institute of Neurological and Communicative Disorders and Stroke. Within the population of infants who are normal by conventional criteria (term infants with appropriate weight and head‐circumference for gestational age), a group with relatively small heads was defined by each of four different methods. Developmental outcome measures included the Bayley Mental and Motor Scales at eight months, Stanford‐Binet IQ at four years and Wechsler Intelligence Scales IQ at seven years. No clinically meaningful differences in developmental outcome were found between the infants with relatively small heads and the remainder of the infants.

The British Case Conference in child sexual abuse: another model for America

In 1990, I had an opportunity to observe the civic response to child sexual abuse in Leeds, England. During this time, I also attended the British Case Conference and found it to be a central event in the development of diagnosing and treating child abuse, especially sexual abuse. The purpose of this report is to describe this multidisciplinary, multiagency procedure that is used throughout Britain, and to offer opinions on its strengths and weaknesses.