bluuebunny/crossref_metadata_2025 huggingface dataset:
Smoking habits in school‐children with 2 years follow‐up
Authors: HOLMQVIST P.
Published: April 2006

Summary
The proportion of smokers among Swedish schoolchildren between 12 and 15 years of age and their short‐ and long‐term attitudes and reactions towards smoking during an antismoking campaign was studied. Of a total of 413 pupils interviewed, 13·3% of the boys and 9·5% of the girls were smokers. Among the 15‐year‐old pupils 21% were smokers, whereas none of the 12–13‐year‐old pupils smoked at all. Everyday smoking was twice as common in boys as in girls but on follow‐up there was no difference. Our study confirms a trend of diminishing smoking habits in boys but not among girls. Antitobacco campaigns may have a long‐term positive effect in supporting changed attitudes towards smoking.
Addicted mothers and their children: a case for coordinated welfare services
Authors: MERRICK JOAV
Published: April 2006

Summary
Children of drug‐addicted mothers are at an increased risk of premature birth, neonatal complications, developmental delay, understimulation, deprivation, neglect, abuse and even premature death. Research results from four Danish centres are presented and discussed. The material covers the period from 1970–1983. The studies clearly show a need for more coordinated support and services for these families and their children in order to prevent a new generation of ‘social losers’.
Comparative study of social and family correlates of children's behaviour ratings
Authors: GHODSIAN MAYER , ZAJICEK EVA , WOLKIND STEPHEN
Published: April 2006

Summary
Using a random sample of first‐time mothers the associations between their children's behaviour problems at three points in time are presented. A moderate to low correlation was obtained between the ages of 27 and 42 months. No correlation existed between 14 and 27 or 42 months. The relationships between behaviour problems and social and family factors at each age were also examined. These generally increased with the children's age and included maternal depression, lack of social contacts, poorer relationships and housing problems. It is tentatively suggested that the differing patterns of associations at the three ages might indicate a progression, with increasing age, towards a more difficult situation for the families.
Aspects of early social smiling by infants with Down's syndrome
Authors: BERGER J. , CUNNINGHAM C.
Published: April 2006

Summary
Smiling by live Down's syndrome and seven non‐handicapped infants was recorded longitudinally during face‐to‐face interactions with their mothers over the first 6 months of the infants' lives. Two conditions, “mobile” (mothers were asked to talk to the baby as naturally as possible) and ‘immobile’ (silent and maintain an impassive face), were contrasted. Between‐group comparisons confirmed previous findings of significantly delayed emergence and less frequent smiling by the infants with Down's syndrome. Their smiles were also found to be shorter, and less discriminative between the two free‐to‐face conditions. The non‐handicapped infants showed significantly more cry/distress vocalizations in the immobile than in the mobile condition, while the reverse was found for the Downs syndrome infants. A close temporal association between smiling and eye contact with mothers was found for both groups of infants. In a free interaction condition, mothers of the Down's syndrome babies showed a stronger tendency to use kinaesthetic and tactile stimulation than mothers of the non‐handicapped infants.
Child impairment and parent/infant communication
Authors: FRASER B. C.
Published: April 2006

Summary
This paper sets out to explore the potential effects of child impairment upon the development of parent/infant interaction patterns. Interaction is seen as an important determinant of the level of social and material experience to which a child is likely to be exposed. It follows that a reduction or negative alteration of interaction patterns will have important experiential consequences and thence an effect upon cognitive development, social and emotional skills and learning ability. It is shown that the development of interactions is dependent upon stimulation of the mother by the infant and it is postulated that this stimulation or signalling can be potentially inhibited by factors which are inherent in the impairing condition and by affective and cognitive factors projected onto the child by parents. Implications for treatment are considered with emphasis placed upon a need for counselling and guidance.
Preventive health care for preschool children or health surveillance
Authors: BRYANT GILLIAN
Published: April 2006

Summary
The debate about provision of health surveillance programmes for preschool children is described. Improvement in the health of the child population has caused a need for its continuance in its present form to be questioned. The aspects of child health and development that still cause concern and the current approaches to them are reviewed. The problem of disadvantaged children and their health needs are discussed. Changes in social policy are required as well as continued initiatives in the provision of preventive health care for vulnerable families.
Practical and psychological problems for parents of children with epidermolysis bullosa
Authors: LANSDOWN RICHARD , ATHERTON DAVID , DALE ANNABELLE , SPROSTON SUZANNE , LLOYD JULIA
Published: April 2006

Summary
Parents of children with epidermolysis bullosa were sent a questionnaire seeking information on problems associated with the condition; 45% replied and their responses are discussed in terms of reported needs.
Aspects of congenital hypothyroidism
Authors: FROST G. J.
Published: April 2006

Summary
This article describes aspects of congenital hypothyroidism, outlining retrospective studies and indicating the effects on development in childhood of the deficiency of thyroid hormone in early life. The intellectual problems persist into adult life and are associated with motor and behavioural abnormalities, causing social difficulties to many of the patients. Prospective screening and early treatment have resolved many of these difficulties but treatment must be given appropriately to ensure adequate progress.
Clinicians' assessment of stress occurring with toddler's diarrhoea
Authors: FURNELL JAMES R. G. , DUTTON PHILIP V.
Published: April 2006

Summary
From biographical and behavioural data, four clinicians independently rated the degree of stress as either (1) due to general environmental influences or (2) induced by family relationships likely to act upon two groups of children—one with toddler's diarrhoea and a matched control group with other physical disorders. Each clinician rated the experimental group significantly higher on both scales of stress than the control group; inter‐rater correlation was positive and significant. The results suggest that environmental stress influences are associated with the aetiology and maintenance of toddler's diarrhoea, and imply that modification of such stress is relevant to treatment of the condition.
Down's syndrome and toddler temperament
Authors: HUNTINGTON GAILS. , SIMEONSSON RUNE J.
Published: April 2006

Summary
The temperament profiles of infants and toddlers with Down's syndrome were compared with those of a non‐handicapped, age reference group. The comparison revealed that the children with Down's syndrome were generally similar to the non‐handicapped group in terms of temperament characteristics. The results provide support for examining the temperament of children with Down's syndrome as a function of chronological rather than developmental age. The significance of documenting the diversity of behavioural styles among toddlers with Down's syndrome in evaluation and intervention is discussed.
Linking prenatal and perinatal adversities with child development
Authors: JAMES‐ROBERTS IAN St
Published: April 2006

Summary
Several professional groups share an interest in the effects of prenatal and perinatal adversities on children's development. The aim is to present a conceptual and methodological framework which will foster multidisciplinary study in this area. Recent evidence and principles about early life adversities, and developmental processes, are reviewed. The limitations of studies which address discrete variables at single points in time are highlighted. The proposal is that reproductive adversities are most effectively conceptualized as perturbations of infants' endogenous and social regulatory systems, which lead to adaptive developmental processes. The origins of maladaptations are to be found not simply in fixed, within‐the‐child, characteristics but in an understanding of regulatory processes; particularly the regulatory exchange between child and caregivers. A study is used to illustrate the translation of the model into research design.
Measurement of attention in severely motor impaired infants: a clinical evaluation of a new approach
Authors: ROUSSOUNIS S. H. , GAUSSEN T. H.
Published: April 2006

Summary
Current procedures for cognitive assessment of severely motor impaired infants are of limited value because of their reliance on motor responsivity. Methodologies which make use of infant attentional responsiveness offer the possibility of assessing cognitive function relatively independently of motor ability. We report the results of a study in 15 motor impaired infants of attentional changes to visual and auditory stimuli using heart rate change and observed behaviour as indices. Using these methods it was possible to show differences in infant cognitive functioning in otherwise hard to test' infants.
Assessment of abnormalities of gait in children from measurements of the instantaneous foot velocities during the swing phase
Authors: LAW H. T. , MINNS R. A.
Published: April 2006

Summary
A new gait analysis system is described which is microcomputer‐based, of low cost and both suitable for and acceptable to children with neurological motor disorders. A variety of different gait abnormalities and neurological conditions have been analysed and quantitative gait information is illustrated from this equipment which provides, after a short walk, an immediate profile of the objective measurements of the main spatial and temporal parameters of the gait cycle, i.e. step length, stride time, double support time, cadence, average walking speed and maximum velocity of the foot during the swing phase.
Poorly coordinated children: a survey of 95 cases
Authors: JOHNSTON OLIVE , SHORT HELEN , CRAWFORD JOAN
Published: April 2006

Summary
Screening of 717 5‐year‐olds and 757 7‐year‐olds, found 55 of the former and 77 of the latter possibly to be poorly coordinated. Further diagnostic testing with the McCarthy Motor Scales confirmed the problem in a total of 95 children, a prevalence of 6.4%. Neurological examination showed 43% of the 5‐year‐olds and 21% of the 7‐year‐olds to have choreiform movements. Of the total 95, proprioception was abnormal in 40%, but abnormal muscle tone present in only 4%. An increased prevalence of hearing loss and obesity and a history of developmental delays was found. Low birth weights, prematurity, post‐maturity and perinatal problems were significantly associated with poor coordination. Socioeconomic status was not a significant factor. The difficulties of testing and measuring poor coordination and the need for more precise measures are discussed. Follow‐up of at risk children at age 5 with tests of motor coordination is recommended.
Illness experience and related knowledge amongst children with asthma
Authors: EISER CHRISTINE , TOWN CAROL , TRIPP JOHN H.
Published: April 2006

Summary
Forty‐nine children with asthma (aged 7–16 years) completed a questionnaire concerned with (1) general knowledge about the body and how it works, and (2) specific knowledge about the cause and prognosis of asthma, knowledge of allergens and self‐care behaviours. Compared with a matched group of healthy children, they were less well‐informed about general knowledge of the body. Knowledge of asthma was also poor. Few children made any specific attempts to avoid situations known to precipitate attacks. There was no significant increase with age in knowledge of allergens or awareness of how to control attacks. The results indicate a need to make asthmatic children more aware of their illness, particularly with regard to self‐care.
Sexual maturation in girls with severe mental handicap
Authors: EVANS A. L. , McKINLAY I. A.
Published: April 2006

Summary
It is becoming accepted that sex education of handicapped adolescents should not be neglected. For such education to be effective, it should begin before sexual maturity. In an attempt to provide a starting guideline for girls attending ESN(S) schools in the Manchester area, a cross‐sectional survey was performed to determine mean age of menarche. The results showed the group as a whole to be on average 13 months later than normal. However, Down's syndrome formed a large identifiable subgroup with a mean menarcheal age 11 months earlier than normal, leaving the non‐Down's group 21 months later than normal, and 2 years 8 months behind the Down's group. The implications for education are discussed.
Working with families of children with special needs: the parent adviser scheme
Authors: BUCHAN LINDA , CLEMERSON JILL , DAVIS HILTON
Published: April 2006

Summary
This paper describes a project in which an attempt is made to provide regular, ongoing support and counselling for families of children with severe developmental delays and intellectual or physical impairments. This service is available to both English speaking and Bangladeshi families, and is concerned with the needs of the whole family, not just the child. Professionals already working in this field are trained in counselling skills and then work in partnership with the families, attempting to develop a respectful, open relationship based upon active listening.
Temperament characteristics of toddlers born prematurely
Authors: GOLDSTEIN DONALD J. , BRACEY REBECCA J.
Published: April 2006

Summary
An examination was made of the hypothesis that prematurity is associated with difficult temperament outcome in childhood. Temperament ratings for 40 preterm, very low birthweight 3‐year‐olds were compared with those of a matched, term control group. Results suggested that while toddlers born prematurely were rated as less rhythmic than their term counterparts, no differences existed between the groups with respect to the diagnostic clusters ‘easy’, ‘difficult’, and ‘slow to warm up’. It was concluded that from a global temperament standpoint, our high‐risk preterm 3‐year‐oIds were not perceived as more temperamentally difficult than term controls. The suggestion was offered that researchers seeking to broaden the scope of outcome assessment of high‐risk children turn to more direct measures of behaviour associated with temperament.
Psychological and social adjustment of obese children and their families
Authors: BANIS HEATHER TWEDDLE , VARNI JAMES W. , WALLANDER JAN L. , KORSCH BARBARA M. , JAY SUSAN M. , ADLER ROBERT , GARCIATEMPLE ERLINDA , NEGRETE VIDA
Published: April 2006

Summary
The psychological and social adjustment of 30 obese children and their families was examined. Mothers completed the Child Behaviour Checklist and the Family Environment Scale; children completed the Self‐Perception Profile for Children. The results consistently indicate that the obese children were less socially competent, had more behaviour problems, and had poorer self‐perceptions than the non‐obese normative samples. Families of obese children differed significantly from families in the non‐distressed normative sample in that they interacted in a more negative way. The findings are discussed in terms of an ‘at risk profile’ and the implications for the behavioural treatment of obese children.
Parent playfulness: a case study of infant twins with handicaps
Authors: McCOLLUM JEANETTE A.
Published: April 2006

Summary
This longitudinal case study was designed to provide descriptive data on game playing between one mother and father and their infant twin sons, each of whom had handicaps. Specific issues addressed were the proportion of interaction time spent playing parent/infant games, the types and characteristics of the games played, whether these varied between the mother and father, and whether there was a relationship between parental game playing and the developing but different abilities of the infants. Results showed many parallels with existing literature on parent/infant games and on differences between mothers and fathers. Results also indicated variations in game playing in relation to the extent of handicap in the infant.
Length of preschool hospitalization, multiple admissions and later educational attainment and behaviour
Authors: HASLVM MARY N.
Published: April 2006

Summary
Differences in educational performance and behaviour at age 10 years between 2900 hospitalized and 11 000 non‐hospitalized children in the 1970 British Births Cohort were described previously. In the present analysis associations were found between the length of time children spent in hospital before the age of 5 years and performance on vocabulary tests at age 5 and age 10. Children whose first admission occurred between 2 and 5 years of age were particularly likely to show this association. There was also a relationship between the length of preschool hospitalization and reading and mathematics attainment at age 10. It was the number of times a child was admitted to hospital before the age of 5, rather than the length of stay, which was associated with antisocial and anxious behaviour at age 5. The association was evident when the first admission occurred between 2 and 5 years of age and not before age 2. There was no association with such behaviour at age 10 once social and family factors and readmission between ages 5 and 10 were taken into account. There was a strong association between admission between ages 5 and 10 and behaviour scores at age 10. The results are interpreted as providing evidence for a need to develop the hospital educational service to ameliorate these associations and to review schemes which reduce the anxiety‐provoking aspects of hospitalization for young children.
Living with impairment: the effects on children of having an autistic sibling
Authors: HOWLIN PATRICIA
Published: April 2006

Summary
Although children of impaired siblings are generally believed to be at risk of suffering from a variety of problems themselves, research studies indicate that living with impairment is not necessarily a harmful experience. This report reviews studies in this area, with particular emphasis on those involving autistic sibships. Although often lacking adequate experimental controls, the current literature suggests various factors that are likely to influence the risks on siblings. Possible ways of minimizing such risk factors are discussed.
Obesity management via diet and exercise intervention
Authors: HILLS ANDREW P. , PARKER ANTHONY W.
Published: April 2006

Summary
To assess the effects of exercise and diet on obese prepubertal children, a group of subjects embarked upon a 16‐week exercise programme designed to improve body composition parameters and physical fitness. This was complemented by dietary counselling and nutrition education. Subjects comprising the experimental group (n= 10) on average lost body weight, reduced the sum of four skinfold measures (P < 0· 001) and in addition, noticed a reduction in body circumference measures whilst preserving or increasing lean body mass. In contrast, there was an increase in all measures for the control group (n= 10). The present study highlights the effectiveness of an exercise programme initiated as a function of an obesity clinic in association with a home programme. An interrelated approach to weight control in obese children should include exercise, diet and behaviour modification with appropriate guidance and follow‐up.
The emotional experience of multiple handicap: issues in assessment
Authors: McCONACHIE HELEN R. , SINASON VALERIE
Published: April 2006

Summary Guidelines for good practice in the assessment of children with multiple disabilities are presented. These arose from working groups of parents and professionals, drawn from a variety of theoretical orientations, who met together during a workshop sponsored by the Mary Kitzinger Trust.
Impact of gestational age on preterm motor development at 4 months chronological and adjusted ages
Authors: PIPER MARTHA C. , DARRAH JOHANNA , BYRNE PAUL
Published: April 2006

Summary A cohort of 62 low‐risk preterm infants was identified and followed prospectively through the first 4 months of life to assess whether motor development is determined by biological maturity or the duration of the extrauterine experience. After identification, the cohort was subdivided into two groups according to gestational age at birth: <32 weeks gestation (n = 23) and ≥32 weeks gestation (n = 39). Neuromotor assessments were performed on every infant at both 4 months chronological and 4 months adjusted ages. Analyses revealed that (1) the two groups of infants differed significantly at 4 months chronological age in terms of tone, primitive reflexes and volitional movement, but not in automatic reactions, and (2) the two groups of infants differed significantly at 4 months adjusted age in terms of primitive reflexes, but not in tone, automatic reactions or volitional movement. These findings suggest that the development of volitional movement and tone appear to evolve according to biological maturity alone. In contrast, primitive reflexes and automatic reactions in the preterm infant may be influenced by both biological maturation and environmental experience.
Analysis of the weights of infants of Bangladeshi origin attending two clinics in tower Hamlets
Authors: DAVIES A. G. , WHEELER ERICA
Published: April 2006

Summary The weights of 220 infants of Bangladeshi origin attending two clinics in the London Borough of Tower Hamlets were analysed at birth, 6 months and 18 months of age. The weights were compared first with the Tanner‐Whitehouse standards derived from English children and then with Indian data from the infants of well‐to‐do families. The mean weights of the infants of Bangladeshi origin were below the British Tanner‐Whitehouse 50th centiles, approximating to the 25th centile values. As the means were similar to those reported from well‐nourished Indian infants, it is unlikely that the Bangladeshi infants were undernourished. The reported weights of well‐nourished Indian infants appeared to be a more appropriate reference for the infants of Bangladeshi origin than the Tanner‐Whitehouse values. However the Tanner‐Whitehouse charts can be used, but with their 25th, 10th and 3rd centile lines being taken to read 50th, 25th and 10th centiles, respectively. Significantly more boy than girl infants were brought to one of the clinics.
Psychosocial and background factors in emotional abuse of children
Authors: HICKOX ANNE , FURNELL JAMES R. G.
Published: April 2006

Summary Seven parents legally established as emotionally abusing their children were compared with a closely matched control group of seven ‘problem’ parents in a day nursery. The experimental group parents showed significantly more psychosocial and background factors associated with undifferentiated abuse or physical abuse and neglect; specifically, these factors included poor coping skills, difficulty in building relationships, and poor child management techniques. In addition, the emotionally abusing parents reported a significantly higher incidence of behavioural deviancy in their children than the control caregivers. Perceived stress and lack of support also appeared critical in differentiating the two groups. The results suggest that a background of emotional abuse or deprivation may predispose an adult to have inadequate or absent coping strategies to handle difficult child behaviour, resulting in a negative parent‐child interaction and failure to make use of outside support.
Behaviour management cards as a method of anticipatory guidance for parents
Authors: SHOWERS JACY
Published: April 2006

Summary The purpose of this research project was to determine whether reading informational cards about appropriate developmental and behavioural expectations of children and non‐violent approaches to child behaviour management would result in significant changes in parental knowledge and/or behaviour. Pre‐ and post‐test data are compared and self‐reports from parents about changes in feelings and behaviour subsequent to reading the cards are reported.
Determining the contribution of residential respite care to the quality of life of children with severe learning difficulties
Authors: GERARD KAREN
Published: April 2006

Summary This paper investigates factors which may be influential in determining the impact of residential respite services on residents’quality of life. Residents are all aged 19 or under and have severe learning difficulties. The objective of respite care is to ameliorate some of the burdens which carers associate with caring but to do so without adversely affecting those being cared for, while preferably improving residents’quality of life. The usual focus of evaluations of respite care, however, tends to be directed at how well carers’needs are supported. Only when it is possible to determine the impact of respite care on the quality of lives of both carer and cared for will researchers be in a position to complete a full evaluation. Until then a better understanding of all recipients’responses to respite care is needed. This paper, therefore, takes as its focus the often‘forgotten’recipients, the children with severe learning difficulties themselves. The analysis is somewhat preliminary but this is inevitable reflecting as it does the current state of research work in this area.
Visual screening in a school for hearing‐impaired children
Authors: MVRDOCH HEATHER , RUSSELL‐EGGlTT ISABELLE
Published: April 2006

Summary Hearing‐impaired children use vision to compensate for impaired auditory information. This fact, and the relatively high incidence of visual defect among the deaf population, render regular visual screening essential. The Royal School for Deaf Children, Margate, caters for children with a wide range of needs; screening involving a single‐assessment structure for all pupils is felt to be inappropriate. This paper describes the implementation of a ‘tiered’ screening system, and the factors affecting allotment of pupils to particular ‘tiers’. The screening structure is illustrated by a case study, and generalization of the system to other educational settings is discussed.
Educational and occupational outcome in Prader‐Willi syndrome
Authors: WATERS J. , CLARKE D.J. , CORBETT J. A.
Published: April 2006

Summary An educational and occupational history was obtained for affected members of the Prader‐Willi Syndrome Association (UK). Of 32 females and 29 males over 16 years of age (mean 23 years), over 45% attended mainstream infant schools, but by the time they reached junior and secondary schools the majority were in schools for children with learning disabilities. On reaching adulthood, 31% were attending adult training centres or day centres. Nearly one in six were in employment, usually of a sheltered type. The majority had no formal educational qualifications, but over 10% had at least one Certificate of Secondary Education and one person had three O levels. Nearly three‐quarters of those with known intelligence quotients had IQs in the 70 to 100 range. The physical and behavioural characteristics of the study population closely resembled those reported in Prader‐Willi syndrome by other authors, although it is possible that some members of the Prader‐Willi Syndrome Association (UK) may not have Prader‐Willi syndrome. The findings highlight the heterogeneity in educational achievements associated with Prader‐Willi syndrome, and illustrate the importance of assessing individual educational strengths and needs.
From the other side: parents’views of their early contacts with health professionals
Authors: McKAY MARY , HENSEY OWEN
Published: April 2006

SummaryThe parents of 84 school‐age children with cerebral palsy were interviewed about their early experiences of dealing with health professionals. Seventy per cent of families expressed dissatisfaction with some aspects of their contact with the health services during the initial period of diagnosis and referral. Lack of explanation, either about the child's condition or the reasons for follow‐up, was the commonest complaint (58%), followed by having their worries dismissed by doctors and the need to make repeated visits before their child's problem was recognized (51%). Twenty per cent complained about the manner in which they had been told about their child's disability and 5% were critical of the lack of understanding on the part of doctors of the practical difficulties they faced. A high level of dissatisfaction was found among parents of children who had recognized perinatal problems but dissatisfaction was not found to be proportional to the severity of the child's handicap. Ways in which the quality and delivery of services could be improved are discussed.
A child‐to‐child programme in rural Jamaica
Authors: KNIGHT JENNIFER , GRANTHAM‐McGREGOR SALLY , ISMAIL SURAIYA , ASHLEY DEANNA
Published: April 2006

Summary Summary A child‐to‐child programme was carried out in six rural schools in Jamaica. School children in grades 4 and 5 were taught concepts of nutrition, environmental and personal hygiene, and child development. The children were encouraged to take messages home to their parents and improve the care of their younger siblings. Four hundred and twenty‐three children and 90 mothers and guardians from four of the project schools were evaluated and compared with 199 children and 47 parents from two control schools. The project children showed higher scores on a test of knowledge in the topics at the end of the year. They also improved in some practices at home. The mothers improved in knowledge in some areas but not in their practices. We consider the results sufficiently encouraging to justify incorporating the programme into the country's education curriculum for primary schools.
Improving attendance at intake in children's outpatient services of a community mental health centre
Authors: DE ANE FRANK P.
Published: April 2006

Summary Concern that non‐attendance at initial appointments may lead to increased delays for new clients attempting to enter treatment, led to the development of an intervention to improve attendance at intake in children's out‐patients services of a community mental health centre. The new procedure encouraged parents who telephoned the centre to come into children's services to complete a behaviour checklist on their child before receiving an initial appointment time. In the sample of 464 consecutive initial appointments scheduled over the study period, there was a reduction in the broken appointment rate from 37·7% during baseline to 26·5% during the intervention phase. Although this was a simple, flexible and inexpensive intervention, it is suggested that the result is replicated with a controlled experimental design, and interventions are tailored to specific types of attendance problems.
Parents’attitudes to developmental screening in the first year of life
Authors: JOHNSON ANN , SHERRATT FRANCES , HOLMES SHEILA
Published: April 2006

Summary It has been suggested that screening for impairment in early childhood may cause anxiety to parents. Using self‐administered questionnaires, we studied the attitudes and concerns of parents of infants aged 6 months and 8–9 months. Parents were randomly allocated to one of two groups. One group completed the second questionnaire after the 8‐month assessment routinely performed by health visitors, and the other group completed the second questionnaire before the assessment. We showed changes in attitude and concerns over the 2–3 month period, but these were not related to the assessment. It appeared that particular concerns and anxieties were not resolved by a recent contact with a health visitor, although a high proportion of mothers stated that they found the assessment reassuring. There was some evidence of a lack of appreciation, both of the purpose of the tests and of the implication of test failure. Screening tests performed by health visitors at an age of 8 months do not appear to generate undue anxiety in parents. However, as many of the tests used are of doubtful validity, a review of the purpose and content of this early health visitor assessment is needed.
Adolescent smoking
Authors: FERGUSON ANNE , McKINLAY IAN
Published: April 2006

Summary Most smokers start experimenting with cigarettes in early adolescence. This paper describes the factors which influence the development of the smoking habit. Methods of intervention, both in and out of the classroom, are discussed. Recommendations for further legislation and increased taxation on tobacco are supported.
A longitudinal study of night waking in the first year
Authors: SCHER ANAT
Published: April 2006

Summary A longitudinal study of the development of sleep patterns addressed the issue of continuity and change in night waking in the course of the first year. Mothers of 118 infants, who took part in a follow‐up study of normal babies, completed a sleep questionnaire at 3, 6, 9 and 12 months. Regular night waking was a common characteristic throughout the first year (46% at 3 months, 39%, 58% and 55% respectively at 6, 9 and 12 months). The number of awakenings per night was a function of age. Following a decline in the number of interruptions from 3 to 6 months, an increase in night waking at age 9 months was recorded. Although the methodology does not lend itself to an objective validation of the changes in sleep–wake states, nor is it suitable for causal explanations, it is, nevertheless, important to note this profile. The increase in night waking towards the end of the first year coincides with significant socio‐emotional advances which characterize this developmental stage.
Observation of emotional functioning in young handicapped children
Authors: ROGERS SALLY J.
Published: April 2006

Summary Young children with handicaps are at greater risk of emotional problems than young children without handicaps because of several factors, two of which include (a) altered parent–child interaction patterns from infancy onward and (b) societal attitudes regarding handicaps. Early interventionists are in a unique position to observe signs of emotional problems and assist families in obtaining psychological help. Greenspan's framework for systematically observing aspects of emotional development is described, and ways of drawing conclusions from observations are presented in order to assist interventionists from many disciplines to observe emotional development with greater clarity.
Occupational therapy intervention guidelines for children and adolescents with spina bifida
Authors: WATSON DIANE
Published: April 2006

Summary Children and adolescents with spina bifida present with a number of characteristics that affect functional performance and developmental skills. The focus of this paper will be to share information about spina bifida and the overall approach to care within the Glenrose Rehabilitation Hospital Spina Bifida Clinic and, more specifically, the role of the occupational therapist.
A preschool child psychiatric service: predictors of post‐assessment default
Authors: BEER ROSEMARY
Published: April 2006

Summary
A study of post‐assessment default from a preschool child psychiatric service found that about two‐thirds of the sample defaulted (two‐thirds of these immediately after assessment) and, as in other services, most referrals were seen three times or less. Default, as predicted, was not related to sociodemographic factors. In addition, in contrast to previous studies, there was no overall relationship to type or severity of child symptoms nor to maternal mood disorder. However, default was unexpectedly associated with staff inexperience, shorter initial interview duration and type of treatment offered. Possible explanations for these results and further avenues of research are discussed.
Methodological issues and future directions in the evaluation of early intervention programmes
Authors: EAYRS CAROLINE B. , JONES ROBERT S. P.
Published: April 2006

Summary
Early intervention programmes have grown rapidly over the last 30 years. Despite numerous attempts to answer the apparently simple question of whether or not early intervention works, results to date have been equivocal. This paper looks at the reasons why this question has not been answered satisfactorily and suggests that this question may not, in fact, be possible to answer in a global sense. It is suggested that questions must be addressed to the evaluation of specific services rather than to the evaluation of early intervention as a whole.
The perception and use of child health clinics in a sample of working class families
Authors: McINTOSH JAMES
Published: April 2006

Summary
The frequency and pattern of clinic use by a sample of 60 working class families is described. An attempt is made to explain attendance and non‐attendance in terms of the mothers' perceptions of the clinic's functions and relevance and in terms of certain social and organizational barriers. The implications of the findings for clinic use and for the organization and delivery of the service to working class families are discussed.
Child development: what do parents expect?
Authors: EDWARDS‐BECKETT JOY
Published: April 2006

Summary
Expectations of future development were assessed in parents of non‐disabled children (n= 240) using the Predictive Adaptive Ability Questionnaire (PAAQ). The reliability estimate for the overall PAAO was 0·90, with a test‐retest reliability of 0·99 and an interrater reliability of 0·83. Parental expectations did not significantly differ from normal adaptive ability developmental standards. Longitudinal examination of parental expectations and their influence on child development and the impact of chronic illness on such expectations is recommended.
Training of head control in the sitting and semi‐prone positions
Authors: KRAMER JOHN F. , ASHTON BARBARA , BRANDER ROSEMARY
Published: April 2006

Summary
The purpose of this study was to compare the semi‐prone (SP) and sitting (SIT) training positions with respect to head control in children with cerebral palsy, before and after 5 weeks biofeedback training using a head position trainer (HPT). Four children were randomly assigned to each of two training groups: (a) SP on a prone board inclined 45° above the horizontal and (b) SIT in their personal wheelchair and orthotic device. The HPT, secured to the child's head, controlled a video‐cassette player, turning it off when the head deviated beyond 25° from the vertical (termed an error). The time in error and the number of errors during test periods of 3 minutes, without feedback and completed in both the SP and the SIT positions, were determined immediately before and after, and at 16 weeks after training. The SIT trained group performed significantly better immediately post‐training in three of four comparisons (P <0.01), but the groups performed similarly in the other eight comparisons—four immediately pre‐training and four at 16 weeks post‐training (P >0.05). Post‐training scores for the total group (n= 8) were significantly improved over pre‐training scores, regardless of the test position or the criterion measurement (P <0.05). Biofeedback training with a HPT can be effective in either the SIT or the SP positions, with improvement lasting at least 16 weeks after training is discontinued.
Gastrooesophageal reflux in children with cerebral palsy
Authors: REYES A. L. , CASH A. J. , GREEN S. H. , BOOTH I. W.
Published: April 2006

Summary Feeding difficulties, vomiting and recurrent chest infections associated with poor growth and nutrition are common in children with cerebral palsy (CP). However, the role of gastrooesophageal reflux as a possible cause has been little studied. We therefore investigated 23 children with cerebral palsy (median age 2–3 years, range 0–6‐11‐8) whose symptoms were consistent with gastrooesophageal reflux (severe feeding difficulties 70%, failure to thrive 52%, anaemia 31% and recurrent chest infections 31%). Using 24‐hour ambulatory oesophageal pH monitoring, we determined the relationship between gastrooesophageal reflux and: (a) developmental age (Griffith's scales); (b) feeding behaviour skills score; (c) nutritional status and (d) clinical assessment of cerebral palsy (type and severity). Abnormal gastrooesophageal reflux (i.e. reflux index > 5%) was detected in 16 (70%) patients (median reflux index 11–4%; range 5·4–59%).

Reflux was unrelated to chronological or developmental age, but there was a significant, unexplained association with male gender (P < 0·01). No correlation was found with feeding behaviour skills score, malnutrition (which was commonly severe) and type and severity of cerebral palsy. We conclude that gastrooesophageal reflux is common and should be sought in symptomatic, neurologically handicapped children as effective treatment is likely to improve quality of life.
Sleep management — the hidden agenda
Authors: WALTERS JENNIFER
Published: April 2006

Summary The management of apparent sleep problems is often not straight‐forward because of a proportion of clients attending with a ‘hidden agenda’, requiring more in‐depth long‐term treatment for psychological problems. This paper looks at a sample of 100 consecutive referrals to a community sleep clinic in the East End of London and attempts to address the question of who comes to the sleep clinic and why. A proportion of clients responded to brief intervention of a behavioural nature but 19% were referred on to other services for psycho‐therapeutic help.
Training needs of staff in Romanian institutions for young children
Authors: STEPHENSON PATRICIA , ANGHELESCU CARMEN , FUMAREL STELIANA , GEORGESCU ADRIAN , IORGULESCU DANIELA , MCCREERY ROSEMARY , NANU RODICA , FALACARI GEORGETA , POPA STELIAN , STANESCU ALIN , STATIVA ECATERINA
Published: April 2006

Summary In order to make adequate provision for staffing and staff training in leagane (long‐term residential care institutions for preschool age children in Romania) a postal survey was conducted in the autumn of 1991 to ascertain the demographic characteristics, job titles and educational attainment of directors and staff, staffing needs and the kinds of positions currently filled, the numbers of directors and staff exposed to continuing education programmes within the last 2 years, and the opinions of directors and staff regarding their most important continuing educational needs.

The bulk of the direct care workforce was less than 50 years old. Thirty‐four per cent of the direct care staff had less than a high‐school education. Sixty‐seven per cent of the staff were health professionals or health care workers. There were few psychologists, physical therapists, teachers or social workers.

In the last 2 years, directors and other physicians had been mostly exposed to courses in the areas of psycho‐social care/management and paediatric medical care. Nurses had attended professional development courses. Infirmiera (nursing assistants) had also attended professional development courses such as those offered by foreign non‐governmental organizations on the care of institutionalized children. Educators (teaching assistants) had attended courses in child development and rehabilitation. Directors and staff expressed clear opinions regarding their needs and preferences for additional training
Alcoholic parents and their children
Authors: MÜTZELL STURE
Published: April 2006

Summary Some 211 male alcoholic in‐patients were compared with a simple random sample of 200 men from Greater Stockholm. The group of male alcoholic in‐patients and the random sample were subdivided with respect to alcohol consumption and use of hepatotoxic drugs: (IA) men from the random sample with low or moderate alcohol consumption and no use of drugs (n= 169); (IB) men from the random sample with low or moderate alcohol consumption with use of drugs (n= 31); (IIA) alcoholic in‐patients with use of alcohol but no drugs (n= 171); (IIB) alcoholic in‐patients with use of alcohol and drugs (n= 40). Earlier and more severe alcohol‐related and anti‐social problems were found among subjects with an alcoholic parent than among subjects without an alcoholic parent. The highest level of problems was noted for subjects with alcoholism in both parents and among the alcoholic in‐patients. Groups which resembled each other were the drug users in the alcoholic group and in the general sample. Both inherited and environmental factors are important determinants and many of these individuals have psycho‐social problems as children and adults. The children of those adults who used alcohol in combination with drugs (IIB) had most problems and the most severe problems. In the general population sample, those who used alcohol in combination with drugs (IB) had so many problems in the family and psycho‐social problems themselves that they resembled the alcoholic in‐patients and especially the group with high alcohol consumption in combination with drugs (IIB). A new finding is that the high‐risk groups IB and IIB, who used both alcohol and drugs, had experienced a more disturbed school career and were more aggressive, had more nervous problems, and were more emotionally disturbed than the population studied belonged to a concealed alcoholic group raises the question whether it is really true that every sixth inhabitant of Greater Stockholm has a serious alcohol problem. However, the sample was relatively small, and this implies some uncertainty in the determination of the prevalence. A finding that indicates that the figure is not in fact so far from reality is that 65% of group IB were themselves of the opinion that they drank alcohol often or regarded themselves as alcoholics.
Assessing response to a proposed peto‐inspired early education group at a pre‐school assessment and treatment centre
Authors: CHESSON ROSEMARY
Published: April 2006

Summary Parents' and professionals' attitudes towards a Petoinspired early education group are explored within the context of a feasibility study carried out in a pre‐school assessment and treatment centre. Interviews with 52 staff, including doctors, nurses, teachers, therapists and social workers revealed that there was a considerable interest in Peto‐type methods and that the majority were in favour of such a group as their gains were thought to be beneficial to all concerned. The main concern expressed related to the consequences for those children without motor impairments attending the centre. Parents, without exception, were enthusiastic regarding the possibility of such an initiative and anticipated that it would offer the opportunity of support, encouragement and reassurance for mothers.
Social class, social support and obesity risk in children
Authors: GERALD L. B. , ANDERSON A. , JOHNSON G. D. , HOFF C. , TRIMM R. F.
Published: April 2006

Summary
Selected characteristics of the social environment are tested as predictors of children's risk for obesity. Data were collected during the summer of 1991 at the University of South Alabama Springhill Paediatric Clinic (Mobile, AL, USA). Data were collected on 77 children, aged 2·5–5 years, and their primary caretaker. Obesity risk was measured by the child's weight for height score and calorie intake. Caretaker's socio‐economic status, marital status, and social support predict children's obesity risk for this sample. Lower social class position, lower expressive social support, and unmarried status of the caretaker are associated with a higher calorie intake and a higher weight for height score in the child.