bluuebunny/crossref_metadata_2025 huggingface dataset:
Sibling response to childhood cancer: a new approach
Authors: EVANS C. A. , STEVENS M. , CUSHWAY D. , HOUGHTON J.
Published: April 2006

Summary
It is well recognized that serious illness in children can have important consequences for siblings who may manifest their concerns as behavioural difficulty. The aim of the present study was to explore sibling psychological response to childhood cancer and to observe the effects that sibling knowledge had on their response. Siblings and parents of patients at the Children's Hospital, Birmingham, were interviewed using the Achenbach Child Behavior Checklist and semi‐structured ‘Illness Knowledge’ questionnaires designed by the first author. Siblings were not experiencing significant behaviour problems. The level of sibling knowledge about cancer was related to the level of sibling social competence but not to the prevalence of behaviour problems. One‐third of the siblings were talking to no one at all about their feelings, and sibling feedback yielded some important sibling needs. It was concluded that sibling response to childhood cancer may not necessarily be pathological and may also be mediated by the level of sibling social competence as well as sibling knowledge.
Treatment of childhood encopresis — a review
Authors: THAPAR ANITA , DAVIES GILLIAN , JONES TESSA , RIVETT MARK
Published: April 2006

Summary
Children with encopresis may present to a number of different professionals. The literature on different treatment methods is reviewed. The roles of verbal psychotherapy, physical treatment, behaviour therapy and mixed treatment programmes are discussed.
Portage guide to early intervention: cross‐cultural aspects and intra‐cultural variability
Authors: STURMEY P. , THORBURN M. J. , BROWN J. M. , REED J. , KAUR J. , KING G.
Published: April 2006

Summary
The issues arising from implementing an early intervention service, developed in the rural United States in the late 1960s in a range of different cultural contexts over a period of a quarter of a century, are explained. Services from India, Bangladesh, Jamaica and the United Kingdom are compared.

As well as considering cross‐cultural aspects of Portage, variability within one country, the United Kingdom, is considered by comparing one service in an inner‐city area and one in a rural area.
Sleep clinics with health visitors: a 2‐year evaluation
Authors: RICHARDS ELIZABETH , BIDDER REETTA T. , GARDNER SANDRA
Published: April 2006

Summary
This study was undertaken to evaluate a service for sleep clinics over a time span of 2 years. The service was operated jointly by health visitors and clinical psychologists and based on a previous model run by the same team of psychologists and child development advisors. The outcome was not supportive of this type of service in terms of referral rates over a period of time, improvement rate, continued existence or cost‐effectiveness of such a service. The reasons for the difficulties of such clinics are discussed.
Parents' evaluations of pre‐school services for children with Down syndrome in two Scottish regions
Authors: WISHART JENNIFER G. , MACLEOD HAMISH A. , ROWAN CATHIE
Published: April 2006

Summary Parental evaluations of current pre‐school provision for children with Down's syndrome were surveyed in two Scottish regions. Two methods were used: postal questionnaires and telephone interviews. Services covered were those provided by general practitioners, hospital specialists, health visitors, speech therapists, occupational therapists, physiotherapists, educational psychologists, home teachers, social workers and voluntary organizations. Regional differences were found in provision and in parental satisfaction with currently available services, with some of these differences being dependent on child age. Overall, parents felt they were being given insufficient professional support, with contradictory advice not uncommon. Findings indicate that if limited resources are to be used to the maximum benefit of family and child, both subjective and objective measures of the relative values of different kinds of support at different ages are urgently needed.
Five‐year‐follow‐up of very low birth weight infants: neurological and psychological outcome
Authors: ROUSSOUNIS S. H. , HUBLEY P. A. , DEAR P. R. F.
Published: April 2006

Summary All surviving infants with birthweight ≤ 1500 g born in 1982 and 1983 at St. James's University Hospital, Leeds, were followed up for 5 years. There were 88 survivors (including 5 in utero transfers) from the original cohort of 126 infants. In their fifth year the following assessments were made; neurological, audiological, intellectual, behavioural, growth and general health. A comparison group of full‐term male infants was also studied with respect to intellectual status, social and emotional behaviour and general health.

Principal neurological impairments found were: cerebral palsy 9 (10·2%), hydrocephalus 1 (1·1%), epilepsy 2 (2·3%) and sensorineural deafness 2 (2·3%). One third of the VLBW children required the services of the child development centre. Seventy‐nine of the 88 VLBW children were tested with the WPPSL Seven (8·8%) scored below 70. The VLBW boys had mean IQ scores of 90·6 while the mean for the girls was 100–2. The very low birthweight boys were significantly intellectually impaired compared with their peers.

Socially and emotionally they were largely comparable with their full‐term peers. The findings suggest that there has been no increase in severe disability following a policy of active neonatal intensive care. However, the quality of survival of VLBW children born in the 1980s, despite improvements care perinatal care, remains a major concern.
Reliability and validity of the Portage assessment scale for clinical studies of mentally handicapped populations
Authors: ARVIO MARIA , HAUTAMÄKI JARKKO , TILIKKA PIRKKO
Published: April 2006

Summary The Finnish version of the Portage Assessment Scale was used with 114 aspartylglucosaminuria (AGU) persons aged between 1 and 56 years. Ninety‐three persons with AGU were also given psychological tests, mainly SB (Finnish), WISC‐R and WPPSI, but also Merrill‐Palmer, Bayley, Leiter and WAIS tests. The data also include for the reliability assessment a sample of 30 normal pre‐school children. The internal consistency reliability was calculated for the areas of socialization 0·80, language 0·81, self‐help 0·73, cognitive 0·70, motor 0·‐75 and for the whole scale 0·80. The factor analysis produced one very strong factor. The results of the Portage assessment were compared to the developmental levels provided by the tests. Both methods gave almost identical cross‐sectional descriptions of the skills of patients with AGU, which was interpreted as providing a cross‐validation for Portage in clinical use and to mean that Portage can be used as a reasonable assessment method. The advantages of Portage include easy use by non‐psychologists, concrete descriptions of the skills, the 5 areas, and the close relation to rehabilitation.
Are primary school children gaining heart health benefits from their journeys to school?
Authors: SLEAP MIKE , WARBURTON PETER
Published: April 2006

Summary Information was collected in relation to 1133 children, aged 4–11 years, regarding methods of travel to and from school, together with distances involved. Ninety‐seven per cent of the children walked, travelled by car or alternated between these 2 methods of travel. Some 584 children (51·5%) walked to school every day with an average one‐way‐distance of less than half a mile. It would seem therefore that few primary school children are walking far enough to gain heart health benefits from their journeys to school. Reasons are given, however, as to why it is important for young children to be encouraged to walk to school providing adequate safety considerations are taken into account.
Annotation: Care of children in hospital
Authors: CHALMERS BEVERLEY
Published: April 2006

Summary The Charter for Children in Hospitals, drawn up by professional and women's groups from a number of European countries at the First Conference for the Care of Children in Hospital (Netherlands 1988) presents many fine guidelines for. protecting the rights of children and their parents before, during and after hospitalization. The development of these guidelines, their current acceptance in Europe and the psychological principles underlying them, are outlined here.
Handedness in children at school entry: does the ‘Mesker test’ provide a valid method for testing writing handedness?
Authors: WARREN ELISABETH , McKINLAY IAN
Published: April 2006

SummaryThe ‘Mesker test’, an experiment devised after the psycho‐motor dominance test described by the Dutch paediatrician Mesker, was evaluated as a method for testing writing handedness in 145 children at school entry in Crewe Health Authority. Also included in the assessment was if, and how these children know their laterality.

Positive outcome was measured as Mesker test result corresponding to spontaneous hand‐preference in symbol copying. The correct indication of right arm or leg was evaluated in relation to the outcome by chance.

The Mesker test could not confirm hand‐preference in children at school entry. There was no significant relation to the child's maturity and no significant consistency in test performance. The sub‐group of right‐handed writers who confirmed their handedness showed an almost significant level of consistency.

No more children who thought they knew the right side indicated the correct limb then could have been arrived at by chance. This was not significantly related to having been taught, writing handedness or maturity. It is concluded therefore, that at school entry age children don't have a good knowledge of their body's laterality.

Although the Mesker test does not confirm writing handedness at school entry, it may be useful in older children with inconsistent laterality.
Liverpool visual assessment team 1985–1989: 5 years on
Authors: HIRST CHRISTINE , POOLE JUDITH J. , SNELLING G. SIAN
Published: April 2006

Summary An update of the work of the Liverpool Visual Assessment Team. This is a multi‐disciplinary team for the assessment, remediation and management of severely visually impaired children in Liverpool and the surrounding region.
Parents' views of community care for children with motor disabilities
Authors: HAYLOCK CLARE L. , JOHNSON M. ANN , HARPIN VALERIE A.
Published: April 2006

Summary In this study we have ascertained the views of 40 parents of 4‐year‐old children with motor disabilities, on the health and education services, social service and the availability of respite care. The children with moderate or severe motor disability who were born in 1985, were identified from the Oxford Regional Register of Early Childhood Impairment.

Thirty‐three (83%) completed a questionnaire taken to the home by the health visitor. Although most parents had access to a range of services, lack of information in the early years, fragmentation of services and limited choices were identified as problems. Parents regarded the breadth of care provided by the pre‐school teacher counsellor and the nursery school as very useful, whereas the health service and social services were perceived as less appropriate.

This small study suggests that for some families, the objectives of community care as identified in the Griffiths Report (Griffiths 1988) and reiterated in the Children Act (1989) are not yet being met.
Screening and assessment of childhood deafness: experience from a centralized multi‐disciplinary service
Authors: O'HARE ANNE E. , GRIGOR JACQUELINE , COWAN DAVID
Published: April 2006

Summary A paediatric hearing assessment unit was set up in Lothian in 1978 to provide a clear referral pathway for children with suspected sensorineural hearing impairment and particularly for those children detected by the health visitor screening test.

Over a 6‐year‐period the incidence of bilateral sensorineural deafness was 1–3/1000 suggesting that all children in the region were being seen. The mean age of diagnosis fell significantly over this period. Children in high risk groups, through adverse perinatal events or a positive family history, were not detected any earlier than other children. They were therefore not contributing to this improved earlier age of diagnosis. These findings support the continuation of health visitor screening but changes in practice are needed to encourage earlier diagnosis in high‐risk groups.
A descriptive study of blind children in nurseries with sighted children
Authors: PREISLER GUNILLA M.
Published: April 2006

Summary In a longitudinal descriptive and qualitative study, nine blind pre‐school children have been observed in natural inter‐actional settings in their nurseries. The objective was to give a detailed description of the blind child's activities and social situation in a group of sighted children. The results showed that the blind child's overall behaviour in the pre‐school setting was different when compared with the sighted children's behaviour, as shown in activities like orientation, exploration and play. The blind children seldom participated in sighted children's play and they seldom initiated contact with the other children. The sighted children initially showed an interest in the blind child but as their initiatives were often neglected, they were not encouraged to proceed. The teachers played an important role for the blind children, both as a visual interpreter and as a play‐mate. However, many of the teachers had great difficulties in understanding the blind child's way of functioning. Alternative pre‐school settings for blind children are discussed.
Assessing the written information given to families prior to their attendance at a child development centre
Authors: REED JULIE , CONNEELY JULIA , GORHAM PAUL , COXHEAD SAMANTHA
Published: April 2006

Summary This paper describes an analysis of the written information given to parents of pre‐school children with developmental delay prior to their attendance at a Child Development Centre. Texts were analysed for their readability and human interest, and the usefulness of the information was assessed through consultation with parent consumers. The discussion of the results includes suggestions for staff who are involved in the development of client leaflets and booklets.
Children and adolescents with brittle bones — psycho‐social aspects
Authors: BRODIN JANE
Published: April 2006

Summary Osteogenesis imperfecta (OI) or brittle bones is a most unusual disease and there is a limited number of people in the whole world suffering from it. Most studies reported from this area are in the medical field and few illuminate the psycho‐social effects of the disease.

Three studies of children and young people with brittle bones have been carried out within the psycho‐social field in Sweden. They are all based on inquiries and interviews with children and parents engaged in the Swedish National Organization for Physically Disabled Children and Adolescents.
Promoting inter‐agency collaborátion in child services
Authors: BRADFORD ROGER
Published: April 2006

Summary Effective collaboration between agencies is often difficult to achieve. Children and their families/carers, who have complex therapeutic needs, present particular difficulties in that agencies need to work together, if they are to produce a co‐ordinated and integrated package of care. A Multi‐Agency‐Consultation‐Team (MACT) was set up in an attempt to overcome some of these problems of interagency co‐operation. This paper describes the protocol, types of children referred and the recommendations made by the team. Follow‐up of these children at 4 months suggests that a MACT does have a role to play in developing high quality services.
Easing the strain: assessing the impact of a Family Fund grant on mothers caring for a severely disabled child
Authors: BERESFORD BRYONY A.
Published: April 2006

Summary Measures of perceptions of care‐related stress and maternal adjustment were used to assess the extent to which receiving help from the Family Fund eases the stress of caring for a disabled child. A sample of 162 mothers completed a questionnaire before and after receiving help from the Family Fund. The findings suggest that the Family Fund has a significant impact on mothers' perceptions of the stresses of caring for their child, as well as improving mothers’ wellbeing and adjustment. However, receiving help from the Family Fund did not improve mothers' perceptions of the severity of the child's disability or the extent to which the disability had adversely affected their personal lives.
The effect of a waiting list on attendance at initial appointments in a child and family clinic
Authors: STERN G. , BROWN R.
Published: April 2006

Summary
A significant relationship was found between failure to attend initial appointments and the length of time between referral and appointment dates following the introduction of a waiting list in a child and family clinic. Families responding negatively to the questionnaire were found to be less likely to attend than those who responded neutrally or did not respond at all.
Early parental adjustment to visible congenital disfigurement
Authors: BRADBURY E. T. , HEWISON J.
Published: April 2006

Summary
When a baby is born with a visible disfigurement, then parents need to adjust to the loss of the anticipated ‘perfect’ child and thus accept their baby. The impact of the birth on the parents is described in the context of a measure which identifies areas of potential difficulty. The two groups studied were parents of children with cleft palates and parents of children with congenital hand deficit. A wide range of adjustment was found. There was no significant difference between the two groups in terms of their overall adjustment, but there were individual differences in adjustment which did not relate to the severity or type of anomaly. The only significant variable found to relate to parental adjustment was perceived family support.
Muscle and brain disease: an update
Authors: GORDON N.
Published: April 2006

Summary
A number of syndromes included under this rubric are considered, and their main features discussed The congenital muscular dystrophy of the Fukuyama type as it occurs in Japan and in the western world are almost certainly the same condition. The muscle disorder is associated with cerebral lesions which may be due to an arrest of neural migration or to demyelination. Muscle, eye and brain disease, or Santavuori's syndrome, shows ocular abnormalities, as well as those of the muscle and brain, as does the Walker‐Warburg syndrome. In the latter disorder the cerebral lesions tend to be more severe, and it is more rapidly fatal.

The manifestations of all these syndromes undoubtedly overlap, but there has been controversy on the question of their identity. Are they separate entities, or are they different expressions of a similar genetic disorder? The genes for all these conditions will have to be isolated to see if the different phenotypes are alleles of the same gene, or not. Some of the arguments, for and against, are presented.
Language development in a non‐vocal child
Authors: ROGOW S. M.
Published: April 2006

Summary
Many children who cannot speak, comprehend both oral and written language. Having knowledge of language is not the same as being able to use language for social transactions. Non‐vocal children learn to use augmented and assisted systems, but they experience specific difficulties in initiating and maintaining conversations and making use of the pragmatic functions of language. The purpose of this study was to investigate the semantic and syntactic knowledge of a child with severe multiple disabilities who can read and write and comprehend two languages, but does not initiate conversation. The study demonstrates that high levels of language comprehension and ability to read and write do not automatically transfer to conversational competence or narrative ability.
Management of infant sleep problems in a residential unit
Authors: LEESON R. , BARBOUR J. , ROMANIUK D. , WARR R.
Published: April 2006

Torrens House provides a short residential programme for families with a baby (8–12 months of age) identified by parents as having a sleep problem such as waking frequently at night and being difficult to settle. The programme involves the promotion of infant self‐settling by the use of a controlled crying technique, together with wrapping, cessation of night feeds and establishment of a day‐time routine.

Twenty families (with 23 babies) were followed through the programme and for 3 months afterwards. There were significant decreases in the number of times the babies woke, the number of night‐feeds and the length of time awake at night at 1 month follow‐up, with a reduction in depressive symptomatology of the parents and a perceived improvement in their infants' behaviour. Twenty of the 23 babies were sleeping well at 3 month follow‐up.
Social support received by mothers of chronically ill children*
Authors: PELLETIER L. , GODIN G. , LEPAGE L. , DUSSAULT G.
Published: April 2006

The main purpose of this study was to describe the characteristics of the social networks and social support of mothers of chronically ill children and adolescents. The data collected also allowed for the identification of the predisposing factors to receiving low social support among the mothers. Receipt of social support was assessed according to six dimensions: source of support, type of support, perceived need for support, satisfaction with the quality and the quantity of support, as well as most valued source of support. Results indicate that mothers wanted more support than they received, particularly in the areas of emotional, appraisal, and informative support. Furthermore, spouses, professionals, and immediate family members were identified by mothers as important sources of support. Discriminant analysis showed that the probability of receiving low support increased if the chronically ill child was an adolescent, the father had a higher level of education, and the family income was middle‐low. Results are discussed in terms of the implications for intervention.
Multidisciplinary teams and childhood visual impairment: a study of two teams
Authors: Youngson‐Reilly S , Tohin M J , Fielder A R
Published: April 2006

Summary
Multidisciplinary teams are generally viewed as beneficial in the management of the visually impaired child, yet little is known about them. Two teams were studied. Team A had well‐defined functions relating to Identification of visually impaired children, co‐ordination of services and liaison. Team B had a more general aim of sharing information on a range of ophthalmic issues other than visual impairment. By comparing the two teams, we conclude that a multidisciplinary team is more likely to be effective if it draws its membership from a range of appropriate professions and its functions are focused. Benefits of teams include increased and earlier referral, improved interdisciplinary liaison and collaboration, and speedier and more appropriate implementation of services. Lack of time to participate, particularly by medical personnel, is a problem.
The identification of severe hearing loss in west Essex
Authors: Lehner K G , Prendergast M P
Published: April 2006

Summary
The records were studied of all children identified in the last 16 years as having severe sensorineural hearing loss (bilateral 60 dB or more, across all frequencies) in west Essex (a typical health district with a child population, 0–16 years, of 54 000). The person to first suspect the child's hearing loss and the results of their 8‐month distraction test are discussed. The reasons for delay in diagnosis and acquisition of aids are examined.
Post‐traumatic stress symptoms in children and parents following a school‐based fatality
Authors: Parker J , Watts H , Allsopp M R
Published: April 2006

In 1991 the roof blew off a Swindon Primary School. One child was killed. Two years later 19 of her classmates were interviewed. The parent who collected the child from school that day was also interviewed. Recalled levels of post‐traumatic stress syndrome (PTSD) symptoms were assessed in both parent and child in the month following the incident The children's symptom levels at 2 years were also assessed. Parents and children recalled significant post‐traumatic stress reactions at 1 month. The level of symptoms in parents did not correlate with that of their own children.
Personal health record for school children with multiple needs
Authors: Vaz I
Published: April 2006

Children with severe learning difficulties in special schools often have multiple physical disabilities. Their case notes are frequently bulky. Many professionals are involved in their care and information on the child is seldom readily available or accessible. A concise, regularly updated Personal Health Record given to the child or carer would overcome these problems and allow for timely and appropriate care to be provided.
Family involvement in multidisciplinary team evaluation: professional and parent perspectives
Authors: Simeonsson R J , Edmondson R , Smith T , Camahan S , Bucy J E
Published: April 2006

For many children and families, a multidisciplinary team evaluation Is their introduction to special education systems. Increasingly, federal guidelines mandating parent involvement in ail aspects of service provision have meant that parents are being asked to participate as part of the evaluation team. If families and professionals are to serve as partners in the evaluation process, mutual respect and understanding of one anothers’perspectives will be crucial. This paper uses survey data from 39 parents and 81 professionals to examine the various expectations and perceptions brought by participants to the assessment process. Results indicated that there is substantial variability of perceptions among parents and professionals about the nature of child assessment and their respective roles in it. implications for research and practice are discussed, along with techniques for involving families in the assessment process in more meaningful ways.
Chronic childhood illnesses: what aspects of caregiving do parents value?
Authors: Baine S , Rosenbaum P , King S
Published: April 2006

Parents of children with chronic iiinesses are at significantly increased risk to experience mental health problems. Because such families are in frequent contact with the health care system, it is possible that aspects of the organization and content of health services might contribute to the development or prevention of these emotional burdens. The purpose of the present study was to examine the patterns of parental values about a variety of aspects of care and services, assessing both the absolute and relative importance of 22 defined components of care (COCs). Respondents were 80/111 parents (72%) of children with diabetes mellitus and 45/56 parents (80%) of children with cystic fibrosis, followed at a regional university‐affiliated children's hospital. They completed a two‐part mailed questionnaire, rating independently each COC, and then ranking all 22 COCs using a modified Q‐sort technique. While the majority of COCs were judged as 'somewhat’or‘very’important by over 75% of respondents, there was also significant agreement between the two groups on their rankings of the COCs (Spearman rank coefficient r= 0.92, P< 0.001). The COCs ranked most highly by both groups were diagnosis, treatment, education/information, continuity/ consistency, accessible and available care, evaluation of chronic illness, and parental involvement. Furthermore, the concordance between this combined medical illness group and a previously‐studied neurodevelopmental group was r = 0.72 (P < 0.001). These results are discussed in relation to the
The control of sexuality in young people with Down's syndrome
Authors: Shepperdson B
Published: April 2006

Three studies were undertaken of two cohorts of young people with Down's syndrome. One cohort, of 52 people, was born in the 1960s and they were seen in their teens and again in their mid‐20s. The other cohort, of 26 people, was born in the 197ds and they were seen in their teens. The studies show that while carers in both cohorts paid lip service to the rights of young people with learning disabilities to have sexual experiences and to marry, they did not necessarily feel that this applied to their own youngsters. Carers of the 1970s cohort at teenage were more permissive than carers of the 1960s cohort at adulthood. How carers controlled the sexuality of their young people is discussed. Carers in both cohorts were rarely in favour of parenthood for people with teaming disabilities and over half the carers thought that sterilization might be appropriate, in some circumstances. At teenage, about two‐thirds of carers in both cohorts thought that their youngsters needed sex education. By adulthood, in the 1960s cohort, only one‐third of the same group of carers continued to hold the same view. According to carers, more young people knew about events that they were unlikely to experience themselves, namely pregnancy and birth, than knew about the most likely event, sexual intercourse. So, in spite of holding permissive views on sexual expression for people with teaming disabilities, carers left their own young people iii‐prepared for such experiences. Few young people were given the education or freedoms necessary to encourage sexual relationships. Reasons for this discrepancy are discussed.
“Sexuality, disability and abuse: advice for life … not just for kids!”*
Authors: Blackburn M
Published: April 2006

This annotation addresses the debate about the availability, taboos, choices and risks concerning the sexuality and abuse of young disabled people, it highlights the vulnerability of some disabled young people and discusses the dilemmas of maintaining the disabled person's dignity, safeguarding his/her independence and recognizing the need for appropriate sex education while providing protection from abuse, it is suggested that statutory agencies as well as legislation should assume greater responsibility for protecting and safeguarding the interests of disabled youngsters, some of whom may risk physical, emotional and sexual abuse beyond childhood. The manner in which sexuality and abuse are dealt with often reflects the way disabled people are regarded by the society. This paper attempts to address some of the legal and conceptual issues surrounding this area.
Talking with children about death and dying
Authors: Pettle S A , Britten C M
Published: April 2006

This paper outlines the development of childrens’understanding about the concept of dearth, and describes common grief reactions. Using this framework, the principle elements of talking with children on such a sensitive topic are discussed. A variety of potential clinical interventions at individual, family and group levels are proposed
The effects on the family of miscarriage, termination for abnormality, stillbirth and neonatal death
Authors: Thomas J
Published: April 2006

This article explores the feelings of ereaved parents and other family members, looks at the way in which health care professionals can offer support, and discusses the need for more training for professionals.
Modulation off birthweight through gestational age and fetal growth
Authors: Petridou E , Trichopoulos D , Revinthi K , Tong D , Papathoma E
Published: April 2006

Summary
Several factors are known to affect birthweight and their effects are variously mediated through gestational duration or through fetal growth conditional on this gestation, in order to quantify independent associations of birthweight conditional and unconditional on gestational age, all 2538 mothers of singleton babies delivered during 1993 in two Maternity Hospitals in Athens were interviewed and their obstetric records abstracted. Birthweight was modelled as outcome variable through multiple regression including 32 potentially predictive factors. The regression model was fitted with and without gestational age as an additional independent variable in order to apportion birthweight associations into those independent of, or mediated through, gestational length. The factors studied were found to be classifiable into the following categories: factors associated with birthweight mostly through increases in gestational duration, either positively (age at menarche, long menstrual cycles, parity 4 or higher), or negatively (single motherhood, maternal age, tobacco smoking); those associated with birthweight mostly through increase of birthweight conditional on gestational duration, either positively (male gender, short menstrual cycles, maternal pre‐pregnancy weight, anaemia, oedema) or inversely (employment during pregnancy, stillbirth, primiparity, pregnancy induced hypertension, coffee drinking); and those associated with birthweight through apparently dual effects, either positively (maternal education) or inversely (perceived stress, bleeding during pregnancy). The other studied factors were not demonstrably related to birthweight in this data set. Identification and quantification of these relations is useful for understanding underlying physiological and pathophysiological processes and for increasing specificity in exploring the association of birthweight with adult onset diseases, like coronary heart disease or cancer.
Birthweight and health and development at the age of 7 years
Authors: Middle C , Johnson A , Alderdice F , Petty T , Macfarlane A
Published: April 2006

Summary
This study was set up to compare the frequency of health, educational and behavioural problems in a geographically defined birth cohort of 7‐year‐old children grouped by weight at birth. The study design was based on a multi‐stage postal survey, with sampling stratified by birthweight. It took place in the four counties of Oxfordshire, Buckinghamshire, Berkshire and Northamptonshire which make up the former Oxford region. We studied 1319 live births to women resident in the former Oxford region in1985, including all those with birthweights under 1500 g, or whose weight was not recorded, and a sample of those who weighed 1500–2499 g, and of those who weighed 2500 g or more at birth. The children in the sample were traced through the National Health Service Central Register (NHSCR) and self‐administered questionnaires were sent to their parents, general practitioners (GP) and teachers. Of the 1169 children who were alive at the age of 7 years and were successfully traced, 805 (75%) were followed up by postal survey. The use of health services, and of additional educational support was higher, and school performance was poorer among children who had weighed less than 1500 g at birth than among children who had weighed 2500 g or more, with the rates for children who had weighed 1500–2499 g falling in between. This survey method identifies the higher rate of health and educational problems in children weighing under 2500 g at birth, particularly those with birthweight under 1500 g, compared with other children. The method could be developed to provide a way of monitoring any changes over time in the prevalence of these problems. This information can be used to assess the health and educational needs of 7‐year‐old children in the population.
Screening for failure to thrive— what are we looking for?
Authors: Wright C M , Talbot E
Published: April 2006

Summary
This paper describes the process by which our clinical service identifies and manages children in the population with differing levels of severity of Failure to Thrive (FTT), ranging from cases managed solely by their own Health Visitor (HV), through to those requiring registration under child protection procedures or even removal into care. We outline the theoretical principles, research evidence and clinical experience that has informed the development of the service and discuss the lessons learnt that could be applied elsewhere.
What do we know about children who fail to thrive?
Authors: Raynor P , Rudolf M C J
Published: April 2006

Summary
It is the aim of this article to provide an overview of difficulties in children with poor growth enrolled in an intensive community intervention trial for failure to thrive (FTT). Children were assessed for developmental delay (Bayley test), inadequate diet, iron deficiency, eating and other behavioural problems, and maternal anxiety and depression (HAD Scales). Sixty‐three children aged 6 months to 2 1/2 years were studied. The majority of children were from families living in poverty with many from divorced, separated or single families. On developmental testing (Bayley Developmental Scales) 55% were delayed, 27% severely. Seventy seven per cent had caloric intakes below the expected average requirement (EAR) with 19% reported at less than 50% of requirements, Iron Intakes were similarly low and one‐third had iron deficiency anaemia on testing. Sixty per cent of children were reported to have eating difficulties, principally in terms of responding negatively to food. Eating difficulties had commonly presented within the first weeks of life. Other behavioural and sleeping difficulties were also common. Children identified as failing to thrive in the community are likely to have associated developmental, dietary and behavioural problems which may not be immediately evident and to an extent which may require intensive multidisciplinary Involvement.
Non‐organic failure to thrive dietetic practice in a community setting
Authors: Moores J
Published: April 2006

Summary
failure to thrive, the direct result of inadequate nutrition and in particular energy intake, is commonly encountered. This paper considers how to identify the nature of this inadequacy using specific nutritional assessment methodology and how the information can be used to enable appropriate and effective intervention to take place. It discusses the observations and findings of 7 years of community dietetic practice and the potential impact on other health professionals working with children who are failing to thrive.
Resolving the feeding difficulties associated with non‐organic failure to thrive
Authors: Hampton D
Published: April 2006

Summary
Since 1991 The Children's Society's Infant Support Project has been working in Wiltshire with the families of under 3 year olds identified as failing to thrive non‐organically. Research has shown that the only common factor in children with this problem is the presence of feeding difficulties. The service concentrates on helping parents/caregivers to resolve the problems which are allowing the difficulties to continue. The multidisciplinary staff team work on a domiciliary basis, using working practices founded on social learning theory. A recent evaluation indicated that for more than two‐thirds of the children with whom the project had worked, a satisfactory or very satisfactory outcome was achieved. Funding for the service is received from the Health Commission for Wiltshire and Bath, Wiltshire Social Services Department and the Children's Society.
Consumer opinion concerning the treatment off a common sleep problem
Authors: Bramble D
Published: April 2006

Summary
In an uncontrolled, open, pilot study, 15 severely learning disabled children suffering from severe and lifelong night‐settling and night‐waking (NS/NW) problems were treated with a brief behavioural modification approach based upon the behavioural therapy principles of rapid extinction, cueing and stimulus control. Following the treatment positive changes in these problems occurred quicikly (within a few days) and these were sustained at both the 4‐ and 18‐month follow‐up stages in the majority of the children. Despite the misgivings of previous commentators concerning rapid extinction techniques, the children's parents found this treatment approach to be safe, helpful and acceptable. This study explores their views about this form of treatment and also about previous help they had received.
The development and validation of a measure off parent‐reported child health and morbidity: The Warwick Child Health and Morbidity Profile
Authors: Spencer Professor N.J. , Coe C.
Published: April 2006

Summary
Objective: to validate a simple instrument for the measurement of parentreported health and morbidity in infancy and childhood suitable for research and service planning purposes and capable of measuring both cross‐sectional and longitudinal health and morbidity experience in a child population. Setting: child health clinic (CIHC), child development unit (CDU) and paediatric outpatient department (OPD) in Coventry. Design: 3‐phase field testing to establish testretest rellabllity, validity and inter‐observer variation of the instrument. Field testing samples: phases 1 and 2; 188 parents of pre‐school children attending one of the three health service settings — CHC, CDU or paediatric OPD; phase 3; 40 parents of pre‐school children attending CHCs. Methods: test‐retest reliability of each domain of the WCHMP was estimated using weighted Kappa; criterion validity was estimated for selected domains against health records; construct validity against medically plausible constructs was tested by comparing responses between domains; inter‐observer variation was estimated using weighted Kappa. Results: the test‐retest reliability of the WCHMIP varied from ‘moderate’ for behaviour, functional health and life quality status to ‘very good’ for acute significant Illness and hospital admission status; criterion and construct validity were high; weighted Kappas for all domains for inter‐observer variation between the researcher and family health visitor were in the ‘good’ to ‘very good’ range and inter‐observer variation remained unaffected by change in the order of administration of the WCHMP. Conclusions: the WCHMP is a simple measure of parent‐reported health and Illness which, on Field‐testing, has been shown to be reliable and valid with low inter‐observer variation. After further development and validation including incorporation into the parent‐held record, it should be suitable for use in infancy and early childhood to collect cross‐sectional and longitudinal health and morbidity data for research and service planning purposes.
Neighbourhood support to families with a disabled child: observations on a coping strategy off caregivers in a Jamaican community‐based rehabilitation programme
Authors: Bischoff R , Thorburn M J , Reitmaier P
Published: April 2006

Summary
In Jamaica, a low degree of practical helpfulness of neighbours of families with a disabled child has been described. This seems to cast doubt on the World Health Organization's concept of community‐based rehabilitation which simply assumes that the community is a source of support. Our study tries to elucidate which reasons, in a Jamaican socio‐cultural setting, make neighbours give support to or withhold it from disabled children and their caregivers. A concept of neighbourhood help is identified, according to which help is something to be asked for and provided under exceptional circumstances only. Caregivers claim to give and receive support in child rearing within the limits of this definition, generally irrespective of the presence of a disability. The impression that neighbours are unconcerned can arise when the support needed becomes too extensive to fit into the local definition of neighbourhood help — which is more likely in the case of disabled children.
Sending a copy off the letter to the general practitioner also to the parents in a child development centre: does it work?
Authors: Bailey G , Hyde L , Morton R
Published: April 2006

Summary
Following concerns that a considerable extra workload would be involved in sending a copy of the GP outpatient letter to parents following a medical consultation, 100 consecutive letters from the CDC were analysed to see if they could be sent to parents. Changes would have been necessary in 11, of which 6 would need an extra letter to the GP conveying additional specific information. Letters were generally intelligible, but it was recommended that they could be written in a more simple way for parents. Following these recommendations, copies of letters to the GP were sent to parents and the practice reviewed 2 years later. GP letters from 100 consecutive patients who had just visited the Centre were analysed and found to have been sent in 94. Of the remaining six, five were not sent because they contained information specific to the GP. It was felt that this could be rectified fairly easily. An anonymous questionnaire, sent to those receiving a copy of the letter, indicated that it had been very well received. It was felt that this policy was most helpful to the parents and justified a small additional workload.
Anthropometric and motor characteristics of Senegalese with different nutritional histories
Authors: Bénéfice E , Fouéré T , Malina R M , Beunen G
Published: April 2006

The effects of Protein Energy Malnutrition (PEM) on the motor performance of 4.5‐6.5‐year‐old Senegalese children were studied. Body dimensions included weight, lengths, circumferences, and four skinfolds. Motor performance tests included a 3‐min endurance run, 4 × 10 m shuttle‐run, distance throw, standing long jump and grip strength. The sample consisted of 147 children: 52 children who were hospitalized for severe undernutrition (severe UN group) during infancy but who had been nutritionally rehabilitated; 63 children who were never severely malnourished but who were chronically exposed to mild‐to‐moderate undernutrition up to the time of study (chronic UN group); and 32 well nourished children (well nourished group) from well‐off households. After adjusting for sex and age, the well nourished group performed better than the severe UN and chronic UN groups. Principal components analysis resulted in two factors which explained 65% of the variance in anthropometry and motor performance. One was related to body size and the second to body composition. The three nutritional groups differed significantly in principal component scores for the two factors; chronic UN and severe UN children also differed for the second factor. Body composition, especially low fat mass appeared to be an important feature for motor performance In chronically undernourished children.
Management of minor ailments in primary schoolchildren in rural and urban areas
Authors: Cantrill J A , Johannesson B , Nicolson M , Noyce P R
Published: April 2006

The concept of self‐management in healthcare includes disease prevention, self‐diagnosis, self‐treatment and appropriate consultation with health care practitioners. Within the context of childrens’ailments the decision‐maker will usually be a carer The aim of this study was to examine carers’management of minor childhood aliments within urban and rural settings. The subjects were primary schoolchildren (4‐12 years of age) and the respondents were their parents or carers. Data were gathered using a pre‐piloted structured questionnaire. The questionnaires were distributed through and collected by the head teachers of the 13 participating schools. Of the 491 questionnaires distributed, 306 (62%) were returned and suitable for analysis, in total, 96 (31%) children had experienced a minor aliment in the preceding 2 weeks; the most commonly reported were cold, headache and gastrointestinal disturbance. Ninety‐five respondents indicated how they managed this episode; the most common response was to treat the child with a medicine which they already had in the house (41%). A further 24 obtained a medicine specifically to manage the episode; 12 on prescription and 12 purchased an over‐the‐counter (OTC) medicine. The majority of respondents (86%) felt that they based their management decision on their own experience, only 10 felt their action was influenced by the advice of a pharmacist or doctor. Fifty children (16%) were reported to have a chronic illness. Several respondents volunteered comments suggesting that they would be cautious in their use of OTC medicines. This study indicates that in the majority of cases, carers manage children's minor aliments without recourse to professional advice.