Maternal feeding practices and childhood obesity: a focus group study of low-income mothers

OBJECTIVE: To identify maternal beliefs and practices about child feeding that are associated with the development of childhood obesity. DESIGN: Four focus groups. One group of dietitians from the Supplemental Nutrition Program for Women, Infants, and Children (WIC) in the Northern Kentucky Health District and 3 groups of mothers with children enrolled in WIC. SETTING: The WIC program in the Northern Kentucky Health District. PARTICIPANTS: Fifteen WIC dietitians and 14 mothers (14 to 34 years of age) with young children (12 to 36 months of age) enrolled in WIC. RESULTS: The mothers in this study (1) believed that it was better to have a heavy infant because infant weight was the best marker of child health and successful parenting, (2) feared that their infants were not getting enough to eat, which led them to introduce rice cereal and other solid food to the diets before the recommended ages, and (3) used food to shape their children's behaviors (eg, to reward good behavior or to calm fussiness). The mothers acknowledged that some of their child-feeding practices went against the advice of their WIC nutritionists and physicians. Instead, the participants relied on their mothers as their main source of information about child feeding. CONCLUSIONS: Physicians and allied health professionals discussing childhood growth with mothers should avoid implying that infant weight is necessarily a measure of child health or parental competence. Parents who use food to satisfy their children's emotional needs or to promote good behavior in their children may promote obesity by interfering with their children's ability to regulate their own food intake. Interventions to alter child-feeding practices should include education of grandmothers.     

Epoxide derivatives of pipecolic acid and proline are inhibitors of pipecolate oxidase

BACKGROUND: Regulations concerning services for handicapped children in France have defined the notion of multi-handicap. There are, however, divergences in the procedures for applying this definition, and differences in the prevalence in different areas. This study is aimed at clarifying these two points. POPULATION AND METHODS: A survey in three French departments provided data about disabled children born between 1975 and 1985 who received services from the departmental committee for special education or from day hospitals. The data was systematically collected by a physician using medical files. RESULTS: The results showed that the group of multi-handicapped children was heterogeneous. The most restrictive definition (motor disability with profound mental retardation, bed-ridden or restricted to a chair) resulted in a prevalence of 0.73%. A broader definition based on the concept of zero autonomy, but excluding mild or moderate mental retardation, resulted in a prevalence of 1.28%. CONCLUSION: The importance of specifying the objectives of a definition selected for operational reasons is stressed in order to improve the estimation of specific needs.     

Prognosis and long-term follow-up of a twin after antenatal death of the co-twin

It is generally believed that among twin pregnancies with one fetal loss prior to delivery, the surviving twin has an increased rate of perinatal mortality and childhood morbidity (cerebral palsy and mental retardation). By using data from the National Medical Birth Registry of Sweden between 1973 and 1983, we identified 206 gestations with the death of at least one twin (in 36 pregnancies both twins died) prior to delivery. The original medical records were retrieved for study. The presence of childhood morbidity for 65 of 129 surviving (8 years of age or older) twins born between 1973 and 1980 was evaluated by a questionnaire sent to rehabilitation centers for disabled children, as well as to offices for the Provision of Care for the Mentally Retarded. Perinatal mortality for a twin after the antenatal death of the co-twin was considerable. Fifty percent of survivors died before 34 weeks' gestation, and 18.7% thereafter. At follow-up, 8 years or more after birth, three twins (4.6%) were handicapped. Our results indicate the need for careful monitoring of the surviving twin fetus after one twin has succumbed prenatally.     

Hennekam syndrome

Hennekam syndrome is a disorder comprising intestinal lymphangiectasia, facial anomalies and moderate mental retardation. Eight cases have been previously reported. CASE REPORT: A 17-month-old girl was admitted to hospital for peripheral edema. On physical examination, she presented with a normal mental development. Facial anomalies were noted including a flat face, depressed and broad nasal bridge, puffy eye lids, mild down-slanting palpebral fissures, hypertelorism, epicanthal folds, bulbous nasal tip, small mouth, and low set ears. A simian line and haemangiomas on the arms, trunk and left limb were also noted. There was no organomegaly. Laboratory investigations showed iron deficiency anemia, hypoproteinemia, hypogammaglobulinemia and an elevated level of alpha-1 antitrypsin excreted in the feces. Endoscopic investigation and the small bowel biopsy showed findings consistent with lymphangiectasia. The patient did well on 24 hour enteral nutrition including medium-chain triglyceride rich diet and infusion of human albumin. CONCLUSION: We have aimed to remind that Hennekam syndrome should be included in differential diagnosis when intestinal lymphangiectasia are associated with facial anomalies.     

Nitric oxide synthase inhibition with N omega-nitro-L-arginine methyl ester affects blood pressure and cardiovascular structure in the genetically hypertensive rat strain

We examined an 18-year-old female and an 18-year-old male with mild mental retardation who suffered from the oscillatory form of sporadic essential myoclonus from an age of 3 years. Although the generalized oscillatory myoclonus resembled severe essential tremor, surface electromyography revealed small myoclonic jerks with frequencies of 6-8 Hz. As concomitant symptoms, the female case exhibited overanxious irritability from early childhood and generalized epileptic seizures occurred from the age of 4 years. In the male case, an obsessive-compulsive disorder and photosensitive convulsive seizures were persistently noted from early childhood. All their symptoms had been stable for at least the last 10 years. Thus, although non-progressive tremulous movements are rare in early childhood, sporadic essential myoclonus is causative. In contrast to hereditary essential myoclonus, sporadic essential myoclonus is considered to be more heterogeneous, especially in the various associated symptoms.     

Mild hearing loss in children with communication disorders

The prevalence of MHL in 202, 1 to 6 year-old children with communication disorders who visited our clinic in 1991 was investigated. 1) 31% of the subjects had MHL bilaterally. The prevalence of MHL was 44% at age 1 year, 20% at age 2 years, 36% at age 3 years, 24% at age 4 years, 39% at age 5 years, 33% at age 6 years. 2) 88% of children with MHL had OME, 10% had mild sensorineural hearing loss, and 2% had cerminous plug. 3) The prevalence of MHL in children with mental retardation and autistic disorders was 9%, that with stuttering was 9%, that of OME accompanied by moderate and severe hearing disorders was 6%. 4) The primary causes in 191, except for those with stuttering, were as follows; the prevalence of MHL was 30%, that of mental retardation and autistic disorders was 24%, and that of articulation disorders was 28%. 5) On the other hand, the prevalence of MHL in children with retarded language development and articulation disorders was 30%, which was significantly higher than that of the other communication disorders. Accordingly, the results of this study suggest that MHL in early childhood greatly influences communication disorders.     

Validation of cardiovascular fitness field tests in children with mental retardation

The validity of the 600-yard walk/run, the 20-m shuttle run, and a modified 16-m shuttle run was determined to measure aerobic capacity (VO2peak) in children with mild and moderate mental retardation. Practice sessions for all tests were conducted. All field tests were very reliable, and VO2peak was significantly related to them all. A stepwise multiple regression showed that field test performance, body mass index (BMI), and gender, but not age, were also significant predictors of VO2peak. All field tests were valid and reliable indicators of aerobic capacity, suggesting that these tests can be used to predict VO2max in children with mild and moderate mental retardation.     

Agreement between school study team decisions and authoritative definitions in classification of students at-risk for mild disabilities.

Investigated the degree to which school study teams (SSTs) considered and used results from traditional psychoeducational measures in determining eligibility or ineligibility for special education. Research definitions based on authoritative criteria were used to define 3 groups of students: 47 learning disabled students, 43 students with mild mental retardation, and 60 low achieving students. These groups were then compared to SST classification decisions to determine relative rates of agreement and disagreement. Results show that SSTs show relatively low rates of agreement with authoritative definitions of mild disability groups. Results also suggest that SSTs are making classification decisions based on perceived educational need rather than test scores provided by school psychologists, and the extent to which these scores meet arbitrary eligibility criteria. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Integrating behavioral and physiological models of hippocampal function

Mortality of people with mental retardation receiving services in California was examined. The large population (N = 118,653) enabled us to work directly with mortality rates at specific ages. Up to about age 35, mortality rates of people with Down syndrome were comparable to those of people with mental retardation due to other causes. Subsequently, the increase was much more rapid in the group with Down syndrome. Mortality rates of individuals with Down syndrome doubled every 6.4 years compared to 9.6 years for people without Down syndrome. Life tables were constructed; the remaining life expectancy of a 1-year-old child with Down syndrome with mild/moderate retardation was 55 years and with profound mental retardation, 43 years.     

Synthesis and activity of partial retro-inverso analogs of the antimetastatic laminin-derived peptide, YIGSR-NH2

Very low birth weight (VLBW) children at school age show variability in their outcome, compared with normal birth weight children, although many early physical and health differences are equalized by middle childhood. Studies of nonhandicapped VLBW children have found a higher rate of school retention and school problems in this population. Differences in intelligence have been reported, although these are often confounded by socioeconomic factors such as educational level of the parent. Few studies today of children born in the late 1970s and early 1980s have related school age outcome to central nervous system (CNS) status, yet for learning disabilities or other neuropsychological deficits, this may be highly relevant. Better understanding of medical risk factors, however, will not affect the decisive influence of social factors on their expression in the school age child.     

Impact of a large-scale immunization initiative in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)

CONTEXT: Inner-city immunization rates have lagged behind those in other areas of the country. OBJECTIVE: To evaluate the impact of an initiative linking immunization with distribution of food vouchers in the inner city. DESIGN: Retrospective analysis of immunization data gathered in 1996 and 1997. SETTING: Nineteen Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) sites serving 30% of the Chicago, III, birth cohort. PARTICIPANTS: A total of 16581 children 24 months old or younger. INTERVENTIONS: Voucher incentives (varying frequency of food voucher issuance based on immunization status) and assessment of immunization status and referral to immunization provider. MAIN OUTCOME MEASURES: Age-appropriate immunization rates and WIC enrollment rates. RESULTS: During the 15-month period of evaluation, immunization rates increased from 56% to 89% at sites performing voucher incentives. The proportion of children needing voucher incentives declined from 51% to 12%. Sites performing assessment and referral, but not providing voucher incentives, showed no evidence of improvement in immunization coverage. No difference was observed in enrollment rates between sites performing voucher incentives and those that did not. CONCLUSION: Applied in a large-scale, programmatic fashion, voucher incentives in WIC can rapidly increase and sustain high childhood immunization rates in an inner-city population.     

Critical analysis of the 1992 AAMR definition: Implications for school psychology.

The 1992 definition of mental retardation written by the American Association on Mental Retardation (AAMR) represents a radical departure from definitions of R. Heber (1961) and H. Grossman (1983). Levels of mental retardation (mild, moderate, severe, and profound) have been eliminated and replaced with intensities of needed supports to facilitate an individual's functioning across environments (intermittent, limited, extensive, and pervasive). The 1992 definition establishes an upper IQ cutoff of 75 and requires that 2 of 10 specified adaptive skill areas be "limited" to establish a diagnosis of mental retardation. The authors critically analyze this definition and discuss several challenges it presents to school psychologists in assessing and classifying intelligence, adaptive behavior, and intensities of needed supports. Potential for renewed overrepresentation cases is discussed in the context of the 1992 AAMR definition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Characteristics of participants in a supported education program for adults with psychiatric disabilities

OBJECTIVE: Supported education programs provide assistance, preparation, and support to individuals with psychiatric disabilities who desire to pursue postsecondary education. To determine the extent to which "typical" clients with severe mental illness can participate in a supported education program, the study examined characteristics of participants in a large supported education program. METHODS: Baseline interviews with participants in a supported education program in the metropolitan Detroit area gathered demographic data, as well as information about school, work, and psychiatric history; social adjustment and support; psychiatric symptoms; and self-perceptions in the areas of school efficacy and self-esteem. Cluster analysis used five variables (sex, age, educational attainment, work background, and symptoms) to produce a client typology. RESULTS: Five clusters emerged: well-functioning young men, young aspiring women, young dependent men, well-functioning but unemployed participants, and distressed unemployed participants. The clusters also differed on a large number of variables not used in the cluster analysis. However, members of all clusters had similar rates of program participation and first-semester attendance. Overall, the supported education participants were younger, better educated, and higher functioning than subjects in general samples of persons with severe mental illness. Although many participants had significant problems with symptoms, social adjustment, and substance abuse, they were able to remain active program participants. CONCLUSIONS: The results indicate that supported education is a feasible alternative for many individuals to meet goals for educational advancement, personal development, and better jobs.     

Diagnosis of phenylketonuria in a 35-year-old mother in relation to prenatal diagnosis of intrauterine growth retardation with microcephaly

BACKGROUND: Some French pregnant women with phenylketonuria (PKU), born before 1978, have not been tested with the Guthrie method during the neonatal period. They have a risk of spontaneous abortion and their infants are often mentally retarded with microcephaly and/or congenital heart anomaly. CASE REPORT: A woman with a moderate mental retardation became pregnant at the age of 31 years. Her newborn had a severe intrauterine growth retardation with microcephaly and developed mental retardation. This mother became pregnant again 4 years later. Repeated fetal ultrasonography showed progressive growth retardation. Maternal blood phenylalanine concentration was 18 mg/100 mL. Therapeutic abortion at 27 weeks of gestational age showed a fetus with several abnormalities, particularly cardiovascular and cerebral. CONCLUSION: It is still possible to meet women with unrecognized atypical PKU. Fetus or infant born with unexplained growth retardation and microcephaly requires search for maternal PKU.     

Family Involvement Questionnaire: A multivariate assessment of family participation in early childhood education.

The study developed and evaluated the Family Involvement Questionnaire (FIQ), a multidimensional scale of family involvement in early childhood education. The FIQ was guided by theory and coconstructed with parents and teachers in preschool, kindergarten, and 1st-grade programs in a large urban school district. Demographic and FIQ data were collected from 641 parents. Factor analyses revealed 3 involvement constructs: school-based involvement, home-school conferencing, and home-based involvement. Multivariate analyses of demographic and program differences in these constructs revealed that parents with education beyond high school were engaged in higher levels of school-based involvement and home-school conferencing than parents with less than high school education. There were higher levels of home-school conferencing and home-based involvement in 2-parent families than in single-parent households. Head Start evidenced the highest levels of school-based involvement activity. However, higher school-based contact was not associated with higher levels of home-school conferencing or home-based involvement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Early intervention improves intellectual development in asphyxiated newborn infants. Intervention of Asphyxiated Newborn Infants Cooperative Research Group

OBJECTIVE: To evaluate the effect of early intervention on the intellectual development in asphyxiated newborn infants. METHODS: Full term asphyxiated infants (Apgar score < or = 6 at 5 minutes after birth) were randomly assigned to early intervention group (34 cases) and conventional care (30 cases) group. The normal control group consisted of 38 infants. Sex, mother's educational background, environmental condition and physical development were not significantly different in the 3 groups. Zero to two years early intervention program was compiled on basis of the national and foreign material about 1 month ahead of average development of the child. It included motor, cognitive, speech development and social behavior. Parents were instructed to carry out early intervention. RESULTS: At the age of 1.5 years, average score of mental development index (MDI) in early intervention group was 14.6 higher than that in conventional care group (F = 18.86, P < 0.0001). MDI score in early intervention group caught up with that in normal control group (F = 2.17, P > 0.05). Conventional care group was 9.7 lower than normal control group (F = 10.14, P < 0.01). Two of 30 cases (6.7%) in conventional care group was mentally retarded while none was mentally retarded in the early intervention group. CONCLUSIONS: The results showed that the early intervention could promote intellectual development of asphyxiated infants and be of much benefit to the prevention of mental retardation.     

Do peers contribute to the likelihood of secondary school graduation among disadvantaged boys?

This 17-year longitudinal study tested whether low peer-perceived acceptance and association with aggressive-disruptive friends during preadolescence predicted students' failure to graduate from secondary school. Participants were 997 Caucasian, French-speaking boys from low-socioeconomic status, urban neighborhoods. The boys were recruited in kindergarten (age 6) and followed through early adulthood (age 23). Low levels of prosocial behaviors and high levels of aggressive-disruptive behaviors in childhood were expected to predict negative preadolescent peer experiences. Adolescent academic achievement and school commitment were expected to mediate the link between preadolescent peer experiences and early adulthood graduation status. Results of structural equation modeling analyses tended to support these hypotheses. Greater childhood aggression-disruptiveness positively predicted friends' preadolescent aggression-disruptiveness. Having aggressive-disruptive friends, in turn, was related to a lower likelihood of graduation. Lower academic achievement and school commitment partially mediated the association between friend characteristics and graduation. Peer acceptance did not contribute to graduation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship between age and head movement during stepping in place by nonhandicapped children and persons with mental retardation

We investigated developmental changes in head movement during stepping in place by nonhandicapped children and clarified the relationship between chronological or mental age and head movement of persons with mental retardation. 39 nonhandicapped children aged 3 to 6 years, 13 adults aged 19 to 22 years, and 10 persons with mental retardation (range of chronological age: 17 to 22 years, range of mental age: 3 to 8 years) participated. The total extent of head movement in the frontal plane during ordinary stepping in place for 20.48 sec. was measured to assess the magnitude of head movement. Changes in the magnitude of head movement of children are noticeable across ages, and the magnitude clearly was smaller at the age of 6 years. For subjects with mental retardation, no relationship has been found between chronological age and the magnitude of head movement but rather between mental age and the magnitude of head movement.     

Association of Duane anomaly with mental retardation, cardiac and urinary tract abnormalities: a new autosomal recessive condition?

The authors report on a child in which the occurrence of cardiac defect, urinary tract anomaly, and Duane anomaly was associated with mental retardation. The parents were first cousins. The index case was a 3-year-old girl referred for mental retardation. Auricular septal defect was diagnosed at birth. She was surgically treated for bilateral vesico-ureteral reflux at 2 years of age. At examination, she had a mild facial dysmorphism, microcephaly, spastic paraplegia and Duane anomaly. The Duane anomaly may occur in association with various partly overlapping syndromes that may be part of the same clinical spectrum, as the cervico-oculo-acoustic syndrome, the cat eye syndrome and syndromes inherited in an autosomal dominant fashion: the acro-reno-ocular syndrome and the Okihiro syndrome. Their patient seems to have a different condition from all of these previously reported syndromes associated with the Duane anomaly. Their suggest that this condition is best described as a new syndrome.     

Malnutrition and mental deficiency.

Indicates that inadequate nutrition can affect both physiological and psychological development in humans. The 9 mo. of gestation and the 1st few yr. of life are the most critical in the growth of brain tissue and are also the periods of greatest vulnerability to malnutrition. Variables that mediate the effect of nutrition on mental development include prematurity, birth weight, and the nutritional status of the mother during her childhood. A model for thorough research is suggested and is used to evaluate the major studies of the relationship between malnutrition and mental deficiency. (71 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)