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The article informs that a variety of evidence suggests altered vitamin B[sub6] metabolism in Down's syndrome. Studies using deoxypyridoxine suggested that the vitamin B[sub6] pool was either reduced or turned over more rapidly in Down's syndrome than in controls. When individuals with Down's syndrome were given 350 mg pyridoxine hydrochloride per day, the concentration of pyridoxal phosphate in plasma was significantly higher than in controls receiving the same intake. Therefore, the regulation of pyridoxal phosphate concenrations in plasma appears to be altered in Down's syndrome.

The article presents information on the effect of thyroid stimulating hormone on adaptive behaviour in Down's syndrome. Alzheimer's dementia is associated with characteristic histopathological and neurochemical changes, both in the cerebral cortex and sub-cortical structures including the hypothelamus. Such neurochemical changes include reduced activities of choline acetyl transferase, noradrenaline and a somatostatin. Neurotransmitters such as acetylcholine, noradrenaline and somatostatin have been shown to control the secretion of pituitary hormones.

The article presents information on the behavioural observations in children with Down's syndrome. There has been a growing interest in the behaviour of children with developmental disabilities in the past few decades. Some investigators have pointed out the increased prevalence of behaviour problems and psychiatric disorders in persons with mental retardation and other handicapping conditions. Thirty-one per cent of the children with Down's syndrome and 29% of controls were judged to be well adjusted, whereas 38% of the children with Down's syndrome and 49% of the controls had significant behaviour disorders.

This article reports the case of a 42-year-old woman with Down's syndrome who developed a misidentification syndrome, erotomanic delusions towards her instructor, and increasing grandiosity following the death of her father. This patient is remarkable for the additional presence of a Fregoli-like misidentification state. Erotomanic delusions are characteristically described in schizophrenia, but may also occur in bipolar affective disorders and in amphetamine abuse, alcoholism and organic brain syndromes.

The article examines the occurrence of moyamoya disease in a child with Down's syndrome. The subject is the second child of healthy, non-consanguineous parents. Apart from her, there is no family history of Down's syndrome or related disabilities. Following a full-term normal pregnancy and birth, the subject was suspected neonatally to have Down's syndrome. This diagnosis was confirmed on blood leucocyte culture that revealed standard trisomy 21 without evidence of mosaicism. However, her overall progress is consistent with that of children with Down's syndrome in general, seizures have not occurred, and she is a contented, friendly child with an estimated mental age of 3 years.

The article describes the case of two children with Down's syndrome and Moyamoya disease. Moyamoya disease is a cerebro-vascular abnormality characterized both by stenosis or occlusion of the internal carotid artery at its terminal bifurcation, and by a pathological and extensive collateral circulation at the basal ganglia. A boy with trisomy 21 and mild retardation in motor and mental development was struck by two sudden and transitory episodes of right hemiparesis. A bilateral cerebral angiography was performed. It showed a stenosis of both internal carotid arteries, low perfusion of the anterior and middle cerebral arteries, and collateral channels at the base of the brain, typical of moyamoya disease.

The article examines the validity and applicability of the Attention-Distractability, Inhibition-Excitation Classroom Assessment Scale (ADIECAS) in a sample of children with Down's syndrome. The lower verbal ability of the children in the current study even after allowing for the effect of their lower age range, suggests that the scale's speech items may be unreliable for some children with Down's syndrome, and for younger children in particular. The omission of the speech items and of the lack of inhibition item from the excitability factor reduces the number of its components to two, suggesting that it should not be regarded as a true factor.

The article presents a study, which describes how Down's syndrome children reply to the offers their parents make to them. In this study, videorecordings were made in the homes of six children with Down's syndrome whose developmental ages ranged between about 1 and 2 years. Analysis of sequences initiated by parental offers to their children suggests that these children's response behaviour is sensitive to both non-verbal aspects of the offerer's behaviour and the context in which the offer is made.

The article presents a discussion on ocular abnormalities related to Down's syndrome. Ocular abnormalities are rather common in Down's syndrome. Many previous reports concern certain aspects of eye pathology in Down's syndrome; for example, visual acuity, keratoconus and blindness. The article presents information on ocular findings in 30 patients with Down's syndrome from a central institution with approximately 200 patients. Strabismus was significantly more prevalent in the Down's syndrome subjects. In most cases, the disorder was obvious and diagnosed by clinical examination.

The article focuses on hormonal and biochemical disturbances in Down's syndrome. Down's syndrome is the most frequent single cause of mental retardation, occurring in about one in every 700 births. The syndrome is associated with mental retardation and a large variety of malformations, and other medical complications evolve over the years. The small stature, small testes and reduced fertility typical of Down's syndrome indicate hormonal disturbances. Hypothyroidism is frequent in these cases and low levels of somatomedin C have been demonstrated as well.

The article presents information on a study which determines biological responses in Down's syndrome subjects for an incremental exercise lasting 10 min. After a training programme specially adapted for children and adolescents with mental handicaps, 11 healthy Down's syndrome subjects, seven boys and four girls aged from 15 to 20 years, performed a progressive exercise until exhaustion on an ergometric bicycle. The aim of the study was to evaluate the influence of an intensive physical exercise on biological parameters and on haematocrit and haemoglobin concentration.

The article focuses on the prevalence of severe mental handicap in Northern Ireland. Basic data were taken from the files of all registered, mentally handicapped individuals. The present authors would argue that the best estimate of severe mental handicap in Northern Ireland lies in the 20-29-year-old category. In their survey of mental handicap, researchers also found a marked geographical variation between the Eastern and Western parts of the country. The high Down's syndrome rates can only account in part for the elevated rates of severe mental handicap in the province.

The article focuses on various factors related to self-sufficiency in children with Down's syndrome. Recognition of the need to measure the level of self-sufficiency or independent functioning achieved by people with mental disabilities has resulted in the use of the concept of adaptive behavior. The measurement of self-sufficiency is particularly relevant to children with mental handicap in middle childhood, both as a measure of the degree of handicap and of the additional burden on the family. Parental coping strategies for problems concerning their children with Down's syndrome were measured through an adaptation of the Ways of Coping Questionnaire.

Eight adult male stutterers with Down's syndrome (DS) were compared with a matched group of fluent speakers with DS on verbal and manual motor production tasks at two levels of complexity. The simpler tasks involved diadochokinetic rate (syllable repetition) and finger tapping; the more complex tasks involved the imitation of sentences and placing pegs in the grooved pegboard. On both verbal and manual tasks, stutterers were faster on the simpler but slower on the more complex tasks than were the fluent speakers. The findings suggest that stutterers with DS have a different motor organization than fluent speakers with DS. [ABSTRACT FROM AUTHOR]

A questionnaire in the form of a bipolar rating scale was constructed using 26 personality attributes drawn from the literature on personality of children with Down's syndrome (DS). This was administered to nine groups of adults with differing levels of experience and contact with children with DS. Adults who had frequent contact proved to be significantly less likely to rate the personality of children with DS as stereotypical than those with little contact. The implications of acceptance of the stereotype are discussed in relation to integration and to development of the mother-child relationship. [ABSTRACT FROM AUTHOR]

In previous reports, deficiencies in serum vitamin A were considered a frequent finding in persons with Down's syndrome. Based on this assumption, the regular determination of both serum carotene and vitamin A has been recommended for the preventive care of this population. In the author's preventive medicine clinic for children with Down's syndrome, we have checked these items routinely in 44 fasting patients (aged 14 months to 19 years). The author was surprised to find no patient with either a deficiency of carotene or vitamin A, but 14 patients had hypercarotenemia. Any known aetiology of this finding, such as excessive ingestion, diabetes mellitus or hypothyroidism, could not be verified. It has to be mentioned that the previous reports on serum carotene levels were based on determinations by conventional spectrophotometric methods (normal range: 50-670 µg/dl), whereas the author applied an improved method of high-performance liquid chromatography with a much lower normal range (50-750 µg/l). Further investigations are to be performed to verify these findings and to evaluate probable mechanisms of hypercarotenemia in persons with Down's syndrome. [ABSTRACT FROM AUTHOR]

The total daily vitamin A intake, physical signs associated with vitamin A deficiency, and the response to a vitamin A challenge were studied in 33 patients with Down's syndrome and in 14 intellectually normal persons (comparison group). The evaluation of detailed dietary histories revealed that the study subjects' mean daily vitamin A intake was similar to the recommended daily allowance for adults and that there was no significant difference of the mean daily vitamin A intake between study and comparison groups (5029 IU and 5706 IU, respectively). Subjects with Down's syndrome had more symptoms usually seen in patients with hypovitaminosis A than the persons in the comparison group. The baseline serum vitamin A levels in the Down's syndrome and comparison groups were within the normal range (106.0 µg/dl and 136.5 µg/dl, respectively). The vitamin A absorption curve of persons with Down's syndrome paralleled that of normal individuals and no significant difference of vitamin A levels between study and comparison groups was observed except for the 6-h values. Also, the absorption differential (Δ = 3-h value + 6-h value/2 --0-h value) did not show a significant difference between the two groups. Thus, these investigations do not support previous reports of significantly decreased vitamin A absorption in individuals with Down's syndrome. [ABSTRACT FROM AUTHOR]

Correlations between regional cerebral metabolic rates for glucose. determined by positron emission tomography with [18F]-2-fluoro-2-deoxy-D-glucose, have been used to indicate functional associations between pairs of brain regions. This method was applied to data from 14 healthy adult subjects with trisomy 21 Down's syndrome (age <34 years) and from 24 age-matched healthy controls. Correlations were obtained between ratios of regional-to-global resting glucose utilization. In comparison to age-matched controls, the Down's syndrome group had many smaller correlations for region-pairs within and between the frontal and parietal lobes; some correlations were large and negative in the Down's syndrome group, but large and positive in the controls. One region so affected was the inferior frontal gyrus that includes Broca's area. This result is consistent with the relatively greater language impairment in Down's syndrome subjects. The thalamus also had smaller correlations with temporal and occipital regions in the Down's syndrome group compared to controls. These results suggest that Down's syndrome is accompanied by a functional disruption of neural circuits associated with directed attention. [ABSTRACT FROM AUTHOR]

The relationship between speech dysfluency and manual lateralization was studied in 31 adults with Down's syndrome. Analysis of speech samples from videotapes indicated that frequency of dysfluency ranged from normal to very severe; 42% of the subjects were stutterers. Manual lateralization was measured by the demonstrated use of five objects (pencil, comb, toothbrush, ball and scissors); 61% of the subjects had a clear right-hand preference, 13% a left-hand preference, and the remaining subjects (39%) were mixed-handed. Increased dysfluency was associated with increased non-right-handedness, and this finding could not be explained by reference to either generalized linguistic or intellectual deficits. Results suggest individual variation in the speech motor control system in adults with Down's syndrome which may be associated with anomalous cerebral dominance. [ABSTRACT FROM AUTHOR]

A 26-year-old profoundly mentally handicapped woman with Down's syndrome and severe self-injurious behaviour was treated by dietary means. Treatment consisted of regular institutional entrees, supplemented with serotonin-containing foods, and modified to ensure dietary sources of potassium each intake and low protein relative to carbohydrate. Dramatic benefit was evident the first day and, after 6 months self-hitting was still close to 90% lower than baseline rates. Relevant literature was discussed regarding why a serotonergic approach was chosen for reducing self-injury. [ABSTRACT FROM AUTHOR]

The thyroid status of 106 adults with Down's syndrome was assessed. Six were previously diagnosed as hypothyroid and were already receiving thyroxine. A further 37 patients showed abnormal thyroid function. Biochemical evidence of hypothyroidism (T4<50 nmol/l and T.S.H.>4 mu/<) was found in one person. Six patients were found to have an unequivocally elevated T.S.H. but normal T4 (T4>50 nmol/l and T.S.H.>20 mu/l) and 29 were found to have a modest elevation of T.S.H. but normal T4 concentration (T4>50 nmol/l and T.S.H. between 4 and 20 mu/l). There was one patient with mild thyrotoxicosis(T4=180 nmol/l and T.S.H.<0·1 mu/l). Clinical findings were of little use in making a diagnosis of hypothyroidism in this group of patients. A raised level of thyroid microsomal auto-antibodies was found in about a third of the patients, this occurred more commonly in females and slightly more often in those with a raised thyroid stimulating hormone. The importance of this is discussed. Recommendations for regular biochemical screening are made. [ABSTRACT FROM AUTHOR]

It is well established that there is an increased frequency of atlanto-axial instability in Down's syndrome. In two out of the 27 patients with Down's syndrome who were examined, there was an atlanto-axial dislocation, but without any corresponding neurological symptoms. However, scrutiny of the X-rays revealed many cases with marked degenerative changes, particularly in the upper part of the cervical spine. The degenerative changes In Down's syndrome patients were compared with those in age- and sex-matched patients examined because of cervicalgia. Patients examined because of acute neck traumatas constituted a second control group. The results indicate that there is a significant increase in degenerative changes in the upper part of the cervical spine in Down's syndrome. [ABSTRACT FROM AUTHOR]

The ability to comprehend syntactically ordered sequence by Down's syndrome adults and adults with menial retardation of no specific aetiology was studied. Both samples exhibited patterns of comprehension that resembled those of children who are not mentally retarded. However, the Down's syndrome individuals had significantly more difficulty when sequence was indicated by syntax with no supporting extralinguistic context. The Down's syndrome adults appeared to be arrested at an earlier stage of development than the other mentally retarded adults. [ABSTRACT FROM AUTHOR]

A profoundly menially handicapped patient is described with the karyotype 47,X, fra (X) (q27), + 21. Her phenotype demonstrates features of both Down's Syndrome and fragile-X syndrome. The authors believe only one other similar case has been described. [ABSTRACT FROM AUTHOR]

The numbers of young adults with Down's syndrome is currently increasing due to improvements in survival and a period of increased incident numbers in the 1960s. Deaths from infection have shown the largest decline. Forty-one per cent of survivors suffer from one or more serious morbid conditions, principally congenital heart disease. These changes are adding to the pressures upon local authorities for day and residential care facilities. [ABSTRACT FROM AUTHOR]

The article discusses magnetic resonance imaging of moyamoya disease in a 2-year-old girl with Down's syndrome. Her first days after birth had been complicated by B-streptococcal septicaemia. During the treatment, she developed refractory cardiac failure as well because of a total atrioventricular canal. Magnetic resonance imaging revealed a reduced signal intensity of the cortex and parts of the white matter on the left side. This may be explained by the existence of an old haemorrhagic infarct in the area supplied by the cerebri media artery, which could be seen as narrowed at the origin and, on another slice, inferior.

The article discusses relationship between Down's syndrome and atlanto-axial instability by citing case report of a 25-year-old Caucasian female patient. She has no symptoms of high cervical cord compression or vertebrobasilar insufficiency. Her general health has been good, although she is prone to chest infections and suffers from exertional dyspnoea. Views of the cervical spine in both flexion and extension, demonstrate no instability of the atlanto-axial joint. Joint disorders are common in patients with Down's syndrome.

The article presents a research study, in which authors report the prevalence of taurodontism in a sample of extracted molar teeth from individuals with Down's syndrome (DS). The sample consisted of 77 extracted mandibular molar teeth, 40 first molars and 37 second molars, from 33 DS individuals who were all residents at the Kimberley Hospital and Training School, Levin, New Zealand. Taurodontism does not appear to have special clinical significance, except perhaps in relation to endodontic treatment. Although DS individuals often display wear on teeth, generally associated with nonfunctional habits such as toothgrinding and clenching, it is unlikely that their larger pulp chambers provide an advantage in this regard.

The article discusses dermatoglyphic indicators of congenital heart defects in Down's syndrome (DS) patients. Forty percent of DS patients are concordant for congenital heart defects. The sample used for analysis included 38 DS patients in the without congenital heart disease groups and 13 DS patients in the group with congenital heart defects from Green Bay, Wisconsin. Complete data sets were obtained from all patients and included age, sex and digital and palmar dermatoglyphics. The main program utilized for the analysis was Stepwise Discriminant Analysis.

The article presents the case report of a Down's syndrome patient with secondary cystathioninuria. Chromosomal examination in December 1985 verified that the patient has a trisomy 21 or Down's syndrome. The patient has received vitamin supplementation ever since the discovery of the cystathioninuria. According to the authors, cystathionin is an intermediate product in the formation of cysteine from methionine. Theoretically, cystathioninuria could be a result of overproduction of the substrate, homocysteine, as well.

The article examines the Basal metabolic rate (BMR) in healthy Down's syndrome adults. Basal metabolism is different in the sexes when expressed in terms of surface area. Therefore, BMR was examined in each sex separately, in addition to the sexes combined. When metabolic values were normalized to surface area or lean body mass, no difference in BMR was noted between the Down's syndrome and control groups for either sex. Further, normalization to percent predicted basal metabolism also should have corrected for any sex differences.

The article presents a neuropsychological evaluation of adults with Down's syndrome. A battery of neuropsychological tests developed to study patterns of age-related differences in adults with Down's syndrome, was administered to 10 Down's syndrome adults over age 35 and 19 younger Down's syndrome adults. Although all adults with Down's syndrome are reported to develop the neuropathological changes of Alzheimer's disease by the fourth decade of life, only four of the 10 old adults were judged to have dementia based on clinical criteria.

The article focuses on a study which explains why individuals with Down's syndrome have difficulty sustaining physical exertion. Ten subjects of both sexes with Down's syndrome who were between 13 and 19 years old, and a control group of six males and two females aged between and 13 and 17 were engaged in the study. As blood sampling during exercise was not possible in this population, the use of urinary catecholamines seemed to be justified for a preliminary trial. It is believed that Down's syndrome deficit in motor and adaptive behaviour is not only based upon a lack of motivation, but also physiological and particularly cardiovascular impairments which can be sustained by inactivity.

The article focuses on a study which was undertaken to find if the changes in plasma amino acids seen in senile dementia occur also in Down's syndrome. Nineteen patients with Down's syndrome aged 25-48 years were selected and matched as closely as possible for age, sex and approximate IQ with 19 control patients on the same hospital diet. The Down's syndrome subjects differed markedly from both their controls and from the patients with dementia. The abnormalities lie within the large neutral amino acid group, but mostly involve leucine, isoleucine, phenylalanine and cystine and are in the opposite direction to that seen in senile dementia.

The article focuses on a study related to the attention disorder in a group of young Down's syndrome children. Thirteen of the 14 Down's syndrome children in Oxfordshire aged 2-4 years were studied. The sample varied considerably in developmental age. Therefore, it was important to have a protocol wherein the appropriate developmental level could be quickly located. Therefore, along with the graded increase in difficulty of the tasks through the examination, there was a graded withdrawal of examiner intervention. The attention deficits of these children appear to affect everyday life and carry implications for management.

The article presents information on a research that was conducted to find out the response to music and movement in the development of children with Down's syndrome. Previous researches have shown a fondness for music by the people suffering with Down's syndrome. Two schools were chosen by the scientists which provide special education to students suffering from the disorder. The students were divided into different age groups. The group which had more opportunity to have music in their curriculum showed significant growth than the other group.

This article focuses on nocturnal periodic breathing in adults with Down's syndrome. Nineteen patients with Down's syndrome were examined in familiar surroundings in the Rinnekoti Institution for the Mentally Retarded. A single whole-night static charge sensitive bed recording was made of each patient. The ballistocardiographic, respiratory and body-movement signals were separated by selective filters. Recordings ranging from 4 h, 31 min to 10 h, 54 min were stored on an Oxford Medilog cassette recorder as in long-term EEG-monitoring. The values stored on computer allowed for quantification of the length and frequency of the sequences with periodic breathing.

The article focuses on a study related to the significance of Atlanto-axial instability in Down's syndrome. Seventeen people with Down's syndrome were identified among a population of 180 mentally handicapped adults living in a NHS hospital. All 17 fell into the range of severe mental handicap on the basis of social skills and intellectual functioning. The prevalence of Atlanto-axial instability detected radiologically is between 12 and 20 percent of all Down's syndrome individuals. A longitudinal study of 32 Down's syndrome individuals suggested a higher incidence of Atlanto-axial instability among boys over 10 years of age.

The article focuses on a study which proposes that the risk of developing Alzheimer-like neuropathology is a characteristic feature of Down's syndrome (DS) but some other factors influence the age of onset of clinical dementia. 24 subjects with DS over the age of 30 years were selected for the investigation. Evidence of deterioration over time in self-care skills was assessed using a modified version of the Handicap, Behaviour and Skills schedule. The results show that there may be an interaction between the inherent risk of Alzheimer's disease in Down's syndrome and the possible protective action of vitamin E in slowing down this process.

The article focuses on a 2-year follow-up study related to the auditory P300 response in the assessment of Alzheimer's disease in Down's syndrome. The present study was designed to show whether serial testing of auditory event-related potentials could be a sensitive measure of the onset and course of Alzheimer-type dementia (ATD). The results showed that a large increase in P3 latency was observed in seven out of nine subjects in this study who showed clinical deterioration between the two periods of recording. Overall, the results suggest that P3 change is a sensitive early index of the onset of ATD in Down's syndrome.

The article focuses on a study to assess the usefulness of the auditory P300 response as a measure of the onset of dementia in Down's subjects, who because of poor language development may be difficult to assess by psychological tests. The P3 (P300) responses recorded in this study is a long latency positive deflection which occurs some 300 msec after the stimulus during an odd-ball recognition task. In this task, the subject attends to an infrequent but relevant tone stimulus presented in a series of frequent ignored tones. Satisfactory auditory event-related potentials were recorded in 89 subjects. In this study, there was a greater range of P3 latency amongst Down's subjects than fragile-X or controls and this was most marked amongst the older Down's group.

This article focuses on a study conducted to analyze stage transitioning in the sensorimotor development of Down's syndrome (DS) infants. Six DS infants and six non-retarded (NR) infants were tested every 6 to 12 weeks and the ages at which the landmarks representing Stage V and Stage VI functioning determined. The amount of time necessary for the DS and NR infants to move from Stage V to Stage VI was nearly identical for both the object permanence and means-ends domains. The investigators interpreted these findings as evidence that DS infants have no more difficulty making the transition to Stage VI functioning than do NR infants.

This article focuses on a study that was designed to determine whether aortic regurgitation (AR) and mitral valve prolapse (MVP) are specifically associated with Down's syndrome, or occur in a comparably retarded population without Down's syndrome. The 92 control subjects had mental retardation attributable to low birth weight or perinatal asphyxia. In this case-control study, AR and MVP occurred about three times more often in institutionalized adults with Down's syndrome compared with those whose mental retardation was due to perinatal asphyxia or low birth weight. The low frequency of AR in both groups probably explains why the difference between the two groups did not achieve statistical significance.

The article presents a study, conducted by the authors, which investigated parental perceptions of social interactions, interest in the opposite sex, sexual functions and issues concerning sex education in young persons with Down's syndrome. More than half of the study population showed interest in the opposite sex. Many of the youngsters had expressed a desire to get married, however, only a few had an interest in sexual relationships. Masturbation was observed in 40% of the young men and in 22% of the young women. About half of the parents feel that their children should be sterilized or should have other forms of birth control if they would be able to reproduce. Only a limited number of adolescents had sex education.

The article presents a study, conducted by the authors, which analyzed blood cell populations, plasma zinc and natural killer cell activity in young children with Down's syndrome. Blood samples of 16 children, 5 years of age or younger, who were trisomic for chromosome 21 were included in the study. For each trisomic child sampled, a healthy normal child, who was within one year of the age of the trisomic child, was also studied. Hematocrits, number of total white blood cells and differentials were performed by standard techniques.

The article presents a study, conducted by the authors, which investigated the oral zinc supplementation in Down's syndrome. In the study, 18 non-institutionalized Down's syndrome children were given an oral non-pharmacological supplementation of zinc sulphate and monitored immunologically. A dramatic increase of plasma Serum Thymic Factor (STF) level and concomitantly an almost complete disappearance of inactive STF molecules was observed. The absolute number of circulating T-lymphocytes was significantly increased by zinc treatment. The marginal zinc deficiency was also corrected without any appreciable influence on copper plasma levels. On the whole, findings of the study suggest that there exists a defect in the bio-availability and/or in the utilization of zinc in Down's syndrome.

The article reports a further case of Tourette syndrome occurring in a young female patient in whom Down's syndrome was complicated by some autistic features. The association between Tourettism, Down's syndrome and autism is discussed. Clinical examination shows her to have the characteristic features of Down's syndrome. She is of medium build, but of short stature and low weight. No abnormalities have been detected in her chest, cardiovascular system or abdomen. Her cranial nerves are intact and her fundi normal. Her limbs show normal muscular bulk, tone, power and coordination.

The article presents a study, which attempted to determine whether the failure of Down's syndrome (DS) individuals to show the modality effect is due to the verbal-expressive demands of oral responding in memory tasks. The study found that the nonverbal, manual response procedures enhanced neither DS auditory recall nor recall by subjects in any condition or group. Potential sources of difficulty other than oral responding may eventually prove to be more crucial limiting factors in DS auditory short-term memory. Further, the short-term memory performance of the DS group was depressed relative to that of the nonretarded group in each realm assessed.

The article discusses mortality and survival of the Down's syndrome population in Western Australia. Survival rates of Down's syndrome cases were determined by analysis of an estimated 1205 cases born in Western Australia between the years 1916 and 1984. Life table methodology was used in the conventional way. At the appropriate age division, withdrawal of cases from the table was undertaken, either because of death or because they had no possibility of achieving the next age division during the period of this investigation. The cause of death was ascertained from Health Department records and death registration papers. Of the 149 cases born between 1976 and 1984, 14 had died by December 31, 1984. A congenital heart disease condition was present in seven of the 14 who died and 40 of the 135 known survivors. Cardiac and respiratory conditions were the major causes of death.

The article reports that the combined early intervention (El) benefits analysis for Down's Syndrome (DS) subjects reveals greatest consistency of gains for finer coordination, self-help skills and DQ/IQ scores. Evidently, El programmes place major emphasis on finer coordination and self-help skills training because these respond most readily to contemporary behavioural and physiotherapy technologies. Furthermore, since infant schedules largely tap these skills, impressive DQ gains by programme end are hardly unexpected. Nor then should it be surprising that test intelligence measures will correspondingly erode as test-item content takes on a progressively greater load of cognitive and linguistic content.