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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 in perinatal care, remains a major concern. [ABSTRACT FROM AUTHOR]

Over a 4-year period a significant fall occurred in the mean birthweight and mean gestational age of prematurely born children who subsequently developed spastic diplegia. This coincided with a considerable improvement in perinatal mortality in the unit in which they were delivered. However, although the number of premature deliveries remained stable, the disorder did not become less common. No specific aetiological factors were identified, but the 24 affected children frequently had a history of adverse prenatal or perinatal factors. We conclude that high standards of obstetric and neonatal care prevent the subsequent development of spastic diplegia in low birthweight infants. However, these factors have also improved the survival of very low birthweight infants who have a much higher risk for the disorder and this has prevented a significant reduction in its frequency. [ABSTRACT FROM AUTHOR]

The article focuses on a 2-year follow-up study of children with motor coordination problems identified at school entry age. Children attending primary schools in Leeds, England, were tested soon after school entry with the Standardized Motor Test Battery (SMTB), specifically designed for this study and comprising: finger tapping, peg moving, bead threading, standing on one leg, hopping and walking. Norms of motor performance are provided for each test. Seventeen children failed the SMTB and were designated to the clumsy group and then matched for age and sex with a control group of children from the survey. Observations by parents and teachers rated the clumsy children inferior to their controls in writing, sporting ability and clumsiness.

The article focuses on a study on cognitive assessment of infants with severe motor impairment. The assessment is most important to both parents and professionals but is as yet very unreliable because current assessment procedures, such as the Griffiths Scale of Mental Abilities and the Bayley Scales of Infant Development, rely heavily on motor responsively. The patients in this study were selected on the basis of a nonprogressive severe motor impairment of varying etiology of prenatal or prenatal origin. At the time of entry into the study no meaningful assessment of cognitive abilities was possible because of the young age of the babies combined with the severity of the motor problems.

A case of progressive spinocerebellar syndrome due to isolated vitamin E deficiency is reported. Measurement of the vitamin E concentration in serum should be included when investigating all children with unexplained, progressive ataxia, even in the absence of malabsorption. Replacement treatment in patients with a vitamin E deficiency can arrest or improve the associated neurological disorder. [ABSTRACT FROM AUTHOR]

Hemiplegic cerebral palsy is appearing as the commonest cerebral palsy syndrome found at the Yorkshire Regional Child Development Centre, Leeds, and in the majority of cases does not follow a definable perinatal injury. As a practical consequence of this changing pattern of cerebral palsy a large proportion of these children will now be detected at 'well baby' clinics rather than at hospital neonatal 'at risk' clinics. As lack of awareness of the signs of cerebral palsy in the young infant lead to delay in detection and management, the early signs of congenital hemiplegia are discussed.

Charing Cross Hospital provides facilities for the study of handicapped children in a normal nursery which forms part of its Child Development Centre. The period of assessment varies from one day to three weeks; the advantages of prolonged assessment are discussed. Parental involvement and support, and the teaching of medical students are emphasized. A study of the Centre's first 385 patients is presented.