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This study aimed to examine motor performance in deaf elementary school children and its association with sports participation. The population studied included 42 deaf children whose hearing loss ranged from 80 to 120 dB. Their motor skills were assessed with the Movement Assessment Battery for Children, and a questionnaire was used to determine their active involvement in organized sports. The deaf children had significantly more borderline and definite motor problems than the normative sample: 62% (manual dexterity), 52% (ball skills), and 45% (balance skills). Participation in organized sports was reported by 43% of the children; these children showed better performance on ball skills and dynamic balance. This study demonstrates the importance of improving deaf children's motor skill performance, which might contribute positively to their sports participation.

Emotional/behavioral problems of 238 deaf Dutch children ages 4-18 years were studied. Parental reports indicated that 41% had emotional/behavioral problems, a rate nearly 2.6 times higher than the 16% reported by parents of a Dutch normative sample. Mental health problems seemed most prevalent in families with poor parent-child communication. Deaf children ages 12-18 showed more problems with anxiety and depression and more social problems than those ages 4-11. Deaf children with relatively low intelligence showed more social problems, thought problems, and attention problems than those with relatively high intelligence. The authors stress the need to get information on deaf children's mental health functioning not just from parents but from other informants such as teachers and the children themselves. An expansion assessment of deaf children, and of special services and treatments for deaf children and adolescents with emotional/behavioral problems, is recommended.

Objectives: This study attempted to determine factors that help currently employed people with rheumatoid arthritis, diabetes mellitus or hearing loss to continue working., Methods: This was a qualitative study that used three concept-mapping sessions. Sixty-nine participants (rheumatoid arthritis 21, diabetes mellitus 23, and hearing loss 25) were recruited from the patient records of the rheumatology, diabetes, and audiology outpatients of the Academic Medical Center (AMC), Amsterdam, and referrals from occupational physicians and patient associations. An arthritis consultant, a diabetes consultant, and an audiologist screened the patients for the used illness inclusion criteria. A researcher screened the patients for the inclusion criteria of age and work., Results: The main factors enabling employees to continue working were ability to cope with the illness, support from management and colleagues, adequate work conditions, support of patient organizations and society, support of medical professionals and facilities, and benefits. The three groups of employees rated the priority of these factors differently. For the employees with rheumatoid arthritis, the support of management was the most important, followed by self-acceptance, self-efficacy, and professional advice on how to cope at work. For those with diabetes mellitus, self-acceptance, self-care, and support from management, colleagues and health professionals were the most important. For employees with hearing loss, being well informed about hearing equipment, reimbursement, and self-acceptance were the most important. A topic list was developed that can be used by health professionals as a guideline for exploring the work-related problems of patients with a chronic disease., Conclusion: The results provide an understanding of the needs chronically ill employees have at work and the areas to which health professionals need to pay attention.

A screening of hearing and visual function was performed using clinical assessment methods in a Dutch institutionalized population of 672 people with mild to profound intellectual disability (ID). Because the studied population was not comparable to the total Dutch population with ID, subgroups were distinguished according to level of ID, age younger and older than 50 years, and the presence or absence of Down's syndrome (DS). The prevalences of both hearing and visual impairment were considerably increased in all subgroups, as compared with the general population. In the least affected group, i.e. those < 50 years with a mild or moderate ID by other causes than DS, the prevalences of hearing and visual impairment were 21% and 4%, respectively (as opposed to 2-7% and 0.2-1.9% in the general Dutch population <50 years, respectively). The prevalence of hearing impairment showed a sharp and highly significant increase in individuals with DS and subjects > or = 50 years. To a lesser extent, young adults with severe or profound ID had an increased risk of hearing impairment. Visual impairment and blindness were specifically highly prevalent in people with severe or profound ID (51% < 50 years of age). Down's syndrome and an age > or = 50 years were also significant risk factors for visual impairment. There was an alarmingly high prevalence of combined sensory impairment, especially in those with severe or profound ID (20%). Although hearing impairment had been diagnosed prior to this screen in 138 people and visual impairment in 65 individuals, a first diagnosis of hearing impairment was made in 128 subjects and of visual impairment in 90 cases. This highlights the tendency for sensory impairments to go unnoticed in people with ID, which is not restricted to those with severe or profound ID. Therefore, the present authors stress the importance of regular screening as outlined in the existing IASSID international consensus statement.

Children with Down's syndrome have an increased risk of congenital anomalies and additional medical problems. These can be treated but are often seen as part of the syndrome and not as the cause of developmental retardation. Based on the current level of knowledge, specific medical tests and evaluations are recommended. The reasons for these guidelines, composed by the Down's syndrome Work Group of the Paediatric Association of the Netherlands, are illustrated by the case reports of five patients: in a 4-year-old boy, retardation improved after celiac disease had been diagnosed. In a 5-year-old boy, slow speech development was reversed after hearing loss was diagnosed. In a 2-year-old girl, development improved after a mitral valve stenosis had been corrected. In a 6-month-old boy, drinking problems were reversed when torticollis was diagnosed and a self-deflating drinking bottle was introduced. An adult man suffering from epilepsy and from self-mutilative rubbing and hitting of his eyes, regained his sight after cataract, myopia and atrophy bulbi were diagnosed. A well-balanced disclosure of the diagnosis, repeated medical screening, early motor training and social interventions combined with active parental participation, warrant optimal development. In cooperation with the Down's syndrome Parent Association, multidisciplinary medical teams have been established to offer and promote this care.

An aetiological study was performed on 57 pupils at the deaf-blind department of the Institute for the Deaf at Sint-Michielsgestel, The Netherlands, in the school year 1998-1999 and on 49 deaf-blind pupils at the same department in the school year 1986-1987. The pupils were 5-20 years of age. In addition, the aetiologies were studied in 55 deaf infant pupils in 1998 and compared with those of 68 deaf infant pupils in 1988. Their age was 1-5 years. All the pupils showed hearing impairment with thresholds of >60 dB HL. Among the deaf-blind pupils and deaf infant pupils, there were several cases with rare hereditary syndromes. The prevalence of acquired causes of deafness, especially congenital rubella, had decreased over the years, whereas perinatal causes of deafness had increased. Chromosomal anomalies were found in 15% of the infant pupils in 1998. Over the study period, the percentage of pupils with multiple handicaps increased from 25 to 38%.

Approximately 1 to 2 per thousand live-born infants suffer from a serious perceptive hearing loss. Normal hearing from birth is essential for optimal human development (language and speech, social and emotional development, communicative skills and learning). The earlier the hearing loss is diagnosed the better the prognosis for the infant with a hearing impairment. Suitable methods are now available for neonatal hearing screening: automated measurement of auditory brain stem response and measurement of oto-acoustic emissions. Screening must be viewed as only the first step in a program of diagnosis, treatment and habilitation of these children. The ultimate goal of the implementation of neonatal hearing screening is: identification of bilateral hearing losses before the age of 3 months and start of therapy and counselling before the age of 6 months.

During an investigation into behavioral problems of deaf children, 41 deaf boys were compared to a large group of hearing children of the same age. T.M. Achenbach's Child Behavior Checklist was used for data collection and analysis. It appeared the deaf boys had more behavioral problems overall but that they were no more often disturbed than their hearing counterparts. Internalizing and externalizing behavioral problems emerged with greater frequency in the deaf group. Younger deaf boys showed more behavioral problems than older deaf boys with differences in age emerging as discriminating factors.