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Background: Patients with congenital heart disease (CHD) will transition to lifelong adult congenital cardiac care. However, their structural heart disease is challenging to convey via two-dimensional drawings. This study utilized a tele-educational environment, with personalized three-dimensional (3D) modeling and health Details (3D + Details = "4D"), to improve actual and perceived knowledge, both important components of transition readiness in CHD patients. Methods: Participants aged ≥13 years with a history of CHD and cardiac magnetic resonance imaging (MRI) studies were eligible. Cardiac MRI datasets were then used to segment and create 3D heart models (using Mimics, Materialize Inc.). Participants first completed the MyHeart Questionnaire, a validated survey of actual knowledge. A tele-educational session was then scheduled, during which participants were shown a 3D model of a normal heart, followed by their personal 3D heart model and specific health details. Participants then repeated the actual knowledge survey, in addition to questionnaires assessing perceived knowledge pre- and post-session, as well as a satisfaction survey. Results: Twenty-two patients were included. Actual knowledge increased from 75% ± 15% to 89% ± 20% (p = 0.00043) and perceived knowledge increased in five of seven questions. Actual knowledge correlated with perceived knowledge (r = 0.608, p < 0.0001). Ninety-one percent of participants ranked the 3D model as "very satisfactory" and ninety-five percent ranked the educational session as "very helpful" or "extremely helpful." Conclusions: The use of "4D" tele-education increased both actual and perceived knowledge and may help improve transition readiness in CHD patients. [ABSTRACT FROM AUTHOR]

This study examined achievement, neuropsychological, and intervention outcomes at a mean age of 11 years in children with very low birthweight (VLBW, < 1,500 g) compared with a term-born control group. To assess the prevalence and correlates of specific learning disabilities (LD), the sample was limited to children without neurosensory disorders who had at least low average IQ. Participants included 31 children with < 750 g birthweight, 41 with 750?1,499 g birthweight, and 52 controls. The < 750 g group obtained lower scores in math, IQ, and perceptual?organizational skills than the termborn group. The < 750 g group also had higher rates of past and present LD than the controls. Despite these differences, the groups did not differ significantly in rates of special education or tutorial/remedial assistance. These findings suggest that children with extremely low birthweight without gross physical or intellectual impairments are at higher risk for LD and cognitive deficiencies than their termborn peers and that further efforts are needed to improve identification and treatment of these learning problems.

Making choices is an essential part of functioning independently as an adult in society. Activities specifically directed toward helping students learn to make choices, however, are typically neglected in educational programs for students with severe disabilities. This paper presents a rational for the inclusion of choice-making as an important skill area for persons with severe disabilities. Behavioral approaches that present useful means of conceptualizing choice-making in the school life of severely disabled students are identified. Procedures are suggested for teaching choice-making skills, for integrating opportunities for exercising those skills throughout the course of the student's school life, and for fostering choice-making skills through the use of logical consequences.

Discusses issues related to having music programs for Parent Teacher Association (PTA) meetings to increase parental PTA meeting attendance. Highlights different types of programs focusing on parental involvement that music teachers can utilize. Includes a list of ten ideas. (CMK)

OBJECTIVE. The purpose of this study was to document the impact and burden of extremely low birth weight ( METHODS. A prospective study was completed at 8 years of a cohort of 219 children with extremely low birth weight born 1992-1995 and 176 children with normal birth weight. Measures included the following predictor variables: socioeconomic status and parent risk, birth risk, neonatal risk, neurodevelopmental outcome, impairment in adaptive abilities, and functional impact of chronic conditions. The primary outcome measure was the Impact on Family scale. A measure of family stressors and resources (the Life Stressors and Social Resources Inventory) was also obtained. RESULTS. The primary finding was that the total family impact was greater in the extremely low birth weight group compared with controls. Moreover, the negative impact on family in specific domains was greater in the extremely low birth weight group in financial impact, caretaker burden, and familial burden. These differences were not attributable to general family stressors, socioeconomic status, child, gender, or race. Higher parent/socioeconomic risk, neurodevelopmental outcomes, and the functional impact of chronic conditions predicted greater family impact within the extremely low birth weight group, whereas birth and neonatal risk scores did not. CONCLUSIONS. Extremely low birth weight was associated with a negative impact on families. Socioeconomic parental risk, but most especially child-related factors such as neurodevelopmental and the functional impact of chronic conditions, predicted the negative family impact within the extremely low birth weight group. Findings underscore the need to develop and test interventions to provide support for families of extremely low birth weight infants to ameliorate the burden of extremely low birth weight and associated risk factors on families. Key Words extremely low birth weight, prematurity, family impact, outcome, predictive, school age Abbreviations ELBW--extremely low birth weight BW--birth weight GA--gestational age VLBW--very low birth weight NBW--normal birth weight SES--socioeconomic status IOF--Impact on Family survey LISRES--Life Stressors and Social Resource Inventory-Adult Form, MAJOR ADVANCES IN neonatal care that have taken place in the 1990s, including surfactant therapy and use of antenatal steroids that have resulted in increased survival rates for extremely low [...]

Objective. The Bayley Scales of Infant Development, Second Edition (BSID II) are commonly used to assess outcomes of extremely low birth weight (ELBW) infants. We sought to assess the predictive validity of the BSID II Mental Developmental Index (MDI) for cognitive function at school age. Design/Methods. Of 330 ELBW infants admitted in 1992-1995, 238 (72%) survived to the age of 8 years, of whom 200 (84%) were tested at both 20 months&apos; corrected age (CA) and 8 years. Mean birth weight was 811 g, mean gestational age was 26.4 weeks, 41% were boys, and 60% were black. Measures included the BSID II at 20 months&apos; CA and the Kaufman Assessment Battery for Children (KABC) Mental Processing Composite (MPC) at 8 years&apos; postnatal age. BSID II MDI and MPC scores were compared and the predictive validity calculated for all 200 ELBW children and for the 154 ELBW neurosensory-intact subgroup. Predictors of stability or change in cognitive scores were examined via logistic regression adjusting for gender and sociodemographic status. Results. For all ELBW children, the mean MDI was 75.6 [+ or -] 16 versus a mean KABC of 87.8 [+ or -] 19. For the neurosensory-intact subgroup, the mean MDI was 79.3 [+ or -] 16 and the mean KABC was 92.3 [+ or -] 15. Rates of cognitive impairment, defined as an MDI or KABC of 70. Conclusions. The predictive validity of a subnormal MDI for cognitive function at school age is poor but better for ELBW children who have neurosensory impairments. We are concerned that decisions to provide intensive care for ELBW infants in the delivery room might be biased by reported high rates of cognitive impairments based on the use and presumptive validity of the BSID II MDI. Pediatrics 2005;116:333-341; extremely low birth weight, prematurity, outcome, prediction, intelligence, school age. ABBREVIATIONS. ELBW, extremely low birth weight; MDI, Mental Developmental Index; BSID II, Bayley Scales of Infant Development, Second Edition; CA, corrected age; MPC, Mental Processing Composite; SES, socioeconomic status; CI, confidence interval; VLBW, very low birth weight., The increased survival of infants of extremely low birth weight (ELBW) in the 1990s, which resulted from advances in perinatal care, has been accompanied by high rates of neonatal complications [...]

Neurosensory, developmental, and medical conditions together with the associated functional limitations and special health care needs of extremely low-birth-weight (ELBW) children compared with normal-birth-weight (NBW) term-born children are examined. Findings reveal that the ELBW survivors in school at age 8 years who were born during the 1990s period have considerable long-term health and educational needs.

Objective. Information on the mental health of very low birth weight (VLBW; Methods. We compared a cohort of 241 survivors among VLBW infants who were born between 1977 and 1979 (mean birth weight: 1180 g; mean gestational age at birth: 29.7 weeks), 116 of whom were men and 125 of whom were women, with 233 control subjects from the same population in Cleveland who had normal birth weights (108 men and 124 women). Young adult behavior was assessed at 20 years of age with the Achenbach Young Adult Self-Report and the Young Adult Behavior Checklist for parents. In addition, the young adults and parents completed the ADHD Rating Scale for Adults. Gender-specific outcomes were adjusted for sociodemographic status. Results. VLBW men reported having significantly fewer delinquent behaviors than normal birth weight (NBW) control subjects, but there were no differences on the Internalizing, Externalizing, or Total Problem Behavior scales. Parents of VLBW men reported significantly more thought problems for their sons than did parents of control subjects. VLBW women reported significantly more withdrawn behaviors and fewer delinquent behavior problems than control subjects. Their rates of internalizing behaviors (which includes anxious/depressed and withdrawn behaviors) above the borderline clinical cutoff were 30% versus 16% (odds ratio: 2.2; 95% confidence interval [CI]: 1.2-4.1). Parents of VLBW women reported significantly higher scores for their daughters on the anxious/depressed, withdrawn, and attention problem subscales compared with control parents. The odds ratios for parent-reported rates above the borderline-clinical cutoff among women for the anxious/depressed subscale was 4.4 (95% CI: 1.4-13.5), for thought problems was 3.7 (95% CI: 1.2-11.6), and for attention problems was 2.4 (95% CI: 1.0-5.5). There were no differences in the young adult self-report of attention-deficit/ hyperactivity disorder (ADHD). Parents of VLBW men reported higher mean scores on the attention subtype of ADHD but not higher rates of ADHD. Conclusion. The increase in psychopathology among VLBW survivors in young adulthood indicates a need for anticipatory guidance and early intervention that might help to prevent or ameliorate potential psychopathology. Pediatrics 2004;114:932-940; very low birth weight, psychopathology, behavior., ABBREVIATIONS. VLBW, very low birth weight; NBW, normal birth weight; YASR, Young Adult Self-Report; YABCL, Young Adult Behavior Checklist; CBCL, Child Behavior Checklist; ADHD, attention-deficit/hyperactivity disorder; DSM, Diagnostic and Statistical [...]

Prenatal cocaine exposure is associated with an increased risk for specific cognitive impairments and lower likelihood of IQ above the normative mean at four years. The findings underscore the beneficial effects of environmental intervention in the prevention of mental retardation for cocaine-exposed children.

Adults who had very low birth weights may have intellectual defects that prevent them from graduating from high school and attaining a college education. This was the conclusion of a study of 242 adults with very low birth weights and 233 adults with normal birth weights who were born between 1977 and 1979.