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This paper reports or, the experience accumulated over more than 10 years by the multidisciplinary team of a Center for early medico-social action in accompanying infants at risk after they leave a Neonatology Center. The members of this team, located in the same building, came to the conclusion that the difficulties encountered are in part connected directly with the psychological trauma experienced during the infant's stay in the hospital and with a poor elaboration of the affects of this period and inadequate planning for appropriate action during this time. As a result, well before they leave the hospital, arrangements are made for immediate support to the children and their families. The support is determined by the seriousness of the situation, whether it be the disease itself, the long stay in the hospital, or some particular weakness in the family. These activities have been intensified in the past 3 years and have been strengthened with regard to children with broncho-pulmonary dysplasia or ulcero-necrotizing enterocolitis. They also are concerned with infants with severe neurological lesions, particularly porencephalia, and children whose mothers are alcoholics, drug addicts, or psychotics. [ABSTRACT FROM AUTHOR]

Visual evoked potentials (VEPs) induced by brief flashes and electroretinograms (ERGs) were recorded in 15 infants (9 prematures and 6 babies with perinatal cerebral injuries) suffering from important disturbances in their visual behavior (abnormal fixation, cortical blindness). The parallel evolution of the visual symptoms and the electrophysiological signs were studied and a good correlation was observed between these clinical and electrical signs. The authors insist on the clinical and prognostic value of the VEP in this category of infants.

The outcome of 404 prematures born before 32 weeks of gestation and admitted on the first day of life to the Institut de Puériculture (IP) in 1978-1980 was studied with respect to post-menstrual age and birth weight: 83 (20,5%) died during the hospitalization. Of the 321 still alive after the neonatal hospitalization, 71% were followed until at least 2 years of age; 3,1% died unexpectedly at home. There was a 8% handicap rate (9 with cerebral palsy and 9 with psychomotor deficiency) in the survivors. The problems of the children without handicap consisted mostly of strabismus and psychosocial disturbances. Thus, on admission to the IP on the first day of life during 1978-1980, according to gestational age (a) less than 28 weeks, (b) between 28 and 29 weeks 6 days (c) between 30 and 31 weeks 6 days, a premature presented the following risks: death during hospitalization: (a) 47%, (b) 20% and (c) 15%; death at home (b) 5%, (c) 1%; handicap (a) 3%, (b) 10%, (c) 5%; normal survival (a) 47%, (b) 63%, (c) 75%. This study shows the value of gestational age in estimating the outcome of prematures and the utility of analysing the results according to the 2 variables of gestational age and birth weight.

Handicaps in childhood often go by 2 or 3, more often than usually said. Multiple handicaps create difficult problems as to their diagnosis and care. On the basis of an epidemiological survey conducted in the Paris area, the authors underline the frequency of behavioral problems as supplementary handicap, and the role and importance of the mental deficiency in multiple handicaps in childhood, the most frequency associations according to the level of mental deficiency, the social factors significantly associated with the mental handicap, in terms of inequality of risks and inequality of access to health care and rehabilitation.

The authors have carried out a study on 472 subjects using auditory evoked response techniques in the evaluation of hearing difficulties and deafness in the child. They were able to demonstrate excellent correlation between the technique used and the clinical data and its additional prognostic value. Furthermore because of its safety and its ability to assess high tones it can be recommended whenever a hearing deficit is suspected in the neonate or toddler.