Optimal Care For Children Research Articles

MATERNAL FACTORS AFFECTING DEVELOPMENTAL OUTCOME OF INFANTS OF ADOLESCENT MOTHERS

Research indicates that infants of adolescent mothers (IAM) are at risk for developmental disability. However little is known regarding the factors that place their infants at risk. This study assessed developmental outcome in infants of teenage and adult mothers to examine which maternal factors affected the individual differences observed. Forty-four (21 mothers ≤17 years of age) primiparous, caucasian low to middle class mothers and their full term healthy infants participated in the study. When the infants were 4 mos. old, the Caldwell Home Scale was scored by an unbiased observer during a two-hour home visit. When the infants were 4 & 8 mo. old, information on child care support and life stress was obtained. At 8 mo. neuro-developmental assessments were performed. Neurologic status and motor development were similar between the two groups. However, IAM had lower Mental Development Indices (MDI) (T=3.35, p<.01). Lower MDI in both groups were related to lower HOME total score (r=.41, p<.01), less optimal child care support at 4 (r=.40, p<.01) and 8 mo. (r=.38, p<.05) and a greater number of stressful life events experienced by the mother since the infants' birth (r=.36 p<.05). Thus in a medically low risk population we have documented the significant roles of home and personal factors in mediating the cognitive outcome of IAM.

Intracranial pressure monitoring in the management of the pediatric trauma patient

Intracranial pressure (ICP) monitoring is an important adjunct in the management of the severely injured child with major head trauma. From a series of 18 patients with multiple trauma, smoke inhalation, and near-drowning, we report an illustrative case of head injury and pulmonary aspiration in which ICP monitoring was vital to appropriate therapy. The two most common techniques of ICP monitoring, the intraventricular catheter and the subarachnoid bolt, are described. Treatment of intracranial hypertension is discussed based on physiological principles. The continuous, objective recording of ICP assumes particular importance when therapy directed at other injured organ systems (ie, institution of positive end-expiratory pressure) could adversely affect the ICP. It is suggested that optimal care of children with multiple trauma and head injury include early ICP monitoring.

The role of the clinical child psychologist in an endstage renal disease program

Abstract The psychosocial problems seen in endstage renal disease offer the child psychologist several opportunities to utilize their specific expertise. Psychological testing, behavior modification, interviewing and counseling, and patient and staff support are areas in which the child psychologist may contribute to the multidisciplinary approach required for the optimal care of children with chronic renal failure.

The widening scope of obstetric responsibility: A statement

This article is a statement made by the author before a meeting held on Feb. 23 and 24, 1967, in the Stone House of the National Institutes of Health. The meeting was entitled “Conference on Manpower for Optimal Child Care” in which Dr. McGaughey appeared as a “Special Consultant in Obstetrics and Gynecology to the National Institute of Child Health and Human Development.” For some time Dr. McGaughey had been actively formulating a plan for broadening the scope of obstetrics and its training programs to meet the demands of the future. On the day of his death he delivered this statement to the Conference which had been called by Federal agencies to advise the Government as to how best to aid in accomplishing these ends. The statement is a moving one, and specially poignant, since it represents Dr. McGaughey's last professional words, given at the height of his career as clinician, researcher, and teacher. Partly in tribute and partly so that his provocative thoughts can reach his fellow physicians after his death, the Editors of the Journal have sought and received permission to publish this statement.

GROWTH, DEVELOPMENT AND CARE OF THE CHILD

Medical care has been eminently successful in improving the physical status of the child. Progress has been so rapid and on the whole so satisfactory that it has not seemed necessary to define the fundamental principles on which present procedures are based. On the other hand, the introduction of psychologic care into the practice of pediatrics has been retarded mainly by failure to define those very principles which are subconsciously applied daily in the physical care of the child. Obviously optimal child care means the best adjustment which can be made between the individual child and his environment. To what extent can the child be expected to adapt himself to his environment, and in what way must the environment be adjusted to the child? It is the purpose of this paper to show how more recent knowledge of growth and development assists in the clarification of these problems. THE MATURATION