Percentile Of Weight For Age Research Articles

60 DEVELOPMENTAL OUTCOME IN INFANT TRACHEOSTOMY

Twenty-one survivors of long-term tracheostomy in infancy were seen for developmental follow-up at a mean age of 4.7 years (SD=1.6). Measures of intellectual ability (standardized IQ tests), growth (weight for age), and social and behavioral competence based on Child Behavior Checklist (CBC) were taken. The sample was primarily white (67%), male (57%) and middle class with a mean length of tracheostomy of 44 months (SD=31). Almost half (45%) were prematures with 30% VLBW. One-quarter had some indication of neurological damage, although children with documentable mental retardation were excluded from follow-up. The group as a whole achieved a mean Full Scale IQ of 89.9 (SD=16), in the low normal range. Mean percentile of weight for age was 42.6 (SD=24). The majority of children showed significant behavioral and social problems with 70% scoring in the deviant range on at least one subscale of the CBC. Correlational analyses indicated that, within this sample, prematurity was associated with lowered IQ (r=.59, p <.003) and poorer behavioral functioning (r=.42, p <1.05). Neurological impairment (r=.49, p <.03) and socioeconomic status (r=.68, p<.002) were associated with behavioral difficulties, but not intellectual problems. The present data suggest that the impact of infant tracheostomy on later development is complex and interactive with other biological and environmental factors.

ABNORMAL ANTHROPOMETRIC MEASURES IN CHILDREN EX-POSED TO ENVIRONMENTAL TOXINS

Initial studies of children living near the hazardous waste site, Love Canal, showed that several health problems and low birthweight were more prevalent compared to control children. To determine whether growth was affected by exposure to environmental toxins, stature for age and weight for age percentiles (SAPR and WAPR) were determined for 493 Love Canal and 428 control children. For prepubertal children, a dose-response effect was seen with longer exposure associated with greater decreases in SAPR and WAPR. Those born and spending at least 75% of their lives in the Love Canal area were most affected: SAPR was 46.6 ± SE 2.2 for exposed compared to 53.0 ± 1.0 for controls (p=0.004) and WAPR was 50.1 ± SE 2.2 for exposed compared to 54.0 ± 1.0 for controls (p=0.05). Multiple linear regression analysis showed that white and black males and black females were most affected. The difference in stature could not be accounted for by differences in mid-parent stature, socioeconomic class, nutrition, birthweight, or chronic illness leaving exposure to the Love Canal area as the most likely cause. Differences seen in prepubertal children were not seen in pubertal children nor in parents who grew up in the Love Canal area suggesting a possible cohort effect. We conclude that anthropometric measures are valid and sensitive tools in assessing health impact of hazardous waste sites on children.

An examination of factors believed to be associated with infantile obesity

Forty-two normal (25th to 75th percentiles of weight for age) and 47 “obese” (above the 90th percentile) infants, 4 to 9 months of age, were compared with regard to energy and macronutrient intake, breast-feeding history, age of introduction of solids, and maternal reliance on external feeding cues. The study failed to reveal characteristic group differences. The current stereotype of the obese infant as one who is overfed, is given solids very young, is not breast fed, and whose mother is not responsive to his satiety signals is challenged. As a result, the nature of current group counseling for the prevention of infantile obesity is questioned.

A comparison of the psychological adjustment of obese vs. non-obese children.

No THOROUGH objective investigation of the psychological adjustment of obese children, as compared to non-obese children, had been done. What opinions and explorations had been made pointed to the apparent relative psychological maladjustment of the obese. Therefore, it was hypothesized that: (1) obese children as a group show significantly poorer adjustment than non-obese children; (2) obese girls show significantly poorer adjustment than obese boys; and (3) there are significant differences in adjustment among obese children in grades 3, 5,8, and Il. Psychological adjustment was divided into two areas-social adjustment (operationally defined as the score on the Ohio Social Acceptance Scale) and emotional adjustment (operationally defined as scores on the California Test qf Personality and on The Way I feel About Myself Scale). Subjects were 120 obese and 120 non-obese students, with equal representation for each sex and for grades 3, 5, 8, and 11. The cut-off point for defining obesity was the seventy-fifth percentile of weight for age and sex on the revised Stuart and Meredith Tables [l, 21 and one standard deviation above average for age and sex in skinfold thickness. Analyses of variance and, where indicated, the Newman-Keuls test and the test for treatment means were used to analyze data. With regard to social adjustment, there were no significant differences for any of the hypotheses. Only the self-concept aspect of emotional adjustment differed between the obese and non-obese, with the obese showing a poorer self-concept. Grade and sex differences were not as hypothesized. Possible explanations for the results and some implications were discussed. Initial attitudes towards the obese have been notoriously negative and suggestive of unhappiness on the part of this group. The name “fatty” is certainly almost as popular in elementary school as the name “retard”. Obviously, the obese child’s social experiences are often negative. It would seem likely that these experiences would be reflected in his or her social and emotional adjustment. In terms of social learning theory [3], these ‘distorted’ reactions serve as a set of cues associated with expectancies for certain behavioral reactions. Once a person comes to expect these reactions, he acts in a manner which is more likely to produce them or defends against them. Thus, the obese may come to expect rejection and act in a defensive manner which leads to further rejection and corresponding maladjustment. For example, groups of ten to twelve year old children (N > 600) consistently ranked children’s pictures according to their liking of them in the following order (from most to least liked): a normal child, a child with crutches and a leg brace, a child in a wheel chair, a child with a left forearm amputation, a child with a slight facial disfigurement, and a obese child [4]. Although this ordering is found among mean ranks consistently, few children actually choose the drawings in exactly this order. However, almost all chose the normal child first and the obese child last [5]. The same type of ordering was also found in a high school sample [6]. The very definite possibility that such dislike of the obese relates to their emotional well-being is pointed out by Mayer [7], who conducted a study using mainly projective techniques to investigate the feelings of 100 obese female adolescents, as compared to 65 controls. The overwhelming conclusion of the study was that there are both “striking similarities between the characteristic psychological traits of these obese adolescent girls and those of ethnic and