Active epilepsy in mentally retarded children. II. Etiology and reduced pre– and perinatal optimality

A population–based study of active epilepsy in mentally retarded children identified 98 children, 6–13 years old. A biopathological origin was established in 66% of mildly and 92% of severely retarded children: a prenatal etiology was considered in 51 % and 57%, a perinatal in 9% and 19%, a postnatal in 6% andl6% and an untraceable etiology in 34% and 8%, respectively. Severe mental retardation was more frequent in the peri– and postnatal groups (80% and 83%) than in the prenatal and untraceable groups (67% and 29%). Thirty–four pre– and perinatal optimal items were defined. Children with a prenatal etiology did not differ from controls in any of the periods. Children with a perinatal etiology had, compared with controls, higher proportions of non–optimal items successively increasing through the pre– and perinatal periods showing the accumulation of negative events. Children, epilepsy, etiology, mental retardation, reduced optimality     

Nutritional status of mentally retarded children in north-west Spain. I. Anthropometric indicators

AIM: To evaluate the nutritional status of mentally retarded children in the region of Galicia in north-west Spain, on the basis of anthropometric variables. METHODS: The following variables were determined in a sample of 128 mentally retarded children (81 M, 47 F): birthweight, bodyweight, height/length, head circumference, mid-arm circumference, mid-arm muscle circumference, triceps skinfold thickness, subscapular skinfold thickness, arm area, arm muscle area, arm fat area, arm lean-to-fat ratio, Shukla's nutrition index and Quetelet's body mass index (BMI). A preliminary statistical analysis indicated that most information content could be maintained considering only eight of these variables. A factor analysis of the resulting 8 x 128 (variables by subjects) data matrix was performed, identifying two factors (FA1 and FA2) that together explained 82% of total variance. Taking these factors as indicators of nutritional status, the data were analysed for possible effects of age, gender, socioeconomic and family environment, intelligence quotient (IQ), presence/absence of cerebral palsy, quality of diet, appetite and antiepileptic use. RESULTS: The analysis suggested that most subjects were in the normal nutrition range, but about 33% showed either borderline or definite malnutrition. Mean score on FA2 showed a significant negative correlation with age. Children with cerebral palsy had lower mean scores on both factors, and scores on both factors varied with IQ. Children with definite malnutrition had a significantly lower IQ than those in the normal nutrition range. Mean score on both factors varied with appetite and quality of diet. The mean FAI score of children from inland-rural areas was significantly lower than that of children from coastal or urban areas. Mean FA1 score increased with increasing age of the parents. The prevalence of obesity was 13% when obesity was defined on the basis of Shukla's nutrition index, and 19% when defined on the basis of FA1 score. CONCLUSION: Malnutrition as revealed by anthropometric variables occurs with a high prevalence among mentally retarded children. The prevalence increases with age, increasing IQ deficit and cerebral palsy.     

Temperament characteristics of mentally retarded children

In a comparative study of temperament and intelligence in groups of mentally retarded and normal children, it was found that mentally retarded children who also had excess of psychopathology in them, showed greater signs of ‘difficult’ child temperament. Relationship between intelligence and emotionality variable of temperament was linear and positive in the mentally retarded children. This study generates the hypothesis that negative mood may be temperamental correlated with mental retardation.     

Osteomalacia associated with anticonvulsant drug therapy in mentally retarded children.

A survey of 289 severely retarded inpatients at a school for retarded children in American Fork; Utah revealed 67 patients with osteomalacia as defined by hypocalcemia, hypophosphatemia, elevated serum alkaline phosphatase levels, and appropriate bone changes. Investigation of the variables which might influence bone mineralization revealed no differences in age, sex, physical activity, sunshine exposure, or dietary intake of vitamin D between the osteomalacia and nonosteomalacia groups. However, all of the patients with osteomalacia were receiving anticonvulsant medications, either phenobarbital, diphenylhydantoin, or both. Duration of anticonvulsant therapy was the most important contributing factor to the development of osteomalacia. Seventy-five percent of patients who had received anticonvulsants for more than ten years had osteomalacia. The single most costly medical problem at the school is the treatment of pathologic bone fractures due to demineralized bone.     

The evaluation of reaction time on mentally retarded children

This study was designed to compare the parameters of reaction time on mentally retarded and healthy children and also to find out the effect of sport on reaction time. The study consisted of 20 non-retarded (group I), 20 non-sporting trainable mentally retarded (group II), and 20 sporting trainable mentally retarded (group III). The avarage age of subjects were determined as 15.35 +/- 0.21 years in group I, 15.00 +/- 0.22 years in group II, and 15.15 +/- 0.21 years in group III. The audiovisual reaction time of both non-retarded and retarded children were measured. It was found that reaction time is lower in trainable mentally retarded children (p < 0.05). It can be concluded that sport is a valid and effective means of training which affects the reaction time positively.     

Genetic analysis of a group of mentally retarded children

Genetic analysis of 169 mentally retarded (MR) children from Madras, revealed chromosomal abnormalities in 17%. Down syndrome was the major chromosomal anomaly (24/169=14.2%). These included three cases of trisomy-21 mosaics, and one case ofde novo Robertsonian translocation. MR children with chromosomal abnormalities were either mildly or moderately retarded. Syndromes with known etiology occurred in 3% of the MR cases. Microcephaly, neonatal anoxia, perinatal stress and pharmacological attempt for abortion were found to be important pathogenic factors associated with MR. Most of the microcephalies (11/ 169=6.5%) were severely retarded, whereas those associated with neonatal anoxia and perinatal stress were either mildly or moderately retarded. Birthorder effects were found only among Down syndrome patients. Segregation analysis of the three groups of proband families (viz. mild, moderate and severe MR) indicated that autosomal recessive mode of inheritance is compatible in moderate and severe MR proband families. The proportion of X-linked instances of MR is estimated to be about 22% of the cases.