Related Experiment Videos
Aetiology of severe handicapping conditions in early childhood
Insights
Intensive care for newborns may not significantly reduce major childhood handicaps. Many conditions stem from prenatal factors, not perinatal complications, suggesting limited impact of neonatal intensive care units (NICUs).
Area of Science:
- Pediatrics
- Neurology
- Developmental Disabilities
Background:
- Investigated the hypothesis that increased neonatal intensive care could reduce childhood handicaps.
- Examined etiological factors in 128 children with mental and/or neurological handicaps.
- Study period: 1973-1977, Armitstead Child Development Centre, Dundee.
Purpose of the Study:
- To assess the role of perinatal factors in childhood handicap.
- To determine the potential impact of neonatal intensive care facilities.
- To identify etiological origins of mental and neurological handicaps in children.
Main Methods:
- Retrospective review of 128 children with diagnosed handicaps.
- Analysis of potential etiological factors, including perinatal events and birth weight.
- Categorization of handicaps based on suspected origin (embryonic, perinatal, other).
Main Results:
- Primary mental retardation: 33 cases, 1 implicated perinatal factor.
- Cerebral palsy: Low birth weight implicated in 23/73 cases; 37% had neonatal complications.
- Prenatal origins suspected in 75% of primary mental retardation and 33% of cerebral palsy cases.
Conclusions:
- Adverse perinatal factors may have caused or exacerbated existing brain damage in at most one-third of this selected group.
- Severity of cerebral palsy increased with prenatal origin handicaps.
- The hypothesis that neonatal intensive care significantly reduces major childhood handicap incidence is not strongly supported by this data.
Abstract:
The hypothesis that the incidence of major childhood handicap could be significantly reduced by an increase in the availability of intensive care facilities for newborn babies has been considered in an examination of possible aetiological factors in 128 young children with mental and/or neurological handicaps referred to the Armitstead Child Development Centre, Dundee, 1973-77. Thirty-three children suffered from primary mental retardation; adverse perinatal factors were possibly implicated in one case. Low birth weight was considered to be the primary aetiological factor in 23 of 73 children with cerebral palsy +/- mental retardation and in 13 with other adverse perinatal factors. Moderate or severe neonatal complications were reported for 37% but in 27% complications were likely to have resulted from existing brain damage or abnormality. Available evidence suggested that early embryonic origin of handicap was most likely in three-quarters of cases of primary mental retardation, and in one-third of cases of cerebral palsy. Severity of handicap in children with cerebral palsy was significantly increased in those whose handicaps had a prenatal origin. Of this selected group of handicapped children (cerebral palsy being over-represented), adverse perinatal factors may have caused or exacerbated existing brain damage in, at most, one-third.