Utility of kindergarten teacher judgments in identifying early learning problems.

Most existing research on early identification of learning difficulties has examined the validity of methods for predicting future academic problems. The present study focused instead on the sensitivity of kindergarten teachers to learning problems in their students and on the continuity of teacher-identified problems over time. To identify early learning problems, kindergarten teachers in a suburban school district rated student progress toward six academic objectives as satisfactory or unsatisfactory. Twenty percent of the district's 303 kindergarten children received unsatisfactory ratings in at least one area. Thirty-eight of these children (identified group) were matched to 34 children with satisfactory ratings in all areas (nonidentified group). Results of testing conducted during kindergarten revealed poorer academic achievement in identified children than in nonidentified children. Children from the identified group also performed more poorly than children from the nonidentified group on tests of phonological processing and working memory/executive function and were rated by teachers as having more behavior and attention problems and lower social competence. Follow-up of the sample to first grade documented continued learning problems in the identified group. These findings support the use of teacher judgements in early detection of learning problems and argue against reliance on discrepancy criteria.

Motor development of cocaine-exposed children at age two years.

OBJECTIVE: This article was designed to investigate effects of prenatal cocaine exposure on motor development of young children from a predominately underprivileged, urban population. METHODOLOGY: A total of 260 infants and young children were initially recruited from either the newborn nursery or the at-risk pediatric clinic of an urban teaching hospital. Prenatal history and birth outcomes were collected from medical records. Demographic characteristics and additional drug histories were obtained from the mothers. The 199 subjects (98 cocaine-exposed and 101 unexposed) who returned at age 2 years were assessed by examiners blinded to drug exposure status using the Peabody Developmental Motor Scales. RESULTS: Compared with control subjects, the cocaine-exposed group performed significantly less well on both the fine and the gross motor development indices. Mean scores for both groups were within the average range on the gross motor index, but greater than 1 standard deviation below average on the fine motor index. Differences were significant on the balance and the receipt and propulsion subscales of the gross motor scale, and on the hand use and the eye-hand coordination subscales of the fine motor scale. Cocaine status independently predicted poorer hand use and eye-hand coordination scores. There also was an effect of alcohol exposure on the receipt and propulsion subscale. CONCLUSIONS: Findings indicate that deficiencies in motor development remain detectable at 2 years of age in children exposed to drugs prenatally. Although other environmental variables may influence motor development, children exposed to cocaine and to alcohol in utero may encounter developmental challenges that impede later achievement.

Sarcoidosis in a patient with myasthenia gravis. Case report and review of the literature.

The case of a 38-year-old white female, with a long history of myasthenia gravis, who developed sarcoidosis is presented. The diagnosis of myasthenia gravis had been established on the basis of typical clinical symptoms with severe myastenic crises necessitating respiratory support, characteristic electromyographic findings, positive anti-acetylcholine receptor antibodies and response to appropriate medications. After 9 years of disease and while in apparent remission, she presented with ankle arthritis and bilateral hilar adenopathy. A transbronchial lung biopsy showed noncaseating granuloma, typical of sarcoidosis. To our knowledge, the combination of myasthenia gravis and sarcoidosis is extremely rare and emphasizes the intriguing tendency of some immunologic disorders to appear together in certain individuals.