Relationship of cranial midline shift to outcome of very-low-birth-weight infants with periventricular hemorrhagic infarction.

The purpose of this study was to determine the relationship of a cranial midline shift accompanying periventricular hemorrhagic infarction to subsequent handicap in very-low-birth-weight infants. A study group of 44 infants with intraventricular hemorrhage and an associated periventricular hemorrhagic infarction was retrospectively selected from 1,080 very-low-birth-weight infants evaluated by cranial sonography. A cranial midline shift is defined sonographically as displacement of the septum pellucidum (or cavum septi pellucidi) more than 3 mm from the spatial midline. The midline is measured as half the distance between the right and left inner tables on an anterior coronal view. Other sonographic data recorded were the size of the lateral ventricle, the intracranial hemisphere, and the periventricular hemorrhagic infarction. Also noted was the appearance of the area of infarction at the time of initial detection of a midline shift. After discharge, the infants were periodically evaluated for major handicap in vision, hearing, cognition, and motor activity. A midline shift was identified in 29 (66%) of 44 infants with periventricular hemorrhagic infarction. Seven (24%) of the 29 infants with midline shift and 3 (20%) of the 15 infants without a midline shift died. In all of the 22 surviving infants with a midline shift and in 3 (25%) of 12 survivors without a midline shift, a handicap developed (p < 0.01). As a predictor of handicap, midline shift showed a sensitivity of 88% and a specificity of 100%. Predictability was not improved by combining midline shift with the size of the parenchymal infarct.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparison of Vineland Adaptive Behavior Scales-Survey Form age equivalent and standard score with the Bayley Mental Development Index.

The Vineland Adaptive Behavior Scales-Survey Form standard score, Vineland Adaptive Behavior Scales-Survey Form age equivalent and Bayley scales' Mental Development Index were given to 44 high-risk infants age 12 mo. and suspected of developmental delay. The VABS-Survey Form, a revision of the Vineland Social Maturity Scale is frequently used in assessment of developmental delay; however, questions have arisen as to whether the standard score or age equivalent is the better measure. A developmental quotient based on VABS-SF age equivalent and VABS-SF standard score was compared with the Bayley Mental Development Index. The mean VABS-SF standard score was significantly higher than the age equivalent quotient and the Bayley Mental Development Index. Implications for the use of VABS-SF age equivalent in evaluating such infants are discussed.

Comparison of the Vineland Social Maturity Scale, the Vineland Adaptive Behavior Scales--survey form, and the Bayley Scales of Infant Development with infants evaluated for developmental delay.

The Vineland Adaptive Behavior Scales is an extensive revision of the Vineland Social Maturity Scale; however, research comparing the two scales with different populations and measures of intelligence is limited. The Vineland Adaptive Behavior Scales--Survey Form, the Vineland Social Maturity Scale, and the mental scale of the Bayley Scales of Infant Development were administered to 44 infants referred for evaluation of developmental delay. The differences between means were compared and shared variance examined. The Vineland Adaptive Behavior Scales--Survey Form scores were significantly higher than those of the Vineland Social Maturity Scale and the Bayley Mental Development Index. No significant differences were found between the means of the Vineland Social Maturity Scale and the Bayley Scales of Infant Development--Mental Development Index. Correlations were .59 between the Bayley Index and scores on the Vineland--Survey Form and .72 between the Bayley Index and the Vineland Social Maturity Scale. Between versions of the Vineland scale r = .39. Implications for diagnosis and educational classification are discussed.

Survey of treatment practices for neonatal seizures.

A nationwide survey of neonatologists was conducted to determine the common management of neonatal seizures. The questionnaire addressed practice setting, causes, length of treatment, and criteria used in discontinuation of treatment. A response rate of 68% was achieved. Results indicate continued disagreement among practitioners. The prevailing literature recommends treatment of neonatal seizures in the acute phase. Recent studies indicate that 8% to 15% of infants with neonatal seizures will have recurrent seizures after the newborn period. Animal models have shown that brain growth retardation and behavioral and learning impairment may occur from the use of phenobarbital in early infancy. The question of continued treatment of neonatal seizures beyond the acute phase is raised.

Comparability of the Vineland Social Maturity Scale and the Vineland Adaptive Behavior Scale--survey form with infants evaluated for developmental delay.

The Vineland Social Maturity Scale and its revision, the Vineland Adaptive Behavior Scale-Survey Form, were evaluated with infants referred for suspected developmental delay. Since the latter is being used more often by psychologists in evaluation and placement of children in the age group of birth to two years, comparative studies must ensure appropriate placement of children observed to have developmental delays. The present study indicated significantly higher over-all adaptive functioning on the Vineland Adaptive Behavior Scale-Survey Form for 33 black and 11 white infants of mean age 12 mo. than on the original Vineland scales. Substituting the Survey Form for the original Vineland scales when evaluating developmentally delayed infants is questionable. These results are also noteworthy in that children whose Vineland Social Maturity scaled scores make them eligible for special services would be excluded if the revised form were used in the evaluation process.