Self-reported physical disabilities in children in the Netherlands.

PURPOSE: To assess the prevalence of self-reported physical disabilities in school children, through the Child Health Monitoring System. METHODS: In 1992/1993. data were obtained in mainstream education (n = 5484), and in 1994/1995 in special education (n = 2622). The data were weighted to calculate estimates representative of the Dutch population. RESULTS: Physical disabilities were reported in 21% [20.9%; 99% confidence interval 20.0-21.8], and 5% [4.7%; 99% confidence interval 4.3-5.2] had a severe disability. Severe physical disabilities were more frequent in the youngest age group, and certain of these disabilities may be related to normal development. In older children, accidents are an important cause of disabilities. Boys had disabilities more often than girls, especially speech disabilities. Disabilities were more common among children whose parents had a low level of education. Only a minority (14%) of the children with a severe disability, reported to be restricted in the daily pursuits. CONCLUSIONS: Physical disabilities are a common health problem in school children, but they do not usually cause a handicap.

School absence and treatment in school children with respiratory symptoms in The Netherlands: data from the Child Health Monitoring System.

STUDY OBJECTIVE: To assess the prevalence of respiratory problems, and the relation of these problems with school attendance, medicine use, and medical treatment. DESIGN: The Child Health Monitoring System. SETTING: Nineteen public health services across the Netherlands. PARTICIPANTS: 5186 school children aged 4-15 years, who were eligible for a routine health assessment in the 1991/1992 school year. MAIN RESULTS: Respiratory symptoms were present in 12% of the children. Recent symptoms suggestive of asthma (wheezing or episodes of shortness of breath with wheezing in the past 12 months, or chronic cough, or a combination of these) were reported for 8%. These symptoms were most frequent in the younger children, and in children at school in towns with less than 20,000 inhabitants. Of the children with recent symptoms suggestive of asthma, 37% reported school absence for at least one week during the past 12 months, compared with 16% in children without respiratory symptoms. School absence because of respiratory illness was reported for 22%, and medicine use for respiratory problems for 38% of the children with recent symptoms suggestive of asthma. Of these children, 21% were receiving medical treatment, compared with 15% of the asymptomatic children. CONCLUSIONS: Respiratory symptoms are a common health problem in children, and they are an important cause of school absence and medicine use. However, the percentage of children receiving medical treatment seemed quite low, indicating that proper diagnosis and treatment are probably still a problem.

Childhood nocturnal enuresis in The Netherlands.

OBJECTIVES: To assess the prevalence of nocturnal enuresis in school children aged 5 to 15 years, and to investigate the association of bedwetting with ethnicity, the educational level of the parents, and the type of education (mainstream or special) received by the child. METHODS: Data were obtained for 5360 children in mainstream education and 2571 children in special education. The data were weighted to calculate estimates representative of the Dutch population. Nocturnal enuresis was examined in children 5 or 6 years of age who wet their bed at least twice in the 4 weeks previous to questioning, and in children 7 years of age and older who did so at least once in the previous 4 weeks. RESULTS: The prevalence of nocturnal enuresis was 6%; 15% in the 5 to 6-year-age group and 1% in the 13 to 15-year age group. Marked enuresis (at least twice a week) was reported in 4%. Nocturnal enuresis was more common in Turkish/Moroccan (14%) than in Dutch children (6%). The educational level of the parents was not significantly related to nocturnal enuresis. Children in special education more frequently reported nocturnal enuresis than children in mainstream education (14% and 6%, respectively). This was especially true for children in schools for the mentally retarded as compared to children in mainstream education ¿odds ratio [OR] in boys 3.21 (99% confidence interval [CI] 2.26 to 4.55) and OR in girls 4.25 [99% CI 2.61 to 6.92]¿. CONCLUSIONS: Nocturnal enuresis occurs most frequently among mentally retarded children. Children attending special education schools for reasons other than mental retardation are also at a higher risk of experiencing nocturnal enuresis than children attending mainstream education schools. Nocturnal enuresis is more prevalent in Turkish/Moroccan children than in Dutch children.

[Sequelae of premature birth: substantial medical consumption and physical limitations; survey among parents of 10-year-olds]. / Gevolgen van vroeggeboorte: veel medische consumptie en lichamelijke beperkingen; enquête onder ouders van 10-jarigen.

OBJECTIVE: To determine health and disabilities of preterm infants at age 10. DESIGN: Prospective follow-up study. SETTING: TNO Preventive en Gezondheid, sector Jeugd. Leiden, the Netherlands. METHOD: A questionnaire on medical consumption and physical disabilities was sent to the parents of a Dutch cohort of infants born alive in 1983 with a gestational age < 32 weeks and (or) a birth weight < 1500 g. The data were compared with outcomes at 5 years of age and with a peer group in mainstream education (data collected in a representative sample from the school health care system). RESULTS: Questionnaires on 75% of the eligible children were returned. Almost 40% of the preterm children had been admitted to hospital after the age of 5. Children in special education were significantly more often treated by a physiotherapist and (or) speech therapist. Overall 45% of the children suffered from a physical disability. This was six times as frequent as in a peer group from the school health survey. Although the assessment of physical disabilities was based on a paediatric examination at age 5 and on a parental questionnaire at age 10, differences were small. CONCLUSION: Mild developmental problems and learning disabilities are frequent in preterm infants. Research of preventive methods and timely interventions are needed and should be incorporated in the facilities for neonatal intensive care.