Preschool development of coloured children in Cape Town.

Developmental screening was applied during infancy to a birth cohort of 1,000 coloured infants born consecutively in Cape Town. The developmental progress of a sample of 187 children randomly selected from the cohort was followed over a period of 5 years. The value of the use of developmental screening is questioned, since 4 of the children in the cohort with major handicap had been diagnosed before the first screening was carried out and a 5th child with deafness was not detected by the screening process. Developmental milestones were similar to those studies reported in the literature. At 12 months the development correlated best with family stability. Language development at 30 months was associated with mother's education and family stability and reflected a general lag in verbal skills. By 5 years there was a good correlation between development and social indicators, particularly income and mother's education.

Growth of preschool coloured children in Cape Town.

The growth of a random sample of coloured children in Cape Town was studied from birth until 5 years. At birth they were relatively light and short for gestational age. Size at birth correlated with social class. A rapid postnatal weight gain rendered them relatively overweight between 3 and 6 months. Thereafter they became lighter and shorter than the NCHS reference values and this persisted throughout the preschool period. Genetic factors, reflected by parental growth, were found to predict growth during childhood, but they were more predictive of weight and head circumference than of length. From 12 months onwards, socio-economic factors played a significant role in determining growth even after the effects of the genetic factors had been taken into account.

A gas-flow cryostat for use in freeze-quench studies: design and application to discontinuous pre-steady-state spectral analyses.

A design for an improved freeze-quench apparatus is presented. A freeze-quench apparatus has two main parts: the apparatus which mixes the reactants and after a set time sprays the reacting mixture into the quencher, and the quenching apparatus itself. The quenching apparatus is the novel feature of our design and it comprises a gas-flow cryostat mounted directly onto a liquid nitrogen storage Dewar. The gas flow maintains the temperature of a small volume of isopentane, which acts as the freeze-quench agent, at -140 degrees C. (The apparatus can maintain the quenching temperature over the range -190 degrees C to room temperature.) Because of the small size of the cryostat and the much reduced volume of solvent used by this method it is more convenient to use than its predecessors, can be used in the open laboratory, and is safer. Our apparatus is designed for application to electron paramagnetic resonance studies but could be easily modified for use with other spectroscopic techniques.

Psychosocial outcome and CT findings after gross undernourishment during infancy: a 20-year developmental study.

This prospective 20-year follow-up study contrasts the development of a group of 20 children grossly undernourished during infancy (index group) with that of a matched control group. There were significant differences between two groups in head circumference, height, weight, full-scale IQ, verbal quotient, non-verbal quotient and in visuo-motor perceptual function. Despite their disadvantages, the index group have integrated effectively into the community, and their children have not experienced the nutritional deprivation they suffered during their own childhoods.

A study on child development in Cape Town. The cohort and sample.

A study of growth and development was initiated on a cohort of Coloured children born during May 1976 in Cape Town. Approximately 90% of the infants were born in hospital or in midwife obstetric units and about 14% weighed less than 2 500 g. Poor maternal education, low income and overcrowding are considered to be risk factors in child rearing. Sixty-five per cent of the mothers were not educated further than primary school level and over half the families were living below an effective minimum level of income. Similarly, over half the families lived in grossly overcrowded conditions.

A prospective 15-year follow-up study of kwashiorkor patients. Part I. Physical growth and development.

A series of 221 infants admitted to hospital with kwashiorkor between 1958 and 1960 has been followed up for 15 years. Seventy-two (32%) died of malnutrition either at the time of first admission or shortly thereafter. The subsequent physical growth and development of the survivors remaining in Cape Town has been compared with that of 89 of their siblings who had never had kwashiorkor, but grew up in the same environment. No differences were noted between the two groups, but considered together they demonstrated a pattern of retarded growth and delayed development. This suggests an adaptive mechanism suited to survival in poor socio-economic circumstances. The years of poor growth in childhood and early adult life are not associated with an undue mortality, and malnutrition exacts its toll of morbidity and mortality in the early years of life. It is to this age group that intervention with short-term solutions (food subsidization and supplementation) should be applied with the expectation of demonstrable benefit. The long-term solution depends on advancing socio-economic conditions, bringing better nutrition and enlightened health practices; this will eventually lead to improved standards of growth and development.

A prospective 15-year follow-up study of kwashiorkor patients. Part II. Social circumstances, educational attainment and social adjustment.

Of 221 infants serially admitted to hospital with kwashiorkor and continuously observed thereafter, 116 were available for study after 15 years. Eighty-nine siblings formed the comparison group. This report is a final assessment of their social circumstances, attainment in education and adjustment to society. Economic circumstances had improved considerably, housing adequacy had deteriorated and family instability had become relatively less marked. Achievement in education resembled that of the population from which the sample was drawn, and there was no difference between that of ex-patients and siblings. The majority of school-leavers were in gainful occupation but the nature of the work was unskilled or semiskilled. Delinquency was equally common in ex-patients and siblings. More than a quarter of the boys showed serious or potentially serious antisocial behaviour.

Intellectual development and nutrition.

One newborn child was selected from 14 families in which kwashiorkor had occurred. Undernutrition in this test group was prevented for the first two years of life by the provision of supplementary feeding. Controls who were the siblings directly preceding each of the 14 test children received no supplementary feeding, but received medical attention and management. In each family an older child who previously had kwashiorkor (kwashiorkor group), and the nearest sibling who had received neither extra feeding nor medical management (kwasiorkor control group) were also available for comparison. A battery of psychologic tests was administered when the mean age of the test group was 8.9 years. The mean full-scale IQ of the supplementary feeding group at an average age of 8.9 years was significantly higher than that of any of the other three groups. There was no significant difference between test and control groups on nonverbal IQ. Measures of "brain damage" did not discriminate between any of the four groups. The results suggest that nutritional factors contribute especially to the elevation of verbal intelligence. Environmental stimulation (daily contact with a more alert child) apparently contributed to the elevation of the nonverbal scores of the controls.