Neglected and abused children of mentally retarded parents.

Sixty-four neglected and abused children with a mentally retarded parent seen from one to seven years earlier, were followed to determine placement outcomes. At the time of follow-up, 11 of 64 children remained with their low functioning parents. Six children had been relinquished voluntarily for adoption and courts had terminated parental rights for 34, resulting in a total of 40 who had been adopted. Nine children were in foster care at the time of the study; two had been awarded to their nonretarded parent following divorce; and two had died. All families had received public financial assistance and medical care and used an average of 10 other services per family. Because of their cognitive limitations, most of these retarded parents were unable to benefit sufficiently from community services to enable them to care for their children. These findings point up the need for a mechanism whereby the retarded adult's right to parent and the child's right to nurturance and protection may both be preserved. Until this dilemma can be resolved, decisions to terminate parental rights in such cases should be made more quickly.

Trauma to the bones of small infants from passive exercise: a factor in the etiology of child abuse.

Four infants, three premature and one term, developed serious bony injury from parent- or caretaker-administered passive exercises. In the three infants born prematurely, the exercise program was prescribed by neonatal intensive care unit staff before discharge; in the fourth infant, the babysitter initiated the program. In each case the passive exercise was begun to diminish actual or presumed muscle tightness. When these infants were presented to the physician with a serious traumatic injury between the ages of 4 and 10 months, the presumptive diagnosis of child abuse was made after radiologic assessment revealed multiple bone injuries. The several traumatic injuries to bones resulting from the home-administered physical therapy were most impressive. Passive exercise in three of the four infants was a significant factor in the cause of their injuries. Caution must be used in prescribing this form of "therapy" in small infants.