The health and educational status of adolescents with congenital rubella syndrome.

As part of a longitudinal study of children with congenital rubella syndrome, 53 adolescents between 16 and 18 years of age were surveyed to determine their health and educational status. The findings were compared with those at the 18-months evaluation. At 16 to 18 years neurosensory impairments, cerebral dysfunction and organic behaviour syndromes were predominant, but the majority of children had multiple handicaps. A higher proportion had hearing loss. Although all the hearing-impaired children were begun in oral-based educational programs, 90 per cent of those with severe to profound hearing-loss diagnosed before the age of 18 months had changed to total or manual communication. Those with mild to moderate hearing-loss diagnosed after 18 months primarily communicate orally. The educational implications of these findings are discussed.

The effect of intrauterine malnutrition on the term infant. A 14-year progressive study.

The developmental outcome of 33 newborn infants with clinical intrauterine malnutrition at birth and 13 clinically well nourished infants from a middle to high socio-economic population have been followed from birth to 12-14 years of age. Psychometric studies revealed a lowering of the IQ score in malnourished infants compared to well nourished infants (104 +/- 15 compared to 121 +/- 13, p less than 0.05) and a need for special education (p less than 0.03). Forty-five percent of the malnourished infants' birth weights were above the 10th percentile on the Colorado Intrauterine Growth Grid. The Full Scale IQ of malnourished infants with BW greater and less than 10th percentile on the Colorado Intrauterine Growth Grid were comparable. Malnourished infants with birth weights greater than 10th percentile had lower IQ scores than well nourished infants (101 +/- 13 compared to 121 +/- 13, p less than 0.006). Thirty-nine percent of the infants with handicaps would have been missed if only infants with birth weights less than 10th percentile were considered high risk.

The longitudinal course of congenital rubella encephalitis in nonretarded children.

The neurologic course of congenital rubella syndrome was traced in 29 nonretarded children to 9 to 12 years. During the first two years, manifestations involved abnormal tone and reflexes (69%), motor delays (66%), feeding difficulties (48%), and abnormal clinical behavior (45%). Hearing loss was documented in 76%. From three to seven years, poor balance, motor incoordination (69%), and behavioral disturbances (66%) predominated. Hearing losses increased to 86%. Currently, at 9 to 12 years, 25 have residua which include learning deficits (52%), behavioral disturbances (48%), poor balance (61%), muscle weakness (54%), and deficits in tactile perception (41%). Two additional children now have hearing loss. The encephalitic manifestations of congenital rubella syndrome are diverse. Overriding problems differ at each phase of childhood. Current deficits influence progress in educational and home environments. For these children, adequate intelligence alone does not guarantee academic success.