Percentile curves provide valuable information on developmental course and age-specific variability of sleep duration for the health care professional who deals with sleep problems in pediatric practice.

The World Health Organization (WHO), in collaboration with a number of research institutions worldwide, is developing new child growth standards. As part of a broad consultative process for selecting the best statistical methods, WHO convened a group of statisticians and child growth experts to review available methods, develop a strategy for assessing their strengths and weaknesses, and discuss methodological issues likely to be faced in the process of constructing the new growth curves. To select the method(s) to be used, the group proposed a two-stage decision-making process. First, to select a few relevant methods based on a list of set criteria and, second, to compare the methods using available tests or other established procedures. The group reviewed 30 methods for attained growth curves. Using the pre-defined criteria, a few were selected combining five distributions and two smoothing techniques. Because the number of selected methods was considered too large to be fully tested, a preliminary study was recommended to evaluate goodness of fit of the five distributions. Methods based on distributions with poor performance will be eliminated and the remaining methods fully tested and compared.

Actigraphy and diary may be interchangeably used for the assessment of sleep start, sleep end, and assumed sleep but not for nocturnal wake times. The diary is a cost-effective and valid source of information about children's sleep-schedule times, while actigraphy may provide additional information about nocturnal wake times or may be used if parents are unable to report in detail. It is insufficient to collect information by a questionnaire or an interview asking about children's normal sleep patterns.

These new international reference values for Tvol by ultrasound can be used for goiter screening in the context of IDD monitoring.

Timed performance in specific motor tasks is an essential component of a neurological examination applied to children with motor dysfunctions. This article provides centile curves describing normal developmental course and interindividual variation of timed performances of non-disabled children from 5 to 18 years. In a cross-sectional study (n=662) the following motor tasks were investigated: repetitive finger movements, hand and foot movements, alternating hand and foot movements, sequential finger movements, pegboard, and dynamic and static balance. Intraobserver, interobserver, and test-retest reliability for timed measurements were moderate to high. Timed performances improved throughout the entire prepubertal period, but differed among various motor tasks with respect to increase in speed and when the 'adolescent plateau' was reached. Centile curves of timed performance displayed large interindividual variation for all motor tasks. At no age were clinically relevant sex differences noted, nor did socioeconomic status significantly correlate with timed performance. Our results demonstrate that timed motor performances between 5 and 18 years are characterized by a long-lasting developmental change and a large interindividual variation. Therefore, a well standardized test instrument, and age-specific standards for motor performances are necessary preconditions for a reliable assessment of motor competence in school-age children.

BMI is an excellent proxy measure of adiposity in 6-12-y-old children. In Swiss children, both BMI criteria accurately predict overweight, but the sensitivity of the IOTF obesity criteria is poor. They failed to detect one-half of the children identified as obese on the basis of %BF from SFTs.

Treatment, and even more so, care of children with Type I (insulin-dependent) diabetes mellitus is a difficult and demanding task for parents as well as for health professionals. Aiming for good metabolic control is often hindered by the dynamics of the disease, an insufficiency of insulin therapy, the impossibility of an exact control of carbohydrate intake and the irregularities of daily life. The knowledge of the risk of long-term vascular complications and the permanent uncertainty of threatening hypoglycaemia as an immediate complication, is a great burden for the responsible paediatric diabetologist and thus narrows his or her therapeutic possibilities.There is now clear evidence that poor long-term metabolic control is the crucial factor for developing late vascular complications [1 ± 3]. In addition, there is growing evidence that the quality of metabolic control even during pre-pubertal years greatly influences Diabetologia (2002) Abstract Aims/hypothesis. Good metabolic control in diabetic children is already crucial before puberty to prevent diabetic complications later in life. However, tight metabolic control could increase the risk of severe hypoglycaemia, which might be responsible for impaired intellectual performance later in life. The purpose of this prospective longitudinal study was to evaluate the relevance of long-term metabolic control and hypoglycaemia possibly affecting the intellectual development of young children with Type I (insulin-dependent) diabetes mellitus.Methods. The intellectual development in 64 diabetic children between the ages of 7 and 16 years was assessed at least four times using the German version of the Hamburg Wechsler intelligence scale for preschool children, Children-Revised and by the ªAdap-tives Intelligenz Diagnostikumº (Adaptive Intelligence Diagnosticum). Data were analysed longitudinally compared with a control group.Results. A significant decline in performance by age 7 and in verbal intelligence quotient between age 7 and 16 years was observed in diabetic boys diagnosed before the age of 6 but not in those diagnosed later and not in diabetic girls. The deterioration of intellectual performance in boys diagnosed at a very young age was not associated with the occurrence of severe hypoglycaemic episodes but was correlated with the degree of metabolic deterioration at diagnosis and with high long-term average of glycated haemoglobin. Conclusion/interpretation. Our study in diabetic children shows that the male sex, diagnosis at a young age, metabolic condition at diagnosis and long-term metabolic control, rather than experienced hypoglycaemic attacks are risk factors for intellectual development. [Diabetologia (2002) 45: 108±114]

Bed sharing and nocturnal wakings are common during early childhood. Developmental changes in separation-attachment processes, cognitive capabilities to develop self-recognition and nighttime fears, and motor locomotion may contribute to the particular age trend of night wakings and bed sharing during early childhood.