Mental retardation and growth failure are considered integral manifestations in the CHARGE association, reported to be present in as many as 90% of cases. Recent studies have reported a better than expected outcome in some patients; however, the conclusions of these studies have been confounded to some extent by their inclusion criteria. We report follow-up of 17 patients with CHARGE association in whom the diagnosis was based on clinical findings present in early infancy, before developmental patterns were established. Of the 7 survivors, all had motor delay, and 6 had feeding difficulties during infancy. Psychometric assessment at follow-up (age range 2 years, 10 months, to 15 years) showed that 2 were functioning in the normal range, 3 had specific language delay, one had moderate mental retardation, and one had severe mental retardation. Feeding problems persisted in only the 2 youngest patients. After initial failure to thrive, normal height was reached in 4 of 5 children older than age 3 years. The effects of visual and hearing deficits, their management, and the effects of physical illness are discussed with respect to developmental outcome. Our results suggest that some infants with CHARGE association who survive early infancy have a better prognosis for feeding difficulties, growth, and mental development than may be expected from early performance and better than that generally predicted from the current literature. The prompt management of sensory deficits is emphasized.
The papers begin with an outline of investigations of some relationships between drive and performance in simple controlled situations, where measures of anxiety are used as indices of drive. A brief account of a Melbourne standardization of two Anxiety scales will be given.Evidence pertaining to some intra-personal correlates of anxiety (drive) will be presented. Then, there will be an examination of some relationships between anxiety (drive) and school performance.Finally, some issue related to interpretation of the above evidence will be raised. Discussion will be focussed, firstly, on the status of the concept of generalized drive strength versus the hypothesis of more specific sources of. motivation; and secondly, on analysis of whether anxiety scales are not more usefully applied as empirical predictors of performance.
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