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.
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.
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]
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