Fifteen women with pharmacologically intractable epilepsy were given physical exercise (aerobic dancing with strength training and stretching) for 60 min, twice weekly, for 15 weeks. Seizure frequency was recorded by the patients for 3-7 months before the intervention, during the intervention period, and for 3 months after the intervention. Medication and other known seizure-influencing factors were kept as constant as possible. Self-reported seizure frequency was significantly reduced during the intervention period. The exercise also led to reduced level of subjective health complaints, such as muscle pains, sleep problems, and fatigue. The exercise reduced plasma cholesterol ratio and increased maximum O2 uptake. Because most of the patients were unable to continue the exercise on their own after the intervention period, the exercise effects were not maintained during the follow-up period. The patients were not unwilling to continue the exercise, but it was not sufficient to offer them the possibility of continuing similar types of exercise. We believe that 15 weeks is too short a time to establish a life-style change and that continued physical exercise for these patients requires a well-organized and supportive program, requiring experienced and dedicated instructors.

A population based cohort of 144 children weighing less than 2000 g who were without major handicap, and a random control sample of 163 children born at term and weighing over 3000 g were investigated. The aim was to assess the relative importance for cognitive development at 5 years of age, of birthweight, parental demographic factors, and factors related to the environment in which the child was reared. The mean non-verbal IQ was 6 1 points lower (95% CI, 2-3 to 10) for the low birthweight (LBW) group, but the difference was reduced to 4-8 points (95% CI, 1.1 to 8.5) after adjusting for confounding parental demographic and childrearing factors. The verbal IQ was similar for the two groups after such adjustment. Paternal education was the main confounding variable, and demographic factors such as parental education and family income were much stronger predictors of child IQ than birthweight or factors related to the childrearing environment.There was no evidence that the cognitive development of low birthweight children was more sensitive to a nonoptimal childrearing environment than that of normal birthweight children. These findings indicate that the risk of impaired cognitive development increases with decreasing socioeconomic status, and that this risk is much larger than, and independent of, the small risk attributable to low birthweight. (Arch Dis Child 1995; 73: F135-F142)

The purpose of the study was to investigate incidence, severity and types of motor problems in two groups of poor readers compared to good reading controls. A group of children with severe dyslexia referred to specialist evaluation, a teacher selected municipality sample comprising the 5% poorest readers, and a control group consisting of the 5% best readers were all assessed applying a norm-based, standardized measure by Henderson and Sugden 1992; (The Movement Assessment Battery for Children. Kent: The Psychological Corporation). The three groups were compared with regard to total motor impairment scores as well as motor function within the areas of manual dexterity, ball-skills and balance. More than 50% of the children in both groups of poor readers showed definite motor coordination difficulties at or below the 5th centile, for which motor intervention is recommended. Children in both groups showed difficulties within the sub-area of manual dexterity in particular and also performed significantly worse than controls within the sub-area of balance, but not in ball-skills. The high incidence of motor coordination problems in the two groups of poor readers indicates that all children with reading difficulties should be screened for possible motor difficulties.

Aim-To assess the relative significance for cognitive development of small for gestational age, parental demographic factors, and factors related to the child rearing environment. Methods-IQ of a population based cohort of 338 term infants who were small for gestational age (SGA) and without major handicap, and a random control sample of 335 appropriate for gestational age (AGA) infants were compared at 5 years of age. Results-The mean non-verbal IQ was four points lower, while the mean verbal IQ was three points lower for the children in the SGA group. The results were not confounded by parental demographic or child rearing factors. However, parental factors, including maternal non-verbal problem solving abilities, and child rearing style, accounted for 20% of the variance in non-verbal IQ, while SGA versus AGA status accounted for only 2%. The comparable numbers for verbal IQ were 30 and 1%. Furthermore, we found no evidence that the cognitive development of SGA children was more sensitive to a non-optimal child rearing environment than that of AGA children. Maternal smoking at conception was associated with a reduction in mean IQ comparable to that found for SGA status, and this eVect was the same for SGA and AGA children. The cognitive function of asymmetric SGA was comparable to that of symmetric SGA children. Conclusions-Our findings indicate that child cognitive development is strongly associated with parental factors, but only marginally associated with intrauterine growth retardation. (Arch Dis Child 2000;83:25-30)