Birth records of 30 children with asthma and two groups of 30 matched controls were reviewed to find the incidence of antepartum, labor and delivery, and postpartum complications. Since early experiences of life have been shown to affect later behavioral patterns and biological characteristics, we anticipated that asthmatic children would have a greater incidence of perinatal complications than nonasthmatic children. The results indicated that there was a significant difference between the number of asthmatic children with a history of complications and the number of nonasthmatic control children with complications. These findings indicate that the study of predisposing factors of asthma, both biological and psychological, must include the perinatal history of the children being studied. Complications during pregnancy and birth may well contribute to a predisposition of respiratory symptoms of asthma under conditions of stress.The cause of asthma has been de¬ bated by allergists, psychologists, and psychiatrists. The high incidence of family history argues for a genetic factor. Other physiological predis¬ posing factors are anatomical changes in the respiratory system, neuroendocrine disorders, and hypersensitivity to certain allergens as demonstrated by a significant re¬ sponse to the histamine challenge test and skin test.12 On the other hand, certain psychological findings, such as the history of faulty family interaction patterns, a personality constellation that stresses depen¬ dency needs, and anxiety in both the asthmatic patient and his mother are

The relative importance of (1) birth weight, gestational age, and head circumference at birth, and (2) appropriateness of birth weight and head circumference to gestational age in the predictability of neurobehavioral outcome was evaluated in 127 low-birth-weight infants at 7 months of age. Lower absolute birth weights, shorter gestational ages, and smaller head circumferences at birth correlated with poorer outcome (Bayley Scales of Infant Development and abnormal neurologic examination) at the corrected chronologic age of 7 months (r = .28 to .42, all P <.005). The incidence of low scores on the Mental Development Index and of severe neurologic deficit was significantly higher in small head circumference for gestational age infants than in appropriate head circumference for gestational age infants (both, P <.05). In the absence of small head circumference, small for gestational age infants had similar incidences of low Bayley scores and abnormal neurologic examinations as did appropriate for gestational age infants. These observations suggest that head circumference at birth may be the single most important variable for subsequent neurobehavioral outcome, and that both birth weight and gestational age may simply be markers of fetal head growth in their relationship to later outcome.

Social workers and other mental health professionals have developed and applied a number of typologies of family types in clinical practice, as well as for program planning. Most such taxonomies have emerged from theory and practice, but few are based on more than two or three dimensions or have been rigorously tested empirically. In this study of a representative sample of 625 households from which clients of a child and family mental health and social services agency come, inductive cluster analysis extracted eight discrete household clusters. The household types included (a) high-aversive households, (b) isolated (mostly single-adult) households, (c) multideficit households, (d) families experiencing circumscribed problems, (e) households with family problems but substantial external supports, (f) extremely isolated families, (g) seriously stressed families with significant strengths, and (h) significant family-functioning problems. Demographic factors and other stressors associated with these clusters were also examined Clinical and programmatic implications of these findings are presented, along with suggestions for further systematic replications in other settings.

, content and e v a l u a t i o n method were made known p r i o r t o t h e experience. Evaluation was done i n the above emphasis areas. Student a t t i t u d e s were q u a n t i f i e d using pre-established c r i t e r i a .Students, upon completion of t h e c l e r ks h i p and l a t e r a s housestaff, were asked t o permit 2 supervisors t o evaluate t h e i r performance a s housestaff. One hundred f i f t e e n s t u d e n t s responded and 153 e v a l u a t i o n s were made by housestaff supervisors. Performance was analyzed and comparisons made of emphasis a r e a s an w e l l a s between c l e r k s h i p , housestaff, and Nat i o n a l Board performances. Performance was compared t o s p e c i a l t y choice and graduates indicated the degree of c l e r k s h i p influence, i f any, on t h e i r choice.Achievement wan documented by: National Boards (NB) (Pass: Clerkship-99%/~S-97%); e v a l u a t i o n of housestaff (HS)(96% no d e f ic i t i n ped. knowledge, average o r above performance: c l e r k s h i p -79%/NB-99%); and r e t r o s p e c t i v e assessment by HS (objectives highl y appropriate-47% and preparation e x p e c i a l l y strong-612). There were n o t a b l e d i f f e r e n c e s i n performances f o r various o b j e c t i v e s and a l l exce a t t i t u d e c o r e l a e w t h a p e c i a l t cho ce (ped. HS significan!fy higher than 5 an3 o i s i x s p e c i a l t y c i o i c e s ) . GESTATIONAL AGE ESTIMATION IN SICK NEWBOWSCecelia Daum. Diane Kurtzberg. Bruce Grellong, Susan Albin and Herbert Vaughan (Spon. by Lawrence Gartner),Departmenta of P e d i a t r i c s , Neuroscience and Psychiatry. Albert E i n s t e i n College of Medicine, Bronx, New YorkThe Dubowitz examination f o r e s t i m a t i o n of g e s t a t i o n a l age is o f t e n d i f f i c u l t o r impossible t o administer i n i t s e n t i r e t y i n s i c k i n f a n t s , e s p e c i a l l y those receiving v e n t i l a t o r y support. A shortened v e r s i o n of t h e examination has been devised which permits assessment of g e s t a t i o n a l age with minimal l o s s of p r e d i c t i v e accuracy. The complete Dubowitz examination was adminiatered t o 112 i n f a n t s from 29 t o 42 weeks g e s t a t i o n a l age. Factor a n a l y s i s and atepwise r e g r e s s i o n were performed t o i d e n t i f y t h e items t h a t contributed preponderantly t o t h e t o t a l variance. Three non-discriminating items (edema, s k i n c o l o r , posture) were eliminated on t h e b a s i s of t h e s e analyses, a s well a s t h r e e a d d i t i o n a l items (lanugo, head l a g , v e n t r a l suspension) which cannot be assessed i n i n f a n t s on r e s p i r a t o r s . The shortened s c a l e c o r r e l a t e d highly with t h e t o t a l Dubowitz score ( r -.985), providing a n instrument which can be admini s t e r e d t o s e r i o u s l y ill i n f a n t s with l i t t l e l o s s of pred i c t i v e accuracy (95% confidence l i m i t * 1 week). NEUROBEHAVIORAL ASSESSMENT OF HIGH-RISK NEONATE...