No abstract

While body functions and structure are well-addressed, other ICF elements, specifically participation, are poorly integrated into practice. The emerging focus on the environment in therapy intervention, by modifying the context rather than changing aspects of the child, is consistent with current approaches and evidence. Knowledge translation implementation initiatives are recommended to bridge identified gaps.

A prospective study has been done on 96 full term small-for-date infants to determine the incidence and type of neurological and intellectual sequelae. Major neurological defects were uncommon with an incidence of 1% for cerebral palsy and 6% for convulsions. Minimal cerebral dysfunction characterized by hyperactivity, a short attention span, learning difficulties, poor fine coordination and hyper-reflexia was diagnosed in 25%. EEG abnormalities predominantly of a diffuse mild nature were seen in 59% of the boys and 69% of the girls (similar EEC tracings are reported in 27% of apparently normal children). Speech defects featuring immaturity of reception and expression were present in 33% of the boys and 26% of the girls. Hearing and vision were not appreciably affected. The average IQ was 95 (boys) and 101 (girls). However 50% of the boys and 36% of the girls had a poor school performance.

In a prospective study, 96 of a possible 131 full term small-for-date (SFD) infants have been followed for a minimum of 4 years. Serial measurements for weight, height, and head circumference have been compared with the Stuart growth percentiles. By 4 years of age the mean weight and height were between the 10th and 25th percentiles with 35% below the 3rd and only 8% above the 50th percentiles. Increase in head circumference paralleled linear growth. Bone age showed a high positive correlation with height age. Siblings of normal birth weight tended to be larger than the study children with 3% below the 3rd and 45% above the 50th percentiles. Heights of parents were normal, mothers were slightly underweight. There was no difference in the 6-year height or weight between the most severely intra-uterine retarded babies and their less affected counterparts. The growth pattern of the SFD children was similar to the normal child with the greatest velocity of growth occurring in the first 6 months. Those children whose 4-year height exceeded the 3rd percentile showed an accelerated velocity of growth in the first 6 months.