The purpose of this study was to assess the long-term effects of pneumococcal meningitis in children. From 1967 to 1988, a total of 90 children were admitted to the Hospital for Infectious Diseases, Thessaloniki, Greece, with the diagnosis of pneumococcal meningitis. Sixteen patients died in the hospital as a direct result of meningitis. Eleven others were excluded from the study (neurologic deficits prior to onset of meningitis, two; death subsequent to hospitalization, two; recurrent meningitis, seven). Of the remaining 63 survivors, we were able to evaluate 47 patients (75%). Evaluation was performed 4 to 23 years (mean 12.3 +/- 5.8 years) after discharge. Forty patients returned to hospital for evaluation, and seven were evaluated by their primary physicians, who sent information by a standardized questionnaire. The following examinations were carried out: history, physical and neurologic examination, ophthalmologic and hearing evaluation, and psychometric testing. Fourteen patients (30%) had at least one neurologic handicap; nine (19%) had mental retardation, eight (17%) hearing loss, seven (15%) seizure disorder, five (11%) motor defects, and one each (2%) behavioral problems and visual impairment. The presence of coma was the strongest predictor of increased morbidity. The high frequency of long-term sequelae observed in our study supports the need of an effective vaccine.

Some of the factors that may have contributed to faster motor development are passage of time and the environmental and cultural differences between countries. The findings reinforce the need for standardization of a test before it is applied to the population of a country, and its re-standardization on the population of the country where it was first applied.

From a population of 765 preschool children 4-6 years old, 31 children (4.1%) were identified as left-handers. Using the two motor subscales A (gross motor) and D (fine motor) of the Griffiths Test No. II, these children were compared with 31 right-handers, matched for age, sex, and preschool attended. Right-handed children received higher quotients than left-handed on both Griffiths' subscales, with a significant difference only on Scale D. However, the differences between right- and left-handed children arose from the poorer performance of left-handed boys on fine motor tasks (Scale D). These differences could be responsible for learning difficulties that left-handed children face later at school. Such difficulties should be identified as early as possible to facilitate psychoeducational intervention in preschool programs.

To explore knowledge of and attitudes about children who have special needs, a questionnaire was submitted to 1145 persons (305 lyceum students, 94 teachers of secondary education, 247 medical students, 354 physical education students, and 145 persons having an exceptional child in their families). Questions concerned the knowledge of categories of children with special needs, acceptance of them in regular classrooms, and willingness to work with them. Analysis showed that most people including teachers had limited awareness of exceptional children, their problems, education, and integration. They showed partial acceptance of mainstreaming and desire to work with such children. Careful education for all, especially teachers, seems advisable.