We describe the cognitive profile in a complete national cohort of children with cerebral palsy (CP). One hundred and twentyseven Icelandic children (67 females, 60 males) with CP, born between 1985 and 2000 and assessed between the ages of 4 and 6 years 6 months (mean age 5y 5mo, SD 6mo), were included in the study. IQ was measured using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) and developmental quotient (DQ) was obtained using various developmental scales. Physiological classification of CP in the children was: spasticity, n=104 (82%); dyskinesia, n=14 (11%); ataxia, n=six (4.7%), and unclassified CP, n=3 (2.3%). Spastic diplegia was the most prevalent subtype (35%) followed by hemiplegia and quadriplegia. Forty-five per cent of the group were at Level I of the Gross Motor Function Classification System, 32% were at Levels II and III, and 23% were at Levels IV and V. Sixty per cent of the children had an IQ or DQ >70. Median scores on the WPPSI were Full-scale IQ 84, Verbal IQ (VIQ) 92, and Performance IQ (PIQ) 77. Children with spastic diplegia and quadriplegia had a significantly lower PIQ than VIQ. Of the children who failed to complete the WPPSI, 20% had DQ >85. Thus, cognitive skills can be masked by limitations of movement and motor control in children with CP.

Spina bifida (SB) is one of the most frequent congenital deformities of the neural tube. It is a complex congenital deformity with a variety of complications that require comprehensive multidisciplinary medical care. During the twenty-first century lifestyle-related conditions have been among the leading causes of morbidity and premature death in both developing and developed countries. Because of the limitations and complications associated with SB, individuals with SB are at increased risk for developing lifestyle-related conditions. Aim: The aim of the study was to perform a descriptive epidemiological investigation of the SB population in Iceland and to assess health and well-being of the adult SB population. Methods: The first part of the study was a retrospective study which described the incidence and prevalence of SB between 1972 and 2011; and the mobility, cognitive functioning and the comorbidities children with SB had at the age of five years. The second part of the study was a crosssectional study and assessed the health and well-being of the adult Icelandic SB population currently living in Iceland, born between 1967 and 1996. Twenty-five participants (69%, age 18-47 years, 9 men and 16 women), took part and answered the survey "Research on the health and well-being of Icelanders in 2012". Each participant wore an accelerometer for seven days to measure physical activity and kept a physical activity diary. The waist-and hip-circumferences were measured to evaluate the risk of metabolic/lifestyle complications. In the third part of the study, the results of the questionnaire "health and well-being of Icelanders" were compared with the results from a group of Icelandic participants who answered the survey in 2012 (age 18-47 years, n=2159). Results: The incidence of SB has markedly declined in Iceland during the last forty years. At five years of age most of the children with SB could walk, had a low borderline or normal intelligence and the comorbidities were mostly orthopedic impairments, impairments affecting the central nervous system and urinary and bowel function. Most participants with SB (≥ 72%) considered their physical and mental health as being good or very good and similar or better than last year. Ninety-two percent of them didn't smoke, 32% didn't drink alcohol and 48% drank less than once a month. Adults with SB did not carry out moderately intense physical activity for 30 min. a day. Most of them had an increased waist circumference. This study also showed that adults with SB drank less alcohol than the comparison group but tended to eat unhealthily. Conclusion: The incidence of SB has declined in recent years. Most five year old children with SB can walk, however as adults with SB they are at increased risk of developing lifestyle related conditions. Therefore, education about a healthy lifestyle is of uttermost importance.