GD/01(P).CLINICAL CHARACTERISTICS OF CHILDREN HAVING SPECIFIC
LEARNING
DISABILITY
WITH
ASSOCIATED
ATTENTION
DEFICIT
HYPERACTIVITY DISORDER
Sunil Karande, Nitin Satam, Madhuri Kulkarni, Rukhshana Sholapurwala, Anita Chitre, Nilesh
Shah
Departments of Pediatrics & Psychiatry, Lokmanya Tilak Municipal Medical College & General
Hospital, Sion, Mumbai - 400 022
Introduction: Almost 5-15% of school-going children have specific learning disability (SpLD) in
the form of dyslexia, dysgraphia and/or dyscalculia. Attention deficit hyperactivity disorder
(ADHD) occurs as a co-morbidity in about 20% of children having SpLD. Aim: To study the
clinical characteristics of children having SpLD and associated ADHD. Design: A prospective
hospital based study. Setting and Methods: 50 children diagnosed with SpLD and associated
ADHD in our clinic from August-November 2004 were subjects of the study. SpLD was diagnosed
on the basis of psycho-educational testing. ADHD was diagnosed as per DSM-IV-revised criteria.
Results: The mean age of children at diagnosis was 11.3 years ± S.D. 2.6 (range 6.5 years to 17.6
years) although in 66% of children the parents had noticed problems between 5-8 years of age.
There was no significant difference in mean age of boys and girls at diagnosis. Boys outnumbered
girls (34 versus 16; male: female ratio 2.1:1). All 50 children were studying in English-medium
schools and 92% were from the upper or upper middle socioeconomic class of society. There were
two peaks for referral to our clinic; children were either in standards V/VI or in standards IX/X.
Chief complaints in these children was: difficulty in writing (47%), poor attention (43%), difficulty
in mathematics (37%), hyperactivity (34%), and difficulty in reading (30%). 30% of children had
abnormal birth history, 36% had delayed developmental history, and 20% had primary nocturnal
enuresis. 30% children had history of school detainment and 26% had poor interpersonal
relationships with either sibs or peers. Aggressive behavior was demonstrated by 30% and
withdrawn behavior by 10%. Conclusion: Children with SpLD and associated ADHD need to be
identified at an early age to prevent psychological problems developing in them due to chronic poor
academic performance.
GD/02(P).PARENTAL PERCEPTIONS OF CHILDREN WITH BORDERLINE
INTELLECTUAL CAPACITY
Sunil Karande, Sandeep Kanchan, Madhuri Kulkarni
Departments of Pediatrics, Lokmanya Tilak Municipal Medical College & General Hospital, Sion,
Mumbai - 400 022 (India)
Introduction: By definition, children with borderline intellectual capacity (Slow Learners) have
intelligence quotient (IQ) scores between 71 to 84. Although they comprise about 15% of the school
going population there is limited literature available about them. Aim: The present study was
conducted to document the academic problems faced by Slow Learners and to assess parental
knowledge and attitudes regarding this condition. Design: A prospective hospital based study.
Setting and Methods: The academic history of Slow Learners diagnosed in our Learning Disability
clinic over a period of six months (November 2004 to April 2005) was documented and analyzed.
IQ scores were documented using the Wechsler Intelligence Scale for Children test (Indian
adaptation by MC Bhatt). Their parents’ were interviewed at the time of certification. Results: Of
the 349 children referred for poor school performance, 70 (20%) were diagnosed as Slow Learners.
Of these 55 (35 boys, 20 girls) participated in the study. Their male: female ratio was 1.7:1. Their
mean age at time of diagnosis was 11.9 years (±S.D. 2.3). Their chief academic complaints were
difficulty in writing (93%), poor performance in all school subjects (89%), and difficulty in
mathematics (76%). Majority of children (62%) had already repeated a class standard. Almost all
parents (98%) were unaware that their child’s poor school performance was largely due to
subnormal intelligence. Majority of parents (51%) attributed their child’s poor school performance
either to poor memory, or to inattentiveness in the class room (36%). Majority (58%) of parents
believed that their child had developed emotional/ behavioral problems such as anger, anxiety,
withdrawn behaviour or depression due to the poor school performance. A large majority of parents
(82%) believed that they would be able to increase their child’s intellectual capacity by better
supervising their child’s school work, employing private tuitions, or by using ayurvedic or
homeopathic medicines. Conclusion: Slow learners need to be identified at an early age to prevent
psychological problems developing in them due to chronic poor school performance. Their parents
need counseling sessions to understand their child’s condition and academic abilities.
GD/03(R).EFFECT OF NUTRITIONAL STATUS, SOCIAL AND THE HOME MICROENVIRONMENT ON THE DEVELOPMENT OF CHILDREN
Dharmendra Kumar Gupta, R.Tuli, R.Agarwal, S.P. Goel
Department f Pediatrics and Neonatlogy, L.L.R.M. Medical College, Meerut 250004
Objective : To assess the impact of nutritional deprivation on the development of children aged 0-6
years and to identify their social and home micro-environmental factors associated with delay in
development. Material & Method: A total of 450 children were assessed for their nutrition,
development, social and family environment. Nutritional status was assessed by weight for age
criteria according to recommendation of Indian Academy of Peadiatrics (1975). We used modified
Denver Development screening test i.e. : DENVER–II. Gupta & Sethi classification (1998) of
ICMR was used. Results were interpreted and statistical analysis was done using chi-square (2–
test) and test of propositions (Z-test). Results : The prevalence of malnutrition was 50% in the study
population.. The overall prevalence of developmental delay in malnourished children was 30.6%
whereas in well nourished children developmental delay was 10.8% compared to 50.8% in
malnourished children (P < .001). Most common parameter to delay was language & personal
social. Malnourished children had significant developmental delay in all areas of development (P <
.01). The severity of malnutrition had direct adverse effects on all the areas of development. Most of
the well nourished children had isolated developmental delay whereas malnourished children had
global developmental delay. Better socio-economic status, small family, parental literacy, joint
family, non-alcoholic parents & better housing were found to be important social factors for better
development of children. The family & home environmental risk factors affecting development of
children were emotional deprivation, unavailability of play materials, parents not spending time
with children. Conclusion : Factors identified in this study can be addressed for better development
of children by relevant intervention at community & home level, so there is a need for multi faceted
community based programme & their proper implementation to give a better future to our children,
society and nation.
GD/04(P).GROWTH PATTERN OF EXCLUSIVE BREAST FEED LOW BIRTH WEIGHT
BABIES (LBW) TILL SIX MONTHS OF AGE.
S Manazir Ali, Mohd. Faisal, A.J Ahamad, Zeeba Z. Rub, Musharraf Shamim
Neonatal section, Department of Pediatrics, JNMCH, AMU, Aligarh -202002
This prospective study was carried out in well baby clinic of Department of Pediatrics , Jawahar Lal
Nehru Medical College, AMU w.e.f Octuber 2004 to December 2005 to evaluate the growth
velocity of LBW Vs growth velocity of term babies weighing >2.5 Kgs. Out of 2461, 842 were low
birth weight babies (32.4%) of which 134 LBW babies were included in study group while 42 term
babies weighing >2.5 kgs. served as control group. The control group of the present study was
comparable to the study group. There was predominance of female over male with M:F 1:1.2 and 1:
1.1 in study and control group respectively. Control group received exclusive breast feeding while
LBW babies received exclusive breast feeding along with Vitamin supplementations. The weight
and length were recorded by Electronic weighing machine and infantometer respectively while head
circumference, chest circumference were recorded by non stretchable measuring tape accurately by
one of the author. The weight velocities of control and LBW groups were 22.41 gms and 21.66gms
per day respectively while the head circumference 1.31 cm &1.4cm per month, chest circumference
1.52 & 1.55cm per month and length2.53& 2.19 cm per month in control and LBW babies group.
On analysis it was observed that the growth velocity of control were slightly higher than the LBW
babies while the growth velocity of head circumference was higher than control. Hence in
conclusion growth velocity of LBW babies are comparable to control group on exclusive breast
feeding.