精神運動発達遅滞児の早期診断と発達評価に関する研究

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  • A study on early diagnosis and developmental evaluation of mentally retarded chiloren.
  • セイシン ウンドウ ハッタツ チタイジ ノ ソウキ シンダン ト ハッタツ ヒ

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The relationship between the occurrence of mental retardation and risk factors was studied, based on Prechtl scores, in 79 mentally retarded children not having obvious hereditary involvement. The average scores of mentally retarded children, cerebral palsy children, and normal children were 3.86, 5.67, and 1.96, respectively. Mantally retarded children had higher associations with high maternal age at delivery and with small-for-date births than did cerebral palsy children and normal children. Mentally retarded children had high incidences of toxaemia, infection, psychological stress, and other problems due to environmental factors. Certain characteristics were also noted in the course of pregnancy and delivery of mentally retarded children. We thus found that Prechtl scores could provide the initial clue leading to an early diagnosis of mental retardation.<br>We examined symptomatic characteristics in the developmental course of infancy for 71 cases of mental retardation. The general trend during one year after birth included the following facts. 1) The children were poor in activity and quiet in behavior. 2) The rhythm of sleeping and waking was irregular, with many hours spent in sleep. 3) The orientation response to visual or auditory stimulation was poor. 4) These children disliked the prone position. 5) They were not easy to hold in arms and did not like being held. 6) Behavioral development was retarded in comparison to motor capacity.<br>The most characteristic findings in initial diagnosis for 21 cases diagnosed within six months after birth were poor head control, abnormal postural tone, poor spontaneous reactions towards the environment, and lack of facial expression.<br>We used behavioral developmental indices in the evaluation of development. Instructions on habilitation were provided for children who showed developmental retardation for more than three months within the first year of age.

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