To assist the pediatrician in studying this issue, a self-assessment Pre-Test is offered below, so that the reader may challenge himself on his knowledge of the subject before reading further in this issue. To qualify for continuing-medical-education credits, it will be necessary to read carefully each of the articles that follow, successfully complete the CME quiz at the end of the issue, and return the quiz to the CME center for scoring.
As an organization accredited for continuing medical education, the Lenox Hill Hospital of New York designates this continuing-medical-education activity as meeting the criteria for three credit hours in Category 1 for Educational Materials for the Physician's Recognition Act of the American Medical Association, provided it has been completed according to instructions.
1. A child's risk of having cerebral palsy is increased if
A. He is premature.
B. He is of Mediterranean origin.
C. He has suffered from asphyxia.
D. He has had neonatal jaundice.
2. While not always present, which of the following would be the earliest indication of the presence of a significant motor disability in children with cerebral palsy?
A. A failure to begin walking.
B. A failure to roll over in the crib.
C. Delay in the disappearance of a primitive reflex or presence of a primitive reflex to an abnormal degree.
D. Inability to sit up without help.
3. The results of recent studies supported by the U.S. Office of Education indicates thai children with developmental disabilities
A. Will make the most progress if institutionalized in state facilities
B Will make the most progress in their own homes.
C. Will make the most progress if institutionalized in private facilities with one-to-three staff-patient ratios
D. Will make the most progress if separated from their mothers in early infancy
4. In 1971, Dr. Irving Cooper introduced a new method of chronic cerebellar stimulation by an electric implant to reduce spasticity in cerebral palsy. Controlled studies now show
A. The method has no effect on motor control.
B. The method affects motor control, but not always in ways that help the patient.
C. The method will almost always help the patient if the site and rate of stimulation are correct
D. The method is most helpful to purely athetoid quadnparetic patients.
The educational objective of this issue of Pediatric Annals is to update the pediatrician on recent advances in the diagnosis and treatment of cerebral palsy The pediatrician's role in noting the existence of the disorder in early infancy is stressed, and new methods are outlined to assist in the diagnosis and prognosis A detailed plan for the musculoskeletal examination is given, along with management recommendations for the child. An outline of the material to be covered is presented in the Table of Contents