Revaccination Safe In Kids With Prior Reaction/ Early Intervention Study

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August 14, 2000

Revaccination Safe In Kids With Prior Reaction/ Early Intervention Study

Also: * Brain’s Cerebellum Contributes To Higher Functions

* Premature Kids Linked To Problems

* 7 Million Kids Eligible For Health Program

Revaccination Safe In Kids With Prior Adverse Reactions

[From Reuters Health]

www.reutershealth.com/archive/2000/08/14/professional/links/20000814clin008.

htm

Children who have a past history of an adverse event following

immunization (AEFI) can be safely revaccinated in most cases, according to a

report in the August issue of the Archives of Disease in Childhood.

Most countries now recognize only a few absolute contraindications to

revaccination of children who have experienced a prior AEFI, the authors

explain. Several countries now have special immunization services that

review and promote vaccination of children with AEFI or medical disorders

thought to contraindicate vaccination.

Dr. Gold and colleagues from the South Australian Immunization

Coordination Unit of the Department of Human Services, in Adelaide, South

Australia, analyzed the experience of their special immunization services in

revaccinating children with a past history of an AEFI.

Between 1996 and 1999, 469 children with a prior AEFI attended one of

three special immunization service centers. According to the report, 63% had

minor post-vaccination reactions and 37% experienced hypotonic

hyporesponsive episodes, convulsions, skin rash, anaphylaxis, apnea, or

various miscellaneous symptoms.

Most children (90%) were revaccinated after careful clinical review,

the authors report. Among the 421 children vaccinated, 83% experienced no

AEFI. All but one of the remaining children experienced only minor

reactions, including fever, local reactions, and/or lethargy, during the 7

days following immunization.

The sole serious event was likely a hypotonic hyporesponsive episode,

which occurred 5 hours after vaccination with DTPa, H. influenzae B, and

oral polio vaccine, the researchers note. The episode resolved spontaneously

without requiring hospitalization.

Among 101 children whose previous AEFI included significant neurologic

reactions (hypotonic hyporesponsive episodes, convulsions, or apnea), none

experienced a recurrence of a significant AEFI, the results indicate.

" We consider that a special immunization service should be an

essential component of an immunization program, " the authors conclude.

" Further research is required to ascertain what factors determine which

parents presented for review and whether this sample is representative of

all children who have experienced an AEFI. "

Arch Dis Child 2000;83:128-131.

* * *

Intensive Early Intervention Study

Abstract. Am J Ment Retard 2000 Jul;105(4):269-85

Randomized trial of intensive early intervention for children with pervasive

developmental disorder.

T, Groen AD, Wynn JW Washington State University, USA.

tristram@...

Young children with pervasive developmental disorder were randomly

assigned to intensive treatment or parent training. The intensive treatment

group (7 with autism, 8 with pervasive developmental disorder not otherwise

specified--NOS) averaged 24.52 hours per week of individual treatment for

one year, gradually reducing hours over the next 1 to 2 years.

The parent training group (7 with autism, 6 with pervasive

developmental disorder NOS) received 3 to 9 months of parent training. The

groups appeared similar at intake on all measures; however, at follow-up the

intensive treatment group outperformed the parent training group on measures

of intelligence, visual-spatial skills, language, and academics, though not

adaptive functioning or behavior problems.

Children with pervasive developmental disorder NOS may have gained

more than those with autism.

PMID: 10934569, UI: 20390226

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* * *

Brain’s Cerebellum Contributes To Higher Functions

[Abstract. Thanks to J. Coetzee. Brain 2000 May;123 ( Pt 5):1051-61.]

The cerebellum contributes to higher functions during development:

evidence from a series of children surgically treated for posterior fossa

tumours. Riva D, Giorgi C

Developmental Neurology Division, Carlo Besta National Neurological

Institute, Milan, Italy. driva@...

We present data on the intellectual, language and executive functions

of 26 children who had undergone surgery for the removal of cerebellar

hemisphere or vermal tumours. The children with right cerebellar tumours

presented with disturbances of auditory sequential memory and language

processing, whereas those with left cerebellar tumours showed deficits on

tests of spatial and visual sequential memory. The vermal lesions led to two

profiles: (i) post-surgical mutism, which evolved into speech disorders or

language disturbances similar to agrammatism; and (ii) behavioural

disturbances ranging from irritability to behaviours reminiscent of autism.

These data are consistent with the recently acknowledged role of the

cerebellum as a modulator of mental and social functions, and suggest that

this role is operative early in childhood.

PMID: 10775549, UI: 20239745

* * *

Premature Kids Linked To Problems

http://www.discoveryhealth.com/enews?c=294245

AP - Babies born prematurely tend to have more problems in school and

in childhood socializing than do babies that were carried to full term,

according to a new study.

The study, by psychology researchers at Syracuse University, found

that significantly more children born prematurely had behavioral, learning

and thinking problems than did children who were born full term. The study

was presented Monday at the national convention of the American

Psychological Association.

Lawrence Lewandowski of Syracuse University said the study was

important because more babies born at 24 to 31 weeks now are being kept

alive and become well enough physically to leave the hospital.

A study co-authored by Lewandowski and Jeremie R. Barlow compared the

development of 118 babies born prematurely (gestation of 24 to 31 weeks)

with that of 119 babies who were delivered after a full term gestation, 38

to 42 weeks. The study conclusions were based on tests that started at birth

and were continued at intervals until the age of 10.

Barlow said that she found 39 percent of the premature babies had

below normal IQs of 85 or less, while only 13 percent of the full term

infants had such IQs. The international average for IQs of 85 or less is 16

percent.

Based on data from questionnaires filled out by teachers and parents,

Barlow said the researchers also found that the premature youngsters had

more social problem.

" More of them did poorly on measures of social skills, " said Barlow.

+ Article continues:

http://www.discoveryhealth.com/enews?c=294245

* * *

7 Million Kids Eligible For Health Program

http://www.discoveryhealth.com/enews?c=294459

AP - Nearly two-thirds of the nation's 11 million uninsured children

are eligible for free or low-cost health insurance through the government,

but their parents mistakenly believe they don't qualify, according to a

study released Wednesday.

The survey found that about three of five parents whose children

qualify for the Children's Health Insurance Program (CHIP) or Medicaid

believe they're not eligible for these programs, leaving 7 million children

unnecessarily uninsured.

About four of five parents of eligible children said they would

enroll their children if they knew they could, said Shuptrine, head

of the Covering Kids program of The Wood Foundation, a

philanthropic group devoted to health issues.

" Many families really believe that they have to have very low

incomes or have to be on welfare in order for children to be eligible, "

Shuptrine said. " It's critically important that we try to reach these

families and let them know about these opportunities. "

The government created the children's program in 1997 to help kids

whose families earn too much to qualify for Medicaid but can't afford

private insurance. About 2 million children were enrolled in the program in

1999.

Stovall, 23, a portrait photographer from Boise, Idaho,

signed up her 2-year-old son, Tyler, for CHIP coverage only three days

before he suffered a serious asthma attack requiring medical attention.

" With everything we've gone through with his health, it's really

helpful to have something that helps to pay, " Stovall said.

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