The influence of multiple administration of a psychomotor test on performance and learning

Exercise scientists frequently use criterion measure tests to assess levels of motor performance and physical fitness or to evaluate the success of their intervention programs. During this process, the same motor test might be administered multiple times. The aim of the present study was to examine whether familiarization with a psychomotor test would influence performance and/or learning. One hundred thirty (n = 130) primary school students participated in the study. Participants were randomly divided into two groups, experimental (n = 60, mean age = 10.74 years old, minimum = 9.08, maximum = 11.83) and control (n = 70, mean age = 10.68 years old, minimum = 9.5, maximum = 11.79). The flamingo balance test was used to examine the postulated hypothesis. Initially, both groups executed the balance test. Then, only the experimental group performed two additional trials, one trial every 3 days. A final trial was administered to all participants, followed by a retention trial 1 week later. The results revealed that both groups improved their performance. The experimental group outperformed the control group. The retention trial showed that performance levels for both groups continued to improve, suggesting that familiarization with the test influenced not only performance but learning as well. Exercise scientists who implement psychomotor tests, such as balance tests, for evaluative purposes should be aware that performance improvement does not necessary represent changes in individuals' performance, but it may reflect individuals' familiarization with the test.     

Do kinesiologic activities change aberrant behavior in preschool children?

An experimental treatment was carried out in a sample of 117 preschool children by applying kinesiologic activities. The treatment lasting for 60 minutes was applied for a period of 9 months, twice a week. Control group of 139 children were trained according to the program for preschool institutions. Treatment effects were assessed by 7 motor ability tests, one intellectual test (Raven's Colored Progressive Matrices) and 36-item questionnaire for assessing aberrant behavior, which was filled out by parents. Aberrant behavior reduced significantly when motor abilities improved through systematic exercise. These findings point to the importance of motor exercise and applying additional kinesiologic activities with various modalities to reduce aberrant behavior in preschool children.     

Correlation of parental socioeconomic status indicators with morphological and motor dimensions of preschool children

Measuring instruments for assessment of parental socioeconomic status, anthropometric characteristics and motor abilities were used in a sample of 643 preschool children aged 4-6 years and their parents, recruited from preschool institutions in several towns in Voivodina, Serbia. The aim was to analyze the correlation of parental socioeconomic status indicators with morphological and motor dimensions of preschool children. Study results showed the socioeconomic status of the children's families to be relatively homogeneous, with no statistically significant differences in any of the socioeconomic status indicators between families with male and female children. Male and female children differed significantly in the overall space of anthropometric and motor variables, and to a lesser extent in individual variables. The general morphological factor treated as the children's growth and development, and general motor factor were qualitatively comparable. The correlations of socioeconomic factor with general morphological and motor factors of the children were not statistically significant, with the exception of motor factor in 6-year-old male children, at elementary school enrolment. Study results suggested the differences in biological growth and development and motor development recorded in preschool children from Voivodina, Serbia, to be attributable to hereditary factor rather than socioeconomic and environmental factors. Inclusion of older children and use of more socioeconomic status indicators along with some additional indicators should probably yield more reliable results on the issue.     

Influence of familiarization on the reliability of vertical jump and acceleration sprinting performance in physically active men

The purpose of the present study was to determine the number of familiarization sessions required to obtain an accurate measure of reliability associated with loaded vertical jump and 20-m sprint running performance. Ten physically active men attended 5 separate testing sessions over a 3-week period where they performed unloaded and loaded (10-kg extra load) countermovement (CMJ) and static (SJ) jumps, followed by straight-line 20-m sprints. Jump height was recorded for the vertical jumps using a jump mat, while the time for 10 m and 20 m was recorded during the sprints using photocells. The highest (jump conditions) and fastest (sprint) of 3 trials performed during each of the 5 testing sessions was used in the subsequent analysis. Familiarization was assessed using the scores obtained during the 5 separate testing sessions. Reliability was assessed by calculating intraclass correlation coefficients (ICCs) and coefficient of variation (CV). No significant differences were obtained between the testing sessions for any of the measures. ICCs ranged from 0.89 to 0.95, while CVs ranged from 1.9 to 2.6%. These results indicate that high levels of reliability can be achieved without the need for familiarization sessions when using loaded and unloaded CMJ and SJ and 20-m sprint performance with physically active men.     

The influence of familiarization on the reliability of force variables measured during unloaded and loaded vertical jumps

The purpose of this study was to determine the number of familiarization sessions required to obtain an accurate measure of reliability associated with force variables recorded during unloaded and loaded (30 and 60% of 1 repetition maximum squat [1RM]) static vertical jumps (SJ). Nine physically active men attended 4 separate testing sessions over a 2-week period. Force platform recordings of peak force, peak rate of force development (pRFD), average rate of force development, takeoff velocity, average power, and peak power were obtained for each jump. During each of the 4 testing sessions, 3 jumps were performed under each of the load conditions. The average of the force variables were used in the analysis. Familiarization was assessed using the scores obtained during the 4 separate testing sessions. Reliability was assessed by calculating intraclass correlation coefficients (ICCs) and coefficient of variation (CV) associated with the force variables. No significant differences (p > 0.05) were obtained between the testing sessions for any of the force variables. With the exception of pRFD, the force variables showed reasonably good levels of test-retest reliability (ICC range: 0.75-0.99; CV range: 1.2-7.6%). High levels of reliability can be achieved in a variety of force variables without the need for familiarization sessions when performing SJ under unloaded conditions and with loads of 30 and 60% of 1RM squat with physically active men.     

The impact of football training on motor development in male children

The aim of the study was to determine the effect of football school program and physical education curriculum on changes in the motor abilities of 7- and 8-year-old boys. The study included a sample of 180 boys divided into group 1 (7-year-old boys), subdivided to experimental (n = 40) and control (n = 50) groups, and group 2 (8-year-old boys), subdivided to experimental (n = 40) and control (n = 50) groups. Experimental groups included children attending three training units of football training over a 9-month period, in addition to the conventional physical education curriculum. Control groups included children attending only conventional physical education curriculum. All study subjects underwent testing with a battery of 12 motor tests at the beginning and at the end of the study. Results obtained by discriminative canonic analysis showed no statistically significant between-group difference in motor abilities at the beginning of the study. However, significant differences in favor of experimental groups were recorded at the end of the study. Favorable changes in all motor variables were observed in both experimental and control groups of children from the initial through the final state. These changes were more pronounced in experimental groups. Analysis of variance for difference variables (final to initial measurement) indicated programmed education in the form of football training in addition to regular physical education curriculum to predominantly influence the development of aerobic endurance, agility, speed and flexibility in 7-year-old boys, and of explosive strength, aerobic endurance, flexibility and speed in 8-year-old boys. In the latter, football training led to the formation of a motor complex integrating explosiveness, speed, coordination, endurance and flexibility as a general motor factor determining future quality development in football.     

Serum thyroid hormone profile and trace elements in children receiving valproic acid therapy: A longitudinal and controlled study

Valproic acid (VPA) may affect thyroid hormone profile, causing alteration in serum trace elements concentrations. The aim of this study was to prospectively investigate this relationship in children receiving VPA monotherapy for a period up to 6 months. Serum thyrotropin (TSH), free thyroxine (FT4), free triiodothyronine (FT3), thyroxine (T4), triiodothyronine (T3), thyroglobuline (TG), selenium (Se), zinc (Zn), and copper (Cu) levels were evaluated at baseline and at the 6th month in all the patients and in the control group. The mean Cu concentration in the 6th months of VPA therapy was significantly lower than that of the control group. TSH level was significantly increased in the patient group whereas FT4 was significantly decreased. The mean TSH level in the 6th month of VPA therapy was significantly higher than that of the control group, whereas mean T4 level was significantly lower. The Cu level in the 6th months of VPA therapy was positively correlated with T4 level. Δlog Cu and ΔTSH were negatively correlated. This study suggests that the alteration in the serum thyroid hormone profile during VPA therapy may result from the reduction in serum Cu levels.     

Effects of balance training using wobble boards in the elderly

Few studies have examined balance training of elderly people using wobble boards. This study assessed the effects of wobble board balance training on physical function in institutionalized elderly people. This study examined 23 subjects (age 84.2 ± 5.9 years) who lived in a nursing home. The exercise program for the training group comprised balance training standing on a wobble board for 9 weeks, twice a week. In all, 11 training group subjects and 11 control group subjects completed this study. After 9 weeks, standing time on a wobble board, standing time on a balance mat, and maximum displacement distance of anterior-posterior center of pressure in the training group were significantly greater than those of the control group. Frequency analysis revealed that the power spectrum in 0.1-0.2 Hz significantly increased in the training group. These results suggest that wobble board training is effective for elderly people to improve their standing balance, by which they frequently control their center of gravity and maintain a standing posture on unstable surface conditions.     

Genetic analysis of motor milestones attainment in early childhood.

The age of attainment for four motor developmental traits, such as turning over, sitting up without support, pulling up to a standing position and walking without support, was examined in 822 children, including 626 siblings from families with 2 to 6 children, 68 pairs of dizygotic twins and 30 pairs of monozygotic twins. Correlation analysis, carried out separately for each type of sibship, showed the highest pairwise correlations in monozygotic twins and the lowest correlation in non-twin siblings for all motor milestones. Variance component analysis was used to decompose the different independent components forming the variation of the studied trait, such as genetic effect, common twin environment, common sib environment and residual factors. The results revealed that the major proportion of the total variance after adjustment for gestation age for the attainment of each motor skill, except pulling up to standing position, is explained by the common twin environment (50.5 to 66.6%), whilst a moderate proportion is explained by additive genetic factors (22.2 to 33.5%). Gestational age was found to be an important predictor of appearance of all motor milestones, affecting delay of 4.5 to 8.6 days for the attainment of the motor abilities for each week of earlier gestation. The age of attainment of the standing position was affected only by shared sibs environment (33.3% of the total variance) and showed no influence of either genetic or common twin environment. Phenotypic between trait correlations were high and significant for all studied traits (range between 0.40 and 0.67, P < 0.01 in all instances). Genetic cross correlations, however, were not easily interpreted and did not show clear variance trends among the different groups of children.     

Sex and age-level differences of walking time in preschool children on an obstacle frame

Background

Stepping over an obstacle is a kind of compound movement that makes walking more difficult, especially for preschool children. This study examines sex and age-level differences in walking time in preschool children on an obstacle frame.

Methods

The participants included 324 healthy preschool children: four-year-old boys (51) and girls (51), five-year-old boys (50) and girls (60), and six-year-old boys (62) and girls (50). A 5 cm- or 10 cm-high obstacle (depth 11.5 cm, width 23.5 cm) was set at the halfway point of a 200 cm × 10 cm walking course.

Results

The participants walked to the end of the course and back as fast as possible under three conditions: no obstacle, low obstacle and high obstacle. Walking time showed age-level differences in all conditions, but there were no differences in sex. Age levels were divided into two groups, with one group within the first six months of their birthday, and the second group within the last six months of that year. Walking time for children in the first half of their fourth year was longer than that of the five- and six-year-old children. In addition, for children in the last half of their fourth year, walking time was longer than both sexes in the last half of their fifth and sixth years. The children in the latter half of their fifth year had a longer walking time in the high obstacle condition than those in the last half of their sixth year. In the four-year-old participants, walking time was shorter with no obstacles than with a high obstacle frame.

Conclusions

In the above data, obstacle course walking time does not show a gender difference, except that the four-year-old participants needed longer than the five- and six-year-old children. Setting the obstacle 10 cm high also produced a different walking time in the five- and six-year-old participants. The high obstacle step test (10 cm) best evaluated the dynamic balance of preschool children.     

Age-related,interindividual, and right/left differences in anterior-posterior foot pressure ratio in preschool children

Background

This study aimed to examine age-related, interindividual, and right/left differences in anterior-posterior foot pressure ratio in 764 preschool children (364 boys and 400 girls) aged 3.5-6.5 years.

Methods

Subjects maintained an upright standing posture for 10 seconds on the Footview Clinic, an instrument designed to calculate the anterior-posterior foot pressure ratio. The ratio of anterior foot pressure in each subject’s right and left feet was selected as a variable, and the mean of a 10 s measurement was used for analysis.

Results

The ratio of anterior foot pressure was significantly larger in the right foot than in the left foot. With regard to age, the ratio of anterior foot pressure was significantly larger in children aged over 4.5 years than in children aged 3.5 years. It was also larger in children aged 6 and 6.5 years than in children aged 4 years. Interindividual differences in variables were large, and coefficients of variance were highest in children aged 3.5 years and lowest in children aged 6.5 years.

Conclusions

In conclusion, anterior foot pressure increases with age in preschool children. Interindividual differences in anterior foot pressure are large and tend to decrease with age. Furthermore, the anterior foot pressure is slightly higher in the right foot than in the left foot. These results will be useful for various studies, such as examining relationships between the anterior-posterior foot pressure ratio and factors, such as untouched toes, physical fitness, and level of exercise.     

Maximal and explosive force production capacity and balance performance in men of different ages

A group of 32 healthy men (M) divided into three different age groups, i.e. M20 years [mean 21 (SD 1); n = 12], M40 [mean 40 (SD 2); n = 10] and M70 [mean 71 (SD 5); n = 10] volunteered as subjects for examination of maximal and explosive force production of leg extensor muscles in both isometric and dynamic actions (squat jump, SJ and counter movement jump, CMJ, and standing long-jump, SLJ). The balance test was performed on a force platform in both isometric and dynamic actions. Maximal bilateral isometric force value in M70 was lower (P < 0.001) than in M40 and as much as 46% lower (P < 0.001) than that recorded in M20 (P < 0.001). The maximal rate of force development (RFD) on the force-time curve was in M70 lower (P < 0.001) than in M40 and as much as 64% lower than in M20. The heights in SJ and CMJ and the distance in SLJ in M70 were lower (P < 0.001) than in M40 and M20 (P < 0.001). In response to modifications of the visual surroundings the older subjects were 24%-47% (P < 0.05 and P < 0.001) slower in their response time in reaching the lit centre (TT) and remained 20%-34% (P < 0.001) less time inside the centre (TC) from the overall time of lighting than M40 and M20, respectively. In both older groups the individual values of isometric RFD correlated significantly (P < 0.05) with the individual balance values of TT and TC. The present results would suggest that the capacity for explosive force production declines drastically with increasing age, even more than maximal muscle strength. Aging may also lead to impaired balance with a decrease in event detection and speed of postural adjustments. The decreased ability to develop force rapidly in older people seems to be associated with a lower capacity for neuromuscular response in controlling postural sway.     

Measurement of talent in team handball: the questionable use of motor and physical tests

Testing for selection is one of the most important fundamentals in any multistep sport program. In most ball games, coaches assess motor, physical, and technical skills on a regular basis in early stages of talent identification and development. However, selection processes are complex, are often unstructured, and lack clear-cut theory-based knowledge. For example, little is known about the relevance of the testing process to the final selection of the young prospects. The purpose of this study was to identify motor, physical, and skill variables that could provide coaches with relevant information in the selection process of young team handball players. In total, 405 players (12-13 years of age at the beginning of the testing period) were recommended by their coaches to undergo a battery of tests prior to selection to the Junior National Team. This number is the sum of all players participating in the different phases of the program. However, not all of them took part in each testing phase. The battery included physical measurements (height and weight), a 4 x 10-m running test, explosive power tests (medicine ball throw and standing long jump), speed tests (a 20-m sprint from a standing position and a 20-m sprint with a flying start), and a slalom dribbling test. Comparisons between those players eventually selected to the Junior National Team 2-3 years later with those not selected demonstrated that only the skill test served as a good indicator. In all other measurements, a wide overlap could be seen between the results of the selected and nonselected players. It is suggested that future studies investigate the usefulness of tests reflecting more specific physical ability and cognitive characteristics.     

感觉统合训练结合常规康复训练对痉挛型脑瘫患儿平衡控制及运动功能的影响

目的:探讨感觉统合训练结合常规康复训练对痉挛型脑瘫患儿平衡控制及运动功能的影响。方法:选取2016年1月到2017年12月期间成都市妇女儿童中心医院康复科收治的痉挛型脑瘫患儿80例为研究对象,根据随机数字表法将80例患儿分为对照组(40例)和观察组(40例)。对照组患儿采用常规康复训练进行治疗,观察组患儿采用感觉统合训练结合常规康复训练进行治疗。比较两组脑瘫患儿的平衡控制功能、步态、粗大运动功能测试量表-88(GMFM-88)D区和E区的评分。结果:治疗3个月后两组患儿的Rivermead活动指数、Berg平衡量表得分均明显升高,且观察组患儿的Rivermead活动指数、Berg平衡量表得分高于对照组(P0.05)。治疗3个月后两组患儿的步行足长、步速明显增加,步宽明显减小(P0.05),且观察组患儿步行足长、步速大于对照组,步宽小于对照组(P0.05)。治疗3个月后两组患儿的GMFM-88 D区、GMFM-88 E区得分均分别明显升高(P0.05),且观察组患儿的GMFM-88 D区、GMFM-88 E区得分均分别高于对照组(P0.05)。结论:感觉统合训练结合常规康复训练可有效改善痉挛型脑瘫患儿的平衡控制功能、步态以及粗大运动功能。     

Sex differences in motor characteristics of elementary school children included/not included in swimming training

The aim of the study was to assess the development of motor abilities in elementary school fifth- to eighth-graders (age 11-14 years) according to sex, age and physical activity. Study sample included 312 subjects divided according to age and sex into four groups: male subjects aged 11-12 (n = 93) and 13-14 years (n = 84); and female subjects aged 11-12 (n = 65) and 13-14 years (n = 70). Then, differences in basic motor abilities between children included (experimental group) and those not included (control group) in swimming training were analyzed. In male fifth- and sixth-graders, experimental group was superior to control group in the variables of trunk repetitive strength, sprint, flexibility and coordination, while in male seventh- and eighth-graders experimental group showed better performance than control group in agility, aerobic endurance and explosive throw and jump strength. In female fifth- and sixth-graders, experimental group proved superior to control group in the variables of explosive strength, coordination, trunk strength and aerobic endurance, whereas in female seventh- and eighth-graders experimental group had better performance in coordination, endurance, explosive strength, speed and flexibility. Discriminative analysis of motor variables between male and female subjects revealed male subjects to be superior in explosive strength, throw strength in particular, coordination and aerobic endurance, whereas female subjects showed better performance in the variables of flexibility and movement frequency, leg movement in particular. Study results showed the formation of appropriate motor system determining achievement of top results in swimming to be influenced by swimming training from age 11 to 14. In male children, motor system was found to integrate coordination/agility, aerobic endurance and explosive strength, whereas in female children it integrated coordination in terms of cortical movement regulation, aerobic endurance, explosive strength and psychomotor speed.     

Sir Francis Galton and proficiency testing in cytopathology

Data from the National Cytology Proficiency Testing Update show that as of January 31, 2006, 9% of 12,786 examinees failed the test on the first attempt. For the second attempt, the failure rate among those who had initially failed remained surprisingly similar, 10%, although common sense would dictate that it should be much higher among those who have already failed the test once and should have lower professional skills. What is the reason for this remarkable improvement in performance? There is a simple explanation: this is a statistical phenomenon, known as "regression toward the mean." Two groups of examinees earn failing scores during proficiency testing: those whose skills are really insufficient and those who are competent but who achieved lower scores due to random variation in the test results. The latter, "misclassified" examinees subsequently "regress" toward the mean during the second test; that is, their test results become more commensurate with their genuine skills. Since the failure rates of all participants during the first and second attempts were similar, we must assume that the majority of the examinees who failed on the first attempt fall into the second, misclassified group, and only a minority have truly insufficient skills.     

Chair rising exercise is more effective than one-leg standing exercise in improving dynamic body balance: A randomized controlled trial

A randomized controlled trial was conducted to compare the effect of a one-leg standing exercise and a chair-rising exercise on body balance in patients with locomotive disorders. Thirty ambulatory patients (mean age: 66.6 years) were randomly divided into two groups (n=15 in each group): a one-leg standing exercise group and a chair-rising exercise group. All the participants performed calisthenics of the major muscles, a tandem gait exercise, and a stepping exercise. The exercises were performed 3 days per week, and the study period was 5 months. Physical function was evaluated at baseline and at one-month intervals. No significant differences in the baseline characteristics were observed between the two groups. After the 5-month exercise program, the timed up and go, one-leg standing time, and tandem gait time improved significantly in the one-leg standing exercise group, while the walking time and chair-rising time in addition to above parameters improved significantly in the chair-rising exercise group. The improvements in the walking time, chair-rising time, and tandem gait time were significantly greater in the chair-rising exercise group than in the one-leg standing exercise group. The present study showed that the chair-rising exercise was more effective than the one-leg standing exercise for improving walking velocity and dynamic body balance.     

American society of maxillofacial surgeons outcome study: preoperative and postoperative neurodevelopmental findings in single-suture craniosynostosis

The purpose of this study was to prospectively determine the neurodevelopmental effects associated with single-suture, nonsyndromic craniosynostosis before and after surgery. Children diagnosed with single-suture craniosynostosis were evaluated by a psychologist using the Bayley Scales of Infant Development-Second Edition (BSID-II) within 2 months before and again 1 year after surgical correction. The BSID-II is a widely used measure of infant cognitive and motor development. The scale consists of three parts, the Mental Developmental Index (MDI), the Psychomotor Developmental Index (PDI), and the Behavior Rating Scale. The MDI and PDI yield age-standard scores (mean, 100; SD, 16). The children ranged in age from 2.5 to 10 months at the time of the craniofacial reconstruction (average age, 5.9 months). Metopic synostosis was diagnosed in 23 percent, sagittal synostosis in 45 percent, and unilateral coronal synostosis in 32 percent of patients. Twenty-two patients were evaluated preoperatively, of whom 15 patients were evaluated postoperatively. Mean baseline BSID-II scores revealed a mild delay in mental and motor scores (MDI, 82.3; PDI, 79.5). Mean postoperative BSID-II scores still revealed a mild delay in mental scores but significantly improved motor scores (MDI, 79.3; PDI, 89.3). Of the 15 children, four (27 percent) had BSID-II evaluations that were in the average range for all scales and nine infants (60 percent) had at least one MDI or PDI score in the significantly delayed range (<70). Among children with single-suture nonsyndromic craniosynostosis, mean Bayley scores indicated mild baseline deficits in both mental and motor scores. After surgical treatment, improvement was seen in the motor scale. It appears from this sample that neurodevelopmental abnormalities may be present in children with single-suture synostosis, and some may persist at 1 year of follow-up.     

Horses do not exhibit motor bias when their balance is challenged

In many equestrian pursuits such as dressage and show-jumping, it is important that the horse exhibits the same level of balance when ridden to the left as when ridden to the right in canter - that is, to show no motor bias. It is a long-held belief within such disciplines that to reduce bias that exists in horses and thus to enhance symmetry of performance to the left and right, the horse needs to be worked equally in both directions, although there is a lack of scientific evidence of this influencing bias. There also is little compelling evidence for either the existence or absence of motor bias in unridden (and therefore younger) or ridden (and therefore older) horses. In this study, we tested whether there was a difference in motor bias between unridden (n = 15) and ridden (n = 15) horses when their balance was challenged by cantering them in circles both to the left and to the right on the lunge. As indicators of a difference in balance between the left and right and thus as indicators of motor bias, we conducted three lunging tests - time spent in canter, whether the horse cantered on the correct lead and whether it became disunited. A grazing stance test, where the extended foreleg during grazing was recorded as the preferred forelimb, was also used to compare responses in a test where balance was not actively challenged, to the three lunging tests where balance was actively challenged. No bias was found in either the unridden or ridden groups when their balance was challenged, but ridden horses exhibited a motor bias in grazing stance - when their balance was not challenged. There was also a correlation between the responses in all three lunging tests, but none between the grazing stance test and any of the three lunging tests. We therefore conclude that neither ridden nor unridden horses are biased when their balance is challenged; thus it cannot be concluded that ambidextrous training affects an inherent bias, and that estimation of motor bias in horses is affected by the test conditions. Finally, if ridden horses are truly unbiased, strong human motor bias might be responsible for the common perception amongst riders that horses are biased.     

How good is general practice developmental screening?

All developmental screening in Somerset is performed by general practitioners and health visitors. A retrospective review of a cohort of 1504 7 year old children living in semirural Somerset found that the development assessment by a health visitor at age 3 1/2 years had a sensitivity of 45% for identifying the 103 children with special educational needs, whereas the sensitivity of the preschool examination by a general practitioner was 56%. There was no relation between results of preschool developmental assessment and later reading ability. Of the 23 children in special schools, 22 had been identified independently of the developmental screening programme before starting school. Intervention was started at a mean age of 1 year 5 months (range 2 months to 3 years) for children with severe learning difficulties, and 3 years 9 months (2 years 3 months to 6 years 6 months) for children with moderate learning difficulties. The preschool medical examination revealed fairly minor medical problems: 29 of 81 children referred for specialist opinions were shown to be medically normal, and for only seven of the medically abnormal children was information about their conditions given to their teachers. In Somerset screening the development of all children at predetermined ages has not been very useful.