Short-chain acyl-CoA dehydrogenase (SCAD) deficiency: an examination of the medical and neurodevelopmental characteristics of 14 cases identified through newborn screening or clinical symptoms.

The medical and neurodevelopmental characteristics of 14 children with short-chain acyl-CoA dehydrogenase deficiency (SCADD) are described. Eight were detected as neonates by newborn screening. Three children diagnosed on the basis of clinical symptoms had normal newborn screening results while three were born in states that did not screen for SCADD. Treatment included frequent feedings and a low fat diet. All children identified by newborn screening demonstrated medical and neuropsychological development within the normative range on follow-up, although one child had a relative weakness in the motor area and another child exhibited mild speech delay. Of the three clinically identified children with newborn screening results below the cut-off value, two were healthy and performed within the normal range on cognitive and motor tests at follow-up. Four clinically identified children with SCADD experienced persistent symptoms and/or developmental delay. However, in each of these cases, there were supplementary or alternative explanations for medical and neuropsychological deficits. Results indicated no genotype-phenotype correlations. These findings suggest that SCADD might be benign and the clinical symptoms ascribed to SCADD reflective of ascertainment bias or that early identification and treatment prevented complications that may have occurred due to interaction between genetic susceptibility and other genetic factors or environmental stressors.

Predictors of stress in adolescents: an exploratory study of pregnant and of parenting females.

PIP: A study of 152 adolescents enrolled in school-based programs for pregnant and parenting youth in Colorado in 1987-88 found no differences in overall stress levels between these two groups; however, salient predictors of stressful life events for pregnant teens were not the same as those for teen mothers. The mean age of study subjects was 16.5 years (range 14-19 years); most were living with a parent rather than the child's father. The dependent variable, level of stress, was measured through use of an abbreviated Life Events Questionnaire. Independent variables were assessed through administration of the Inventory of Social Supportive Behaviors, Rosenberg Self-Esteem Scale, and the Adolescent Coping Orientation for Problem Experiences scale. Of the 5 sources of stress measured (family, accidents, autonomy, deviance, relocation, and distress), only stress related to accidents differed significantly between pregnant and parenting adolescents. For pregnant adolescents, self-esteem was the only significant predictor of the overall level of stress; among parents, the only significant predictor was objective social support. Among adolescents, self-esteem was associated with more frequent use of social support and coping strategies. For parenting adolescents, self-esteem was correlated with the frequency of use of social support, satisfaction resulting from such use, and frequent use of coping strategies. Overall, the independent variables of social support, self-esteem, coping, and age were stronger predictors of stress in pregnant than in parenting adolescent females. This finding suggests that parenting teens may have successfully negotiated the multiple transitions involved in this new stage of the life-cycle. An important implication of this study is the need to design separate counseling components of school-based programs for pregnant versus parenting adolescents rather than to use a single curriculum.^ieng

Birth order and self-concept in adolescence.

The effect of birth order on self-concept was examined in a sample of adolescent boys and girls. Based upon self-theory, which suggests that the two main processes of self-concept formation (e.g., reflected appraisals and social comparisons) are affected by the power and role relationships associated with ordinal position in the family, several hypotheses were tested: (1) The self-evaluations of only and oldest children are more positive than those of younger siblings; (2) middle-borns have the lowest self-evaluations; (3) these relationships are affected by the sex and spacing of nearest sibling; and (4) the self-conceptions of oldest and only children are more similar to those of their parents than the self-conceptions of younger siblings and their parents. Using analysis of variance and several different measures of self-evaluation, very little support was found for any of these hypotheses. The strongest support was found for the hypothesis on middle-borns, but even these relationships were not large. Several explanations are offered for these weak and inconsistent findings.