I I I I LETTER TO THE EDITOR

I I

Dear Sir:

Re: Article The Value of Electroencephalogram I n Evalu- ating Children Wi th Minimal Cerebral Dys- function. Journal of School Health, Jan. 1971

I believe that the authors have come up with some good statistics on which to base their con- clusions. The EEG is an expensive test and should be ordered cautiously and the procedure should be carried out only upon the recommenda- tion of the physician.

I take sincere exception to the listing of school nurses, however, as one of the group who make referrals for EEG, “in order to rule out brain damage.” The author of this quote is saying that a nurse has made a diagnosis of brain damage and either wants the diagnosis confirmed or ruled out. School nurses do not make diag- noses. They note symptoms and refer to the family physicians. Nurses are taught very early in their training that they have a place profes- sionally and a job to do, and that job does not include making diagnosis. I have been in school nursing for 16 years and have yet to make a referral to anyone for an EEG. Neither have I made any diagnosis of minimal, or any other type of, brain damage.

Sincerely, Virginia Warren, R.N. (Mrs.) 720 Lees Drive Las Cruces, New Mexico 88001

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An expanded program for the retarded at a Temple University facility not only offers treat- ment for organically affected children, but also tries to reach children who act retarded but are not.

Children mislabeled retarded are being diag- nosed and treated at six locations by the uni- versity’s Community Mental Health/Mental Re- tardation Center, according to L. Wayne Higley, director of mental retardation services.

Preventive care is offered through a home train- ing program which teaches mothers the signs of potential retardation along with methods for stimulating their children’s development.

The incorrect labeling of cliildrcu as retarded sometimes occurs after they arrive a t school lacking toilet training and without iiumbers, color, or language skills. Such labeling can be- come a self-fulfilling prophecy as the school, the home, and the child himself establish low expec- tations for him, Mr. Highley said.

Teachers are also being offered guidance so they can refer children to the center and then participate in programs to aid these children. (“Those Mislabeled Retarded Offered Aid in Program,” in Pediatric News, Vol. 5, No. 3, March, 1971)

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Sniffing airplane glue and other solvents may lead to chromosome injury, according to a Canadian research group.

The evidence comes from a series of tests on some 30 boys (mean age 14) from Toronto who had been charged with sniffing.

In studying 780 cells from 14 patients there were 35 gaps, 13 breaks,and two complex chromo- somes-the “extremely rare” quadriradial and triradial. This gives an abnormality rate of six percent. In chromosomes from eight controls there were six gaps but no breaks or abnormal chromosomes-an average abnormality rate of two percent.

Said Thomas Tyley, MD, the physician who directed this part of the study, “The presence of 13 chromosome breaks and two complex chromo- somes in the patient group and none in the con- trol group of similar age background would appear to be definite evidence of chromosome damage. The significance of 35 gaps in the patient group has yet to be established. The finding is unusual in normals.”

The psychological aspect of the series shows one variable between the sniffers and the controls who were taken from the same public housing area. In only one case of the 24 examined did a sniffer have a meaningful relationship with his father. In every other case the father was absent either physically or psychologically from his son’s life. In the glue sniffing group 54.4 percent were not living with both parents as compared with 20 percent in controls . . . . (“Chromosome Damage from Glue Sniffing,” in A M A Health Education Service For Schools and Colleges, Volume 9, Number 4, April, 1969) (“Glue Sniffiing May Alter Chromosomes,” in Journal of the American Medical Association, February 24, 1969)

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T h e Jorirnml o j School Health-Septemher, 1971 305