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Although this book provides the reader with helpful hints about practice routines such as scheduling, charges, consultations, and the use of the telephone, it is rather a statement of the conventional wisdom which is supposed to transpire between the well patient-family complex and the pediatrician. Dr. Oberst and his colleagues have sharpened the blade of anticipatory guidance to a razor's edge and their methods should be known to all practicing child health specialists. Their system includes a mountain of literature, evening lectures, periodic questionnaires, frequent visits, and community involvement.

The infant and child health and welfare services in Britain were conceived and grew in an era when poverty and ignorance were commonplace; when most women thought it natural that a considerable proportion of the babies they brought into the world should die before they were old enough to know that they were alive. Now in terms of individual experience the loss of a baby is a rarity, and the hard core of infant mortality rests with small or deformed children whose chances have been slim from the outset. It is therefore natural that searching inquiries should be made on whether expensive facilities concerned with routine medical care of babies and small children are still necessary and, if so, what shape they should take. Such inquiries could be directed towards the most efficient method of dispensing prophy lactic vaccinations and inoculations, to the problems of advising on infant management, to the most efficient methods of pre-symptomatic diagnosis, and so on. The present paper, however, confines itself to a study of the attitudes of some mothers to the existing services. Mothers, after all, are not only the customers but in the last resort the people in whose hands the health of the baby lies. Methods

Summary.-Animal research has adopted no standards for lighting practices. One consequence is that light intensity is either unreported or often improperly measured, even in experiments primarily concerned with light. This article tells how to measure and report light intensity and discusses the relative advantages of different kinds of light sources and lighting geometry. Roughly a hundred articles about the motivating properties of light have been published in the last decade. In a few of these, light intensity was reported in a helpful way (e.g., Stewart, 1960). But the vast majority of articles reveal a most casual concern for the stim~ilus whose effects were allegedly investigated. One often finds either a conspic~io~is absence of statements about lighting geometry and light intensity or an amateur discussion of irrelevancies. Also common is a meaningless confusion in which a photometric term is paired with an incompatible unit, as illustrated in a paper (reference withheld) stating "The intensity of illumination was one millilambert." The net result of chis variety of shoddy measurement and reporting practices is to make private what should have been public, namely, the physical value of the stimulus. Since it is quite clear that different light intensities produce different behavioral effects (Lockard, 1963), the "location" of the experiment along an easily measured continuum should be divulged. If it is not, the results of the experiment are not anchored to stimulus conditions and merely demonstrate that a particular effect can occur at some unknown and unduplicable combination of conditions. The experiment cannot be fitted into the fabric of scientific knowledge and cannot be replicated; and the results are, therefore, safe from expose if they are a Type I error. Any collection of such studies soon generates apparent but unresolvable inconsistencies, unresolvable because levels of variables other than light intensity are usually in doubt when one compares different studies. The artful reviewer can juggle the discrepancies in a multidimensional private calculus of guesswork, attaching effects to conditions; but this was the experimentalist's job. Had the experimentalist appreciated the rudiments of photometry, subsequent literary efforts could turn from guesswork about treatment effects to informative summarizing. 'The preparation of this paper was made possible by Grant No. HD 00942 from the National Institute of Child Health and Human Development. The content of the paper is largely from Chapter I, Basic Methodology, by J. B. Sidowski and R. B. Lockard, in Experimental Methods and lnstrumen!a!ion in Psychology, edited by J. B. Sidowski, McGrawHill, New York, 1966. The author is grateful to both J. B. Sidowski and the McGrawHill Book Company for their permission to draw upon copyrighted material.

This publication is a compilation of 15 papers presented, plus a skit and a panel discussion, at the Inservice Training Course on Health Supervision of Children held in Ann Arbor on June 16-17, 1959. The course was held for health personnel in Michigan, and was planned jointly by the faculty of the University of Michigan School of Public Health and by staff members of the Michigan State Department of Health. A course such as this reflects the increasing interest of schools of public health in providing continuing education for public health workers, in cooperation with health departments. The papers present content on the various areas of concern on the part of health personnel working with mothers and children. The topics covered include horizons in child health; the status and needs in child health in Michigan; the health department and the family; planning priorities in child health supervision; health supervision of the adolescent; health supervision as a means of improving family health; nutrition; oral health of children; screening tests; application of the principles of growth and development to health supervision of children; and meeting the emotional needs of the young child. The skit presented wvas that of activities in the well child conference related to the admission of an infant and her mother, and to the postconference counseling of the mother by the public health nurse. The panel discussion consisted of a multidisciplinary team discussing family counseling. Unsolicited reviews cannot be accepted.

Read before the Society, 18 May 1973, This paper presents the results of an inquiry into the influence of a number of social factors on certain growth and development parameters, based on an investigation of 412 Dublin city children aged between four and seven years, carried out in 1971. The social factors considered in this paper are size of family, standard of home conditions and occupation of father while the criteria used to measure child growth and development are height and weight. Other factors of more medical interest, such as birth weight, length of stay in hospital etc., were also studied and other measurements, also of a more medical character (such as skinfold thickness), were also taken in the course of this inquiry; the results of these analyses will be presented elsewhere.

This paper reports further results on a research project that was designed to examine the development of stop consonants occurring in initial position in the vocalizations of children primarily during the second year of life. A previous paper [M. Preston, G. Yeni‐Komshian, R. Stark, and D. Port, “Certain Aspects of the Development of Speech Production and Perception in Children,” J. Acoust. Soc. Amer. 46, 102 (A) (1969)] presented results for apical stops. This report deals with the results for labial and velar stops over the same time period. The principal measure employed in the analysis is voice onset time (VOT), a perceptually and productively relevant measure, which can be easily obtained from spectrograms. In addition, a more complete analysis of apical stops comparing VOT distributions of adults with children between 2 and 212 yr is presented. [Research supported in part by the National Institute of Child Health and Human Development.]

When this column presented the paper by Dr. Lowe on "Observations on the Care of Children in Afghanistan," there was considerable interest in the rather unusual conditions presented. The way children live and are cared for in other countries of the world interests pediatricians, both because of their catholic interest in child health and the possible lessons to be learned from such a study which can be applied in one's own situation. Dr. Robinson has been serving as Consultant in Maternal and Child Health in the Regional Office for South East Asia of the World Health Organization, one of the most populous regions in the world. India itself, as Dr. Robinson indicates in the cold figures of his opening paragraph, has a population larger than that of the 21 American republics, that is of North and South America combined. It is clear that variations within the region must be great and that generalizations must be made with great care.

This paper describes a pilot program in Pennsylvania to develop a link between the community and the State in program planning for children diagnosed as brain-damaged, retarded or emotionally disturbed. Through the vehicle of a comprehensive diagnosis by a multidisciplinary team, the Eastern Pennsylvania Diagnostic and Evaluation Center program was able to shed light on a number of related problems in the fields of child health, education, welfare and child psychiatry.

Summary The “exceptional child” presents a challenge to the diagnostic acumen of every physician, psychologist, orthopsychiatrist, and educator who must contribute toward the satisfactory home and school adjustment of this child. An effort has been made in this paper to correlate material from diversified fields all interested in understanding and treating the behavior deviations of children. Emphasis has been placed upon physical abnormalities which directly or through their psychogenic implications affect the child's behavior to produce what is termed the “hyperkinetic child”. It is incumbent upon every physician to conscientiously evaluate the importance of these physical aberrations as they may or may not contribute to the children's behavior disorders. When the physician is satisfied that the sum of minor or major physical abnormalities does not constitute the etiology of the disorder, he should frankly search for psychogenic factors or refer to those physicians or agencies where examinations can be made to ascertain and deal understandingly with these features of conduct. He should not be among those who contribute to the “miscomprehensions of parents concerning child health and behavior”—a subject so recently studied and reported by Jacques 22 from the Harvard University Psychological Clinic.

In previous publications of this series (Subrahmanyan, Murthy & Swaminathan, 1954; Murthy, Swaminathan & Subrahmanyan, 1954) we reported that: (I) replacement of 25 % of rice in a poor rice diet by tapioca flour did not affect the overall nutritive value of the diet as judged by the growth of young rats, and (2) the retention of calcium in adult human beings on a rice-tapioca diet was greater than that observed on a rice diet; the retention of nitrogen was of the same order on both the diets. The present paper describes the results of an experiment carried out to study the effects on the growth and nutritional status of children of replacing 25 % of rice in a poor rice diet by an equal quantity of tapioca flour.

One of the main objectives of the Oxford Child Health Survey was to study the effects of environment on physical development (Ryle, 1948), and of the two dozen papers which have so far appeared six have dealt with this topic (Hewitt and Stewart, 1952; Acheson, 1952; Stewart and Westropp, 1953; Westropp, 1953; Acheson and Hewitt, 1954a, b; Acheson and Jefferson, 1954). The form that these studies have taken has varied considerably, since methods which are able to detect continuous influences cannot always be applied to the study of influences which operate for short periods or intermittently. In one of the earlier studies measurements of standing height and skeletal maturity at various ages were correlated with economic conditions (Acheson and Hewitt, 1954a). This relatively simple treatment of the data was justified because the number of children whose social background (as judged by the father's occupation) changed during the survey was negligible. Therefore the total measurements, which represented life increments of growth (i.e. height) and development (i.e. skeletal maturity) were appropriate to the analysis. That is to say, the study was focussed on a continuous influence which it was reasonable to suppose would be reflected in increases of certain types of body measurement.

This paper represents an initial at tempt to spell out some of the areas which will be given major emphasis by the Behavioral Science Program of the Growth and Development Program, Na tional Institute of Child Health and Human Development (NICHD).2 Al though the Institute feels that these areas are among the most important ones relating to its current program in terests, these suggestions are to be re garded as permissive and not control ling. The Institute will be constantly alert to, and willing to support a num ber of, high-risk projects in which the probabilities of payoff are not great, but in which payoff, if it does occur, would make an exciting, important, and mean ingful contribution to the understanding of human growth and development. A full understanding of human growth and development demands the coopera tion of investigators in a wide variety of fields. The Growth and Development Behavioral Sciences Program will be receptive to grant applications relevant to its concerns from persons in a variety of disciplines, including anthropology, sociology, psychology, child develop ment, political science, and many others. Proposals will be supported if they meet

to growth during the first year of postnatal life. A majority of the babies (702) came from one private and two municipal welfare clinics in the city; the remainder (580) attended the Institute of Social Medicine. The latter are also enrolled in the Child Health Survey and are the subjects of a more intensive study of growth and development during the first five years of life (Thwaites, 1950). The babies attending the Institute of Social Medicine were seen for the first time at 4 weeks, and again at 3, 6, 9, and 12 months. The remainder were brought to the clinics at monthly intervals. Since the two municipal clinics were held in the same room but on different days, only three different weighing scales (balance type) were used. Four persons were responsible for the records, but each baby was supervised by the same person; they were weighed naked on the same scales, and the weight was recorded to the nearest whole ounce. Although the mothers often failed to bring their children on the appointed dates, in most cases the first visit, due at one month, did not vary by more than a week from the correct day, and those due at 3, 6, 9, and 12 months were rarely more than two weeks too early or too late. In the exceptional cases an estimated weight for the correct date has been obtained from a curve drawn through the five recorded weights. In the result, the weights used in this paper have been derived from actual weighing and from graphic estimation in the following proportions

To the Editor .—We read the article, "Competence of Child Health Associates," by Machotka et al ( Am J Dis Child 125:199-203) with interest. At present the medical profession is under pressure to assure the public that all those who are involved in the delivery of health care are competent (defining competency as having the necessary cognitive, psychomotor, and affective abilities to perform the tasks assigned to an individual within the health care delivery system). To determine the cognitive competency of allied health professionals is, therefore, a highly desirable objective. However, it is essential that research intended to compare the knowledge of various groups of health professionals be as sound as that used in comparing the effectiveness of drugs or different diagnostic procedures. When the authors of the above paper state that their report "documents the extent, adequacy, and relevance of the child health associates' basic science training and knowledge of

This book, a compendium of papers presented at an international symposium supported by the National Institute of Child Health and Human Development and the Population Council, presents a synthesis of modern knowledge regarding the role of the cervix in reproduction and emphasizes areas that require future investigation. Thirty authors have contributed 24 chapters. Major topics considered are embryology, anatomy, and histology of the cervix; biochemical and biophysical studies of cervical tissues and secretions; and the effects of fertility, pregnancy, and contraception on the cervix. Blandau has contributed an important and intriguing chapter on sperm transport through the mammalian cervix and Moghissi has complemented this with a chapter on sperm migration through the human cervix. The chapter on the effects of oral contraceptives on the cervix is of practical importance and clarifies much of the misleading data published during the past decade. Biodynamics of the cervix during pregnancy and labor is

Although the supplementary value of copper with iron as a necessary catalytic agent in the formation of hemoglobin in experimental animals is generally accepted, some investigators feel that this has not been proved satisfactorily for infants. Since we found that approximately 21 per cent of the infants brought to the child health centers of Madison, Wis., during the past year tended to become anemic during their first year of life, the problem of the most efficacious method of treating anemia seems to be one of utmost importance. This report compares the effect of iron alone as a therapeutic agent with that of iron supplemented with copper. In a recent paper, Elvehjem, Siemers and Mendenhall 1 showed that iron plus copper therapy caused an increase in the hemoglobin content of the blood from between 9 and 11 Gm. to 12 and 13.5 Gm. per hundred cubic centimeters. However, Mackay 2 reported

This paper reviews the results of several research projects that have examined the developing capabilities in children for producing and perceiving speech sounds. Most of this work has been carried out with children between the ages of 1 and 5. Particular attention has been directed toward the development of stop consonants as they occur in syllable initial position. Such sounds occur early in the vocalization of infants and are characterized by easily identifiable acoustic features critical for differentiating stops along the dimensions of voicing (voice‐onset time). The projects to be reported in detail include a longitudinal study of productive capabilities in normal and hearing‐impaired children, and a cross‐language study (English and Arabic) of perceptual capabilities in normal‐hearing children. [Research supported in part by the National Institute of Child Health and Human Development.]

The student of child behavior recognizes that there is considerable community of ideas, as expressed in speech, among children in nursery school groups. Children tend to talk about the same things and in much the same terms, but whether or not these common verbal responses are attributable to the cultural contagion of a common environment is hard to determine in a nursery school setting. Similarity in the verbal responses of children who have not enjoyed association with their peers except through informal neighborhood play may throw some sidelights upon the extent to which the cultural background of young children is standardized even in the absence of schooling of any sort. The object of this paper, therefore, is to examine some of the responses commonly made by children between the ages of two and five, as to the frequency with which certain concepts are mentioned, the sex and age differences that obtain in the expression of them, and the function they may serve in the child's adjustment to his world. It is to be hoped that analysis will reveal which responses are common by virtue of their being expressions of common needs and wants of the child, and which are merely a product of early culturization; in other words, which are outgrowths from within the child's own body, and which are superimposed from without. The records used in this analysis are diary-type accounts of the child's all-day visit to a health center in the course of which he is subjected to a number of examinations with periods of rest, play and a meal interspaced. The record contains a verbatim account of the child's speech during a thirty to forty-five minute play period, together with briefer notes on the child's behavior upon arrival at the Center, at examinations, at meal and at rest. These records are obtained at six months' intervals on each child on the occasion of his regular visits to the Center for Research in Child Health and Development.2 Visits occur within a week of the half-yearly birth date; hence, there is no ambiguity in the age grouping of children. For the present study 336 such records of the child's day are used, 168 of each sex, distributed by ages as follows: 20 records at two years, 40 at two and one-half, 50 at three, three and one-half and four years, 60 at four and one-half and 66 at five years. No age level is entirely discrete as to personnel, however, as there are from one to four records on each child. Hence, the records of a given child may be tabulated at four successive age levels. Because of this overlapping of cases, age differences will not be emphasized in the discussion.

Eight years ago I saw Sir James Spence's charming paper, The Methodology of Clinical Science , which, despite its rather formidable and harsh title, was a scholarly critique of the problems of clinical investigation, clinical research, teaching, practice, and administration in the hospital and university setting. Although his background was that of a pediatrician, one of the first specializing in this field in Great Britain, his message was applicable to any branch of clinical medicine and had important implications for the basic sciences as well. As the first whole-time professor of child health in Great Britain, his influence was spread widely throughout the English-speaking world, the United States and the British Commonwealth as well as the British Isles. Though he had an inquisitive and critical mind, there was none of the cold reserve which made Sir Thomas Lewis so aloof and which may explain his wish to separate the function of

Although this volume, which is the report of a recent symposium held in London under the auspices of the CIBA Foundation, would be of greatest interest to laboratory workers in virology, it should also be available for reference reading to anyone concerned with problems of infectious disease. The participants at this symposium were principally from England but there were also a scattering of others from the United States, Germany, Russia, France, and Czechoslovakia. The book contains thirteen individual chapters which are actually the formal papers read by the authors, and following each manuscript is added the recorded discussion of fellow participants.

Recent work at Haskins Laboratories suggests that the time interval between the release of air pressure and the onset of voicing is an effective measure for sorting initial stops into phonemic categories. In general, it appears that three positions along the continuum of voice‐onset time may be utilized: 70–100‐msec voicing lead; 0–30‐msec voicing lag; and 50–110‐msec voicing lag. English utilizes the two voicing‐lag positions while Arabic makes use of the voicing‐lead and short‐voicing‐lag positions. This paper reports the results of a cross‐language study of voicing in initial stops occurring in the prelinguistic vocalizations of three English and three Arab infants all between 11 and 14 months of age. In addition, data obtained six months after acquisition of a hearing aid are presented for two 24‐month‐old severely deaf English children. (Investigation supported in part by the National Institute of Child Health and Development.)

This paper examines the relation between the height of children, the size of family from which they come, the social and educational background of their parents, and the age at onset of puberty. The 1,557 boys and 1,456 girls included in this analysis are all those from the National Survey of Child Health and Development' who were measured at seven, eleven, and fifteen years, and whose stage of sexual maturation was described by the school doctors at special medical examinations given at the last two of these ages. A full description of the National Survey is given elsewhere.2 In brief, the sample consists of all the children of nonmanual and agricultural workers born in Great Britain during the first week in March 1946, and one quarter of the children born during that week to wives of manual workers and to those of self-employed men. Illegitimate children and twins were excluded. For the purpose of this study, the boys and girls were grouped in three ways. First, by the number of brothers and sisters they had