Dr. Barnett: The patient to be presented and discussed by Dr. Taft and by Dr. Sobel provided a series of perplexing problems relating to diagnosis, treatment and prognosis. Some of the questions raised have been answered but others relating particularly to prognosis and future treatment remain. To preserve the chronologic order of the problems as they were presented to us, the presentation will be introduced by Dr. Taft, to whom the patient was referred initially because it was believed that the primary difficulty was one of mental retardation.
Dr. Taft (Assistant Professor of Pediatrics): This infant, at the age of 18 months, was referred to the Developmental Evaluation Clinic by his private physician. The physician had requested an investigation to determine why the infant was slow in psychomotor development and why he was obese.
The relevant history revealed that this was the mother's first pregnancy which was uneventful. Except for vitamins no other medications were taken during the gestation. The delivery and the immediate post-natal course were unremarkable. The patient weighed 5 lb 4 oz at birth.
During the neonatal period the infant was extremely apathetic and listless. He sucked poorly. At 6 weeks of age he was hospitalized for bronchopneumonia.
From the history, his motor development was delayed. He gained head control at 6 months; rolled over at 8 months; and sat unsupported at 1 year of age. He followed objects at 4 months; spoke single words at 1 year; and had conditioned tricks at 13 months.
At approximately 8 months of age it was noticed by the parents that the patient was gaining weight rapidly and had a spurt in linear growth. At this time his appetite became ravenous.
- Copyright © 1959 by the American Academy of Pediatrics