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Selected Abstracts from Pediatrics Esther K. Sleator and Rina K. Ullmann, Can the physician diagnose hyperactivity in the office? (67:13-17,1981) Office diagnosis of hyperactivity can present a problem to the pediatrician because only about 20% of the potential patients show hyperactive behavior during office examination. Exclusion of the children who appear normal in the physician's office can eliminate from medical treatment a large number of patients for whom treatment is appropriate. Eighty percent of the children ultimately accepted into the project on the basis of home and school reports showed exemplary behavior and no sign of hyperactivity in the office. Nonetheless, at a three-year follow-up, these children were rated the same as whose who were obviously hyperactive in the presence of the pediatrician. The groups appeared no different on school grade, teachers' ratings of classroom behavior, amount of stimulant medication prescribed, or duration of drug treatment. The reported outcome data indicate that the physician can have confidence in historical information from the parents combined with current teacher reports as reliable aids in the diagnostic process with hyperactive children. Stephen P. Herman, Gunnar B. Stickler, and Alexander R. Lucas, Hyperventilation syn- drome in children and adolescents: long-term follow-up (67:183-187, 1981) Records of 34 hyperventilating children aged 18 years or younger seen at the Mayo Clinic over a 25-year period were reviewed. Five different clinical subtypes were identified. Evalu- ation and treatment varied considerably. At follow-up, 40% were still hyperventilating as adults, and many had signs and symptoms of chronic anxiety. Hyperventilation in childhood can be a signal that the child is experiencing severe anxiety, which may persist into adult- hood. Olle Jane Z. Sahler, Elizabeth R. McAnarney, and Stanford B. Friedman, Factors influencing pediatric interns' relationships with dying children and their parents (67:207-216, 1981) Events and feelings immediately surrounding the deaths of children in the hospital were in- vestigated in order to identify factors that might influence a house officer's ability to relate in a personally satisfying way to dying children and their parents. Open-ended interviews with the involved interns and their supervising residents were conducted within 36 hours of the deaths of 31 hospitalized children to gain insight into the reactions and responses of new physicians managing terminally ill patients. Interns' relationships with children who were fa- tally ill appeared to be influenced by two factors: the child's age and the child's neurologic status. The interns' relationships with parents reflected their attitudes toward the children but were also affected by the duration of the illness, especially in instances when the patients were comatose or severely impaired. Senior medical staff awareness of the age and respon- siveness of dying patients and the duration of their illness can help to provide case-specific guidance and support to the interns. Such support may help prevent that excessive dis- tancing or overinvolvement that can impair the interns' abilities to provide optimal emotional support to patients, the families, or themselves. Raymond S. Duff, Counseling Families and deciding care of severely defective children: a way of coping with "medical Vietnam" (67:315-320, 1981) 889
