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Research Studies

 

Metropolitan Atlanta Developmental Disabilities Study

The Metropolitan Atlanta Developmental Disabilities Study (MADDS) was the first U.S., population-based epidemiologic study of the prevalence of mental retardation, cerebral palsy, hearing loss, vision impairment, and epilepsy in school-aged children.

The MADDS was conducted as a cooperative agreement between the Division of Public Health, Georgia Department of Human Resources, the former Division of Birth Defects and Developmental Disabilities, National Center for Environmental Health, Centers for Disease Control and Prevention, and the Agency for Toxic Substances and Disease Registry.


PURPOSES:

  • To develop methods for the surveillance of developmental disabilities.

  • To establish prevalence rates of five developmental disabilities: mental retardation, cerebral palsy, vision impairment, hearing loss, and epilepsy.

  • To generate hypotheses for further study of risk factors for these five disabilities.

WHERE: Five counties in metropolitan Atlanta: Clayton, Cobb, DeKalb, Fulton and Gwinnett

WHO: Children born in 1975, 1976, 1977; ascertained at age 10 years, in school years 1985-1986, 1986-1987, and 1987-1988

Population statistics for metropolitan Atlanta (1985-1987): Ten-year-old children: Total 89,534

  • White: 56,082

  • Races other than white: 33,452

SOURCES OF CASE ASCERTAINMENT:

  • State of Georgia Department of Education - Nine public school systems

  • Department of Human Resources

  • Georgia Learning Resources System

  • Georgia Psychoeducational Centers

  • State Schools

  • Private Agencies

  • Hospitals/Clinics

  • Early Intervention Programs

  • CDC-Metropolitan Atlanta Congenital Defects Program

DEFINITIONS:

Developmental Disabilities

  • Group of severe chronic conditions, attributable to an impairment in physical, cognitive, speech or language, psychologic, or self-care areas.

  • Manifested during developmental period (up to 18-21 years of age).

  • Estimated to affect about 10% of school-aged children.

Mental Retardation

Intelligence quotient of 70 or less on the most recent psychometric testing performed by a psychometrist (standardized psychological tests)

Cerebral Palsy

Inclusive term that describes a group of nonprogressive disorders occurring in young children in which abnormalities of the brain cause impairment of motor function. The impairment of motor function may result in paresis, involuntary movement, or incoordination. Motor disorders that are transient, disorders that result from progressive diseases of the brain, and motor disorders due to spinal cord abnormalities or injuries are not included.

Hearing Loss

A bilateral, pure-tone hearing loss that averages 40 dB or worse unaided in the better ear at frequencies of 500, 1000, and 2000 Hz (normal speech range).

Vision Impairment

  • A measured visual acuity of 20/200 or worse in the better eye with correction, or

  • A description of visual acuity that reflects 20/200 or worse (e.g., light perception only), or

  • A statement by a trained person (e.g., ophthalmologist, optometrist, etc.) that a child is blind.

Epilepsy

A condition characterized by recurrent (two or more) epileptic seizures, unprovoked by any immediate cause. Multiple seizures occurring in a 24 hour period are considered a single episode. Individuals who have had only febrile seizures or only neonatal seizures are excluded.

PUBLICATIONS

National Center on Birth Defects and Developmental Disabilities (NCBDDD) staff have written scientific papers using information from MADDS.  These papers look at such topics as how common autism spectrum disorders are and what causes hearing loss in children.  You can see a list of these papers (starting in 1990) by using the keyword search on the NCBDDD publications Web page.  Choose "MADDS (Metropolitan Atlanta Developmental Disabilities Study)" in the keyword box on the search page.  You can choose whether you want the list to be sorted by author or by date.  You can also choose to have the list appear with or without graphics.  Click on the Submit button.  You will see a list of papers that have information from MADDS.  The list will include the complete reference for each paper and a link to an abstract of the paper or to the full text, when available.  [Go to NCBDDD publications keyword search page]

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Follow-Up Study of Children with Developmental Disabilities

In the mid-1980s, CDC conducted the Metropolitan Atlanta Developmental Disabilities Study (MADDS), a study of developmental disabilities (including cerebral palsy) in 10-year-old children living in metropolitan Atlanta. A comparison group of children who did not have any disabilities also took part in the study. The Follow-Up Study of Children with Developmental Disabilities contacted many of the original study participants years later, when they were young adults. They were asked questions about their health, living arrangements, socialization, employment, quality of life, service utilization, and independence. We have started analyzing the information collected in the Follow-Up Study and will be looking at such issues as what environmental factors (for example, wheelchair ramps) make it easier for young adults with disabilities to carry out their daily activities, pain among young adults with disabilities, use of health resources by young adults with disabilities, and obesity among young adults with disabilities. Study results will be posted on this Web site as they become available.  [Read more about MADDS]

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The Infant Development Study

Examining the Effects of Prenatal Magnesium Sulfate Exposure on the Risk for Cerebral Palsy in Low Birthweight Children

Background: In 1995, researchers with the California Birth Defects Monitoring Program, Cerebral Palsy Project, reported about an 80% lower prevalence of cerebral palsy among very low birthweight children (<1500 gms) whose mothers had been treated with magnesium sulfate during pregnancy, either for preeclampsia or preterm labor, in comparison with very low birthweight children whose mothers were not treated with the drug.1 Subsequently, researchers in the Developmental Disabilities Branch also reported an apparent protective effect of prenatal magnesium sulfate exposure on the risk for cerebral palsy or mental retardation among very low birthweight children, based on information obtained through the Metropolitan Atlanta Developmental Disabilities Surveillance Program (MADDSP) and the Georgia Very Low Birthweight Study.2These preliminary studies, based on small numbers of children, prompted DDB researchers to conduct the Infant Development Study (IDS) involving a much larger group of children.

Description: The Infant Development Study (IDS) is a case-control study to investigate the apparent protective effect of prenatal magnesium sulfate exposure on the risk for cerebral palsy among low birthweight children. Over 200 children who have cerebral palsy, who were born in the 5-county metropolitan Atlanta area from 1981 through 1989, and who weighed less than 1750 grams at birth, were selected as age subjects for the IDS from MADDSP 1991-92 surveillance records. A sample of over 300 control children born during the same time interval were randomly selected from vital record files of the Georgia Department of Human Resources, on the basis of birth weight and plurality. For each child included in the study, information on selected maternal and infant characteristics was abstracted from the hospital admission and labor and delivery records of the mother and the newborn records of the child.  This information included: maternal treatment with magnesium sulfate and selected other drugs (other tocolytics, steroids and antihypertension medications) during pregnancy; the presence of preeclampsia, hypertension, proteinuria and other maternal medical conditions during pregnancy; characteristics of labor and delivery; and characteristics and medical course of the newborn. The large numbers of affected children included in the IDS will permit researchers to carefully examine many of the factors that might explain why maternal magnesium sulfate treatment during pregnancy appears to protect very low birthweight infants from developing cerebral palsy.

References:

1. Nelson KB, Grether JK. Can magnesium sulfate reduce the risk of cerebral palsy in very low birthweight infants? Pediatrics 1995; 95:263-269. (Abstract)

2. Schendel, DE, CJ Berg, M Yeargin-Allsopp, CA Boyle, P Decouflé. Prenatal magnesium sulfate exposure and the risk for cerebral palsy or mental retardation in very low birthweight children aged 3 to 5 years. JAMA 1996; 276:1805-1810. (Abstract)

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The Children's Longitudinal Study (CHILD Study)

Developmental disabilities are lifelong conditions and, in many children, may be sufficiently severe to require specialized medical and educational services for many years. In most cases, the etiology of the disability is not well understood, although the prenatal and postnatal environments are felt to play an important role. The Developmental Disabilities Branch is implementing The Children’s Longitudinal Development Study (CHILD Study), an ongoing case-control study in which detailed information will be obtained on pre- and perinatal medical conditions and suspected risk factors for select disabilities in children identified through the Metropolitan Atlanta Developmental Disabilities Surveillance Program (MADDSP). The CHILD Study will expedite special epidemiologic studies by establishing a data base of medical and risk-factor information on a large, population-based series of children with select disabilities and/or control children.

The parents of young children under the age of 7 years who have one or more select disabilities and who were identified through MADDSP will be invited to participate in the CHILD Study. The information obtained for each participant will be gathered from both medical record review and parental interview. Thus, in addition to the diagnostic, medical and educational service information that is routinely collected on each child as part of MADDSP, detailed maternal and infant information will be abstracted from the hospital admission and labor and delivery records of the mother and the newborn records of the child.  This information includes: maternal medical conditions and treatments during pregnancy, characteristics of labor and delivery, and characteristics and medical course of the newborn. Information collected from the parental interview will include demographic information; the medical, reproductive, and prenatal exposure history of the mother; and any family history of developmental problems.

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This page last updated Thursday, August 05, 2004

 

 


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National Center on Birth Defects and Developmental Disabilities

The National Center on Birth Defects and Developmental Disabilities (NCBDDD) promotes the health of babies, children, and adults, and enhances the potential for full, productive living.  Our work includes identifying the causes of birth defects and developmental disabilities, helping children to develop and reach their full potential, and promoting health and well-being among people of all ages with disabilities.