MATERNAL RATING OF CHILD HEALTH AT SCHOOL-AGE - DOES THE VULNERABLE CHILD SYNDROME PERSIST

Objectives. To assess the extent to which parental ratings of child health, including perceived vulnerability to illness, are associated with current and past health events and sociodemographic characteristics of the family and the child. Design. Prospective cohort study of children aged 8 to 10 years previously assessed in infancy in two multi-site studies. Setting. Thirteen sites largely in eastern United States. Participants. 1877 children representing 65% of those originally selected for follow-up from the two previous studies. Participants were specifically selected on the basis of birth weight so that more than two-thirds were low birth weight. Measurement. Parental interviews at school age including measures of several dimensions of child health and sociodemographic characteristics of the family. The former included a six-item scale assessing parental perceptions of child health overall, and on subscales assessing child current health, previous health, and resistance or susceptibility to illness. Data on health problems at birth were derived from previously collected birth certificates, medical records, and interviews. Main results. Although overall parental perceptions of child health reflected both current and past health events, a clear distinction emerged. Parental rating of current child health and resistance or susceptibility were associated with current child health problems, not events in infancy including very low birth weight. Nonwhite race and maternal rating of her own health also influenced maternal rating of child health. Conclusion. The results do not support the persistence of a vulnerable child syndrome, as health in infancy does not affect maternal rating of current child health at school-age in the absence of current health problems.