Outcomes: The Importance of the Long View

The Importance of the Long View Or
Why Medical News Keeps Changing Sides

We have all experienced the confusion, and at times aggravation, of being told one thing about a medical risk factor today, only to be told the opposite tomorrow.  Today coffee causes bladder cancer, tomorrow it does not.  Today sunlight is harmful, tomorrow it is beneficial.  And so it goes for so many, many items.

An article published in the July, 2011 issue of our lead journal, Pediatrics, helps all of us think about how to judge how things really turn out.  http://pediatrics.aappublications.org/content/early/2011/06/29/peds.2010-2782.full.pdf+html

The article looked at  1245 children whose speech developed at the usual rate, and about 142 children who were considered a bit slow to gain speech abilities by age 2.  The standard was being able to say 50 single words and say 2 or 3 word phrases.

Here is where it gets interesting.  If you looked at the 2 year olds, the ones with slower acquisition of speech skills had more behavioral and emotional problems than the typical group.  Had the study stopped there, you would seen in the news that kids who develop speech more slowly have more behavioral and emotional problems.  Two year olds who could not say 50 words would suddenly become deemed abnormal.

But this study looked at these children for many years and measured behavioral functions at ages 5, 8, 10, 14, and 17 years old.  In each instance, no difference between those kids who could say 50 words and those who could not was seen at ages 5, 8, 10, 14, and 17!  Thus, there is nothing abnormal about learning to say 50 words after age 2.

A similar problem is seen when looking at the impact of ear infections on speech development.  If you look at 2-3 year olds, you will find frequent ear infections are associated with a slow down in language development.  But if you look at the same group at age 7 or older, you cannot tell which children had any ear infections, the groups' language development became equal! 

Always look at the timeline when judging outcomes.  Some outcomes take a while to see.  Abnormalities are exaggerated when too short a time is given for people to develop.  When one looks at too short a time frame, many more children get pegged as abnormal who actually will turn out to be quite normal, quite fine.

Dr. Arthur Lavin

Disclaimer* The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

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