Torsion of the spermatic cord

Handicap in childhood is a worldwide phenomenon that is gaining an increasingly high priority as a health problem in developing countries. In Montserrat, prior to 1988, no attempt to define the prevalence, range or severity of handicap had been made. During February to April 1988, a programme of developmental screening in under-five-year-old children, with assessment of any identified problems, was introduced in Montserrat. As part of this programme, a register of handicapped children of all ages was compiled. Sixty children (2 per cent of approx. 3,000 children under 16 years old) with significant disability were identified. This was considerably more than local health workers expected. The main categories diagnosed were 12 with severe global disability, 21 with mental retardation, one with visual, hearing and speech problems only, 7 with physical disability and 3 with learning difficulties. Although all major handicapped children have probably been identified, these figures may still present an under-estimate; particularly of under-five-year-olds, who are not yet all screened, and school learning difficulties (surveys not yet completed). For realistic manpower and resource planning, it is essential that comprehensive handicap registers be compiled (AU)