Cousin cases of Kawasaki disease suggesting person-to-person transmission.

To the Editor.— Dr Dworkin raises many good points in his review, "British and American Recommendations for Developmental Monitoring: The Role of Surveillance." However, I am skeptical that the concept of "surveillance" is actually different from what physicians have practiced in the past. Dr Dworkin acknowledges "that mild mental retardation is not typically identified until the child is confronted with the cognitive demands of school...," especially when physicians rely on subjective impressions. With the concept of "surveillance," "eyeball" estimates will continue to be made of a child9s development; and with each well-child visit and frequently each acute illness visit being of relatively brief duration, I strongly suspect that the overwhelming majority of mildly retarded children will continue to elude detection.