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From a broader longitudinal study, data are presented on five twin pairs, now between three and a half and four and a half years old. The relationship between constitutional adequacy as measured in the first week of life and competence at preschool age is examined. Intratwin comparison offers both a reduction of familial and socioeconomic factors and a built-in 'standard of comparison'. (It also provides interesting data concerning the interaction between parent and child as affected by constitutional differences.)
Methodologically, the study is carefully designed and implemented. Appraisal of constitutional status in the first week is based on the authors' First Week Evaluation Scale (FES) which delineates and rates the following categories: health, physiologic adaptation, calmness, vigor, attention, and neurological findings. At the nursery school age, assessment was made by observing play under standardized conditions, Rorschach testing, IQ testing, psychiatric play interviews, and detailed family interviews. Despite the small group, the results are impressive and convincing due to the meticulous long-term observations in depth. The findings demonstrate vividly the correlation of high FES scores (constitutionally excellent infants) with high level of linguistic and generally adaptive competence, and low FES scores with the poorest levels of later competence. The authors' discussion of the importance of early differences in arousal, attention, and 'soothability', as well as their review of other work in this area, warrants reading.