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Coughlan S, Quigley J, Nixon E. Assessing the Language Abilities of Preterm-Born Children: An Examination of Standardized Testing and Language Sample Analysis. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:2327-2343. [PMID: 38980152 DOI: 10.1044/2024_ajslp-23-00318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
PURPOSE To understand how best to assess the language abilities of preterm-born children, this study: (a) compared preterm- and term-born children's language skills using standardized testing and language sample analysis (LSA), (b) investigated how executive function skills and the language sampling context respectively affect standardized test and LSA scores, and (c) examined the pattern of associations between standardized test and LSA scores among preterm-/term-born groups. METHOD Twenty-five term-born and 23 preterm-born 2-year-old singletons were administered the language scales of the Bayley Scales of Infant and Toddler Development-Third Edition (receptive communication, expressive communication, language composite scores). Parent-child free-play recordings were used to quantify the (para)linguistic features of the children's speech. Executive function was measured via parent report. RESULTS The preterm-born group obtained significantly lower scores than the term-born group on all Bayley language measures (though differences were not consistently observed when using cutoff scores). Few preterm-term differences in LSA measures were found. The preterm-term differences in Bayley scores were not explained by between-group differences in executive function. Some preterm-term differences in LSA scores were moderated by the language sampling context. The preterm- and term-born groups exhibited different patterns of Bayley-LSA correlations. CONCLUSIONS Preterm language difficulties were more apparent on standardized test than LSA scores. Nonetheless, the Bayley-LSA correlations indicate that poor test performance (linked with preterm birth) is associated with functional communication difficulties. The discussion outlines the complementary utility of standardized tests and LSA while acknowledging the limited utility of cutoff scores and the confounding influence of the language sampling context. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.26142661.
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Affiliation(s)
| | - Jean Quigley
- School of Psychology, Trinity College Dublin, Ireland
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Ong WJ, Seng JJB, Yap B, He G, Moochhala NA, Ng CL, Ganguly R, Lee JH, Chong SL. Impact of neonatal sepsis on neurocognitive outcomes: a systematic review and meta-analysis. BMC Pediatr 2024; 24:505. [PMID: 39112966 PMCID: PMC11304789 DOI: 10.1186/s12887-024-04977-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Accepted: 07/26/2024] [Indexed: 08/11/2024] Open
Abstract
INTRODUCTION Sepsis is associated with neurocognitive impairment among preterm neonates but less is known about term neonates with sepsis. This systematic review and meta-analysis aims to provide an update of neurocognitive outcomes including cognitive delay, visual impairment, auditory impairment, and cerebral palsy, among neonates with sepsis. METHODS We performed a systematic review of PubMed, Embase, CENTRAL and Web of Science for eligible studies published between January 2011 and March 2023. We included case-control, cohort studies and cross-sectional studies. Case reports and articles not in English language were excluded. Using the adjusted estimates, we performed random effects model meta-analysis to evaluate the risk of developing neurocognitive impairment among neonates with sepsis. RESULTS Of 7,909 studies, 24 studies (n = 121,645) were included. Majority of studies were conducted in the United States (n = 7, 29.2%), and all studies were performed among neonates. 17 (70.8%) studies provided follow-up till 30 months. Sepsis was associated with increased risk of cognitive delay [adjusted odds ratio, aOR 1.14 (95% CI: 1.01-1.28)], visual impairment [aOR 2.57 (95%CI: 1.14- 5.82)], hearing impairment [aOR 1.70 (95% CI: 1.02-2.81)] and cerebral palsy [aOR 2.48 (95% CI: 1.03-5.99)]. CONCLUSION Neonates surviving sepsis are at a higher risk of poorer neurodevelopment. Current evidence is limited by significant heterogeneity across studies, lack of data related to long-term neurodevelopmental outcomes and term infants.
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Affiliation(s)
- Wei Jie Ong
- MOH Holdings, Singapore, 1 Maritime Square, Singapore, 099253, Singapore
| | - Jun Jie Benjamin Seng
- MOH Holdings, Singapore, 1 Maritime Square, Singapore, 099253, Singapore.
- SingHealth Regional Health System PULSES Centre, Singapore Health Services, Outram Rd, Singapore, 169608, Singapore.
- SingHealth Duke-NUS Family Medicine Academic Clinical Programme, Singapore, Singapore.
| | - Beijun Yap
- MOH Holdings, Singapore, 1 Maritime Square, Singapore, 099253, Singapore
| | - George He
- Yong Loo Lin School of Medicine, 10 Medical Dr, Yong Loo Lin School of Medicine, Singapore, Singapore
| | | | - Chen Lin Ng
- MOH Holdings, Singapore, 1 Maritime Square, Singapore, 099253, Singapore
| | - Rehena Ganguly
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| | - Jan Hau Lee
- Children's Intensive Care Unit, KK Women's and Children's Hospital, SingHealth Paediatrics Academic Clinical Programme, 100 Bukit Timah Rd, Singapore, 229899, Singapore
| | - Shu-Ling Chong
- Department of Emergency Medicine, KK Women's and Children's Hospital, SingHealth Paediatrics Academic Clinical Programme, SingHealth Emergency Medicine Academic Clinical Programme, 100 Bukit Timah Rd, Singapore, 229899, Singapore
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Abstract
Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by challenges in social interaction and communication and the presence of restricted interests and repetitive behaviors. The importance of early detection of ASD and subsequent early intervention is well documented. Efforts have been made over the years to clarify ASD diagnostic criteria and develop predictive, accurate screening tools and evidence-based, standardized diagnostic instruments to aid in the identification of ASD. In this article, we review the most recent changes in ASD diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision, summarize evidence-based instruments for ASD screening and diagnostic evaluations as well as the assessment of co-occurring conditions in ASD, the impact of COVID-19 on ASD assessment, and directions for future research in the field of ASD assessment.
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Affiliation(s)
- Yue Yu
- University of California, Davis, Sacramento, USA
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Qi R, Piggott K, Lloyd-White S, Kearney A. Developmental Outcomes for Children With Unoperated Metopic or Sagittal Craniosynostosis: Findings at 3 and 7 Years From the Craniofacial Collaboration UK. J Craniofac Surg 2023; 34:1953-1958. [PMID: 37264505 DOI: 10.1097/scs.0000000000009463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 04/19/2023] [Indexed: 06/03/2023] Open
Abstract
The Craniofacial Collaboration UK (CC-UK) is a shared initiative with the aim of addressing key limitations in the existing literature and examining the development of homogenous samples of children with craniosynostosis. This article preliminarily describes developmental, behavioral, and cognitive outcomes for children with either metopic synostosis (MS) or sagittal synostosis (SS), who were unoperated and managed conservatively under the CC-UK protocol. A total of 112 patients were included, and assessments conducted at 3 and/or 7 years of age are presented. The majority of unoperated patients were assessed as having mild clinical severity. Findings are broadly consistent with previous work, indicating that the majority of unoperated patients perform within the average ranges across assessments. For unoperated MS patients, higher than expected rates of developmental concerns were seen at 3 years, particularly relating to gross and fine motor skills, and personal social skills. Slightly elevated rates of behavioral concerns relating to hyperactivity and prosocial behavior were also consistently shown. Few developmental issues were found for SS patients at 3 years. Some minor concerns with peer relationships and prosocial behavior at 3 years, and emotional problems at 7 years were shown, but these were inconsistent over time. Cognitive ability in both groups at 7 years seems to be close to average. Overall findings are positive, and future work should build on these findings by recruiting larger samples and examining longer-term outcomes in adolescence and adulthood, to better understand the developmental trajectory of patients with unoperated craniosynostosis.
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Affiliation(s)
- Robert Qi
- Clinical Health Psychology, Alder Hey Children's NHS Foundation Trust, Liverpool
| | - Katie Piggott
- Clinical Health Psychology, Alder Hey Children's NHS Foundation Trust, Liverpool
| | - Samuel Lloyd-White
- Oxford Craniofacial Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Anna Kearney
- Clinical Health Psychology, Alder Hey Children's NHS Foundation Trust, Liverpool
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Peterson-Katz K, Piccone C, Tuzi N, Kulkarni C, Reynolds JN. Barriers and facilitators to implementation of developmental screening and early intervention in Canadian organizations following completion of a training and coaching model: a thematic analysis. FRONTIERS IN HEALTH SERVICES 2023; 3:1160217. [PMID: 37425993 PMCID: PMC10326629 DOI: 10.3389/frhs.2023.1160217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/02/2023] [Indexed: 07/11/2023]
Abstract
Introduction Developmental delay affects approximately 1 in 4 children under 6 years old. Developmental delay can be detected using validated developmental screening tools, such as the Ages and Stages Questionnaires. Following developmental screening, early intervention can occur to address and support any developmental areas of concern. Frontline practitioners and supervisors must be trained and coached to organizationally implement developmental screening tools and early intervention practice. No prior work has qualitatively investigated the barriers and facilitators to implementing developmental screening and early intervention in Canadian organizations from the perspectives of practitioners and supervisors who have completed a specialized training and coaching model. Methods and Results Following semi-structured interviews with frontline practitioners and supervisors, thematic analysis identified four themes: cohesive networks support implementation efforts, implementation success is dependent on shared perspectives, established organizational policies increase implementation opportunities, and COVID-19 guidelines create organizational challenges. Each theme encompasses sub-themes that describe implementation facilitators: strong implementation context, multi-level multi-sectoral collaborative partnerships, adequate and collective awareness, knowledge, and confidence, consistent and critical conversations, clear protocols and procedures, and accessibility to information, tools, and best practice guidelines. Discussion The outlined barriers and facilitators fill a gap in implementation literature by informing a framework for organization-level implementation of developmental screening and early intervention following training and coaching.
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Affiliation(s)
| | - Caitlin Piccone
- School of Rehabilitation Therapy, Queen’s University, Kingston, ON, Canada
| | - Nicole Tuzi
- Infant and Early Mental Health Promotion, The Hospital for Sick Children, Toronto, ON, Canada
| | - Chaya Kulkarni
- Infant and Early Mental Health Promotion, The Hospital for Sick Children, Toronto, ON, Canada
| | - James N. Reynolds
- Centre for Neuroscience Studies, Queen’s University, Kingston, ON, Canada
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Yangin Ergon E, Kivilcim M, Colak R, Dasci Y, Ozdemir SA, Calkavur S. Neonatal outcomes and long-term neurodevelopmental evaluations of hospitalized early term infants; prospective case-control study. J Neonatal Perinatal Med 2023; 16:59-66. [PMID: 36872793 DOI: 10.3233/npm-221076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
BACKGROUNDS It was intended to compare early term babies to term babies by reviewing short-term issues and long-term neurodevelopmental evaluations. METHODS It was planned as a prospective case-control study. Of the 4263 infants admitted to the neonatal intensive care unit, 109 infants born at early term by elective cesarean section and hospitalized within the first 10 postnatal days were included in the study. As the control group, 109 babies born at term were enrolled. Nutrition status of infants, reasons for hospitalization in the first postnatal week were recorded. When the babies were 18-24 months old, an appointment was made for neurodevelopmental evaluation. RESULTS In the early term group, the time of breastfeeding was later than the control group, with a statistically significant difference. Similarly, breastfeeding difficulty, need for formula in the first week postpartum and hospitalization were found to be significantly higher in the early term group. Considering the short-term results; pathological weight loss, hyperbilirubinemia requiring phototherapy and feeding difficulties were statistically significantly higher in the early term group. Neurodevelopmental delay did not statistically differ across the groups, but the early term group's MDI and PDI scores were found to be statistically lower than those of the term group. CONCLUSION Early term infants are thought to be like term infants in many ways. Although these babies are similar to term babies, they are still physiologically immature. The short and long-term negative consequences of early term birth are obvious, non-medical elective early term births should be prevented.
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Affiliation(s)
- E Yangin Ergon
- T.C. Ministry of Health Izmir Provincial Health Directorate H.S.U. Dr. Behçet Uz Children's Education and Research Hospital, Clinic of Neonatology, Izmir, Turkey
| | - M Kivilcim
- T.C. Ministry of Health Izmir Provincial Health Directorate H.S.U. Dr. Behçet Uz Children's Education and Research Hospital, Clinic of Pediatrics, Developmental and Behavioral Pediatrics Unit, Izmir, Turkey
| | - R Colak
- T.C. Ministry of Health Izmir Provincial Health Directorate H.S.U. Dr. Behçet Uz Children's Education and Research Hospital, Clinic of Neonatology, Izmir, Turkey
| | - Y Dasci
- T.C.Ministry of Health Izmir Provincial Health Directorate H.S.U. Dr.Behçet Uz Children's Education and Research Hospital, Clinic of Pediatrics, Izmir, Turkey
| | - S Alkan Ozdemir
- T.C. Ministry of Health Izmir Provincial Health Directorate H.S.U. Dr. Behçet Uz Children's Education and Research Hospital, Clinic of Neonatology, Izmir, Turkey
| | - S Calkavur
- T.C. Ministry of Health Izmir Provincial Health Directorate H.S.U. Dr. Behçet Uz Children's Education and Research Hospital, Clinic of Neonatology, Izmir, Turkey
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Casey T, Thachuthara AJ, Fogarty L, Livingstone V, De Haan M, Marlow N, Kiely ME, Murray DM. Validation of a touchscreen assessment tool to screen for cognitive delay at 24 months. Dev Med Child Neurol 2023. [PMID: 36808732 DOI: 10.1111/dmcn.15555] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 02/22/2023]
Abstract
AIM To validate a touchscreen assessment as a screening tool for mild cognitive delay in typically developing children aged 24 months. METHOD Secondary analysis of data was completed from an observational birth cohort study (The Cork Nutrition & Microbiome Maternal-Infant Cohort Study [COMBINE]), with children born between 2015 and 2017. Outcome data were collected at 24 months of age, at the INFANT Research Centre, Ireland. Outcomes were the Bayley Scales of Infant and Toddler Development, Third Edition cognitive composite score and a language-free, touchscreen-based cognitive measure (Babyscreen). RESULTS A total of 101 children (47 females, 54 males) aged 24 months (mean = 24.25, SD = 0.22) were included. Cognitive composite scores correlated with the total number of Babyscreen tasks completed, with moderate concurrent validity (r = 0.358, p < 0.001). Children with cognitive composite scores lower than 90 (1 SD below the mean, defined as mild cognitive delay) had lower mean Babyscreen scores than those with cognitive scores equal to or greater than 90 (8.50 [SD = 4.89] vs 12.61 [SD = 3.68], p = 0.001). The area under the receiver operating characteristic curve for the prediction of a cognitive composite score less than 90 was 0.75 (95% confidence interval = 0.59-0.91; p = 0.006). Babyscreen scores less than 7 were equivalent to less than the 10th centile and identified children with mild cognitive delay with 50% sensitivity and 93% specificity. INTERPRETATION Our 15-minute, language-free touchscreen tool could reasonably identify mild cognitive delay among typically developing children.
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Affiliation(s)
- Tríona Casey
- The Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Cork, Ireland.,Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Aoife Jones Thachuthara
- The Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Cork, Ireland.,Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Leanna Fogarty
- The Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Cork, Ireland.,Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Vicki Livingstone
- The Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Cork, Ireland.,Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Michelle De Haan
- Department of Developmental Neurosciences, Institute of Child Health, London, UK
| | - Neil Marlow
- UCL EGA Institute for Women's Health, University College London, London, UK
| | - Mairead E Kiely
- The Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Cork, Ireland.,School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Deirdre M Murray
- The Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Cork, Ireland.,Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
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Han G, Lim DH, Kang D, Cho J, Guallar E, Chang YS, Chung TY, Kim SJ, Park WS. Association Between Retinopathy of Prematurity in Very-Low-Birth-Weight Infants and Neurodevelopmental Impairment. Am J Ophthalmol 2022; 244:205-215. [PMID: 35998681 DOI: 10.1016/j.ajo.2022.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 08/07/2022] [Accepted: 08/10/2022] [Indexed: 01/30/2023]
Abstract
PURPOSE To evaluate the impact of retinopathy of prematurity (ROP) severity and the treatment of very-low-birth-weight infants (VLBWIs) on neurodevelopmental impairment in early childhood. DESIGN Prospective cohort study. METHOD This was a prospective cohort study. The data were obtained from the Korean Neonatal Network (KNN), a nationwide registry for VLBWIs. Infants who were born from 2013 to 2015 and underwent ROP evaluation at birth and neurodevelopmental examinations at corrected ages of 18 to 24 months were included in the study. Infants with a history of meningitis or severe congenital anomalies were excluded. The VLBWI patients were grouped into no ROP, no treatment-requiring ROP (non-TR-ROP), and treatment-requiring ROP (TR-ROP) groups. Neurodevelopmental impairment was defined as participants who had at least 1 developmental problem according to the Bayley Scales of Infant and Toddler Development-2nd Edition (Bayley-II; <70), Bayley Scales of Infant and Toddler Development-3rd Edition (Bayley-III; <70), and Korean Developmental Screening Test (K-DST) tests (below -1 SD), and the Korean Ages and Stages Questionnaire (K-ASQ) (below the threshold) and Gross Motor Function Classification System (GMFCS; at level 2 or above). Multivariable logistic regression analysis was performed to evaluate the association between ROP and neurodevelopmental impairment. RESULT Among 3132 infants, 1093 (34.9%) had ROP. Among the ROP infants, 644 were not treated for ROP (non-TR-ROP group) and 449 received ROP treatments (TR-ROP group). The patients in the TR-ROP group had an increased risk of developing neurodevelopmental problems compared to those in the no ROP group (odds ratio [OR] = 1.72, 95% CI = 1.33-2.21). The TR-ROP group had a higher risk of all 3 types of neurodevelopmental problems: mental (OR = 1.62, 95% CI = 1.25-2.09), social (OR = 1.62, 95% CI = 1.12-2.09), and motor (OR = 1.69, 95% CI = 1.31-2.18). The risk of neurodevelopmental problems in patients treated with laser therapy did not differ from that in patients treated with anti-vascular endothelial growth factor (anti-VEGF) therapy (OR = 1.17, 95% CI = 0.73-1.88). CONCLUSION ROP was independently associated with neurodevelopmental impairment in early childhood. The type of ROP treatment (anti-VEGF or laser treatment) did not affect neurodevelopmental impairment in patients in the TR-ROP group.
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Affiliation(s)
- Gyule Han
- From the Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong Hui Lim
- From the Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Korea
| | - Danbee Kang
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Korea; Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Juhee Cho
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Korea; Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eliseo Guallar
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Korea; Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Epidemiology, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Yun Sil Chang
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Health Science and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea
| | - Tae-Young Chung
- From the Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang Jin Kim
- From the Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Won Soon Park
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Sansavini A, Riva M, Zuccarini M, Aceti A, Corvaglia L, Scher A, Guarini A. Night Sleep and Parental Bedtime Practices in Low-Risk Preterm and Full-Term Late Talkers. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121813. [PMID: 36553255 PMCID: PMC9777501 DOI: 10.3390/children9121813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/14/2022] [Accepted: 11/17/2022] [Indexed: 11/25/2022]
Abstract
Night sleep and parental bedtime practices have rarely been investigated in late talkers. This study aimed to explore: night sleep, parental bedtime practices, and their associations in late talkers as well as individual, socio-demographic, and socio-relational factors affecting them. Parents of 47 30-month-old late talkers, born low-risk preterm (n = 24) or full-term (n = 23), with an expressive vocabulary size ≤10th percentile measured by the MacArthur-Bates Communicative Development Inventory Words and Sentences, and normal cognitive abilities measured by the Bayley Scales, completed the Infant Sleep Questionnaire, the Parental Interactive Bedtime Behaviour Scale, and the Parenting Stress Index Short Form. Results showed slight settling difficulties, night wakings, and frequent co-sleeping in late talkers. Encouraging autonomy practices were frequently used by parents, rather than active physical comforting ones. Recurrent settling difficulties were reported by parents who often applied encouraging autonomy practices, whereas greater night waking problems and frequent co-sleeping were reported by parents who often left their child crying. Low-risk preterm birth and mother's parenting stress predicted total sleep difficulties and night wakings; first-born, high maternal education level and mother's parenting stress predicted settling difficulties; mother's parenting stress was the only predictor for co-sleeping and leaving to cry. These findings have relevant implications for improving late talkers' night sleep and their parents' bedtime practices.
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Affiliation(s)
- Alessandra Sansavini
- Department of Psychology “Renzo Canestrari”, University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy
- Correspondence:
| | - Martina Riva
- Department of Psychology “Renzo Canestrari”, University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy
| | - Mariagrazia Zuccarini
- Department of Education Studies “Giovanni Maria Bertin”, University of Bologna, Via Filippo Re 6, 40126 Bologna, Italy
| | - Arianna Aceti
- Neonatal Intensive Care Unit, IRCCS Azienda Ospedaliero-Universitaria Bologna, Via Massarenti 9, 40138 Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy
| | - Luigi Corvaglia
- Neonatal Intensive Care Unit, IRCCS Azienda Ospedaliero-Universitaria Bologna, Via Massarenti 9, 40138 Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy
| | - Anat Scher
- Department of Counseling and Human Development, University of Haifa, Abba Khoushy Ave 199, Haifa 3498838, Israel
| | - Annalisa Guarini
- Department of Psychology “Renzo Canestrari”, University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy
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Smith DK, Libertus K. The Early Motor Questionnaire revisited: Starting points, standardized scores, and stability. J Exp Child Psychol 2022; 223:105492. [PMID: 35779285 DOI: 10.1016/j.jecp.2022.105492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 05/09/2022] [Accepted: 06/01/2022] [Indexed: 11/15/2022]
Abstract
Motor skills are an important aspect of development during infancy and have been found to predict development in other domains. Therefore, fast and reliable assessments of infant motor skills are needed. The current study revisited a time and cost-effective parent-report measure of infants' motor skills-the Early Motor Questionnaire (EMQ)-and aimed to improve the utility of the EMQ as a tool to examine variability, stability, and individual differences in early motor development. A sample of 446 parents of infants provided a total of 775 EMQ responses for analyses. Using this large sample, regression was used to create age-independent scores for global, gross motor, fine motor, and perception-action scores on the EMQ. Age-adjusted scores were then converted to t-scores to facilitate score interpretation for past and future studies using the EMQ. Finally, starting flags for different age groups were created to decrease the time it takes parents to complete the EMQ. Together, these changes to the EMQ will improve the utility and interpretability of the measure. The EMQ is free to use and available in the supplemental materials or via www.onlinebabylab.com/emq.
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Affiliation(s)
- Darcy K Smith
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Klaus Libertus
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA.
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11
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Yim G, Minatoya M, Kioumourtzoglou MA, Bellavia A, Weisskopf M, Ikeda-Araki A, Miyashita C, Kishi R. The associations of prenatal exposure to dioxins and polychlorinated biphenyls with neurodevelopment at 6 Months of age: Multi-pollutant approaches. ENVIRONMENTAL RESEARCH 2022; 209:112757. [PMID: 35065939 DOI: 10.1016/j.envres.2022.112757] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 01/14/2022] [Accepted: 01/15/2022] [Indexed: 05/07/2023]
Abstract
BACKGROUND Prenatal exposure to persistent organic pollutants, including polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), dioxin-like polychlorinated biphenyls (DL-PCBs), and nondioxin-like PCBs (NDL-PCBs), has been hypothesized to have a detrimental impact on neurodevelopment. However, the association of prenatal exposure to a dioxin and PCB mixture with neurodevelopment remains largely inconclusive partly because these chemical levels are correlated. OBJECTIVES We aimed to elucidate the association of in utero exposure to a mixture of dioxins and PCBs with neurodevelopment measured at 6 months of age by applying multipollutant methods. METHODS A total of 514 pregnant women were recruited between July 2002 and October 2005 in the Sapporo cohort, Hokkaido Study on Environment and Children's Health. The concentrations of individual dioxin and PCB isomers were assessed in maternal peripheral blood during pregnancy. The mental and psychomotor development of the study participants' infants was evaluated using the Bayley Scales of Infant Development-2nd Edition (n = 259). To determine both the joint and individual associations of prenatal exposure to a dioxin and PCB mixture with infant neurodevelopment, Bayesian kernel machine regression (BKMR) and quantile-based g-computation were employed. RESULTS Suggestive inverse associations were observed between in utero exposure to a dioxin and PCB mixture and infant psychomotor development in both the BKMR and quantile g-computation models. In contrast, we found no association of a dioxin and PCB mixture with mental development. When group-specific posterior inclusion probabilities were estimated, BKMR suggested prenatal exposure to mono-ortho PCBs as the more important contributing factors to early psychomotor development compared with the other dioxin or PCB groups. No evidence of nonlinear exposure-outcome relationships or interactions among the chemical mixtures was detected. CONCLUSIONS Applying the two complementary statistical methods for chemical mixture analysis, we demonstrated limited evidence of inverse associations of prenatal exposure to dioxins and PCBs with infant psychomotor development.
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Affiliation(s)
- Gyeyoon Yim
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Machiko Minatoya
- Hokkaido University Center for Environmental and Health Sciences, Kita 12, Nishi 7, Kita-ku, Sapporo, 060-0812, Japan
| | | | - Andrea Bellavia
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Marc Weisskopf
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Atsuko Ikeda-Araki
- Hokkaido University Center for Environmental and Health Sciences, Kita 12, Nishi 7, Kita-ku, Sapporo, 060-0812, Japan; Hokkaido University Faculty of Health Sciences, Kita 12, Nishi 5, Kita-ku, Sapporo, 060-0812, Japan
| | - Chihiro Miyashita
- Hokkaido University Center for Environmental and Health Sciences, Kita 12, Nishi 7, Kita-ku, Sapporo, 060-0812, Japan
| | - Reiko Kishi
- Hokkaido University Center for Environmental and Health Sciences, Kita 12, Nishi 7, Kita-ku, Sapporo, 060-0812, Japan.
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12
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Goeral K, Kasprian G, Hüning BM, Waldhoer T, Fuiko R, Schmidbauer V, Prayer D, Felderhoff‐Müser U, Berger A, Olischar M, Klebermass‐Schrehof K. A novel magnetic resonance imaging-based scoring system to predict outcome in neonates born preterm with intraventricular haemorrhage. Dev Med Child Neurol 2022; 64:608-617. [PMID: 34839534 PMCID: PMC9299734 DOI: 10.1111/dmcn.15116] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 10/27/2021] [Accepted: 10/28/2021] [Indexed: 11/28/2022]
Abstract
AIM To create a magnetic resonance imaging (MRI)-based scoring system specific to neonates born preterm with intraventricular haemorrhage (IVH), which could serve as a reliable prognostic indicator for later development and might allow for improved outcome prediction, individually-tailored parental counselling, and clinical decision-making. METHOD This retrospective, two-center observational cohort study included 103 infants born preterm with IVH (61 males, 42 females; median gestational age 26wks 6d), born between 2000 and 2016. Term-equivalent MRI was evaluated using a novel scoring system consisting of 11 items. A total MRI score was calculated and correlated with neurodevelopment between 2 years and 3 years of age. Prediction models for outcome were defined. RESULTS The proposed MRI scoring system showed high correlation and strong predictive ability with regard to later cognitive and motor outcome. The prediction models were translated into easy-to-use tables, allowing developmental risk assessment. INTERPRETATION The proposed MRI-based scoring system was created especially for infants born preterm with IVH and enables a comprehensive assessment of important brain areas as well as potential additional abnormalities commonly associated with IVH. Thus, it better represents the severity of brain damage when compared with the conventional IVH classification. Our scoring system should provide clinicians with valuable information, to optimize parental counselling and clinical decision-making.
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Affiliation(s)
- Katharina Goeral
- Division of Neonatology, Intensive Care and NeuropediatricsDepartment of Pediatrics and Adolescent MedicineComprehensive Center for PediatricsMedical University of ViennaViennaAustria
| | - Gregor Kasprian
- Division of Neuroradiology and Musculoskeletal RadiologyDepartment of RadiologyMedical University of ViennaViennaAustria
| | - Britta M Hüning
- Department of Pediatrics INeonatologyUniversity Children's Hospital EssenUniversity Duisburg‐EssenEssenGermany
| | - Thomas Waldhoer
- Department of EpidemiologyCenter of Public HealthMedical University of ViennaViennaAustria
| | - Renate Fuiko
- Division of Neonatology, Intensive Care and NeuropediatricsDepartment of Pediatrics and Adolescent MedicineComprehensive Center for PediatricsMedical University of ViennaViennaAustria
| | - Victor Schmidbauer
- Division of Neuroradiology and Musculoskeletal RadiologyDepartment of RadiologyMedical University of ViennaViennaAustria
| | - Daniela Prayer
- Division of Neuroradiology and Musculoskeletal RadiologyDepartment of RadiologyMedical University of ViennaViennaAustria
| | - Ursula Felderhoff‐Müser
- Department of Pediatrics INeonatologyUniversity Children's Hospital EssenUniversity Duisburg‐EssenEssenGermany
| | - Angelika Berger
- Division of Neonatology, Intensive Care and NeuropediatricsDepartment of Pediatrics and Adolescent MedicineComprehensive Center for PediatricsMedical University of ViennaViennaAustria
| | - Monika Olischar
- Division of Neonatology, Intensive Care and NeuropediatricsDepartment of Pediatrics and Adolescent MedicineComprehensive Center for PediatricsMedical University of ViennaViennaAustria
| | - Katrin Klebermass‐Schrehof
- Division of Neonatology, Intensive Care and NeuropediatricsDepartment of Pediatrics and Adolescent MedicineComprehensive Center for PediatricsMedical University of ViennaViennaAustria
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13
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Dack K, Fell M, Taylor CM, Havdahl A, Lewis SJ. Prenatal Mercury Exposure and Neurodevelopment up to the Age of 5 Years: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19041976. [PMID: 35206164 PMCID: PMC8871549 DOI: 10.3390/ijerph19041976] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 11/29/2022]
Abstract
Neurodevelopmental delays can interfere with children’s engagement with the world and further development, and may have negative consequences into adulthood. Mercury is highly toxic and may negatively influence neurodevelopment because it can freely cross the placenta and accumulate in the fetal brain. We searched four publication databases (Embase, PsycINFO, PubMed/MEDLINE, Scopus) for studies examining the relationship between early life mercury exposure and scores on neurodevelopmental performance measures in children aged 0 to 5 years old. Study quality was assessed using the National Institutes of Health (NIH) Quality Assessment Tool. Thirty-two prospective studies were included in the review. Neurodevelopmental performance was measured using 23 different scales, most commonly the Bayley Scales of Infant and Toddler Development (BSID). In most cases, the evidence for an association between mercury and neurodevelopment was weak. There did not appear to be exceptions for particular childhood ages, outcome scales, or mercury levels. The small number of results to the contrary were more likely to be studies which did not meet our high-quality criteria, and could be a consequence of multiple testing, selection bias, or incomplete confounder adjustment. Based on current evidence, dietary mercury exposure during pregnancy is unlikely to be a risk factor for low neurodevelopmental functioning in early childhood.
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Affiliation(s)
- Kyle Dack
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol BS8 1TH, UK
- Correspondence:
| | - Matthew Fell
- Cleft Collective, University of Bristol, Bristol BS8 1TH, UK;
| | - Caroline M. Taylor
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol BS8 1TH, UK;
| | - Alexandra Havdahl
- Department of Mental Disorders, Norwegian Institute of Public Health, 0213 Oslo, Norway;
- Nic Waals Institute, Lovisenberg Diaconal Hospital, 0853 Oslo, Norway
| | - Sarah J. Lewis
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1TH, UK;
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14
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Araujo WRM, Malta MB, Faggiani LD, Cardoso MA, Matijasevich A. Suspected neuropsychomotor developmental delay in the first 2 years of life in a birth cohort in the Brazilian Amazon: Incidence, persistence and risk factors. INFANT AND CHILD DEVELOPMENT 2022. [DOI: 10.1002/icd.2287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | - Maíra Barreto Malta
- Department of Nutrition, School of Public Health Universidade de São Paulo São Paulo Brazil
| | - Lucas Damasio Faggiani
- Department of Nutrition, School of Public Health Universidade de São Paulo São Paulo Brazil
| | - Marly Augusto Cardoso
- Department of Nutrition, School of Public Health Universidade de São Paulo São Paulo Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP Universidade de São Paulo São Paulo Brazil
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15
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Steiner M, Urlesberger B, Giordano V, Kasprian G, Glatter S, Oberleitner-Leeb C, Rittenschober-Boehm J, Werther T, Berger A, Olischar M, Goeral K. Outcome Prediction in Neonatal Hypoxic-Ischaemic Encephalopathy Using Neurophysiology and Neuroimaging. Neonatology 2022; 119:483-493. [PMID: 35636405 DOI: 10.1159/000524751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 04/23/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of the study was to determine the predictive power of the combined use of neurophysiological (amplitude-integrated electroencephalography [aEEG], near-infrared spectroscopy [NIRS]) methods and neuroimaging (magnetic resonance imaging [MRI]) for long-term outcome prediction in neonates with hypoxic-ischaemic encephalopathy (HIE). STUDY DESIGN Prospective cohort study of 56 patients with moderate to severe HIE and hypothermia treatment at the Medical University of Vienna between 2008 and 2020. aEEG and NIRS were recorded continuously over a period of >4 days (102 h) starting at the initiation of hypothermia treatment, MRI was performed at a median age of 8 days. Receiver operating characteristic curves and area under the curve were calculated to evaluate the prognostic ability of aEEG, NIRS, and MRI parameters for outcome assessed via Bayley Scales of Infant Development 3rd edition at 2 years of age. RESULTS Combined aEEG and MRI parameters showed highest predictive power regarding long-term outcome. The highest area under the curve values (0.96-0.99) were obtained for aEEG (combination of background pattern and sleep-wake cycling) between 66 and 102 h after initiation of hypothermia in combination with MRI findings. NIRS parameters did not differ significantly between infants with favourable and adverse outcome. CONCLUSIONS Combined aEEG and MRI parameter scores were more predictive than single parameter scores. No further improvement was observed when combining aEEG/MRI with NIRS data.
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Affiliation(s)
- Mirjam Steiner
- Division of Neonatology, Intensive Care and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | | | - Vito Giordano
- Division of Neonatology, Intensive Care and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Gregor Kasprian
- Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria
| | - Sarah Glatter
- Division of Neonatology, Intensive Care and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Christiane Oberleitner-Leeb
- Division of Neonatology, Intensive Care and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Judith Rittenschober-Boehm
- Division of Neonatology, Intensive Care and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Tobias Werther
- Division of Neonatology, Intensive Care and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Angelika Berger
- Division of Neonatology, Intensive Care and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Monika Olischar
- Division of Neonatology, Intensive Care and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Katharina Goeral
- Division of Neonatology, Intensive Care and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
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Federico A, Shi D, Bradshaw J. Agreement Between Parental Report and Clinician Observation of Infant Developmental Skills. Front Psychol 2021; 12:734341. [PMID: 34795613 PMCID: PMC8593390 DOI: 10.3389/fpsyg.2021.734341] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 10/07/2021] [Indexed: 11/24/2022] Open
Abstract
Understanding the convergence between parent report and clinician observation measures of development is important and became even more critical during the COVID-19 pandemic as clinician contact with families was significantly limited. Previous research points to inconsistencies in the degree of agreement between parents and clinicians and very little research has examined these associations for infants within the first year of life. This study investigated the association between parent report and clinician observation measures of social communication and motor skills in 27 young infants who were assessed at 9 and 12 months of age. Results suggest a strong relation between clinician and parent rated motor skills, but weak to moderate associations between clinician and parent rated communication skills. Infant temperament played a significant role in parent ratings of infant communication. Together, these results provide support for data collection via parent report or clinician observation of infant motor skills, but suggest that multiple measures of infant communication may be helpful to obtain high-quality, perhaps more accurate, assessment social-communication skills. Specifically, multiple parent report measures along with an observation of parent-infant interactions will likely provide a more rich and accurate characterization of infant social-communication abilities.
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Affiliation(s)
| | | | - Jessica Bradshaw
- Department of Psychology, University of South Carolina, Columbia, SC, United States
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17
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Dean B, O'Carroll S, Ginnell L, Ledsham V, Telford E, Sparrow S, Boardman JP, Fletcher‐Watson S. Longitudinal assessment of social cognition in infants born preterm using eye‐tracking and parent–child play. INFANT AND CHILD DEVELOPMENT 2021. [DOI: 10.1002/icd.2275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Bethan Dean
- MRC Centre for Reproductive Health, The University of Edinburgh, Edinburgh BioQuarter Edinburgh UK
| | - Sinéad O'Carroll
- MRC Centre for Reproductive Health, The University of Edinburgh, Edinburgh BioQuarter Edinburgh UK
| | - Lorna Ginnell
- MRC Centre for Reproductive Health, The University of Edinburgh, Edinburgh BioQuarter Edinburgh UK
| | - Victoria Ledsham
- MRC Centre for Reproductive Health, The University of Edinburgh, Edinburgh BioQuarter Edinburgh UK
| | - Emma Telford
- MRC Centre for Reproductive Health, The University of Edinburgh, Edinburgh BioQuarter Edinburgh UK
| | - Sarah Sparrow
- MRC Centre for Reproductive Health, The University of Edinburgh, Edinburgh BioQuarter Edinburgh UK
| | - James P. Boardman
- MRC Centre for Reproductive Health, The University of Edinburgh, Edinburgh BioQuarter Edinburgh UK
- Centre for Clinical Brain Sciences, The University of Edinburgh, Chancellor's Building, Edinburgh BioQuarter Edinburgh UK
| | - Sue Fletcher‐Watson
- Salvesen Mindroom Research Centre, The University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital Edinburgh UK
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18
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The Test of Infant Motor Performance (TIMP) in very low birth weight infants and outcome at two years of age. J Perinatol 2021; 41:2432-2441. [PMID: 34127791 DOI: 10.1038/s41372-021-01067-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 03/29/2021] [Accepted: 04/22/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To evaluate TIMP in preterm very low birth weight (VLBW) infants, analyze risk factors, for atypical TIMP (aTIMP) scores, and explore TIMP's predictive relationship with Bayley-III at 2 years. METHOD A prospective study of 288 VLBW infants, with TIMP assessment between 34 weeks postmenstrual age and 16 weeks age, corrected for prematurity. RESULT aTIMP scores were observed in 58/288(20%) infants, whose mean birth weight (BW) and gestational age were 1122 ± 257 g and 29.2 ± 2.12 weeks respectively. Risk factors included BW < 750 g (OR 4.8, 95% CI 1.3-17.7) and 750-1000 g (OR 2.9, 95% CI 1.2-6.9), presence of necrotizing enterocolitis ≥ stage 2; or focal intestinal perforation (OR 4.6, 95% CI 1.4-14.4), periventricular leukomalacia (OR 22.4,95% CI 2.0-246.2), and need for intensive resuscitation at birth (OR 2.7, 95% CI 1.3-5.5). aTIMP scores correlated with Bayley-III Score <85 in motor and cognitive domains with high specificity (80-82%) and negative predictive value (85-94%). CONCLUSION Identification of the risk factors for aTIMP scores will enable targeted intervention to optimize resources and outcomes in VLBW infants.
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19
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Sansavini A, Zuccarini M, Gibertoni D, Bello A, Caselli MC, Corvaglia L, Guarini A. Language Profiles and Their Relation to Cognitive and Motor Skills at 30 Months of Age: An Online Investigation of Low-Risk Preterm and Full-Term Children. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:2715-2733. [PMID: 34215160 DOI: 10.1044/2021_jslhr-20-00636] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose Wide interindividual variability characterizes language development in the general and at-risk populations of up to 3 years of age. We adopted a complex approach that considers multiple aspects of lexical and grammatical skills to identify language profiles in low-risk preterm and full-term children. We also investigated biological and environmental predictors and relations between language profiles and cognitive and motor skills. Method We enrolled 200 thirty-month-old Italian-speaking children-consisting of 100 low-risk preterm and 100 comparable full-term children. Parents filled out the Italian version of the MacArthur-Bates Communicative Development Inventories Infant and Toddler Short Forms (word comprehension, word production, and incomplete and complete sentence production), Parent Report of Children's Abilities-Revised (cognitive score), and Early Motor Questionnaire (fine motor, gross motor, perception-action, and total motor scores) questionnaires. Results A latent profile analysis identified four profiles: poor (21%), with lowest receptive and expressive vocabulary and absent or limited word combination and phonological accuracy; weak (22.5%), with average receptive but limited expressive vocabulary, incomplete sentences, and absent or limited phonological accuracy; average (25%), with average receptive and expressive vocabulary, use of incomplete and complete sentences, and partial phonological accuracy; and advanced (31.5%), with highest expressive vocabulary, complete sentence production, and phonological accuracy. Lower cognitive and motor scores characterized the poor profile, and lower cognitive and perception-action scores characterized the weak profile. Having a nonworking mother and a father with lower education increased the probability of a child's assignment to the poor profile, whereas being small for gestational age at birth increased it for the weak profile. Conclusions These findings suggest a need for a person-centered and cross-domain approach to identifying children with language weaknesses and implementing timely interventions. An online procedure for data collection and data-driven analyses based on multiple lexical and grammatical skills appear to be promising methodological innovations. Supplemental Material https://doi.org/10.23641/asha.14818179.
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Affiliation(s)
| | | | - Dino Gibertoni
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | | | | | - Luigi Corvaglia
- Department of Medical and Surgical Sciences, University of Bologna, Italy
- Neonatology and Neonatal Intensive Care Unit, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Annalisa Guarini
- Department of Psychology "Renzo Canestrari", University of Bologna, Italy
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20
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Dean B, Ginnell L, Ledsham V, Tsanas A, Telford E, Sparrow S, Fletcher-Watson S, Boardman JP. Eye-tracking for longitudinal assessment of social cognition in children born preterm. J Child Psychol Psychiatry 2021; 62:470-480. [PMID: 32729133 DOI: 10.1111/jcpp.13304] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/24/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Preterm birth is associated with atypical social cognition in infancy, and cognitive impairment and social difficulties in childhood. Little is known about the stability of social cognition through childhood, and its relationship with neurodevelopment. We used eye-tracking in preterm and term-born infants to investigate social attentional preference in infancy and at 5 years, its relationship with neurodevelopment and the influence of socioeconomic deprivation. METHODS A cohort of 81 preterm and 66 term infants with mean (range) gestational age at birth 28+5 (23+2 -33+0 ) and 40+0 (37+0 -42+1 ) respectively, completed eye-tracking at 7-9 months, with a subset re-assessed at 5 years. Three free-viewing social tasks of increasing stimulus complexity were presented, and a social preference score was derived from looking time to socially informative areas. Socioeconomic data and the Mullen Scales of Early Learning at 5 years were collected. RESULTS Preterm children had lower social preference scores at 7-9 months compared with term-born controls. Term-born children's scores were stable between time points, whereas preterm children showed a significant increase, reaching equivalent scores by 5 years. Low gestational age and socioeconomic deprivation were associated with reduced social preference scores at 7-9 months. At 5 years, preterm infants had lower Early Learning Composite scores than controls, but this was not associated with social attentional preference in infancy or at 5 years. CONCLUSIONS Preterm children have reduced social attentional preference at 7-9 months compared with term-born controls, but catch up by 5 years. Infant social cognition is influenced by socioeconomic deprivation and gestational age. Social cognition and neurodevelopment have different trajectories following preterm birth.
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Affiliation(s)
- Bethan Dean
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - Lorna Ginnell
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - Victoria Ledsham
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | | | - Emma Telford
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - Sarah Sparrow
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - Sue Fletcher-Watson
- Salvesen Mindroom Research Centre for Learning Difficulties, University of Edinburgh, Edinburgh, UK
| | - James P Boardman
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK.,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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21
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Han S, Kim O, Yoo C, Heo JS, Lee HS, Jeon J. Neurodevelopmental Correlations between the Korean Developmental Screening Test and Bayley Scale III in Very-Low-Birth-Weight Infants. NEONATAL MEDICINE 2020. [DOI: 10.5385/nm.2020.27.4.167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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22
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Min K, Suh MR, Cho KH, Park W, Kang MS, Jang SJ, Kim SH, Rhie S, Choi JI, Kim HJ, Cha KY, Kim M. Potentiation of cord blood cell therapy with erythropoietin for children with CP: a 2 × 2 factorial randomized placebo-controlled trial. Stem Cell Res Ther 2020; 11:509. [PMID: 33246489 PMCID: PMC7694426 DOI: 10.1186/s13287-020-02020-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 11/06/2020] [Indexed: 02/06/2023] Open
Abstract
Background Concomitant administration of allogeneic umbilical cord blood (UCB) infusion and erythropoietin (EPO) showed therapeutic efficacy in children with cerebral palsy (CP). However, no clinical studies have investigated the effects of UCB and EPO combination therapy using a 2 × 2 four-arm factorial blinded design with four arms. This randomized placebo-controlled trial aimed to identify the synergistic and individual efficacies of UCB cell and EPO for the treatment of CP. Methods Children diagnosed with CP were randomly segregated into four groups: (A) UCB+EPO, (B) UCB+placebo EPO, (C) placebo UCB+EPO, and (D) placebo UCB+placebo EPO. Based on the UCB unit selection criteria of matching for ≥ 4/6 of human leukocyte antigen (HLA)-A, -B, and DRB1 and total nucleated cell (TNC) number of ≥ 3 × 107/kg, allogeneic UCB was intravenously infused and 500 IU/kg human recombinant EPO was administered six times. Functional measurements, brain imaging studies, and electroencephalography were performed from baseline until 12 months post-treatment. Furthermore, adverse events were closely monitored. Results Eighty-eight of 92 children enrolled (3.05 ± 1.22 years) completed the study. Change in gross motor performance measure (GMPM) was greater in group A than in group D at 1 month (△2.30 vs. △0.71, P = 0.025) and 12 months (△6.85 vs. △2.34, P = 0.018) post-treatment. GMPM change ratios were calculated to adjust motor function at the baseline. Group A showed a larger improvement in the GMPM change ratio at 1 month and 12 months post-treatment than group D. At 12 months post-treatment, the GMPM change ratios were in the order of groups A, B, C, and D. These results indicate synergistic effect of UCB and EPO combination better than each single therapy. In diffusion tensor imaging, the change ratio of fractional anisotropy at spinothalamic radiation was higher in group A than group D in subgroup of age ≥ 3 years. Additionally, higher TNC and more HLA-matched UCB units led to better gross motor outcomes in group A. Adverse events remained unchanged upon UCB or EPO administration. Conclusions These results indicate that the efficacy of allogeneic UCB cell could be potentiated by EPO for neurological recovery in children with CP without harmful effects. Trial registration ClinicalTrials.gov, NCT01991145, registered 25 November 2013.
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Affiliation(s)
- Kyunghoon Min
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University School of Medicine, 59 Yatap-ro, Bundang-gu, Seongnam, Gyeonggi-do, Republic of Korea.,Rehabilitation and Regeneration Research Center, CHA University, Seongnam, Republic of Korea
| | - Mi Ri Suh
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University School of Medicine, 59 Yatap-ro, Bundang-gu, Seongnam, Gyeonggi-do, Republic of Korea
| | - Kye Hee Cho
- Rehabilitation and Regeneration Research Center, CHA University, Seongnam, Republic of Korea.,Department of Rehabilitation Medicine, CHA Ilsan Medical Center, CHA University School of Medicine, Ilsan, Republic of Korea
| | - Wookyung Park
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University School of Medicine, 59 Yatap-ro, Bundang-gu, Seongnam, Gyeonggi-do, Republic of Korea.,Rehabilitation and Regeneration Research Center, CHA University, Seongnam, Republic of Korea
| | - Myung Seo Kang
- Department of Laboratory Medicine, CHA Bundang Medical Center, CHA University School of Medicine and CHA Cord Blood Bank, Seongnam, Republic of Korea
| | - Su Jin Jang
- Department of Nuclear Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Sang Heum Kim
- Department of Radiology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Seonkyeong Rhie
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Jee In Choi
- Rehabilitation and Regeneration Research Center, CHA University, Seongnam, Republic of Korea
| | - Hyun-Jin Kim
- Rehabilitation and Regeneration Research Center, CHA University, Seongnam, Republic of Korea
| | - Kwang Yul Cha
- CHA Hollywood Presbyterian Medical Center, Los Angeles, CA, USA
| | - MinYoung Kim
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University School of Medicine, 59 Yatap-ro, Bundang-gu, Seongnam, Gyeonggi-do, Republic of Korea. .,Rehabilitation and Regeneration Research Center, CHA University, Seongnam, Republic of Korea.
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23
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Venancio SI, Bortoli MC, Frias PG, Giugliani ERJ, Alves CRL, Santos MO. Development and validation of an instrument for monitoring child development indicators. J Pediatr (Rio J) 2020; 96:778-789. [PMID: 31794693 PMCID: PMC9432335 DOI: 10.1016/j.jped.2019.10.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 10/01/2019] [Accepted: 10/16/2019] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE To create and validate an instrument for child development monitoring. METHODS Methodological study, based on the World Bank's proposition to monitor child development indicators in low- and middle-income countries. The stages of the study included the following: development of an inventory of items for child development evaluation, based on open access instruments; content validation by a group of experts on the topic, using consensus techniques; selection of questions to describe children and their families; pre-test of the instrument during the vaccination campaign in 2016 in three municipalities, and conducting cognitive interviews. RESULTS A total of 431 items were sent for the evaluation of the specialists; 77 were initially excluded and the others were evaluated in-person by the group, with 162 items covering the motor, cognitive, language, and socio-emotional domains, distributed in ten age ranges. Questions about health, nutrition, early learning, protection and safety, and responsive care were also included. The instrument was applied by volunteer undergraduate students to 367 mothers of children under 5 years, showing good adherence of the caregivers. The time of application of the questionnaire was, on average, 20minutes. The cognitive interviews allowed the final adjustment of 19 items of the instrument for better understanding by the caregivers. CONCLUSIONS The instrument created and validated by experts fills a gap, as it allows a comprehensive evaluation of the development of children under 5 years at the population level, using a fast and inexpensive tool, and can be useful for monitoring indicators of development in Brazilian children in vaccination campaigns.
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Affiliation(s)
- Sonia I Venancio
- Secretaria de Estado da Saúde de São Paulo, Instituto de Saúde, São Paulo, SP, Brazil.
| | - Maritsa C Bortoli
- Secretaria de Estado da Saúde de São Paulo, Instituto de Saúde, São Paulo, SP, Brazil
| | - Paulo G Frias
- Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Programa de Pós-Graduação em Avaliação em Saúde, Recife, PE, Brazil
| | - Elsa R J Giugliani
- Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Departamento de Pediatria, Porto Alegre, RS, Brazil
| | - Cláudia R L Alves
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Pediatria, Belo Horizonte, MG, Brazil
| | - Miriam O Santos
- Universidade Católica de Brasília, Escola de Saúde e Medicina, Brasília, DF, Brazil
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Venancio SI, Bortoli MC, Frias PG, Giugliani ER, Alves CR, Santos MO. Development and validation of an instrument for monitoring child development indicators. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2020. [DOI: 10.1016/j.jpedp.2019.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Picotti E, Bechtel N, Latal B, Borradori-Tolsa C, Bickle-Graz M, Grunt S, Johnson S, Wolke D, Natalucci G. Performance of the German version of the PARCA-R questionnaire as a developmental screening tool in two-year-old very preterm infants. PLoS One 2020; 15:e0236289. [PMID: 32881866 PMCID: PMC7470267 DOI: 10.1371/journal.pone.0236289] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 07/01/2020] [Indexed: 11/29/2022] Open
Abstract
Objective To validate and test a German version of the revised Parent Report of Children's Abilities questionnaire (PARCA-R). Methods Multicentre cross-sectional study. Parents of infants born <32 gestational weeks, completed the PARCA-R within three weeks before the follow-up assessment of their child at age two years. Infants were assessed using the Mental Development Index (MDI) of the Bayley Scales of Infant Development 2nd edition (BSID-II). Pearson correlation between the Parent Report Composite (PRC) of the PARCA-R and MDI was tested. The optimal PRC cut-off for predicting moderate-to-severe mental delay, defined as MDI<70, was identified through the receiver operating characteristic (ROC) curve. Results PARCA-R and BSID-II data were collected from 154 consecutive infants [51% girls, mean (SD) gestational age 29.0 (2.0) weeks, birth weight 1174 (345) grams] at 23.2 (1.6) months of corrected age. The PRC score [70.5 (31.1)] correlated with the MDI [92.2 (17.3); R = 0.54; p < 0.0001]. The optimal PRC cut-off for identifying mental delay was 44 with 0.81 (0.54–0.96) sensitivity (95%-CI), 0.81 (0.74–0.87) specificity, area under the ROC curve of 0.840 (0.729–0.952). Conclusion The German version of the PARCA-R had good validity with the BSID-II and PCR scores < 44 proved optimal discriminatory power for the identification of mental delay at two years of corrected age.
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Affiliation(s)
- Eleonora Picotti
- Department of Neonatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Nina Bechtel
- Division of Neuropaediatrics and Developmental Medicine, University Children's Hospital Basel, Basel, Switzerland
| | - Beatrice Latal
- Child Development Centre, University Children’s Hospital Zurich, Zurich, Switzerland
| | | | - Myriam Bickle-Graz
- Department Woman-Mother-Child, University Hospital Lausanne, Lausanne, Switzerland
| | - Sebastian Grunt
- Division of Neuropaediatrics, Development and Rehabilitation, University Children's Hospital, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Samantha Johnson
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Giancarlo Natalucci
- Department of Neonatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
- Child Development Centre, University Children’s Hospital Zurich, Zurich, Switzerland
- Larson-Rosenquist Family Foundation Centre for Neurodevelopment, Growth and Nutrition of the Newborn, University of Zurich, Zurich Switzerland
- * E-mail:
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Zuccarini M, Guarini A, Savini S, Faldella G, Sansavini A. Do 6-Month Motor Skills Have Cascading Effects on 12-Month Motor and Cognitive Development in Extremely Preterm and Full-Term Infants? Front Psychol 2020; 11:1297. [PMID: 32670158 PMCID: PMC7332837 DOI: 10.3389/fpsyg.2020.01297] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 05/18/2020] [Indexed: 11/17/2022] Open
Abstract
In this study, we analyzed whether 6-month gross and fine motor skills were related to 12-month gross and fine motor skills and cognitive development, controlling for 6-month cognitive skills, and neonatal status (extremely low gestational age ELGA ≤ 28 weeks vs. full-term FT ≥ 37 weeks). We also investigated, at 6 months, predictive indexes for motor and cognitive delay at 12-months. We assessed 40 infants (20 ELGA and 20 FT) at 6 and 12 months (corrected age for the ELGA infants). Six-month gross motor skills were related to 12-month gross motor, fine motor, and cognitive skills and predicted 12-month gross motor delay. Six-month cognitive skills explained an additional amount of variance of 12-month gross motor skills, whereas neonatal status explained an additional amount of variance of 12-month cognitive skills. Considering the intradomain and cross-domain cascading effects of early gross motor skills on later motor and cognitive development, these skills should be repeatedly assessed in ELGA infants in the first year of life for early identification of infants with delayed gross motor skills and implementation of customized interventions.
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Affiliation(s)
| | | | - Silvia Savini
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Giacomo Faldella
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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Armstrong-Buisseret L, Powers K, Dorling J, Bradshaw L, Johnson S, Mitchell E, Duley L. Randomised trial of cord clamping at very preterm birth: outcomes at 2 years. Arch Dis Child Fetal Neonatal Ed 2020; 105:292-298. [PMID: 31371434 PMCID: PMC7363783 DOI: 10.1136/archdischild-2019-316912] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 07/15/2019] [Accepted: 07/17/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To report outcomes at 2 years corrected age for children of women recruited to a trial comparing alternative policies for timing of cord clamping and immediate neonatal care at very preterm birth. DESIGN Parallel group randomised (1:1) trial. SETTING Eight UK tertiary maternity units. PARTICIPANTS Two hundred and seventy-six babies born to 261 women expected to have a live birth before 32+0 weeks' gestation. INTERVENTIONS Deferred cord clamping (≥2 min) and immediate neonatal care with cord intact or immediate (≤20 s) clamping and immediate neonatal care after clamping. MAIN OUTCOME MEASURE Composite of death or adverse neurodevelopmental outcome at 2 years corrected age. RESULTS Six babies born after 35+6 weeks were excluded. At 2 years corrected age, outcome data were not available for a further 52 children, leaving 218 for analysis (115 deferred clamping, 103 immediate clamping). Overall, 24/115 (21%) children allocated deferred clamping died or had an adverse neurodevelopmental outcome compared with 35/103 (34%) allocated immediate clamping; risk ratio (RR) 0.61 (95% CI 0.39 to 0.96); risk difference (RD) -13% (95% CI -25% to -1%). Multiple imputation for missing data gave an RR 0.69 (95% CI 0.44 to 1.09) and RD -9% (95% CI -21% to 2%). CONCLUSIONS Deferred clamping and immediate neonatal care with cord intact may reduce the risk of death or adverse neurodevelopmental outcome at 2 years of age for children born very premature. Confirmation in larger studies is needed to determine the real benefits and harms. TRIAL REGISTRATION NUMBER ISRCTN21456601.
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Affiliation(s)
| | - Katie Powers
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - Jon Dorling
- Division of Neonatal-Perinatal Medicine, Dalhousie University, Halifax, Canada
| | - Lucy Bradshaw
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - Samantha Johnson
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Eleanor Mitchell
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - Lelia Duley
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
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Do developmental and temperamental characteristics mediate the association between preterm birth and the quality of mother-child interaction? Infant Behav Dev 2020; 58:101421. [PMID: 32135402 DOI: 10.1016/j.infbeh.2020.101421] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 12/05/2019] [Accepted: 01/18/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND The current study aims to evaluate the association between preterm birth and the quality of mother-child interaction of very preterm-, moderate preterm-, and full-term-born children at 18 and 36 months and to determine whether developmental and behavioral characteristics mediate the association between preterm birth and the quality of mother-child interaction. METHOD Participants included 110 preterm-born children and 39 full-term-born children assessed at ages 18 and 36 months. Mother-child free play interactions, the Mullen Scales of Early Learning, the Infant Behavior Questionnaire, and the Early Childhood Behavior Questionnaire were administered. RESULTS Significant associations between preterm birth and the quality of mother-child interaction were found at 18 and 36 months. The mother-child interaction quality was less optimal for the preterm-born children compared with the full-term-born children, mainly so for the very preterm-born children. Unlike behavioral characteristics, cognitive development was found to mediate the association between the gestational age-based group and the quality of mother-child interaction. CONCLUSIONS Intervention programs for preterm-born children and their families, should consider maternal and children's behaviors during mother-child interactions, in addition to cognitive, language, motor and emotional regulation abilities, and particularly so with very preterm-born children, who exhibit slower cognitive development.
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Ouellet-Scott N, Gagnon M, Fortin P, Girouard-Chantal É, Peckre P, Martini R, Lambert J, Luu TM, Simard MN. Screening for mild to moderate motor impairments in very preterm children: Utility of parent questionnaires. Early Hum Dev 2020; 141:104940. [PMID: 31862628 DOI: 10.1016/j.earlhumdev.2019.104940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 11/15/2019] [Accepted: 12/10/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Nellie Ouellet-Scott
- Research Center, Centre Hospitalier Universitaire Ste-Justine, Montreal, Canada; School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Mélanie Gagnon
- Research Center, Centre Hospitalier Universitaire Ste-Justine, Montreal, Canada; School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Pascale Fortin
- Research Center, Centre Hospitalier Universitaire Ste-Justine, Montreal, Canada; School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Élise Girouard-Chantal
- Research Center, Centre Hospitalier Universitaire Ste-Justine, Montreal, Canada; School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Perrine Peckre
- Research Center, Centre Hospitalier Universitaire Ste-Justine, Montreal, Canada
| | - Rose Martini
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
| | - Jean Lambert
- School of Public Health, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Thuy Mai Luu
- Research Center, Centre Hospitalier Universitaire Ste-Justine, Montreal, Canada; Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada
| | - Marie-Noëlle Simard
- Research Center, Centre Hospitalier Universitaire Ste-Justine, Montreal, Canada; School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada.
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Gridley N, Blower S, Dunn A, Bywater T, Bryant M. Psychometric Properties of Child (0-5 Years) Outcome Measures as used in Randomized Controlled Trials of Parent Programs: A Systematic Review. Clin Child Fam Psychol Rev 2019; 22:388-405. [PMID: 30806864 PMCID: PMC6669186 DOI: 10.1007/s10567-019-00277-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
This systematic review is one of the three which sought to identify measures commonly implemented in parenting program research, and to assess the level of psychometric evidence available for their use with this age group. This review focuses specifically on measures of child social-emotional and behavioral outcomes. Two separate searches of the same databases were conducted; firstly to identify eligible instruments, and secondly to identify studies reporting on the psychometric properties of the identified measures. Five commercial platforms hosting 19 electronic databases were searched from their inception to conducted search dates. Twenty-four measures were identified from Search 1: a systematic search of randomized controlled trial evaluations of parenting programs. For Search 2, inclusion/exclusion criteria were applied to 21,329 articles that described the development and/or validation of the 24 measures identified in Search 1. Thirty articles met the inclusion criteria. resulting in 11 parent report questionnaires and three developmental assessment measures for review. Data were extracted and synthesized to describe the methodological quality of each article using the COSMIN checklist alongside the overall quality rating of the psychometric property reported for each measure. Measure reliability was categorized into four domains (internal consistency, test-re-test, inter-rater, and intra-rater). Measure validity was categorized into four domains (content, structural, convergent/divergent, and discriminant). Results indicated that supporting evidence for included measures is weak. Further work is required to improve the evidence base for those measures designed to assess children's social-emotional and behavioral development in this age group. PROSPERO Registration number: CRD42016039600.
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Affiliation(s)
- Nicole Gridley
- Department of Health Sciences, University of York, York, YO10 5DD, UK
- Carnegie School of Education, Leeds Beckett University, Leeds, UK
| | - Sarah Blower
- Department of Health Sciences, University of York, York, YO10 5DD, UK.
| | - Abby Dunn
- Department of Health Sciences, University of York, York, YO10 5DD, UK
| | - Tracey Bywater
- Department of Health Sciences, University of York, York, YO10 5DD, UK
| | - Maria Bryant
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
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Modi N, Ashby D, Battersby C, Brocklehurst P, Chivers Z, Costeloe K, Draper ES, Foster V, Kemp J, Majeed A, Murray J, Petrou S, Rogers K, Santhakumaran S, Saxena S, Statnikov Y, Wong H, Young A. Developing routinely recorded clinical data from electronic patient records as a national resource to improve neonatal health care: the Medicines for Neonates research programme. PROGRAMME GRANTS FOR APPLIED RESEARCH 2019. [DOI: 10.3310/pgfar07060] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background
Clinical data offer the potential to advance patient care. Neonatal specialised care is a high-cost NHS service received by approximately 80,000 newborn infants each year.
Objectives
(1) To develop the use of routinely recorded operational clinical data from electronic patient records (EPRs), secure national coverage, evaluate and improve the quality of clinical data, and develop their use as a national resource to improve neonatal health care and outcomes. To test the hypotheses that (2) clinical and research data are of comparable quality, (3) routine NHS clinical assessment at the age of 2 years reliably identifies children with neurodevelopmental impairment and (4) trial-based economic evaluations of neonatal interventions can be reliably conducted using clinical data. (5) To test methods to link NHS data sets and (6) to evaluate parent views of personal data in research.
Design
Six inter-related workstreams; quarterly extractions of predefined data from neonatal EPRs; and approvals from the National Research Ethics Service, Health Research Authority Confidentiality Advisory Group, Caldicott Guardians and lead neonatal clinicians of participating NHS trusts.
Setting
NHS neonatal units.
Participants
Neonatal clinical teams; parents of babies admitted to NHS neonatal units.
Interventions
In workstream 3, we employed the Bayley-III scales to evaluate neurodevelopmental status and the Quantitative Checklist of Autism in Toddlers (Q-CHAT) to evaluate social communication skills. In workstream 6, we recruited parents with previous experience of a child in neonatal care to assist in the design of a questionnaire directed at the parents of infants admitted to neonatal units.
Data sources
Data were extracted from the EPR of admissions to NHS neonatal units.
Main outcome measures
We created a National Neonatal Research Database (NNRD) containing a defined extract from real-time, point-of-care, clinician-entered EPRs from all NHS neonatal units in England, Wales and Scotland (n = 200), established a UK Neonatal Collaborative of all NHS trusts providing neonatal specialised care, and created a new NHS information standard: the Neonatal Data Set (ISB 1595) (see http://webarchive.nationalarchives.gov.uk/±/http://www.isb.nhs.uk/documents/isb-1595/amd-32–2012/index_html; accessed 25 June 2018).
Results
We found low discordance between clinical (NNRD) and research data for most important infant and maternal characteristics, and higher prevalence of clinical outcomes. Compared with research assessments, NHS clinical assessment at the age of 2 years has lower sensitivity but higher specificity for identifying children with neurodevelopmental impairment. Completeness and quality are higher for clinical than for administrative NHS data; linkage is feasible and substantially enhances data quality and scope. The majority of hospital resource inputs for economic evaluations of neonatal interventions can be extracted reliably from the NNRD. In general, there is strong parent support for sharing routine clinical data for research purposes.
Limitations
We were only able to include data from all English neonatal units from 2012 onwards and conduct only limited cross validation of NNRD data directly against data in paper case notes. We were unable to conduct qualitative analyses of parent perspectives. We were also only able to assess the utility of trial-based economic evaluations of neonatal interventions using a single trial. We suggest that results should be validated against other trials.
Conclusions
We show that it is possible to obtain research-standard data from neonatal EPRs, and achieve complete population coverage, but we highlight the importance of implementing systematic examination of NHS data quality and completeness and testing methods to improve these measures. Currently available EPR data do not enable ascertainment of neurodevelopmental outcomes reliably in very preterm infants. Measures to maintain high quality and completeness of clinical and administrative data are important health service goals. As parent support for sharing clinical data for research is underpinned by strong altruistic motivation, improving wider public understanding of benefits may enhance informed decision-making.
Future work
We aim to implement a new paradigm for newborn health care in which continuous incremental improvement is achieved efficiently and cost-effectively by close integration of evidence generation with clinical care through the use of high-quality EPR data. In future work, we aim to automate completeness and quality checks and make recording processes more ‘user friendly’ and constructed in ways that minimise the likelihood of missing or erroneous entries. The development of criteria that provide assurance that data conform to prespecified completeness and quality criteria would be an important development. The benefits of EPR data might be extended by testing their use in large pragmatic clinical trials. It would also be of value to develop methods to quality assure EPR data including involving parents, and link the NNRD to other health, social care and educational data sets to facilitate the acquisition of lifelong outcomes across multiple domains.
Study registration
This study is registered as PROSPERO CRD42015017439 (workstream 1) and PROSPERO CRD42012002168 (workstream 3).
Funding
The National Institute for Health Research Programme Grants for Applied Research programme (£1,641,471). Unrestricted donations were supplied by Abbott Laboratories (Maidenhead, UK: £35,000), Nutricia Research Foundation (Schiphol, the Netherlands: £15,000), GE Healthcare (Amersham, UK: £1000). A grant to support the use of routinely collected, standardised, electronic clinical data for audit, management and multidisciplinary feedback in neonatal medicine was received from the Department of Health and Social Care (£135,494).
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Affiliation(s)
- Neena Modi
- Department of Medicine, Imperial College London, London, UK
| | - Deborah Ashby
- Imperial Clinical Trials Unit, Imperial College London, London, UK
| | | | - Peter Brocklehurst
- Birmingham Clinical Trials Unit, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Kate Costeloe
- Centre for Genomics and Child Health, Queen Mary University of London, London, UK
| | | | - Victoria Foster
- Department of Social Sciences, Edge Hill University, Ormskirk, UK
| | - Jacquie Kemp
- National Programme of Care, NHS England, London, UK
| | - Azeem Majeed
- School of Public Health, Imperial College London, London, UK
| | | | - Stavros Petrou
- Division of Health Sciences, University of Warwick, Coventry, UK
| | - Katherine Rogers
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
| | | | - Sonia Saxena
- School of Public Health, Imperial College London, London, UK
| | | | - Hilary Wong
- Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - Alys Young
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
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García Reymundo M, Hurtado Suazo JA, Calvo Aguilar MJ, Soriano Faura FJ, Ginovart Galiana G, Martín Peinador Y, Jiménez Moya A, Demestre Guasch X. Follow-up recommendations for the late preterm infant. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2019. [DOI: 10.1016/j.anpede.2019.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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García Reymundo M, Hurtado Suazo JA, Calvo Aguilar MJ, Soriano Faura FJ, Ginovart Galiana G, Martín Peinador Y, Jiménez Moya A, Demestre Guasch X. Recomendaciones de seguimiento del prematuro tardío. An Pediatr (Barc) 2019; 90:318.e1-318.e8. [DOI: 10.1016/j.anpedi.2019.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 01/02/2019] [Accepted: 01/09/2019] [Indexed: 10/27/2022] Open
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Harel-Gadassi A, Friedlander E, Yaari M, Bar-Oz B, Eventov-Friedman S, Mankuta D, Yirmiya N. Developmental assessment of preterm infants: Chronological or corrected age? RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 80:35-43. [PMID: 29906778 DOI: 10.1016/j.ridd.2018.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 02/19/2018] [Accepted: 06/07/2018] [Indexed: 06/08/2023]
Abstract
The aim of this study is to examine the effect of age correction on the developmental assessment scores of preterm infants, using for the first time, the Mullen scales of early learning (MSEL) test. Participants included 110 preterm infants (born at a gestational age of ≤ 34 weeks) at ages 1, 4, 8, 12, 18, 24 and 36 months. The corrected age-based MSEL composite score and each of the five MSEL scale scores were significantly higher than chronological age-based scores at all ages. These corrected scores were significantly higher than the chronological scores regardless of gestational age whether weight was, or adequate or small for gestational age. Larger differences between corrected and chronological age-based scores significantly correlated with earlier gestational age and with lower birth weight between 1 and 24 months but not at 36 months. Using chronological age-based scores yielded significantly more infants identified with developmental delays than using corrected age-based scores. The findings indicate that clinicians and researchers, as well as family members, should be aware of and acknowledge the distinction between corrected and chronological ages when evaluating preterm infants in research and clinical practices.
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Affiliation(s)
- Ayelet Harel-Gadassi
- School of Education, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, 9190501, Israel
| | - Edwa Friedlander
- Department of Psychology, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, 9190501, Israel
| | - Maya Yaari
- Department of Psychology, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, 9190501, Israel
| | - Benjamin Bar-Oz
- Department of Neonatology, Hadassah University Hospital, Jerusalem, 91120, Israel
| | | | - David Mankuta
- Department of Obstetrics & Gynecology, Hadassah University Hospital, Jerusalem, 91120, Israel
| | - Nurit Yirmiya
- Department of Psychology, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, 9190501, Israel.
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Twomey DM, Wrigley C, Ahearne C, Murphy R, De Haan M, Marlow N, Murray DM. Feasibility of using touch screen technology for early cognitive assessment in children. Arch Dis Child 2018. [PMID: 29535111 DOI: 10.1136/archdischild-2017-314010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To explore the feasibility of using a touch screen assessment tool to measure cognitive capacity in toddlers. DESIGN 112 typically developing children with a median age of 31 months (IQR: 26-34) interacted with a touch screen cognitive assessment tool. We examined the sensitivity of the tool to age-related changes in cognition by comparing the number of items completed, speed of task completion and accuracy in two age groups; 24-29 months versus 30-36 months. RESULTS Children aged 30-36 months completed more tasks (median: 18, IQR: 18-18) than those aged 24-29 months (median: 17, IQR: 15-18). Older children also completed two of the three working memory tasks and an object permanence task faster than their younger peers. Children became faster at completing the working memory items with each exposure and registered similar completion times on the hidden object retrieval items, despite task demands being twofold on the second exposure. A novel item required children to integrate what they had learnt on preceding items. The older group was more likely to complete this item and to do so faster than the younger group. CONCLUSIONS Children as young as 24 months can complete items requiring cognitive engagement on a touch screen device, with no verbal instruction and minimal child-administrator interaction. This paves the way for using touch screen technology for language and administrator independent developmental assessment in toddlers.
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Affiliation(s)
- Deirdre M Twomey
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Conal Wrigley
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland.,Department of Applied Psychology, University College Cork, Cork, Ireland
| | - Caroline Ahearne
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Raegan Murphy
- Department of Applied Psychology, University College Cork, Cork, Ireland
| | - Michelle De Haan
- Centre for Developmental Cognitive Neurosciences, University College London, London, UK
| | - Neil Marlow
- UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - Deirdre M Murray
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
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Song YH, Chang HJ, Shin YB, Park YS, Park YH, Cho ES. The Validity of Two Neuromotor Assessments for Predicting Motor Performance at 12 Months in Preterm Infants. Ann Rehabil Med 2018; 42:296-304. [PMID: 29765883 PMCID: PMC5940606 DOI: 10.5535/arm.2018.42.2.296] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 08/23/2017] [Indexed: 11/05/2022] Open
Abstract
Objective To evaluate the validity of the Test of Infant Motor Performance (TIMP) and general movements (GMs) assessment for predicting Alberta Infant Motor Scale (AIMS) score at 12 months in preterm infants. Methods A total of 44 preterm infants who underwent the GMs and TIMP at 1 month and 3 months of corrected age (CA) and whose motor performance was evaluated using AIMS at 12 months CA were included. GMs were judged as abnormal on basis of poor repertoire or cramped-synchronized movements at 1 month CA and abnormal or absent fidgety movement at 3 months CA. TIMP and AIMS scores were categorized as normal (average and low average and >5th percentile, respectively) or abnormal (below average and far below average or <5th percentile, respectively). Correlations between GMs and TIMP scores at 1 month and 3 months CA and the AIMS classification at 12 months CA were examined. Results The TIMP score at 3 months CA and GMs at 1 month and 3 months CA were significantly correlated with the motor performance at 12 months CA. However, the TIMP score at 1 month CA did not correlate with the AIMS classification at 12 months CA. For infants with normal GMs at 3 months CA, the TIMP score at 3 months CA correlated significantly with the AIMS classification at 12 months CA. Conclusion Our findings suggest that neuromotor assessment using GMs and TIMP could be useful to identify preterm infants who are likely to benefit from intervention.
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Affiliation(s)
- You Hong Song
- Department of Physical Medicine and Rehabilitation, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Hyun Jung Chang
- Department of Physical Medicine and Rehabilitation, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Yong Beom Shin
- Department of Rehabilitation Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Young Sook Park
- Department of Physical Medicine and Rehabilitation, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Yun Hee Park
- Department of Physical Medicine and Rehabilitation, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Eun Sol Cho
- Department of Physical Medicine and Rehabilitation, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
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Yi YG, Sung IY, Yuk JS. Comparison of Second and Third Editions of the Bayley Scales in Children With Suspected Developmental Delay. Ann Rehabil Med 2018; 42:313-320. [PMID: 29765885 PMCID: PMC5940608 DOI: 10.5535/arm.2018.42.2.313] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 07/20/2017] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To compare the scores of the Bayley Scales of Infant Development second edition (BSID-II) and the third edition, Bayley-III, in children with suspected developmental delay and to determine the cutoff score for developmental delay in the Bayley-III. METHODS Children younger than 42 months (n=62) with suspected developmental delay who visited our department between 2014 and 2015 were assessed with both the BSID-II and Bayley-III tests. RESULTS The mean Bayley-III Cognitive Language Composite (CLC) score was 5.8 points higher than the mean BSID-II Mental Developmental Index (MDI) score, and the mean Bayley-III Motor Composite (MC) score was 7.9 points higher than the mean BSID-II Psychomotor Developmental Index (PDI) score. In receiver operating characteristic (ROC) analysis of a BSID-II MDI score <70, Bayley-III CLC scores showed a cutoff of 78.0 (96.6% sensitivity and 93.9% specificity). In ROC analysis of a BSID-II PDI score <70, the Bayley-III MC score showed a cutoff of 80. CONCLUSION There was a strong correlation between the BSID-II and Bayley-III in children with suspected developmental delay. The Bayley-III identified fewer children with developmental delay. The recommended cutoff value for developmental delay increased from a BSID-II score of 70 to a Bayley-III CLC score of 78 and Bayley-III MC score of 80.
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Affiliation(s)
- You Gyoung Yi
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - In Young Sung
- Department of Physical Medicine and Rehabilitation, Division of Pediatric Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin Sook Yuk
- Department of Physical Medicine and Rehabilitation, Division of Pediatric Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Zuccarini M, Guarini A, Savini S, Iverson JM, Aureli T, Alessandroni R, Faldella G, Sansavini A. Object exploration in extremely preterm infants between 6 and 9 months and relation to cognitive and language development at 24 months. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 68:140-152. [PMID: 28779627 DOI: 10.1016/j.ridd.2017.06.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 05/03/2017] [Accepted: 06/03/2017] [Indexed: 06/07/2023]
Abstract
Although early object exploration is considered a key ability for subsequent achievements, very few studies have analyzed its development in extremely low gestational age infants (ELGA- GA <28 weeks), whose early motor skills are delayed. Moreover, no studies have examined its developmental relationship with cognitive and language skills. The present study examined developmental change in Motor Object Exploration (MOE) and different types of MOE (Holding, Oral, Manual and Manual Rhythmic Exploration) in 20 ELGA and 20 full term (FT) infants observed during mother-infant play interaction at 6 and 9 months. It also explored whether specific types of MOE were longitudinally related to 24-month language and cognitive abilities (GMDS-R scores). ELGA infants increased MOE duration from 6 to 9 months, eliminating the initial difference with FT infants. In addition, ELGA infants showed a different pattern of Oral Exploration, that did not increase at 6 months and decrease at 9 months. Oral and Manual Exploration durations at 6 months were longitudinally related to 24-month GMDS-R language and cognitive performance scores respectively. We discuss the relevance of assessing early exploratory abilities in ELGA infants in order to implement customized intervention programs for supporting the development of these skills.
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Affiliation(s)
- Mariagrazia Zuccarini
- Department of Psychology, University of Bologna, Via Berti Pichat, 5-40127 Bologna, Italy.
| | - Annalisa Guarini
- Department of Psychology, University of Bologna, Via Berti Pichat, 5-40127 Bologna, Italy.
| | - Silvia Savini
- Department of Psychology, University of Bologna, Via Berti Pichat, 5-40127 Bologna, Italy.
| | - Jana M Iverson
- Department of Psychology, University of Pittsburgh, USA.
| | - Tiziana Aureli
- Department of Neuroscience, Imaging and Clinical Sciences, University of Chieti-Pescara, Italy.
| | - Rosina Alessandroni
- Neonatology and Neonatal Intensive Care Unit - S. Orsola-Malpighi Hospital, Department of Medical and Surgical Sciences, University of Bologna, Italy.
| | - Giacomo Faldella
- Neonatology and Neonatal Intensive Care Unit - S. Orsola-Malpighi Hospital, Department of Medical and Surgical Sciences, University of Bologna, Italy.
| | - Alessandra Sansavini
- Department of Psychology, University of Bologna, Via Berti Pichat, 5-40127 Bologna, Italy.
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Johansen K, Persson K, Sonnander K, Magnusson M, Sarkadi A, Lucas S. Clinical utility of the Structured Observation of Motor Performance in Infants within the child health services. PLoS One 2017; 12:e0181398. [PMID: 28723929 PMCID: PMC5517004 DOI: 10.1371/journal.pone.0181398] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 07/02/2017] [Indexed: 11/25/2022] Open
Abstract
AIM This study aimed to evaluate the clinical utility of the Structured Observation of Motor Performance in Infants (SOMP-I) when used by nurses in routine child healthcare by analyzing the nurses' SOMP-I assessments and the actions taken when motor problems were suspected. METHOD Infants from three child health centers in Uppsala County, Sweden, were consecutively enrolled in a longitudinal study. The 242 infants were assessed using SOMP-I by the nurse responsible for the infant as part of the regular well-child visits at as close to 2, 4, 6 and 10 months of age as possible. The nurses noted actions taken such as giving advice, scheduling an extra follow-up or referring the infant to specialized care. The infants' motor development was reassessed at 18 months of age through review of medical records or parental report. RESULTS The assessments of level of motor development at 2 and 10 months showed a distribution corresponding to the percentile distribution of the SOMP-I method. Fewer infants than expected were assessed as delayed at 4 and 6 months or deficient in quality at all assessment ages. When an infant was assessed as delayed in level or deficient in quality, the likelihood of the nurse taking actions increased. This increased further if both delay and quality deficit were found at the same assessment or if one or both were found at repeated assessments. The reassessment of the motor development at 18 months did not reveal any missed infants with major motor impairments. INTERPRETATION The use of SOMP-I appears to demonstrate favorable clinical utility in routine child healthcare as tested here. Child health nurses can assess early motor performance using this standardized assessment method, and using the method appears to support them the clinical decision-making.
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Affiliation(s)
- Kine Johansen
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Uppsala University Children’s Hospital, Uppsala, Sweden
| | - Kristina Persson
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Karin Sonnander
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Margaretha Magnusson
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Anna Sarkadi
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Steven Lucas
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Uppsala University Children’s Hospital, Uppsala, Sweden
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Clausen NG, Pedersen DA, Pedersen JK, Møller SE, Grosen D, Wehby GL, Christensen K, Hansen TG. Oral Clefts and Academic Performance in Adolescence: The Impact of Anesthesia-Related Neurotoxicity, Timing of Surgery, and Type of Oral Clefts. Cleft Palate Craniofac J 2017; 54:371-380. [PMID: 27043652 PMCID: PMC6687065 DOI: 10.1597/15-185] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE Early life exposure to anesthesia and surgery is suspected to associate with cognitive impairment later in life. We compared academic achievement among adolescents with cleft lip only (CL), cleft palate only (CP), and cleft lip and cleft palate (CLP) with a noncleft control group to investigate whether outcome depends on timing and number of operations during childhood and/or type of oral cleft. DESIGN Nationwide register-based follow-up study. SETTING Danish birth cohort 1986 to 1990. PARTICIPANTS Five hundred fifty-eight children with isolated CL (n = 171), CLP (n = 222), or CP (n = 195), of which 509 children had been exposed to anesthesia and one or more cleft operation(s), and a 5% sample of the birth cohort (n = 14,677). MAIN OUTCOME MEASURE(S) Test score in the Danish standardized ninth-grade exam and proportion of nonattainment, defined as "results for ninth-grade exam unavailable." Data adjusted for sex, birth weight, parental age, and parental level of education. RESULTS Compared to controls, children with CL achieved higher scores (mean difference 0.12, 95% CI -0.05; 0.29) and children with CLP presented with lower scores (mean difference -0.06, 95% CI -0.21; 0.09), albeit both statistically insignificant. Children with CP achieved significantly lower scores, mean difference -0.20 (95% CI -0.38; -0.03). Odds ratios for nonattainment at final exam were: CL 0.79 (95% CI 0.46; 1.35), CLP 1.07 (95% CI 0.71; 1.61), CP 2.59 (95% CI 1.78; 3.76). CONCLUSIONS Oral cleft type rather than number and timing of anesthesia and operations associate to poorer academic performance. Although a potential neurotoxic effect due to anesthetic agents is not reflected in the data, it cannot be completely excluded.
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Morales-Monforte E, Bagur-Calafat C, Suc-Lerin N, Fornaguera-Martí M, Cazorla-Sánchez E, Girabent-Farrés M. The Spanish version of the Alberta Infant Motor Scale: Validity and reliability analysis. Dev Neurorehabil 2017; 20:76-82. [PMID: 28125359 DOI: 10.3109/17518423.2015.1066461] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Validity and reliability of the cross-cultural adaptive translation of the Alberta Infant Motor Scale (AIMS), to monitor gross motor development in infants from 0 to 18 months of age, were evaluated. METHODS A cross-cultural translation was used to generate a Spanish version of the AIMS. Fifty infants at risk or with diagnosis of motor delay, 0-18 months of age, participated in this study. Two independent physical therapists scored infants on the AIMS. Concurrent validity was tested using the AIMS and the Bayley Scales of Infant and Toddler Development - III (Bayley - III). RESULTS Reliability and the internal consistency were high (ICCs ranged from 0.94 to 1.00 and KR-20 ranged from 0.90 to 0.98, respectively). AIMS and Bayley - III scores correlated strongly (r = 0.97). CONCLUSION The Spanish version of the AIMS presented excellent validity and reliability. Further studies are suggested in order to assess the AIMS in preterm babies.
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Affiliation(s)
- Erica Morales-Monforte
- a Physical Therapy Department , Universitat Internacional de Catalunya , Barcelona , Spain
| | - Caridad Bagur-Calafat
- a Physical Therapy Department , Universitat Internacional de Catalunya , Barcelona , Spain
| | - Neus Suc-Lerin
- b Neurology Unit, Hospital Sant Joan de Déu , Barcelona , Spain , and
| | | | | | - Montserrat Girabent-Farrés
- c Biostatistics and Epidemiology Department , Universitat Internacional de Catalunya , Barcelona , Spain
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Aghakhanyan G, Bonanni P, Randazzo G, Nappi S, Tessarotto F, De Martin L, Frijia F, De Marchi D, De Masi F, Kuppers B, Lombardo F, Caramella D, Montanaro D. From Cortical and Subcortical Grey Matter Abnormalities to Neurobehavioral Phenotype of Angelman Syndrome: A Voxel-Based Morphometry Study. PLoS One 2016; 11:e0162817. [PMID: 27626634 PMCID: PMC5023118 DOI: 10.1371/journal.pone.0162817] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Accepted: 08/29/2016] [Indexed: 12/14/2022] Open
Abstract
Angelman syndrome (AS) is a rare neurogenetic disorder due to loss of expression of maternal ubiquitin-protein ligase E3A (UBE3A) gene. It is characterized by severe developmental delay, speech impairment, movement or balance disorder and typical behavioral uniqueness. Affected individuals show normal magnetic resonance imaging (MRI) findings, although mild dysmyelination may be observed. In this study, we adopted a quantitative MRI analysis with voxel-based morphometry (FSL-VBM) method to investigate disease-related changes in the cortical/subcortical grey matter (GM) structures. Since 2006 to 2013 twenty-six AS patients were assessed by our multidisciplinary team. From those, sixteen AS children with confirmed maternal 15q11-q13 deletions (mean age 7.7 ± 3.6 years) and twenty-one age-matched controls were recruited. The developmental delay and motor dysfunction were assessed using Bayley III and Gross Motor Function Measure (GMFM). Principal component analysis (PCA) was applied to the clinical and neuropsychological datasets. High-resolution T1-weighted images were acquired and FSL-VBM approach was applied to investigate differences in the local GM volume and to correlate clinical and neuropsychological changes in the regional distribution of GM. We found bilateral GM volume loss in AS compared to control children in the striatum, limbic structures, insular and orbitofrontal cortices. Voxel-wise correlation analysis with the principal components of the PCA output revealed a strong relationship with GM volume in the superior parietal lobule and precuneus on the left hemisphere. The anatomical distribution of cortical/subcortical GM changes plausibly related to several clinical features of the disease and may provide an important morphological underpinning for clinical and neurobehavioral symptoms in children with AS.
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Affiliation(s)
- Gayane Aghakhanyan
- Unit of Neuroradiology, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy
| | - Paolo Bonanni
- Epilepsy and Clinical Neurophysiology Unit, E. Medea Scientific Institute, Conegliano (TV), Italy
| | - Giovanna Randazzo
- Epilepsy and Clinical Neurophysiology Unit, E. Medea Scientific Institute, Conegliano (TV), Italy
| | - Sara Nappi
- Epilepsy and Clinical Neurophysiology Unit, E. Medea Scientific Institute, Conegliano (TV), Italy
| | - Federica Tessarotto
- Epilepsy and Clinical Neurophysiology Unit, E. Medea Scientific Institute, Conegliano (TV), Italy
| | - Lara De Martin
- Epilepsy and Clinical Neurophysiology Unit, E. Medea Scientific Institute, Conegliano (TV), Italy
| | - Francesca Frijia
- Unit of Neuroradiology, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy
| | - Daniele De Marchi
- Unit of Neuroradiology, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy
| | - Francesco De Masi
- Division of Anesthesiology and Intensive Care, University Hospital of Pisa, Pisa, Italy
| | - Beate Kuppers
- Division of Anesthesiology and Intensive Care, University Hospital of Pisa, Pisa, Italy
| | - Francesco Lombardo
- Unit of Neuroradiology, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy
| | - Davide Caramella
- Diagnostic and Interventional Radiology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Domenico Montanaro
- Unit of Neuroradiology, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy
- * E-mail:
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Zuccarini M, Sansavini A, Iverson JM, Savini S, Guarini A, Alessandroni R, Faldella G, Aureli T. Object engagement and manipulation in extremely preterm and full term infants at 6 months of age. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 55:173-184. [PMID: 27101093 DOI: 10.1016/j.ridd.2016.04.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 04/01/2016] [Accepted: 04/02/2016] [Indexed: 06/05/2023]
Abstract
Delays in the motor domain have been frequently observed in preterm children, especially those born at an extremely low gestational age (ELGA;<28 weeks GA). However, early motor exploration has received relatively little attention despite its relevance for object knowledge and its impact on cognitive and language development. The present study aimed at comparing early object exploration in 20 ELGA and 20 full-term (FT) infants at 6 months of age during a 5-minute mother-infant play interaction. Object engagement (visual vs manual), visual object engagement (no act vs reach), manual object engagement (passive vs active), and active object manipulation (mouthing, transferring, banging, turn/rotating, shaking, fingering) were analyzed. Moreover, the Griffiths Mental Development Scales 0-2 years (1996) were administered to the infants. Relative to FT peers, ELGA infants spent more time in visual engagement, and less time in manual engagement, active manipulation, mouthing, and turning/rotating. Moreover, they had lower scores on general psychomotor development, eye & hand coordination, and performance abilities. Close relationships emerged between manual object engagement and psychomotor development. Clinical implications of these results in terms of early evaluation of action schemes in ELGA infants and the provision of intervention programs for supporting these abilities are discussed.
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Affiliation(s)
- Mariagrazia Zuccarini
- Department of Psychology, University of Bologna, Via Berti Pichat 5, 40127 Bologna, Italy.
| | - Alessandra Sansavini
- Department of Psychology, University of Bologna, Via Berti Pichat 5, 40127 Bologna, Italy.
| | - Jana M Iverson
- Department of Psychology, University of Pittsburgh, USA.
| | - Silvia Savini
- Department of Psychology, University of Bologna, Via Berti Pichat 5, 40127 Bologna, Italy.
| | - Annalisa Guarini
- Department of Psychology, University of Bologna, Via Berti Pichat 5, 40127 Bologna, Italy.
| | - Rosina Alessandroni
- Neonatology and Neonatal Intensive Care Unit - S. Orsola-Malpighi Hospital, Department of Medical and Surgical Sciences, University of Bologna, Italy.
| | - Giacomo Faldella
- Neonatology and Neonatal Intensive Care Unit - S. Orsola-Malpighi Hospital, Department of Medical and Surgical Sciences, University of Bologna, Italy.
| | - Tiziana Aureli
- Department of Neuroscience, Imaging and Clinical Sciences, University of Chieti-Pescara, Italy.
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44
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Systematic Screening for Developmental Delay in Early Childhood: Problems and Possible Solutions. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2016. [DOI: 10.1007/s40474-016-0090-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Telford EJ, Fletcher-Watson S, Gillespie-Smith K, Pataky R, Sparrow S, Murray IC, O'Hare A, Boardman JP. Preterm birth is associated with atypical social orienting in infancy detected using eye tracking. J Child Psychol Psychiatry 2016; 57:861-8. [PMID: 26934180 DOI: 10.1111/jcpp.12546] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/07/2016] [Indexed: 01/26/2023]
Abstract
BACKGROUND Preterm birth is closely associated with neurocognitive impairment in childhood including increased risk for social difficulties. Eye tracking objectively assesses eye-gaze behaviour in response to visual stimuli, which permits inference about underlying cognitive processes. We tested the hypothesis that social orienting in infancy is altered by preterm birth. METHODS Fifty preterm infants with mean (range) gestational age (GA) at birth of 29(+1) (23(+2) -33(+0) ) weeks and 50 term infants with mean (range) GA at birth 40(+2) (37(+0) -42(+3) ) weeks underwent eye tracking at median age of 7 months. Infants were presented with three categories of social stimuli of increasing complexity. Time to first fixate (TFF) and looking time (LT) on areas of interest (AoIs) were recorded using remote eye tracking. RESULTS Preterm infants consistently fixated for a shorter time on social content than term infants across all three tasks: face-scanning (fixation to eyes minus mouth 0.61s vs. 1.47s, p = .013); face pop-out task (fixation to face 0.8s vs. 1.34s, p = .023); and social preferential looking (1.16s vs. 1.5s p = .02). Time given to AoIs containing social content as a proportion of LT at the whole stimulus was lower in preterm infants across all three tasks. These results were not explained by differences in overall looking time between the groups. CONCLUSIONS Eye tracking provides early evidence of atypical cognition after preterm birth, and may be a useful tool for stratifying infants at risk of impairment for early interventions designed to improve outcome.
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Affiliation(s)
- Emma J Telford
- MRC/Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | | | | | - Rozalia Pataky
- MRC/Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - Sarah Sparrow
- MRC/Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - Ian C Murray
- Department of Child Life and Health, University of Edinburgh, Edinburgh, UK
| | - Anne O'Hare
- Salvesen Mindroom Centre, University of Edinburgh, Edinburgh, UK
| | - James P Boardman
- MRC/Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK.,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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O'Connor B, Kerr C, Shields N, Imms C. A systematic review of evidence-based assessment practices by allied health practitioners for children with cerebral palsy. Dev Med Child Neurol 2016; 58:332-47. [PMID: 26645152 DOI: 10.1111/dmcn.12973] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/05/2015] [Indexed: 12/16/2022]
Abstract
AIM The routine use of psychometrically robust assessment tools is integral to best practice. This systematic review aims to determine the extent to which evidence-based assessment tools were used by allied health practitioners for children with cerebral palsy (CP). METHOD The Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocols 2015 was employed. A search strategy applied the free text terms: 'allied health practitioner', 'assessment', and 'cerebral palsy', and related subject headings to seven databases. Included articles reported assessment practices of occupational therapists, physiotherapists, or speech pathologists working with children with CP aged 0 to 18 years, published from the year 2000. RESULTS Fourteen articles met the inclusion criteria. Eighty-eight assessment tools were reported, of which 23 were in high use. Of these, three tools focused on gross motor function and had acceptable validity for use with children with CP: Gross Motor Function Measure, Gross Motor Function Classification System, and goniometry. Validated tools to assess other activity components, participation, quality of life, and pain were used infrequently or not at all. INTERPRETATION Allied health practitioners used only a few of the available evidence-based assessment tools. Assessment findings in many areas considered important by children and families were rarely documented using validated assessment tools.
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Affiliation(s)
- Bridget O'Connor
- School of Allied Health, Australian Catholic University, Fitzroy, Vic., Australia
| | - Claire Kerr
- Centre for Disability and Development Research, Australian Catholic University, Fitzroy, Vic., Australia.,School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Nora Shields
- School of Allied Health, La Trobe University, Bundoora, Vic., Australia.,Northern Centre for Health Education and Research, Epping, Vic., Australia
| | - Christine Imms
- Centre for Disability and Development Research, Australian Catholic University, Fitzroy, Vic., Australia
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47
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Benassi E, Savini S, Iverson JM, Guarini A, Caselli MC, Alessandroni R, Faldella G, Sansavini A. Early communicative behaviors and their relationship to motor skills in extremely preterm infants. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 48:132-144. [PMID: 26555385 DOI: 10.1016/j.ridd.2015.10.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 10/18/2015] [Accepted: 10/19/2015] [Indexed: 06/05/2023]
Abstract
Despite the predictive value of early spontaneous communication for identifying risk for later language concerns, very little research has focused on these behaviors in extremely low-gestational-age infants (ELGA<28 weeks) or on their relationship with motor development. In this study, communicative behaviors (gestures, vocal utterances and their coordination) were evaluated during mother-infant play interactions in 20 ELGA infants and 20 full-term infants (FT) at 12 months (corrected age for ELGA infants). Relationships between gestures and motor skills, evaluated using the Bayley-III Scales were also examined. ELGA infants, compared with FT infants, showed less advanced communicative, motor, and cognitive skills. Giving and representational gestures were produced at a lower rate by ELGA infants. In addition, pointing gestures and words were produced by a lower percentage of ELGA infants. Significant positive correlations between gestures (pointing and representational gestures) and fine motor skills were found in the ELGA group. We discuss the relevance of examining spontaneous communicative behaviors and motor skills as potential indices of early development that may be useful for clinical assessment and intervention with ELGA infants.
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Affiliation(s)
- Erika Benassi
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Silvia Savini
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Jana M Iverson
- Department of Psychology, University of Pittsburgh, Pittsburgh, USA
| | | | - Maria Cristina Caselli
- Institute of Cognitive Sciences and Technologies, National Research Council, Rome, Italy
| | - Rosina Alessandroni
- Neonatology and Neonatal Intensive Care Unit, S. Orsola-Malpighi Hospital, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Giacomo Faldella
- Neonatology and Neonatal Intensive Care Unit, S. Orsola-Malpighi Hospital, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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48
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Howe TH, Sheu CF, Hsu YW, Wang TN, Wang LW. Predicting neurodevelopmental outcomes at preschool age for children with very low birth weight. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 48:231-241. [PMID: 26630614 DOI: 10.1016/j.ridd.2015.11.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 10/28/2015] [Accepted: 11/07/2015] [Indexed: 06/05/2023]
Abstract
The purpose of this study was to examine predictors of neurodevelopmental outcome in very low birth weight children without major impairment at 5 years of age, as well as to identify the contribution of early neurodevelopmental assessment to preterm children's later developmental outcomes. The participants in this study included 126 children who were prematurely born with very low birth weight. Outcomes of the childrens' later development were measured in tests that factored cognitive function, motor performance, and adaptive behavior. The results indicated that more than 50% of full-scale intelligence and 30% of both motor performance and adaptive behavior at the age of 5 can be explained by four predictors. The four predictors include preterm children's medical complications at birth, maternal education, early motor assessments, and cognitive assessments. Adding each test score obtained in early ages provides additional information to predict children's cognitive, motor, and adaptive behavior at 5 years of age. Manifold assessments conducted in multiple time periods strengthen the predictive values of later developmental outcomes. In addition, the findings of this study indicate that very low birth weight children tend to have lower adaptive behavior at 5 years old. With regard to our findings, we believe that having adaptive function is a reflection of a child's overall integrated abilities. Further study is warranted to increase understanding of this topic, as well as to be able to predict adaptive strengths and weakness and pinpoint limiting factors that may be useful for targeting behaviors in intervention.
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Affiliation(s)
- Tsu-Hsin Howe
- Department of Occupational Therapy, Steinhardt School of Culture, Education and Human Development, New York University, New York, NY, United States
| | - Ching-Fan Sheu
- Institute of Education, National Cheng Kung University, Tainan City, Taiwan
| | - Yung-Wen Hsu
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Tien-Ni Wang
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei City, Taiwan.
| | - Lan-Wan Wang
- Department of Pediatrics, Chi-Mei Medical Center, Tainan City, Taiwan
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49
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Welch MG, Firestein MR, Austin J, Hane AA, Stark RI, Hofer MA, Garland M, Glickstein SB, Brunelli SA, Ludwig RJ, Myers MM. Family Nurture Intervention in the Neonatal Intensive Care Unit improves social-relatedness, attention, and neurodevelopment of preterm infants at 18 months in a randomized controlled trial. J Child Psychol Psychiatry 2015; 56:1202-11. [PMID: 25763525 DOI: 10.1111/jcpp.12405] [Citation(s) in RCA: 106] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/04/2015] [Indexed: 01/21/2023]
Abstract
BACKGROUND Preterm infants are at high risk for adverse neurodevelopmental and behavioral outcomes. Family Nurture Intervention (FNI) in the Neonatal Intensive Care Unit (NICU) is designed to counteract adverse effects of separation of mothers and their preterm infants. Here, we evaluate effects of FNI on neurobehavioral outcomes. METHODS Data were collected at 18 months corrected age from preterm infants. Infants were assigned at birth to FNI or standard care (SC). Bayley Scales of Infant Development III (Bayley-III) were assessed for 76 infants (SC, n = 31; FNI, n = 45); the Child Behavior Checklist (CBCL) for 57 infants (SC, n = 31; FNI, n = 26); and the Modified Checklist for Autism in Toddlers (M-CHAT) was obtained for 59 infants (SC, n = 33; FNI, n = 26). RESULTS Family Nurture Intervention significantly improved Bayley-III cognitive (p = .039) and language (p = .008) scores for infants whose scores were greater than 85. FNI infants had fewer attention problems on the CBCL (p < .02). FNI improved total M-CHAT scores (p < .02). Seventy-six percent of SC infants failed at least one of the M-CHAT items, compared to 27% of FNI infants (p < .001). In addition, 36% of SC infants versus 0% of FNI infants failed at least one social-relatedness M-CHAT item (p < .001). CONCLUSIONS Family Nurture Intervention is the first NICU intervention to show significant improvements in preterm infants across multiple domains of neurodevelopment, social-relatedness, and attention problems. These gains suggest that an intervention that facilitates emotional interactions between mothers and infants in the NICU may be key to altering developmental trajectories of preterm infants.
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Affiliation(s)
- Martha G Welch
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA.,Department of Pediatrics, Columbia University Medical Center, New York, NY, USA.,Department of Pathology & Cell Biology, Columbia University Medical Center, New York, NY, USA.,Department of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, USA
| | - Morgan R Firestein
- Department of Pediatrics, Columbia University Medical Center, New York, NY, USA
| | - Judy Austin
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Amie A Hane
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA.,Department of Psychology, Williams College, Williamstown, MA, USA
| | - Raymond I Stark
- Department of Pediatrics, Columbia University Medical Center, New York, NY, USA
| | - Myron A Hofer
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA.,Department of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, USA
| | - Marianne Garland
- Department of Pediatrics, Columbia University Medical Center, New York, NY, USA
| | | | - Susan A Brunelli
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA.,Department of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, USA
| | - Robert J Ludwig
- Department of Pediatrics, Columbia University Medical Center, New York, NY, USA
| | - Michael M Myers
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA.,Department of Pediatrics, Columbia University Medical Center, New York, NY, USA.,Department of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, USA
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50
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Gong A, Johnson YR, Livingston J, Matula K, Duncan AF. Newborn intensive care survivors: a review and a plan for collaboration in Texas. Matern Health Neonatol Perinatol 2015; 1:24. [PMID: 27057341 PMCID: PMC4823685 DOI: 10.1186/s40748-015-0025-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 09/15/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Neonatal intensive care is a remarkable success story with dramatic improvements in survival rates for preterm newborns. Significant efforts and resources are invested to improve mortality and morbidity but much remains to be learned about the short and long-term effects of neonatal intensive care unit (NICU) interventions. Published guidelines recommend that infants discharged from the NICU be in an organized follow-up program that tracks medical and neurodevelopmental outcomes. Yet, there are no standardized guidelines for provision of follow-up services for high-risk infants. The National Institute of Child Health and Human Development Neonatal Research Network and the Vermont Oxford Network have made strides toward standardizing practices and conducting outcomes research, but only include a subset of developmental follow-up programs with a focus on extremely preterm infants. Several studies have been conducted to gain a better understanding of current practices in developmental follow-up. Some of the major themes in these studies are the lack of personnel and funding to provide comprehensive follow-up care; feeding difficulties as a primary issue for NICU survivors, families, and programs; wide variability in referral and follow-up care practices; and calls for standardized, systematic developmental surveillance to improve outcomes. FINDINGS We convened a one-day summit to discuss developmental follow-up practices in Texas involving four academic and three nonacademic centers. All seven centers described variable age and weight criteria for follow-up of NICU patients and a unique set of developmental practices, including duration of follow-up, types and timing of developmental assessments administered, education and communication with families and other health care providers, and referrals for services. Needs identified by the centers focused on two main themes: resources and comprehensive care. Participants identified key challenges for developmental follow-up, generated recommendations to address these challenges, and outlined components of a quality program. CONCLUSIONS The long-term goal is to ensure that all children maximize their potential; a goal supported through quality, comprehensive developmental follow-up care and outcomes research to continuously improve evidence-based practices. We aim to contribute to this goal through a statewide working group collaborating on research to standardize practices and inform policies that truly benefit children and their families.
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Affiliation(s)
- Alice Gong
- Department of Pediatrics, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., San Antonio Texas, 78229 USA
| | - Yvette R Johnson
- Cook Children's Hospital, 1500 Cooper St., Dodson Specialty Building, 2nd Floor, Fort Worth, TX 76104 USA
| | - Judith Livingston
- Department of Pediatrics, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., San Antonio Texas, 78229 USA
| | - Kathleen Matula
- Department of Pediatrics, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., San Antonio Texas, 78229 USA
| | - Andrea F Duncan
- The University of Texas Health Science Center-Houston, 6431 Fannin St.,, Houston Texas, 77030 USA
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