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Wheeler AC. The Multiple Odysseys in Research and Clinical Care for Neurogenetic Conditions. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2024; 129:110-115. [PMID: 38411239 DOI: 10.1352/1944-7558-129.2.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
Neurogenetic conditions (NGC; e.g., fragile X, Angelman, Prader-Willi syndromes) represent the cause for intellectual or developmental disabilities in up to 60% of cases. With expanded diagnostic options and an increasing focus on the development of gene therapies comes the potential of improved quality of life for individuals with NGCs and their families. However, these emerging initiatives also bring new challenges and considerations for NGC researchers and clinicians, including considerations for supporting caregivers and assuring outcome measures for clinical trials adequately reflect the lived experiences of people with NGCs. This paper summarizes the advances and current and future challenges of research and clinical service provision for people with NGCs and their caregivers.
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Affiliation(s)
- Anne C Wheeler
- Anne C. Wheeler, Genomics, Ethics, and Translational Research Program, RTI International
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Onnivello S, Schworer EK, Prince MA, Daunhauer LA, Fidler DJ. Early developmental profiles among infants with Down syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:228-238. [PMID: 36484342 DOI: 10.1111/jir.12997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 07/18/2022] [Accepted: 11/03/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Down syndrome (DS) generally predisposes children to a pattern of relative developmental strengths and challenges, but within-syndrome heterogeneity is also commonly observed across many dimensions. The present research examines whether heterogeneity in developmental presentation can be detected during infancy in DS and whether factors associated with differing profiles can be identified. METHODS Infants with DS (n = 75; age range: 3.9-17.6 months) were administered the Bayley Scales of Infant Development III (Bayley-III). A primary caregiver provided information regarding developmental history and family demographics. Latent profile analysis was conducted to identify whether early profiles were present across the five Bayley-III domains. RESULTS Three developmental profiles were observable within the sample: a 'Mild Delay' Profile, an 'Moderate Delay' Profile and a 'Pronounced Delay' Profile. In addition, chronological age, having received heart surgery and having received occupational therapy were associated with probability of profile membership. CONCLUSIONS Findings from this study contribute to the growing knowledgebase regarding heterogenous presentations associated with DS and can inform early intervention planning.
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Affiliation(s)
- S Onnivello
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
| | - E K Schworer
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - M A Prince
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - L A Daunhauer
- Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
| | - D J Fidler
- Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
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Foster-Cohen S, Macrae T, Newbury J. Variation in morpho-lexical development within and between diagnoses in children with neurodevelopmental disorders. Front Psychol 2023; 13:968408. [PMID: 36710780 PMCID: PMC9878158 DOI: 10.3389/fpsyg.2022.968408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 12/20/2022] [Indexed: 01/15/2023] Open
Abstract
While primary diagnosis is only one aspect of the presentation of a child with neurodevelopmental delay/disorder, the degree to which early expressive language reflects diagnostic divisions must be understood in order to reduce the risk of obscuring clinically important differences and similarities across diagnoses. We present original data from the New Zealand MacArthur-Bates Communicative Development Inventory (NZCDI) from 88 English-speaking children aged 2;6 to 5;6 years receiving multidisciplinary intervention within a single family-centered program. The children had one of six pediatrician-assigned genetic or behaviorally determined diagnoses: Down syndrome (DS); motor disorders (cerebral palsy and developmental coordination disorder); global development delay; disorders of relating and communicating (R&C); other genetically defined diagnoses; or language delay due to premature (PREM) birth. Morphological and lexical development were compared within and across diagnostic groups, using both data visualization and mixed-effects modeling. Groups varied in the amount of variation within and between them, but only prematurity reached significance, in interaction with age, as a predictor of morpho-lexical scores. Further analysis of longitudinal data available from a subset of the sample (n = 62) suggested that individual trajectories of vocabulary growth could not be reliably predicted by diagnosis. Moreover, the distribution of word types (nouns, predicates, etc.) only distinguished PREM children with language delay from those with DS and those in the R&C group. There were strong similarities in early morpho-lexical development across these clinical populations, with some differences. These findings align with research and clinical approaches which accommodate individual variation within diagnosis, and broad similarities across diagnostic groups.
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Affiliation(s)
- Susan Foster-Cohen
- Department of Linguistics, University of Canterbury, Christchurch, New Zealand
- New Zealand Institute of Language, Brain and Behaviour, University of Canterbury, Christchurch, New Zealand
- Christchurch Early Intervention Trust, The Champion Centre, Christchurch, New Zealand
| | - Toby Macrae
- New Zealand Institute of Language, Brain and Behaviour, University of Canterbury, Christchurch, New Zealand
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Jayne Newbury
- New Zealand Institute of Language, Brain and Behaviour, University of Canterbury, Christchurch, New Zealand
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
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Chung WK, Berg JS, Botkin JR, Brenner SE, Brosco JP, Brothers KB, Currier RJ, Gaviglio A, Kowtoniuk WE, Olson C, Lloyd-Puryear M, Saarinen A, Sahin M, Shen Y, Sherr EH, Watson MS, Hu Z. Newborn screening for neurodevelopmental diseases: Are we there yet? AMERICAN JOURNAL OF MEDICAL GENETICS. PART C, SEMINARS IN MEDICAL GENETICS 2022; 190:222-230. [PMID: 35838066 PMCID: PMC9796120 DOI: 10.1002/ajmg.c.31988] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 06/13/2022] [Accepted: 06/30/2022] [Indexed: 01/01/2023]
Abstract
In the US, newborn screening (NBS) is a unique health program that supports health equity and screens virtually every baby after birth, and has brought timely treatments to babies since the 1960's. With the decreasing cost of sequencing and the improving methods to interpret genetic data, there is an opportunity to add DNA sequencing as a screening method to facilitate the identification of babies with treatable conditions that cannot be identified in any other scalable way, including highly penetrant genetic neurodevelopmental disorders (NDD). However, the lack of effective dietary or drug-based treatments has made it nearly impossible to consider NDDs in the current NBS framework, yet it is anticipated that any treatment will be maximally effective if started early. Hence there is a critical need for large scale pilot studies to assess if and how NDDs can be effectively screened at birth, if parents desire that information, and what impact early diagnosis may have. Here we attempt to provide an overview of the recent advances in NDD treatments, explore the possible framework of setting up a pilot study to genetically screen for NDDs, highlight key technical, practical, and ethical considerations and challenges, and examine the policy and health system implications.
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Affiliation(s)
- Wendy K Chung
- Department of Pediatrics and Medicine, Columbia University, New York, New York, USA
| | - Jonathan S Berg
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jeffrey R Botkin
- Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | - Steven E Brenner
- Department of Plant and Microbial Biology, University of California, Berkeley, California, USA
| | - Jeffrey P Brosco
- Institute for Bioethics and Health Policy, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Kyle B Brothers
- Department of Pediatrics, University of Louisville, Louisville, Kentucky, USA
| | - Robert J Currier
- School of Medicine, University of California, San Francisco, California, USA
| | - Amy Gaviglio
- Connetics Consulting, Minneapolis, Minnesota, USA
| | | | - Colleen Olson
- Steinhardt Graduate School of Education, New York University, New York, New York, USA
| | | | | | - Mustafa Sahin
- Rosamund Stone Zander Translational Neuroscience Center, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Yufeng Shen
- Department of Systems Biology, Columbia University, New York, New York, USA.,Department of Biomedical Informatics, Columbia University, New York, New York, USA
| | - Elliott H Sherr
- Department of Neurology, Weill Institute of Neurosciences, University of California, San Francisco, California, USA
| | - Michael S Watson
- Department of Pediatrics, School of Medicine, Washington University (Adjunct), St. Louis, Missouri, USA
| | - Zhanzhi Hu
- Department of Systems Biology, Columbia University, New York, New York, USA.,Department of Biomedical Informatics, Columbia University, New York, New York, USA
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Infants exploring objects: A cascades perspective. ADVANCES IN CHILD DEVELOPMENT AND BEHAVIOR 2022; 64:39-68. [PMID: 37080674 DOI: 10.1016/bs.acdb.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Infants spend much of their time exploring objects (Herzberg et al., 2021), and object exploration is linked to learning and development in various domains (e.g., social, cognitive, motor). But how does exploration develop in the first place, and how, exactly, does exploration promote learning? One way to approach these process-oriented questions is with a developmental cascades perspective, which holds that new skills emerge from earlier-developing ones and that various interactions with people and objects accumulate over time to influence multiple domains of development (Masten & Cicchetti, 2010). In this chapter, we describe object exploration from a developmental cascades perspective. In Section 2, we describe typical and atypical trajectories of exploration behaviors, noting how these behaviors emerge from earlier-developing cognitive and motor skills. In Section 3, we discuss how object exploration opens the door for new types of learning opportunities. In Section 4, we discuss early experiences that may shape the development of object exploration. Altogether, we aim to convey that new developments in exploration skills are extensions of earlier-developing skills, and that seemingly insignificant exploratory behaviors (e.g., shaking a rattle) may result in numerous and varied consequences for the developing infant.
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Riggs NR, Hepburn SL, Pinks ME, Fidler DJ. A prevention science approach to promoting health and quality of life for individuals with intellectual and developmental disabilities. INFANT AND CHILD DEVELOPMENT 2021. [DOI: 10.1002/icd.2278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Nathaniel R. Riggs
- Human Development and Family Studies Colorado State University Fort Collins Colorado USA
- Prevention Research Center Colorado State University Fort Collins Colorado USA
| | - Susan L. Hepburn
- Human Development and Family Studies Colorado State University Fort Collins Colorado USA
| | - Miranda E. Pinks
- Human Development and Family Studies Colorado State University Fort Collins Colorado USA
| | - Deborah J. Fidler
- Human Development and Family Studies Colorado State University Fort Collins Colorado USA
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