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Davenport ML, Cornea E, Xia K, Crowley JJ, Halvorsen MW, Goldman BD, Reinhartsen D, DeRamus M, Pretzel R, Styner M, Gilmore JH, Hooper SR, Knickmeyer RC. Altered Brain Structure in Infants with Turner Syndrome. Cereb Cortex 2021; 30:587-596. [PMID: 31216015 DOI: 10.1093/cercor/bhz109] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 04/26/2019] [Accepted: 04/29/2019] [Indexed: 01/15/2023] Open
Abstract
Turner syndrome (TS) is a genetic disorder affecting approximately 1:2000 live-born females. It results from partial or complete X monosomy and is associated with a range of clinical issues including a unique cognitive profile and increased risk for certain behavioral problems. Structural neuroimaging studies in adolescents, adults, and older children with TS have revealed altered neuroanatomy but are unable to identify when in development differences arise. In addition, older children and adults have often been exposed to years of growth hormone and/or exogenous estrogen therapy with potential implications for neurodevelopment. The study presented here is the first to test whether brain structure is altered in infants with TS. Twenty-six infants with TS received high-resolution structural MRI scans of the brain at 1 year of age and were compared to 47 typically developing female and 39 typically developing male infants. Results indicate that the typical neuroanatomical profile seen in older individuals with TS, characterized by decreased gray matter volumes in premotor, somatosensory, and parietal-occipital cortex, is already present at 1 year of age, suggesting a stable phenotype with origins in the prenatal or early postnatal period.
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Affiliation(s)
- M L Davenport
- Department of Pediatrics, University of North Carolina at Chapel Hill, North Carolina, 27599, USA
| | - E Cornea
- Department of Psychiatry, University of North Carolina at Chapel Hill, North Carolina, 27599, USA
| | - K Xia
- Department of Psychiatry, University of North Carolina at Chapel Hill, North Carolina, 27599, USA
| | - J J Crowley
- Department of Genetics, University of North Carolina at Chapel Hill, North Carolina, 27599, USA
| | - M W Halvorsen
- Department of Genetics, University of North Carolina at Chapel Hill, North Carolina, 27599, USA
| | - B D Goldman
- Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, North Carolina, 27599, USA.,Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, North Carolina, 27599, USA
| | - D Reinhartsen
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, North Carolina, 27599, USA
| | - M DeRamus
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, North Carolina, 27599, USA
| | - R Pretzel
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, North Carolina, 27599, USA
| | - M Styner
- Department of Psychiatry, University of North Carolina at Chapel Hill, North Carolina, 27599, USA.,Department of Computer Science, University of North Carolina at Chapel Hill, North Carolina, 27599, USA
| | - J H Gilmore
- Department of Psychiatry, University of North Carolina at Chapel Hill, North Carolina, 27599, USA
| | - S R Hooper
- Department of Psychiatry, University of North Carolina at Chapel Hill, North Carolina, 27599, USA.,Allied Health Sciences, University of North Carolina at Chapel Hill, North Carolina, 27599, USA
| | - R C Knickmeyer
- Department of Psychiatry, University of North Carolina at Chapel Hill, North Carolina, 27599, USA.,Department of Pediatrics, Michigan State University, North Carolina, 27599, USA.,Institute for Quantitative Health Sciences and Engineering, Michigan State University, East Lansing, MI 48824, USA.,Center for Research on Autism, Intellectual and other Neurodevelopmental Disabilities (C-RAIND) Fellow, Michigan State University, East Lansing, Michigan, 48824, USA
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2
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Martinez M, Thomas KC, Williams CS, Christian R, Crais E, Pretzel R, Hooper SR. Family Experiences with the Diagnosis of Autism Spectrum Disorder: System Barriers and Facilitators of Efficient Diagnosis. J Autism Dev Disord 2019; 48:2368-2378. [PMID: 29453706 DOI: 10.1007/s10803-018-3493-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This paper examines family experiences with the efficiency of ASD diagnosis. Children were age 8 or younger with ASD (n = 450). Outcomes were delay from first parent concern to diagnosis, shifting diagnoses, and being told child did not have ASD. Predictors were screening, travel distance, and problems finding providers. Logit models were used to examine associations. Screening was associated with reduced delay in diagnosis; problems finding providers were associated with greater delay. Screening, travel distance, and delay in diagnosis were associated with shifting diagnoses and being told child did not have ASD. Physician and parent training in communication and addressing mental health professional shortages and maldistribution may improve the diagnosis experiences of families of children with ASD.
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Affiliation(s)
- M Martinez
- Cecil G Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 MLK Blvd, Chapel Hill, NC, 27599-7590, USA
| | - K C Thomas
- Cecil G Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 MLK Blvd, Chapel Hill, NC, 27599-7590, USA.
| | - C S Williams
- Cecil G Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 MLK Blvd, Chapel Hill, NC, 27599-7590, USA
| | - R Christian
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, 101 Renee Lynne Ct, Carrboro, NC, 27510, USA
| | - E Crais
- Department of Allied Health Sciences, 321 S. Columbia Street, Bondurant Hall, CB#7190, Chapel Hill, NC, 27599-7190, USA
| | - R Pretzel
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, 101 Renee Lynne Ct, Carrboro, NC, 27510, USA
| | - S R Hooper
- Department of Allied Health Sciences, 321 S. Columbia Street, Bondurant Hall, CB#7190, Chapel Hill, NC, 27599-7190, USA
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Greene C, Kealy J, Humphries MM, Gong Y, Hou J, Hudson N, Cassidy LM, Martiniano R, Shashi V, Hooper SR, Grant GA, Kenna PF, Norris K, Callaghan CK, Islam MDN, O’Mara SM, Najda Z, Campbell SG, Pachter JS, Thomas J, Williams NM, Humphries P, Murphy KC, Campbell M. Dose-dependent expression of claudin-5 is a modifying factor in schizophrenia. Mol Psychiatry 2018; 23:2156-2166. [PMID: 28993710 PMCID: PMC6298981 DOI: 10.1038/mp.2017.156] [Citation(s) in RCA: 121] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 05/22/2017] [Accepted: 06/07/2017] [Indexed: 11/12/2022]
Abstract
Schizophrenia is a neurodevelopmental disorder that affects up to 1% of the general population. Various genes show associations with schizophrenia and a very weak nominal association with the tight junction protein, claudin-5, has previously been identified. Claudin-5 is expressed in endothelial cells forming part of the blood-brain barrier (BBB). Furthermore, schizophrenia occurs in 30% of individuals with 22q11 deletion syndrome (22q11DS), a population who are haploinsufficient for the claudin-5 gene. Here, we show that a variant in the claudin-5 gene is weakly associated with schizophrenia in 22q11DS, leading to 75% less claudin-5 being expressed in endothelial cells. We also show that targeted adeno-associated virus-mediated suppression of claudin-5 in the mouse brain results in localized BBB disruption and behavioural changes. Using an inducible 'knockdown' mouse model, we further link claudin-5 suppression with psychosis through a distinct behavioural phenotype showing impairments in learning and memory, anxiety-like behaviour and sensorimotor gating. In addition, these animals develop seizures and die after 3-4 weeks of claudin-5 suppression, reinforcing the crucial role of claudin-5 in normal neurological function. Finally, we show that anti-psychotic medications dose-dependently increase claudin-5 expression in vitro and in vivo while aberrant, discontinuous expression of claudin-5 in the brains of schizophrenic patients post mortem was observed compared to age-matched controls. Together, these data suggest that BBB disruption may be a modifying factor in the development of schizophrenia and that drugs directly targeting the BBB may offer new therapeutic opportunities for treating this disorder.
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Affiliation(s)
- C Greene
- 0000 0004 1936 9705grid.8217.cDepartment of Genetics, Smurfit Institute of Genetics, Lincoln Place Gate, Trinity College Dublin, Dublin, Ireland
| | - J Kealy
- 0000 0004 1936 9705grid.8217.cDepartment of Genetics, Smurfit Institute of Genetics, Lincoln Place Gate, Trinity College Dublin, Dublin, Ireland
| | - M M Humphries
- 0000 0004 1936 9705grid.8217.cDepartment of Genetics, Smurfit Institute of Genetics, Lincoln Place Gate, Trinity College Dublin, Dublin, Ireland
| | - Y Gong
- 0000 0001 2355 7002grid.4367.6Division of Renal Diseases, Department of Internal Medicine, Washington University School of Medicine, St Louis, MO USA
| | - J Hou
- 0000 0001 2355 7002grid.4367.6Division of Renal Diseases, Department of Internal Medicine, Washington University School of Medicine, St Louis, MO USA
| | - N Hudson
- 0000 0004 1936 9705grid.8217.cDepartment of Genetics, Smurfit Institute of Genetics, Lincoln Place Gate, Trinity College Dublin, Dublin, Ireland
| | - L M Cassidy
- 0000 0004 1936 9705grid.8217.cDepartment of Genetics, Smurfit Institute of Genetics, Lincoln Place Gate, Trinity College Dublin, Dublin, Ireland
| | - R Martiniano
- 0000 0004 1936 9705grid.8217.cDepartment of Genetics, Smurfit Institute of Genetics, Lincoln Place Gate, Trinity College Dublin, Dublin, Ireland
| | - V Shashi
- 0000000100241216grid.189509.cDepartment of Pediatrics, Duke University Medical Center, Durham, NC USA
| | - S R Hooper
- 0000000122483208grid.10698.36Department of Allied Health Sciences, University of North Carolina School of Medicine, Chapel Hill, NC USA
| | - G A Grant
- 0000000419368956grid.168010.eDepartment of Neurosurgery, Stanford University School of Medicine, Stanford, CA USA
| | - P F Kenna
- 0000 0004 1936 9705grid.8217.cDepartment of Genetics, Smurfit Institute of Genetics, Lincoln Place Gate, Trinity College Dublin, Dublin, Ireland
| | - K Norris
- 0000 0001 0303 540Xgrid.5884.1Biosciences Department, Faculty of Health and Wellbeing, Biosciences and Chemistry, Sheffield Hallam University, Sheffield, UK
| | - C K Callaghan
- 0000 0004 1936 9705grid.8217.cTrinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland ,0000 0004 1936 9705grid.8217.cSchool of Psychology, Trinity College Dublin, Dublin, Ireland
| | - M dN Islam
- 0000 0004 1936 9705grid.8217.cTrinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland ,0000 0004 1936 9705grid.8217.cSchool of Psychology, Trinity College Dublin, Dublin, Ireland
| | - S M O’Mara
- 0000 0004 1936 9705grid.8217.cTrinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland ,0000 0004 1936 9705grid.8217.cSchool of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Z Najda
- 0000 0004 1936 9705grid.8217.cDepartment of Genetics, Smurfit Institute of Genetics, Lincoln Place Gate, Trinity College Dublin, Dublin, Ireland
| | - S G Campbell
- 0000 0001 0303 540Xgrid.5884.1Biosciences Department, Faculty of Health and Wellbeing, Biosciences and Chemistry, Sheffield Hallam University, Sheffield, UK
| | - J S Pachter
- 0000000419370394grid.208078.5Department of Cell Biology, University of Connecticut Health Center, Farmington, CT USA
| | - J Thomas
- 0000 0001 0807 5670grid.5600.3Department of Psychological Medicine and Neurology, MRC Centre in Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK
| | - N M Williams
- 0000 0001 0807 5670grid.5600.3Department of Psychological Medicine and Neurology, MRC Centre in Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK
| | - P Humphries
- 0000 0004 1936 9705grid.8217.cDepartment of Genetics, Smurfit Institute of Genetics, Lincoln Place Gate, Trinity College Dublin, Dublin, Ireland
| | - K C Murphy
- 0000 0004 0488 7120grid.4912.eDepartment of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - M Campbell
- Department of Genetics, Smurfit Institute of Genetics, Lincoln Place Gate, Trinity College Dublin, Dublin, Ireland.
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Shashi V, Harrell W, Eack S, Sanders C, McConkie-Rosell A, Keshavan MS, Bonner MJ, Schoch K, Hooper SR. Social cognitive training in adolescents with chromosome 22q11.2 deletion syndrome: feasibility and preliminary effects of the intervention. J Intellect Disabil Res 2015; 59:902-913. [PMID: 25871427 PMCID: PMC5824427 DOI: 10.1111/jir.12192] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/25/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Children with chromosome 22q11.2 deletion syndrome (22q11DS) often have deficits in social cognition and social skills that contribute to poor adaptive functioning. These deficits may be of relevance to the later occurrence of serious psychiatric illnesses such as schizophrenia. Yet, there are no evidence-based interventions to improve social cognitive functioning in children with 22q11DS. METHODS Using a customised social cognitive curriculum, we conducted a pilot small-group-based social cognitive training (SCT) programme in 13 adolescents with 22q11DS, relative to a control group of nine age- and gender-matched adolescents with 22q11DS. RESULTS We found the SCT programme to be feasible, with high rates of compliance and satisfaction on the part of the participants and their families. Our preliminary analyses indicated that the intervention group showed significant improvements in an overall social cognitive composite index. CONCLUSIONS SCT in a small-group format for adolescents with 22q11DS is feasible and results in gains in social cognition. A larger randomised controlled trial would permit assessment of efficacy of this promising novel intervention.
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Affiliation(s)
- V Shashi
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA
| | - W Harrell
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA
| | - S Eack
- School of Social Work and Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - C Sanders
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA
| | - A McConkie-Rosell
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA
| | - M S Keshavan
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - M J Bonner
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA
| | - K Schoch
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA
| | - S R Hooper
- Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Ferris M, Cohen S, Haberman C, Javalkar K, Massengill S, Mahan JD, Kim S, Bickford K, Cantu G, Medeiros M, Phillips A, Ferris MT, Hooper SR. Self-Management and Transition Readiness Assessment: Development, Reliability, and Factor Structure of the STARx Questionnaire. J Pediatr Nurs 2015. [PMID: 26209873 DOI: 10.1016/j.pedn.2015.05.009] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The Self-Management and Transition to Adulthood with Rx=Treatment (STARx) Questionnaire was developed to collect information on self-management and health care transition (HCT) skills, via self-report, in a broad population of adolescents and young adults (AYAs) with chronic conditions. METHODS Over several iterations, the STARx questionnaire was created with AYA, family, and health provider input. The development and pilot testing of the STARx Questionnaire took place with the assistance of 1219 AYAs with different chronic health conditions, in multiple institutions and settings over three phases: item development, pilot testing, reliability and factor structuring. RESULTS The three development phases resulted in a final version of the STARx Questionnaire. The exploratory factor analysis of the third version of the 18-item STARx identified six factors that accounted for about 65% of the variance: Medication management, Provider communication, Engagement during appointments, Disease knowledge, Adult health responsibilities, and Resource utilization. Reliability estimates revealed good internal consistency and temporal stability, with the alpha coefficient for the overall scale being .80. The STARx was developmentally sensitive, with older patients scoring significantly higher on nearly every factor than younger patients. CONCLUSION The STARx Questionnaire is a reliable, self-report tool with adequate internal consistency, temporal stability, and a strong, multidimensional factor structure. It provides another assessment strategy to measure self-management and transition skills in AYAs with chronic conditions.
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Affiliation(s)
- M Ferris
- The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC.
| | - S Cohen
- The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
| | - C Haberman
- Wake Forest University, Winston-Salem, NC; Victory Junction Camp, Randleman, NC
| | - K Javalkar
- The University of North Carolina at Chapel Hill School of Public Health, Chapel Hill, NC
| | - S Massengill
- Levine Children's Hospital at Carolinas Medical Center, Charlotte, NC
| | - J D Mahan
- Nationwide Children's Hospital, Columbus, OH; The Ohio State University, Columbus, OH
| | - S Kim
- Nationwide Children's Hospital, Columbus, OH; The Ohio State University, Columbus, OH
| | - K Bickford
- The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
| | - G Cantu
- Escuela de Medicina, Universidad Panamericana
| | - M Medeiros
- Hospital Infantil de México Federico Gómez
| | - A Phillips
- Hospital Infantil de México Federico Gómez
| | - M T Ferris
- The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
| | - S R Hooper
- The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
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Goodwin J, Schoch K, Shashi V, Hooper SR, Morad O, Zalevsky M, Gothelf D, Campbell LE. A tale worth telling: the impact of the diagnosis experience on disclosure of genetic disorders. J Intellect Disabil Res 2015; 59:474-486. [PMID: 25059276 PMCID: PMC4305500 DOI: 10.1111/jir.12151] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/25/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Research suggests children with genetic disorders exhibit greater coping skills when they are aware of their condition and its heritability. While the experiences parents have at diagnosis may influence their decision to disclose the diagnosis to their children, there is little research into this communication. The aim of the current study was to examine the relationship between the diagnosis experience and the disclosure experience for parents of children with developmental disorders of a known genetic aetiology: parents of children with 22q11.2 deletion syndrome (22q11DS) were compared with a group of parents with children affected with other genetic diagnoses, with a similar age of diagnosis (e.g. fragile X syndrome) and a group where diagnosis generally occurs early (i.e. Down syndrome). METHOD The sample comprised 559 parents and caregivers of children with genetic developmental disorders, and an online survey was utilised. Items from the questionnaire were combined to create variables for diagnosis experience, parental disclosure experience, child's disclosure experience, and parental coping and self-efficacy. RESULTS Across all groups parents reported that the diagnosis experience was negative and often accompanied by a lack of support and appropriate information. Sixty-eight per cent of those in the 22q11DS and 58.3% in the Similar Conditions groups had disclosed the diagnosis to their child, whereas only 32.7% of the Down syndrome group had. Eighty-six per cent of the Down syndrome group felt they had sufficient information to talk to their child compared with 44.1% of the Similar Conditions group and 32.6% of the 22q11DS group. Parents reported disclosing the diagnosis to their child because they did not want to create secrets; and that they considered the child's age when disclosing. In the 22q11DS and Similar Conditions groups, a poor diagnosis experience was significantly associated with negative parental disclosure experiences. In the Similar Conditions group, a poor diagnosis experience was also significantly associated with a more negative child disclosure experience. CONCLUSIONS As expected this study highlights how difficult most parents find the diagnosis experience. Importantly, the data indicate that the personal experiences the parents have can have a long-term impact on how well they cope with telling their child about the diagnosis. It is important for clinicians to consider the long-term ramifications of the diagnosis experience and give the parents opportunities; through, for instance, psychoeducation to prepare for telling their child about the diagnosis. Further research is warranted to explore what type of information would be useful for parents to receive.
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Affiliation(s)
- J Goodwin
- University of Newcastle, School of Psychology, Ourimbah, NSW, Australia
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Allen TM, Hersh J, Schoch K, Curtiss K, Hooper SR, Shashi V. Association of the family environment with behavioural and cognitive outcomes in children with chromosome 22q11.2 deletion syndrome. J Intellect Disabil Res 2014; 58:31-47. [PMID: 23742203 PMCID: PMC4086857 DOI: 10.1111/jir.12054] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/09/2013] [Indexed: 05/04/2023]
Abstract
BACKGROUND Children with 22q11.2 deletion syndrome (22q11DS) are at risk for social-behavioural and neurocognitive sequelae throughout development. The current study examined the impact of family environmental characteristics on social-behavioural and cognitive outcomes in this paediatric population. METHOD Guardians of children with 22q11DS were recruited through two medical genetics clinics. Consenting guardians were asked to complete several questionnaires regarding their child's social, emotional and behavioural functioning, as well as family social environment and parenting styles. Children with 22q11DS were asked to undergo a cognitive assessment, including IQ and achievement testing, and measures of attention, executive function and memory. RESULTS Modest associations were found between aspects of the family social environment and parenting styles with social-behavioural and cognitive/academic outcomes. Regression models indicated that physical punishment, socioeconomic status, parental control and family organisation significantly predicted social-behavioural and cognitive outcomes in children with 22q11DS. CONCLUSION Characteristics of the family social environment and parenting approaches appear to be associated with functional outcomes of children with 22q11DS. Understanding the impact of environmental variables on developmental outcomes can be useful in determining more effective targets for intervention. This will be important in order to improve the quality of life of individuals affected by 22q11DS.
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Affiliation(s)
- T M Allen
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
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Chakraborty D, Bernal AJ, Schoch K, Howard TD, Ip EH, Hooper SR, Keshavan MS, Jirtle RL, Shashi V, Shashi V. Dysregulation of DGCR6 and DGCR6L: psychopathological outcomes in chromosome 22q11.2 deletion syndrome. Transl Psychiatry 2012; 2:e105. [PMID: 22832905 PMCID: PMC3337078 DOI: 10.1038/tp.2012.31] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Chromosome 22q11.2 deletion syndrome (22q11DS) is the most common microdeletion syndrome in humans. It is typified by highly variable symptoms, which might be explained by epigenetic regulation of genes in the interval. Using computational algorithms, our laboratory previously predicted that DiGeorge critical region 6 (DGCR6), which lies within the deletion interval, is imprinted in humans. Expression and epigenetic regulation of this gene have not, however, been examined in 22q11DS subjects. The purpose of this study was to determine if the expression levels of DGCR6 and its duplicate copy DGCR6L in 22q11DS subjects are associated with the parent-of-origin of the deletion and childhood psychopathologies. Our investigation showed no evidence of parent-of-origin-related differences in expression of both DGCR6 and DGCR6L. However, we found that the variability in DGCR6 expression was significantly greater in 22q11DS children than in age and gender-matched control individuals. Children with 22q11DS who had anxiety disorders had significantly lower DGCR6 expression, especially in subjects with the deletion on the maternal chromosome, despite the lack of imprinting. Our findings indicate that epigenetic mechanisms other than imprinting contribute to the dysregulation of these genes and the associated childhood psychopathologies observed in individuals with 22q11DS. Further studies are now needed to test the usefulness of DGCR6 and DGCR6L expression and alterations in the epigenome at these loci in predicting childhood anxiety and associated adult-onset pathologies in 22q11DS subjects.
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Affiliation(s)
- D Chakraborty
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA
| | - A J Bernal
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA
| | - K Schoch
- Division of Medical Genetics, Department of Pediatrics, Duke University Medical Center, Durham, NC, USA
| | - T D Howard
- Center for Genomics & Personalized Medicine Research and Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - E H Ip
- Center for Genomics & Personalized Medicine Research and Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - S R Hooper
- Department of Psychiatry and the Carolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - M S Keshavan
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - R L Jirtle
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA
| | - V Shashi
- Division of Medical Genetics, Department of Pediatrics, Duke University Medical Center, Durham, NC, USA,Division of Medical Genetics, Department of Pediatrics, Duke University Medical Center, Box 102857, DUMC, 595 LaSalle Street, Durham, NC 27710, USA. E-mail:
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Abstract
The Common Belief Inventory for Students (CBIS) was developed to create a measure of rationality in children. The CBIS was formulated within Ellis's conceptual framework of Rational Behavior Training. It was constructed to yield a total score as well as a score for each of Ellis's 11 irrational ideas. A pretest/post-test design was employed over experimental and control groups (n = 1,226), Subjects in the experimental group were exposed to one hour of Rational Behavior Training each week for six weeks. Results indicated that the items were reliable indicators of the total test score and the belief scores. Belief components were reliable indicators of the total test score. Total test reliability estimates were adequate. The CBIS also appeared sensitive to the use of RBT methods to enhance rational thinking.
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Abstract
Background The social-behavioural functioning of children and adolescents with chronic kidney disease (CKD) is not well studied and not fully understood, with available studies reflecting a mixed set of findings. The primary purpose of this paper is to compare the social-behavioural functioning of children with CKD with typical controls using multiple raters. A secondary analysis also examines the impact of disease severity on social-behavioural functioning. Methods Parental ratings and self-reports on the Behavior Assessment System for Children were obtained from a patient sample of 26 children and adolescents with CKD. This sample was comprised of those with end-stage renal disease (end-stage renal disease; n= 13) and those with chronic renal insufficiency (n= 13). For comparison, a typically developing control group (n= 33) also was ascertained. Results While behaviour ratings by parents and children fell within the average range, parent ratings showed an increased number of internalizing symptoms when compared with the CKD Group. Exploratory analyses revealed parental ratings showing more specific concerns on the Behavior Assessment System for Children individual clinical scales of Anxiety, Depression and Somatization. No differences were observed between the groups on the children's self-ratings, or in terms of numbers of children falling above the 90th percentile for both parent and child ratings. Secondary analyses did not produce any group differences between the chronic renal insufficiency and end-stage renal disease severity groupings. Conclusions These findings failed to show the presence of social-behavioural difficulties in children with CKD, although there may be specific concerns for the presence of internalizing symptoms as per parent ratings. These findings suggest the need for follow-up of the subtle affective symptoms that might be present in children with CKD as recognizing these subthreshold social-behavioural symptoms may be a critical part of their overall clinical care.
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Affiliation(s)
- S R Hooper
- Department of Psychiatry, The Carolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
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Hooper SR, Callahan B. Traumatic brain injury. State of the state. N C Med J 2001; 62:336-9. [PMID: 11729461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Affiliation(s)
- S R Hooper
- Clinical Center for the Study of Development and Learning, CB# 7255, UNC School of Medicine, Chapel Hill, NC 27599-7255, USA.
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Hooper SR, Walker NW, Howard C. Training school psychologists in traumatic brain injury. The North Carolina model. N C Med J 2001; 62:350-4. [PMID: 11729464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Affiliation(s)
- S R Hooper
- Department of Psychiatry, Clinical Center, UNC School of Medicine, USA
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King BH, Wright DM, Handen BL, Sikich L, Zimmerman AW, McMahon W, Cantwell E, Davanzo PA, Dourish CT, Dykens EM, Hooper SR, Jaselskis CA, Leventhal BL, Levitt J, Lord C, Lubetsky MJ, Myers SM, Ozonoff S, Shah BG, Snape M, Shernoff EW, Williamson K, Cook EH. Double-blind, placebo-controlled study of amantadine hydrochloride in the treatment of children with autistic disorder. J Am Acad Child Adolesc Psychiatry 2001; 40:658-65. [PMID: 11392343 DOI: 10.1097/00004583-200106000-00010] [Citation(s) in RCA: 139] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To test the hypothesis that amantadine hydrochloride is a safe and effective treatment for behavioral disturbances--for example, hyperactivity and irritability--in children with autism. METHOD Thirty-nine subjects (intent to treat; 5-19 years old; IQ > 35) had autism diagnosed according to DSM-IV and ICD-10 criteria using the Autism Diagnostic Interview-Revised and the Autism Diagnostic Observation Schedule-Generic. The Aberrant Behavior Checklist-Community Version (ABC-CV) and Clinical Global Impressions (CGI) scale were used as outcome variables. After a 1-week, single-blind placebo run-in, patients received a single daily dose of amantadine (2.5 mg/kg per day) or placebo for the next week, and then bid dosing (5.0 mg/kg per day) for the subsequent 3 weeks. RESULTS When assessed on the basis of parent-rated ABC-CV ratings of irritability and hyperactivity, the mean placebo response rate was 37% versus amantadine at 47% (not significant). However, in the amantadine-treated group there were statistically significant improvements in absolute changes in clinician-rated ABC-CVs for hyperactivity (amantadine -6.4 versus placebo -2.1; p = .046) and inappropriate speech (-1.9 versus 0.4; p = .008). CGI scale ratings were higher in the amantadine group: 53% improved versus 25% (p = .076). Amantadine was well tolerated. CONCLUSIONS Parents did not report statistically significant behavioral change with amantadine. However, clinician-rated improvements in behavioral ratings following treatment with amantadine suggest that further studies with this or other drugs acting on the glutamatergic system are warranted. The design of these and similar drug trials in children with autistic disorder must take into account the possibility of a large placebo response.
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Affiliation(s)
- B H King
- Department of Psychiatry, Dartmouth Medical School, Hanover, NH 03756-0001, USA.
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Minter KR, Roberts JE, Hooper SR, Burchinal MR, Zeisel SA. Early childhood otitis media in relation to children's attention-related behavior in the first six years of life. Pediatrics 2001; 107:1037-42. [PMID: 11331683 DOI: 10.1542/peds.107.5.1037] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study examined whether otitis media with effusion (OME) and associated hearing loss during the first 4 years of life were related to the ratings of parents, teachers, and clinicians of children's attention and behavior in the first 6 years of life. METHODS In a prospective study, 85 black children were recruited from community-based child care programs when they were between 6 and 12 months old. OME and hearing status were monitored repeatedly from 6 months to 4 years old. Measures of attention and behavior were collected from parents, teachers, and clinicians when the children were infants, preschoolers, and first graders. RESULTS On average, children experienced either bilateral or unilateral OME 30% of the time and hearing loss 19.9% of the time between 6 months and 4 years old. Descriptive and inferential analyses revealed no significant associations between OME or hearing loss and the measures of attention or behavior completed by parents, teachers, and clinicians. CONCLUSIONS In this sample of children, there was no relationship between amount of early childhood OME or hearing loss and measures of attention or behavior in the first 6 years of life as reported by parents, teachers, and clinicians.otitis media, hearing, attention, behavior.
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Affiliation(s)
- K R Minter
- Frank Porter Graham Child Development Center, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-8180, USA
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15
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Roberts JE, Burchinal MR, Jackson SC, Hooper SR, Roush J, Mundy M, Neebe EC, Zeisel SA. Otitis media in childhood in relation to preschool language and school readiness skills among black children. Pediatrics 2000; 106:725-35. [PMID: 11015515 DOI: 10.1542/peds.106.4.725] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To examine whether otitis media with effusion (OME) and associated hearing loss (HL) during the first 5 years of life were related to children's language skills during the preschool years and to school readiness skills at entry to kindergarten. METHODS In a prospective study, the ears of 85 black children primarily from low-income families and recruited from community-based childcare programs were repeatedly examined from 6 months to 5 years of age for the presence of OME and from 6 months to 4 years of age for HL when well and ill with OME. Assessments were made annually of the children's child-rearing environments at home and in childcare, and children's language skills between 3 and 5 years of age and readiness skills in literacy and math were evaluated at entry into kindergarten. RESULTS Children had either bilateral or unilateral OME approximately 30.4% and HL 19.6% of the observation time. OME and associated HL were significantly positively correlated with some measures of expressive language at 3 and 4 years of age; however, these direct relationships were no longer significant when the child's gender, socioeconomic status, maternal educational level, and the responsiveness and support of the home and childcare environments were also considered. Further, both OME and HL were moderately correlated with school readiness skills at entry to school, with children having more OME scoring lower in verbal math problems and with children with more HL scoring lower in math and recognizing incomplete words. These associations continued to remain significant even after partialing out the child and family background factors. CONCLUSIONS There was not a significant relationship between children's early OME history or HL and language skills during the preschool years. However, children with more frequent OME had lower scores on school readiness measures. These associations were moderate in degree, however, and the home environment was more strongly related to academic outcomes than was OME or HL. These results should be interpreted cautiously when generalizing to other populations.
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Affiliation(s)
- J E Roberts
- Frank Porter Graham Child Development Center, Department of Allied Health Sciences University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-8180, USA.
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Hooper SR, Murphy J, Devaney A, Hultman T. Ecological outcomes of adolescents in a psychoeducational residential treatment facility. Am J Orthopsychiatry 2000; 70:491-500. [PMID: 11086527 DOI: 10.1037/h0087807] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Cross-sectional follow-up data on 111 adolescents in a re-education residential facility were obtained in three domains--school, legal, and level of care--at 6, 12, 18, and 24 months postdischarge. Reports by community-based professionals on individual functioning were assessed on several criteria, the most stringent of which indicated successful outcomes for nearly 60% of the adolescents. Characteristics of the more successful students are noted, applications of the psychoeducational residential approach for program structure are considered, and implications for positive ecological outcomes are discussed.
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Affiliation(s)
- S R Hooper
- Department of Psychiatry and CCSDL, University of North Carolina School of Medicine, Chapel Hill, USA.
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Castillo M, Kwock L, Courvoisie H, Hooper SR. Proton MR spectroscopy in children with bipolar affective disorder: preliminary observations. AJNR Am J Neuroradiol 2000; 21:832-8. [PMID: 10815657 PMCID: PMC7976743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
BACKGROUND AND PURPOSE Bipolar affective disorder (BPAD) can have its onset during childhood, but the diagnosis may be difficult to establish on the basis of clinical findings alone. Our purpose was to determine whether proton MR spectroscopy can be used to identify abnormalities in the brain of children with BPAD. METHODS Ten children, ages 6 to 12 years, underwent clinical testing to establish the diagnosis of BPAD. After a drug washout period, all patients underwent MR spectroscopy in which a TE of 135 was used along with a single-voxel placement in both frontal and temporal lobes during a single session. Peaks from N-acetylaspartate (NAA), choline (Cho), glutamate/ glutamine (Glu/Gln), and lipids were normalized with respect to the creatine (Cr) peak to obtain ratios of values of peak areas. These data were compared with those obtained in 10 non-age-matched control subjects. To corroborate our data, five children with BPAD also underwent 2D MR spectroscopic studies of the frontal lobes with parameters similar to those used in the single-volume studies. RESULTS All children with BPAD had elevated levels of Glu/Gln in both frontal lobes and basal ganglia relative to the control group. Children with BPAD had elevated lipid levels in the frontal lobes but not in the temporal lobes. Levels of NAA and Cho were similar for all locations in both groups. Two-dimensional MR spectroscopic studies in five children with BPAD confirmed the presence of elevated lipids in the frontal lobes. CONCLUSION Our preliminary observations suggest that MR spectroscopy may show abnormalities in children with BPAD not found in unaffected control subjects. It remains to be established whether these abnormalities are a signature of the disease and can be used as a screening test.
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Affiliation(s)
- M Castillo
- Department of Radiology, University of North Carolina School of Medicine, Chapel Hill 27599, USA
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Castillo M, Kwock L, Courvoisie HE, Hooper SR, Greenwood RS. Proton MR spectroscopy in psychiatric and neurodevelopmental childhood disorders: early experience. Neuroimaging Clin N Am 1998; 8:901-12. [PMID: 9769349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Variations in brain morphology are increasingly being found in patients with psychiatric disorders. There is early evidence that some metabolic abnormalities may also be present in these patients. In many patients with psychiatric disorders, the diagnosis is not straight forward and may be confounded by co-morbid processes. Establishing the correct diagnosis is important as it leads to institution of appropriate therapies. Descriptions of the authors early experience using proton MR spectroscopy in the evaluation of children with bipolar affective disorder, attention deficit hyperactivity disorder, neurodevelopmental abnormalities in patients with neurofibromatosis type 1, and the effects of certain types of treatment used for these disorders are discussed.
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Affiliation(s)
- M Castillo
- Department of Radiology, Section of Neuroradiology, University of North Carolina School of Medicine, Chapel Hill 27599-7510, USA.
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Farel AM, Hooper SR. Relationship between the Maternal Social Support Index and the Parenting Stress Index in mothers of very-low-birthweight children now age 7. Psychol Rep 1998; 83:173-4. [PMID: 9775676 DOI: 10.2466/pr0.1998.83.1.173] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Two measures, the Maternal Social Support Index and the Parenting Stress Index were used to assess parents' stress and social support among mothers of 7-yr-old children born at very low birthweight. The MSSI Total scores did not significantly correlate with the PSI Total Child, Total Parent, or Total Stress Indices, although they were significant, but modestly correlated with scores on the Parent subscale of Social Isolation. The relationship between parental stress and maternal social support requires continued investigation.
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Affiliation(s)
- A M Farel
- Department of Maternal and Child Health, School of Public Health, University of North Carolina at Chapel Hill 27599-7400, USA
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20
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Roberts JE, Burchinal MR, Zeisel SA, Neebe EC, Hooper SR, Roush J, Bryant D, Mundy M, Henderson FW. Otitis media, the caregiving environment, and language and cognitive outcomes at 2 years. Pediatrics 1998; 102:346-54. [PMID: 9685437 DOI: 10.1542/peds.102.2.346] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To examine the relationship between otitis media with effusion (OME) and associated hearing loss between 6 and 24 months of age and children's language and cognitive development at 2 years of age. STUDY DESIGN A prospective cohort design in which 86 African-American infants who attended group child-care centers were recruited between 6 and 12 months of age. Between 6 and 24 months, assessments included serial ear examinations using otoscopy and tympanometry, serial hearing tests, two ratings of the childrearing environment at home and in child care, and language and cognitive outcomes at 2 years. RESULTS Children experienced either unilateral or bilateral OME an average of 63% and reduced hearing sensitivity an average of 44% of the time between 6 and 24 months of age. Although proportion of time with OME or with hearing loss was modestly correlated with measures of language and cognitive skills, these relationships were no longer significant when the ratings of the home and child-care environments were also considered. Children with more OME or hearing loss tended to live in less responsive caregiving environments, and these environments were linked to lower performance in expressive language and vocabulary acquisition at 2 years. CONCLUSIONS Both OME and hearing loss were more strongly related to the quality of home and child-care environments than to children's language and cognitive development. Study results might be explained either by suggesting that children in less responsive caregiving environments experience conditions that make them more likely to experience OME and/or by suggesting that it may be more difficult for caregivers to be responsive and stimulating with children with more OME.
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Affiliation(s)
- J E Roberts
- Frank Porter Graham Child Development Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-8180, USA
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Farel AM, Hooper SR, Teplin SW, Henry MM, Kraybill EN. Very-low-birthweight infants at seven years: an assessment of the health and neurodevelopmental risk conveyed by chronic lung disease. J Learn Disabil 1998; 31:118-126. [PMID: 9529782 DOI: 10.1177/002221949803100202] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
To determine whether history of chronic lung disease (CLD) in children born at very low birthweight (VLBW) confers additional risk for impaired health, growth, and neurodevelopment, 17 VLBW children born in 1984 who had CLD (requiring supplemental oxygen more than 30 days after birth) in infancy and 28 VLBW children who did not have CLD were assessed at age 7 years. Assessments included a medical history, standard physical and neurological examinations, pulmonary-function tests, and tests of neuropsychological and psychoeducational functioning. Health status did not differ between the groups. In contrast, children with CLD did not perform as well in neuropsychological and psychoeducational assessments. Although CLD confers little added risk to health, it seems to add significantly to risks for poor school performance that are known to be associated with very low birthweight.
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Affiliation(s)
- A M Farel
- Department of Maternal and Child Health, School of Public Health-CB #7400, University of North Carolina, Chapel Hill 27599, USA
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22
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Hooper SR, Whitt JK, Tennison MB, Burchinal M, Gold SH, Hall CD. HIV-infected children with hemophilia: one- and two-year follow-up of neuropsychological functioning. Pediatr AIDS HIV Infect 1997; 8:91-7. [PMID: 11361782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
This report describes the absence of neuropsychologic change observed over a 2-year period for 25 HIV-seropositive (HIV+) children and adolescents with hemophilia and 33 HIV-seronegative (HIV-) controls. Efforts were made to match the groups on the basis of chronological age, race, and hemophilia severity. The baseline evaluation included blinded neuropsychologic measurement of motor, attention, language, visual processing, memory, and general intelligence. HIV+ and HIV-group means did not differ at baseline on any neuropsychologic domain, and this trend continued at the 2-year follow-up. Mixed models analyses did not indicate that the HIV+ group performed more poorly than the HIV- group on any of the neuropsychological domains, nor did they show different patterns of change over time on these variables for the HIV+ group. Consistent with emergent findings, it continues to be premature to attribute subtle neuropsychologic deficits in seropositive children with hemophilia directly to the central nervous system (CNS) effects of HIV infection.
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Affiliation(s)
- S R Hooper
- Department of Psychiatry, University of North Carolina, Chapel Hill, USA
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Semrud-Clikeman M, Hooper SR, Hynd GW, Hern K, Presley R, Watson T. Prediction of group membership in developmental dyslexia, attention deficit hyperactivity disorder, and normal controls using brain morphometric analysis of magnetic resonance imaging. Arch Clin Neuropsychol 1996; 11:521-8. [PMID: 14588457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
This study explored the utility of using selected brain morphometric indices for predicting group membership for children with developmental dyslexia (n = 10), attention deficit hyperactivity disorder: combined type (n = 10), and a control group (n = 10). Subjects ranged in age from 6.1 to 16 years (M = 10.5 years, SD = 2.8). None of the subjects were diagnosed with mental retardation, nor did any of the subjects have a history of seizure disorder, head trauma, or other neurodevelopmental disorders. WISC-R Full Scale IQ ranged from 87 to 149 (M = 114.4, SD = 13.3) with no significant differences noted between the clinical groups. Six brain regions, as defined by MRI scans, were selected a priori for inclusion in a discriminant function analysis. Reliability of the morphometric measures ranged from 0.94 to 0.97. One significant discriminant function was generated which accounted for about 61.4% of the variance between groups. The predictive discriminant analysis using the six morphometric MRI measurements classified subjects with an overall 60% accuracy with the best accuracy found for the developmental dyslexia and control groups. A predictive discriminant analysis incorporating these six morphometric measures as well as chronological age and FSIQ increased the overall classification accuracy to 87% with the misclassfied subjects assigned to one of the clinical groups. The findings support the presumed neurological basis for many neurodevelopmental disorders. They also underline the importance of including brain morphometric measures in predictive models.
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Affiliation(s)
- M Semrud-Clikeman
- Department of Neurology, University of Minnesota, Minneapolis, MN 55455, USA
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Semrud-Clikeman M, Hooper SR, Hynd GW, Hern K, Presley R, Watson T. Prediction of group membership in developmental dyslexia, attention deficit hyperactivity disorder, and normal controls using brain morphometric analysis of magnetic resonance imaging. Arch Clin Neuropsychol 1996. [DOI: 10.1093/arclin/11.6.521] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hooper SR. Relationship between the Luria-Nebraska Neuropsychological Battery and Woodcock-Johnson Tests of Achievement-Revised in children with psychiatric impairment. Percept Mot Skills 1995; 80:1353-4. [PMID: 7478896 DOI: 10.2466/pms.1995.80.3c.1353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
This study was conducted to estimate the relationship between the Luria-Nebraska Neuropsychological Battery and the Woodcock-Johnson Tests of Achievement-Revised at two ages in a child psychiatric sample (N = 113). Analysis showed significant correspondence between scores on the Luria-Nebraska and the Woodcock-Johnson tests at both ages; however, the former tended to show greater impairment than the latter, particularly for the older group.
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Affiliation(s)
- S R Hooper
- Department of Psychiatry, Clinical Center for the Study of Development and Learning, University of North Carolina School of Medicine, Chapel Hill 27599-7255, USA
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Abstract
30 normally achieving and 24 high school students with learning disabilities from one public high school were enrolled in an exploratory study of adolescents' perceptions of their learning difficulties. Adolescents completed a structured interview based on metacognitive and information-processing theories. Items on which subjects reported the most substantial problems related mainly to attention and organization. Comparison of the frequencies of endorsement of items for each group showed adolescents with learning disabilities most commonly reported problems with use of strategies, retrieval memory, and rapid processing. Current assessment methods and instructional approaches often ignore these crucial aspects of learning and productivity by high school students.
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Affiliation(s)
- A D Sandler
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill 27599
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Abstract
Multiple regression equations predicting WISC-R IQs from Luria-Nebraska T scores and subjects' chronological age were developed and cross-validated on a total sample of 152 adolescent psychiatric patients. Data from a randomly drawn subsample of 100 subjects were entered into three stepwise multiple-regression analyses to derive equations predicting WISC-R IQs. These equations were applied to the remaining subsample (n = 52) as were the equations developed by McKay, et al. (1981) for estimating adult WAIS IQs. Mean differences, correlations, and classification hit rates between the two sets of predicted IQs and the actual WISC-R IQs were examined. Findings were similar to those of previous studies examining the predictive relationship between the Luria-Nebraska and adult intelligence. As expected, chronological age entered significantly into all three stepwise multiple-regression analyses. The newly derived equations had significantly higher correlations with the WISC-R for Verbal and Full Scale IQs and significantly better predictive accuracy for Full Scale IQ. Rates of IQ misclassification warrant caution in the use of these methods, but it is concluded that the equations derived here predict about as well as do short forms of the WISC-R.
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Affiliation(s)
- T A Boyd
- Department of Psychology, Rehabilitation Hospital at Heather Hill, Chardon, OH 44024
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Hooper SR, Boyd TA, Hynd GW, Rubin J. Definitional issues and neurobiological foundations of selected severe neurodevelopmental disorders. Arch Clin Neuropsychol 1993; 8:279-307. [PMID: 14589661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
This article reviews current definitional issues, selected neuropsychological findings, and presumed neurobiological underpinnings of two of the more commonly identified severe neurodevelopmental disorders: mental retardation and autistic disorder. Although these disorders represent two of the more common severe neurodevelopmental disorders encountered by child neuropsychologists practicing in clinical and research settings, they have not received the amount of attention from the field of neuropsychology as other kinds of neurodevelopmental disorders. Although there are few definitional controversies surrounding these disorders, findings accrued to date reveal solid evidence for neurological processes underlying each of these disorders. In addition, each of these diagnoses likely represents a heterogeneous group of disorders, suggesting that a syndrome analysis approach would prove beneficial for increasing our understanding of each disorder. Conclusions are drawn for the clinician and researcher, particularly with respect to using a neuropsychological perspective and assessment strategies with children with more severe disorders.
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Affiliation(s)
- S R Hooper
- Department of Psychiatry and The Clinical Center for the Study of Development and Learning, The University of North Carolina School of Medicine, Chapel Hill, 27599-7255, USA
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Sandler AD, Hooper SR, Watson TE, Coleman WL, Footo M, Levine MD. Talkative children: verbal fluency as a marker for problematic peer relationships in clinic-referred children with attention deficits. Percept Mot Skills 1993; 76:943-51. [PMID: 8321611 DOI: 10.2466/pms.1993.76.3.943] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The relationships between attention deficits, hyperactivity, neurodevelopmental performance, and problematic peer relationships were examined in 99 consecutive children (ages 9 to 11 years) referred for school problems to a clinic. Using a teachers' rating scale, 32 children with cognitive inattention and a comparison group of 67 children without cognitive inattention were identified. The former group comprised children who met criteria for Attention Deficit-Hyperactivity Disorder (ADHD). The latter group comprised children with learning disorders and school problems, 42 of whom did not meet criteria for ADHD. Analysis indicated that the study group had greater peer problems, as estimated by teachers' ratings, than the comparison group. Cognitive inattention was related to peer problems over and above the effects of hyperactivity. Neurodevelopmental predictors of peer problems were different among children with ADHD and those without ADHD. Among children with ADHD, proficiency in tasks of verbal fluency was significantly predictive of peer problems. These preliminary findings suggest that children showing teacher-rated cognitive inattention also manifest significant peer problems and that the presence of strong verbal fluency may make these children prone to inappropriate excessive talking and, subsequently, to alienation of peers.
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Affiliation(s)
- A D Sandler
- Department of Pediatrics, University of North Carolina, Chapel Hill 27599
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Hooper SR, Whitt JK, Tennison M, Burchinal M, Gold S, Hall C. Behavioral adaptation to human immunodeficiency virus-seropositive status in children and adolescents with hemophilia. Am J Dis Child 1993; 147:541-5. [PMID: 8488800 DOI: 10.1001/archpedi.1993.02160290047024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To examine the behavioral adaptation to human immunodeficiency virus (HIV)-seropositive status, as defined by parental report, in children and adolescents with hemophilia. RESEARCH DESIGN A clinical descriptive study of two groups of patients as part of a longitudinal design. SETTING A university-based comprehensive hemophilia center and department of neurology acquired immunodeficiency syndrome dementia center. PATIENTS Forty-six male children with hemophilia divided into two groups based on HIV-seropositive (n = 18) or -seronegative (n = 28) status. None of the patients were symptomatic for acquired immunodeficiency syndrome. SELECTION PROCEDURES All pediatric patients with documented factor VII or IX deficiency aged between 4 and 19 years at study onset and their families were eligible to participate. All subjects were recruited without regard to human immunodeficiency virus status. INTERVENTIONS None. MEASUREMENTS AND RESULTS Profiles of behavioral adjustment were obtained from parents' reports on the Child Behavior Checklist for the HIV-seropositive and HIV-seronegative groups. The two groups did not differ on any of the major indexes of the Child Behavior Checklist, even after adjusting for maternal education and severity of hemophilia. There also was no difference between the groups when individual cases were examined for the number of child behavior checklist scales falling within a clinically significant range. CONCLUSIONS The current findings fail to confirm any clear evidence of behavioral problems in an asymptomatic group of HIV-seropositive children and adolescents with hemophilia.
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Affiliation(s)
- S R Hooper
- Department of Psychiatry, School of Medicine, University of North Carolina, Chapel Hill 27599-7255
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Abstract
This study investigated the utility of the Hobby WISC-R Split-half Short Form in a sample of children and adolescents with severe head injury. Subjects included 30 patients with severe closed-head injuries who were referred for neuropsychological testing as part of their hospitalization in a pediatric rehabilitation center. Subjects ranged in age from 7.5 to 16.2 years and were of the low to middle socioeconomic range. Analyses yielded significant correlations between scores on the standard WISC-R and the Split-half Short Form. Except for the WISC-R Split-half Short Form slightly overestimating scores on Object Assembly, no other score differences were obtained between the two forms. Patterns of strengths and weaknesses were variable for the two forms, with over-all agreements ranging from 46% on the Performance subtests to 53.7% on the Verbal subtests. The rate of classification agreement between the standard and short-form formats in assigning a child to one of five traditional IQ categories was 76.7%, with nearly all scores on the short form falling within one standard error of measurement of the standard WISC-R scores. There was a tendency for younger children to show more stability in their classification categories across the two WISC-R forms than older children. Issues related to the use of the WISC-R Split-half Short Form for a severely head-injured pediatric population are discussed.
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Affiliation(s)
- S R Hooper
- Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill 27599-7255
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Whitt JK, Hooper SR, Tennison MB, Robertson WT, Gold SH, Burchinal M, Wells R, McMillan C, Whaley RA, Combest J. Neuropsychologic functioning of human immunodeficiency virus-infected children with hemophilia. J Pediatr 1993; 122:52-9. [PMID: 8093486 DOI: 10.1016/s0022-3476(05)83486-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Efforts to detect subtle but objective neuropsychologic deficits could clarify the early involvement of the central nervous system and the progression of human immunodeficiency virus (HIV) infection in older children and young adolescents. Baseline examinations of 63 children and adolescents with hemophilia were conducted by examiners unaware of HIV status or staging or of our study's major hypotheses. They measured six domains of neuropsychologic functioning (motor, language, memory, attention, visual processing, and problem solving), and no differences between groups of similar age, race, and socioeconomic status defined by HIV seropositivity (n = 25) and HIV seronegativity (n = 38) were revealed. A high incidence of subtle neuropsychologic deficits relative to (1) age norms and (2) individual cognitive potential was found on measures of motor performance, attention, and speeded visual processing within both infected and uninfected groups. On the basis of these baseline data, it seems premature to attribute early, subtle neuropsychologic deficits in seropositive children with hemophilia to the central nervous system effects of HIV infection.
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Affiliation(s)
- J K Whitt
- Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill 27599
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Hooper SR, Boyd TA, Hynd GW, Rubin J. Definitional issues and neurobiological foundations of selected severe neurodevelopmental disorders. Arch Clin Neuropsychol 1993. [DOI: 10.1093/arclin/8.4.279] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Stern RA, van der Horst CM, Hooper SR, Bloodgood KM, High KA. Zidovudine overdose in an asymptomatic HIV seropositive patient with hemophilia. Psychosomatics 1992; 33:454-7. [PMID: 1461972 DOI: 10.1016/s0033-3182(92)71951-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- R A Stern
- Department of Psychiatry, University of North Carolina, Chapel Hill School of Medicine 27599-7160
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Hooper SR, Willis WG. Learning disability subtyping: a reply to Adams. J Clin Exp Neuropsychol 1992; 14:638-40. [PMID: 1400923 DOI: 10.1080/01688639208402850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- S R Hooper
- Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill 27599
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Sandler AD, Watson TE, Footo M, Levine MD, Coleman WL, Hooper SR. Neurodevelopmental study of writing disorders in middle childhood. J Dev Behav Pediatr 1992; 13:17-23. [PMID: 1556195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This study investigated patterns of neurodevelopmental dysfunction in children with writing disorders (WD). Records of children, ages 9 to 15 years, referred to a school problems clinic were examined. Using teacher questionnaire information, including ratings of writing legibility, mechanics, rate, linguistic sophistication, and spelling, 99 cases of WD were found. Sixty-three children without WD served as clinic controls. A cluster analysis revealed four discrete subtypes of WD and two non-WD control clusters. The four WD clusters were found to have different patterns of writing and reading characteristics. Neurodevelopmental tests discriminated among the clusters (F = 2.8, p less than .0001), and an examination of neurodevelopmental performance characteristics among the clusters showed different patterns of strengths and weaknesses. An empirically derived subtyping of WD is proposed: WD with fine motor and linguistic deficits, WD with visual-spatial deficits, WD with attention and memory deficits, and WD with sequencing deficits. This subtyping, if confirmed in a population study, may have important diagnostic and therapeutic implications.
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Affiliation(s)
- A D Sandler
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill
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Horton AM, Hooper SR. The exceptional brain. Neuropsychology of talent and special abilities. Arch Clin Neuropsychol 1992. [DOI: 10.1093/arclin/7.5.461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Abstract
Academic achievement within a child psychiatric sample was examined as a function of six variables: IQ, socioeconomic status, age, sex, neuropsychological status, and the severity of behavioral disturbance. As expected, the results revealed a different pattern of predictors than what is generally the case of normal school-aged children. The results underscored the importance of neuropsychological factors, more than IQ and demographic variables, in understanding the academic deficits often seen in children with significant mental and emotional disturbance.
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Affiliation(s)
- M G Tramontana
- Department of Psychiatry, Vanderbilt University, Nashville, TN
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Linz TD, Hooper SR, Hynd GW, Isaac W, Gibson LJ. Frontal lobe functioning in conduct disordered juveniles: Preliminary findings. Arch Clin Neuropsychol 1990. [DOI: 10.1093/arclin/5.4.411] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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40
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Linz TD, Hooper SR, Hynd GW, Isaac W, Gibson LJ. Frontal lobe functioning in conduct disordered juveniles: preliminary findings. Arch Clin Neuropsychol 1990; 5:411-6. [PMID: 14589537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
This investigation assessed the hypothesis that conduct disordered juveniles may suffer from a maturational lag in the development of behaviors believed associated with the frontal cortex. Twenty conduct disorder (CD) juveniles and 20 normal comparison subjects were compared on nine Lurian tasks that measure behavior attributed to frontal lobe functioning. A three-way ANOVA, with gender, race, and group as factors of interest, revealed significant differences on the verbal conflict task, verbal retroactive inhibition task, and on a measure of receptive vocabulary. Using receptive vocabulary as a covariate, an ANCOVA showed no significant differences between the groups on any of the tasks. These findings appear to support the potential impact that language dysfunction can have in the development of disinhibitory behavior. Other interpretations of the findings are presented.
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Affiliation(s)
- T D Linz
- University of North Carolina-Chapel Hill, USA
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Tramontana MG, Hooper SR, Nardolillo EM. Behavioral manifestations of neuropsychological impairment in children with psychiatric disorders. Arch Clin Neuropsychol 1988. [DOI: 10.1093/arclin/3.4.369] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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42
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Tramontana MG, Hooper SR, Nardolillo EM. Behavioral manifestations of neuropsychological impairment in children with psychiatric disorders. Arch Clin Neuropsychol 1988; 3:369-74. [PMID: 14591427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
The behavioral manifestations of neuropsychological impairment were examined in a sample of hospitalized boys with psychiatric disorders. The presence of neuropsychological deficits was found to be associated with more extensive behavior problems regardless of factors such as IQ, socioeconomic status, and whether there was a documented history of brain injury. However, the relationship applied specifically to younger as opposed to older subjects, and mainly involved internalizing rather than externalizing behavior problems. The results are taken to suggest that the behavioral manifestations of neuropsychological impairment may change with development.
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Affiliation(s)
- M G Tramontana
- Bradley Hospital and Brown University, East Providence, RI 02915, USA
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Abstract
This study investigated the merits of substituting the Digit Span subtest for an invalid Verbal Scale subtest versus a proration method in calculating WISC--R Verbal and Full Scale IQ. Subjects were 93 child and adolescent psychiatric patients (67 boys and 26 girls) who ranged in age from 8 to 16 yr. Analysis indicated that the use of Digit Span as a substitute for the regularly administered Verbal subtests was inferior to the use of the comparable proration method. Although relatively few cases of misclassification occurred for either method in relation to Full Scale IQ, the rate of Verbal IQ misclassification by the Digit Span substitution method was significantly greater than with use of its proration. When faced with a choice, clinicians should attach greater validity to prorated estimates of a child's WISC--R Verbal IQ.
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Affiliation(s)
- T A Boyd
- Department of Psychiatry and Human Behavior, Brown University
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Boyd TA, Tramontana MG, Hooper SR. Cross-validation of a psychometric system for screening neuropsychological abnormality in older children. Arch Clin Neuropsychol 1986; 1:387-91. [PMID: 14591418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
The Discriminant Equation (DE) represents a recently developed system for screening neuropsychological abnormality in older children. The DE was subjected to cross-validation on a sample of 82 child and adolescent psychiatric patients referred for a comprehensive neuropsychological assessment. An overall hit rate of 79.3% correct classification was found which supported the validity of the DE in predicting neuropsychological impairment. The findings are discussed in relation to population characteristics and the nature of the criterion to be predicted as they may affect the application of neuropsychological screening procedures.
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Affiliation(s)
- T A Boyd
- Bradley Hospital and Department of Psychiatry and Human Behavior, Brown University, East Providence, RI 02915, USA
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Boyd TA, Tramontana MG, Hooper SR. Cross-validation of a psychometric system for screening neuropsychological abnormality in older children. Arch Clin Neuropsychol 1986. [DOI: 10.1093/arclin/1.4.387] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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