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Biomedical subjects

H Als

Publications and source records attributed to H Als.

16 recordsLinked to original sources
PubMed1991

Neurobehavioral organization of the newborn: opportunity for assessment and intervention.

A functional model has been formulated that attempts to specify the behavioral subsystems of functioning that exemplify in their respective interplay an infant's individuality of behavioral functioning in the manner in which they move from stable to disorganized functioning and in the flexibility with which they maintain organized functioning in the face of varied exogenous and endogenous events. Based on this model, Als and colleagues have attempted to develop systematic assessments, the APIB and the K-Box Paradigm, to quantify the degree of differentiation and modulation of these behaviorally defined subsystems of functioning. It is hypothesized that the differences documented via these assessments are brain based (i.e., part of the child's biological makeup, which is influenced by the intrauterine and extrauterine environment, be it sensory and/or drug exposure, and which shows a recognizable pattern along a definable trajectory).

Behavior↗
PubMed1990

Quantified neurophysiology with mapping: statistical inference, exploratory and confirmatory data analysis.

Topographic mapping of brain electrical activity has become a commonly used method in the clinical as well as research laboratory. To enhance analytic power and accuracy, mapping applications often involve statistical paradigms for the detection of abnormality or difference. Because mapping studies involve many measurements and variables, the appearance of a large data dimensionality may be created. If abnormality is sought by statistical mapping procedures and if the many variables are uncorrelated, certain positive findings could be attributable to chance. To protect against this undesirable possibility we advocate the replication of initial findings on independent data sets. Statistical difference attributable to chance will not replicate, whereas real difference will reproduce. Clinical studies must, therefore, provide for repeat measurements and research studies must involve analysis of second populations. Furthermore, Principal Components Analysis can be employed to demonstrate that variables derived from mapping studies are highly intercorrelated and data dimensionality substantially less than the total number of variables initially created. This reduces the likelihood of capitalization on chance. The need to constrain alpha levels is not necessary when dimensionality is low and/or a second data set is available. When only one data set is available in research applications, techniques such as the Bonferroni correction, the "leave-one-out" method, and Descriptive Data Analysis (DDA) are available. These techniques are discussed, clinical and research examples are given, and differences between Exploratory (EDA) and Confirmatory Data Analysis (EDA) are reviewed.

Brain↗
PubMed1990

Behavioral and electrophysiological evidence for gestational age effects in healthy preterm and fullterm infants studied two weeks after expected due date.

We investigated the effects of gestational age at birth on behavioral and electrophysiological measures of 135 medically healthy infants, studied at 42 weeks postconception, and stratified into 3 groups--early-born preterms, 26-32 weeks (n = 55); middle-group preterms, 33-37 weeks (n = 43); and fullterms, 38-41 weeks (n = 37). Subjects were studied behaviorally with the Assessment of Preterm Infants' Behavior (APIB) and electrophysiologically with brain electrical activity mapping (BEAM). Fullterms showed significantly better behavioral function than both preterm groups. Less difference was found between the preterm groups. EEG spectral and photic evoked response were of significantly less amplitude for the preterms than the fullterms. Path analysis showed gestational age effects on behavioral (3 of 6) and electrophysiological (13 of 17) variables due to postnatal complications. We conclude that some differences attributable to gestational age at birth are explained by the cumulative effect of minor but unavoidable complications associated with premature birth. We speculate that remaining effects may result from developmentally inappropriate sensorimotor stimulation consequent to the premature experience of an extrauterine environment.

Arousal↗
PubMed1990

Imaging procedures and developmental outcomes in the neonatal intensive care unit.

Behavioural and environmental modification techniques in the neonatal intensive care unit for oxygen-dependent premature infants with chronic lung disease have been shown to result in a decrease in the number of days of respirator support and number of days of supplemental oxygen therapy. Long-term neurodevelopment outcome was significantly better for infants in the experimental therapy group who received specialized environmental modification to decrease stressful stimuli. We present results of cranial ultrasound and chest radiograph studies in this very high-risk population and suggest that such studies represent additional stressful stimuli that should be scheduled with consideration of an overall behavioral infant care plan.

Bronchopulmonary Dysplasia↗
PubMed1978

II. Assessing an assessment: conceptual considerations, methodological issues, and a perspective on the future of the Neonatal Behavioral Assessment Scale.

The Brazelton Neonatal Behavioral Assessment Scale is a behavior analysis instrument which provides the researcher with a systematic way of eliciting and documenting a series of complex behavioral parameters reflecting the healthy term newborn's current repertoire of organization and functioning. This assessment focuses on the newborn's adaptation as a social interactive organism embedded in a feedback system with an adult caregiver. It brings out those processes which the individual newborn uses to deal with his animate and inanimate environment and yields a series of defined and scaled behavioral descriptors which permit quantification of aspects of behavioral parameters reflecting such subsystems of functioning as physiological organization, motoric organization, state organization, and interactive organization. As such, it provides a window on the complexity of current organization of the human newborn. It does not provide a ready-made method of synthesizing the information gained about the individual newborn. It becomes the researcher's task to develop a synthesis method appropriate to the question under investigation.

Adaptation, Psychological↗
PubMed1976

The behavior of the full-term but underweight newborn infant.

Ten underweight full-term newborns were compared with 10 full-weight newborns on the Brazelton Neonatal Behavioral Assessment Scale. The Brazelton examination differentiated the two groups clearly on the reflexes of walking, crawling and passive movements of arms and legs, and on rooting and sucking. More importantly, it differentiated the two groups on behaviors which are important for the caretaker of the baby: these are attractiveness, need for stimulation, interactive processes and motor processes. The 10 underweight infants were followed up at a later date during the first year. They showed temperamental organizational difficulties and some indication of psychosomatic reaction to stress. It is possible that the underweight newborn's fragile organization elicits anxiety in the caretaker which makes interaction difficult.

Child Behavior↗
PubMed1976

Regional obstetric anesthesia and newborn behavior: effect over the first ten days of life.

This study examined the effects of carefully controlled amounts of analgesic premedications and anesthetics administered to mothers during delivery on the behavior of the newborn over the first ten days of life. The subjects were selected to minimize the synergistic effects of medication and other stress factors, such as abnormalities of pregnancy, labor, or delivery. The effects of these drugs on the behavior of these infants was small. The data provide a picture of the behavioral recovery of a group of minimally stressed newborns.

Adult↗
PubMed1975

Early mother-infant reciprocity.

By three weeks of age, the human neonate demonstrates behaviours which are quite different with an object and with a human interactant. He also demonstrates an expectancy for interaction with his caregiver which has clearly defined limits, as demonstrated behaviourally. In microanalysis of videotape, we saw regularly a set of interactive behaviours which were demonstrable in optimal face-to-face interaction between infants and their mothers. All parts of the infant's body move in smooth circular patterns as he attends to her. His face-to-face attention to her is rhythmic with approach-withdrawal cycling of extremities. The attention phase and build-up to her cues are followed by turning away and a recovery phase in a rhythm of attention-non-attention which seems to define a cyclical homeostatic curve of attention, averaging several cycles per minute. When she violates his expectancy for rhythmic interaction by presenting a still, unresponsive face to him, he becomes visibly concerned, his movements become jerky, he averts his face, then attempts to draw her into interaction. When repeated attempts fail, he finally withdraws into an attitude of helplessness, face averted, body curled up and motionless. If she returns to her usual interactive responses, he comes alive after an initial puzzled period, and returns to his rhythmic cyclical behaviour which has previously characterized their ongoing face-to-face interaction. This attentional cycling may be diagnostic of optimal mother-infant interactions and seems not to be present in more disturbed interactions.

Attention↗