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Biomedical subjects

M Burchinal

Publications and source records attributed to M Burchinal.

15 recordsLinked to original sources

Developmental outcomes of infants with bronchopulmonary dysplasia: comparison with other medically fragile infants.

The purpose of this study was to compare the developmental outcomes and mother-infant interactions of infants with bronchopulmonary dysplasia (BPD) and those of other medically fragile infants. One-hour behavioral observations were made of the interactions of mothers with two groups of infants (23 with BPD, 39 medically fragile without BPD or neurological problems) at enrollment, every 2 months during hospitalization, 1 month after discharge, and at 6 months' and 12 months' corrected age. Assessment of the home environment also was done at 6 and 12 months. Multiple regressions were calculated separately for child mental, adaptive, language, and motor outcomes. Predictors were: home environment assessment, measures of maternal interactive behaviors (positive attention, expression of negative affect, medicalized caregiving), infant group membership, and presence of intraventricular hemorrhage (IVH) in the infant. There were no significant differences between the two groups in any of the developmental outcomes or interactive variables, and the presence of IVH had no effect on these variables. Maternal positive attention and the home environment were correlated with mental development, and mother negative affect was related to adaptive behavior for both groups. Differences in developmental and interactive behaviors between infants with BPD and other prematurely born infants found in other studies appear to be a result of chronic health problems and, thus, are not unique to infants with BPD.

Bronchopulmonary Dysplasia↗

The development of cognitive and academic abilities: growth curves from an early childhood educational experiment.

In the Abecedarian Project, a prospective randomized trial, the effects of early educational intervention on patterns of cognitive and academic development among poor, minority children were examined. Participants in the follow-up were 104 of the original 111 participants in the study (98% African American). Early treatment was full-time, high-quality, educational child care from infancy to age 5. Cognitive test scores collected between the ages of 3 and 21 years and academic test scores from 8 to 21 years were analyzed. Treated children, on average, attained higher scores on both cognitive and academic tests, with moderate to large treatment effect sizes observed through age 21. Preschool cognitive gains accounted for a substantial portion of treatment differences in the development of reading and math skills. Intensive early childhood education can have long-lasting effects on cognitive and academic development.

Adolescent↗

Receptive and expressive communication development of young males with fragile X syndrome.

We prospectively examined the developmental trajectories of receptive and expressive communication skills of 39 young males, 20 to 86 months of age, with fragile X syndrome. Eight showed features characteristic of autism. Children were tested one to three times using a standardized language test. They showed marked delays in language development, but substantial individual variability. Participants acquired expressive language skills more slowly than receptive language over time, gaining receptive language at about half the rate expected for typically developing children and expressive language at one third the rate. Both cognitive skills and autistic characteristics of the young males with fragile X syndrome related to receptive and expressive communication development, but neither predicted the discrepancies between expressive and receptive language acquisition over time.

Child↗

Depression, disease severity, and sickle cell disease.

The present study examined depressive symptomatology in 440 adults with sickle cell disease (SCD). Participants completed the Center for Epidemiologic Studies--Depression scale (CES-D) as part of their yearly routine visits to the Duke University--University of North Carolina Comprehensive Sickle Cell Center. They also completed questions regarding demographics, disease severity, pain, and health care use. Data analyses revealed that the percentage of patients with SCD exhibiting significant depressive symptomatology dropped from 43 to 18% when a more stringent cutoff was used on the CES-D, suggesting that future studies should determine the most valid cutoff score for identifying depression in patients with SCD. Gender and family income were positively and significantly associated with depressive symptomatology. Also, patients who reported more frequent painful episodes were more likely to report depressive symptoms. Implications for assessment and treatment of depression in adults with SCD are discussed.

Adult↗

HIV-infected children with hemophilia: one- and two-year follow-up of neuropsychological functioning.

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.

AIDS Dementia Complex↗

Adolescent paid labor and relationships with parents: early work-family linkages.

Earnings represent an important mechanism by which changes occur in the adolescent-parent relationship. The present study examines adolescent earnings and multiple dimensions of relationships with parents by drawing on 4 waves of data from the Iowa Youth and Families project. Dynamic models based on the multiple perspectives of adolescent and parent are estimated with hierarchical equations. Between the seventh and tenth grades, rural adolescent earnings and nonleisure spending are related to time spent with the family, less parental monitoring, and more sharing of advice within the family. Earnings and nonleisure spending have positive associations with the affective quality of the adolescent-parent relationship. These results are discussed in terms of the multifaceted dimensions of adolescent work experiences and their implications for the life course.

Adolescent↗

Behavioral adaptation to human immunodeficiency virus-seropositive status in children and adolescents with hemophilia.

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.

Adaptation, Psychological↗

Neuropsychologic functioning of human immunodeficiency virus-infected children with hemophilia.

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.

Adolescent↗

Severity of spatial learning impairment in aging: development of a learning index for performance in the Morris water maze.

The Morris water maze task was originally designed to assess the rat's ability to learn to navigate to a specific location in a relatively large spatial environment. This article describes new measures that provide information about the spatial distribution of the rat's search during both training and probe trial performance. The basic new measure optimizes the use of computer tracking to identify the rat's position with respect to the target location. This proximity measure was found to be highly sensitive to age-related impairment in an assessment of young and aged male Long-Evans rats. Also described is the development of a learning index that provides a continuous, graded measure of the severity of age-related impairment in the task. An index of this type should be useful in correlational analyses with other neurobiological or behavioral measures for the study of individual differences in functional/biological decline in aging.

Aging↗

Neurodevelopmental, health, and growth status at age 6 years of children with birth weights less than 1001 grams.

The neurodevelopmental, health, and growth outcomes for 28 six-year-old extremely low birth weight (ELBW) (birth weight less than 1001 gm) children were compared with those of 26 control children born at term. The two groups did not differ in mean weight or height, but the ELBW group had smaller head circumferences (p = 0.015). Kaufman mental processing scores correlated with head circumference (p = 0.0003). Significantly more of the ELBW children (61%) had mild or moderate to severe neurologic problems compared with control children (23%) (p = 0.003). Three ELBW children had mild spastic diplegia; one was blind. Eighteen (64%) of the ELBW children had required rehospitalization versus five (20%) of the comparison group. The mean Kaufman Mental Processing Composite was lower for the ELBW group, but when the data were analyzed by maternal education, only those children whose mothers had a twelfth-grade education had significantly lower scores (p = 0.0001). A similar pattern of group differences was seen for scores on visual-motor function (p = 0.0045), visual-perceptual abilities (p = 0.003), and attention span (p = 0.0001). No group differences were seen regarding hyperactivity or parental stress. Overall functional disability among the ELBW children was considered absent in 46%, mild in 36%, and moderate to severe in 18%. There was a significant association (p = 0.029) between classification of handicap at 12 to 34 months and classification at 6 years. No neonatal factors correlated with 6-year outcome. A significant proportion of ELBW children had no severe disabilities, but many had dysfunctions likely to affect learning and behavior in school.

Attention Deficit Disorder with Hyperactivity↗

Phonological process decline from 2 1/2 to 8 years.

The phonological development of 145 children between the ages of 2 1/2 and 8 years was examined. Speech was assessed annually using a standardized articulation test and analyzed for the occurrence of both common and uncommon phonological processes. A marked decline in process usage was observed between the ages of 2 1/2 and 4 years and infrequent process usage was observed after the age of 4. Uncommon processes were used infrequently, even at 2 1/2 years. No sex differences were found. Race differences were found with respect to isolated processes.

Articulation Disorders↗

Type of day-care and preschool intellectual development in disadvantaged children.

Levels and patterns of intellectual development of 3 groups of socioeconomically disadvantaged children were compared. The groups consisted of (1) children who were randomly assigned to receive extensive university-based intervention group day-care, (2) children whose parents placed them in community day-care centers for varying amounts of time, or (3) children whose parents chose little to no center-based day-care for their children. Two repeated-measures analyses of variance were performed to identify possible day-care effects on IQ level and on patterns of infant and preschool cognitive development. The results suggest that quality community day-care, as well as intervention day-care, may positively change both the level and pattern of preschool intellectual development of socioeconomically disadvantaged children.

Child Day Care Centers↗

Parents' report of vocabulary and grammatical development of African American preschoolers: child and environmental associations.

This study examined how child and family factors affect individual differences in the language development of African American children between 18 and 30 months of age. Participants were 87 African American children, primarily from low-income families. Children's vocabulary and grammatical skills were assessed at 18, 24, and 30 months of age using the short form of the MacArthur Communicative Development Inventory (CDI), a standardized parent report tool. Standardized language tests were administered repeatedly between 1 and 3 years of age. Results showed that children's vocabulary and utterance length grew linearly over time between 18 and 30 months of age. Children from more stimulating and responsive homes were reported to have larger vocabularies, to use more irregular nouns and verbs, and to use longer utterances, in addition to having more rapid rates of acquisition of irregular forms and longer utterances over time. Girls used longer utterances than boys and more irregular forms. Girls also had larger vocabularies in a secondary analysis that eliminated children whose parent report of their vocabulary was substantially lower than children's scores on a standardized language test. There are indications that some parents may be under-reporting their children's early vocabulary and grammatical development, with a high proportion of the parents reporting their child's 30 month vocabulary and grammatical development as being at or below the 10th percentile according to the CDI norms.

Black or African American↗

The home environments of children in the United States part II: relations with behavioral development through age thirteen.

This study examined the frequency with which children were exposed to various parental actions, materials, events, and conditions as part of their home environments, and how those exposures related to their well-being. Part 1 focused on variations by age, ethnicity, and poverty status. In Part 2 of the study, relations between major aspects of the home environment (including maternal responsiveness, learning stimulation, and spanking) and developmental outcomes for children from birth through age 13 were investigated. The outcomes examined were early motor and social development, vocabulary development, achievement, and behavior problems. These relations were examined in both poor and nonpoor European American, African American, and Hispanic American families using hierarchical linear modeling. The most consistent relations found were those between learning stimulation and children's developmental status, with relations for parental responsiveness and spanking varying as a function of outcome, age, ethnicity, and poverty status. The evidence indicated slightly stronger relations for younger as compared with older children.

Adolescent↗