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Biomedical subjects

S H Landry

Publications and source records attributed to S H Landry.

At least 37 records · Page 2Linked to original sources
PubMed1995

Verbal and nonverbal skill discrepancies in children with hydrocephalus: a five-year longitudinal follow-up.

Compared verbal and nonverbal skills of 65 children ages 5 to 7 years, with a history of shunted hydrocephalus (n = 26), arrested hydrocephalus (n = 11), and no hydrocephalus (n = 28), over a 5-year period. Comparison of these skills in 4 assessments revealed poorer average nonverbal than verbal skills on measures from the McCarthy Scales of Children's Abilities, the Wechsler Intelligence Scales for Children-Revised (WISC-R), and composites of neuropsychological skills for the shunted hydrocephalus group in comparison to the arrested-hydrocephalus and no hydrocephalus groups. There were higher rates of significant discrepancies between WISC-R Verbal IQ (VIQ) and Performance IQ (PIQ), with PIQ < VIQ in the shunted group. However, relatively few children exhibited significant discrepancies on multiple test occasions. The poorer performance of the shunted hydrocephalus group could not be attributed to motor demands of the nonverbal tasks.

Cerebrospinal Fluid Shunts↗
PubMed1994

Prospective, controlled study of developmental outcome in survivors of extracorporeal membrane oxygenation: the first 24 months.

OBJECTIVE: Survivors of venoarterial extracorporeal membrane oxygenation (ECMO) are considered to be at risk for developmental disabilities, but there are few controlled outcome studies. A prospective, controlled study of outcome was performed to quantify the degree and frequency of developmental disabilities in ECMO survivors compared with a matched control group. METHODS: From May 1987 through November 1990, 40 of 47 neonates treated with ECMO survived at the University of Texas Medical Branch in Galveston. Longitudinal developmental data were collected, using the Bayley Scales of Infant Development, on 22 ECMO infants and 29 healthy term control infants at 6, 12, and 24 months. Language was assessed at 24 months using the Sequenced Inventory of Communication Development. An additional 13 ECMO infants had developmental data for at least one time point. RESULTS: Healthy term infants performed significantly better than ECMO infants on the Bayley Scales of Infant Development at 6 and 24 months and on the Sequenced Inventory of Communication Development at 24 months. Mean scores of ECMO infants were well within the average range and 77% of the ECMO infants were developmentally normal. CONCLUSIONS: These data suggest that early developmental morbidity in ECMO survivors is low, considering the severity of their neonatal illness.

Analysis of Variance↗
PubMed1993

Longitudinal outcome for low birth weight infants: effects of intraventricular hemorrhage and bronchopulmonary dysplasia.

This study addresses the mental and motor development of 78 low birth weight infants (LBW) classified into five groups according to early medical complications: (1) respiratory distress syndrome (RDS); (2) intraventricular hemorrhage (IVH Grades I-II); (3) IVH (Grade III); (4) IVH (Grade IV) with hydrocephalus; and (5) bronchopulmonary dysplasia (BPD) with or without IVH. Each child received an assessment of mental and motor development at 6, 12, 24 and 36 months of age. Results of mental scores revealed clear effects of group and age, but no interaction of group and age. The RDS and IVH (Grades I-III) groups generally had higher scores on indices of mental development than did IVH (Grade IV) and BPD infants with or without IVH. Although most groups had higher mental scores at the older ages, rates of growth were essentially parallel across the five groups. There was some support for differential rates of motor development, with the IVH (Grade IV) group showing acceleration between 24 and 36 months of age while the BPD group continued to show motor delay at 36 months. These results call into question the common practice of correcting psychology test scores of LBW infants for gestational age.

Bronchopulmonary Dysplasia↗
PubMed1993

Goal-directed behavior and perception of self-competence in children with spina bifida.

Compared a group of school-age children with spina bifida (n = 15) between the ages of 6 and 12 years with an age- and IQ-matched control group of normal children (n = 15). As predicted, the spina bifida children spent less time using goal-directed behaviors and more time in simple manipulation of the toys compared to the normal children. There were no group differences between the spina bifida and normal children's perceived competence but parents of the spina bifida children rated their children as having lower cognitive and physical competence. Associations were found between goal-directed behaviors and perceived self-competence for children in the spina bifida group but not the normal group.

Child↗
PubMed1992

Neurodevelopmental outcome in neonates after extracorporeal membrane oxygenation: cranial magnetic resonance imaging and ultrasonography correlation.

Irreversible ligation of the right common carotid artery and right internal jugular vein is usual in venoarterial extracorporeal membrane oxygenation (ECMO) for treatment of severe respiratory failure in neonates. Vessel ligation with ECMO may magnify risks of cerebral hemorrhage or infarction (CHI) and adversely affect neurodevelopmental outcome. To correlate CHI after ECMO with neurodevelopmental outcome, we reviewed cranial ultrasonography (US) and magnetic resonance imaging (MRI) scans in 22 consecutive neonatal ECMO survivors and compared these with results of Bayley Scales of Infant Development obtained at 3, 6, 12, and 24 months of follow-up. All patients had US, and 19 had MRI. No US or MRI had focal abnormal findings attributable to ECMO; specifically, there was no evidence of CHI. Two infants had generalized cerebral atrophy, and one of these had an abnormal Bayley examination. One infant with a normal MRI had a single right focal seizure 4 days after ECMO. Of 20 infants with Bayley developmental tests at 3 to 30 months of age (mental index range, 72 to 135; motor index range, 71 to 150), only 3 were abnormal. In our experience, the incidence of CHI secondary to ECMO is less than that reported. After ECMO, the absence of intracranial hemorrhage, cerebral infarct, or cerebral atrophy on US or MRI usually correlates with normal short-term neurodevelopmental outcome.

Brain↗
PubMed1991

Cognitive and motor abilities in preschool hydrocephalics.

The neuropsychological performance of three groups of preschool children was evaluated: (a) one with hydrocephalus associated with myelomeningocele; (b) one with hydrocephalus associated with intraventricular hemorrhage and very low birth weight; and (c) a nonhydrocephalic normal comparison group. Multivariate profile analysis revealed lower levels of performance on measures of verbal and nonverbal cognitive skills for both groups of hydrocephalic children relative to normals. Comparison of group profiles on tasks requiring figure copying as opposed to figure matching and analysis of specific gross and fine motor skills revealed that both hydrocephalic groups had impaired visual-motor integration in the presence of average visual perceptual matching. In addition, different patterns of motor skill deficits were found for each hydrocephalic group. The results of this study suggest that decreased visual-motor integration and etiology-specific motor deficits are major sequelae of these forms of hydrocephalus in the preschool years.

Cerebral Hemorrhage↗
PubMed1990

The social competence of children born prematurely: effects of medical complications and parent behaviors.

36-month-old, full-term children (n = 21) and low-birthweight (LBW) children of high (n = 25) and low (n = 23) medical risk status were observed in interactions with mothers in teaching and social context. Child compliance, self-directed behaviors, and problem behaviors were evaluated as well as associations among aspects of children's social competence, mothers' behaviors, and context factors. Degree of medical risk was associated with impairments in children's self-directed behavior and quality of response to maternal directives. Mothers of LBW children showed a smaller proportion of behaviors that provided choices compared to mothers of full-term children. Medical complications, children's cognitive status, and mothers' interactive behaviors were significantly associated with LBW children's social competence. Results of regression analyses suggested that mothers and LBW children influence each others' behavior in ways similar to mothers and full-term children in both teaching and social contexts.

Attention↗
PubMed1990

Joint attention of six-month-old Down syndrome and preterm infants: I. Attention to toys and mother.

Six-month-old infants with Down syndrome (n = 14) and mental and motor-age-matched high-risk preterm infants (n = 15) were studied with respect to their use of separate attentional processes under conditions with and without their mother's direct involvement in play. As predicted, compared to preterm infants, the infants with Down syndrome spent less time involved with toys and more time looking at their mothers whether or not their mothers were actively involved. Although both infant groups showed an increase in the amount of time spent attending to toys in the mother-involved condition compared to the independent condition, only the preterm infants examined a wider range of toys when interacting with their mothers. Also, the infants with Down syndrome showed fewer shifts of attention to a toy in response to their mother's attempts to redirect their attention and, unlike the preterm infants, did not show increased positive affect when interacting with their mothers compared to playing on their own.

Affect↗
PubMed1990

Goal-directed behavior in children with spina bifida.

A group of school-age children with spina bifida (n = 15) between the ages of 6 and 12 years were compared with an age- and IQ-matched control group of normal children (n = 15). Goal-directed behavior in these two groups was measured by videotaped observational measures of the number of different task-oriented play activities the children performed and the amount of time they spent in independent task-oriented activities. Measures of time spent off-task and in simple manipulation of the play materials were taken, as well as the number of social initiations the child directed to the examiner. The children with spina bifida spent less time in task-oriented activities than the control group, even though there were no group differences in the number of activities performed. The differences could not be explained by cognitive impairments or socioeconomic factors. These results suggest that children with spina bifida may have specific problems with sustaining goal-directed behavior, and need assistance in formulating and implementing a sequence of actions in order to achieve concrete short-term goals.

Attention↗
PubMed1989

The effect of social context on the functional communication skills of autistic children.

This study investigated autistic children's use of attention-directing gestures and language in three different interactive situations which varied in social context factors. These behaviors were videotaped and compared in autistic children (n = 15), children with developmental language delay (n = 14), matched on mental age and mean length of utterance (MLU), and MLU-matched young normal children (n = 13). Results supported the hypothesis that autistic children's attention-directing behavior would differ most from that of the other groups in spontaneous interactions. However, contrary to expectation, the autistic children did not produce more attention-directing behavior when a high degree of adult direction was provided. Overall, the autistic group used attention-directing behaviors less frequently than the other groups, and in the autistic group these behaviors varied less across social context factors. Results are interpreted in terms of their implications for language intervention programs with autistic children.

Adolescent↗
PubMed1989

Joint attention and infant toy exploration: effects of Down syndrome and prematurity.

12-month-old infants with Down syndrome (n = 14) and mental and motor age-matched high-risk preterm infants (n = 14) were studied with respect to their ability to attend to and explore their environment in interactions with their mothers. The effectiveness of particular maternal attention-directing techniques in modifying infant responses to toys was expected to vary across the 2 infant groups. In general, higher-level responses to toys were expected to be associated with mother's attempts to maintain rather than redirect the child's attention and the mother's use of structured verbal and nonverbal attention-directing techniques. Results indicated that mothers of the 2 groups of infants used different attention-directing strategies, and their use of particular strategies was differentially related to the attentional capacity of the 2 groups. Differences in the infants' responses to particular maternal strategies were related to the amount of structure provided and to the demands placed on their capacity to shift attention between objects. Fewer specific maternal techniques for directing attention elicited higher-level play behavior from the Down syndrome infants, compared to the preterm group.

Attention↗
PubMed1989

The effects of intraventricular hemorrhage on functional communication skills in preterm toddlers.

A group of 24-month-old preterm toddlers (n = 27) were subdivided into three groups according to their early specific medical complications [i.e., respiratory distress syndrome (RDS), without intraventricular hemorrhage (IVH), IVH (Grades I and II), and IVH (Grades III and IV]) and were matched to a group of full-term toddlers (n = 10) on socioeconomic status and mental and receptive language age. We evaluated (1) the effects of IVH on functional use of language (e.g., speech acts), and (2) the relationship of mothers' verbal attempts to stimulate children's interest in topics and toys with the communication behaviors used by the children. The preterm groups used verbalizations and gestures less frequently to express a range of functions, but were comparable to the full-term children in their use of communicative acts that served to continue interactions. Although child behaviors did not differ in relation to specific medical complications, these differences were apparent in the mothers' behavior patterns and in the relationships between mother and child behavior. Mothers' verbal maintaining behavior was strongly associated with children's use of language for the full-term and two lower risk preterm groups, but not the higher risk IVH (Grades III and IV) group. The mothers of the IVH (Grades III and IV) group showed high responsiveness to lower level child behaviors, a pattern that was not apparent in the other preterm groups for lower risk children who showed comparable delays in their functional communication development.

Brain Damage, Chronic↗
PubMed1988

The functions of immediate echolalia in autistic children: a developmental perspective.

This study examined differences in the use of immediate echolalia by autistic children at different stages of language development. Eighteen autistic children, aged 4 to 12 years, were videotaped in play sessions with a parent and with an examiner. Data were collected on frequency of echolalia, percentage of language that was echolalic, functions of echolalia (Prizant & Duchan, 1981), chronological age, nonverbal mental age, and language level. Frequency of immediate echolalia varied with expressive language level but not with nonverbal mental age or chronological age. The percentage of language that was echolalic was high at early stages of language development but decreased as language skills improved. No significant relationships were found between number of functions and language level, chronological age, or nonverbal mental age. Although coding of functions was reliable, the validity of functional categories for echolalia was not strongly supported. Implications for autistic language development and for methodology in this area are discussed.

Adolescent↗
PubMed1988

Speech acts and the pragmatic deficits of autism.

In a videotaped free-play session with a parent, autistic children were compared with mental-age matched Developmental Language Delay (DLD) children and with normally developing (ND) 2-year-olds in the use of communicative acts by parent and child. Groups were matched for language level. Autistic children had more incidents of no responses, produced less affirming, turn-taking vocalization, and gesture, and were less likely to initiate communication than other children. Parent groups differed only in a greater amount of initiating and use of imperatives by parents of autistic children. Few relations between parent behaviors and child behaviors were found. Nonresponses by all children were concentrated subsequent to parent imperatives and questions, but no group differences were found in the distribution of nonresponses to various parent communicative acts. Results are interpreted to support the hypothesis that autistic children's language can serve a number of useful functions but that their pattern of language functions differs from that of nonautistic language-impaired children and much younger normal children of similar language level.

Autistic Disorder↗
PubMed1988

Communication behaviors in autism and developmental language delay.

The communicative behavior of autistic and developmental language delay (DLD) children matched for nonverbal mental age and mean length of utterance (MLU) was compared to that of normally-developing (ND) 2-yr-olds. Autistic children were less able than other children to respond correctly to language or gestures used to direct their attention, used attention directing (pointing, showing) less frequently, and produced more echolalic speech when making requests. DLD and ND children differed only in number of pronouns used while requesting. Attention-directing gestures were associated with receptive and expressive language abilities for autistic, DLD and normal children.

Attention↗
PubMed1986

Joint attention and language in autism and developmental language delay.

The relationship of gestural joint attention behaviors and the development of effective communication skills in autism and developmental language delay (DLD) was investigated. Autistic and DLD children matched for MA and MLU were compared on measures of gestural joint attention behavior, personal pronoun use, and spontaneous communicative behavior. DLD children responded correctly to joint attention interactions more often than autistic children, and their spontaneous gestural behavior was more communicative and developmentally advanced. Correct production of "I/you" pronouns was related to number of spontaneous initiations for autistic but not for DLD children. Measures of spontaneous joint attention behaviors were in general not related to MA, CA, or MLU for either group. DLD children's performance suggests no special impairment of joint attention skills, whereas autistic children's performance suggests a joint attention deficit in addition to a language deficit.

Attention↗