Biomedical subjects

S R Hooper

Publications and source records attributed to S R Hooper.

At least 19 recordsLinked to original sources

PubMed2001

Double-blind, placebo-controlled study of amantadine hydrochloride in the treatment of children with autistic disorder.

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.

Adolescent↗

PubMed2001

Early childhood otitis media in relation to children's attention-related behavior in the first six years of life.

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.

Attention↗

PubMed2000

Ecological outcomes of adolescents in a psychoeducational residential treatment facility.

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.

Adolescent↗

PubMed2000

Otitis media in childhood in relation to preschool language and school readiness skills among black children.

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.

Auditory Threshold↗

PubMed2000

Proton MR spectroscopy in children with bipolar affective disorder: preliminary observations.

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.

Aspartic Acid↗

PubMed1998

Otitis media, the caregiving environment, and language and cognitive outcomes at 2 years.

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.

Black People↗

PubMed1998

Relationship between the Maternal Social Support Index and the Parenting Stress Index in mothers of very-low-birthweight children now age 7.

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.

Child↗

PubMed1998

Proton MR spectroscopy in psychiatric and neurodevelopmental childhood disorders: early experience.

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.

Attention Deficit Disorder with Hyperactivity↗

PubMed1997

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↗

PubMed1996

Prediction of group membership in developmental dyslexia, attention deficit hyperactivity disorder, and normal controls using brain morphometric analysis of magnetic resonance imaging.

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.

Journal Article↗

PubMed1995

Relationship between the Luria-Nebraska Neuropsychological Battery and Woodcock-Johnson Tests of Achievement-Revised in children with psychiatric impairment.

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.

Achievement↗

PubMed1993

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↗

PubMed1993

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↗

PubMed1993

Talkative children: verbal fluency as a marker for problematic peer relationships in clinic-referred children with attention deficits.

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.

Attention↗

PubMed1993

WISC-R IQ estimates from the Luria-Nebraska Neuropsychological Battery.

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.

Adolescent↗

PubMed1993

Academic confessions of high school students: an analysis of adolescents' developmental concerns.

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.

Adaptation, Psychological↗

PubMed1993

Utility of the Hobby WISC-R Split-half Short Form for children and adolescents with severe head injury.

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.

Adolescent↗

PubMed1993

Definitional issues and neurobiological foundations of selected severe neurodevelopmental disorders.

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.

Journal Article↗