Biomedical subjects

Sharon L Ramey

Publications and source records attributed to Sharon L Ramey.

8 recordsLinked to original sources

PubMed2006

Intensive pediatric constraint-induced therapy for children with cerebral palsy: randomized, controlled, crossover trial.

A randomized crossover trial of a new form of pediatric rehabilitation was conducted with 18 children with hemiparesis. Half were randomly assigned to receive pediatric constraint-induced therapy involving constraint of the functional upper extremity and intensive therapy with the hemiparetic upper extremity. Controls received conventional physical and occupational therapy and then were crossed over to receive pediatric constraint-induced therapy. Pediatric constraint-induced therapy produced significantly greater gains than conventional rehabilitation services.

Adaptation, Physiological↗

PubMed2005

Injury risk among children of low-income U.S.-born and immigrant mothers.

The number of immigrants in the United States is at an all time high, yet psychologists have largely ignored the domain of immigrant health. This article considers 1 aspect of immigrant health, risk for pediatric injury. A sample of over 5,000 5-year-old children from impoverished families was studied; approximately 13% had immigrant mothers. Children of immigrants had a significantly lower rate of injury in the prior year. This was particularly true of non-White children of immigrants. Three possible mediators for this finding--assistance with parenting, parenting style, and health care accessibility--were considered, but none explained the difference. The need for further research on the topic and implications of results for injury prevention are discussed.

Attention Deficit Disorder with Hyperactivity↗

PubMed2005

Folate status of mothers during pregnancy and mental and psychomotor development of their children at five years of age.

OBJECTIVE: There are limited data relating folate nutritional status of mothers during pregnancy to mental and psychomotor development of their offspring. Using an existing data set from a study on the effect of prenatal zinc supplementation on child neurodevelopment, we evaluated the association between folate nutritional status of mothers during pregnancy and neurodevelopment of their children. METHODS: Maternal blood folate and total homocysteine (tHcy) concentrations were measured at 19, 26, and 37 weeks of gestation. At a mean of 5.3 years of age, 355 black children with low-socioeconomic background were given 6 tests: Differential Ability Scales, Visual and Auditory Sequential Memory, Knox Cube Test, Gross Motor Scale, and Grooved Pegboard. The scores of the tests between the 2 groups of mothers with poor versus adequate folate nutritional status classified by blood folate or tHcy concentrations were compared. RESULTS: There were no differences in the test scores of neurodevelopment between the 2 groups. CONCLUSION: Folate nutritional status of mothers in the later half of pregnancy assessed by plasma and erythrocyte folate and plasma tHcy concentrations had no impact on neurodevelopment of their children at age 5. It is unknown whether our findings in a low-socioeconomic population can be readily extrapolated to other populations.

Adult↗

PubMed2004

Interactions between child behavior patterns and parenting: implications for children's unintentional injury risk.

OBJECTIVES: Two factors were considered as predictors of children's risk for unintentional injury: (a) children's temperamentally difficult behavior patterns and (b) parenting. Along with hypotheses to replicate previous univariate effects, it was hypothesized that active, involved parents with sufficient time resources might reduce injury risk among temperamentally at-risk children. METHODS: Study 1 used a retrospective design with a diverse sample of over 10,000 5-year-olds. Study 2 replicated Study 1 using a prospective design and behavioral data from a sample of over 1,000 children followed from 6 to 36 months of age. RESULTS: In Study 1, male gender, child hyperactivity, and family poverty predicted injury in a univariate manner. In Study 2, male gender and lack of positive parenting predicted injury in a univariate manner. Interaction effects also emerged: in Study 1 the interaction between child hyperactivity and parental time resources protected children from injury, and in Study 2 the interaction between child's difficult temperament and positive parenting protected children from injury. CONCLUSIONS: Children at increased risk for injury, i.e., those with hyperactive and difficult behavior patterns, might be protected in the environment of positive parenting. Theoretically, results suggest that researchers should consider Temperament x Environment interactions along with univariate predictors of outcome behavior. From an applied perspective, results have implications for the design of injury prevention campaigns: Parents who spend positive time with temperamentally difficult children might protect them from injury.

Analysis of Variance↗

PubMed2003

Maternal prepregnancy body mass index and psychomotor development in children.

BACKGROUND: In a prospective study, the association between maternal nutritional status and psychomotor development of low-income African-American children was evaluated. We hypothesized that low maternal body mass index (BMI) would predict worse neurodevelopmental status in children, while higher maternal BMIs would be associated with better neurodevelopmental outcomes. METHODS: Psychomotor tests for general intelligence and motor skills were given to 355 children at a mean age of 5.3 years. Maternal nutritional status was assessed by prepregnancy body mass index (BMI) and weight gain during pregnancy. RESULTS: Fifty-four percent of the women in this study were overweight or obese. The means of the general IQ, nonverbal and verbal ability, and Gross Motor Scales of the children were 82.1 +/- 12.6, 87.4 +/- 15.7, 80.1 +/- 10.8 and 332.3 +/- 13.2, respectively. Seventeen percent of the children had general IQ scores of less than 70. To our surprise, in multiple regression analyses, adjusting for other covariates, maternal prepregnancy BMI was a significant negative predictor of IQ (beta = - 0.25, P = 0.001) and nonverbal ability (beta = - 0.29, P = 0.02). The IQ and nonverbal scores of children of women who were obese before pregnancy were approximately 5 units lower than for children whose mothers had a normal prepregnancy BMI. The other significant predictors of IQ and nonverbal scores of the children were childcare status (beta = 3.5, P = 0.04 and beta = 0.26, P < 0.0001, respectively) and the mother's receptive language scores (beta = 5.2, P = 0.01 and beta = 0.25, P < 0.0001, respectively). CONCLUSION: This study of low-income African-American children indicates that obese women are at risk of having children with diminished intellectual ability, but not motor skills.

Black or African American↗

PubMed2003

Effect of zinc supplementation of pregnant women on the mental and psychomotor development of their children at 5 y of age.

BACKGROUND: A negative effect of prenatal zinc deficiency on brain function has been well established in experimental animals, but this association in humans is controversial. OBJECTIVE: We evaluated the effect of prenatal zinc supplementation on the mental and psychomotor development of 355 children whose mothers participated in a double-blind trial of zinc supplementation that resulted in increased head circumference and birth weight. DESIGN: The children took 6 tests-the Differential Ability Scales, Visual Sequential Memory, Auditory Sequential Memory, Knox Cube, Gross Motor Scale, and Grooved Pegboard tests-at a mean age of 5.3 y. The scores were compared between the children of women who received a daily oral dose of 25 mg Zn during the second half of pregnancy and the children of women who received placebo. RESULTS: There were no differences in the test scores of neurologic development between the 2 groups. We analyzed the scores in 4 subgroups on the basis of maternal body mass index, because the increases in birth weight and head circumference due to the supplementation occurred only in the children of women with a body mass index (in kg/m(2)) < 26.0 in the original trial. No differences in the scores were found between these subgroups. CONCLUSIONS: Zinc supplementation of women in the latter half of pregnancy had no effect on the neurologic development of their children at age 5 y. It is not known whether our findings of no positive effect in the population with apparently inadequate zinc nutriture can be readily extrapolated to other populations.

Adult↗

PubMed2003

Pediatric constraint-induced movement therapy for a young child with cerebral palsy: two episodes of care.

BACKGROUND AND PURPOSE: This case report describes the use of "Pediatric Constraint-Induced Therapy (Pediatric CI Therapy)" given on 2 separate occasions for a young child with quadriparetic cerebral palsy. CASE DESCRIPTION: The child was 15 months of age at the beginning of the first episode of care. She had previously received weekly physical therapy and occupational therapy for 11 months, but she had no functional use of her right upper extremity (UE), independently or in an assistive manner. She scored from 5 to 7 months below her chronological age on developmental assessments in gross motor, fine motor, and self-help skills. INTERVENTION: Pediatric CI Therapy involved placement of a full-arm, bivalved cast on the child's less affected UE while providing 3 weeks of intensive intervention (6 hours a day) for the child's more affected UE (intervention 1). Therapy included activities that were goal oriented but broken down into progressively more challenging step-by-step tasks. Pediatric CI Therapy was administered again 5 months later to promote UE skills and independence (intervention 2). OUTCOMES: The child developed new behaviors throughout both interventions. During intervention 1, the child developed independent reach, grasp, release, weight bearing (positioned prone on elbows) of both UEs, gestures, self-feeding, sitting, and increased interactive play using both UEs. During intervention 2, she had increased independence and improved quality of UE movement, as supported by blinded clinical evaluations and parent ratings.

Cerebral Palsy↗

PubMed2002

Cord serum ferritin concentrations and mental and psychomotor development of children at five years of age.

OBJECTIVE: Our purpose was to evaluate the association between fetal iron status and mental and psychomotor development at 5 years of age. STUDY DESIGN: We evaluated the association of fetal iron status (umbilical cord serum ferritin concentrations) with test scores of mental and psychomotor development of 278 children. Six tests were given, including full-scale intelligence quotient (FSIQ), language ability, fine- and gross-motor skills, attention, and tractability. RESULTS: Compared with children with cord ferritin in the 2 median quartiles, those in the lowest quartile scored lower on every test and had significantly worse language ability, fine-motor skills, and tractability. They were also 4.8-fold more likely to score poorly in fine-motor skills and 2.7-fold more likely to have poor tractability than children in the median quartiles. FSIQ in the highest quartile was slightly, but not significantly, lower than the median quartiles, but the odds ratio for having a FSIQ score of less than 70 for children in the highest quartile was 3.3 (95% CI 1.2-9.1). CONCLUSION: Poor iron status (low ferritin) in utero appears to be associated with diminished performance in certain mental and psychomotor tests. The reason for the association between high ferritin concentrations and low FSIQ scores is unknown.

Brain↗