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PubMedDate not supplied

Enhancing the coping skills of mothers with developmentally delayed children.

Recent studies have shown that mothers of developmentally delayed children are at risk for depression. During weekly psychoeducational group meetings, Roy's adaptation model was used to identify the focal, contextual, and residual stimuli that contributed to the mothers' depression. Nursing interventions that encouraged adaptation in the four modes were implemented by group facilitators providing parent education and emotional support. Implications for nurses in a variety of settings are given.

Adaptation, Psychological↗
PubMed2005

Longitudinal assessment of stereotypic, proto-injurious, and self-injurious behavior exhibited by young children with developmental delays.

Twelve children (CA, 12 to 32 months) with developmental delay were observed in their homes during monthly analogue functional analysis probes to document patterns of emerging self-injurious behavior. Two patterns of emerging self-injury were observed for 5 participants: (a) The topography and functional analysis pattern remained the same, but the behavior eventually caused tissue damage; or (b) a new topography emerged that was similar to an established stereotypic motor behavior. Functional analysis results were inconclusive for the majority of target behaviors across participants due to undifferentiated responding across conditions. One participant exhibited two topographies that appeared to become sensitive to positive reinforcement over time. Results are discussed in terms of implications for future research on early intervention and prevention of self-injury.

Child, Preschool↗
PubMed1996

Acquisition of services recommended by a multidisciplinary medical diagnostic team for children under three years of age evaluated for developmental delays.

After multidisciplinary medical diagnostic teams evaluate children with developmental delays, they recommend to parents that they seek specific services, but the team rarely knows which services are obtained. We sought to determine which services pursued by the parents were actually acquired and to determine if there were barriers to the acquisition of services. In a diagnostic clinic located in a teaching hospital in an urban setting, we evaluated 92 children less than 3 years of age mainly from an inner city population. At a family conference, the parents had indicated an interest in pursuing an average of 1.87 +/- 1.34 social services, 1.70 +/- 1.32 educational services, and 3.61 +/- 2.31 medical services recommended by the team. Four months after the family conference, the actual services obtained by families included 38.5% of the social services, 70.87% of the educational services, and 71.36% of the medical services. Significantly fewer social services were obtained than educational and medical services.

Chicago↗
PubMed2003

Antiepileptic Drugs in Children with Developmental Delays and Behavioral Problems.

Children with multiple handicaps, including developmental delays and behavioral problems, frequently have epilepsy that requires treatment. Different strategies should be used for acute treatment versus chronic treatment. Experience suggests that there is no true drug of choice that can be used for all children with epilepsy; however, seizure type, epilepsy syndrome, and likely efficacy and side effect spectrum of the antiepileptic drug (AED) will determine the best treatment for each child. In general, phenobarbital has posed multiple behavioral problems, and, thus, is less commonly used. Carbamazepine is the most frequently used drug for the treatment of partial seizures with or without secondary generalization, and valproate is the long established, broad spectrum AED for children with generalized convulsive and nonconvulsive seizures. Newer AEDs allow alternative treatments to those with adverse effects to the more frequently used medications and may have cognitive or behavioral advantages.

Journal Article↗
PubMed1995

Maternal directiveness and infant compliance at one year of age: a comparison between mothers and their developmentally-delayed infants and mothers and their nondelayed infants.

Maternal directiveness and infant compliance at one year of age were observed in social interactions between mothers and their handicapped and nonhandicapped infants. Eleven nondelayed, typically developing infants, and nine developmentally delayed infants, matched for chronological age, were observed in a free play situation with their mothers. Mothers of the delayed infants attempted to direct their children's play significantly more than those with nondelayed infants, and they engaged more frequently in social play involving physical contact with their infants. Nondelayed infants complied with their mothers' directives more than the developmentally delayed infants. Further study of infant capabilities and maternal affect and behaviors with this age group is suggested.

Cooperative Behavior↗
PubMed1999

No relationship between the size of the deletion and the level of developmental delay in cri-du-chat syndrome.

Molecular cytogenetic and developmental assessment was performed on 50 individuals with cri-du-chat syndrome. Fluorescent in situ hybridization analysis was used to confirm a terminal deletion karyotype and map more precisely the location of the deletion breakpoint. We identified terminal deletion breakpoints mapping from 5p15.2 to 5p13. Developmental assessment was performed using the Vineland Adaptive Behavior Scales test. Composite Vineland Scores ranged from 20-75. In general, the communication score was higher than the composite score. Comparison of the size of the deletion with the composite Vineland score, as well as the Vineland Communication score, demonstrated that there was no correlation between the size of the deletion and the level of developmental delay. These results demonstrate that patients with cri-du-chat syndrome show high variability in the level of developmental achievement.

Chromosome Deletion↗
PubMed2004

Disruption of contactin 4 (CNTN4) results in developmental delay and other features of 3p deletion syndrome.

3p deletion syndrome is a rare contiguous-gene disorder involving the loss of the telomeric portion of the short arm of chromosome 3 and characterized by developmental delay, growth retardation, and dysmorphic features. All reported cases have involved, at a minimum, the deletion of chromosome 3 telomeric to the band 3p25.3. Despite the presence of several genes in this region that are involved in neural development, a causative relationship between a particular transcript and the observed clinical manifestations has remained elusive. We have identified a child with characteristic physical features of 3p deletion syndrome and both verbal and nonverbal developmental delay who carries a de novo balanced translocation involving chromosomes 3 and 10. Fine mapping of this rearrangement demonstrates that the translocation breakpoint on chromosome 3 falls within the recently identified minimal candidate region for 3p deletion syndrome and disrupts the Contactin 4 (CNTN4) mRNA transcript at 3p26.2-3p26.3. This transcript (also known as BIG-2) is a member of the immunoglobulin super family of neuronal cell adhesion molecules involved in axon growth, guidance, and fasciculation in the central nervous system (CNS). Our results demonstrate the association of CNTN4 disruption with the 3p deletion syndrome phenotype and strongly suggest a causal relationship. These findings point to an important role for CNTN4 in normal and abnormal CNS development.

Cell Adhesion Molecules, Neuronal↗
PubMed1998

Parents' developmental expectations and child characteristics: longitudinal study of children with developmental delays and their families.

The relation between child characteristics and parents' developmental expectations for their children with developmental delays at ages 3, 7, and 11 was examined. Parents' developmental expectations were moderately stable over time, tending to decline as children matured. As hypothesized, parents' developmental expectations were associated with child characteristics at age 3 and became increasingly correlated with child characteristics over time. Results of regression analyses generally support the hypothesis that early child characteristics, but not early parent expectations, are the best predictors of parents' developmental expectations and child outcomes at child age 11. The one exception was the prediction of children's daily living competence by a combination of early parent expectations and children's Gesell DQ scores.

Child↗
PubMed2002

Diagnostic significance of Wada procedure in very young children and children with developmental delay.

Localization of vital components of neurological functioning has to be performed before epilepsy surgery can be considered in children with intractable epilepsy. This study reports the experience with the Wada procedure in very young children and/or developmentally delayed children with an a priori considerable chance of failing the procedure. The aim of this study was to indicate the applicability of this procedure in this patient group. The Wada procedure is described in 16 children under 10 years of age and/or have intelligence quotient scores below 50 and/or are critically ill and/or are behaviourally disturbed. Information on motor, language and memory functioning is obtained in respectively 13/15, 9/13, and 5/11 children. Nine children underwent epilepsy surgery without postoperative impairment of neurological functioning. In five children epilepsy surgery was not performed because of the results of the Wada procedure or the lack of information during the Wada procedure. One child became seizure-free before surgery. Even in very young, developmentally delayed or behaviourally disturbed children, the Wada test can provide important information with respect to the decision pro or contra epilepsy surgery.

Amobarbital↗
PubMed1992

Language intervention with children who have developmental delays: effects of an interactive approach.

The interactive model of language intervention instructs parents to use techniques that promote reciprocal social interactions and facilitate the development of communication and language abilities. In this evaluation study, 32 mothers and their preschool-age children with developmental delays were randomly assigned to treatment and control (delayed treatment) groups. Consistent with the interactive model, mothers in the treatment group became more responsive, less directive, and provided clearer linguistic models. Furthermore, these changes were maintained for at least 4 months after intervention, and involvement in the parent-centered intervention program did not increase maternal stress. More important, these changes were accompanied by concomitant increases in children's use of vocal turns. Contrary to predictions, developmental improvements in children's communicative and linguistic abilities were comparable in both groups. Findings suggest that an interactive model may afford a useful adjunct to other intervention approaches by instructing parents on how to promote children's use of existing abilities, but an interactive model may have no effect on language acquisition of at least some children with developmental delays.

Adult↗
PubMed1985

Correlates of peer-related social competence of developmentally delayed preschool children.

The peer-related social interactions of 33 developmentally delayed preschool children were examined. Measures of social participation and individual social behaviors were obtained during free-play periods and correlated with assessments of language development, MA, and teacher-rated social competence and behavior problems. Results suggested the existence of major deficits in peer-related social interactions for delayed children and the absence of specific individual social behaviors highly associated with peer-related social competence. Mental age was positively correlated with social play but unrelated to not playing at all. Although language comprehension was related to social interaction, expressive language did not correlate with any of the key measures. Teacher-rated behavior problems were associated with not playing, even when MA was controlled. Findings were discussed in terms of the congruence between the developmental processes of normally developing and delayed children as well as their clinical implications.

Child↗
PubMed1999

Developmental delay in fetal aminopterin/methotrexate syndrome.

Maternal exposures to aminopterin and methotrexate have been associated with a pattern of malformation which includes prenatal-onset growth deficiency, severe lack of ossification of the calvarium, hypoplastic supraorbital ridges, small, low-set ears, micrognathia, and limb abnormalities. We report on a patient whose mother received methotrexate during the first trimester of pregnancy and who, in addition to the structural anomalies typical of maternal methotrexate exposure, has significant developmental delay. This is the third patient exposed to folic acid antagonists with mental retardation, providing further evidence that developmental delay is one feature of fetal aminopterin-methotrexate syndrome. Therefore, it is recommended that formal developmental testing be performed in all patients prenatally exposed to methotrexate.

Abnormalities, Drug-Induced↗
PubMedDate not supplied

Stability, change, and correlates of the peer relationships of young children with mild developmental delays.

The peer relationships of young children with mild developmental (cognitive) delays recruited at 4-6 years of age were examined in a longitudinal study across a 2-year period. Results revealed only modest increases in children's peer interactions, a high degree of intraindividual stability, and the existence of a poorly organized and conflict-prone pattern of peer interactions. Child cognitive and language levels as well as family stress and support were associated with children's peer interactions. A subgroup was identified of initially low interactors who were at especially high risk for future peer interaction problems. These findings further underscore the importance of designing and implementing early intervention programs in the area of peer relationships for children with mild developmental delays.

Child, Preschool↗
PubMed1999

Developmental delay in P300 production in children at high risk for developing alcohol-related disorders.

BACKGROUND: Reduction of P300 amplitude in children and adolescents at high risk for developing alcoholism has frequently been reported. It has been hypothesized that this reduction represents a developmental delay in reaching age-appropriate levels in P300 amplitude. Using latent growth analysis of longitudinal data obtained at yearly intervals, this study seeks to define normal growth, and determine if the pattern seen in high-risk children differs from that obtained in normal low-risk controls. METHODS: A total of 156 children from either high or low-risk families have been assessed multiple times (two-thirds more than 4 times) using both a clinical assessment (K-SADS) and ERP evaluation performed on the same day. A total of 635 separate assessments were available for modeling. RESULTS: Quadratic growth curves revealed a slower rate of change in P300 amplitude in high-risk than low-risk males. High-risk girls showed reduced visual P300 amplitude only when the presence of a K-SADS diagnosis was considered. No differences were seen for P300 latency. CONCLUSIONS: This study confirms the hypothesis that when reduction of P300 amplitude is seen in males at high risk for developing alcoholism, it is due to a developmental delay.

Adolescent↗
PubMed1999

Predictors of developmental delay at 18 months and later school achievement problems.

The aim of the study was to examine the predictive value of the variables of parental assessment score, pre-, peri-, and postpartum optimality, sex, socioeconomic status (SES), and maternal education with respect to developmental delay at 18 months, and intellectual disability and school achievement problems at 8 and 14 years. The sample studied comprised 101 children (53 low scorers and 48 controls) originally from a total population of 2783 children assessed by their parents at 18 months using a screening instrument. Data were analysed by logistic regression. The results yielded moderate but statistically significant correlations between predictor and outcome variables. Optimality score and maternal education were the best predictors of developmental delay at 18 months. At 8 years, parental assessment score and maternal education constituted the best predictors of school achievement problems. At 14 years, SES together with parental assessment score were included in the model, when school achievement problems were predicted. Parental assessment score showed the strongest association with school achievement problems at both 8 and 14 years, when children with intellectual disability were included in the analysis. The exclusion of children with intellectual disability from the analyses yielded a stronger association between maternal education (at 8 years) and SES (at 14 years) and school achievement problems. The overall classification accuracy of the models varied between 67% and 88%. Specificity varied from 65% at 18 months to 95% at 14 years. Sensitivity varied from 70% at 18 months and 55% (all cases) and 42% (children with intellectual disability excluded) at 14 years.

Adolescent↗
PubMed1994

A case of profound iron deficiency anemia owing to corrosive esophagitis in a 20-year-old developmentally delayed male.

The level of severe compensated iron deficiency anemia incompatible with life is not defined in the pediatric or adolescent literature. A hemoglobin of 1.5 gm/dl in an older adolescent with few physical symptoms is distinctly unusual. A case of profound iron deficiency anemia in a 20-year-old developmentally delayed male is the subject of this brief report. There were only subtle physical findings in spite of this severe anemia. The anemia was the result of corrosive esophagitis associated with a hiatal hernia and reflux. Physicians dealing with developmentally delayed adolescents should be aware of the fact that a severe anemia may develop, and such individuals should be periodically screened for anemia, melena, hematochezia, and hematemesis.

Adult↗
PubMedDate not supplied

Evaluation of teaching methods in a home-based training scheme for developmentally delayed pre-school children.

Thirty-eight pre-school developmentally delayed children receiving the South Glamorgan Home Advisory Service were included in the study. The children were grouped according to developmental ability and manifesting problems. The effectiveness of three methods of teaching (activity charts, target setting, suggestion) were assessed under a balanced design. Weekly skill gain and increments on checklists were measured at the start and at the end of the study period. Parents' opinions on the different methods of teaching were requested and time samples of duration of home visiting were taken. On weekly skill gain, suggestion proved less effective than activity charts or target setting. Severely delayed children made least progress on weekly skill gains. Progress on checklists was independent of teaching method. However, group differences were observed in that severely delayed children (DQ range 22-61) and older (greater than 17 months) Down's syndrome children made least gains on the checklists. Activity charts were preferred by parents although they were also rated as being the most time consuming. Duration of home visits tended to be greater when activity charts were used. Implications of the findings are discussed with reference to ways of improving advice given to parents and alternative ways of evaluating pre-school educational programmes for particular groups of children.

Child, Preschool↗