Effect of verbalization on reversal shifts in children: additional data.
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Half-amplitude recovery of electodermal responses is compared in children of schizophrenic parents (high-risk subjects) and children of depressed or normal parents. The results are dissimilar to those reported by Mednick and colleagues on a Danish high-risk sample. No significant differences emerged among the three groups in our study. Recovery did not differ according to sex or severity of illness of the schizophrenic parent. Recoveries of high-risk subjects separated from their homes were not shorter than recoveries of subjects who remained home. Recovery time recorded in childhood was unrelated to global adjustment in adolescence.
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Normative measures of open quotient, speed quotient, maximum flow declination rate (MFDR), and subglottal pressure were determined for 75 children between the ages of 6 years 0 months and 10 years 11 months. The participants produced a sustained /a/ at low, comfort, and high pitches for a minimum of 5 seconds, and five to seven repetitions of /pa/ at low, comfort, and high pitches. No statistically significant differences were found in the mean measures of any aerodynamic variables (open quotient, speed quotient, maximum flow declination rate, subglottal pressure) between the frequency levels (low, comfort, high pitches). Also, no strong evidence (P > .05) exists that age or sex effect differed between the frequency levels (low, comfort, high) for any of the aerodynamic measures. For /a/ response tasks, mean open quotient measures increased slightly from low to comfort frequency and from comfort to high frequency. Mean speed quotient measures showed minimal differences between low and comfort frequency, with decreased mean measures for high frequency. Mean MFDR measures increased from low to comfort frequency and from comfort to high frequency. Mean subglottal pressure measures increased slightly from low to comfort frequency and from comfort to high frequency.
The way humans comprehend narrative speech plays an important part in human development and experience. A group of 313 children with ages 5-18 were subjected to a large-scale functional magnetic resonance imaging (fMRI) study in order to investigate the neural correlates of auditory narrative comprehension. The results were analyzed to investigate the age-related brain activity changes involved in the narrative language comprehension circuitry. We found age-related differences in brain activity which may either reflect changes in local neuroplasticity (of the regions involved) in the developing brain or a more global transformation of brain activity related to neuroplasticity. To investigate this issue, Structural Equation Modeling (SEM) was applied to the results obtained from a group independent component analysis (Schmithorst, V.J., Holland, S.K., et al., 2005. Cognitive modules utilized for narrative comprehension in children: a functional magnetic resonance imaging study. NeuroImage) and the age-related differences were examined in terms of changes in path coefficients between brain regions. The group Independent Component Analysis (ICA) had identified five bilateral task-related components comprising the primary auditory cortex, the mid-superior temporal gyrus, the most posterior aspect of the superior temporal gyrus, the hippocampus, the angular gyrus and the medial aspect of the parietal lobule (precuneus/posterior cingulate). Furthermore, a left-lateralized network (sixth component) was also identified comprising the inferior frontal gyrus (including Broca's area), the inferior parietal lobule, and the medial temporal gyrus. The components (brain regions) for the SEM were identified based on the ICA maps and the results are discussed in light of recent neuroimaging studies corroborating the functional segregation of Broca's and Wernicke's areas and the important role played by the right hemisphere in narrative comprehension. The classical Wernicke-Geschwind (WG) model for speech processing is expanded to a two-route model involving a direct route between Broca's and Wernicke's area and an indirect route involving the parietal lobe.
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PURPOSE: To estimate the prevalence of ocular morbidity among children of rural southern India before developing a service delivery model for community-based pediatric eye care. DESIGN: Population-based cross sectional study. METHODS: Trained field-workers performed door-to-door enumeration in 74 randomly selected villages of the Kariapatti block in southern India to identify children aged 15 years or younger and performed visual acuity measurements using Cambridge crowded cards and external eye examination with torchlight. Pediatric ophthalmologists further examined subjects with ocular problems identified by the field-worker. The clinical team performed repeat visual acuity measurements with Cambridge crowded cards, refraction, slit-lamp anterior segment examinations, and dilated posterior segment examinations at the screening site. The ophthalmologist identified and recorded one major cause for each visually impaired eye. RESULTS: Field-workers screened 10605 (94.6%) of 11206 children enumerated, and identified 1441 (13.6%) children as requiring further clinical examination. An additional 449 children identified as normal by the field-worker were randomly chosen for repeat examinations at the screening sites. In all, 1578 (83.5%) of these 1890 children were examined at the screening site. According to World Health Organization criteria, 6.2 of 10000 children were blind; 42.9% of this blindness was potentially avoidable. Refractive errors (0.55%, 95% confidence interval: 0.41, 0.69) and strabismus (0.43%, 95% confidence interval: 0.30, 0.55) were the major ocular morbidity in this population. CONCLUSIONS: Developing an appropriate service delivery model for this region will require a balance between the relatively low prevalence of morbidity and blindness and the need for service in this population.
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The comparative effect of semi-dimensional (SD) and non-dimensional (ND) normalisation on the results of a longitudinal study of gait in 5-12-year old children was investigated. The use of both height and leg length in the normalisation was examined. Only ND analysis could be used to identify subjects with the same accelerations. ND analysis of the children's gait indicated that there was little change in the combination of step length and cadence used to achieve a particular velocity between 5 and 12. The first peak and mid-stance trough values of the vertical component of ground reaction force did not change with age. We recommend the use of ND normalisation rather that SD to allow comparisons between individuals of differing size and mass.
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In pediatric cancer patients, malnutrition is commonly observed. This may represent the metabolic effect of the primary disease or it may be a consequence of multimodal therapy. This report evaluates the efficacy of using basic anthropometric measurements to predict morbidity during therapy. Twenty children with Wilms' tumor (Stage III, IV, and V) or neuroblastoma (Stage IV) diagnosed at Children's Hospital (Columbus, OH) between January 1983 and December 1985 were evaluated. When compared with the Wilms' tumor patients, the children with neuroblastoma had a significantly lower weight for age at diagnosis. At the completion of therapy, both weight-for-height and weight-for-age measurements were statistically lower in the neuroblastoma group (p less than 0.05). Significant differences were observed between the neuroblastoma and Wilms' tumor patients in the morbidity reported during therapy. Children with neuroblastoma had more frequent hospital admissions, spent a much greater proportion of their treatment time as hospital inpatients, experienced longer delays in therapy, and sustained many more complications. Each of the anthropometric indices was evaluated as a predictor of the complications observed during treatment. In the Wilms' tumor group, the patients with lower weight-for-height percentiles had an increased incidence of incomplete drug infusions, many more complications, more frequent hospital admissions, and an increase in the percentage of time spent as hospital inpatients. In the neuroblastoma group, the anthropometric measurements had no correlation with the subsequent development of complications. Nutritional staging based on anthropometric measurements recorded at diagnosis may be useful in predicting an increased risk of morbidity during therapy in children with Wilms' tumor.
The Listening in Spatialized Noise test (LISN) produces a three-dimensional auditory environment under headphones, using only a PC and an audiometer, and was designed to provide an ecologically valid assessment of auditory figure-ground skills in children. The listener is required to indicate the intelligibility level of a story presented at 0 degree azimuth, in the presence of distracter sentences simultaneously presented at either 0 degree or +/- 90 degrees azimuth. Various measures assess the extent to which either spatial, vocal, or spatial and vocal cues combined, increase a listener's ability to comprehend the story, without being affected by differences between participants in variables such as linguistic skills. There was a trend of improved performance with increasing age for 48 normally hearing seven-, eight-, and nine-year-olds, and sixteen adults. Whereas some significant differences were found between adults and children, there were no significant differences in performance between the seven-, eight-, and nine-year-olds on any measure, and no significant gender or practice effects were observed. Future studies on children with suspected auditory processing disorder were considered warranted.
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Neisseria meningitidis is the main cause of bacterial meningitis in Spain. Of the 213 children included in this study with meningococcal meningitis, 7 died. Mortality was linked to a shorter time from the first symptom to diagnosis (mean time for fatal cases was 9.5 h, mean time for survivors was 19 h, p = 0.034), to deteriorated consciousness (DC) (mortality rate (MR) with DC = 6/87, MR without DC = 1/124, p = 0.02) and to shock (MR with shock = 5/7, MR without shock = 2/206, p < 0.0001). Previous treatment reduced the yield from blood culture (36/54 versus 45/137, p < 0.0001). Positivity in both Gram stain (GS) and cerebrospinal fluid (CSF) culture increased with longer duration of symptoms (mean GS+ = 25 h, GS- = 16 h, p = 0.004; CSF+ = 20 h, CSF- = 12 h, p = 0.001), and blood culture (BC) gave more positive results when carried out earlier (mean BC- = 14 h, BC- = 24 h, p < 0.001). Reduced susceptibility to penicillin was seen in 34% of the strains, and rapidly evolving forms were responsible for most of the deaths; reduced susceptibility was more frequent among strains responsible for death or sequelae (9/15 = 60%) as compared with the more harmless strains (69/ 215 = 32%) (p = 0.04). The progressive reduction of susceptibility to penicillin indicates that it should be replaced by a third-generation cephalosporine.
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AIMS: To assess the presence of a first night effect (FNE) in children and adolescents and to examine if a single night polysomnography (PSG) is sufficient for diagnosing obstructive sleep apnoea syndrome (OSAS). METHODS: Prospective case study of 70 patients (group 1: 2-6 years, n = 22; group 2: 7-12 years, n = 32; group 3: 13-17 years, n = 16) referred for OSAS. Diagnostic criteria for OSAS: one or more of the following: (1) obstructive apnoea index (OAI) > or =1; (2) obstructive apnoea hypopnoea index (oAHI) > or =2; (3) SaO2 < or =89% in association with obstruction. RESULTS: In all age groups, but mainly in the oldest children, REMS increased during the second night, mainly at the expense of stage 2 sleep. The first night PSG correctly identified OSAS in 86%, 91%, and 100% of the children for groups 1, 2, and 3 respectively. This represents 9% false negatives for OSAS when only the first night PSG was used. All cases missed had mild OSAS, except for one with oAHI >5 on night 2. There were also seven patients with OSAS on night 1 but with a normal PSG on night 2: all had oAHI <5. CONCLUSION: There is a FNE in children and adolescents. A single night PSG is sufficient for diagnosing OSAS, but in cases with a suggestive history and examination and with a negative first night, a second night study might be advisable.