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PubMed2006

The transition to school: adaptation in young children with and without intellectual disability.

BACKGROUND: Previous research has highlighted the importance of the transition to school for young children and their families. A child's successful adaptation to school is likely influenced by a number of factors, including academic, social, emotional, behavioural and cognitive competencies. Children with intellectual disability (ID) may be at heightened risk for early school difficulties, in part due to their deficits in cognitive and adaptive behaviours. METHODS: Factors associated with the adaptive transition to school in young children with (n = 24) and without (n = 43) ID were examined. Adaptive transitions were defined as having few teacher-reported problem behaviours and positive student-teacher relationships. Child self-regulatory skills and both parent- and teacher-reported social skills were evaluated to determine if they predicted positive adaptation in school for 5- to 6-year-old children. Data were gathered from child assessments, parent reports on standardized measures, direct observations of delay of gratification tasks and teacher reports on standardized measures. RESULTS: Children with ID had significantly more teacher-reported problem behaviour, poorer overall student-teacher relationships, fewer parent- and teacher-reported social skills and fewer self-regulation skills than typically developing children. Self-regulation at child age 36 months (latency to touch a desired toy) was significantly related to adaptation to school, as were parent and teacher reports of social skills. Social skills significantly predicted adaptation to school, even after accounting for the effects of child IQ and adaptive behaviour. CONCLUSIONS: Children with ID had less positive early school experiences, as indicated by multiple indices of adaptation to school. Fostering early social skills may be an important target for increasing the positive adaptation to school for young children, especially those with ID.

Adaptation, Psychological↗

PubMed1988

Financing health care for disabled children.

Information about health care use, charges, and out-of-pocket expenses is critical to the development of an equitable and efficient treatment system for disabled children. Data from the 1980 National Medical Care Utilization and Expenditure Survey were used, and differences in use, charges, and out-of-pocket expenses for children with and without limitations in their activities due to chronic health problems are described. The results indicate that children limited in their activities used more medical services than other children, especially hospital-based services and services provided by health professionals other than physicians. Charges and out-of-pocket expenses were two to three times higher on average for disabled children, compared with other children. Charges and out-of-pocket expenses were also skewed; 10% of the sample children accounted for more than 60% of total charges and out-of-pocket expenses for the disabled population. The skewed distribution of out-of-pocket expenses suggests that financial burdens are unevenly shared by families of disabled children. Several public policy options designed to result in a more equitable distribution of financial risks are discussed.

Adolescent↗

PubMed1995

[Respiratory function in myasthenic children].

Results of lung function testing in myasthenic children to be thymectomized were compared with the results in healthy children. Data of adult myasthenic patients were also included for comparison. Lung function was within normal range. It seems reasonable to widen functional diagnostics in myasthenic children by occlusion pressure and minute voluntary ventilation measurements.

Adolescent↗

PubMed2001

Preventive therapy in pediatric migraine.

Preventive therapy for migraine headache includes identification of migraine precipitants, possible adjustments in lifestyle, appropriate management of acute headache, and, when necessary, the use of pharmacologic agents. There are no well-controlled clinical trials with sufficient patient numbers to support the use of any agent in the prevention of migraine headache in children. Data on the use of amitriptyline and divalproex sodium in open-label studies suggest that these agents may be efficacious. The mechanism of action for these agents is unknown but may be related to the 5-hydroxytyptamine-2 (5-HT2) receptor antagonism or regulation of ion channels. A review of the pertinent literature on migraine prophylaxis in children is presented. Dosing guidelines are presented based on the limited data available and clinical experience.

Adrenergic beta-Antagonists↗

PubMed2004

Pharmacologic treatment of bronchiolitis in infants and children: a systematic review.

BACKGROUND: Bronchiolitis is the most common lower respiratory tract infection in infants. Up to 3% of all children in their first year of life are hospitalized with bronchiolitis. Bronchodilators and corticosteroids are commonly used treatments, but little consensus exists about optimal management strategies. OBJECTIVE: To conduct a systematic review of the effectiveness of commonly used treatments for bronchiolitis in infants and children. DATA SOURCES: We searched MEDLINE and the Cochrane Controlled Trials Register for references to randomized controlled trials of bronchiolitis treatment published since 1980. STUDY SELECTION: Randomized controlled trials of interventions for bronchiolitis in infants and children were included if they were published in English between 1980 and November 2002 and had a minimum sample size of 10. DATA EXTRACTION: We abstracted data on characteristics of the study population, interventions used, and results of studies meeting entry criteria into evidence tables and analyzed them by drug category. DATA SYNTHESIS: Interventions were grouped by drug category and qualitatively synthesized. RESULTS: Of 797 abstracts identified in the literature search, we included 54 randomized controlled trials. This review includes 44 studies of the most common interventions: epinephrine (n = 8), beta2-agonist bronchodilators (n = 13), corticosteroids (n = 13), and ribavirin (n = 10). Studies were, in general, underpowered to detect statistically significant outcome differences between study groups. Few studies collected data on outcomes that are of great importance to parents and clinicians, such as the need for and duration of hospitalization. CONCLUSIONS: Overall, little evidence supports a routine role for any of these drugs in treating patients with bronchiolitis. A sufficiently large, well-designed pragmatic trial of the commonly used interventions for bronchiolitis is needed to determine the most effective treatment strategies for managing this condition.

Adrenal Cortex Hormones↗

PubMed1997

Preschool vision screening.

OBJECTIVES: To undertake a systematic review of the effectiveness of preschool vision screening. To provide evidence on which decisions about the future provision of this service can be made. To indicate areas for further research. STUDY SELECTION: The Centre for Reviews and Dissemination guidelines for systematic reviews were used. The research questions were formulated using the Wilson and Jungner criteria for evaluating screening programmes. They concerned prevalence, natural history, disability, treatment and screening in relation to three target conditions: amblyopia, refractive errors and squints which are not cosmetically obvious. Studies were considered for inclusion according to pre-determined criteria for the age group studied, the outcomes measured and the study design. The following types of study design were considered: cross-sectional studies of prevalence, cohort studies of natural history, any type of study (e.g., cross-sectional surveys, case-series, qualitative studies) of disability attributable to a target condition, controlled trials, observational studies and audits of screening programmes, and prospective controlled trials of treatment. DATA SOURCES: The following electronic databases were searched: Biological Abstracts, CINAHL, Embase, ERIC, IAC Health Periodicals, IAPV, Medline, Psychlit, Science Citation Index, System for Information on Grey Literature in Europe, DHSS-Data, Faculty of Public Health Medicine Database of Dissertations, Index of Scientific and Technical Proceedings, Dissertation Abstracts, Index of Theses, NHS Research Register, Public Health Information Sharing Database. A limited amount of handsearching was undertaken. Reference lists were scanned to identify other relevant studies, and requests for unpublished data were made to people working in the field. DATA EXTRACTION: Data was extracted by the first author and then checked by the second. DATA SYNTHESIS: Quantitative analysis was undertaken where possible. Qualitative analysis was performed where studies were too heterogeneous for the data to be combined, or for research questions that were not suitable for quantitative synthesis. RESEARCH FINDINGS: The electronic search yielded over 5000 references, and over 500 abstracts were downloaded from the databases for further scrutiny. A total of 85 studies were included in the main analysis. PREVALENCE: No studies were found with the primary aim of establishing the prevalence of visual defects in preschool children. Data from studies of screening programmes report a range of yields for all the target conditions combined of 2.4-6.1%. NATURAL HISTORY: No studies designed with the intention of documenting the natural history of the target conditions in children aged 3 or 4 years were found. Other studies that provide some natural history data suggest that mild degrees of amblyopia may resolve spontaneously. In the absence of information about natural history it is impossible to estimate the effect of treatment from studies without a control group that was not treated. DISABILITY: A total of 21 studies exploring disability in relation to the target conditions were included. The literature provides a reasonable basis for generating plausible hypotheses about the ways in which the target conditions might disable people, but is insufficient to draw any firm conclusions about their impact on quality of life. The research to date is not sufficient to determine appropriate outcomes for controlled trials of treatment. TREATMENT: Five randomised controlled trials of treatment and six prospective controlleld trials without randomisation were found. No studies compared treatment with no treatment. Most of the studies were methodologically flawed.(ABSTRACT TRUNCATED)

Child, Preschool↗

PubMed2003

Pediatric allergy: a brief review of risk factors associated with developing allergic disease in childhood.

OBJECTIVE: To briefly review some of the factors that have been implicated in the causation of the increased prevalence of allergic disease in children. DATA SOURCES: MEDLINE search of original research and review articles related to the various risk factors considered responsible for the increased prevalence of allergic disease in children. STUDY SELECTION: Author selected references. CONCLUSIONS: It has been established that there is an increased prevalence of allergic disease, especially in children. Risk factors that are currently under investigation include: genetic atopic predisposition, early childhood allergen exposure and sensitization, occurrence of viral respiratory infections in young children, maternal smoking during pregnancy, poor dietary factors, lack of breast-feeding, childhood obesity, having a certain immunologic predisposition (Th2-prone), air pollution, and frequent immunizations in childhood. It is most likely that the occurrence of allergic disease will be found to be multifactorial.

Child↗

PubMed1983

Nasopharyngeal flora and acute otitis media.

A semiquantitative nasopharyngeal culture was found to be sensitive and specific in predicting middle ear pathogens in children with acute bacterial otitis media. In nasopharyngeal specimens with growth of at least 1,000 colonies, the tympanocentesis isolate was present and was either the predominant isolate or accounted for 50% of growth in 16 of 16 children. Data suggest that virulence of nasopharyngeal organisms plays a role in the pathogenesis of acute otitis media. Qualitative differences were found in the nasopharyngeal flora of children with bacterial otitis media as compared with children with clinical otitis media and sterile tympanocentesis cultures, children with uncomplicated upper respiratory illness, and healthy children. Abundant growth of Haemophilus influenzae (greater than or equal to 50% total colony count) was associated with children with bacterial otitis media, and abundant Branhamella catarrhalis was associated with the others (P less than or equal to 0.01). Abundant growth of Streptococcus pneumoniae occurred frequently and regardless of clinical category. Antibiotic treatment of children with otitis media resulted in rapid quantitative and qualitative changes in nasopharyngeal flora.

Acute Disease↗

PubMed1997

Coping strategies and laboratory pain in children with sickle cell disease.

Studies have found that coping strategies are significant predictors of pain report, health care use, and psychosocial adjustment in children with sickle cell disease (SCD); however, the mechanisms of the relationship are not clear. In this study, 41 children with SCD completed a laboratory pain task to analyze their pain perception under standardized conditions. Sensory decision theory analyses were used to analyze the pain perception data. Children and their parents also completed measures of coping strategies and adjustment. Hierarchical regression analyses controlling for the child's age indicated that children who reported using active cognitive and behavioral coping strategies had a lower tendency to report pain during the laboratory pain task. Results are discussed in terms of the utility of using laboratory pain models with children and the need for future intervention studies to target coping strategies in children with SCD pain.

Adaptation, Psychological↗

PubMed2005

Antiepileptic drug monotherapy: pediatric concerns.

Selecting the optimal antiepileptic drug (AED) begins with accurate epilepsy classification, including seizure type and epilepsy syndrome if possible. Based on the available data, children with focal epilepsy, with or without secondary generalization, can be treated with a traditional or newer narrow-spectrum or broad-spectrum AED. Children with generalized convulsive epilepsy, mixed epilepsy, or seizures of an unknown type are best treated with a broad-spectrum AED. Children with childhood absence epilepsy can be treated with ethosuximide, valproate, or lamotrigine. In all cases, the best choice among the various AED options requires consideration of factors such as seizure frequency, seizure severity, AED adverse event profile, AED titration schedule, patient comorbidities, prescription plan coverage, and cost. Most children with epilepsy achieve the goal of "no seizures and no side effects" and most children eventually become seizure free without AEDs. If accurate epilepsy classification is made, clear differences in efficacy are not evident among the multiple available AEDs. Better comparative data emphasizing adverse event profiles, comorbidities and longer-term outcome are needed between the traditional and newer AEDs.

Adolescent↗

PubMed1978

Body rocking, head banging, and head rolling in normal children.

Body rocking, head banging, and head rolling--three rhythmic behaviors that involve stimulation of the vestibular system--were studies in 525 normal children. Data analyses focused on two issues: (1) the prevalence and duration of these habits and their relationship to child and family factors and (2) the hypothesis that children who persistently displayed such behaviors would be reported as developmentally more advanced than "non-self-stimulators." Body rocking was the earliest to appear and most prevalent of the three habits. Head banging and head rolling had roughly the same prevalence and age of onset. Comparisons of "self-stimulators" with "non-self-stimulators" yielded no significant effects for birth order or SES; only for head banging was a significant (3:1) ratio of males to females found. A comparison of the ages at which 12 "milestones" first appeared supported the hypothesis of developmental precocity for the body rockers and the head bangers, but not for the head rollers.

Birth Order↗

PubMed2006

Brain activity related to working memory and distraction in children and adults.

In order to retain information in working memory (WM) during a delay, distracting stimuli must be ignored. This important ability improves during childhood, but the neural basis for this development is not known. We measured brain activity with functional magnetic resonance imaging in adults and 13-year-old children. Data were analyzed with an event-related design to isolate activity during cue, delay, distraction, and response selection. Adults were more accurate and less distractible than children. Activity in the middle frontal gyrus and intraparietal cortex was stronger in adults than in children during the delay, when information was maintained in WM. Distraction during the delay evoked activation in parietal and occipital cortices in both adults and children. However, distraction activated frontal cortex only in children. The larger frontal activation in response to distracters presented during the delay may explain why children are more susceptible to interfering stimuli.

Adolescent↗

PubMedDate not supplied

Curing children with leukemia in West Virginia.

Leukemia is the most common cancer in childhood with acute lymphoblastic leukemia (ALL) the most common subtype. While once uniformly fatal, today leukemia is a highly curable disease. To determine the outcomes of children with acute lymphoblastic leukemia in West Virginia, we performed a retrospective analysis of the results of treatment of children and adolescents with B-lineage ALL diagnosed between 2/86 and 1/91 and treated by the pediatric oncology teams at Morgantown or Charleston. Forty-one children with B-lineage ALL were identified and treated by a uniform protocol. Twenty-nine (71%) have remained disease-free for more than two years off therapy and are considered cured. Of the 10 patients who relapsed, five have now been off rescue therapy for greater than two years and are likely to be cured. Thirty-five of the original cohort of 41 children are alive and disease-free yielding an overall survival of 85%. The results of treatment of childhood leukemia in West Virginia are comparable to national data. Children with ALL diagnosed and treated by pediatric oncology teams in West Virginia have a very good chance of being cured.

Adolescent↗

PubMed1981

Incidence, age at onset and seasonal variation of diabetes mellitus in Norwegian children, 1973-1977.

A retrospective study was undertaken to estimate the incidence of diabetes mellitus in Norwegian children. Data were collected from all hospitals in the country and from a central insurance register. Eight hundred and forty-five new cases in the age group 0-14 years and with onset in the five-year study period 1973-1977 were detected. The calculated mean annual incidence was 17.6 per 100 000 children, with a year-to-year variation of 15.4-19.3 per 100 000. The geographic variation in incidence was considerable with the lowest rate in the North (6.8/100 000/year) and the highest rates in the South-Eastern part of the country (approx. 20/100 000/year). There was a significantly higher incidence for boys (18.8/100 000/year) than for girls (16.4/100 000/year). The age variation in the incidence rates showed rising values towards a peak at 12 years for girls and a plateau at 12-14 years for boys, with an abrupt decline after 12 and 14 years, respectively. There were more cases with onset in the winter and autumn, with significant peaks in February and October. From these data the prevalence of diabetes mellitus in the age group 0-14 years can be calculated to 1.2 per 1 000 children. In the whole of Norway, about 170 new cases of diabetes mellitus below the age of 15 years can be expected every year. Compared with previous studies, the present data suggest an increasing incidence of childhood diabetes in Norway.

Adolescent↗

PubMed2006

Media-based behavioural treatments for behavioural problems in children.

BACKGROUND: Many approaches are used to address behavioural problems in childhood including medication or, more usually, psychological treatments either directly with the child and/or his/her family. Behavioural and cognitive-behavioural interventions have been shown to be highly effective but access to these treatments is limited due to factors such as time and expense. Presenting the information parents need in order to manage these behaviour problems in booklet or other media-based format would most likely reduce the cost and increase access to these interventions. OBJECTIVES: To review the effects of media-based cognitive-behavioural therapies for any young person with a behavioural disorder (diagnosed using a recognised instrument) compared to standard care and no-treatment controls. SEARCH STRATEGY: The following electronic databases were systematically searched: CENTRAL (The Cochrane Library Issue 3, 2005), MEDLINE (1966 to August 2005), EMBASE (1980 to August 2005), PsycINFO (1887 to August 2005), CINAHL (1982 to August 2005), Biosis (1985 to August 2005) and Sociofile (1974 to August 2005). References in all selected trials were checked for other trials and experts in the field were contacted for additional information. SELECTION CRITERIA: Randomised and quasi-randomised controlled trials (e.g. trials which used sequential randomisation) of media-based behavioural treatments for behaviour problems in children. DATA COLLECTION AND ANALYSIS: Abstracts and titles of studies identified from searches of electronic databases were read to determine whether they met the inclusion criteria. Full copies of those possibly meeting these criteria from electronic or other searches were assessed by the reviewers and queries were resolved by discussion. Data were analysed using RevMan 4.2. MAIN RESULTS: Eleven studies including 943 participants were included within this review. In general, media-based therapies for behavioural disorders in children had a moderate, if variable, effect when compared with both no-treatment controls with effects sizes ranging from -0.12 (-1.65, 1.41) to -32.60 (-49.93, -15.27) and as and adjunct to medication with effect sizes ranging from -2.71 (-5.86, -0.44) to -39.55 (-75.01, -4.09). Significant improvements were made with the addition of up to two hours of therapist time. AUTHORS' CONCLUSIONS: These formats of delivering behavioural interventions for carers of children are worth considering in clinical practice. Media-based interventions may, in some cases, be enough to make clinically significant changes in a child's behaviour, and may reduce the amount of time primary care workers have to devote to each case. They can also be used as the first stage of a stepped care approach. Consequently this would increase the number of families who could possibly benefit from these types of intervention, releasing clinician time that can be reallocated to more complex cases. Media-based therapies would therefore appear to have both clinical and economic implications as regards the treatment of children with behavioural problems.

Adolescent↗

PubMed1992

A high linear growth is associated with an increased risk of childhood diabetes mellitus.

Insulin release and growth are intimately connected. The aim of the present study was to investigate height and weight in diabetic children from birth to onset of Type 1 (insulin-dependent) diabetes mellitus compared to that in referent children. Data on height and weight were collected from mailed questionnaires and from growth records obtained from the child health clinics and schools in 337 recent-onset diabetic children, 0-14 years old, and from 517 age-, sex-, and geographically matched referent children. A total of 9002 paired height and weight observations were collected. The anthropometric development of the children was expressed as standard deviation scores using the National Center for Health Statistics/Centers for Disease Control (NCHS/CDC) growth reference material. On the average, the diabetic children were consistently taller than the referent children, a finding more pronounced among the boys. The diabetic boys were significantly taller from 7 to 1 years before the clinical onset of the disease, regardless of age at onset. A similar tendency was found for the girls. When mean height from 5 to 1 years before onset was used as a possible risk factor for diabetes, a linearly increasing trend in the odds ratio was found for diabetes in boys (odds ratio = 1.0; 1.57; 2.46 for height standard deviation score values less than 0; 0-1 and greater than 1, respectively; p = 0.002 for trend). A similar, but statistically not significant, tendency was found for girls (odds ratio = 1.0; 1.44; 1.43). As regards height increment from birth similar trends in odds ratios were found.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed2007

Relationship between quality of life and child traffic fatalities.

Traffic injuries are the leading cause of morbidity and mortality of children around the world. Economic development and quality of life are main components of public health. Using canonical correlation analysis, this study examined the relationship between quality of life and traffic fatality among children. Data were collected from 19 countries by using World Health Organization and OECD statistics. The results indicated that there is a strong relationship between quality of life and children traffic fatality. Growing quality of life has become protective against child traffic accident mortality. Increasing in gross national income per capita, life expectancy at birth number of years, road motor vehicles per thousand population, and share of persons of working age (15-64 years) in employment also increases children traffic safety.

Accidents, Traffic↗

PubMed1991

Foods and drinks at four daily time intervals in a group of young children.

This study provides information about snacks and drinks regularly consumed by a group of 2139 4-year-old children. Data were collected through a simple questionnaire completed at interview. Findings were related to caries levels measured at clinical examination 6 months later. Results confirmed that nearly all children had one or more snacks or drinks on most days. The most popular time for these was mid-afternoon. Sweet biscuits and fruit were the most popular snack foods and diluted fruit squash and milk the most popular drinks. Caries, as expressed in mean dmft, increased significantly with increasing number of intakes.

Child, Preschool↗