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PubMed1982

A prevention and early intervention mental health program for disadvantaged pre-school children.

In this study, 155 disadvantaged pre-school children, ages 3 to 6, were screened for developmental delays using the Cooperative Pre-school Inventory as the primary evaluation tool. Thirty-eight children participated in the experimental group and 20 children were designated the control group. Experimental group children received developmental therapy and their regular classroom experience. In addition, intervention was provided to parents and teachers in order to affect the child's total environment more positively. The control group received only classroom experience. Sixty-five percent of the control group passed the Cooperative Preschool Inventory per-test compared to 50 percent of the experimental group. On the Cooperative Preschool Inventory post-test, 100 percent of the experimental group passed, compared to only 85 percent of the control group. These results suggest that for disadvantaged children early intervention of developmental therapy and classroom experience help eliminate their developmental delays and provide them with age-appropriate developmental skills.

Child↗

PubMed1996

Neurodevelopment, growth, and viral load in HIV-infected infants.

The relation of HIV-1 infection to infant growth and neurodevelopment was studied prospectively in a cohort of 65 infants born to women at risk for HIV infection. No differences were observed at birth between infected infants (INF) and uninfected infants (SR) of HIV-infected women, and infants of uninfected women (SN) with similar socioeconomic background and exposure to drugs. However, postnatal linear growth and cognitive-motor development of INF infants were impaired when compared to SR and SN infants. Declines in linear growth were observed within the first 6 months of life, whereas delays in neurodevelopment were first appreciated at 12 months. In INF infants, decreased linear growth was positively correlated with developmental delay. Moreover, growth and development were both correlated with HIV viral load. INF infants with high plasma HIV RNA copies (> 5 x 10(5)/ ml) at 6 months of life were more likely to exhibit severe growth and developmental delay than infants with a lower viral burden. The implications of these findings with respect to the mechanism of action of HIV-related growth and neurodevelopmental impairments are discussed.

Body Height↗

PubMed1980

The use of the Denver Developmental Screening Test in infant welfare clinics.

The results of a single Denver Developmental Screening Test performed at the age of nine months on 823 infants attending maternal and child health centres were compared with the developmental information recorded by public health nurses during their routine well-baby care of these same infants. The single Denver test detected a significantly greater number of infants with developmental delay than did the routine observations, and the nurses tended to under-use the available resources for developmental assessment. Suggestions are made for more effective use of maternal and child health centres in the primary recognition of developmental delay.

Child Development↗

PubMed1999

The relationship between magnetic resonance imaging findings and clinical manifestations of hypothalamic hamartoma.

OBJECT: Hypothalamic hamartoma is generally diagnosed based on its magnetic resonance (MR) imaging characteristics and the patient's clinical symptoms, but the relationship between the neuroradiological findings and clinical presentation has never been fully investigated. In this retrospective study the authors sought to determine this relationship. METHODS: The authors classified 11 cases of hypothalamic hamartoma into two categories based on the MR findings. Seven cases were the "parahypothalamic type," in which the hamartoma is only attached to the floor of the third ventricle or suspended from the floor by a peduncle. Four cases were the "intrahypothalamic type," in which the hamartoma involved or was enveloped by the hypothalamus and the tumor distorted the third ventricle. Six patients with the parahypothalamic type exhibited precocious puberty, which was controlled by a luteinizing hormone-releasing hormone analog, and one patient was asymptomatic. No seizures or mental retardation were observed in this group. All patients with the intrahypothalamic type had medically intractable seizures, and precocious puberty was seen in one. Severe mental retardation and behavioral disorders including aggressiveness were seen in two patients. The seizures were controlled in only one patient, in whom stereotactically targeted irradiation of the lesion was performed. This topology/symptom relationship was reconfirmed in a review of 61 reported cases of hamartoma, in which the MR findings were clearly described. The parahypothalamic type is generally associated with precocious puberty but is unaccompanied by seizures or developmental delay, whereas the intrahypothalamic type is generally associated with seizures. Two thirds of patients with the latter experience developmental delays, and half also exhibit precocious puberty. CONCLUSIONS: Classification of hypothalamic hamartomas into these two categories based on MR findings resulted in a clear correlation between symptoms and the subsequent clinical course.

Adolescent↗

PubMed1991

The psychomotor development during the first year of life of infants exposed to intrauterine alcohol of various duration. Fetal alcohol exposure and development.

The developmental abilities of 80 children exposed to alcohol of various duration in utero were assessed 1 to 3 times during their first year of life. The occurrence of developmental delay increased towards the end of the first year. The longer the exposure the more common and severe was the developmental delay. If alcohol consumption could be reduced by the second trimester only a slight abnormality of motor development was seen at the age of 12 months. If heavy maternal drinking continued throughout the second trimester cognitive development was also delayed. Psychomotor retardation by the age of one year occurred in 38% of children who had been exposed to continuous heavy alcohol consumption during pregnancy. The psychomotor retardation diagnosed at the age of one year could be found earlier in 80% of the children but pure motor or pure cognitive delay only in some cases. The beneficial effect of reducing maternal alcohol consumption before the last trimester of the child's development was clear.

Alcohol Drinking↗

PubMedDate not supplied

[Characteristics of growth and development in children from families at social risk].

INTRODUCTION: Body height and weight are important indicators of children's health status. There are many evidences that children from disadvantaged families have lower height and weight than children of the same age from families without social risk. The aim of this study was to investigate characteristics of growth and development of children from economically disadvantaged families. MATERIAL AND METHODS: The study was partly retrospective and partly prospective. The retrospective study included 509 children from disadvantaged families hospitalized at the Institute of Child and Adolescent Health Care in Novi Sad, during a five-year period. The prospective study included 90 children from disadvantaged families (experimental group) and 132 children from families without social risk (control group) hospitalized at the Institute during a six month period. Height/length, weight, head circumference, and psychomotor/intellectual development have been examined. In the retrospective study results were compared with theoretically expected values, whereas the prospective study results of experimental and control group were compared. RESULTS: In the retrospective study that included only children from disadvantaged families, 136 (26.7%) children had height/length, 173 (34%) had weight, and 86 (16.9%) children had head circumference below 10th percentile. Delay in psychomotor/intellectual development was established in 177 (34.8%) children. Children from families with social risk have significantly more often height/length, weight, head circumference and developmental delay than theoretically expected. In the prospective study 40 (44.4%) children from experimental group had height/length, 29 (32.2%) had weight, 20 (22.2%) children had head circumference below 10th percentile, and 17 (26.2%) had delay in psychomotor/intellectual development. Children from disadvantaged families (experimental group) significantly more often had delay in growth and development comparing with children from families without social risk (control group). CONCLUSION: Children from disadvantaged families significantly more often exhibit delay in growth and development, comparing with children of the same age from families without social risk. Therefore, pediatricians should consider social risk factors whenever treating children with growth or developmental delay.

Body Height↗

PubMed2004

Low levels of sodium and potassium in the water from wetlands in Minnesota that contained malformed frogs affect the rate of Xenopus development.

Water samples were collected between 1999 and 2000 from wetlands in Minnesota that contained malformed frogs. The water samples were analyzed for 14 minerals/ions and screened for the presence of biologically active compounds using Xenopus laevis. Results indicated that water from two sites, CWB and ROI2, induced severe retardation with embryo lengths reduced 20% after 96 hr of development. The developmental delay observed with water from ROI2 was alleviated by supplementation with sodium, while both sodium and potassium alleviated the developmental delay observed with water whose mineral content mimicked that of CWB. Seasonal fluctuations in the sodium and potassium content at ROI2 and NEY correlated with changes in the rates of Xenopus development. Xenopus embryos reared on water from ROI2 for 120 hr displayed gut malformations not present in embryos reared on a synthetic media designed to mimic the mineral content of the water from ROI2. Embryos reared on water from ROI2 supplemented with minerals at levels comparable to that routinely employed in the rearing of Xenopus were neither retarded nor malformed. It is proposed that climate driven hydrology may influence the mineral composition at selected wetlands and delay development which may alter window(s) of susceptibility towards biologically active agents and the occurrence of malformed frogs.

Animals↗

PubMed2002

Referral diagnosis of Prader-Willi syndrome and Angelman syndrome based on methylation-specific polymerase chain reaction.

BACKGROUND AND PURPOSE: Prader-Willi syndrome (PWS) and Angelman syndrome (AS) are associated with distinct phenotypes that include mental retardation. Both PWS and AS are caused by loss of function of genes located in chromosome 15q11-q13, an area subject to genomic imprinting. Methylation-specific polymerase chain reaction (M-PCR), based on parent of origin specific DNA methylation at the promoter region of the small nuclear ribonucleoprotein polypeptide N gene (SNRPN), can provide accurate and rapid diagnosis for nearly all PWS patients while it is less accurate for AS patients. We report the development of a referral system for molecular diagnosis of PWS and AS based on M-PCR. METHODS: Pediatric geneticists, psychiatrists, or neurologists were asked to evaluate phenotypes of patients with PWS or AS and complete a questionnaire designed according to the consensus criteria to diagnose these conditions. Molecular analysis based on M-PCR was performed for patients with a score of at least two. RESULTS: A total of 108 patients with suspected PWS and 20 patients with suspected AS were referred for diagnostic testing. PWS was diagnosed in 26 of these patients and AS in two. Among the major diagnostic criteria for PWS, excessive weight gain, developmental delay, and hyperphagia were more prevalent in older patients (> or = 1 yr) than in younger patients. Cerebral hypotonia and developmental delay were significantly more prevalent in older PWS patients than in non-PWS patients. CONCLUSION: M-PCR is a cost-effective method for the diagnosis of PWS and AS. The limitations of current scoring systems and the low cost of M-PCR suggest that routine molecular screening is justified for patients suspected of having PWS.

Adolescent↗

PubMed1990

The Peabody Developmental Fine Motor Scale: an interrater reliability study.

This study examined the interrater reliability of two raters on the Fine Motor scale of the Peabody Developmental Motor Scales (Folio & Fewell, 1983). The sample comprised 32 children who were 4 or 5 years of age. Half of the children were considered to have normal development and half had an identified developmental delay. The Pearson product-moment correlation coefficients between the two sets of ratings were r = .97 for the delayed group and r = .77 for the normal group. Intraclass correlations were .97 and .76 for the delayed and normal groups, respectively. These figures appear to reflect the increased variance of the performance of the children with developmental delays. The percentage agreement between the two raters was greater for the group of normal subjects. The results suggest that the Fine Motor scale of the Peabody scales includes enough items to minimize the total score difference between two raters. Individual test items with poor agreement between the two raters were identified.

Child Development↗

PubMed1997

Mosaicism for a small supernumerary ring X chromosome in a dysmorphic, growth-retarded male: mos47,XXY/48,XXY, +r(X).

Supernumerary ring X [r(X)] chromosomes are often found in patients with Turner syndrome. The phenotypic effects of the r(X) chromosome are variable, and largely depend on the presence or absence of the X inactivation (XIST) locus. Ring(X) chromosomes in males are rare and have been previously reported in only four cases, with 47,XY, + r(X) or mos47,XY, +r(X)/46,XY karyotypes. These patients all had developmental delay and dysmorphic features. We describe a 2.5-year-old male patient with facial dysmorphia, growth retardation, microcephaly, global developmental delay, and microphallus. Cytogenetic analysis from peripheral blood lymphocytes and fibroblasts identified mosaicism for two cell lines: mos48,XXY, + r(?X)/47,XXY. Fluorescence in situ hybridization (FISH) with an X chromosome paint showed the ring chromosome to be X chromosome derived. This is the first case of an r(X) chromosome described in a 47,XXY patient. FISH analysis of the r(X) chromosome with an XIST probe showed that the XIST locus was absent. Functional disomy of genes in the r(X) chromosome most likely accounts for the abnormal phenotype in the proband.

Abnormalities, Multiple↗

PubMed1990

Generalized learning of receptive and expressive action-object responses by language-delayed preschoolers.

This study examined the effectiveness of matrix-training procedures in teaching action + object utterances in both the receptive and expressive language modalities. The subjects were 4 developmentally delayed preschool boys who failed to produce spontaneous, functional two-word utterances. A multiple baseline design across responses with a multiple probe technique was employed. Subjects were taught 4-6 of 48 receptive and 48 expressive responses. Acquisition of a word combination rule was facilitated by the use of familiar lexical items, whereas subsequent acquisition of new lexical knowledge was enhanced by couching training in a previously trained word combination pattern. Although receptive knowledge was not sufficient for the demonstration of corresponding expressive performance for most of the children, only minimal expressive training was required to achieve this objective. For most matrix items, subjects responded receptively before they did so expressively. For 2 subjects, when complete receptive recombinative generalization had not been achieved, expressive training facilitated receptive responding. The results of this study elucidate benefits to training one linguistic aspect (lexical item, word combination pattern) at a time to maximize generalization in developmentally delayed preschoolers.

Child, Preschool↗

PubMed2003

Short-term subarachnoid space drainage: a potential treatment for extraventricular hydrocephalus.

INTRODUCTION: Extraventricular hydrocephalus (EVOH), defined as the enlargement of all CSF compartments in the absence of an obstructing lesion, is usually associated with an increased head circumference and a relatively benign clinical course. Occasionally, because of concern about increased intracranial pressure (ICP), treatment with diuretics is initiated. In most cases, surgical drainage or diversion is not indicated. EVOH may follow a more alarming clinical course and be associated with developmental delay and/or other symptoms of increased ICP. CASE REPORT: We describe a 6-month-old girl with EVOH and developmental delay who was treated with temporary drainage of the subarachnoid space. Clinical response was immediate, with stabilization of the head circumference and improvement in motor performance. We propose that such a surgical procedure might be considered for more frequent use in selected cases.

Algorithms↗

PubMed2000

Modulation of the gastrointestinal tract of infants by human milk. Interfaces and interactions. An evolutionary perspective.

Human milk contains agents that affect the growth, development and functions of the epithelium, immune system or nervous system of the gastrointestinal tract. Some human and animal studies indicate that human milk affects the growth of intestinal villi, the development of intestinal disaccharidases, the permeability of the gastrointestinal tract and resistance to certain inflammatory/immune-mediated diseases. Moreover, one cytokine in human milk, interleukin (IL)-10, protects infant mice genetically deficient in IL-10 against an enterocolitis that resembles necrotizing enterocolitis (NEC) in human premature infants. There are seven overlapping evolutionary strategies regarding the relationships between the functions of the mammary gland and the infant's gastrointestinal tract as follows: 1) certain immunologic agents in human milk compensate directly for developmental delays in those same agents in the recipient infant; 2) other agents in human milk do not compensate directly for developmental delays in the production of those same agents, but nevertheless protect the recipient; 3) agents in human milk enhance functions that are poorly expressed in the recipient; 4) agents in human milk change the physiologic state of the intestines from one adapted to intrauterine life to one suited to extrauterine life; 5) some agents in human milk prevent inflammation in the recipient's gastrointestinal tract; 6) survival of human milk agents in the gastrointestinal tract is enhanced because of delayed production of pancreatic proteases and gastric acid by newborn infants, antiproteases and inhibitors of gastric acid production in human milk, inherent resistance of some human milk agents to proteolysis, and protective binding of other factors in human milk; and 7) growth factors in human milk aid in establishing a commensal enteric microflora.

Animals↗

PubMed1991

[Autistic children with mental handicap: differential etiologic, diagnostic, and therapy related principles].

Almost 70% of the autistic children are developmentally deviated and developmentally delayed too. There are still no sufficient diagnostical or intervation-oriented strategies recognizing this fact. Problems of diagnosis and developmental facilitation of autistic, developmental delayed children could be found in the field of unresolved questions of differential-aetiology and differential-diagnosis and of intervention-orientated assessment. This work is an attempt to develop some theoretical foundations and practical issues.

Autistic Disorder↗

PubMed2000

Mitochondrial DNA depletion in children.

The first girl of an unrelated couple was noted to have failure to thrive since age 3 months, generalized hypotonia and weakness, hepatomegaly, hypoglycemia, and lactic acidosis at 4 months. She was found to have severe mitochondrial DNA (mtDNA) depletion and respiratory chain complex IV deficiency in both skeletal muscle and liver but without other common mtDNA mutations. Her younger brother developed vomiting at age 3 weeks and was diagnosed as having pyloric stenosis. His skeletal muscle and liver also showed severe mtDNA depletion. He developed generalized weakness and hypotonia, hepatomegaly, and lactic acidosis at age 3 months. Both siblings died of hepatic failure and hemorrhagic complication before 6 months of age. The brother also had chemical pancreatitis, which had not been reported before in mtDNA depletion in children. Severe mtDNA depletion may present with nonspecific symptoms such as vomiting, failure to thrive, and developmental delay; multiorgan involvement such as hepatomegaly, pancreatitis, and myopathy occurs later. Mitochondrial DNA depletion should be considered in the differential diagnosis in children with developmental delay or failure to thrive of unknown etiology.

DNA Fragmentation↗

PubMed2004

Mental development of children conceived using intracytoplasmic sperm injection. The current evidence.

There are biologically plausible reasons why children conceived using intracytoplasmic sperm injection (ICSI) may be at increased risk for delayed mental development. The first controlled study of mental development in ICSI children which was published in 1998 found 1 year old ICSI children to be at significantly increased risk for developmental delay compared with both in vitro fertilization (IVF) and naturally conceived control children. These results encouraged several groups of investigators to further study developmental outcomes for ICSI children in order to clarify the level of risk, if any. This review considers the currently available evidence from published studies which included control groups and a standardized measure of infant or child development. The 9 publications included in the review include a total of 969 ICSI children and 828 controls (343 IVF, 485 naturally conceived). All studies indicate that the majority of children conceived using ICSI have normal mental development, and most have not found ICSI children to be at increased risk for developmental delay. The evidence to date suggests that ICSI per se is not an independent risk factor for delayed child development, but that demographic factors such as level of maternal education and social class are more important determinants of developmental outcome for ICSI children.

Age Factors↗

PubMed1987

Dyadic peer interactions of mildly delayed and nonhandicapped preschool children.

Mildly developmentally delayed and nonhandicapped 3- and 4-year-old children were paired systematically in a series of dyadic play sessions to evaluate the effects of companion status on important aspects of peer-related social and play behavior. Mildly delayed children were paired with younger nonhandicapped children matched in terms of developmental level, with nonhandicapped children matched in terms of CA, and with other mildly delayed companions. Mixed-age and same-age pairings for the nonhandicapped children were also arranged. Results indicated that mildly delayed children's peer interactions improved substantially when paired with nonhandicapped older children in comparison to pairings with other mildly delayed children. Pairings with nonhandicapped younger children, although matched in terms of developmental level, had no influence on the peer interactions of mildly delayed children. Nonhandicapped children appeared to be able to maintain a consistent level of interaction irrespective of companion status. Explanations for these findings in terms of the directive role adopted by nonhandicapped older children and their developmental implications were discussed.

Child, Preschool↗

PubMed2005

Early development of infants with untreated metopic craniosynostosis.

BACKGROUND: The purpose of this archival descriptive study was to examine the associations among craniosynostosis, perinatal risk factors or complications, and early cognitive development in infants diagnosed with craniosynostosis before they underwent surgery, to provide a greater empirical basis for surgical decision making and other early interventions. Specifically, it was hypothesized that there would be a greater number of infants with developmental delays than seen in the normative population. Furthermore, it was hypothesized that greater severity of synostosis would be correlated with lower cognitive and developmental scores. The secondary purpose of this study was to examine specific developmental domains such as language and motor skills in children with metopic craniosynostosis. METHODS: The research subjects for this retrospective cross-sectional study were a consecutive series of 22 infants diagnosed with metopic synostosis: 86 percent male, ages 3.6 to 25.3 months (mean +/- SD, 10.6 +/- 6.4 months). Mean gestational age was 38.8 (2.3) months, mean birth weight was 107.7 ounces, and 48.1 percent subsequently had craniovault reconstruction. Severity of craniosynostosis was assessed by a plastic surgeon (Buchman) and a neurosurgeon (Muraszko) and was confirmed radiographically by an independent rater (Angobaldo). Cognitive status was assessed with the Bayley Scales of Infant Development, Second Edition, at a mean age 11.6 (4.8) months. RESULTS: The mean Mental Development Index score for the sample was 96.0 (14.5), falling within the average range. Severity of synostosis was not significantly correlated with the overall Mental Development Index score. The mean language quotient for the sample was 77.3 (21.1). CONCLUSIONS: Despite suspicions that increased severity of deformity in infants with metopic craniosynostosis correlates with decreased cognitive and motor development, no such associations could be demonstrated. The results of this study did suggest, however, that children with isolated metopic craniosynostosis might show specific developmental delays in language acquisition. Finally, there were no significant correlations between cognitive development and prenatal risk factors.

Child, Preschool↗