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PubMed1994

Day-care participation as a protective factor in the cognitive development of low-income children.

The impact of day-care participation during the first 3 years of life on the cognitive functioning of school age children was examined. 867 5- and 6-year-old children from the National Longitudinal Survey of Youth who completed the 1986 assessment were included in the sample. The dependent measures were scores on the Peabody Individual Achievement Test (PIAT) subtests of mathematics and reading recognition. In addition to day-care participation, the impact of the pattern of day-care was examined by analyzing the effect of the number of years in day-care, the timing of initiation of day-care, and type of day-care arrangement. After controlling for confounding factors, there were significant interactions between all 3 measures of day-care patterning and family income for reading recognition performance. This association was further examined by exploring the interaction between the pattern of day-care participation and the quality of the home environment. Initiation of day-care attendance before the first birthday was associated with higher reading recognition scores for children from impoverished home environments and with lower scores for children from more optimal environments. In addition, a significant interaction between the type of day-care arrangement and the quality of the home environment emerged for mathematics performance. Center-based care in particular was associated with higher mathematics scores for impoverished children and with lower mathematics scores for children from more stimulating home environments. These findings are discussed in the context of developmental risk.

Child↗
PubMedDate not supplied

Children with hypoplastic enamel defects of primary incisors are not at increased risk of learning-problem syndromes.

Developmental enamel defects of primary teeth have been associated in earlier reports with motor, hearing and psychological disturbances. The relationship between hypoplastic enamel defects and learning problems had not been evaluated previously. For a total of 149 girls and 196 boys we collected a primary tooth shortly after shedding and approximately 2 years later a teacher-completed questionnaire about function in school. Children with a hypoplastic enamel defect of one of their primary incisors were no more likely than their peers without an enamel defect to have any of 7 different learning problem syndromes. In the absence of reason to suspect selection bias, confounding, or misclassification of hypoplastic defects or school problems, we conclude that hypoplastic enamel defects are not associated with teacher-identified learning problems.

Child↗
PubMed1993

The state of childhood asthma in young adulthood.

We investigated whether patients with childhood asthma had improved when reaching adulthood. We also evaluated factors which might influence the course of the disease. The study included a group of 108 asthmatics, diagnosed and monitored throughout childhood at the out-patients clinics of Oulu University Central Hospital. At the age of 20-24 yrs of age they were evaluated for the clinical state of their disease, ventilatory lung function and hyperreactivity of the airways. In the interval 30 (28%) had become totally free of symptoms, whilst 24 (22%) continued to have symptoms weekly, or more often. A quarter of the patients continued to use prophylactic medication, half still suffered from allergic rhinitis, and one third had atopic dermatitis. Skin prick tests showed at least one positive result in 86% of the patients, most often to animal danders. Ventilatory lung function tests showed forced vital capacity (FVC) to be within normal limits, but forced expiratory volume in one second (FEV1)/FVC values less than -2 SD predicted were found in 18%. Forty eight percent of the asthmatics reacted to methacholine at a dose of 0.8 mg or lower, and the degree of airway reactivity showed a significant correlation with the current attack rate. The compliance to treatment of asthma was not adequate, as one third smoked and 81% lacked proper check-ups. Concomitant atopic dermatitis, severe early disease and impaired ventilatory lung function at school age, were observed to be significant risk factors for a severe asthma outcome as a young adult.

Adult↗
PubMed1998

Long-term adjustment issues in patients with exstrophy.

PURPOSE: We explored the psychological adjustment of children with bladder or cloacal exstrophy. MATERIALS AND METHODS: We assessed 29 subjects with a mean age plus or minus standard deviation of 7.8 +/- 3.97 years using age appropriate standard psychological instruments. Psychological adjustment scores in the exstrophy group were compared to the norms of the various instruments. Subjects were divided into dichotomous groups according to several medical and demographic factors. For each factor the differences between the means of the 2 groups on the outcome variables were calculated using a t test. RESULTS: Children with exstrophy perceived their appearance more positively than the norm. Older children performed more poorly than younger children in adaptive behavior, specifically in skills related to functioning in school. Children who achieved continence after age 4 years were more likely to have problems with acting out behavior. There were no differences in adjustment in boys versus girls, bladder versus cloacal exstrophy, type of continence strategy or gender reassignment versus no reassignment. CONCLUSIONS: Children with exstrophy did not have clinical psychopathology. Differences existed in adaptive and acting out behavior rather than depression or anxiety, suggesting that improved outcomes may be achieved through a focus on normal adaptation rather than on potential psychological distress.

Adaptation, Psychological↗
PubMedDate not supplied

Relevance of functional behavioral assessment research for school-based interventions and positive behavioral support.

The Individuals With Disabilities Education Act (IDEA) Amendments of 1997 mandate the use of functional behavioral assessment (FBA) and positive behavioral supports and interventions for students with disabilities. Although much progress has been made in our understanding of functional analysis over the past 15 years, the extent to which these findings can be generalized across clients, methods, settings, and response classes is unknown. This article reviewed 150 school-based intervention studies conducted with children published in the Journal of Applied Behavior Analysis from 1991 to 1999. Fifty-two percent of these intervention studies did not report using FBA information linked to the intervention. Interventions based on descriptive, experimental, or combined FBA procedures were no more effective than interventions in which no FBA information was provided. With respect to positive behavioral support, over half of the studies targeted appropriate behaviors with two-thirds of them using a combination of antecedent- and consequence-based interventions. Recommendations are made for conducting fundamental research on reliability and validity issues in FBA and determining when, how, and under what conditions FBA procedures are most appropriate.

Adolescent↗
PubMed2002

[BREV: a rapid clinical scale for cognitive function evaluation in preschool and school-age children].

BREV, standing for the French "Batterie Rapide d'Evaluation des Fonctions Cognitive", is a rapid test to screen children with disorders of higher functions and to define the patterns of these disorders. We describe here two phases of the validation procedure. The first phase consisted in measuring the internal validity of the scale by testing 500 normal school children free of disability. The validation process provided appropriate values for each of the 18 subtests assessing cognitive functions (oral language, non-verbal abilities, attention and memory, education and memory, educational achievment) in ten age groups from 4 to 8 years. All subtests with the same content for any revealed values which increased significantly with age. Inter-reliability was tested by retesting 70 children. The second phase of validation, comparing BREV results and those from a large classical neuropsychological battery, tested specificity and sensitivity. Each of the BREV subtests were correlated with the similar subtest of the classical battery. Correlations between verbal and non-verbal scores and verbal and performance intellectual quotient (Weschler scale) were very significant. Sensitivity and specificity of BREV were above 75p.100;. This confirms the reliability of this battery for children, with good sensitivity and specificity. BREV is a reliable test, with carefully established norms, appropriate for preschool and school-age children.

Attention↗
PubMed1984

Neurodevelopmental functioning of good and poor readers in urban schools.

This study investigated specific aspects of neurodevelopmental functioning in good and poor readers entering second grade and followed their neurodevelopmental course and reading progress over a three-year period. Poor readers at age seven performed significantly worse than good readers on assessment of gross and fine motor coordination and corticosensory functioning. Furthermore, the presence of soft signs at age seven was significantly predictive of reading achievement at age ten. Group differences in neurodevelopmental functioning disappeared by age ten, and the presence of soft signs at ages eight and nine no longer was predictive of reading achievement. These findings have implications for pediatricians, educators, and researchers exploring brain-behavior relationships.

Achievement↗
PubMed1998

Academic and emotional functioning in early adolescence: longitudinal relations, patterns, and prediction by experience in middle school.

Adopting a motivational perspective on adolescent development, these two companion studies examined the longitudinal relations between early adolescents' school motivation (competence beliefs and values), achievement, emotional functioning (depressive symptoms and anger), and middle school perceptions using both variable- and person-centered analytic techniques. Data were collected from 1041 adolescents and their parents at the beginning of seventh and the end of eight grade in middle school. Controlling for demographic factors, regression analyses in Study 1 showed reciprocal relations between school motivation and positive emotional functioning over time. Furthermore, adolescents' perceptions of the middle school learning environment (support for competence and autonomy, quality of relationships with teachers) predicted their eighth grade motivation, achievement, and emotional functioning after accounting for demographic and prior adjustment measures. Cluster analyses in Study 2 revealed several different patterns of school functioning and emotional functioning during seventh grade that were stable over 2 years and that were predictably related to adolescents' reports of their middle school environment. Discussion focuses on the developmental significance of schooling for multiple adjustment outcomes during adolescence.

Achievement↗
PubMed1999

A VEP investigation of parallel visual pathway development in primary school age children.

Different features of visual function mature along unique timescales through infancy and early childhood. It is not clear which functions continue to mature in school age children. Functions believed to be mediated by the Magnocellular (M) and Parvocellular (P) pathways were compared in five- (n=25), eight- (n=21) and eleven-year-old children (n=21) and young adult controls (n=20). Steady-state visual evoked potentials were recorded from occipital electrodes in response to very low spatial frequency gratings, at a series of contrasts (M), and to high contrast gratings at a series of spatial frequencies (P). No evidence was found to indicate M pathway development across these age groups. However, the youngest children demonstrated elevated VEP thresholds to the high contrast gratings compared with either the adults or eleven-year-olds. This difference in threshold implies an immaturity of the high contrast, high spatial frequency stream, i.e. the putative P pathway.

Adult↗
PubMed2006

Examining school health center utilization as a function of mood disturbance and mental health difficulties.

PURPOSE: We examined the presence and severity of mood disturbance and mental health difficulties as predictors of students' utilization of school health centers. METHODS: Mood disturbance and mental health difficulties were assessed through surveys completed at year end. Visits to school health centers were tracked prospectively over the year. RESULTS: Twenty-three percent of students with mental health difficulties visited the school health centers. Students reporting mood disturbance and difficulties were more likely to use school health centers and to use them more frequently than were students without such difficulties. More than half of all visitors were judged by health clinic staff to be experiencing impairment in functioning and reported difficulties, which typically lasted more than 6 months duration. CONCLUSIONS: Although the presence of mental health difficulties increases the probability of students' visiting school health centers, the majority of students with such difficulties do not avail themselves of this resource. Optimizing the effectiveness of school-based health services depends on understanding the interplay between availability and utilization of school-based services for students with mental health difficulties.

Adolescent↗
PubMed1981

The role of psychiatrists in the medical school admissions process.

Psychiatrists function in various ways in the admissions process of medical schools. They serve on admissions committees, act as consultants, and provide expertise in evaluating applicants known to be at psychological risk. The authors discuss the pros and cons of broadening admissions criteria; the assessment of the diagnosis, functioning, and prognosis of an applicant; the supportive services necessary for students screened into medical school; and the avoidance of homogenization of medical students. They conclude that the participation of psychiatrists is critical to the efficient operation of the admissions process and the medical school itself.

Educational Measurement↗
PubMed1990

A preliminary analysis of a functional model of assessment and treatment for school refusal behavior.

We assessed whether treatment of children and adolescents with school refusal behavior is effective when based upon an individualized, functional analysis. Seven children and adolescents, who were currently experiencing difficulties attending school, were evaluated with the School Refusal Assessment Scale (SRAS), an instrument designed to identify maintaining variables surrounding school refusal behavior. These included specific fearfulness/general overanxiousness, escape from aversive social situations, attention-getting or separation anxious behavior, and tangible reinforcement. Prescriptive treatment was given in accordance with the assessed motivating condition and included systematic desensitization/relaxation training, modeling and cognitive restructuring, shaping and differential reinforcement of other behavior, and contingency contracting for each condition, respectively. Daily measures of anxiety, depression, distress, and school attendance were taken, as well as pretreatment, posttreatment, and 6-month follow-up child and/or parent questionnaires. Results indicated that 6 of the subjects maintained full-time school attendance by posttreatment and at the 6-month follow-up. All reported moderate improvements in daily levels of anxiety, depression, and/or distress. The implications of a prescriptive treatment approach for school refusal behavior are discussed.

Adolescent↗
PubMed2006

Circadian variation of voided volume in normal school-age children.

Functional bladder capacity (FBC) and urine output are important variables in the management of incontinence and nocturnal enuresis. The lack of reference ranges for FBC vs. age, and the arbitrarily defined time-windows for measuring urine output, impede the clinical use of these variables in children. To solve these impediments, we had 26 girls and 28 boys, between 6 and 12 years of age, collect, measure, time, and sample every voiding, using 72-h frequency-volume charts; all samples were analysed for osmolality and creatinine concentration. Voided volumes show a very wide range (10-550 ml) and a subset that is significantly larger than all other voidings: early morning voidings (EMV). The individual maximum voided volume (MVV) belongs to the category of EMV in 74% of the children. MVV, the measure for FBC, fits the 5-95% centiles that have been published for cystographic bladder capacity for age in normal children; all other voiding are mostly below the 5% centile. Voided volume plotted vs. corresponding urine output rate shows that, with output rates below 50 ml/h, rest-phase bladder filling always results in significantly larger voidings (EMV) than activity-phase bladder filling. Two circadian rhythms seem to be involved, one for urine output, and another for inhibition of bladder contractility. With hourly population averages of individual urine and osmole output rates plotted on a time scale, circadian patterns appear; these patterns are masked when urine output is collected in blocks of 6, 8, or 12 h. Both plots are promising tools for studying the pathophysiology of voided volume vs. urine output, e.g. in children with nocturnal enuresis.

Child↗
PubMed2004

Outcomes at school age after postnatal dexamethasone therapy for lung disease of prematurity.

BACKGROUND: We studied the outcomes at school age in children who had participated in a double-blind, placebo-controlled trial of early postnatal dexamethasone therapy (initiated within 12 hours after birth) for the prevention of chronic lung disease of prematurity. METHODS: Of the 262 children included in the initial study, 159 lived to school age. Of these children, 146 (72 in the dexamethasone group and 74 in the control group) were included in our study. All the infants had had severe respiratory distress syndrome requiring mechanical ventilation shortly after birth. In the dexamethasone group, 0.25 mg of dexamethasone per kilogram of body weight was given intravenously every 12 hours for one week, and then the dose was tapered. We evaluated the children's growth, neurologic and motor function, cognition, and school performance. RESULTS: Children in the dexamethasone group were significantly shorter than the controls (P=0.03 for boys, P=0.01 for girls, and P=0.03 for all children) and had a significantly smaller head circumference (P=0.04). Children in the dexamethasone group had significantly poorer motor skills (P<0.001), motor coordination (P<0.001), and visual-motor integration (P=0.02). As compared with the controls, children in the dexamethasone group also had significantly lower full IQ scores (mean [+/-SD], 78.2+/-15.0 vs. 84.4+/-12.6; P=0.008), verbal IQ scores (84.1+/-13.2 vs. 88.4+/-11.8, P=0.04), and performance IQ scores (76.5+/-14.6 vs. 84.5+/-12.7, P=0.001). The frequency of clinically significant disabilities was higher among children in the dexamethasone group than among controls (28 of 72 [39 percent] vs. 16 of 74 [22 percent], P=0.04). CONCLUSIONS: Early postnatal dexamethasone therapy should not be recommended for the routine prevention or treatment of chronic lung disease, because it leads to substantial adverse effects on neuromotor and cognitive function at school age.

Bronchopulmonary Dysplasia↗
PubMed1990

Effects of air pollution episodes on pulmonary function and respiratory symptoms.

In January 1985, a decline of primary school children's pulmonary function was observed during an air pollution episode. Ambient 24 hour average levels of SO2, TSP and RSP were in the range of 200-250 micrograms/m3. The response persisted for at least two weeks. In January 1987, again a decline of school children's pulmonary function was observed associated with an air pollution episode. Levels of TSP were about as elevated as in the 1985 episode. Two weeks after the episode, lung function levels were even lower than during the episode. In June 1987 a long term study was started to investigate potential effects of winter and summer air pollution episodes on pulmonary function and occurrence of acute respiratory symptoms of primary school children. An important issue for this study is the characterization of short term variation of lung function in absence of air pollution. Exposure is characterized by ambient levels of several gases (SO2, NO2, O3, HNO3), PM10, TSP and components of particulate matter (SO4(2-), NO3-, H-, NH4+). Sampling is being conducted on a daily basis to obtain a continuous exposure estimate. In the winter of 1987/1988, no air pollution episodes were observed. The study will continue through the winters of 1988/1989, and 1989/1990.

Air Pollution↗
PubMed1999

Effectiveness of a social influences smoking prevention program as a function of provider type, training method, and school risk.

OBJECTIVES: This study determined the effect of provider (nurse or teacher) and training method (workshop or self-preparation) on outcomes of a social influences smoking prevention program. METHODS: One hundred elementary schools were stratified by school risk score (high risk = high smoking rate among senior students) and assigned randomly to conditions: (1) teacher/self-preparation, (2) teacher/workshop, (3) nurse/self-preparation, (4) nurse/workshop, and (5) control. Intervention occurred in grades 6 to 8. Smoking status at the end of grade 8 was the primary endpoint variable. RESULTS: Intervention reduced grade 8 smoking rates in high-risk schools (smoking rates of 26.9% in control vs 16.0% in intervention schools) but not in low-risk schools. There were no significant differences in outcome as a function of training method and no significant differences in outcome between teacher-provided and nurse-provided interventions in high- and medium-risk schools. Although nurses achieved better outcomes than did teachers in low-risk schools, neither provider type achieved outcomes superior to the control condition in those schools. CONCLUSIONS: Workshop training did not affect outcomes. Teachers and nurses were equally effective providers. Results suggest that programming should target high-risk schools.

Adolescent↗