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PubMed2001

[Prediction of IQ among children with birth weight under 1, 501 gms].

INTRODUCTION: As a group, preterm infants are at considerable risk of cognitive difficulties. However, predicting cognitive sequelae has proved to be difficult. The current study reports on prediction of IQ at age eight years on the basis of the children's perinatal and developmental status, as well as parental socioeconomic status. MATERIALS AND METHODS: The sample consisted of 104 infants with birth weight < or = 1,501 g (53 girls), recruited consecutively in the neonatal intensive care unit and followed up to age eight years. Perinatal status, early cognitive development, and parental socioeconomic status served as predictors. Cognitive ability assessed on two commonly used intelligence tests served as outcome. The participants did not represent a total population, and no control group was used. RESULTS: Regression analyses revealed that birth weight, the Bayley cognitive index at 39 and 56 weeks, and parental socioeconomic status all made significant and independent contributions to outcome. Though the Bayley index made no significant contribution at age 29 weeks, it was the only variable at age two that was related to IQ at age eight. INTERPRETATION: Perinatal data are generally of limited value for the prediction of later IQ among preterm infants. However, when combined with information about parental socioeconomic status and the infants' developmental status up to age 56 weeks, birth weight made a unique and significant contribution as a predictor of later IQ. At age two years the cognitive status of prematurely born children was sufficiently consolidated to yield a valid prediction of outcome.

Child↗
PubMed2003

Alternative method of gifted identification using the AMI: an apparatus for measuring internal meridians and their corresponding organs.

OBJECTIVES: To determine if meridian energy (qi or bioelectricity), as measured by the Apparatus for Measuring the Internal Organs and their Corresponding Meridians (AMI), could distinguish between gifted and average boys and to gather evidence to assess if the AMI device could be effective as an educational diagnostic tool, specifically for identifying gifted children. DESIGN: Quasi-experimental design using discriminant analysis to determine how accurately the AMI could predict group membership previously determined by intelligence tests. SETTINGS/LOCATION: Practitioner's office within clinic in Albuquerque, New Mexico. SUBJECTS: Thirty-three (33 boys; gifted, n = 11 and average, n = 22) ranging in age from 9 to 12 years. OUTCOME MEASURES: Meridian nervous system energy levels as measured by the AMI. RESULTS: On average, boys in the gifted group had statistically significantly calmer nervous system measures than the boys in the average group. The discriminant function generated from the AMI nervous system measures accurately predicted group membership 70% of the time. Classification accuracy by groups indicated that 55% of the gifted cases and 82% of the average cases were correctly classified. Upon cross-validation, accuracy by group stayed consistent with the average group (82%) and improved with the gifted group (64%). CONCLUSIONS: Bioelectrical energy patterns of the nervous system, as measured by the AMI, could distinguish between gifted and average boys. The accuracy found in this current study using the AMI as a screening tool to detect giftedness is promising, however, further studies will need to be conducted to see if the findings can be replicated.

Bioelectric Energy Sources↗
PubMed1996

Facial EMG in an anger-provoking situation: individual differences in directing anger outwards or inwards.

This study was designed to examine whether facial EMG reactions occurred while subjects experienced anger. All subjects (n = 60) were required to perform an intelligence test. Randomly chosen subjects (n = 40) received negative feedback irrespective of their actual test achievement. The remaining twenty subjects served as control group and received neutral feedback. While all subjects received their feedback, facial EMG was recorded over the mm. frontalis lateralis, corrugator supercilii, orbicularis oculi, and zygomaticus major. In addition, anger and fear self-reports were measured. Those subjects receiving negative feedback were post-hoc divided into two groups. One group comprised subjects verbally expressing their anger toward the experimenter (anger-out group, n = 19) while the other anger group comprised subjects who were angry with themselves (anger-in group, n = 18). Facial EMG reactions over the m. frontalis and m. corrugator were only evident for the anger-out group while they received negative feedback. In addition, intensity of anger self-reports were unrelated to facial EMG reactions. It is hypothesized that the anger-out group implicitly communicated with the experimenter by generating facial anger displays including mm. frontalis and corrugator EMG activity. Thus, these results were taken as evidence that facial displays are communicative tools used to communicate with an interactant although he/she is not physically present (implicit audience).

Adult↗
PubMed2005

Social outcomes in adulthood of children with intellectual impairment: evidence from a birth cohort.

BACKGROUND: Social Policy for people with intellectual disabilities (ID) continues to evolve, but little is known about the lives to which such policies are applied. We aimed to use a prospective follow-up of a British birth cohort to identify children with mild and more severe intellectual impairment, and compare a range of social outcomes in adulthood with people in the rest of the cohort. METHOD: We used data from the MRC National Survey for Health and Development. Intellectual impairment was identified by intelligence tests and educational history. Adult outcome measures included employment and social class, education, marriage and children, home ownership, social networks and community use. RESULTS: We identified 111 people with mild intellectual impairment (2.7%) and 23 with severe intellectual impairment (0.6%) at age 15/16. By the age of 43, there were 52 people remaining in the mild impairment group and 14 in the severe impairment group. In adulthood those with intellectual impairment enjoyed contact with friends and family, and joined in informal social activities. Although the mild intellectual impairment group were less likely to attain the following social outcomes than people with normal intellectual functioning, 67% had jobs, 73% were married, 62% had children and 54% owned their own homes. 12% participated in adult education. People with more severe intellectual impairment were less likely to attain these outcomes. CONCLUSIONS: These outcomes highlight issues in current social policy and suggest efforts should be directed particularly towards promoting educational opportunities and developing social inclusion for people with ID.

Achievement↗
PubMed2005

Maternal smoking during pregnancy and offspring IQ.

BACKGROUND: Maternal smoking in pregnancy lowers birthweight. It is unclear, however, whether smoking during pregnancy lowers offspring IQ, and, if it does, whether it is through the smoking effect on fetal growth. METHOD: Representative samples of low birthweight (<2500 g) and normal birthweight children born in 1983-85 from inner-city and suburban communities in southeast Michigan, USA were assessed at ages 6, 11, and 17, using Wechsler intelligence tests. Smoking during pregnancy was ascertained from mothers at the first assessment; and smoking at any time was ascertained at the first and second assessment. Generalized estimating equation models were used, with children's IQ at all three assessments as outcomes (n = 798). RESULTS: Without adjustment, offspring of mothers who smoked during pregnancy scored 6.8 IQ points lower than offspring of mothers who never smoked, on average. Low birthweight children scored 5.4 IQ points lower than normal birthweight children, on average. The statistical association of maternal smoking with offspring IQ was confounded by maternal characteristics, chiefly, maternal cognitive ability as measured by IQ and education; adjustment for these factors eliminated the association. By contrast, adjustment for maternal IQ and education as well as smoking during pregnancy had a negligible effect on the low birthweight-related IQ deficit. Low birthweight did not mediate the association of smoking and lowered IQ in offspring. CONCLUSION: Maternal smoking during pregnancy is a proxy for a matrix of vulnerabilities for adverse child cognitive development and has no direct causal effect on child's IQ. The relationship of low birthweight and IQ is independent of maternal smoking and maternal cognitive abilities.

Adolescent↗
PubMedDate not supplied

Thinking out loud: an exploration of problem-solving language in preschoolers with and without language impairment.

This study investigates the use of language while engaged in solving a complex spatial problem. Children with specific language impairment (SLI) have been reported to lag behind age peers in certain cognitive tasks, despite normal range non-verbal intelligence test scores. It was hypothesized that these delays could reflect some failure to employ language to direct and facilitate thought. Dyads of preschool children were taped during a three-dimensional construction task. Task-relevant utterances were then coded for function and addressee. The speech of six children with SLI, aged 4;10, was compared with that of two control groups, one matched by age, the other by language level. The SLI group used less problem-solving speech and fewer modal expressions than their age peers. Not all differences were statistically significant, but the pattern of findings indicated that what differences did occur were due to overall reductions in the amount of speech rather than any specific failure to use language as a tool of thought. Correlations between the use of problem-solving speech and a measure of cognitive style indicated clear group differences. For children in the control groups, greater use of private speech was associated with greater cognitive efficiency; for children in the SLI group the relationship was in the opposite direction, greater use of private speech being associated with less cognitive efficiency. In all three groups, problem-solving speech could be addressed either to partner or to self, although some individual preferences were observed. The findings, while preliminary, suggest new directions for studies of cognitive deficits in children with SLI. They also indicate the importance of including socially directed utterances, and controls for language proficiency, in future research on private speech.

Analysis of Variance↗
PubMed2004

Figure copying in Williams syndrome and normal subjects.

We evaluated the copying abilities of ten subjects with Williams syndrome (WS; age 6-14 years) and ten normally developing children (age 3-6 years) matched for mental age using the matrices component of the Kaufman Brief Intelligence Test (mKBIT). Each subject copied six figures, including line drawings of closed and open geometrical shapes (alone and in combination), crossed lines, and geometrical shapes made of distinct small, filled circles. Qualitatively, subjects of both groups made comparable copies, although several subjects with WS drew a continuous line when copying figures composed of distinct circles. Quantitatively, the goodness of the copies was assessed by three human observers who rated on an analog scale the similarity of each copy to its visual template. Ratings were converted to a scale from zero (completely different) to 100 (the same) for statistical analyses. We found the following. First, the overall goodness of copies of the templates was very similar between the WS and control groups (WS: mean=46.7, range=0.89-95.4; control: mean=54.5, range=0.89-98.2). Second, there were systematic differences in the goodness of copies between the two groups, depending on the features of the figures. Specifically, the goodness of copies of control subjects was almost the same as that of WS subjects for simple line figures, but was consistently better for composite line figures, and even better for figures in which the shape was made of small, filled circles. Third, there was a significant relation between the goodness of copies (dependent variable) and mental age (mKBIT, independent variable) in both groups, although it was stronger and more highly statistically significant in the control than the WS group. These findings indicate that the principles guiding copying are similar in the two groups and suggest that WS is a case of developmental rather than deviance disorder.

Adolescent↗
PubMed2000

The discrepancy between maturation of visual-evoked potentials and cognitive outcome at five years in very preterm infants with and without hemodynamic signs of fetal brain-sparing.

OBJECTIVE: After intrauterine growth restriction we found at the age of 6 months an acceleration of neurophysiologic maturation. However, at later ages impaired cognitive outcome has been reported. Therefore, we investigated in children with and without fetal hemodynamic adaptation to intrauterine growth restriction whether the accelerated neurophysiologic maturation in infancy might be associated with impaired cognitive outcome at preschool age. DESIGN: At 5 years of age cognitive function was assessed using the Revision of the Amsterdam Children's Intelligence Test in 73 preterm infants (26-33 weeks) who were prospectively followed from the antenatal period up to the age of 5 years. Maternal educational level was used as a background variable to estimate the confounding effects of socioeconomic status on cognitive function. Fetal Doppler studies were performed and the umbilical artery pulsatility index (PI) divided by the middle cerebral artery PI ratio (U/C ratio) was calculated. A U/C ratio >0.725 was considered as an indication of fetal cerebral hemodynamic adaptation to a compromised placental perfusion, ie, fetal brain-sparing. Visual-evoked potentials (VEPs) were recorded at 6 months and 1 year of age. In addition, data on neurologic status at 3 years were available. RESULTS: Mean IQ score was significantly lower for children born with a raised U/C ratio (87 +/- 16) compared with children with a normal U/C ratio (96 +/- 17). VEP latencies decreased significantly in infants with a normal U/C ratio, whereas no decrease was found in infants with a raised U/C ratio. Variables contributing significantly to the variance of cognitive function were: U/C group, VEP latency maturation, level of maternal education, and neurodevelopmental outcome at 3 years. The linear regression model explained 33% of the variance in cognitive function. CONCLUSIONS: Both being born with a raised U/C ratio and an acceleration of VEP latencies are negatively associated with cognitive outcome at 5 years of age. Fetal brain-sparing, although a seemingly beneficial adaptive mechanism for intact neurologic survival, is, however, later associated with a poorer cognitive outcome.

Adaptation, Physiological↗
PubMed2005

Low-level environmental lead exposure and children's intellectual function: an international pooled analysis.

Lead is a confirmed neurotoxin, but questions remain about lead-associated intellectual deficits at blood lead levels < 10 microg/dL and whether lower exposures are, for a given change in exposure, associated with greater deficits. The objective of this study was to examine the association of intelligence test scores and blood lead concentration, especially for children who had maximal measured blood lead levels < 10 microg/dL. We examined data collected from 1,333 children who participated in seven international population-based longitudinal cohort studies, followed from birth or infancy until 5-10 years of age. The full-scale IQ score was the primary outcome measure. The geometric mean blood lead concentration of the children peaked at 17.8 microg/dL and declined to 9.4 microg/dL by 5-7 years of age; 244 (18%) children had a maximal blood lead concentration < 10 microg/dL, and 103 (8%) had a maximal blood lead concentration < 7.5 microg/dL. After adjustment for covariates, we found an inverse relationship between blood lead concentration and IQ score. Using a log-linear model, we found a 6.9 IQ point decrement [95% confidence interval (CI), 4.2-9.4] associated with an increase in concurrent blood lead levels from 2.4 to 30 microg/dL. The estimated IQ point decrements associated with an increase in blood lead from 2.4 to 10 microg/dL, 10 to 20 microg/dL, and 20 to 30 microg/dL were 3.9 (95% CI, 2.4-5.3), 1.9 (95% CI, 1.2-2.6), and 1.1 (95% CI, 0.7-1.5), respectively. For a given increase in blood lead, the lead-associated intellectual decrement for children with a maximal blood lead level < 7.5 microg/dL was significantly greater than that observed for those with a maximal blood lead level > or = 7.5 microg/dL (p = 0.015). We conclude that environmental lead exposure in children who have maximal blood lead levels < 7.5 microg/dL is associated with intellectual deficits.

Child↗
PubMed2000

Multicenter prospective study of children with sickle cell disease: radiographic and psychometric correlation.

After obtaining familial informed consent, between January 1996 and July 1997, 173 children (5 to 15 years old) with sickle cell disease were enrolled in a prospective multicenter study using blood screening, transcranial Doppler ultrasonography (n = 143), cerebral magnetic resonance imaging (n = 144), and neuropsychologic performance evaluation (n = 156) (Wechsler Intelligence tests WISC-III, WIPPSI-R), which were also performed in 76 sibling controls (5 to 15 years old). Among the 173 patients with sickle cell disease (155 homozygous for hemoglobin SS, 8 sickle cell beta0 thalassemia, 3 sickle cell beta+ thalassemia, 7 sickle cell hemoglobin C disease SC), 12 (6.9%) had a history of overt stroke, and the incidence of abnormal transcranial Doppler ultrasonography (defined as mean middle cerebral artery velocity > 200 cm/sec or absent) was 8.4% in the overall study population and 9.6% in patients with homozygous sickle cell anemia The silent stroke rate was 15%. Significantly impaired cognitive functioning was observed in sickle cell disease patients with a history of stroke (Performance IQ and Full Scale IQ), but also in patients with silent strokes (Similarities, Vocabulary, and Verbal Comprehension). However, infarcts on magnetic resonance imaging were not the only factors of cognitive deficit: Verbal IQ, Performance IQ, and Full Scale IQ were strongly impaired in patients with severe chronic anemia (hematocrit < or = 20%) and in those with thrombocytosis (platelets > 500 x 10(9)/L). Multivariate logistic regression analysis showed that abnormal magnetic resonance imaging (odds ratio [OR] = 2.76) (P = .047), hematocrit < or =20% (OR = 5.85) (P = .005), and platelets > 500 x 10(9)/L (OR = 3.99) (P = .004) were independent factors of cognitive deficiency (Full Scale IQ < 75) in sickle cell disease patients. The unfavorable effect of low hematocrit has already been suggested, but this is the first report concerning an effect of thrombocytosis and showing that silent stroke alone is not a factor of cognitive deficit when not associated with low hematocrit or thrombocytosis. The effect of hydroxyurea, which is known to increase hematocrit and decrease platelet count, on cognitive functioning of sickle cell patients should be evaluated prospectively.

Adolescent↗
PubMed2002

Effect of different starting doses of levothyroxine on growth and intellectual outcome at four years of age in congenital hypothyroidism.

To evaluate the effect of different initial levothyroxine (LT4) replacement doses on growth and intellectual outcome in patients with congenital hypothyroidism (CH) detected by neonatal screening program, the longitudinal growth and intelligence quotient (IQ) were assessed and compared at 4 years of age in 83 patients with CH. The patients were divided into three groups according to the initial LT4 dose used: (1) group 1 (n = 42) received the previously recommended dose of 6.0-8.0 microg/kg per day; (2) group 2 (n = 21) received a dose of 8.1-10.0 microg/kg per day; (3) Group 3 (n = 20) a dose of 10.1-15.0 microg/kg per day. The IQ, evaluated by the Wechsler Preschool and Primary Scale of Intelligence test at 4 years of age, was significantly higher in group 3 (IQ 98 +/- 9) compared to group 1 (IQ 88 +/- 13; p < 0.05) but not compared to group 2 (IQ 94 +/- 13). However, the IQs were below the normal range (< 85) in six patients from group 2 (28%), but in none of the patients from group 3 (p = 0.03). Patients from group 3, with severe CH at diagnosis, had an IQ (97 +/- 9) at 4 years of age, which was not different from that of patients from the same group with moderate CH at diagnosis (IQ 99 +/- 9). Similar results were also observed in patients from group 2 however, mean IQ scores in these patients (93 +/- 12) were several points lower than those observed in patients from group 3 (95 +/- 15). After the first month of treatment, optimal serum levels of thyroxine (T4) and free thyroxine (FT4) were achieved in all groups, however, only patients from group 3 were able to normalize thyrotropin (TSH) (group 1, 16.0 +/- 12.0; group 2, 9.2 +/- 10.0; and group 3, 2.4 +/- 3.3 mU/L; p < 0.0001). Twelve patients from group 2 treated with an initial LT4 dose above 9 microg/kg per day were able to normalize TSH levels within the first 3 months of life and this resulted in a better IQ (97 +/- 16) compared to the remaining patients from the same group (IQ 90 +/- 9). In the whole group of 83 patients the IQ at 4 years of age was positively correlated to both initial LT4 dosage (r = 0.27, p < 0.02) and FT4 concentrations after the first month of treatment (r = 0.29, p < 0.02), and negatively correlated to TSH concentrations after the first month of treatment (r = -0.27, p < 0.02). No significant differences were observed in height, weight, head circumference, and bone age maturation among the three groups of patients. No clinical signs or symptoms of overtreatment were observed during follow-up in patients receiving the higher LT4 dosage. Our results indicate that high LT4 starting doses rapidly normalize serum TSH concentrations resulting in an improvement of the IQ at 4 years of age, even in patients with severe CH at diagnosis. Growth and bone age maturation are not affected by such a high dose.

Body Height↗
PubMed1970

Sequelae of neonatal jaundice.

A total of 371 newborn infants falling into 3 groups, non-haemolytic jaundice, haemolytic jaundice, and non-jaundiced controls, have been reassessed in the 6th year of life as regards neurological, audiological, and psychological function. Neurological handicap was concentrated among the infants of low birth weight and was not related to jaundice, apart from one case of athetoid cerebral palsy with deafness. No other cases of perceptive deafness were discovered. Intelligence testing on the Stanford Binet scale showed no relation between depth of jaundice and I.Q.These findings support the majority of reports in the literature that reduction in intelligence does not occur in non-haemolytic jaundiced babies with serum bilirubin below about 20 mg./100 ml. In haemolytic jaundice slight doubt remains. There is no indication for changing present standards for exchange transfusion.

Anemia, Hemolytic↗