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PubMed2005

Offspring of anxious parents: reactivity, habituation, and anxiety-proneness.

Reactivity and habituation patterns were examined in the offspring of anxious and non-anxious parents. Although no differences emerged for magnitude of response to either fear-relevant visual or auditory stimuli, offspring of anxious parents displayed significantly more electrodermal activity during resting baseline and during the inter-trial intervals of these stimulus presentations. Differences also were observed for the number of children per group achieving habituation to the fear-relevant visual and auditory stimuli, where offspring of anxious parents were less likely to habituate to either stimuli. The same pattern of group differences emerged after excluding children diagnosed with an anxiety disorder, indicating that even offspring of anxious parents who did not have an anxiety disorder differ from offspring of normal controls with respect to their pattern of psychophysiological reactivity. It is hypothesized that these features might serve as an indication of anxiety proneness and risk for the development of anxiety disorders.

Adult↗
PubMed1982

Clinical use of temperament data in paediatrics.

Temperament data can aid the clinician in fostering parent-child relationships on three levels. First, general educational discussions about temperament between the clinician and parents provide background information, which increases parents' awareness and understanding of individual differences. Second, identification of the temperament profile of the particular child provides the parents with a more organized picture of the child's behavioural style and of possible distortions in their perceptions of its. This is primarily useful to the clinician when the child is rather difficult or when, for example the mother's perception of the child makes the child seem more difficult than her own ratings suggest. This clarification process may provide parents with enough insight for them to make their own shifts in interaction patterns. Third, the clinician may attempt to influence the temperament-environment interaction, when its dissonance is leading to reactive symptoms, by suggesting alternative methods of parental management. If this is successful, the stress of the interaction should diminish and the reactive symptoms disappear. At the same time parents the teachers must learn to live in a more tolerant and flexible manner with the child's relatively less changeable temperament.

Child↗
PubMed2002

Brief report: postural reactivity to fast visual motion differentiates autistic from children with Asperger syndrome.

The aim of the present study was to search for a sensorimotor marker (i.e., visuopostural tuning) that could be correlated with the severity of motor impairments in children with autistic spectrum disorders. Given that autistic children were previously reported to be posturally hyporeactive to visually perceived environmental motion in comparison with normal control children (Gepner et al., 1995), we sought to determine whether children with Asperger syndrome (AS) would share the same postural hyporeactivity to visual motion. Three autistic children with mild to severe motor impairments, three AS children with soft motor signs, and nine normal control children were tested for overall postural instability and postural reactivity to environmental motion. Results indicate, first, that overall postural instability is significantly reduced in autistic children compared with both AS and normal children. Second, although postural oscillations in the fore-aft axis become more attuned to the oscillation frequency of an immersive dynamic visual display as visual speed is increased, in both control and AS subjects, this is not the case in autistic children. Despite the small number of subjects tested in this study, our data confirm the existence of a visuopostural detuning in autistic children. Third, they argue for a correlation between visuopostural tuning and severity of motor signs in children with autistic spectrum disorders. Finally, they suggest a differentiation between children with autism and children with AS with regard to postural reactivity to fast visual motion. Neurophysiological implications of these results are discussed. In particular, a visuocerebellar pathway deficit hypothesis in autism is proposed.

Asperger Syndrome↗
PubMed1980

A review of psychophysiology in early onset psychosis.

Research on psychophysiological functioning in early onset psychosis is reviewed within the context of etiological formulations stressing perceptual and selective attention abnormalities. Electroencephalographic (EEG) measures, including resting EEG level, alpha blocking, average evoked response, and contingent negative variation, have received most attention in the literature; cardiovascular and electrodermal indices have not been so extensively explored in this group of children. While the nature of differential reactivity in early onset psychosis has not been thoroughly investigated, limited evidence suggests that the central behavioral anomalies associated with the condition may result from abnormal neurophysiological reactivity to sensory stimulation. Further studies of the psychophysiological functioning of these children should yield data useful in the clarification of etiology.

Adolescent↗
PubMed2000

Atypical symptoms of depression in a sample of depressed child and adolescent outpatients.

OBJECTIVE: To examine the presence of symptoms of atypical depression among children and adolescents with a major depressive disorder (MDD). METHOD: One thousand forty-six youths (aged 6-19 years) meeting DSM-III-R criteria for MDD were included in the study. All subjects had presented at an outpatient clinic seeking treatment and were identified as having MDD via clinical interviews using the semistructured Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present Episode (K-SADS-P) with the youngster themselves and a parent/guardian. A diagnosis of atypical depression was derived from the symptoms of depression assessed in the K-SADS-P and required the presence of mood reactivity and at least one the following symptoms: hypersomnia, increased appetite, weight gain, or psychomotor retardation (substituted for leaden paralysis). RESULTS: One hundred sixty-two (15.5%) of the depressed youths met criteria for atypical depression. The symptoms of atypical depression were found to correlate marginally, and the diagnosis of atypical depression had marginal construct validity for both children and adolescents. CONCLUSIONS: The findings from this large sample of depressed children and adolescents suggest that atypical features of depression occur in this age group. However, the diagnosis of atypical depression appears to have only marginal construct validity for both children and adolescents.

Adolescent↗
PubMed1989

Full circle or forward.

In the early 70s when a parent with abuse problems named Jolly K. sought help to stop her abusive behavior, there were no services for parents. Today, nearly two decades later, there has not been much improvement with regard to the provision of services for parents. Our belief is that the dichotomy which occurred early in the field's development between those who were for the child, and those (such as Parents Anonymous) who sought to provide services to parents and were presumed to be for the parent and implicitly against the child is largely responsible for an ever more punitive approach to the problem. The solution lies in shifting our focus away from the exclusive mandate to protect the child towards support for the family unit. Such a shift should include expanding the knowledge base of the field by the inclusion of information from fields such as alcoholism, spouse abuse, and eating disorders, as well as by advocating for services which support the family. Research into the part that neuro-chemistry plays in violence should also be undertaken. The impetus for change within the field cannot come from the child protective services (CPS) system, which, as a creature of the law, can only be reactive, not pro-active. Professionals working outside the CPS system must take responsibility for change if it is to occur.

Brain Chemistry↗
PubMed2002

Joint attention and disorganized attachment status in infants at risk.

The development of joint attention skills is a major milestone of infancy. Recent research suggests that the development of these skills may be affected by disorganized (D) attachment. This hypothesis was examined in a longitudinal study of attachment and joint attention skill development in a sample of infants at risk for developmental-behavioral morbidity. The results revealed that toddlers with D classifications initiated joint attention with an experimenter significantly less often than did secure, or even other insecure, toddlers. However, no group differences in the capacity to respond to the joint attention bids of others were observed in this study. These data suggest that a disturbance in the tendency to initiate episodes of joint attention with others may be indicative of early social-cognitive and social-emotional disturbance among infants affected by disorganized attachment status. Theory and research is reviewed to suggest that an early impairment in joint attention facility may make a significant contribution to risk for negative cognitive and emotional outcomes among these infants.

Attention↗
PubMed2005

Minding the baby a reflective parenting program.

Minding the Baby, an interdisciplinary, relationship based home visiting program, was initiated to help young, at-risk new mothers keep their babies (and themselves) "in mind" in a variety of ways. The intervention--delivered by a team that includes a nurse practitioner and clinical social worker--uses a mentalization based approach; that is, we work with mothers and babies in a variety of ways to develop mothers' reflective capacities. This approach--which is an adaptation of both nurse home visiting and infant-parent psychotherapy models--seems particularly well suited to highly traumatized mothers and their families, as it is aimed at addressing the particular relationship disruptions that stem from mothers' early trauma and derailed attachment history. We discuss the history of psychoanalytically oriented and attachment based mother-infant intervention, the theoretical assumptions of mentalization theory, and provide an overview of the Minding the Baby program. The treatments of two teenage mothers and their infants are described.

Adult↗
PubMed1977

A study of serum antibodies to isolated milk proteins and ovalbumin in infants and children.

Serum antibodies to cow milk proteins and ovalbumin were measured quantitatively. Food hypersensitivity of the immediate type was determined to be present or absent by skin tests and double-blind food challenges. Elevated levels of antibodies to milk proteins in sera characteristic of infants fed cow milk were found to decline with age, so that sera from children who were 6 to 15 years of age (inclusive), not hypersensitive to food, had significantly lower levels than the infants. In contrast, sera from age-matched children, who were shown to have hypersensitivity to some food, were found to have levels of antibodies to milk proteins as elevated as in infancy. Hypersensitivity was not necessarily to milk but often to some other food. This persistence of greater antibody production to milk throughout childhood in those hypersensitive to some food indicates a fundamental difference from those without hypersensitivity to food, either in permeability, in immunological reactivity of the gut or in development of immunological unresponsiveness. Implications for pathogenesis of clinical disorders are discussed.

Adolescent↗
PubMed2004

[Differential diagnosis of absolute lymphocytosis].

The differential diagnosis of absolute lymphocytosis is variegated. In general, reactive (secondary) lymphocytosis can be well differentiated from a lymphoproliferative disease (primary lymphocytosis). Together with correspondent clinical characteristics, an absolute lymphocytosis often suggests a potential diagnosis and the further diagnostic process. Reactive lymphocytosis is usually self limiting and normalizes after cessation of the inflammatory stimulus. If a lymphoproliferative disorder is suspected further diagnostic procedures (i.e. cytometry, bone marrow examinations, biopsies of other organs if needed and molecular analyses) should be performed. If the distinction between malignant lymphoproliferation and reactive lymphocytosis cannot be done immediately, a watch and wait strategy may be implemented. In case of persistent lymphocytosis for longer than six months or occurrence of additional symptoms earlier on, diagnosis should be forced.

Adolescent↗
PubMed1991

Critical issues for practice in residential treatment: the view from within.

A large proportion of children in residential treatment engage in extreme acting-out behavior and suffer from severe attachment disorders and abuse reactivity. At the same time, practice is increasingly alienated from theory and public policy. The challenges to practitioners posed by these difficulties are described and illustrated by vignettes, their impact on residential group care practice is discussed, and their implications for the redesign of practice and for the development of a new theoretical base are examined.

Acting Out↗
PubMed1985

Ocular findings in incontinentia pigmenti.

Incontinentia pigmenti is an uncommon disorder affecting females, and is associated with ocular, dental, skeletal, and central nervous system abnormalities. Ocular abnormalities are found in 35% of cases. The authors present an eight-month-old girl with neonatal history of skin bullae, who was noted to have esotropia, leukocoria, and a fixed pupil. Histologic examination of the enucleated globe reveals total retinal detachment with retinal neovascularization into the collapsed vitreous, reactive retinal gliosis, and scattered giant nodular proliferations of retinal pigment epithelium. It is suggested that the underlying defect is at the level of the retinal pigment epithelium and that the neurosensory retinal changes are secondary.

Child Development↗
PubMed2001

Sensory modulation dysfunction in children with attention-deficit-hyperactivity disorder.

This study investigates the presence of sensory modulation dysfunction (SMD) among children with attention-deficit-hyperactivity disorder (ADHD). Twenty-six children with ADHD (mean age 8.3 years, 18 males, 8 females), and 30 typically developing children (mean age 8.2 years, 21 males, 9 females) were tested using a laboratory procedure that gauges responses to repeated sensory stimulation by measuring electrodermal reactivity (EDR). Parental report measures of limitations in sensory, emotional, and attentional dimensions were administered using the Short Sensory Profile, the Leiter International Performance Scale-Revised, Parent Rating subscales, and the Child Behavior Checklist (CBCL). Compared to the typical sample, the children with ADHD displayed greater abnormalities in sensory modulation on both physiological and parent-report measures. The children with ADHD also displayed more variability in responses. Within the group with ADHD, levels of SMD were highly correlated with measures of psychopathology on the CBCL. Implications of findings relate to the importance of considering sensory processing abilities in a subgroup of children with ADHD.

Adolescent↗
PubMed2003

Feeding behavior problems in children with cystic fibrosis in the UK: prevalence and comparison with healthy controls.

BACKGROUND: Feeding behavior problems contribute to inadequate dietary intake for many patients with cystic fibrosis (CF). However, to establish effective intervention programs, more needs to be known about the occurrence and distribution of these difficulties. The aims of this study were to establish the prevalence and range of disruptive child behaviors (DCB) in patients with CF and the inappropriate parental responses (IPR) during mealtimes and to compare the results with those of healthy children. METHODS: In study A, parents of 108 patients (aged 1-7 years) completed a Behavioural Paediatric Feeding Assessment Scale comprising two domains: DCBs and IPRs during mealtimes. Parents rated the frequency of the behaviors and responses and identified those they considered problematic. In study B, data from the CF group (n = 69, aged 1-12 years) were compared with 69 age- and sex-matched control subjects. RESULTS: Parents of children with CF aged 5 to 8 years recorded significantly more DCBs than those in all other age ranges. These parents also reported significantly more IPRs than did parents of children aged 9 to 12 years and 13 to 17 years. Parents of children with CF reported significantly more DCBs and IPRs than did those of the control subjects. There were significantly more problematic DCBs and IPRs in the CF group than in the control group for children aged 5 to 8 years and 9 to 12 years but not for those aged 1 to 4 years. CONCLUSIONS: Parents of children with CF report more feeding behavior problems than do those of healthy control subjects. The high prevalence of feeding behavior problems in older children suggests that preventative and reactive interventions must continue throughout childhood and vary according to the child's developmental abilities.

Adolescent↗
PubMed1985

Clinical use of temperament data in pediatrics.

Temperament data can aid the clinician in fostering parent-child relationships on three levels. First, general educational discussions about temperament between the clinician and parents provide background information, which increases parents' awareness and understanding of individual differences. Second, identification of the temperament profile of the particular child provides the parents with a more organized picture of the child's behavioral style and of possible distortions in their perceptions of it. This is primarily useful to the clinician when the child is rather difficult or when, for example the mother's perception of the child makes the child seem more difficult than her own ratings suggest. This clarification process may provide parents with enough insight for them to make their own shifts in interaction patterns. Third, the clinician may attempt to influence the temperament-environment interaction, when its dissonance is leading to reactive symptoms, by suggesting alternative methods of parental management. If this is successful, the stress of the interaction should diminish and the reactive symptoms disappear. At the same time parents and teachers must learn to live in a more tolerant and flexible manner with the child's relatively less changeable temperament.

Achievement↗
PubMed1994

Epidemiology of physician-diagnosed allergic rhinitis in childhood.

OBJECTIVE: To investigate the natural history of and risk factors for allergic rhinitis in the first 6 years of life. METHODS: Parents of 747 healthy children followed from birth completed a questionnaire when the child was 6 years old. Data were obtained regarding physician-diagnosed allergic rhinitis (PDAR), associated symptoms, and age at onset. Risk-factor data were taken from earlier questionnaires, and data regarding immunoglobulin E (IgE) and skin-test reactivity were obtained at age 6. RESULTS: By the age of 6, 42% of children had PDAR. Children whose rhinitis began in the first year of life had more respiratory symptoms at age 6 and were more likely to have a diagnosis of asthma. Early introduction of foods or formula, heavy maternal cigarette smoking in the first year of life, and higher IgE, as well as parental allergic disorders, were associated with early development of rhinitis. Risk factors for PDAR that remained significant in a multivariate model included maternal history of physician-diagnosed allergy (odds ratio: 2.2, 95% confidence interval: 1.35-3.54), asthma in the child (4.06, 2.06-7.99), and IgE greater than 100 IU/mL at age 6 (1.93, 1.18-3.17). The odds for atopic as opposed to nonatopic PDAR were significantly higher only among those with high IgE and those who had dogs. CONCLUSION: Allergic rhinitis developing in the first years of life is an early manifestation of an atopic predisposition, which may be triggered by early environmental mental exposures.

Age of Onset↗
PubMed1995

Multiple clonal chromosome aberrations in a case of childhood focal nodular hyperplasia of the liver.

A case of focal nodular hyperplasia is described that was accompanied by intense reactive stromal changes giving rise to a pseudosarcomatous appearance. Cytogenetic study revealed complex karyotypic abnormalities including five partially identifiable clonal aberrations and one marker chromosome. The composite karyotype was interpreted as: 45-46,XY,add(4)(q21-25)[24], add(11)(p14)[24], add (19)(p13)[15], der(20)t(1;20)(q25;p12)[31], add(21) (q22)[13],-22[3], +mar[2][cp31]. In addition, quadriradial or complex figures, telomeric associations tas, unidentified ring chromosomes, chromosome breaks, and markers were seen in some cells. Such cytogenetic findings, although suggestive of malignancy, could most likely be related to a nonneoplastic condition, i.e., the unusual florid reactive changes associated with this focal nodular hyperplasia.

Child, Preschool↗