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PubMed1992

[Study on the relationship between toddler temperament and development (second report)--the relationship between toddler temperament and developmental delay].

The purpose of this study is to clarify the relationship between toddler temperament and developmental delay, and to examine whether the result could be adapted to the health practice of mother and child. As the conceptual framework, we used A. J. Sameroff's transactional model. Questionnaires concerning toddler temperament, rearing environment and toddler development were sent to mothers whose children were scheduled to receive 1 year and 6 months child health examinations, and collected 306 responses. We assessed the developmental status of 41 children among the 306 by means of the Japanese edition of the Denver Developmental Screening Test. All 306 children were classified into either the developmental delayed group (30) or the normal group (275). The data analyses were conducted both quantitatively and qualitatively with the following results. Compared with normal children, developmentally delayed children showed these characteristics: (1) The temperamental category scores of adaptability and persistence were higher, indicating low adaptability and persistence. The prevalence of difficult child, slow to warm up (STWU) child and intermediate high child was relatively higher, with STWU child the highest. (2) The score for the rearing environment was lower. (3) There were cases where disagreement between a child's temperament and the mother's rearing behavior had an influence on the child's development. As a conclusion, these results indicate that a child's temperament must be considered developmental and child-rearing counseling in child health examinations.

Child, Preschool↗
PubMed2000

Urinary tract infections during pregnancy and mental retardation and developmental delay.

OBJECTIVE: To investigate the association between urinary tract infections during pregnancy and mental retardation or developmental delay in infants. METHODS: An inception cohort design was used to analyze Medicaid maternal and infant-linked records and vital records for 41,090 pregnancies from 1995-1998. RESULTS: The relative risk (RR) for mental retardation or developmental delay among infants of mothers with diagnosed urinary tract infections but no antibiotic claims was 1.31 with a 95% confidence interval (CI) of 1. 12, 1.54 compared with the group without urinary tract infections. The RR for infants of mothers with urinary tract infections without antibiotic claims was 1.22 (95% CI 1.02, 1.46) compared with infants of mothers with urinary tract infections and antibiotic claims. The RR was significant in the first trimester (1.46, 95% CI 1.07, 1.99) and third trimester (1.41, 95% CI 1.11, 1.79) after controlling for race and gestational age at birth. CONCLUSION: There was a statistically significant association between maternal urinary tract infections without evidence of antibiotics and mental retardation or developmental delay in infants. The relationship persisted when we assumed that over 30% of women who had antibiotic claims filled but did not take the medicine, and 40% of the women who did not have antibiotic claims did take the medication.

Adolescent↗
PubMed1983

The effects of developmental delay on sustained attention in young children.

The development of developmentally delayed young children is similar to that of normal children in sequence and organization. The hypothesis of this research was that delayed children do differ from the norm when tasks involve discerning nuances, balancing competing stimuli, or acquiring and retaining selected information. Using a videotaped free-play situation, we examined attention deployment behaviors of 3 groups: normally developing (ND), Down syndrome (DS), and developmentally delayed with uncertain etiology (UE). Gesell DQ scores ranged from 50 to 75 in the latter 2 samples. In Study 1, infants had developmental ages of 12-24 months. The UE subjects spent less time engaged with toys than ND or DS subjects, and both delayed groups had less simultaneous appraisal of the environment, more time unoccupied in any way, and more throwing behavior than the ND group. In Study 2, at the 22-30-month developmental age range, DS and UE subjects had patterns of play that included many primitive activities such as banging and mouthing. Taken together, the results show reductions in ongoing acquisition and elaboration of information during play; these in turn may have significant developmental ramifications.

Attention↗
PubMed2003

How do primary care physicians identify young children with developmental delays? A national survey.

Little is known about the current practices of primary care physicians regarding developmental surveillance and screening during pediatric preventive care visits. We conducted a mailed survey of a random national sample of pediatricians and family physicians to describe their practices and identify factors that predict use of developmental screening tools, an efficacious way of identifying children with developmental delays. Most physicians reviewed developmental milestones and prompted parents for developmental concerns at preventive care visits. Approximately half of the physicians used a formal developmental screening instrument. Female physician gender predicted higher rates of use of screening tools for family physicians, but not for pediatricians. Most physicians seemed committed to the early diagnosis of developmental delays. Substantial variability in surveillance and screening practices, barriers of time and reimbursement, and under-reliance on parent-completed questionnaires underscore areas for improvement.

Adult↗
PubMedDate not supplied

A clinical analysis of children with developmental delay.

The purpose of this study was to identify the functional domains and etiological risk factors of children with developmental delay (DD). During a 41-month period, a retrospective chart review was carried out on all 1192 patients who visited pediatric clinics for evaluation of developmental delay or behavioral problems. Etiological risk factors or associated disorders were identified after the completion of clinical evaluation and a series of laboratory investigations. Clinical psychologists examined the functional domains of those patients who underwent developmental and psychological assessments. Those children who met the criteria of DD were subdivided into six functional subtypes, including cognitive, motor, language, social adaptation, global and non-specific developmental delay. A total of 1192 children were diagnosed as DD, 86.7% had cognitive DD, 58.4% had language DD and 47.9% had motor DD. Of 1192 children, 831 were male, and the ratio male to female was 2.3 to 1. Only 20.5% (244) of children had identifiable etiological risk factors and 35.6% (424) had associated disorders. Results showed DD was more prevalent in males, and cognitive delay was the most common subtype. Identifying the etiological risk factors of DD remains difficult because of its heterogeneity.

Autistic Disorder↗
PubMed1996

Social responsivity: judging signals of young children with and without developmental delays.

This was an experimental study of the ability of adults to detect 1 social signal that is important in social interactions, children's glances or looks at their social partners. Adult judges were either parents of children with developmental delays, parents of nondelayed children, or nonparents with little experience with children. Each participant viewed 120 videotaped episode in which very young children's looks (of 2 types, either a focus on parent's face or nonface focus) occurred or no looking occurred. Half the episodes featured children with documented developmental delays and half featured nondelayed children. Participants made judgments about the occurrence of a look in each episode and rated their confidence in each judgment. Participants made more accurate and quicker responses to social looks by children without than those with developmental delays. Accuracy effects were qualified by interactions with type of look. Participants were more confident of their judgments of looks for nondelayed toddlers than those with delays. Signal detection statistics indicated that looks of delayed toddlers were harder to identify and that judges set a more stringent criterion for responding to those looks. No effects of judges' level of experience with delayed or nondelayed children were found. Implications of these findings for social interaction involving individuals with developmental delays are discussed.

Adult↗
PubMed1990

Do parental questions and topic continuations elicit replies from developmentally delayed children? A sequential analysis.

This sequential analysis tested the relative extent to which several adult utterance types elicited conversational replies from developmentally delayed children. Eight developmentally delayed children in Brown's stages I and II and their primary parents were the subjects. Parent-child pairs were video and audio taped during their interactions with experimenter-provided toys in a lab setting. Transcripts of the interactions were coded for adult topic relatedness and obligation level and for child topic relatedness, length, and intelligibility. The results indicated that child replies of any length were elicited by adult topic continuations more than by any other adult utterance type. If a new topic was initiated, explicit prompts for child talk elicited child replies more than other adult utterance types. Multiword child replies were most likely to be elicited by explicit prompts that continued the child's topic. Child effects on the presence and effectiveness of adult conversational recruiting strategies were also tested.

Child↗
PubMed2005

Global developmental delay, osteopenia and ectodermal defect: a new syndrome.

UNLABELLED: Global developmental delay is a serious social problem. It is often unrecognized and the phenotypes are inadequately studied. To investigate the phenotypes of children with aspecific central nervous system (CNS) impairment (poor speech, maladaptive behavioral symptoms such as temper tantrums, aggressiveness, poor concentration and attention, impulsiveness, and mental retardation). SETTING: Tertiary care hospital. PATIENTS: Three children (two male siblings, and one unrelated girl). METHODS: We used the results from clinical neurological evaluations; imaging and electrodiagnostic studies; metabolic and genetic tests; skin biopsies and bone mineral densitometry. All three children suffered from (A) global developmental delay, (B) osteopenia, and (C) identical skin defects. The skin ultrastructural abnormalities were abnormal keratin differentiation, consisting of hyperkeratosis and granular layer thickening; sweat gland abnormalities, consisting of focal, cytoplasmic clear changes in eccrine secretory cells; and melanocyte abnormalities, with both morphological changes (reduced number and size without evident dendritic processes), and functional changes (defects in the migration of melanosomes in the keratinocytes). These patients present a previously unrecognized syndrome. We retain useful to report this new association, to be recognized, in the next future, as a specific key-sign of a well-defined genetic defect.

Biopsy↗
PubMed1995

Diagnostic yield of the neurologic assessment of the developmentally delayed child.

OBJECTIVE: The aim of this study was to determine the etiologic yield of the neurologic assessment of a consecutive cohort of developmentally delayed children. STUDY DESIGN: A retrospective chart review was carried out on all patients referred to a single university-based pediatric neurologist for evaluation of global developmental delay from July 1991 to December 1993. Patients referred because of isolated speech or motor delay or autism or those who had been previously evaluated by another neurologist were excluded. RESULTS: A total of 77 patients were identified; 47 were male, and 62 were referred by a pediatrician. Neurologic evaluation did not confirm global delay in 10, and 8 did not complete diagnostic evaluation; one child was included in both groups. Of the remaining 60, an etiologic diagnosis was suspected by the referring physician at the time of referral in 13. Although parents suspected a delay at a mean age of 0.66 (+/- 0.69) year, children were examined by the neurologist at a mean age of 3.58 (+/- 2.42) years. Twenty-five were mildly delayed, 23 were moderately delayed, and 12 were severely delayed. Diagnostic studies (history, physical examination, and selected investigations, including screens for metabolic disease, karyotype, fragile X testing, electroencephalography, and neuroimaging) yielded an etiologic diagnosis in 38 (63.3%) of the 60 patients. Etiologic categories included cerebral dysgenesis (16.7%), hypoxic-ischemic encephalopathy (10.0%), chromosomal abnormalities (10%), toxins (8.3%), metabolic disorders (5.0%), and neurocutaneous (3.3%), neuromuscular (3.3%), genetic/dysmorphic (3.3%), and epileptic (3.3%) syndromes. Etiologic yield was equivalent across categories and degree of developmental delay. CONCLUSION: Referral to a pediatric neurologist and application of a selected battery of investigations yield etiologic findings with important implications with respect to management, prognosis, and recurrence risk estimate in a significant portion of globally delayed children.

Child, Preschool↗
PubMed1992

Treatment of elective mute behavior in two developmentally delayed children using modeling and contingency management.

Most classification schemes differentiate elective mutism from language problems seen in the developmentally delayed population. Two preschool developmentally delayed children were treated for speech reluctance using modeling and contingency management. Employing a multiple baseline across therapists, it was found that these treatment components were effective in increasing frequency of labeling behavior in both children. Results were maintained at follow-up. Generalization to new words and to spontaneous speech were also noted, and suggest that characteristics of elective mutism in this population may be similar to what is found in the general population.

Child Language↗
PubMed1990

Comparison of constant time delay and the system of least prompts in teaching preschoolers with developmental delays.

This investigation compared the effectiveness and efficiency (sessions, errors, percent of errors, and minutes of instructional time through criterion) of constant time delay and the system of least prompts in teaching sight words to developmentally delayed preschoolers. Maintenance of sight words and generalization across instructors and materials were assessed. Also, students' acquisition of relationships between the target behavior and previously learned information were assessed. Two sessions were conducted each day in their classroom, one with each procedure. Two of the children were taught 16 words and one child learned 12 words. The parallel treatments design was used to assess the effectiveness of the two instructional strategies. The results indicated that (a) both strategies produced criterion level responding in the instructional setting, (b) constant time delay resulted in fewer total trials, errors, percent of errors, and minutes of direct instructional time through criterion than the system of least prompts, (c) both strategies produced criterion-level responding that maintained in 1-, 3- and 5-week follow-up probes, (d) both strategies resulted in generalization across instructors and materials, and (e) both strategies resulted in cross-modal generalization from expressive to receptive, receptive and expressive identification of the words' function or action, and matching the written word to a photograph of its referent.

Attention↗
PubMed1992

Child developmental delay and socio-economic disadvantage in Australia: a longitudinal study.

Socio-economic inequalities in adult and child health in Australia have been an issue of national concern. While a large body of data has discussed adult health, there have been relatively few Australian reports of socio-economic inequalities in child health. This occurs in a context where there have been increases in the proportion of Australian children living in poverty and where there has been an increased interest in child developmental delay as an indicator of child health status. This paper reports the result of a longitudinal study of pregnancy outcomes and one indicator of child health, namely child developmental delay. Three indicators of socio-economic status (chronic socio-economic disadvantage, mother's education, family income) were used to predict child developmental delays observed some 5 1/2 years after the study commenced. Mothers who had the lowest socio-economic status (using any of the indicators) had substantially higher rates of children manifesting developmental delays.

Australia↗
PubMed2006

KCNJ11 activating mutations are associated with developmental delay, epilepsy and neonatal diabetes syndrome and other neurological features.

Heterozygous activating mutations in the gene encoding for the ATP-sensitive potassium channel subunit Kir6.2 (KCNJ11) have recently been shown to be a common cause of permanent neonatal diabetes. Kir6.2 is expressed in muscle, neuron and brain as well as the pancreatic beta-cell, so patients with KCNJ11 mutations could have a neurological phenotype in addition to their diabetes. It is proposed that some patients with KCNJ11 mutations have neurological features that are part of a discrete neurological syndrome termed developmental Delay, Epilepsy and Neonatal Diabetes (DEND), but there are also neurological consequences of chronic or acute diabetes. We identified KCNJ11 mutations in four of 10 probands with permanent neonatal diabetes and one affected parent; this included the novel C166F mutation and the previously described V59M and R201H. Four of the five patients with mutations had neurological features: the patient with the C166F mutation had marked developmental delay, severe generalised epilepsy, hypotonia and muscle weakness; mild developmental delay was present in the patient with the V59M mutation; one patient with the R201H mutation had acute and chronic neurological consequences of cerebral oedema and another had diabetic neuropathy from chronic hyperglycaemia. In conclusion, the clinical features in these patients support the existence of a discrete neurological syndrome with KCNJ11 mutations. The severe DEND syndrome was seen with the novel C166F mutation and mild developmental delay with the V59M mutation. These features differ markedly from the neurological consequences of acute or chronic diabetes.

Adolescent↗
PubMed1993

Conversational roles of children with developmental delays and their mothers in natural and semi-structured situations.

The pragmatic characteristics of conversations between mothers and their preschool children with developmental delays were examined in both naturally occurring and researcher-introduced semi-structured situations in the home, using a spot observation time-sampling technique. There were significant differences between natural and semi-structured situations in the proportions of conversational turns taken and in the pragmatic functions of utterances of mother and children with developmental delays. The type of activity occurring within the structured and natural situations also appeared to influence the nature of the interaction. Results were discussed in terms of the differential goals and interpretations of their conversational roles that mothers of children with developmental delays hold in researcher-introduced versus everyday interaction.

Adult↗
PubMed1994

Generalizing spontaneous language in developmentally delayed children via a visual cue procedure using caregivers as therapists.

Developmentally delayed children are recognized by deficits in language, motor skills, and social interaction. The importance of this topic is demonstrated by the fact that many studies have focused on increasing different aspects of this population's language. New training elements for this population were used here (e.g., the visual cue method was used in home settings). Caregivers were trained as therapists to teach children spontaneous speech by targeting two behaviors. The visual cue method was effective for increasing spontaneous speech in developmentally delayed children in the home. This finding is significant in that home training with caregivers promoted generalization of language by programming common stimuli. Implication of these data for future research is discussed.

Caregivers↗
PubMed2004

Co-occurrence of developmental delays in a screening study of 4-year-old Finnish children.

The aim of this population study was to examine the severity and prevalence of co-occurring developmental delays in 4-year-old children, the rate of overlapping problems, and sex differences. A sample of 434 children (196 males, 238 females; mean age 4 years 3 months, SD 1 month) were administered the 'Lene' test: a comprehensive neurodevelopmental screening test. Results suggest that co-occurrence of attention-behavioural, motor-perceptual, and language delays occurring in school-aged children could already be detected at the age of 4 years. Isolated delays were usually mild, but co-occurring difficulties were mostly moderate or severe. Overlap between developmental delays depended on the severity of the problems. It emerged that males had more severe and more often co-occurring problems than females. Co-occurrence of developmental delays as a risk factor at the early stage of development is discussed.

Catchment Area, Health↗
PubMed2006

The visual regulation of goal-directed reaching movements in adults with Williams syndrome, Down syndrome, and other developmental delays.

Williams syndrome (WS) is a genetic disorder that causes general cognitive and developmental delays. Compared to persons with Down syndrome (DS) at the same developmental level, individuals with WS generally exhibit superior expressive language abilities, but have difficulty with tasks that require the visual control of movement. Recently it has been suggested that this latter problem reflects a deficit in dorsal stream function. In the present study, this hypothesis was investigated by examining the kinematics of rapid aiming movements. The performance of the participants with WS (n=4) was compared to the performance of participants with DS (n=8), with undifferentiated developmental delays (n=8), and from the general population (n=8). In partial support of the dorsal deficit hypothesis, the results suggest that, compared to people from the other groups, the participants with WS had difficulty in preparing their movements on the basis of the visual and other information available to them. This was particularly evident in their inability to properly scale movement velocities to the amplitude of the movements and in the number of discrete corrections made during movement execution.

Adult↗
PubMed1990

Comparability of the Vineland Social Maturity Scale and the Vineland Adaptive Behavior Scale--survey form with infants evaluated for developmental delay.

The Vineland Social Maturity Scale and its revision, the Vineland Adaptive Behavior Scale-Survey Form, were evaluated with infants referred for suspected developmental delay. Since the latter is being used more often by psychologists in evaluation and placement of children in the age group of birth to two years, comparative studies must ensure appropriate placement of children observed to have developmental delays. The present study indicated significantly higher over-all adaptive functioning on the Vineland Adaptive Behavior Scale-Survey Form for 33 black and 11 white infants of mean age 12 mo. than on the original Vineland scales. Substituting the Survey Form for the original Vineland scales when evaluating developmentally delayed infants is questionable. These results are also noteworthy in that children whose Vineland Social Maturity scaled scores make them eligible for special services would be excluded if the revised form were used in the evaluation process.

Child, Preschool↗