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Low birth weight, developmental milestones, and behavioral problems in Chinese children and adolescents.

This study examined the association of low birth weight (LBW) and developmental milestones with behavioral and emotional problems in a general population sample of 3344 Chinese children and adolescents aged 6-16 years in 1997. Parents completed a self-administrated questionnaire including information about birth weight and developmental milestones (i.e. lifting the head up, tooth eruption, speech, walking and bedwetting cessation), and the Child Behavioral Checklist (CBCL). Teachers completed the Teacher's Report Form (TRF) to assess classroom behavior problems. Results indicated that LBW and delayed developmental milestones were significantly associated with an increased risk for almost all parent- and teacher-reported behavioral problems after controlling for the potential effects of child's gender, age and birth order, parental ages at birth, education, occupation, complications at birth and number of children in the family. LBW was significantly associated with delay in achieving all developmental milestones including lifting of the head, tooth eruption, sitting without support, walking without help, speech as saying words with meaning, and bedwetting cessation. It is concluded that LBW and delayed early childhood development may predict the occurrence of a wide range of behavioral and emotional problems in later childhood and adolescence.

Adolescent↗

Peer-related communicative competence of preschool children: developmental and adaptive characteristics.

The peer-related communicative interactions of nonhandicapped 3- and 4-year-old children as well as a group of 4-year-old mildly developmentally delayed children were investigated in a cross-sectional descriptive study. Adjustments of speakers to companions varying in terms of chronological age and developmental status were of interest, as were comparisons among the three groups. All three groups made adjustments in communicative functions (directives and information statements), interactive style (strong and joint directives), and communications involving affect (disagreements), but only to mildly delayed children. Adjustments to mildly delayed children were more closely related to interpersonal and social status factors than to children's developmental levels. The communicative interactions of mildly delayed children were highly similar to the developmentally matched nonhandicapped group on all measures except for a lower level of speech complexity. Significant differences between 3- and 4-year-old nonhandicapped children were obtained only for measures of speech complexity.

Affect↗

Soto's syndrome with bilateral hydronephrosis and hydroureters.

Soto's syndrome, also known, as cerebral gigantism is a rare syndrome characterized by large size, large head and early psychomotor delay. Major diagnostic criteria include facial dysmorphisms, advanced bone age and developmental delay. Herein, a case of Soto's syndrome with rare finding of bilateral hydronephrosis and hydroureters is being reported.

Developmental Disabilities↗

Taking advantage of early diagnosis: preschool children with the 22q11.2 deletion.

PURPOSE: The purpose of this study is to review the neurodevelopmental outcome of infants and preschoolers with a 22q11.2 microdeletion and to discuss the our clinical observations of clinical implications for educational and therapeutic interventions. METHODS: One hundred twelve children (4 to 70 mos) with the 22q11.2 deletion were assessed using standardized tests (Bayley Scales of Infant Development-II, Preschool Language Scales, Wechsler Preschool and Primary Scales of Intelligence-Revised). RESULTS: Fifty-four percent of the children were significantly delayed, 24% had mild delay, 22% had average cognitive development, and 80% were below average in language development. Delays are not explained by cardiac defects or palatal defects. CONCLUSION: Developmental delays, mild hypotonia, language and speech delays, and feeding disorders are common, and this finding indicates the need for early intervention services beginning in infancy for children with the 22q11.2 deletion.

Abnormalities, Multiple↗

Deafness: ever heard of it? Delayed recognition of permanent hearing loss.

Records of approximately 1,000 children seen for evaluation of developmental delay during the period July 1979 to December 1985 were reviewed; 46 children with permanent hearing loss were identified. Age at diagnosis of deafness and factors contributing to delay in diagnosis were sought. Mean age at diagnosis of profound congenital deafness was 24 months. Lesser degrees of congenital hearing loss were not diagnosed until 48 months of age. High-risk medical history or physical anomalies associated with embryologic abnormalities of the auditory system that should have triggered a prompt search for deafness went unheeded in most instances. In 40% of subjects, the author was the first to diagnose hearing loss. For two thirds of this subgroup, audiologic referral was prompted by medical, physical, or developmental findings rather than clinically evident hearing loss during physical examination. Adherence to specific historical, physical, or developmental risk criteria, regardless of the examiner's subjective impression of how well the child seems to hear, would have permitted the timely diagnosis of hearing impairment in all children in this series.

Child, Preschool↗

Occipital encephalocoeles in 57 Nigerian children: a retrospective analysis.

Fifty-eight patients with occipital encephalocoeles were retrospectively examined. These comprised about one-half of the cases seen and evaluated for treatment at the University College Hospital, Ibadan, Nigeria, between January 1973 and December 1987. There was a female-to-male preponderance of 2:1. Of the patients 91% were treated during infancy. Only one patient was precluded from surgery because his large ulcerated lesion was associated with severe microcephaly and neonatal sepsis, to which he succumbed. About four-fifths of the lesions exceeded 5 cm in diameter. The operative mortality was 6%, all deaths occurring in patients who were neonates at the time of surgery and whose hernia sacs contained brain substance. Clinically apparent hydrocephalus was more frequently encountered postoperatively, than preoperatively. Developmental delay was apparent in 5 of the 13 patients in whom developmental milestones were assessed during follow-up. For most patients, the follow-up period was short, possibly a reflection of the poor prognosis of the disease.

Encephalocele↗

Epilepsy surgery in infants.

PURPOSE: We report 12 infants who had frontal (n = 3), temporal (n = 2), or temporoparieto-occipital (n = 2) resection or functional hemispherectomies (n = 5) at age 2.5-29 (mean 15.3) months for catastrophic epilepsy due to focal cortical dysplasia (n = 5), Sturge-Weber syndrome (n = 3), ganglioglioma (n = 3), or hemimegalencephaly (n = 1). Seizures began at 1 day to 14 months (mean, 4.0 months) after birth, occurred frequently (often many times per day, and were refractory to antiepileptic drugs. Patients were evaluated for surgery at 2.5-24 (mean 12.4) months of age. Seven patients had hemiparesis and eight had slowed cognitive development. Seizures were characterized by arrest or marked reduction of behavioral motor activity with nuclear level of consciousness (n = 4, with temporal or temporoparietal EEG seizures), focal clonic activity (n = 3, with perirolandic EEG seizures), generalized tonic stiffening (n = 3, with temporoparieto-occipital, parietal, or frontal EEG seizures), or infantile spasms and hypsarrhythmia (n = 2, with a frontal tumor or temporoparieto-occipital cortical dysplasia). METHODS: Magnetic resonance imaging (MRI) revealed the epileptogenic lesion in all but two patients, both with cortical dysplasia localized by interictal positron-emission tomography (PET) and other clinical or EEG features and confirmed on histopathologic examination of resected tissue. RESULTS: At follow-up 4-86 (mean 32) months after surgery, six patients were seizure free (Engel outcome class I), three had rare seizures with none in at least the previous 6 months (Engel class II), and two had worthwhile improvement (Engel class III). Except for the severely developmentally delayed infant with hemimegalencephaly, several patients had marked "catch-up" developmental progress after class I, II, or III outcome. Postoperative complications included subdural hematoma over the contralateral hemisphere (one patient) and entrapment and enlargement of the ipsilateral temporal horn (one patient) after hemispherectomy, both corrected uneventfully with a second surgical procedure. One patient died of unexplained causes several hours after frontal lobectomy. No patients had new neurologic deficits after surgery, and one patient had resolution of progressive fluctuating hemiparesis after resection of temporoparieto-occipital cortical dysplasia. CONCLUSIONS: Our results agree with previous reports that epilepsy surgery can provide relief from catastrophic epilepsy in carefully selected infants.

Age Factors↗

[Epidemiology of developmental disorders in children in Tel Aviv].

We assessed the prevalence of developmental disorders, the need for intervention, potential for rehabilitation, and also characterized the risk factors, from files of 1,944 children referred during 1981-1990. The study group consisted of 4.3% of the children born in Tel Aviv during this period. Referral was highest between the ages 3-4 years and the causes for referral were language, speech and communication disorders (38%), global developmental delay (20%), motor disorders (16%), and behavioral and emotional problems (15%). Developmental disorders were more prevalent in boys (M/F ratio 1.8:1). 84% had at least 1 risk factor, either pre/perinatal, social or genetic. 66% had a social risk factor requiring involvement of a community social worker, or a parent with a chronic disease. The principal genetic risk factors were a developmental problem in a sibling, and parental consanguinity. The most common perinatal risk factors were birth weight under 2500 grams, hyperbilirubinemia of the newborn and severe asphyxia. Prognosis was good: 83% had normal intelligence and only 10% had severe disability. Upon discharge from the development center at the age of 5 years only 18% required special schooling, but 63% were referred for continuation of rehabilitation services. This study provides multi-disciplinary information that allows planning of requirements for diagnostic, therapeutic and rehabilitation services in the human, logistic and economic fields.

Child↗

Color pattern formation on the wing of a butterfly Pieris rapae. 2. Color determination and scale development.

It has been shown that microcautery on the prospective apical black region of the early pupal forewing of a butterfly, Pieris rapae, causes alteration of the scale color on the adult wing and a delay in histogenesis of the pupal wing. From these results, it has been assumed that the developmental delay of scale cells in the pupal wing alters their developmental fate and the hypothesis that different color fates of scales are determined by differences in the developmental timetables between scale cells is proposed. In this study, we attempted to find the developmental timetables of individual scales expressing specific color to test this hypothesis. It was found that the holes on the upper surface of a scale become larger as they develop and the hole sizes of scales in the white region are always larger than in the black region on the same wings either during pupal period or after eclosion. This suggests that the scale hole size is a good index that reflects developmental rate of the scale and a difference in the hole size between adult scales is attributed to a difference in the developmental timetables when their ancestral scale precursor cells were in the pupal period. A comparison of the hole sizes between adult scales in different color regions suggested that normal white scales were in a more advanced state than were the black ones but white scales induced by microcautery were in a less advanced state than black ones on the same wing. This supports our hypothesis.

Animals↗

What do we know about children who fail to thrive?

It is the aim of this article to provide an overview of difficulties in children with poor growth enrolled in an intensive community intervention trial for failure to thrive (FTT). Children were assessed for developmental delay (Bayley test), inadequate diet, iron deficiency, eating and other behavioural problems, and maternal anxiety and depression (HAD Scales). Sixty-three children aged 6 months to 2 1/2 years were studied. The majority of children were from families living in poverty with many from divorced, separated or single families. On developmental testing (Bayley Developmental Scales) 55% were delayed, 27% severely. Seventy-seven per cent had caloric intakes below the expected average requirement (EAR) with 19% reported at less than 50% of requirements. Iron intakes were similarly low and one-third had iron deficiency anaemia on testing. Sixty per cent of children were reported to have eating difficulties, principally in terms of responding negatively to food. Eating difficulties had commonly presented within the first weeks of life. Other behavioural and sleeping difficulties were also common. Children identified as failing to thrive in the community are likely to have associated developmental, dietary and behavioural problems which may not be immediately evident and to an extent which may require intensive multidisciplinary involvement.

Child, Preschool↗

Delayed maturation of the vagus nerve in sudden infant death syndrome.

Abnormalities of the respiratory control system have been implicated in the cause of death in sudden infant death syndrome (SIDS). The vagus nerve is a major component of the neural regulation of respiration. Ultrastructural quantitative morphometry of myelinated and unmyelinated fibers was performed on cervical vagus nerves taken from 30 SIDS victims and 29 age-matched controls between 1 and 9 months of age. In SIDS infants, more small and fewer large myelinated vagal fibers were found than in controls, suggesting that the vagus nerve in SIDS is relatively immature. Delayed vagal nerve maturation, together with delays in central nervous system myelination and dendritic development, indicates a neural developmental delay in SIDS, the cause of which is undetermined.

Aging↗

Outcome of very low birth weight infants with histopathologic chorioamnionitis.

OBJECTIVE: To determine neonatal outcome at 7 months of corrected age in very low birth weight (VLBW) infants with placental chorioamnionitis. METHODS: We conducted a cohort study of 287 VLBW infants delivered as a result of preterm premature rupture of membranes (PROM) or preterm labor. Control subjects (n = 123) had placentas with absent umbilical cord inflammation and absent or low-grade membrane inflammation. Case subjects (n = 164) had moderate membrane inflammation or any umbilical cord inflammation. Neonatal and 7-month outcomes were compared. A power analysis showed that 98 total subjects were needed to reject the two-sided null hypothesis with a difference in mean Bayley index scores of at least 8. RESULTS: Infants in the study group had significantly more preterm PROM, antenatal antibiotics, lower birth weight, lower gestational age, longer duration of ruptured membranes, and clinical chorioamnionitis. Intraventricular hemorrhage occurred more commonly in infants with placentas demonstrating chorioamnionitis (relative risk = 1.6, 95% confidence interval 1.1, 2.4, P =.013). One hundred sixty-seven (69%) of the 243 surviving infants had 7-month follow-up. There was no difference between cases and controls in mean Bayley mental developmental index (93 compared with 90, P =.25), psychomotor developmental index (89 compared with 90, P =.68), or in the number of infants that were developmentally delayed. CONCLUSION: Despite a higher frequency of intraventricular hemorrhage, no difference in developmental scores was detected at 7 months of corrected age in VLBW infants with histologic chorioamnionitis.

Adult↗

Reprogramming of primordial germ cells begins before migration into the genital ridge, making these cells inadequate donors for reproductive cloning.

Germ cells undergo epigenetic modifications as they develop, which suggests that they may be ideal donors for nuclear transfer (cloning). In this study, nuclei from confirmed embryonic germ cells were used as donors to determine whether they are competent for cloning and at which stage they are most competent. Embryos cloned from migrating 10.5-days-postcoitum (dpc) primordial germ cells (PGCs) showed normal morphological development to midgestation but died shortly thereafter. In contrast, embryos cloned from later-stage germ cells were developmentally delayed at midgestation. Thus, donor germ cell age inversely correlated with the developmental stage attained by cloned embryos. The methylation status of the H19- and Snrpn-imprinting control regions in germ cell clones paralleled that of the donors, and revealed that demethylation, or erasure of imprints, was already initiated in PGCs at 10.5 dpc and was complete by 13.5 dpc. Similarly, clones derived from male 15.5-dpc germ cells showed increased methylation correlating with the initiation of de novo methylation that resets imprints at this stage, and clones from neonatal germ cells showed nearly complete methylation in the H19 imprinting control region. These results indicate that the epigenetic state of the donor nucleus is retained in cloned embryos, and that germ cells are therefore inadequate nuclear donors for cloning because they are either erasing or resetting epigenetic patterns.

Animals↗

Soyacystatin N inhibits proteolysis of wheat alpha-amylase inhibitor and potentiates toxicity against cowpea weevil.

Genetic engineering may be used to introduce multiple insect resistance genes with different modes of action into crop plants. We explored the possible interactions of two differing gene products fed in the diet of cowpea weevil, Callosobruchus maculates (F.), a stored grain pest. The soybean cysteine protease inhibitor soyacystatin N (scN) and alpha-amylase inhibitor (alphaAI) from wheat have defensive function against this coleopteran. When artificial seeds containing both scN and alpha(AI) were infested with eggs of C. maculatus, the delays in larval development were longer than was predicted by summing the developmental delays seen when larvae were fed a diet containing the individual proteins, indicating that the effects of scN and alpha(AI) are synergistic. Alpha(AI) was readily hydrolyzed when incubated with insect gut extract. This proteolytic degradation was inhibited by scN, but not by Kunitz inhibitor (a serine protease inhibitor). Thus, degradation of alpha(AI) was due to proteolysis by insect digestive cysteine proteases. These data suggest that C. maculatus uses digestive enzymes not only to function in food protein digestion but also to defend the insects themselves by helping reduce the concentration of a toxic dietary protein.

Animals↗

Delayed and progressive multiple suture craniosynostosis.

A considerable amount of information is available on various types of craniosynostoses. The patient exhibiting single suture synostosis that progresses to involve multiple sutures is distinctly uncommon, as is the patient exhibiting delayed synostosis involving all of the calvarial sutures. We report a group of 11 such patients with progressive and delayed holocalvarial synostosis. Most patients exhibited features of raised intracranial pressure or developmental delay, and in all patients symptoms were relieved after surgery. The diagnostic and therapeutic implications of this type of presentation in craniosynostosis are discussed.

Child↗

A comparative review of developmental screening tests.

Public Law 99-457 amends the Education of the Handicapped Act to include services for children from birth through 3 years. Inasmuch as detection and referral of children with developmental delays continues to reside largely with pediatricians and other health care professionals, developmental screening, using standardized tests, is increasingly important. To help physicians select from the array of instruments, 19 different screening tests were administered by a pediatrician and rated by a panel of pediatricians and a special educator. While the panel found few tests that fit within the time constraints of pediatric practice, several tests approached standards for educational and psychologic tests. These included the Battelle Developmental Inventory Screening Test, Infant Monitoring System, Developmental Indicators for Assessment of Learning-Revised, Screening Children for Related Early Educational Needs, and the Developmental Profile II.

Child↗

The Early Neuropsychologic Optimality Rating Scale (ENORS-9): a new developmental follow-up technique.

The development and application of the Early Neuropsychologic Optimality Rating Scale (ENORS-9) is described. This 24-item technique, scored in an optimal/nonoptimal fashion, enables assessment of posture, tone, and movement, as well as developmental delays. The ENORS-9 was compared with the Bayley Mental and Psychomotor Developmental indexes and a neurologic examination administered at 9 months, in terms of sensitivity and specificity of cognitive, motor, and neurologic outcome at 36 months. Using an ENORS-9 cut-off score of 85% for cognitive and motor, and 75% for neurologic outcome, sensitivity values were more than three times greater than more traditional assessment techniques. This instrument meets many needs in developmental follow-up because of straightforward scoring, decreased personnel requirements and cost, and flexibility in regard to missing data and cut-off scores. The implications of these findings are discussed.

Child Development↗

Effects of limited paternal exposure to xenobiotic agents on the development of progeny.

This report represents a series of investigations of the postnatal functional sequelae of paternal exposure to opioids and other xenobiotic agents. In separate studies, young adult male mice were exposed to (1) morphine; (2) levorphanol or its nonanalgesic isomer dextrorphan; or (3) 80% nitrous oxide/20% oxygen. Males (5-8/group) were injected twice daily for 5 1/2 or 8 1/2 days with opioids or saline, or received a single 4 hour inhalation exposure to nitrous oxide/oxygen or compressed air. At 6-8 1/2 days post-treatment, each male was housed with 3 drug-naive nulliparous females. With the exception of birth weights of litters, no alterations in reproductive indices were observed. Changes in reproductive endocrine parameters included marked attenuation of serum luteinizing hormone response to castration in both young adult (8 week) and older (18 week) F1 morphine offspring, when compared with saline-derived groups. The morphine progeny showed decrements in body weight and delayed onset of maturational indices through four generations of selective inbreeding. Similar developmental delays occurred in F1 offspring originating from paternal levorphanol, dextrorphan and nitrous oxide groups, when compared with their respective controls. Behavioral study of F1 offspring revealed alterations in: water maze performance and learning, if preceded by unavoidable footshock, in morphine offspring at 8 and 18 weeks; aberrant swim patterns in both levorphanol and dextrorphan progeny at 6 1/2 and 8 1/2 weeks. Nitrous oxide progeny showed a blunting of hypothermic response to pharmacologic challenge at 16 weeks, in comparison to compressed air controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗