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PubMed1993

Biological and environmental risk for poor developmental outcome of young children.

A cross-sectional retrospective study was conducted to develop and field test a state-wide screening method for identifying children at risk for developmental problems. Families of 2.5- to 3-year-old children were sampled from the Ohio birth certificate register. Standardized telephone interviews were conducted with 1,601 parents concerning home environment and demographic characteristics. Developmental delay, the outcome variable, was defined by low scores on an abbreviated Developmental Profile II, which was also administered over the telephone. Obstetric history and health status of the newborns was obtained from birth certificates. By means of logistic regression analysis, we found six independent variables representing environmental and biological determinants.

Child Development↗
PubMed1998

Shaken baby syndrome.

Fourteen cases of shaken baby syndrome seen between 1993 to 1997 at the Kaohsiung Medical College Hospital were reviewed. The common clinical presentations were seizure, respiratory problem and disturbed consciousness. The signs and symptoms of this form of head trauma were nonspecific. The findings may mimic infection, intoxication, seizure disorder or metabolic abnormalities. The CT scan is the most common diagnostic tool in cases of suspected shaken baby syndrome. The common CT findings were acute subdural hematoma followed by chronic subdural hematoma and subarachnoid hemorrhage. One infant died due to delay in seeking medical help. Five patients sustained significant morbidity which included developmental delay, seizure, motor deficit and visual impairment. Early recognition and prompt treatment were key to the overall success of case management. The incidence of shaken baby syndrome can be reduced through public awareness and education of the parents not to shake the baby.

Brain Injuries↗
PubMed1984

Factors affecting delayed walking skill in malnourished children.

This research examined children between 13 and 23 months of age with developmental delays in walking. Children in the experimental group received intensive infant stimulation and, subsequently approximately 71% were able to walk by themselves. In contrast, 32% of those children receiving only verbal instruction were able to achieve this important milestone. There was a significant difference (p less than 0.05) between the control and experimental group in acquiring walking skills. Mothers' lack of awareness about infant stimulation and lack of supervision on the part of health workers are the major contributing factors to delayed walking skill in these children. The study highlights the importance of taking health care to the home of clients, the most neglected aspect of primary health in this part of the world.

Female↗
PubMed2005

A girl with pervasive developmental disorder and complex chromosome rearrangement involving 8p and 10p.

We report a 4-year-old girl with a de novo, apparently balanced complex chromosome rearrangement. She initially presented for assessment of velopharyngeal insufficiency due to hypernasal speech. She has distinctive facial features (long face, broad nasal bridge, and protuberant ears with simplified helices), bifid uvula, strabismus, and joint laxity. She is developmentally delayed, with language and cognitive skills approximately 2 SD below the mean expected for her age, and meets ADI, ADOS, and DSM-IV criteria for pervasive developmental disorder. She has poor eye contact, atypical communication and social interaction, repetitive behaviours and significant difficulties with processing sensory input. Her karyotype is characterized by the presence of two derivative chromosomes; 46,XX, der(8)(10pter- >10pl2.32::8p12- >8qter), der(l0)(8pter- >8p21.3::10p12.32- >10p11.23::8p21.3- > 8p12::10p11.23- >l0qter). The der(8) is a result of translocation of the segment 10p12.32-pter onto 8p12. The der(l0) has two 8p segments collectively from 8p12-pter in that the segment 8p21.3-pter is translocated onto 10p12.32 and the segment 8p12-p21.3 is inserted at 10p11.23. FISH analysis showed no microdeletion of the major locus at 22q11.2 nor for the minor locus at 10p13p14. This case suggests that aberrations at 8p12, 8p21.3, 10p11.23 and/or 10p12.32 may result in pervasive developmental disorder, associated with mild cognitive delay and specific facial anomalies.

Child Development Disorders, Pervasive↗
PubMed2006

Neurodevelopmental delays in children with deformational plagiocephaly.

BACKGROUND: The purpose of this study was to determine whether, in fact, infants with deformational plagiocephaly, or plagiocephaly without synostosis, demonstrated cognitive and psychomotor developmental delays when compared with a standardized population. Through this study, we chose to expand upon our earlier findings from 2001 on patients with deformational plagiocephaly. METHODS: The study population includes a total of 110 consecutive patients, prospectively followed then retrospectively reviewed. Each infant was assessed using the Bayley Scales of Infant Development-II scoring system. The developmental analysis was categorized as either mental or psychomotor using the mental developmental index or the psychomotor developmental index, respectively. These infants were subcategorized into four groups: accelerated, normal, mild, or severely delayed. The groups were then compared with a standardized Bayley's age-matched population, using chi-square test goodness-of-fit tests. RESULTS: Infants with deformational plagiocephaly were found to have significantly different psychomotor development indexes and mental developmental indexes when compared with the standardized population (p < 0.0001; p < 0.0001). With regards to the mental developmental index scores, none of the infants with deformational plagiocephaly were accelerated, 90 percent were normal, 7 percent were mildly delayed, and 3 percent were severely delayed. With regards to the psychomotor development index scores, none of infants were accelerated, 74 percent were normal, 19 percent were mildly delayed, and 7 percent were severely delayed. CONCLUSIONS: This study indicates that before any intervention, infants with deformational plagiocephaly show significant delays in both mental and psychomotor development. Also of particular note is that no child with deformational plagiocephaly showed accelerated development.

Alcohol Drinking↗
PubMed2003

Cowpea bruchid Callosobruchus maculatus uses a three-component strategy to overcome a plant defensive cysteine protease inhibitor.

The soybean cysteine protease inhibitor, soyacystatin N (scN), negatively impacts growth and development of the cowpea bruchid, Callosobruchus maculatus[Koiwa et al. (1998) Plant J 14: 371-379]. However, the developmental delay and feeding inhibition caused by dietary scN occurred only during the early developmental stages (the 1st, 2nd and 3rd instars) of the cowpea bruchid. The 4th instar larvae reared on scN diet (adapted) exhibited rates of feeding and development which were comparable to those feeding on an scN-free diet (unadapted) prior to pupation. Total gut proteolytic capacity at this larval stage significantly increased in the scN-adapted insects. The elevated enzymatic activity was attributed to a differential expression of insect gut cysteine proteases (representing the major digestive enzymes), and of aspartic proteases. scN degradation by the gut extract was observed only in adapted bruchids, and this activity appeared to be a combined effect of scN-induced cysteine and aspartic proteases. Thirty cDNAs encoding cathepsin L-like cysteine proteases were isolated from insect guts, and they were differentially regulated by dietary scN. Our results suggest that the cowpea bruchid adapts to the challenge of scN by qualitative and quantitative remodelling of its digestive protease complement, and by activating scN-degrading protease activity.

Amino Acid Sequence↗
PubMed1988

[Minimal brain dysfunction--on the revision of a clinical concept. Clinical data of a total pediatric and adolescent psychiatric patient population].

After a discussion of the changes of the MCD concept over the years, the authors describe their own investigation of a total sample of 3280 children, attending outpatient and inpatient facilities of three counties with a total population of 574,000 inhabitants. The aim of the study was to investigate the frequency, sex distribution, and social class dependency of the MCD-diagnosis and its relationship to clinical-psychiatric syndromes. The following results were obtained: There is a strong correlation of MCD-diagnosis with age, sex, and social class. MCD was most frequently diagnosed in the age groups of 3-6, 6-9 and 9-12 years, being twice as frequent in boys than in girls and dominating among the lower social classes. The frequency of MCD in the total sample was 11%, taking into consideration all age-classes. MCD was significantly associated only with two psychiatric syndromes: conduct disorders and hyperkinetic syndrome. There was no correlation with emotional disorders or neurosis, however, a very strong one with specific delays in development, defined according to the multiaxial classification system. 72% of the children diagnosed as MCD-children revealed specific delays in development. But this high correlation was caused only by two conditions: developmental speech/language disorders and specific motor retardation. There was no correlation between MCD and specific reading retardation nor with other specific learning difficulties or mixed developmental disorders. Future research in this field should look upon the so-called MCD more in terms of general developmental delays than in terms of brain pathology.

Achievement↗
PubMed1997

Effects of thyroxine supplementation on neurologic development in infants born at less than 30 weeks' gestation.

BACKGROUND: Premature infants who have transient hypothyroxinemia in the first weeks of life may have developmental delay and neurologic dysfunction. Whether thyroxine treatment during this period results in improved developmental outcomes is not known. METHODS: We carried out a randomized, placebo-controlled, double-blind trial of thyroxine supplementation in 200 infants born at less than 30 weeks' gestation. Thyroxine (8 microg per kilogram of birth weight) or placebo was administered daily, starting 12 to 24 hours after birth, for six weeks. Plasma free thyroxine concentrations were measured weekly for the first eight weeks after birth. Scores on the Bayley Mental and Psychomotor Development Indexes and neurologic function were assessed at 6, 12, and 24 months of age (corrected for prematurity). RESULTS: Mortality and morbidity up to the time of discharge from the hospital were similar in the study groups. At 24 months of age, 157 infants were evaluated. Overall, neither mental nor psychomotor scores differed significantly between the study groups at any time, nor was the frequency of abnormal neurologic outcome significantly different. In thyroxine-treated infants born at gestational ages of less than 27 weeks, the score on the Bayley Mental Development Index at 24 months of age was 18 points higher than the score for the infants with similar gestational ages at birth in the placebo group (P=0.01); for thyroxine-treated infants born at 27 weeks or later, the mental-development score was 10 points lower than that of their counterparts in the placebo group (P=0.03). There was no relation between the initial plasma free thyroxine concentration and the effect of treatment. CONCLUSIONS: In infants born before 30 weeks' gestation, thyroxine supplementation does not improve the developmental outcome at 24 months.

Central Nervous System↗
PubMed1982

Concept learning by retarded children: a comparison of three discrimination learning procedures.

The effectiveness of stimulus delay and stimulus fading procedures was compared with differential reinforcement only in training developmentally delayed children on a concept learning task. Twenty-four children were randomly assigned to one of the three treatment conditions. All three experimental conditions contained five discrimination programmes, each designed to teach the child to discriminate one pair of exemplars from the target concepts bottle and jar. Following successful completion of one training programme, a concept acquisition probe was administered to determine whether the target concepts had been engendered. Alternate presentations of successively different training programmes and concept acquisition probes were continued until the subject passed the probe, failed to complete a training programme, or completed all five training programmes. Five 'stimulus fading' subjects, three 'stimulus delay' subjects, and four 'reinforcement only' subjects learned the concepts. All children who learned to discriminate one pair of exemplars displayed conceptual behaviour after training on two or fewer pairs of exemplars. It was suggested that the absence of pronounced differences between conditions may have been due to the complexity of the task or the type of prompts employed.

Child, Preschool↗
PubMed1996

Oral aluminum administration during pregnancy and lactation produces gastric and renal lesions in rat mothers and delay in CNS development of their pups.

The expression of the neurofilament protein of the highest molecular weight (NF-H) is developmentally and spatially regulated. For example, the MAb RMO24.9, directed against a phosphorylated epitope in the tail domain of NF-H, immunohistochemically labels specific tracts within the rat brainstem prenatally, but does not label diencephalic tracts until after postnatal day 10 (P10). A diet providing 300 mg/kg/d Al (as Al lactate) to rat dams throughout gestation causes behavioral deficits in their offspring (Bernuzzi et al., 1989). We repeated this regimen by substituting 120 mM Al lactate (pH 6.5) for drinking water during gestation and lactation, and examined the distribution of immunolabeling by RMO 24.9 after exposure to Al. Tracts within the diencephalon that bind RMO 24.9 on P11 in control pups did not bind the MAb until P14 in Al-treated pups. In these preliminary experiments, Al seemed to have caused a developmental delay in the expression of phosphorylated NF-H in the pups of mothers that received Al during gestation. However, subsequent experiments showed that the neuropathology observed--and that reported by other investigators using similar Al levels--may not be the result of the direct effects of Al on the pups. Throughout lactation, treated dams appeared progressively more cachexic. Unlike the normal viscera of pair-watered controls, the stomachs of treated dams were ulcerated, and their kidneys had decreased cortical thickness and contained stones. Lesions such as these compromise a rat's ability to absorb nutrients, to excrete toxins, and to regulate water and electrolytes. In a lactating dam, these alterations could compromise the dam's ability to nourish her pups. Our experiments point out that the mechanisms of Al toxicity-- already complex in the adult--are further complicated in a system in which the pup is dependent on the mother for delivery of both nutrients and toxins. It is therefore impossible to determine the cause of any neuropathology in the pup in a system where Al delivery overlies a background of multisystem defect and altered maternal homeostasis.

Administration, Oral↗
PubMed2005

Adverse effects of prenatal exposure to atrazine during a critical period of mammary gland growth.

Prenatal exposure to 100 mg/kg atrazine (ATR) delays mammary gland (MG) development in resulting female offspring of Long-Evans rats. To determine if the fetal MG was sensitive to ATR effects during specific periods of development, timed-pregnant dams (n = 8/group/block) were dosed for 3- or 7-gestation day (GD) intervals (GD 13-15, 15-17, 17-19, or 13-19) with 100 mg ATR/kg/day or vehicle (C), and their offspring were evaluated for changes. Mammary glands taken from pups prenatally exposed to ATR displayed significant delays in epithelial development as early as postnatal day (PND) 4 compared to C, with continued developmental delays at later time points that varied by time of exposure. However, the most persistent and severe delays were seen in the GD 17-19 and GD 13-19 ATR exposure groups, demonstrating statistically similar growth retardation. Because MG developmental deficits persisted into adulthood, we hypothesized that ATR-exposed animals may have had difficulties nursing their young. Females exposed prenatally to either ATR (as defined) or C (n = 4 litters/group) were bred, and the resulting F(2) offspring from GD 17-19 and GD 13-19 exposure groups were significantly smaller in body weight (BW) than C. In a separate study, it was determined that ATR (25-100 mg/kg), delivered from GD 15-19, did not decrease fetal body weights on GD 20, even though the higher doses significantly decreased weight gain of the dosed dams. These data suggest that the consequences of brief ATR exposure during a critical period of fetal MG development (GD 17-19), are both delayed MG development of the offspring and inadequate nutritional support of F2 offspring, resulting in adverse effects on pup weight gain.

Animals↗
PubMedDate not supplied

Serial MR imaging in neonatal cerebral injury.

The results of serial MR imaging of the brain in 32 patients with neonatal cerebral injury who had two or more examinations are reviewed. By comparison with normal age-matched controls, delayed or deficient myelination was identified in eight patients on follow-up examination. Developmental delay was present in all of these patients. In three patients delayed myelination was identified at the first study and was normal at follow-up. These patients improved clinically. The most severe delays or deficits in myelination and the most severe handicaps were present in patients with subcortical and periventricular leukomalacia. Ventricular size was readily assessed. Development of porencephalic cysts at sites of previous hemorrhage and infarction was recognized. The lack of ionizing radiation is of particular importance in follow-up MR of children, and an increasing role for this technique in pediatric developmental neurology appears likely.

Birth Injuries↗
PubMed2002

Do baby walkers delay onset of walking in young children?

Baby walkers have been a source of considerable controversy. Some people suggest developmental benefit from their use while others focus on the potential harm that stems from accidents and even suggest developmental delay. This mini-review aimed to determine if use of a baby walker delays affects the onset of walking. The Cochrane library, Embase, CINAHL and Medline were searched for randomized controlled trials (RCTs) and cohort studies, which compared the onset of walking in infants who used baby walkers with a group who did not. Two RCTs and two cohort studies were identified and available for consideration. All of the studies examined the effect of infant walkers on the onset of walking. The results of the two RCTs did not demonstrate a significant effect on the onset of walking. The cohort studies suggest that the use of infant walkers delayed the onset of walking in young children and a pooled analysis of the four studies suggested a delay of between 11 and 26 days. Although the quality of the studies was relatively poor these studies lend no support to the argument that walkers aid the development of walking. The significance of a delay of this magnitude is however unclear. Further work is required to determine whether walkers are an independent causal factor in accidents.

Age Factors↗
PubMed1999

Developmental and psychiatric evaluation in the preschool context.

This article documents the ways in which a school-based developmental evaluation can be an effective and powerful alternative to the traditional clinic-based evaluation. The child is not taken to a strange new place but observed and evaluated in his or her naturalistic environment. The families have increased access to care, and the foundation is laid for cohesive, trusting working relationships with families and teachers. Children are evaluated in one of two models or a combination of both naturalistic observation and individual direct assessment. Tensions between the clinical and educational system exist, but the early childhood evaluator who educates himself or herself about the cultures and forces at work can build from the strengths of each system to effect positive growth for young children at risk for developmental delays or psychiatric disorders.

Child, Preschool↗
PubMed1977

Home observation for measurement of the environment: a validation study of screening efficiency.

Home environments of 91 6-month-old infants were assessed with the Home Observation for Measurement of the Environment (HOME) Inventory. Multiple discriminant functions composed of the six subscale scores from the HOME Inventory were used to predict whether a child would be low IQ (below 70), low average (70 to 89), or average to superior (90 and above) at age 3 years. The mean vector of Home inventory subscales for the three IQ groups was significantly different (p less than .01). Significant univariate effects were observed for three HOME Inventory subscales: organization of the physical and temporal environment, provision of appropriate play materials, and maternal involvement with child. The discriminant function of HOME Inventory subscale scores correctly predicted 71 percent of all children who scored below 70 IQ. Results attest to the usefulness of the HOME Inventory in a comprehensive program of screening for developmental delay.

Child, Preschool↗
PubMed1990

Relation of global ratings of functioning with behaviour and development in delayed and disturbed preschoolers.

Ratings on the Global Assessment Scale for Children (GASC) were assessed in relation to a battery of objective developmental and behavioural measures. Children aged three to six years (N = 55) attending a day treatment program for developmental delays, language disorders, and behavioural and emotional problems comprised the sample. A battery of tests was administered to the children. Parents and teachers completed standardized questionnaires to measure developmental, behavioural and emotional problems. The results indicated that the GASC score correlated significantly with child developmental level, impulse control, and with teacher ratings of social withdrawal. The GASC was unrelated to ratings of behavioural problems. Ratings on the GASC also were highly consistent over time. These results are discussed with respect to the strengths and limitations of using global ratings with preschool children.

Affective Symptoms↗
PubMed1997

True trisomy 2 mosaicism in amniocytes and newborn liver associated with multiple system abnormalities.

Among 58,000 amniocenteses completed, our laboratories found one case of true cytogenetic trisomy 2 mosaicism in a fetus with multiple abnormalities. In contrast, 11 fetuses phenotypically normal at birth were found to have true trisomy 2 mosaicism in their chorionic villus cells among the 10,500 fetuses tested by chorionic villus sampling (CVS). In our single abnormal case, amniocentesis performed at 19 weeks after finding an elevated maternal serum AFP found two independent cultures with trisomy 2 karyotypes in 8 of 25 and 7 of 31 amniocytes, respectively. Although oligohydramnios was noted by ultrasound, the mother elected to continue the pregnancy. At 26 weeks the fetus had intrauterine growth retardation (IUGR), hydronephrosis, and cardiac abnormalities. When delivered by Cesarean section at 30 weeks, the infant had multiple anomalies and developed necrotizing enterocolitis and severe cholestasis. At 5 months coronal magnetic resonance imaging (MRI) displayed delayed myelination and abnormal brain morphology. The patient also exhibited significant growth failure and developmental delay. Although chromosomes were normal in blood, skin fibroblasts, and ascites fluid cells, 4 of 100 hepatic biopsy fibroblasts were 47,XY,+2. Molecular analysis excluded uniparental disomy (UPD) of chromosome 2 in the 46,XY cell line. This and other reports of rare phenotypically abnormal trisomy 2 mosaic fetuses identified by karyotyping amniocytes emphasizes the substantially higher fetal risk of abnormal development than when trisomy 2 is found only in chorionic villus cells.

Abnormalities, Multiple↗