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PubMed2006

Early language and communication development of infants later diagnosed with autism spectrum disorder.

It is well recognized that delayed "first words" is among the most common presenting symptoms of autistic spectrum disorders (ASD). However, data on earlier language and communication development in children with ASD are limited to retrospective reports from parents and from home videos. In this study, we prospectively collected parent report data on early communication and language development in 97 infant siblings of children with ASD and 49 low-risk controls. Parents completed the MacArthur Communicative Development Inventory--Infant Form at 12 and 18 months. Analysis compared 3 groups defined on the basis of diagnostic assessment at 24 months: (1) siblings with ASD (n = 15), (2) siblings not meeting diagnostic criteria for ASD (n = 82), and (3) low-risk controls, none of whom had ASD (n = 49). Children with ASD showed delays in early language and communication compared with non-ASD siblings and controls. At 12 months, the ASD group was reported to understand significantly fewer phrases and to produce fewer gestures. At 18 months, they showed delays in their understanding of phrases, comprehension and production of single words, and use of gestures. Siblings not diagnosed with ASD also used fewer play-related gestures at 18 months than low-risk controls, even when children with identified language delays were excluded. Overall, this prospective study confirms that delays in communication and language development are apparent early in life in children with ASD, and emphasizes that developmental surveillance should include monitoring for delays in gesture, which may be among the earliest signs of ASD.

Autistic Disorder↗
PubMed2005

Electronically signed documents in health care--analysis and assessment of data formats and transformation.

OBJECTIVES: Our objectives were to analyze and assess data formats for their suitability for conclusive and secure long-term archiving and to develop a concept for legally secure transformation of electronically signed documents that are not available in data formats appropriate for long-term archiving. METHODS: On the basis of literature review and Internet searches we developed general evaluation criteria to assess data formats with regard to their suitability for conclusive and secure long-term archiving. The assessment of data formats refers to format specifications and available literature. For the analyses of the transformation of signed documents we analyzed legal requirements on the basis of laws and ordinances as well as technical requirements by means of literature reviews, Internet searches and technical specifications. RESULTS: The following evaluation criteria are suited for this kind of assessment of data formats: transparency and standardization, stability, presentation and security. According to our assessment the following data formats are most suitable for conclusive and secure long-term archiving: PDF for formatted and unstructured text documents, XML for markup languages, TIFF for images in general, DICOM for medical images and S/MIME for the storage of e-mail. To transform electronically signed documents we propose an elementary procedure and universal basic model in form of an XML schema definition that includes the necessary legal and technical information. CONCLUSIONS: If electronic documents are to replace paper-based documents in patient records, they have to conform to the criteria for secure long-term archiving. The analyzed data formats are to be extended by mechanisms to guarantee the long-term security of electronic signatures. To transform large quantities of documents in a legally secure way, our basic model has to be extended for automated procedures.

Archives↗
PubMed1997

Age-related differences in formal thought disorder in chronically hospitalized schizophrenic patients: a cross-sectional study across nine decades.

OBJECTIVE: This study used a cross-sectional design to examine the frequency of occurrence and severity of 10 different signs of thought disorder in schizophrenic patients across the lifespan. METHOD: Schizophrenic patients, who ranged in age from 19 to 96 years (N = 392), were examined with the Scale for Assessment of Thought, Language, and Communication. The cognitive functioning of the geriatric patients (patients over the age of 64, N = 120) was also assessed. RESULTS: Poverty of speech was more common and more severe in geriatric patients, while four different signs of thought disorder that reflect disconnected speech were less common and less severe in geriatric patients. Analysis of covariance found that the lower severity of disconnection thought disorders in the older patients was not attributable to differences in the amount of speech produced. CONCLUSIONS: Aspects of disconnected speech were less severe in older patients, while the severity and frequency of poverty of speech were greater. These findings suggest that the two previously identified separate dimensions of communication disorder in schizophrenia vary differently with age and possibly in their cognitive and biological underpinnings.

Adult↗
PubMed1993

Magnetic resonance imaging in patients with concurrent Tourette's disorder and Asperger's syndrome.

OBJECTIVE: The purpose of the study was to examine behavioral/cognitive and neuroradiological features of patients with concurrent Tourette's disorder (TD) and Asperger's syndrome (AS). METHODS: The authors studied the occurrence of structural brain abnormalities using magnetic resonance imaging (MRI) in seven males with concurrent TD and AS, and in nine age-matched males, who had TD but did not have AS. Both groups were tested with an extensive battery of neurological and psychiatric rating scales and cognitive tests. RESULTS: Five of the seven patients with TD and AS had developmental brain anomalies. In contrast, normal MRI scans were found in all but one TD patient without AS. Both groups were not significantly different in the severity of motor and phonic tics, obsessionality, depression and anxiety, or in measures of general intelligence, memory, and language function; but patients with TD and AS had a history of more psychiatric hospitalizations, poor academic achievement, more neurological soft signs and appeared more impaired on complex problem-solving and spatial tests than did TD patients without AS. CONCLUSION: These findings suggest that structural cortical and subcortical abnormalities are more common among individuals with concurrent TD and AS than among sex- and age-matched TD patients without AS. Dysfunction of frontal-subcortical systems may play a role in the pathophysiology of concurrent TD and AS.

Adolescent↗
PubMed1995

Mental and somatic health and social adjustment in ordinary school children during childhood and adolescence related to central nervous functions as expressed by a complex reaction time.

A cohort of ordinary Swedish children were followed up from school entry through childhood and adolescence and checked retrospectively from birth to the age of 6 years regarding psychiatric and physical health and contact with the social welfare authorities. The children were allocated to different risk groups at age 7 on the basis of their psycho-physical development expressed as complex reaction time (CRT). It was previously shown that many of the slow CRT children have problems in psychomotor and language development at school, and that many leave compulsory school with poor achievements in Swedish and gymnastics as continuing signs of their developmental delay. This study shows that slow CRT children have an increased prevalence of child psychiatric problems. At an early age there were symptoms of aggression, hyperactivity and withdrawal in conjunction with developmental delay. During adolescence, depression, maladjustment and psycho-somatic disorders were prominent features, often in association with developmental delay, dyslexia and poor motoric skill. These children could have a disadvantage at school and in society and they felt themselves "handicapped" and were stressed by feelings of limited future possibilities. In adolescence, many of them were in need of help, especially financial aid from the social welfare services. The findings stress that a slow cognitive processing ability seen as a slow CRT must be considered a handicap of importance and a risk-factor in the society of today, with primary or secondary psychic and social manifestations often in a multifactorial setting of biological co-morbidity and family problems. In contrast, an advanced CNS development with a fast CRT may be seen as a protective factor.

Adolescent↗
PubMedDate not supplied

Developmental training by parents of the very young child with potential handicap.

Fifteen children aged 9 to 15 months, who were on the observation register of a city, and considered to be showing signs of delayed development, were studied over a 3-month period. Following assessment, the parents were shown ways in which they could train their children appropriate to their development levels, in separate fields of locomotion, social development, language, and hand-eye coordination. Eight out of 13 children with delay showed significant improvement in general quotients of development over the 3 months. This occurred in 5 out of 7 children with no signs of neurological abnormality at the time of the study, and in 3 out of 6 children with signs of neurological disorder. Two children without delay showed no significant improvement. Parents' reactions are discussed, and a description is given of the way in which this project was designed, suggesting implications for future implications for future Community Health services.

Child Development↗
PubMed1999

Subclinical hyperthyroidism and hyperkinetic behavior in children.

The authors report three children who exhibited developmental learning disabilities (DLDs) associated with behavioral disturbances, such as attention deficit, hyperactivity, and autistic features. The thyroid function tests performed as a part of routine endocrinologic evaluation of children with DLDs revealed a hormonal profile consistent with hyperthyroidism. These children had no systemic signs of hyperthyroidism. Treatment with neomercazole resulted in good control of their hyperkinetic behavior and subsequent improvement in language function attributable to an increased attention span, thereby facilitating speech therapy. Although routine screening of all children with DLDs for thyroid dysfunction may not be cost-effective, selective screening of children with familial attention-deficit hyperactivity disorder and those with attention-deficit and hyperactivity in association with DLDs and pervasive developmental disorders appears to be justified.

Antithyroid Agents↗
PubMed1992

The validation of interviews for estimating morbidity.

Health interview surveys have been widely used to measure morbidity in developing countries, particularly for infectious diseases. Structured questionnaires using algorithms which derive sign/symptom-based diagnoses seem to be the most reliable but there have been few studies to validate them. The purpose of validation is to evaluate the sensitivity and specificity of brief algorithms (combinations of signs/symptoms) which can then be used for the rapid assessment of community health problems. Validation requires a comparison with an external standard such as physician or serological diagnoses. There are several potential pitfalls in assessing validity, such as selection bias, differences in populations and the pattern of diseases in study populations compared to the community. Validation studies conducted in the community may overcome bias caused by case selection. Health centre derived estimates can be adjusted and applied to the community with caution. Further study is needed to validate algorithms for important diseases in different cultural settings. Community-based studies need to be conducted, and the utility of derived algorithms for tracking disease frequency explored further.

Algorithms↗
PubMed1985

Systemic lupus erythematosus (SLE) induced by quinidine.

Only two definite cases of quinidine-induced systemic lupus erythematosus (SLE) are reported in the English-language literature. We have treated five patients who had an SLE-like syndrome while receiving quinidine. Symptoms, signs, and abnormal laboratory values improved after quinidine therapy was discontinued and prednisone therapy was started. The disease did not return after steroids were withdrawn. These cases indicate that quinidine can indeed cause an SLE-like syndrome.

Aged↗
PubMedDate not supplied

[Malaria knowledge and practice. Medical study in Songhay-Zarma (Niger)].

Two randomized studies were performed in 1992 and 1994 in the Niger river valley where malaria transmission is thought to be permanent and is reinforced during the rainy season. The sample covered 114 families either in Niamey, the capital of Niger, or in Karma, a rural village 20 km to the west, and its surroundings. The questionnaire contained closed and open questions on the perception of malaria causes, treatment and prevention, including the use of mosquito bed nets. Most of the 114 families studied were monogamic with an average of 4 children per father. The most frequent occupation was agricultural farming (millet and rice) for the sedentary part of this population. During the rainy season, some moved to farms in the neighbouring valley of Taksaba. During the wet season, others migrated to the West African coast. The houses were traditional, being straw huts or made from banco; all the openings were small the the rooms were dark and poorly ventilated. These features constituted good conditions for malaria vectors. Domestic animals, such as goats, sheep, cows and sometimes donkeys, were very frequent in the courtyards. However, there was never any stagnant water in the courtyards or around the water pumps because of the intense sunshine. Drinking water was carried on the head from the public foot pumps or the river and stored in earth calabashes closed by a plate. In the Songhay-Zarma language, Hémar Izé is a symptomatic complex which corresponds closely to a clinical case of malaria. The main sign of this complex is fever known as konni (hot body). But this word is also used as the general name for all diseases with fever. Associated symptoms, well known by the community members, included vomiting, headache and diarrhoea. Hémar Izé was considered to be the most frequent cause of morbidity and the most severe disease, more significant than any other fever or diarrhoea. As perceived by the community members, the leading cause of malaria was described to be mosquitos (44.7%), followed by the rainy season, God, and less commonly, dirtiness, parasites, or the sun. The majority of cases were diagnosed by the parents, and were self-treated at home either with medicinal plant infusions or oral drugs. The self-treatment was not common, because Nivaquine was the only medication known by the people and was often unavailable. It is necessary to manage a regular drug supply with a public awareness campaign about dosage for self-treatment of malaria. Also, the public needs to be informed about any new policies of supplying essential drugs under generic names. Despite some confusion, the people generally believed that mosquitos were responsible for the disease. Thus, the use of mosquito netting over the beds was justified and widespread throughout the population. The traditional practice could be improved upon with an impregnated net even if the comprehension about the causes of the disease remains limited.

Adult↗
PubMed2006

Is math lateralised on the same side as language? Right hemisphere aphasia and mathematical abilities.

The main purpose of the present study was to learn how mathematical abilities are located and develop in the brain with respect to language. Mathematical abilities were assessed in six right-handed patients affected by aphasia following a lesion to their non-dominant hemisphere (crossed aphasia) and in two left-handed aphasics with a right-sided lesion. Acalculia, although in different degrees, was found in all cases. The type of acalculia depended on the type of aphasia, following patterns that have been previously observed in the most common aphasias resulting from left hemisphere lesions. No sign of right hemisphere or spatial acalculia (acalculia in left lateralised right-handed subjects) was detected. These results suggest that, as a rule, language and calculation share the same hemisphere. A primitive computational mechanism capable of recursion may be the precursor of both functions.

Aphasia↗
PubMed1990

[Dysphasia].

"Dysphasia" has been chosen to cover the severe problems related to the awareness and organization of language by the child overall in this study. Using this purely descriptive definition, we usually distinguish clinical forms, emphasizing a group of signs or a psychic movement, which are compared to an etiological value. Then, the theoretical choice justifies the therapeutic treatment and sometimes limits its action and effectiveness. During treatment related in detail, understanding the dysphasia of the child being treated develops as child and parents combine their efforts. Whether it's a question of "therapy" or "psychotherapy" isn't really relevant.

Art Therapy↗
PubMed1981

Cerebral asymmetry in developmental dyslexia.

The computed cranial tomograms (CCTs) of 26 dextral boys with developmental dyslexia were examined for asymmetry of width and length in the frontal and occipital regions. Contrary to several previous reports, reading disability was not associated with an increase in the frequency of reversed occipital widths. There were, however, proportionately more symmetric occipital widths than expected in comparison with a control sample and previously established norms. Differences in verbal or performance IQs were not related to relative cerebral size. Language delay was also not associated with brain measurements. The CCT may be increasing in use as a tool in the investigation of children with developmental dyslexia. We conclude that CCT is not warranted unless an underlying disorder associated with significant neurologic signs is discovered by examination.

Adolescent↗
PubMed1986

Equivalence class formation in language-able and language-disabled children.

Stimulus equivalence seems to have relevance to the study of semantics and of language more generally. If so, there may be a relation between language use and the demonstration of stimulus equivalence. This was examined in three groups of children ranging in chronological age and matched on a conventional measure of mental age: normally developing preschoolers, retarded children who used speech or signs spontaneously and appropriately, and retarded children who did not. All children were taught a series of four related discriminations and were then tested to determine if classes of equivalent stimuli had formed. All of the language-able children (retarded and normal) formed equivalence classes, whereas none of the language-disabled children did so. Although the exact nature of the relation between stimulus equivalence and language remains to be clarified, these results support the view that stimulus equivalence is a phenomenon with relevance to language.

Child, Preschool↗
PubMed2005

Risk factors for persisting neurological and cognitive impairments following cerebral malaria.

BACKGROUND: Persisting neurological and cognitive impairments are common after cerebral malaria. Although risk factors for gross deficits on discharge have been described, few studies have examined those associated with persistent impairments. METHODS: The risk factors for impairments following cerebral malaria were determined by examining hospital records of 143 children aged 6-9 years, previously admitted with cerebral malaria, who were assessed at least 20 months after discharge to detect motor, speech and language, and other cognitive (memory, attention, and non-verbal functioning) impairments. RESULTS: The median age on admission was 30 months (IQR 19-42) and the median time from discharge to assessment was 64 months (IQR 40-78). Thirty four children (23.8%) were defined as having impairments: 14 (9.8%) in motor, 16 (11.2%) in speech and language, and 20 (14.0%) in other cognitive functions. Previous seizures (OR 5.6, 95% CI 2.0 to 16.0), deep coma on admission (OR 28.8, 95% CI 3.0 to 280), focal neurological signs observed during admission (OR 4.6, 95% CI 1.1 to 19.6), and neurological deficits on discharge (OR 4.5, 95% CI 1.4 to 13.8) were independently associated with persisting impairments. In addition, multiple seizures were associated with motor impairment, age <3 years, severe malnutrition, features of intracranial hypertension, and hypoglycaemia with language impairments, while prolonged coma, severe malnutrition, and hypoglycaemia were associated with impairments in other cognitive functions. CONCLUSIONS: Risk factors for persisting neurological and cognitive impairments following cerebral malaria include multiple seizures, deep/prolonged coma, hypoglycaemia, and clinical features of intracranial hypertension. Although there are overlaps in impaired functions and risk factors, the differences in risk factors for specific functions may suggest separate mechanisms for neuronal damage. These factors could form the basis of future preventive strategies for persisting impairments.

Child↗
PubMed1992

A molecular semiotic view of biology. Interferon and 'homeokine' as symbols.

A term "homeokine" was introduced as a generic name covering cytokines and protein hormones which serve the purpose of intercellular communication within the animal body for homeostasis and ontogenetic development. The homeokine system, in its complex way of functioning, seems to be analogous to another communication system, human language. Individual homeokine molecules are likened to words; they have meanings and are viewed as symbols, representing those conditions or events inside and outside the body which are relevant to homeostasis. Extending this view, any protein and other molecule can be considered to take on the character of sign, when integrated into a purposive system of higher hierarchy, because the molecule then represents a meaning relative to the system as a whole that is lacking in the isolated state. Living systems with their biological macromolecules as semantic units are constructed upon the principle of double articulation, just like human languages with words as the semantic units. The structure and function of a molecule (of protein and any other substance) are associated with each other, with various degrees of arbitrariness, as are the expression and the content of a sign in general. Namely the activities or the sign functions of biological molecules are determined by the organized system they belong to, and not vice versa.

Cell Communication↗