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Cognitive Delay (cognitive + delay)
Selected AbstractsDevelopmental assessment of preterm infants at 2 years: validity of parent reportsDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 1 2008Samantha Johnson PhD CPsychol Parental questionnaires are inexpensive alternatives to standardized testing for outcome measurement. The Parent Report of Children's Abilities has previously been revised (PARCA-R) and validated for use with very-preterm infants at 2 years of age. This study revalidated the PARCA-R for assessing cognition in a larger and more inclusive sample of preterm infants. One hundred and sixty-four children (82 males, 82 females) of <32 weeks' gestation (median 29wks, interquartile range [IQR] 28-30wks); and median birthweight 1200g (IQR 925-1463g) were evaluated using the Mental Development Index (MDI) of the Bayley Scales of Infant Development - 2nd edition (BSID-II) at 2 years' corrected age. Parents completed the PARCA-R questionnaire. Significant correlations between PARCA-R Parent Report Composite (PRC) scores and MDI scores (r=0.77, 95% confidence interval [CI] 0.69-0.82, p<0.01) demonstrated concurrent validity. A receiver operating characteristic-determined PRC cut-off of <44 had optimal discriminatory power (area under curve 0.92) for identifying MDI <70, with 85% sensitivity (95% CI 0.58-0.96), 87% specificity (95% CI 0.81-0.92), 98% negative predictive value (95% CI 0.95-1), and 37% positive predictive value (95% CI 0.22-0.54). The PARCA-R has good concurrent validity and diagnostic utility for identifying cognitive delay in very-preterm infants at 2 years of age. It is useful for outcome measurement, developmental screening, and facilitating parental involvement at folow-up. [source] Sensitivity to visual and auditory stimuli in children with developmental dyslexiaDYSLEXIA, Issue 2 2008Bernardine King Abstract This study considered the extent to which 23 children with dyslexia differed from 23 reading age (RA) and 23 chronological age (CA) matched controls in their ability to make temporal judgements about auditory and visual sequences of stimuli, and in the speed of their reactions to the onsets and offsets of visual and auditory stimuli. The children with dyslexia were slower (p,=,0.039) than the CA controls in their reactions to non-verbal auditory onsets (tones), were less able to recognize the first stimulus of a sequence of tones (p,=,0.022), and were less accurate in identifying the initial phoneme of a sequence of three (p,<,0.001). These characteristics may be manifestations of an impaired temporal processing system for rapid auditory stimuli. CA controls responded more quickly to tone onsets than to tone offsets (p,=,0.025), but the dyslexic and RA groups showed no significant difference (p,>,0.05) in their reaction times to onsets and offsets of these non-verbal auditory stimuli. Dyslexic readers showed impairment compared with CA controls in responding to the last of a sequence of three non-verbal visual stimuli (shapes), p,=,0.02. Reaction times in the visual and auditory onset and offset tasks were richly intercorrelated in the control groups, but the dyslexic group did not show as many significant correlations in reaction times between the auditory and visual domains, or between the onset and offset RTs within each modality. These results suggest that there may be a less integrated cross-modal and intra-modal temporal system in children with dyslexia than in controls. In many of the measures in this study, the performance of the dyslexic group resembled that of the RA control group but differed from CA controls, which implies a developmental delay. The possibility that such a cognitive delay may be related to an underlying neurological disorder is discussed. Copyright © 2007 John Wiley & Sons, Ltd. [source] Neurodevelopmental outcomes of premature infants treated with l -arginine for prevention of necrotising enterocolitisJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 4 2009Harish J Amin Aim: This study aimed to compare the long-term neurodevelopmental outcomes at 36 months adjusted age in preterm infants (birth weight , 1250 gm) who received supplementation with l -arginine during the first 28 days of life with controls. Methods: Surviving infants enrolled in a randomised control study of l -arginine supplementation were prospectively followed longitudinally to determine their neurodevelopmental outcomes at 36 months of adjusted age. Neurologic examination and neurodevelopmental assessments were performed by examiners who were unaware of the original treatment assignments. Results: A total of 132 children (95% of survivors) were evaluated at 36 months adjusted age. In the group given l -arginine, 5 of 61 (8.1%) had major neurodevelopmental disabilities, defined as the presence of one or more of cerebral palsy, cognitive delay (cognitive index <70), bilateral blindness or bilateral hearing loss requiring hearing aids as compared with 9 of 71 (12.6%) in the placebo group (relative risk, 0.64; 95 % confidence interval, 0.22,1.82; P= 0.40). Conclusions: There is no increase in neurodevelopmental disability in preterm infants who received l -arginine supplementation. [source] Eosinophilic intracytoplasmic inclusions in Purkinje neurons of childrenNEUROPATHOLOGY, Issue 1 2009Viktor Zherebitskiy Eosinophilic intracytoplasmic inclusions have been rarely described in Purkinje neurons of children with a variety of neurological conditions. Here we document these inclusions in five children from 3 to 14 years of age. One child had 7q deletion syndrome and a second had profound motor and cognitive delay ("cerebral palsy") of unknown origin, while three others were neurologically normal prior to death. These inclusions stain with the PAS method, are not strongly ubiquitinated, and are located in the lumen of endoplasmic reticulum. Their appearance in a wide range of disorders and in neurologically normal children suggests that they are a nonspecific protein trafficking anomaly, possibly aggravated under degenerative conditions. [source] Disparities in the prevalence of cognitive delay: how early do they appear?PAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 3 2009Marianne M. Hillemeier Summary Cognitively delayed children are at risk for poor mental and physical health throughout their lives. The economically disadvantaged and some race/ethnic groups are more likely to experience cognitive delay, but the age at which delays first emerge and the underlying mechanisms responsible for disparities are not well understood. The objective of this study was to determine when sociodemographic disparities in cognitive functioning emerge, and identify predictors of low cognitive functioning in early childhood. Data were from 7308 singleton and 1463 multiple births in the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B), a nationally representative cohort of children born in the USA in 2001. Multiple logistic regression analyses examined associations between sociodemographic characteristics and low cognitive functioning at 9 and 24 months, and tested whether gestational and birth-related factors mediate these associations. Sociodemographic characteristics were statistically significant predictors of low cognitive functioning among singletons at 24 months, including the three lowest quintiles of socio-economic status [lowest quintile, odds ratio (OR) = 2.7, 95% confidence interval [CI][1.7, 4.1]], non-white race/ethnicity (African American OR = 1.8 [95% CI 1.3, 2.5], Hispanic OR = 2.3 [95% CI 1.6, 3.2]), and gender (male OR = 2.1, [95% CI 1.7, 2.5]). Gestational and birth characteristics associated with low cognitive function at 9 months included very low and moderately low birthweight (OR = 55.0 [95% CI 28.3, 107.9] and OR = 3.6 [95% CI 2.6, 5.1]), respectively, and very preterm and moderately preterm delivery (OR = 3.6 [95% CI 2.0, 6.7] and OR = 2.4 [95% CI 1.7, 3.5]), respectively, but they had weaker effects by 24 months (ORs for birthweight: 3.7 [95% CI 2.3, 5.9] and 1.8 [95% CI 1.4, 2.3]; ORs for preterm: 1.8 [95% CI 1.1, 2.9] and 0.9 [95% CI 0.7, 1.3]). Results for multiple births were similar. Sociodemographic disparities in poor cognitive functioning emerged by 24 months of age, but were not mediated by gestational or birth characteristics. Further investigation of processes whereby social disadvantage adversely affects development prior to 24 months is needed. [source] Developing a Policy for Sexual Assault Examinations on Incapacitated Patients and Patients Unable to ConsentTHE JOURNAL OF LAW, MEDICINE & ETHICS, Issue 3 2010Mary E. Carr Sexual assault examinations consist of a medical evaluation and forensic evidence collection. Usually the patient signs a consent form allowing the examination to occur. Occasionally circumstances exist that render a patient unable to give consent for this examination. Such circumstances include young age, mental health disease, cognitive delay, or drug/alcohol ingestion. This article provides suggestions for developing a policy allowing a sexual assault examination to be conducted without patient consent. A sample of such a policy is provided. [source] Assessment of Psychoeducational Outcomes After Pediatric Liver TransplantAMERICAN JOURNAL OF TRANSPLANTATION, Issue 2 2009S. Gilmour Outcomes research in pediatric liver transplant (LT) has focused on mortality and morbidity but there is a need to also evaluate functional outcomes. Standardized cognitive testing was administered to a cohort of children with infantile chronic liver disease who were transplanted at the University of Alberta during their preschool years. Thirty children had comprehensive assessments with the Bayley Scales of Infant Development or Wechsler testing. Patient variables potentially associated with cognitive delay were analyzed with multiple regression analysis. The mean DQ/IQ score (developmental quotient/intelligence quotient) was 81 ± 17. Delay (DQ/IQ score < 70), and borderline delay (DQ/IQ 70,84) were each present in 27% of the cohort, with only 46% demonstrating normal cognition. Regression analysis demonstrated that the decreased IQ was associated with pretransplant growth retardation and elevated calcineurin inhibitor levels. Performance IQ had strong correlation with pretransplant growth retardation and elevated serum ammonia, R2= 45%, compared to verbal IQ that was associated was elevated calcineurin inhibitor levels, R2= 23%. Children post-LT are at high risk for cognitive delay or borderline delay. This is the first study to demonstrate the association calcineurin inhibitors with impaired IQ and also the unique finding of different variables predictive of impaired verbal intelligence quotient (VIQ) versus performance intelligence quotient (PIQ). [source] Genotype differences in cognitive functioning in Noonan syndromeGENES, BRAIN AND BEHAVIOR, Issue 3 2009E. I. Pierpont Noonan syndrome (NS) is an autosomal-dominant genetic disorder associated with highly variable features, including heart disease, short stature, minor facial anomalies and learning disabilities. Recent gene discoveries have laid the groundwork for exploring whether variability in the NS phenotype is related to differences at the genetic level. In this study, we examine the influence of both genotype and nongenotypic factors on cognitive functioning. Data are presented from 65 individuals with NS (ages 4,18) who were evaluated using standardized measures of intellectual functioning. The cohort included 33 individuals with PTPN11 mutations, 6 individuals with SOS1 mutations, 1 individual with a BRAF mutation and 25 participants with negative, incomplete or no genetic testing. Results indicate that genotype differences may account for some of the variation in cognitive ability in NS. Whereas cognitive impairments were common among individuals with PTPN11 mutations and those with unknown mutations, all of the individuals with SOS1 mutations exhibited verbal and nonverbal cognitive skills in the average range or higher. Participants with N308D and N308S mutations in PTPN11 also showed no (or mild) cognitive delays. Additional influences such as hearing loss, motor dexterity and parental education levels accounted for significant variability in cognitive outcomes. Severity of cardiac disease was not related to cognitive functioning. Our results suggest that some NS-causing mutations have a more marked impact on cognitive skills than others. [source] When the Bough Breaks the Cradle Will Fall: Promoting the Health and Well Being of Infants and Toddlers in Juvenile CourtJUVENILE AND FAMILY COURT JOURNAL, Issue 4 2001JUDGE CINDY S. LEDERMAN ABSTRACT Approximately one-third of the children in the child welfare system are under the age of six. These children are almost invisible in our juvenile courts. It is now clear from the emerging science of early childhood development that during the first few years of life children develop the foundation and capabilities on which all subsequent development builds. Living in emotional and environmental impoverishment and deprivation provides a poor foundation for healthy development. These very young and vulnerable children are exhibiting disproportionate developmental and cognitive delays, medical problems, and emotional disorders. However, there is growing evidence that early planned interventions can help. The juvenile court must take a leadership role in focusing on the very young child and learning more about risk, prevention, and early intervention in order to facilitate the healing process. [source] | |||||||||||||