Cognitive Development (cognitive + development)

Distribution by Scientific Domains

Selected Abstracts


Raquel Bernal
This article develops and estimates a dynamic model of employment and child care decisions of women after childbirth to evaluate the effects of these choices on children's cognitive ability. We use data from the National Longitudinal Survey of Youth to estimate it. Results indicate that the effects of maternal employment and child care on children's ability are negative and sizable. Having a mother that works full-time and uses child care during one year is associated with a reduction in ability test scores of approximately 1.8% (0.13 standard deviations). We assess the impact of policies related to parental leave and child care on children's outcomes. [source]


Patricia H. Miller
First page of article [source]

Doesn't see, doesn't know: is anticipatory looking really related to understanding or belief?

Wendy A. Garnham
Clements and Perner (Cognitive Development, 9 (1994), 377,397) reported that children show understanding of a story character's belief in their anticipatory looking responses before they show this in their answers to test questions. According to Clements and Perner the anticipatory looking responses provide evidence of implicit understanding of belief. This paper examines the possibility that the anticipatory looking measure is indicative of (a) children using a seeing = knowing rule, i.e. children linking not seeing with ignorance rather than a sensitivity to belief, or (b) a tendency to associate the protagonist with the left-hand container. Thirty-two children aged between 2 years 11 months and 4 years were told a false belief story similar to that used in Clements and Perner (1994) except that three containers were used instead of two. The protagonist first looks inside the middle box but then puts the object in the left-hand box. In his absence, a second character moves the object unexpectedly to the right-hand box. If children's anticipatory looking was based on sensitivity to belief then they should have looked clearly to the left-hand box. If it was based on an association bias or sensitivity to the character not knowing then they should have looked equally to the left-hand and middle boxes. The results were consistent with the former prediction suggesting that children's anticipatory looking responses may indeed be governed by an implicit sensitivity to belief. [source]

Cognitive Development and Learning: Analyzing the Building of Skills in Classrooms

Marc Schwartz
ABSTRACT This article explores the unique and personal experience of learning within a broader framework of development called skill theory. The framework offers a perspective for recognizing within a diversity of experiences a stable order of increasing complexity in skills that individuals display as they execute or demonstrate changes in their understanding. This order is described in terms of a scale, or ruler, that quantifies across domains the achievement of greater levels of complexity in ability. In particular, we explore the process adults follow as they attempt to understand and apply ideas from science and leadership to allow the reader to witness how individual experiences can map onto a "universal" scale of learning and development. [source]

Nutrients for Cognitive Development in School-aged Children

Janet Bryan Ph.D.
This review considers the research to date on the role of nutrition in cognitive development in children, with a particular emphasis on the relatively neglected post-infancy period. Undernutrition and deficiencies of iodine, iron, and folate are all important for the development of the brain and the emergent cognitive functions, and there is some evidence to suggest that zinc, vitamin B12, and omega-3 polyunsaturated fatty acids may also be important. Considerations for future research include a focus on the interactions between micronutrients and macronutrients that might be influential in the optimization of cognitive development; investigation of the impact of nutritional factors in children after infancy, with particular emphasis on effects on the developing executive functions; and selection of populations that might benefit from nutritional interventions, for example, children with nutrient deficiencies or those suffering from attention deficit-hyperactiv-ity disorder and dyslexia. [source]

The Timing of Prenatal Exposure to Maternal Cortisol and Psychosocial Stress Is Associated With Human Infant Cognitive Development

Elysia P. Davis
The consequences of prenatal maternal stress for development were examined in 125 full-term infants at 3, 6, and 12 months of age. Maternal cortisol and psychological state were evaluated 5 times during pregnancy. Exposure to elevated concentrations of cortisol early in gestation was associated with a slower rate of development over the 1st year and lower mental development scores at 12 months. Elevated levels of maternal cortisol late in gestation, however, were associated with accelerated cognitive development and higher scores at 12 months. Elevated levels of maternal pregnancy-specific anxiety early in pregnancy were independently associated with lower 12-month mental development scores. These data suggest that maternal cortisol and pregnancy-specific anxiety have programming influences on the developing fetus. [source]

Cognitive Development, Culture, and Conversation: Comments on Harris and Koenig's "Truth in Testimony: How Children Learn about Science and Religion"

Maureen A. Callanan
Harris and Koenig make a compelling case for the importance of adult "testimony" and its influence on children's developing conceptions of topics in science and religion. This commentary considers how their analysis relates to constructivist and sociocultural theories and discusses several ways in which Harris and Koenig's arguments help to debunk some prevalent assumptions about research on the social context of cognitive development. Finally, a number of additional issues are raised for debate and discussion, and some critiques and suggestions for future research are discussed. The issues discussed by Harris and Koenig are crucial if we are to take seriously the importance of culture in cognitive development. [source]

Fathers and Mothers at Play With Their 2- and 3-Year-Olds: Contributions to Language and Cognitive Development

Catherine S. Tamis-LeMonda
Father,child and mother,child engagements were examined longitudinally in relation to children's language and cognitive development at 24 and 36 months. The study involved a racially/ethnically diverse sample of low-income, resident fathers (and their partners) from the National Early Head Start evaluation study (n=290). Father,child and mother,child engagements were videotaped for 10 min at home during semistructured free play, and children's language and cognitive status were assessed at both ages. Fathers' and mothers' supportive parenting independently predicted children's outcomes after covarying significant demographic factors. Moreover, fathers' education and income were uniquely associated with child measures, and fathers' education consistently predicted the quality of mother,child engagements. Findings suggest direct and indirect effects of fathering on child development. [source]

The Importance of Cognitive Development in Middle Childhood for Adulthood Socioeconomic Status, Mental Health, and Problem Behavior

Leon Feinstein
This study examined the extent to which continuities and discontinuities in cognitive performance between ages 5 and 10 predicted adult income, educational success, household worklessness, criminality, teen parenthood, smoking, and depression. Assessed were the degree of this change during middle childhood, the influence of socioeconomic status (SES) on this change, and the extent to which this change influenced adult outcomes. The analyses were conducted on 11,200 individuals from the UK Birth Cohort Study who were born in 1970 and who were resurveyed at ages 5, 10, 16, 26, and 30. Substantial discontinuities emerged during middle childhood, with strong SES influences. Changes in middle childhood strongly affected adult outcomes, often outweighing the effects of cognitive development before age 5. [source]

Biological and environmental initial conditions shape the trajectories of cognitive and social-emotional development across the first years of life

Ruth Feldman
Human development is thought to evolve from the dynamic interchange of biological dispositions and environmental provisions; yet the effects of specific biological and environmental birth conditions on the trajectories of cognitive and social-emotional growth have rarely been studied. We observed 126 children at six time-points from birth to 5 years. Intelligence, maternal sensitivity, and child social engagement were repeatedly tested. Effects of neonatal vagal tone (VT) and maternal postpartum depressive symptoms on growth-rates were assessed. Cognitive development showed a substantial growth-spurt between 2 and 5 years and social engagement increased rapidly across the first year and more gradually thereafter. VT improved cognitive and social-emotional growth-rates across the first year, whereas maternal depressive symptoms interfered with growth from 2 to 5 years. Differences between infants with none, one, or two non-optimal birth conditions increased with age. Findings shed light on the dynamics of early development as it is shaped by biological and environmental initial conditions. [source]

What causes 3-year-olds' difficulty on the dimensional change card sorting task?

Josef Perner
Abstract Fifty-six children aged 3;01 to 4;11 years were tested with the standard DCCS task (Frye et al., Cognitive development 10:483,527. 1995) where children have to switch from one sorting dimension (e.g. colour) to another (e.g. shape), and with three variations of this task. The aim was to explore different factors (extra-dimensional vs. reversal shift and presence of visual clash between target and test cards) that may account for 3-year olds' executive problems on this task. The only difficult task was the standard DCCS task with a visual clash and an extra-dimensional shift (mean of 3.55 out of five cards sorted correctly). The three new variations were all much easier (means of 4.6 or higher out of five cards sorted correctly). The difficulty with the DCCS task was particularly pronounced for 3-year olds when the task was presented first (mean of 0.50 correct) whereas when it followed one or more of the other tasks then children's mean number correct was 4.0 or above. Implications of this finding are discussed for the theory that younger children suffer from an inability to inhibit a predominant sorting strategy and the cognitive complexity and control theory postulating limitations in understanding higher order rules, negative priming of the initially ignored dimension, and children's difficulty in understanding that the change in the task consists in a redescription of the original cards. Copyright © 2002 John Wiley & Sons, Ltd. [source]

Predictors of neurodevelopmental outcome of Malaysian very low birthweight children at 4 years of age

LC Ong
Objective: To determine neonatal, early developmental and social risk factors that predict the neurocognitive and behavioural outcome of very low birthweight (VLBW) preschool children at four years of age. Methodology: From a cohort of 151 eligible VLBW survivors born in Kuala Lumpur Maternity Hospital, 116 (76.8%) were prospectively followed up from birth till four years. A standardised neurological examination was performed at one and four years to determine the presence of impairment and cerebral palsy, respectively. Cognitive development was assessed using the Mental Scale of the Bayley Scales of Infant Development (MDI) at one year and the Weschler Preschool and Primary Scale of Intelligence-Revised (WIPPSI-R) at four years. Motor coordination was assessed using the Movement Assessment Battery for Children (Movement-ABC). Mothers completed the Child Behaviour Checklist (CBCL) and Parenting Stress Index (PSI) questionnaires. Logistic and multiple regression analyses were used to determine factors associated with cerebral palsy, IQ scores, Movement-ABC and CBCL scores. Results: Factors associated with cerebral palsy were lower MDI scores at one year (P = 0.001) and late neonatal cranial ultrasound abnormalities (P = 0.036). Minor (P = 0.016) or major impairment (P = 0.003) at one year of age and a low level of paternal education (P = 0.01) were associated with poor motor function on the Movement-ABC scale. Lower levels of maternal education (P < 0.001), impairment at one year (P = 0.002) and late neonatal cranial ultrasound abnormalities (P = 0.039) predicted Full Scale IQ scores. Higher PSI scores (P = 0.001), younger mothers (P = 0.003) and late neonatal cranial ultrasound abnormalities (P = 0.009) were associated with worsened child behaviour scores on the CBCL scale. Conclusion: Social factors and the caregiving environment were important determinants of cognitive and behavioural outcome. Cranial ultrasound abnormalities in the late neonatal period and the developmental status at one year might be useful in identifying high risk infants in need of long-term surveillance. [source]

The caregiving context in institution-reared and family-reared infants and toddlers in Romania

Anna T. Smyke
Background:, We assess individual differences in the caregiving environments of young children being raised in institutions in Romania in relation to developmental characteristics such as physical growth, cognitive development, emotional expression, and problem and competence behaviors. Method:, Videotaped observations of the child and favorite caregiver in their ,home' environment were coded for caregiving quality, and this was related to child characteristics. Child emotional reactivity was assessed during responses to interactional tasks. Cognitive development was assessed from child responses to the Bayley Scales of Infant Development. Data regarding problem behaviors and competence were obtained from caregiver report. Children reared in institutions were compared on all of these measures to never institutionalized children to assist gauging degree of impairment. Results:, Children raised in institutions demonstrated marked delays in cognitive development, poorer physical growth, and marked deficits in competence. Individual differences in caregiving environment were associated with cognitive development, competence, and negative behavior among these young children being reared in institutions. Conclusions:, These data confirm previous findings regarding deficits associated with institutional care and extend our understanding of the impact of individual differences in caregiving quality on the development of young children in institutions. [source]

Cognitive outcome at 2 years of age in Finnish infants with very low birth weight born between 2001 and 2006

P Munck
Abstract Aim:, To study cognitive outcome of premature, very low birth weight (VLBW) infants in relation to parental education and neonatal data. Methods:, A regional cohort of 182 VLBW infants born between 2001 and 2006 was followed up. Brain ultrasounds (US) were examined serially until term age and brain magnetic resonance imaging at term age. Neurological status was examined systematically. Cognitive development was assessed using the Mental Developmental Index (MDI) of Bayley Scales at 2 years of corrected age. A total of 192 healthy full-term (FT) controls were assessed with the MDI at 2 years of age. Results:, The mean MDI in VLBW infants was 101.7 (SD 15.4), which was lower compared with FT controls (109.8, SD 11.7, p < 0.001). In regression analysis of the demographic and medical data of VLBW infants, postnatal corticosteroids (p = 0.04), intestinal perforation (p = 0.03) and major brain pathology (p = 0.02) were negatively associated with the MDI. In VLBW infants, the prevalence of neurodevelopmental impairment was 9.9% (3.3% MDI below 70, 7.1% cerebral palsy, 2.2% hearing aid, no blind infants). Conclusion:, Cognitive development of VLBW infants seemed to have improved in comparison with earlier publications, but it differed from the FT controls. Neonatal factors affected cognitive development. Therefore, updated regional follow-up data are important for clinicians. [source]

Neurophysiologic evaluation of early cognitive development in high-risk infants and toddlers

Raye-Ann deRegnier
Abstract New knowledge of the perceptual, discriminative, and memory capabilities of very young infants has opened the door to further evaluation of these abilities in infants who have risk factors for cognitive impairments. A neurophysiologic technique that has been very useful in this regard is the recording of event-related potentials (ERPs). The event-related potential (ERP) technique is widely used by cognitive neuroscientists to study cognitive abilities such as discrimination, attention, and memory. This method has many attractive attributes for use in infants and children as it is relatively inexpensive, does not require sedation, has excellent temporal resolution, and can be used to evaluate early cognitive development in preverbal infants with limited behavioral repertories. In healthy infants and children, ERPs have been used to gain a further understanding of early cognitive development and the effect of experience on brain function. Recently, ERPs have been used to elucidate atypical memory development in infants of diabetic mothers, difficulties with perception and discrimination of speech sounds in infants at risk for dyslexia, and multiple areas of cognitive differences in extremely premature infants. Atypical findings seen in high-risk infants have correlated with later cognitive outcomes, but the sensitivity and specificity of the technique has not been studied, and thus evaluation of individual infants is not possible at this time. With further research, this technique may be very useful in identifying children with cognitive deficits during infancy. Because even young infants can be examined with ERPs, this technique is likely to be helpful in the development of focused early intervention programs used to improve cognitive function in high-risk infants and toddlers. © 2005 Wiley-Liss, Inc. MRDD Research Reviews 2005;11:317,324. [source]

Do healthy preterm children need neuropsychological follow-up?

Preschool outcomes compared with term peers
Aim, The aim of this study was to determine neuropsychological performance (possibly predictive of academic difficulties) and its relationship with cognitive development and maternal education in healthy preterm children of preschool age and age-matched comparison children born at term. Method, A total of 35 infants who were born at less than 33 weeks' gestational age and who were free from major neurosensory disability (16 males, 19 females; mean gestational age 29.4wk, SD 2.2wk; mean birthweight 1257g, SD 327g) and 50 term-born comparison children (25 males, 25 females; mean birthweight 3459g, SD 585g) were assessed at 4 years of age. Cognition was measured using the Griffiths Mental Development scales while neuropsychological abilities (language, short-term memory, visual,motor and constructive spatial abilities, and visual processing) were assessed using standardized tests. Multivariable regression analysis was used to explore the effects of preterm birth and sociodemographic factors on cognition, and to adjust neuropsychological scores for cognitive level and maternal education. Results, The mean total Griffiths score was significantly lower in preterm than in term children (97.4 vs 103.4; p<0.001). Factors associated with higher Griffiths score were maternal university education (,=6.2; 95% confidence interval [CI] 0.7,11.7) and having older siblings or a twin (,=4.0; 95% CI 0.5,7.6). At neuropsychological assessment, preterm children scored significantly lower than term comparison children in all tests except lexical production (Boston Naming Test) and visual-processing accuracy. After adjustment for cognitive level and maternal education, differences remained statistically significant for verbal fluency (p<0.05) and comprehension, short-term memory, and spatial abilities (p<0.01). Interpretation, Neuropsychological follow-up is also recommended for healthy very preterm children to identify strengths and challenges before school entry, and to plan interventions aimed at maximizing academic success. [source]

Prenatal and family risks of children born to mothers with epilepsy: effects on cognitive development

Karl Titze PhD
The offspring of mothers with epilepsy are considered to be at developmental risk during pregnancy from: (1) generalized maternal seizures (hypoxia); (2) teratogenicity of antiepileptic drugs (AEDs); and (3) adverse socio-familial conditions associated with having a chronically sick mother. Sixty-seven children of mothers with epilepsy and 49 children from non-affected mothers, matched for control variables, were followed from birth to adolescence (53 males, 63 females; mean age 14y 2mo, range 10-20y). Prediction of intellectual performance of these children during adolescence was calculated from the following variables: maternal generalized seizures, prenatal exposure to AEDs, and quality of family stimulation (HOME Inventory) assessed in children at 2 years of age. Children who were prenatally exposed to AEDs achieved lower IQs than control children at adolescence. This effect was moderately significant for children who had been exposed to monotherapy (6 IQ points lower), but was considerable in those exposed to polytherapy (12 IQ points lower). Generalized seizures during pregnancy, observed in half the mothers, did not exacerbate this effect. Relative to prenatal risk status, the quality of the family environment had varied effects on intellectual development. Children with prenatal risks appeared to be more vulnerable to environmental disadvantage than control children, but they also showed longer-lasting effects of environmental support. [source]

Developmental outcome and types of chronic-stage EEG abnormalities in preterm infants

Akihisa Okumura MD
The aims of this study were to determine the types of chronic-stage EEG abnormalities that exist and to clarify their relation to neurodevelopmental outcome in preterm infants. We evaluated 183 preterm infants with gestational ages of less than 33 weeks (mean age 29.2 weeks) and weighing less than 2000g (mean weight 1275g). The first EEG was performed within 72 hours of life; thereafter, EEG was performed once every 1 to 4 weeks until the infant reached a post-conceptional age of 40 to 42 weeks. Two kinds of EEG abnormalities, acute- and chronic-stage abnormalities, were evaluated and we assessed mainly the latter. Chronic-stage EEG abnormalities were divided into two patterns: disorganized and dysmature. Periventricular leukomalacia (PVL) and intraventricular haemorrhage (IVH) were diagnosed on the basis of ultrasound findings. Psychomotor development was examined every 3 months after discharge until at least 18 months of the infants'corrected age. Disorganized and dysmature patterns were observed in 52 and 28 infants respectively. Among the 52 infants with disorganized patterns, PVL was observed in 31 and IVH in seven infants. Thirty-nine infants had cerebral palsy (CP). Twenty-six achieved normal cognitive development. Of the 28 infants with dysmature patterns, PVL was seen in one and IVH in 11 infants. CP was seen in five infants. Only eight infants achieved normal cognitive development. Gestational age and birth weight were significantly lower in infants with dysmature patterns than in those with disorganized ones. Results indicate that types of chronic-stage EEG abnormalities are related to types of neurological sequelae and are useful for assessing the mode of brain injury in preterm infants. [source]

Effects of iodine supplementation during pregnancy on child growth and development at school age

Karen J O'Donnell MEd PhD
Growth and development of 207 children (49% males; mean age 5.4 years [SD 0.2], range 4 to 7.3 years whose mothers received iodine during pregnancy, and children who received iodine first in their 2nd year, were examined in 1996; 192 children(49% males; mean age 6.5 years[SD 0.2], range 5.8 to 6.9 years) whose mothers received iodine while pregnant were seen in 1998. Children were from the southern part of China's Xinjiang Province which has the lowest levels of iodine in water and soil ever recorded. Head circumference but not height was improved for those who received iodine during pregnancy (compared with those receiving iodine at age 2) and for those supplemented before the end of the 2nd trimester (relative to those supplemented during the 3rd trimester). Iodine before the 3rd trimester predicted higher psychomotor test scores for children relative to those provided iodine later in pregnancy or at 2 years. Results from the test for cognitive development resulted in trend only differences between those children supplemented during pregnancy versus later. The results address the question of when maternal iodine supplements should begin in public health programs world wide. Findings may be relevant to the treatment of maternal and newborn thyroid deficiency in industrialized countries, particularly for those infants delivered before the end of the second trimester. [source]

Deletion of 8p: a report of a child with normal intelligence

Linda Gilmore PhD
The case is presented of a female infant with a distal deletion of 8p (8p23.1,pter) whose development was monitored over a 5-year period from 12 months of age. Although previous literature has suggested that 8p deletion is associated with mild to moderate intellectual disability, the child reported here has normal intelligence. Despite initial delays in gross motor and language skills, cognitive development (assessed with the Bayley Scales of Infant Development) and intellectual ability (measured on the Stanford-Binet Intelligence Scale) were within average range. It is argued that the small number of previous case reports may have created a misleading impression of intellectual development in individuals with distal deletions of 8p. [source]

Age-related changes in transient and oscillatory brain responses to auditory stimulation during early adolescence

Catherine Poulsen
Maturational changes in the capacity to process quickly the temporal envelope of sound have been linked to language abilities in typically developing individuals. As part of a longitudinal study of brain maturation and cognitive development during adolescence, we employed dense-array EEG and spatiotemporal source analysis to characterize maturational changes in the timing of brain responses to temporal variations in sound. We found significant changes in the brain responses compared longitudinally at two time points in early adolescence, namely 10 years (65 subjects) and 11.5 years (60 of the 65 subjects), as well as large differences between adults, studied with the same protocol (Poulsen, Picton & Paus, 2007), and the children at 10 and 11.5 years of age. The transient auditory evoked potential to tone onset showed decreases in the latency of vertex and T-complex components, and a highly significant increase in the amplitude of the N1 wave with increasing age. The auditory steady state response to a 40-Hz frequency-modulated tone increased in amplitude with increasing age. The peak frequency of the envelope-following response to sweeps of amplitude-modulated white noise also increased significantly with increasing age. These results indicate persistent maturation of the cortical mechanisms for auditory processing from childhood into middle adulthood. [source]

Bilingual experience and executive functioning in young children

Stephanie M. Carlson
Advanced inhibitory control skills have been found in bilingual speakers as compared to monolingual controls (Bialystok, 1999). We examined whether this effect is generalized to an unstudied language group (Spanish-English bilingual) and multiple measures of executive function by administering a battery of tasks to 50 kindergarten children drawn from three language groups: native bilinguals, monolinguals (English), and English speakers enrolled in second-language immersion kindergarten. Despite having significantly lower verbal scores and parent education/income level, Spanish-English bilingual children's raw scores did not differ from their peers. After statistically controlling for these factors and age, native bilingual children performed significantly better on the executive function battery than both other groups. Importantly, the relative advantage was significant for tasks that appear to call for managing conflicting attentional demands (Conflict tasks); there was no advantage on impulse-control (Delay tasks). These results advance our understanding of both the generalizability and specificity of the compensatory effects of bilingual experience for children's cognitive development. [source]

Development of using experimenter-given cues in infant chimpanzees: longitudinal changes in behavior and cognitive development

Sanae Okamoto-Barth
The use of gaze shifts as social cues has various evolutionary advantages. To investigate the developmental processes of this ability, we conducted an object-choice task by using longitudinal methods with infant chimpanzees tested from 8 months old until 3 years old. The experimenter used one of six gestures towards a cup concealing food; tapping, touching, whole-hand pointing, gazing plus close-pointing, distant-pointing, close-gazing, and distant-gazing. Unlike any other previous study, we analyzed the behavioral changes that occurred before and after choosing the cup. We assumed that pre-choice behavior indicates the development of an attentional and spatial connection between a pointing cue and an object (e.g. Woodward, 2005); and post-choice behavior indicates the emergence of object permanence (e.g. Piaget, 1954). Our study demonstrated that infant chimpanzees begin to use experimenter-given cues with age (after 11 months of age). Moreover, the results from the behavioral analysis showed that the infants gradually developed the spatial link between the pointing as an object-directed action and the object. Moreover, when they were 11 months old, the infants began to inspect the inside of the cup, suggesting the onset of object permanence. Overall, our results imply that the ability to use the cues is developing and mutually related with other cognitive developments. The present study also suggests what the standard object-choice task actually measures by breaking the task down into the developmental trajectories of its component parts, and describes for the first time the social-physical cognitive development during the task with a longitudinal method. [source]

Hypoxia: an acute, intermittent and chronic challenge to cognitive development

Alexandra M. Hogan
No abstract is available for this article. [source]

Connectionist models of infant perceptual and cognitive development

Leslie B. Cohen
No abstract is available for this article. [source]

Peer Commmentaries on Jonas Langer's The descent of cognitive development

Article first published online: 28 JUN 200
Robert W. Mitchell, The role of perception in cognitive development, p. 379 Sue T. Parker, Cascading possibilities through the ontogenetic window of opportunity, p. 381 Jacques Vauclair and Olivier HoudeŽ, Coordination of actions, visual perception and inhibition in non-human and human primate development, p. 382 [source]

Impact of severe epilepsy on development: Recovery potential after successful early epilepsy surgery

EPILEPSIA, Issue 7 2010
Eliane Roulet-Perez
Summary Purpose:, Epilepsy surgery in young children with focal lesions offers a unique opportunity to study the impact of severe seizures on cognitive development during a period of maximal brain plasticity, if immediate control can be obtained. We studied 11 children with early refractory epilepsy (median onset, 7.5 months) due to focal lesion who were rendered seizure-free after surgery performed before the age of 6 years. Methods:, The children were followed prospectively for a median of 5 years with serial neuropsychological assessments correlated with electroencephalography (EEG) and surgery-related variables. Results:, Short-term follow-up revealed rapid cognitive gains corresponding to cessation of intense and propagated epileptic activity [two with early catastrophic epilepsy; two with regression and continuous spike-waves during sleep (CSWS) or frontal seizures]; unchanged or slowed velocity of progress in six children (five with complex partial seizures and frontal or temporal cortical malformations). Longer-term follow-up showed stabilization of cognitive levels in the impaired range in most children and slow progress up to borderline level in two with initial gains. Discussion:, Cessation of epileptic activity after early surgery can be followed by substantial cognitive gains, but not in all children. In the short term, lack of catch-up may be explained by loss of retained function in the removed epileptogenic area; in the longer term, by decreased intellectual potential of genetic origin, irreversible epileptic damage to neural networks supporting cognitive functions, or reorganization plasticity after early focal lesions. Cognitive recovery has to be considered as a "bonus," which can be predicted in some specific circumstances. [source]

Cognitive outcome of status epilepticus in adults

EPILEPSIA, Issue 2007
Christoph Helmstaedter
Summary There is no doubt that structural morphological brain lesions and malformations in epilepsy represent major etiological factors for the cognitive impairments seen in this disease. The role of epileptic activity and seizures for cognition and cognitive development, however, is less easily determined. Epileptic dysfunction ranges from interictal and periictal activity over self-terminating seizures to non-convulsive and convulsive status epilepticus, which appear the most severe conditions along this continuum. The decisive question in this regard is as to whether cognitive impairments observed in the acute epileptic condition are reversible or not. Impairments from interictal or postictal epileptic dysfunction are reversible and may interfere at most with brain maturation and cognitive development in the young patient. Seizures and ictal dysfunction in contrast, even when reversible, can leave a permanent trace which extends the phase of postictal recovery. As for status epilepticus and subsequent cognitive decline it often remains open whether the epileptic condition itself or the underlying clinical condition is causative for the aftermath. While there is evidence for both possibilities, group data from neuropsychological cross sectional and longitudinal studies indicate that more severe mental impairments, which in turn indicate more severe clinical conditions, appear to be a risk factor for sustaining status epilepticus, rather than that status epilepticus causes the cognitive decline. Reviewing the literature the cognitive condition in patients with status epilepticus varies with the type of epilepsy, the etiology of epilepsy, severity of the status, and the age of the patient. [source]

Community-based, Prospective, Controlled Study of Obstetric and Neonatal Outcome of 179 Pregnancies in Women with Epilepsy

EPILEPSIA, Issue 1 2006
Katriina Viinikainen
Summary:,Purpose: This study evaluated obstetric and neonatal outcome in a community-based cohort of women with active epilepsy (WWAE) compared with the general pregnant population receiving modern obstetric care. Methods: We reviewed the total population who gave birth between January 1989 and October 2000 at Kuopio University Hospital. Obstetric, demographic, and epilepsy data were collected prospectively from 179 singleton pregnancies of women with epilepsy and from 24,778 singleton pregnancies of unaffected controls. The obstetric data from the pregnancy register was supplemented with detailed neurologic data retrieved from the medical records. The data retrieved were comprehensive because of a follow-up strategy according to a predecided protocol. Results: During pregnancy, the seizure frequency was unchanged, or the change was for the better in the majority (83%) of the patients. We found no significant differences between WWAE and controls in the incidence of preeclampsia, preterm labor, or in the rates of caesarean sections, perinatal mortality, or low birth weight. However, the rate of small-for-gestational-age infants was significantly higher, and the head circumference was significantly smaller in WWAE. Apgar score at 1 min was lower in children of WWAE, and the need for care in the neonatal ward and neonatal intensive care were increased as compared with controls. The frequency of major malformations was 4.8% (,0.6,10.2%; 95% confidence interval) in the 127 children of WWAE. Conclusions: Pregnancy course is uncomplicated and neonatal outcome is good in the majority of cases when a predecided protocol is used for the follow-up of WWAE in antenatal and neurologic care. Long-term follow-up of the neurologic and cognitive development of the children of WWAE is still needed. [source]

Effects of maternal smoking in pregnancy on prenatal brain development.

The Generation R Study
Abstract Nicotine, as has been shown in animal studies, is a neuroteratogen, even in concentrations that do not cause growth retardation. In humans, there is only indirect evidence for negative influences of nicotine on brain development from studies on the association between maternal smoking in pregnancy and behavioural and cognitive development in the offspring. We investigated the associations of maternal smoking in pregnancy with foetal head growth characteristics in 7042 pregnant women. This study was embedded in the Generation R Study, a population-based prospective cohort study from foetal life until adulthood. Maternal smoking was assessed by questionnaires in early, mid- and late pregnancy. Head circumference, biparietal diameter, transcerebellar diameter and atrial width of lateral ventricles were repeatedly measured by ultrasound. When mothers continued to smoke during pregnancy, foetal head circumference showed a growth reduction of 0.13 mm [95% confidence interval (CI): ,0.18, ,0.09] per week compared to foetuses of mothers who never smoked during pregnancy. Biparietal diameter of foetuses with smoking mothers grew 0.04 mm (95% CI: ,0.05, ,0.02) less per week than that of foetuses of nonsmoking mothers. Atrial width of lateral ventricle was 0.12 mm (95% CI: ,0.22, ,0.02) smaller and transcerebellar diameter was 0.08 mm (95% CI: ,0.15, ,0.00) smaller if mothers smoked, but growth per week of these characteristics was not affected by maternal smoking in pregnancy. In conclusion, continuing to smoke during pregnancy leads to reduced growth of the foetal head. Further research should focus on the causal pathway from prenatal cigarette exposure via brain development to behavioural and cognitive functions. [source]