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Early Childhood (early + childhood)
Terms modified by Early Childhood Selected AbstractsEndocardial Implantation of a Cardioverter Defibrillator in Early ChildhoodJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 12 2005MAURIZIO GASPARINI M.D. Introduction: Experience in endovascular/endocardial techniques for implanting implantable cardioverter defibrillators in early childhood is limited. Potentially, this type of approach could limit the surgical risk, while increasing ICD therapy efficacy. The safety and feasibility of adopting a complete endovascular/endocardial approach for implanting ICDs is assessed by considering the cases of two young children. Methods and Results: Two boys, aged 3 and 6 years, were implanted with ICD for a history of syncope and documented ventricular tachycardia (VT). A complete endovascular/endocardial approach was adopted consisting of positioning a bipolar pacing and sensing lead in the right ventricular (RV) apex with intravascular redundancy forming a loop in the inferior vena cava (IVC), and a caval coil placed in the IVC. Sensing values (7,8 mV), pacing threshold (0.5,0.6 V/0.5 msec), and defibrillation testing (case 1 = 10 J, case 2 = 20 J) were all acceptable. During follow-up, in both cases ICD intervened correctly. In one case, 16 months after implantation, because of change in the IVC coil-active can vector, the IVC coil was effectively repositioned to a more distal position. Conclusion: A complete endovascular/endocardial ICD implantation technique in early childhood is both feasible and safe. This approach avoids thoracotomy and ensures ICD therapy efficacy. [source] Fathering With Multiple Partners: Links to Children's Well-Being in Early ChildhoodJOURNAL OF MARRIAGE AND FAMILY, Issue 3 2009Jacinta Bronte-Tinkew The claim that multiple partner fertility may pose a risk of adverse outcomes for children has not been tested. We test this argument using a sample of 4,027 resident fathers and children from the Fragile Families and Child Well-being Survey by examining the pathways through which fathers' multipartnered fertility is associated with children's externalizing behaviors and physical health status at 36 months. Path analyses indicate that multiple partner fertility exerted both a significant direct and indirect effect through paternal depression to influence children's externalizing behaviors. Fathers' multiple partner fertility also exerted a significant indirect effect through one mediator,father involvement,to influence children's physical health. This evidence suggests that the disruptions brought about by multipartnered fertility are important for understanding child well-being. [source] Sleep Problems in Early Childhood and Early Onset of Alcohol and Other Drug Use in AdolescenceALCOHOLISM, Issue 4 2004Maria M. Wong Abstract: Background: No prospective studies exist on the relationship between sleep problems early in life and subsequent alcohol use. Stimulated by the adult literature linking sleep problems to the subsequent onset of alcohol use disorders in some adults, we examined whether sleep problems in early childhood predicted the onset of alcohol and other drug use in adolescence and whether such a relationship was mediated by other known predictors of this relationship, namely, attention problems, anxiety/depression, and aggression in late childhood. Methods: This study is part of an ongoing longitudinal study of the development of risk for alcohol and other substance use disorders. Study participants were 257 boys from a community-recruited sample of high-risk families. Results: Mothers' ratings of their children's sleep problems at ages 3 to 5 years significantly predicted an early onset of any use of alcohol, marijuana, and illicit drugs, as well as an early onset of occasional or regular use of cigarettes by age 12 to 14. Additionally, although sleep problems in early childhood also predicted attention problems and anxiety/depression in later childhood, these problems did not mediate the relationship between sleep problems and onset of alcohol and other drug use. Conclusions: This is, to our knowledge, the first study that prospectively examines the relationship between sleep problems and early onset of alcohol use, a marker of increased risk for later alcohol problems and alcohol use disorders. Moreover, early childhood sleep problems seem to be a robust marker for use of drugs other than alcohol. Implications for the prevention of early alcohol and other drug use are discussed. [source] Memory Binding in Early Childhood: Evidence for a Retrieval DeficitCHILD DEVELOPMENT, Issue 5 2009Marianne E. Lloyd Previous research has suggested that performance for items requiring memory-binding processes improves between ages 4 and 6 (J. Sluzenski, N. Newcombe, & S. L. Kovacs, 2006). The present study suggests that much of this improvement is due to retrieval, as opposed to encoding, deficits for 4-year-olds. Four- and 6-year-old children (N = 48 per age) were given objects, backgrounds, and object + background combinations to remember. Younger children performed equivalently to 6-year-olds during a working memory task for all types of memory questions but were impaired during a long-term memory task for the object + background combinations. Furthermore, this deficit was completely due to differences in false alarm rates, suggesting that separate analyses of hits and false alarms may be preferable to corrected recognition scores when studying memory development. [source] Infant Temperament Moderates Relations Between Maternal Parenting in Early Childhood and Children's Adjustment in First GradeCHILD DEVELOPMENT, Issue 1 2008Anne Dopkins Stright A differential susceptibility hypothesis proposes that children may differ in the degree to which parenting qualities affect aspects of child development. Infants with difficult temperaments may be more susceptible to the effects of parenting than infants with less difficult temperaments. Using latent change curve analyses to analyze data from the National Institute of Child Health and Human Development Study of Early Child Care, the current study found that temperament moderated associations between maternal parenting styles during early childhood and children's first-grade academic competence, social skills, and relationships with teachers and peers. Relations between parenting and first-grade outcomes were stronger for difficult than for less difficult infants. Infants with difficult temperaments had better adjustment than less difficult infants when parenting quality was high and poorer adjustment when parenting quality was lower. [source] Parenting and Child Behavioral Adjustment in Early Childhood: A Quantitative Genetic Approach to Studying Family ProcessesCHILD DEVELOPMENT, Issue 2 2000Kirby Deater-Deckard The aim of this study was to examine environmental and gene , environment processes linking parenting (i.e., affect, control, responsiveness) and preschool children's behavioral adjustment difficulties (e.g., noncompliance, conduct problems) by using bivariate genetic analyses of parents' and observers' ratings. The sample included 120 identical and same-sex fraternal twin pairs (M age = 43 months). Data sources included in-home observations, interviews, and parents' reports. Observers' ratings of children's difficult behaviors included shared and nonshared environmental variance. In contrast, parents' ratings of children's conduct problems showed genetic and nonshared environmental variance. Observer-rated maternal behavior included shared and nonshared environmental variance, although maternal responsiveness also included child genetic variance. Parent self-reported negative and positive affect included shared and nonshared environment as well as child genetic variance. There was no evidence for gene , environment interaction or dominance. Higher levels of difficult behavior and conduct problems covaried with higher levels of maternal negative affect and control and lower levels of maternal positive affect and control. Shared environmental mediation of these correlations was found for observations, whereas genetic and nonshared environmental mediation was found for parents' ratings. In general, estimates of shared environmental variance and mediation were greatest for observational data, and estimates of child genetic variance and mediation were greatest for parent-rated data. The implications of this pattern of findings for genetic research on family processes are discussed. [source] Congenital polymicrogyria including the perisylvian region in early childhoodCONGENITAL ANOMALIES, Issue 1 2010Tomoyuki Takano ABSTRACT Six pediatric cases including four infants with congenital polymicrogyria including the perisylvian region are presented herein. Their clinical features were analyzed and compared with patients suffering from congenital bilateral perisylvian syndrome (CBPS). Two specific abnormalities were diagnosed as accompanying disorders in two cases, namely Kabuki syndrome and Peters' anomaly. In the other four cases, the pathogenetic etiology was not elucidated. Subtle symptoms, such as choking and drooling became detectable in one case each, and expressive language development was delayed in two patients. A developmental delay became apparent in five cases during the follow-up period, and epilepsy was observed in one patient with onset at 12 years of age. Our results indicate that the presence of perisylvian polymicrogyria may not always result in the development of oropharyngoglossal dysfunction or dysarthria, although most patients tend to gradually show the onset of developmental disorders. To support cognitive and psychosocial development, an early integrated approach, including not only conventional speech and language therapy, but also various communication methods is essential for patients with congenital polymicrogyria including the perisylvian region. [source] Refractory Progression of Coronary Aneurysms, a Case of Delayed Onset Kawasaki Disease as Depicted by Cardiac Computed Tomography AngiographyCONGENITAL HEART DISEASE, Issue 3 2010FACP, Shah Azmoon MD ABSTRACT Background., Kawasaki disease (KD) is an immune-mediated vasculitis of unknown etiology with self-limited clinical course that was first described in 1967 by Dr. Tomisaku Kawasaki. It is a disease of early childhood and rare past late adulthood but one that can have detrimental consequences when there is a delay in diagnosis and treatment. Cardiovascular complications causing increased morbidity and mortality may include coronary artery aneurysms, myocardial infarction, heart failure, arrhythmias, and peripheral artery occlusion. Case Presentation., Here, we present an atypical case of delayed onset KD in a young teenager. DS had visited three different emergency departments during the course of 2 weeks for unrelenting fevers. Despite multiple treatment protocols including immunoglobulin, steroids, and tumor necrosis factor-alpha antagonists, he continued to have progression of cardiovascular complications. While echocardiographic findings were suspicious for cardiac complications, a cardiac computed tomography (CT) angiography was able to clearly distinguish giant coronary aneurysms. Conclusion., Without prompt therapy, fever and manifestations of acute inflammation can last for several weeks to months with increased risk toward complications. The incidence of coronary artery aneurysms has been noted to be 25% in untreated patients with a mortality rate of up to 2%. Using low-dose protocols along with high spatial and temporal resolution of cardiac CT angiography may provide a useful and complimentary imaging modality in accurate diagnosis and follow-up of patients with KD. [source] FS02.5 Nickel allergy and hand eczema , a twenty-year follow-upCONTACT DERMATITIS, Issue 3 2004Anna Josefson Aim:, To investigate the occurrence of hand eczema after 20 years in schoolgirls previously patch-tested to nickel. Methods:, In 1982,83, 960 schoolgirls, aged 8, 11 and 15 years, were investigated for the occurrence of nickel allergy (Larson-Stymne B and Widström L, Contact Dermatitis 1985:13:289,293). The girls were patch-tested and the prevalence of nickel allergy was 9%. Twenty years later, the same individuals have received a questionnaire regarding hand eczema and factors of importance for the development of hand eczema. After two reminders, the response rate was 81%. Results:, In total 17.5% of the girls reported hand eczema after the age of 15. The 1-year prevalence of hand eczema was 12.6%. Of the previously patch-tested schoolgirls who answered the questionnaire, 63 were sensitive to nickel. In this study, the prevalence of hand eczema among those 63 was 16%, compared to 17% in the non-sensitive group (NS). Excluding persons with atopic dermatitis, the prevalence of hand eczema was 12.5% in the nickel-sensitive group, and 10% among the others (NS). 32% of the persons who had had atopic dermatitis reported hand eczema after 15 years of age, compared to 10% of those with no history of atopic dermatitis (p < 0.001). Conclusion:, Contact allergy to nickel in early childhood (8,15 years) did not seem to increase the prevalence of hand eczema later in life. The prevalence of hand eczema was increased by a factor of three among those with a history of atopic dermatitis, which is in accordance with earlier reports. [source] Predicting juvenile delinquency: The nexus of childhood maltreatment, depression and bipolar disorderCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2009Christopher A. Mallett Background,It is important to identify and provide preventative interventions for youth who are most at risk for offending behaviour, but the connection between early childhood or adolescent experiences and later delinquency adjudication is complicated. Aim,To test for associations between specified mental disorders or maltreatment and later delinquency adjudication. Method,Participants were a random sample of youth before the juvenile courts in two Northeast Ohio counties in the USA (n = 555) over a 4-year time frame (2003 to 2006). Results,Logistic regression analysis identified a lifetime diagnosis of depression and/or bipolar disorder to be predictive of later youth delinquency adjudication, but found that childhood maltreatment (or involvement with the child welfare system) made delinquency outcomes less likely. Implications,Study implications are discussed as they relate to professionals working in the fields of child welfare, social work, mental health and juvenile justice. Awareness of risks associated with maltreatment may have led to effective interventions, while there may be less awareness of risks from depression in young people; however, studies tend not to take account of intervention variables. Copyright © 2009 John Wiley & Sons, Ltd. [source] Childhood acne: evaluation and managementDERMATOLOGIC THERAPY, Issue 4 2006Julie L. Cantatore-Francis ABSTRACT:, Acne is a disease that can be seen in the first year of life, early childhood, prepubertal age, and puberty. The purpose of this article is to review the clinical presentation and pathogenesis of the various forms of prepubertal acne and to propose guidelines regarding its evaluation and treatment. The early clinical recognition of the disease and prompt initiation of therapy in these age groups will help prevent the sequelae of emotional distress and severe scarring in both the child and parents. [source] Development of swallowing and feeding: Prenatal through first year of lifeDEVELOPMENTAL DISABILITIES RESEARCH REVIEW, Issue 2 2008Amy L. Delaney Abstract The development of feeding and swallowing involves a highly complex set of interactions that begin in embryologic and fetal periods and continue through infancy and early childhood. This article will focus on swallowing and feeding development in infants who are developing normally with a review of some aspects of prenatal development that provide a basis for in utero sucking and swallowing. Non-nutritive sucking in healthy preterm infants, nipple feeding in preterm and term infants, and selected processes of continued development of oral skills for feeding throughout the first year of life will be discussed. Advances in research have provided new information in our understanding of the neurophysiology related to swallowing, premature infants' sucking and swallowing patterns, and changes in patterns from preterm to near term to term infants. Oral skill development as texture changes are made throughout the second half of the first year of life is an under studied phenomenon. Knowledge of normal developmental progression is essential for professionals to appreciate differences from normal in infants and children with feeding and swallowing disorders. Additional research of infants and children who demonstrate overall typical development in oral skills for feeding is encouraged and will provide helpful reference points in increasing understanding of children who exhibit differences from typical development. It is hoped that new technology will provide noninvasive means of delineating all phases of sucking and swallowing from prenatal through infancy. Further related topics in other articles of this issue provide a comprehensive review of factors influencing oral intake, growth, nutrition, and neurodevelopmental status of children. © 2008 Wiley-Liss, Inc. Dev Disabil Res Rev 2008;14:105,117. [source] Development of motor speed and associated movements from 5 to 18 yearsDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 3 2010THEO GASSER PHD Aim, To study the development of motor speed and associated movements in participants aged 5 to 18 years for age, sex, and laterality. Method, Ten motor tasks of the Zurich Neuromotor Assessment (repetitive and alternating movements of hands and feet, repetitive and sequential finger movements, the pegboard, static and dynamic balance, diadochokinesis) were administered to 593 right-handed participants (286 males, 307 females). Results, A strong improvement with age was observed in motor speed from age 5 to 10, followed by a levelling-off between 12 and 18 years. Simple tasks and the pegboard matured early and complex tasks later. Simple tasks showed no associated movements beyond early childhood; in complex tasks associated movements persisted until early adulthood. The two sexes differed only marginally in speed, but markedly in associated movements. A significant laterality (p<0.001) in speed was found for all tasks except for static balance; the pegboard was most lateralized, and sequential finger movements least. Associated movements were lateralized only for a few complex tasks. We also noted a substantial interindividual variability. Interpretation, Motor speed and associated movements improve strongly in childhood, weakly in adolescence, and are both of developmental relevance. Because they correlate weakly, they provide complementary information. [source] Ring chromosome 20 syndrome with intractable epilepsyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 5 2005Asude Alpman MD Ring chromosome 20 (r[20]) syndrome is characterized by mild to moderate learning disability*, behavioural disorders, epilepsy, and various dysmorphic features. Although still considered rare, r(20) syndrome is being increasingly diagnosed. More than 30 cases have been described in the literature since 1976. Here we report an additional case of a 14-year-old male with r(20). He had moderate to severe learning disability and epileptic seizures manifesting at about 18 months of age. During the 13 years' follow-up period he showed intractable epileptic seizures, behavioural disorders, and mild dysmorphological features including microcephaly, strabismus, micrognathia, down-slanting eyelids, and ear abnormalities. Frequent episodes of atypical absence or non-convulsive status associated with electroencephalogram changes were seen in follow-up. He was treated with several classical and new antiepileptic drugs, including intravenous immunoglobulin, corticotropin, and vagal nerve stimulation, with unsuccessful control of seizures. Finally, surgical treatment (corpus callosotomy) was performed at the age of 13 years; severity of tonic seizures was diminished, but frequency was unchanged. Although his behavioural problems, e.g. hyperactivity, were mild in early childhood they became more severe when he was 11 years old. Aggressiveness, compulsiveness with self-injury, and panic attacks developed at the age of 13 years, and were more pronounced after callosotomy. This case report provides the first description of deterioration in psychological situation in patients with r(20) intractable epilepsy. The patient was diagnosed with r(20) syndrome after 13 years of clinical follow-up. Karyotype analysis should, therefore, be performed in every patient with intractable epilepsy of unknown aetiology. [source] Depressive pseudodementia in a child with autismDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 7 2004Andrew J Pollard MBBS BSc PhD DIC ILTM MRCP(UK) FRCPCH Depression is rare in early childhood and unusual in autism in this age group. We describe a female child aged 6 years with autism who presented with regression of developmental skills previously gained. Her sleep and appetite were poor, her affect was sad, and she had morbid speech content. She responded to treatment with antidepressant medication. When this clinical picture occurs in adults it is called depressive pseudodementia; paediatric neurologists and neuropsychiatrists need to be aware of it in children. [source] Brain responses to surprising sounds are related to temperament and parent,child dyadic synchrony in young childrenDEVELOPMENTAL PSYCHOBIOLOGY, Issue 6 2010Anu-Katriina Pesonen Abstract This study investigated the relationship between temperament characteristics, parent,child dyadic synchrony and auditory event-related potentials (ERP) in 15 two-year-old children. Temperament was assessed with the Early Childhood Behavior Questionnaire, and parent,child dyadic synchrony was analyzed from video-taped play situations. Involuntary switching of attention toward surprising sounds was measured with auditory ERPs by quantifying the P3a response for repeated and nonrepeated novel, naturally varying sounds, presented in a continuous repetitive sound sequence. Lower negative emotionality, higher effortful control and higher dyadic synchrony were associated with larger P3a responses to repeated novel sounds. The results demonstrate that temperament is related to P3a responses in early childhood, and that parent,child synchrony associates with both temperament and P3a responses in a theoretically meaningful way. © 2010 Wiley Periodicals, Inc. Dev Psychobiol 52: 513,523, 2010. [source] Toward a neuro-developmental account of the development of declarative memoryDEVELOPMENTAL PSYCHOBIOLOGY, Issue 1 2008Patricia J. Bauer Abstract The study of the biological bases of memory has a long history. Based on research with patients with specific lesions and disease, animal models, and neuroimaging studies, the neural substrate that supports declarative memory in adults has been relatively well articulated. By contrast, studies of the neural bases of memory in development is in its infancy. Yet joint consideration of the processes involved in building a memory trace, and of the time course of development of the neural structures involved, has contributed to the generation of specific predictions regarding the sources of age-related change. Specifically, there are suggestions that in infancy and very early childhood, encoding and consolidation processes account for substantial age-related variance in long-term declarative memory. With development, the locus of age-related variability in the vulnerability of memory traces shifts to the later-stage processes of memory storage and retrieval. These insights are afforded by consideration of multiple levels of analysis, from the biological to the behavioral. © 2007 Wiley Periodicals, Inc. Dev Psychobiol 50: 19,31, 2008. [source] Developmental changes in baseline cortisol activity in early childhood: Relations with napping and effortful controlDEVELOPMENTAL PSYCHOBIOLOGY, Issue 3 2004Sarah E. Watamura Abstract Development of the hypothalamic,pituitary,adrenocortical (HPA) axis was examined using salivary cortisol levels assessed at wake-up, midmorning, midafternoon, and bedtime in 77 children aged 12, 18, 24, 30, and 36 months, in a cross-sectional design. Hierarchical linear modeling (HLM) analyses were used to characterize cortisol production across the day and to examine age-related differences. Using area(s) under the curve (AUC), cortisol levels were higher among the 12-, 18-, and 24-month children than among the 30- and 36-month children. For all five age groups, cortisol levels were highest at wake-up and lowest at bedtime. Significant decreases were noted between wake-up and midmorning, and between midafternoon and bedtime. Unlike adults, midafternoon cortisol levels were not significantly lower than midmorning levels. Over this age period, children napped less and scored increasingly higher on parent reports of effortful control. Among the 30- and 36-month children, shorter naps were associated with more adultlike decreases in cortisol levels from midmorning to midafternoon. Considering all of the age groups together, effortful control correlated negatively with cortisol levels after controlling for age. These results suggest that circadian regulation of the HPA axis continues to mature into the third year in humans, and that its maturation corresponds to aspects of behavioral development. © 2004 Wiley Periodicals, Inc. Dev Psychobiol 45: 125-133, 2004. [source] Holistic processing for faces and cars in preschool-aged children and adults: evidence from the composite effectDEVELOPMENTAL SCIENCE, Issue 2 2009Viola Macchi Cassia The current study compared the development of holistic processing for faces and non-face visual objects by testing for the composite effect for faces and frontal images of cars in 3- to 5-year-old children and adults in a series of four experiments using a two-alternative forced-choice recognition task. Results showed that a composite effect for faces was present as early as years, and none of the age groups tested showed signs of a composite effect for cars. These findings provide the first demonstration that holistic processing is already selective for faces in early childhood, and confirm existing evidence that sensitivity to holistic information in faces does not increase from 4 years to adulthood. [source] Representational momentum and children's sensori-motor representations of objectsDEVELOPMENTAL SCIENCE, Issue 3 2008Lynn K. Perry Recent research has shown that 2-year-olds fail at a task that ostensibly only requires the ability to understand that solid objects cannot pass through other solid objects. Two experiments were conducted in which 2- and 3-year-olds judged the stopping point of an object as it moved at varying speeds along a path and behind an occluder, stopping at a barrier visible above the occluder. Three-year-olds were able to take into account the barrier when searching for the object, while 2-year-olds were not. However, both groups judged faster moving objects to travel farther as indicated by their incorrect reaches. Thus, the results show that young children's sensori-motor representations exhibit a form of representational momentum. This unifies the perceptually based representations of early childhood with adults' dynamic representations that incorporate physical regularities but that are also available to conscious reasoning. [source] Visual search in typically developing toddlers and toddlers with Fragile X or Williams syndromeDEVELOPMENTAL SCIENCE, Issue 1 2004Gaia Scerif Visual selective attention is the ability to attend to relevant visual information and ignore irrelevant stimuli. Little is known about its typical and atypical development in early childhood. Experiment 1 investigates typically developing toddlers' visual search for multiple targets on a touch-screen. Time to hit a target, distance between successively touched items, accuracy and error types revealed changes in 2- and 3-year-olds' vulnerability to manipulations of the search display. Experiment 2 examined search performance by toddlers with Fragile X syndrome (FXS) or Williams syndrome (WS). Both of these groups produced equivalent mean time and distance per touch as typically developing toddlers matched by chronological or mental age; but both produced a larger number of errors. Toddlers with WS confused distractors with targets more than the other groups; while toddlers with FXS perseverated on previously found targets. These findings provide information on how visual search typically develops in toddlers, and reveal distinct search deficits for atypically developing toddlers. [source] Preferences for colours and colour--emotion combinations in early childhoodDEVELOPMENTAL SCIENCE, Issue 4 2001Marcel R. Zentner Previous research has shown that, by the age of 3 to 4 years, children rely not only on perceptual similarity but also on shared category or other underlying structures to draw analogies. The present study extends this work by showing that children as young as 3 years old detect consistent relationships between colours and facial expressions of emotions , two phenomena that share no physical characteristics, violate conventional categories and have no obvious environmental contiguity. Two explanatory hypotheses are put forward: (a) learning by convention, which is explored against the standard of adults' and older children's matching patterns, and (b) reliance upon a common underlying but perceptually unavailable dimension , operationalized in terms of emotion and colour preferences in the context of the present study. Both explanatory approaches are discussed and avenues for future work are suggested. [source] Drug prevention programmes for young people: where have we been and where should we be going?ADDICTION, Issue 10 2010Richard Midford ABSTRACT Aim Substance use by young people has long been a concern of western society, but opinion is mixed as to which prevention approach offers the greatest benefit, and whether indeed there is any benefit at all. This paper reviews the nature of prevention programmes, the research evidence that underpins these programmes and the prevention objectives against which effectiveness is measured. The aim of this is to create better understanding of the elements that maximize programme effectiveness, what can be achieved by prevention programmes and how programmes can be improved. Findings There is a range of prevention approaches for which there is evidence of effectiveness. Some are classroom-based; some focus upon parenting; some have substantial whole-of-school and community elements; and some target risk and protective factors in early childhood. All, however, are based substantially on the social influence model. In an attempt to improve practice lists of effective programmes have been developed, but there are concerns about the science behind selection. On balance, there is consistent evidence that social influence prevention programmes do have a small, positive effect on drug use, but this then raises the question as to whether harm, rather than use, would be the more worthwhile target for prevention. Prevention that seeks to reduce harm has been demonstrably effective, but has found little support in some jurisdictions. Conclusion Research has created a progressively better understanding of how to optimize programme effectiveness and what can be achieved realistically by even the most effective programmes. However, further research is required to identify which, if any, particular approach offers greater promise. The effectiveness of harm reduction should be compared with more traditional abstinence and the additional effects of whole of school, parent and community elements need to be measured more accurately. Contemporary social influence prevention programmes are flawed, but the approach is still the best way of influencing drug use behaviour in young people as a whole. Evidence-based refinement is the best option for greater benefit. [source] Meetings Across the Paradigmatic DivideEDUCATIONAL PHILOSOPHY AND THEORY, Issue 3 2007Peter Moss Abstract The problematique addressed by the article is the growth of a dominant discourse in early childhood education and care, which has a strong effect on policy and practice, paralleled by an increasing number of other discourses which problematise most of the values, assumptions and understandings of the former. Yet there is very little engagement between these discourses, in large part because they are situated within different paradigms,modernity in the former case, postfoundationalism in the latter. The author argues that the absence of dialogue and debate impoverishes early childhood and weakens democratic practice. The article considers whether and in what conditions the concept of agonistic pluralism might provide a framework for political engagement among at least some on either side of the paradigmatic divide, and takes evaluation as one example of a subject for an agonistic politics of early childhood. [source] Antiepileptogenic and antiictogenic effects of retigabine under conditions of rapid kindling: An ontogenic studyEPILEPSIA, Issue 10 2008Andréy Mazarati Summary Purpose:, To examine antiepileptogenic and antiictogenic potential of retigabine (RTG) under conditions of rapid kindling epileptogenesis during different stages of development. Methods:, The experiments were performed in postnatal day 14 (P14), P21, and P35 male Wistar rats. After stereotaxic implantation of hippocampal stimulating and recording electrodes, the effects of RTG on baseline afterdischarge (AD) properties were studied. Next, the animals underwent rapid kindling (sixty 10 s trains, bipolar 20 Hz square wave pulses delivered every 5 min). The progression of seizures (kindling acquisition), and responses to test stimulations after kindling (retention) were compared between RTG and vehicle-treated rats. Additionally, the effects of RTG on the severity of seizures in previously kindled animals were examined. Results:, When administered intraperitoneally in doses that induced only mild, or no motor deficits, RTG significantly dampened brain excitability, evident as the increase of AD threshold and shortening of AD duration. During kindling, RTG delayed the development of focal seizures in P14 rats, and prevented the occurrence of full limbic seizures at all three ages. At P14 and P21, but not at P35, pretreatment with RTG prevented the establishment of kindling-induced enhanced seizure susceptibility. Administration of RTG to kindled animals decreased the severity of seizures induced by test stimulation. The effect was most prominent at P14. Discussion:, RTG exerted both antiepileptogenic and antiictogenic effects under conditions of rapid kindling model. These effects were apparent during postneonatal, early childhood, and adolescent stages of development. [source] A new animal model of infantile spasms with unprovoked persistent seizuresEPILEPSIA, Issue 2 2008Chong L. Lee Summary Purpose: Infantile spasms is one of the most severe epileptic syndromes of infancy and early childhood. Progress toward understanding the pathophysiology of this disorder and the development of effective therapies has been hindered by the lack of a relevant animal model. We report here the creation of such a model. Methods: The sodium channel blocker, tetrodotoxin (TTX), was chronically infused into the developing neocortex or hippocampus of infant rats by way of an osmotic minipump starting on postnatal day 10,12. Results: After a minimum of 10 days of infusion, approximately one-third of these rats began to display very brief (1,2 s) spasms, which consisted of symmetric or asymmetric flexion or extension of the trunk and sometimes involvement of one or both forelimbs. The typical ictal EEG pattern associated with the behavioral spasms consisted of an initial generalized, high amplitude, slow wave followed by an electrodecrement with superimposed fast activity. The interictal EEG revealed multifocal spikes and sharp waves, and in most animals that had spasms a hypsarrhythmic pattern was seen, at least intermittently, during NREM sleep. Like in humans, the spasms in the rat often occurred in clusters especially during sleep,wake transitions. Comparison of the ictal and interictal EEGs recorded in this model and those from humans with infantile spasms revealed that the patterns and the frequency components of both the ictal events and hypsarrhythmia were very similar. Discussion: The TTX model of infantile spasms should be of value in furthering an understanding of the pathophysiology of this seizure disorder. [source] Current Treatment of Myoclonic Astatic Epilepsy: Clinical Experience at the Children's Hospital of PhiladelphiaEPILEPSIA, Issue 9 2007Sudha Kilaru Summary:,Purpose: Myoclonic astatic epilepsy (MAE) is a generalized epilepsy of early childhood. Little is known about the use of newer antiepileptic treatments (AET) in MAE. The purpose of this study was to describe the characteristics, treatment, and outcome of a contemporary MAE cohort exposed to the new generation AET. Methods: Charts of subjects with MAE treated between 1998 and 2005 were reviewed. Results: Twenty-three subjects (19 boys), with a median (range) follow-up of 38 (2, 86) months were identified. Thirty-nine percent had a family history of epilepsy, and 39% had family history of febrile seizures. Age at seizure onset was a median of 36 (12,24) months. Initial EEG was normal in 30%. When seizures ceased, EEG background and epileptiform abnormalities persisted in 17 and 58%, respectively. On average, each subject was exposed to five AET. The most frequently used AET was valproate (83%). Seizure freedom occurred spontaneously in three subjects, with ethosuximide and levetiracetam in one each, valproate and lamotrigine in two each, topiramate in three and the ketogenic diet (KD) in five subjects. By 36 months after seizure onset, 67% achieved seizure freedom. At the last visit, 43% were developmentally normal, 52% had mild, and 5% had moderate cognitive disabilities. Time to seizure freedom did not correlate with cognitive outcome. Conclusions: The new generation of AET may offer significant benefit to children with MAE. The KD was the most effective AET in this series, and perhaps should be considered earlier in treatment. [source] Absence Epilepsy with Onset before Age Three Years: A Heterogeneous and Often Severe ConditionEPILEPSIA, Issue 7 2003Yves Chaix Summary: Purpose: The classification of epilepsies and epileptic syndromes recognizes three syndromes with typical absences [TA, i.e., childhood and juvenile absence epilepsies (CAE and JAE), and epilepsy with myoclonic absences (EMA), none of which is characterized by onset in early childhood]. Although several other forms of absence epilepsies have been described recently, none concerns infants and very young children, and little is known about the nosology and prognosis of early-onset absences. Methods: We retrospectively selected all cases with onset of absences as the only or major seizure type before age 3 years and ,2 years of follow-up among cases newly referred between 1986 and 2002. Neurospychological assessments (generally IQ measure), behavior patterns, and schooling situations were reviewed for each child. Results: We found 10 patients (7 F, 3 M). No child had sensory or motor deficits: neuroimaging was performed in nine and was normal in eight, with aspecfic findings in one. Only two could be characterized as CAE and EMA, respectively, both with seizure control and a good cognitive outcome. Among the remaining eight cases, four had a fairly homogeneous presentation with predominantly brief absences and clearly asymmetric interictal EEGs. All eight had neuropsychological and/or behavioral difficulties. Three had full seizure control, and five, persisting absences, with a follow-up ranging beetween 2 years 8 months to 9 years 4 months; only one child was older than 12 years. Conclusions: Great heterogeneity exists among absence epilepsies of early onset, which are rare conditions. Only a few patients can be categorized into well-known syndromes. The overall prognosis is poor. Early onset of absences is uncommon, and multicenter studies should help clarify the nosology and prognosis. [source] Operative Results without Invasive Monitoring in Patients with Frontal Lobe Epileptogenic LesionsEPILEPSIA, Issue 10 2001A. Mariottini Summary: ,Purpose: To further explore the still controversial issues regarding whether all or most candidates for epilepsy surgery should be investigated preoperatively with invasive long-term video-EEG monitoring techniques (ILTVE). Methods: We studied five patients with intractable seizures since early childhood using the same protocol: clinical evaluation, magnetic resonance imaging (MRI) with fluid-attenuated inversion recovery (FLAIR) sequences, long-term video-EEG (LTVE) monitoring with scalp electroencephalogram (EEG), interictal single photon emission computed tomography (SPECT), positron emission tomography (PET), and neuropsychological testing. The patients' seizures had clinical features suggesting a frontal lobe (FL) origin. MRI scans revealed focal cortical dysplasia (CD) in four patients and a probable gliotic lesion in the fifth. The findings in both PET and SPECT images were congruent with those of the MRI. Scalp LTVE failed to localize the ictal onset, although the data exhibited features suggestive of both CDs and FL seizures. On the basis of these results, surgery was performed with intraoperative corticography, and the cortical area exhibiting the greatest degree of spiking was ablated. Results: Histopathologic study of four of the resected specimens confirmed the presence of CD, whereas in the fifth, there were features consistent with a remote encephaloclastic lesion. There were no postoperative deficits. Seizures in three of the patients were completely controlled at 2,3.5 years of follow-up; a fourth patient is still having a few seizures, which have required reinstitution of pharmacotherapy, and the fifth has obtained 70% control. All patients have had significant improvement in psychosocial measures. For comparison, five patients with generally similar clinical and neuroradiologic features to the previous group underwent preoperative ILTVE monitoring. The surgical outcomes between the two groups have not differed significantly. Conclusions: We conclude that patients with FL epilepsies may be able to undergo successful surgery without preoperative ILTVE monitoring, provided there is high concordance between neuroimaging tests (MRI, SPECT, PET) and the seizure phenotypes, even when routine EEGs and scalp LVTE fail to localize ictal onset unambiguously. The surgical outcomes of these patients generally paralleled those of the other subjects who also had FL epilepsy but who were operated on only after standard ILTVE monitoring. [source] Electroclinical Picture of Autosomal Dominant Nocturnal Frontal Lobe Epilepsy in a Japanese FamilyEPILEPSIA, Issue 1 2000Masatoshi Ito Summary: Purpose: Autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) is the first described partial epilepsy syndrome known to be due to a single gene mutation. We found a first Japanese ADNFLE family with a novel mutation of the neuronal nicotinic acetylcholine receptor (nAChR) ,4 subunit (CHRNA4) gene. The aim of this report is precisely to describe the electroclinical manifestations of ADNFLE in this family and to compare these findings with those of other families reported previously in the literature. Methods: Three affected family members were investigated electroclinically by close clinical observation, interictal EEG, video-EEG monitoring, magnetic resonance imaging, and single-photon-emission tomography. Information about other affected family members was obtained from either the spouse or the parents. Mutations within the CHRNA4 gene were examined in seven family members. Results: The clinical manifestations and diagnostic findings in the members of this family were consistent with ADNFLE. However, there were intrafamilial and interfamilial variations in clinical features. The seizures of the patients were brief tonic seizures, with hyperventilation in children and secondarily generalized tonic,clonic convulsions in adults. The onset of the children's seizures began in infancy and early childhood. The children's seizures were sometimes provoked by movement and sound stimulation, and did not respond to antiepileptic drugs. On the other hand, the adults' seizures disappeared spontaneously or were easily controlled with carbamazepine. Three children showed hyperactivity, and two children had mild mental retardation. All patients had impaired consciousness during their seizures and no auras. A novel missense mutation (c755C>T) in exon 5 of the CHRNA4 gene was found in four affected family members. Conclusions: The electroclinical pictures of a Japanese family with ADNFLE were basically the same as those of other families reported, but with slight differences. ADNFLE is probably not uncommon, and it is very likely that there are unidentified patients with this inherited disorder in Japan. [source] | ||||||||||||||||||||||||||||||||||||||||||||||