For Children (for + children)

Distribution by Scientific Domains
Distribution within Medical Sciences

Kinds of For Children

  • assessment battery for children
  • assessment system for children
  • battery for children
  • care for children
  • care services for children
  • caring for children
  • data for children
  • health outcome for children
  • hospital for children
  • important for children
  • intelligence scale for children
  • intervention for children
  • inventory for children
  • kaufman assessment battery for children
  • life for children
  • liver transplantation for children
  • management for children
  • medicine for children
  • movement assessment battery for children
  • opportunity for children
  • option for children
  • outcome for children
  • prescribing for children
  • problem for children
  • procedure for children
  • profile for children
  • program for children
  • programme for children
  • rehabilitation for children
  • risk for children
  • scale for children
  • score for children
  • services for children
  • support for children
  • system for children
  • test for children
  • therapy for children
  • tool for children
  • training for children
  • transplantation for children
  • treatment for children
  • wechsler intelligence scale for children


  • Selected Abstracts


    The impact of developmental speech and language impairments on the acquisition of literacy skills

    DEVELOPMENTAL DISABILITIES RESEARCH REVIEW, Issue 3 2004
    C. Melanie Schuele
    Abstract Children with developmental speech/language impairments are at higher risk for reading disability than typical peers with no history of speech/language impairment. This article reviews the literacy outcomes of children with speech/language impairments, clarifying the differential risk for three groups of children: speech production impairments alone, oral language impairments alone, and speech production and oral language impairments. Children at greatest risk for reading and writing disabilities are children with language impairments alone and children with comorbid speech impairments and language impairments. For children with speech impairments alone, there is limited risk for literacy difficulties. However, even when reading skills are within the average range, children with speech impairments may have difficulties in spelling. Children with language impairments are likely to display reading deficits in word decoding and reading comprehension. It is not clear what role early literacy interventions play in the amelioration of reading difficulties in these populations. © 2004 Wiley-Liss, Inc. MRDD Research Reviews 2004;10:176,183. [source]


    Factors affecting vocabulary acquisition at age 2 in children born between 23 and 28 weeks' gestation

    DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 8 2007
    Louise Marston MSc
    Language development is often slower in preterm children compared with their term peers. We investigated factors associated with vocabulary acquisition at 2 years in a cohort of children born at 28 weeks' gestation or less. For children entered into the United Kingdom Oscillation Study, language development was evaluated by using the MacArthur-Bates Communicative Development Inventories score, completed by parents as part of a developmental questionnaire. The effect of demographic, neonatal, socioeconomic factors, growth, and disability were investigated using multifactorial random effects modelling. Questionnaires were returned by 288 participants (148 males, 140 females). The mean number of words vocalized was 42 (SD 29). Multifactorial analysis showed only four factors were significantly associated with vocabulary acquisition. These were: (1) level of disability (mean words: no disability, 45; other disability, 38; severe disability, 30 [severe disability is defined as at least one extreme response in one of the following clinical domains: neuromotor, vision, hearing, communication, or other physical disabilities]; 95% confidence interval [CI] for the difference between no and severe disability 7- 23); (2) sex (39 males, 44 females; 95% CI 0.4-11); (3) length of hospital stay (lower quartile, 47; upper quartile, 38; 95% CI -12 to -4); and (4) weight SD score at 12 months (lower quartile, 39; upper quartile, 44; 95% CI 1,9). There was no significant association between gestational age and vocabulary after multifactorial analysis. There was no significant effect of any socioeconomic factor on vocabulary acquisition. We conclude that clinical factors, particularly indicators of severe morbidity, dominate the correlates of vocabulary acquisition at age 2 in children born very preterm. [source]


    Dyslexia and psycho-social functioning: an exploratory study of the role of self-esteem and understanding

    DYSLEXIA, Issue 4 2009
    Melody M. Terras
    Abstract Individuals with dyslexia may have lower self-esteem and exhibit more emotional and behavioural difficulties than those without reading problems. However, the nature of any relationship between self-esteem and psychopathology remains unknown. This exploratory study assessed levels of self-esteem using the Self-Perception Profile for Children (Manual for the Self-Perception Profile for Children. University of Denver, CO: Denver; 1985) and psycho-social adjustment using the Strengths and Difficulties Questionnaire (J. Child Psychol. Psychiatry, 1997; 38: 581,586) and examined child and parent understanding, attitudes and the perceived impact of reading difficulties on daily life. Sixty-eight children assessed as dyslexic on the basis of discrepancy scores (mean age 11.2 years; 44 male), and their parents, participated. No global self-esteem deficit was found, but the mean score for both child and parent-rated scholastic competence was significantly lower than that of the general population. Rates of social, emotional and behavioural difficulties were significantly higher than in the general population and were correlated with self-esteem. For children who had high global self-worth, both children and their parents had more positive attitudes towards their reading difficulties and were less likely to perceive a negative impact on relationships. The association between academic self-esteem and emotional symptoms is consistent with the proposed link between dyslexia and internalizing difficulties. Good self-esteem and a good understanding of dyslexia may help children avoid some of these difficulties. Further research with larger more representative samples is necessary as understanding the factors that promote successful psycho-social adjustment is essential to the development of effective prevention and intervention strategies. Copyright © 2009 John Wiley & Sons, Ltd. [source]


    Headache and Psychological Functioning in Children and Adolescents

    HEADACHE, Issue 9 2006
    Scott W. Powers PhD
    Headache can affect all aspects of a child's functioning, leading to negative affective states (eg, anxiety, depression, anger) and increased psychosocial problems (for instance, school absences, problematic social interactions). For children and adolescents who experience frequent headache problems, comorbid psychological issues are a well-recognized, but poorly understood, clinical phenomenon. The confusion surrounding the relationship between pediatric headache and psychopathology exists for several reasons. First, in some cases, headache has been inappropriately attributed to psychological or personality features based on anecdotal observations or interpretations that go beyond the available data. Additionally, measures of psychopathology have not always adhered to the American Psychiatric Association's diagnostic criteria, thus reducing the reliability of diagnostic judgments. Furthermore, the diagnosis of headache has not always followed standard criteria, and has been complicated by the emergence of new terms and evolving measures. Finally, methodological shortcomings, such as incomplete descriptions of the procedures and criteria used for the study, inadequate descriptions of headache severity, lack of a control group for comparison with individuals without headaches, reliance primarily on cross-sectional research designs that are often discussed with inferences to causal hypotheses, and the use of unstandardized assessment measures, have significantly limited the validity of research findings. The goal of the current review is to examine the extant literature to provide the most up-to-date picture on what the research has made available about the magnitude, specificity, and causes of psychopathology in children and adolescents with headache, in an effort to further elucidate their relationship and prompt a more methodologically rigorous study of these issues. [source]


    Children of Helicobacter pylori -infected Dyspeptic Mothers are Predisposed to H. pylori Acquisition with Subsequent Iron Deficiency and Growth Retardation

    HELICOBACTER, Issue 3 2005
    Yao-Jong Yang
    Abstract Background., We tested whether Helicobacter pylori -infected dyspeptic mothers had a higher rate of H. pylori infection in their children, and whether such H. pylori -infected children were predisposed to iron deficiency or growth retardation. Materials and methods., A total of 163 children from 106 dyspeptic mothers (58 with and 48 without H. pylori infection) were enrolled to evaluate body weight, height, hemoglobin, serum ferritin, and H. pylori infection using the 13C-urea breath test. A questionnaire was used to evaluate demographic factors of each child. Results., The rate of H. pylori infection in children with H. pylori -infected dyspeptic mothers was higher than that of children with noninfected mothers (20.5% vs. 5.3%; p < .01, OR: 4.6, 95% CI: 1.5,14.2). The rate of H. pylori infection in children elevated as the number of their H. pylori -infected siblings increased (p < .01). For children below 10 years of age, H. pylori infection was closely related to low serum ferritin and body weight growth (p < .05). Conclusion., The children of H. pylori -infected dyspeptic mothers had an increased risk for such infection. The risk further increased once their siblings were infected. H. pylori infection in pre-adolescent children may determine iron deficiency and growth retardation. [source]


    The modulating effect of culture on the expression of dental anxiety in children: a literature review

    INTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 4 2004
    M. O. FOLAYAN
    Summary. The experience of anxiety is a universal human phenomenon. Studies have shown a world-wide variation in the prevalence of dental anxiety with estimates ranging between 3% and 43%. The aetiology of dental anxiety is multifactorial, with factors acting in synergy to affect its expression. For children, age and gender play fundamental roles in its expression. However, these two factors are modulated by other variables such as culture which may influence the context in which anxiety is experienced, the interpretation of its meaning and responses to it. The modulating effect of culture in synergy with other variables may be one of the reasons why reports on dental anxiety have varied from region to region. This paper attempts to identify the interrelating roles of culture, age and gender, and how these relationships may affect variability in the expression and measurement of dental anxiety in children. [source]


    Characteristics of Publicly Insured Children with High Dental Expenses

    JOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 4 2007
    Shervin S. Churchill MPH
    Abstract Background: Dental coverage is provided for all children with Medicaid in Washington State. The goal of this study was to illuminate the characteristics of a sample of Medicaid-enrolled children with high dental expenses. Methods: Dental care utilization data for a 33-month period were obtained from Washington State's Medicaid database. For children, 0 to 6 years, these data were linked with a parent survey addressing oral health behaviors, knowledge, family history of caries, snacking patterns, and access to dental care. Children with dental expenses of $1,000 or more were classified as the "high-expense" group. Risk factors for the high-expense group were evaluated using multiple logistic regression. Results: 345 children had at least one dental procedure including preventive and diagnostic care. Among these, 30 children (9 percent) incurred 64 percent of total dental expenses for the entire group. Parent perception of lack of dental coverage was associated with incurring high dental expenses. Children of Asian or Pacific Islander heritage were at disproportionately high risk compared to White children. Age of child and family history of caries were also associated with increased risk for high expenses. Conclusions: Not all low-income children on Medicaid are at high risk for caries. A combination of factors, including family history of caries and parent's perception of lack of dental insurance coverage, can potentially increase a child's likelihood for high-expense dental treatment. This study highlighted a small group of children with disproportionately high dental expenses. For some, earlier knowledge of coverage may have resulted in more timely access to preventive and diagnostic care, reducing the subsequent need for expensive restorative treatment. [source]


    Effective Methods to Improve Recruitment and Retention in School-Based Substance Use Prevention Studies

    JOURNAL OF SCHOOL HEALTH, Issue 9 2009
    Jean-Marie Bruzzese PhD
    ABSTRACT BACKGROUND: Poor recruitment and high attrition may invalidate results of research studies. This paper describes successful recruitment and retention strategies in a school-based substance use prevention trial and explores factors associated with intervention attendance and retention. METHODS: A total of 384 parent-child dyads from 15 schools in the New York Metropolitan area participated in a control trial, testing the efficacy of parent-training to prevent youth substance use. Assessments were completed immediately post-intervention and 6-, 12-, and 24-month postintervention. Logistic regression analyses were used to determine which familial and study characteristics predicted attendance in the intervention and retention by parents and youth. RESULTS: 84% of intervention parents attended 4 of the 5 workshops; 83% of control parents attended their single workshop. Intervention attendance was predicted by parent job status, but this was not significant after controlling for other family factors. Retention rates ranged from 87% to 91% over the 2 years. No family characteristics predicted retention, but time since baseline and attendance at treatment workshops and the control workshop did. For children, age at baseline and ethnicity predicted retention, but this did not remain significant in the adjusted model. CONCLUSION: Intervention attendance was high and retention rates far exceeded the minimum standard of 70% retention in behavioral studies. Recruitment and retention strategies were effective for different family constellations. Efforts to maximize participation in both treatment and control interventions are critical to retention in longitudinal trials. [source]


    Symptoms and quality of life in obese children and adolescents with non-alcoholic fatty liver disease

    ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 3 2010
    K. D. KISTLER
    Aliment Pharmacol Ther,31, 396,406 Summary Background, Data on the quality of life (QOL) of children with non-alcoholic fatty liver disease (NAFLD) are needed to estimate the true burden of illness in children with NAFLD. Aim, To characterize QOL and symptoms of children with NAFLD and to compare QOL in children with NAFLD with that in a sample of healthy children. Methods, Quality of life and symptoms were assessed in children with biopsy-proven NAFLD enrolled in the NASH Clinical Research Network. PedsQL scores were compared with scores from healthy children. For children with NAFLD, between-group comparisons were made to test associations of demography, histological severity, symptoms and QOL. Results, A total of 239 children (mean age 12.6 years) were studied. Children with NAFLD had worse total (72.8 vs. 83.8, P < 0.01), physical (77.2 vs. 87.5, P < 0.01) and psychosocial health (70.4 vs. 81.9, P < 0.01) scores compared with healthy children. QOL scores did not significantly differ by histological severity of NAFLD. Fatigue, trouble sleeping and sadness accounted for almost half of the variance in QOL scores. Impaired QOL was present in 39% of children with NAFLD. Conclusions, Children with NAFLD have a decrement in QOL. Symptoms were a major determinant of this impairment. Interventions are needed to restore and optimize QOL in children with NAFLD. [source]


    Extending Responsiveness to Intervention to Mathematics at First and Third Grades

    LEARNING DISABILITIES RESEARCH & PRACTICE, Issue 1 2007
    Lynn S. Fuchs
    Responsiveness to intervention (RTI) is an innovative approach to the identification of learning disabilities (LD). The central assumption is that RTI can differentiate between two explanations for low achievement: poor instruction versus disability. If the child responds poorly to validated instruction, then the assessment eliminates instructional quality as a viable explanation for poor academic growth and instead provides evidence of a disability. For children who do respond nicely, RTI serves a critical prevention function. Most of RTI research has been focused on early reading. In this article, we describe two ongoing programs of research on RTI in the area of mathematics: one on a comprehensive mathematics curriculum at first grade and the other focused on word problems at third grade. For each research program, we describe the sample, explain how students are identified as at risk for mathematics disability, provide an overview of the interventions to which responsiveness is gauged, and describe some results to date. [source]


    Monounsaturated Fatty Acid Intake by Children and Adults: Temporal Trends and Demographic Differences

    NUTRITION REVIEWS, Issue 4 2004
    Theresa A. Nicklas Dr.P.H.
    Epidemiologic evidence suggests that dietary monounsaturated fatty acids (MUFA) may have a beneficial health effect. Twenty-four-hour dietary intake data collected on 10-year-olds from 1978 to 1994 and on children and adults (ages 0,30 years) were examined for time, age, gender, ethnic, and geographic location differences in MUFA intake. Children's percent energy from MUFA decreased significantly from 1978 (14.1%) to 1994 (11.9%) with intake of oleic acid decreasing from 33.9 g/day (1973) to 25.7 g/day (1994). In 1994,96, percent energy from MUFA was 13% for children and adults aged 12 to 30 years, with 5% from palmitoleic acid and 93% from oleic acid. Males and blacks had significantly higher MUFA intake across all age groups than females and whites. Intakes of MUFA increased from 0 to 11 years of age to young adulthood (12,19 years), with no further increase at 20 to 30 years of age. Intakes of MUFA were lowest in the Northeast and highest in the Midwest. There were differences in food sources of MUFA by age group. For children 0 to 5 years of age, major sources were whole milk, peanut butter, 2% milk, and French fries; for children 6 to 11 years of age, major sources were whole milk, peanut butter, French fries, and 2% milk; for children 12 to 19 years of age, French fries, salty snacks, whole milk, and meat pizza were the major sources; for adults, French fries, whole milk, potato chips, and ground beef were the most common sources of MUFA. U.S. children and adults displayed temporal trends and demographic differences in intakes and food sources of MUFA. The implications of these changes and differences on biologic risk factors for specific chronic diseases warrant further investigation. [source]


    Central corneal thickness in European (white) individuals, especially children and the elderly, and assessment of its possible importance in clinical measures of intra-ocular pressure

    OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 6 2002
    Michael J. Doughty
    Purpose:,To ascertain the impact of central corneal thickness (CCT, as assessed by pachometry) and central corneal curvature (as assessed by keratometry) on clinical measures of intra-ocular pressure (IOP, as assessed by tonometry), especially in the young and elderly. Methods:,Pachometry, keratometry and tonometry were carried out on three groups, namely children aged 5,15 years, adults aged 32,60 years, and elderly individuals aged between 61 and 82 years. For children, ultrasound pachometry was combined with non-contact tonometry (NCT), specular microscopy was used with Perkins tonometry in the adults, and ultrasound pachometry was used with Perkins tonometry for the elderly. Central corneal curvature was assessed by keratometry. Results:,The average CCT in children was 0.529 ± 0.034 mm (n=104, ±S.D.), averaged 0.533 ± 0.033 in adults (n=75) and 0.527 ± 0.034 mm (n=91) in the elderly. Tonometry values averaged 16.7 ± 2.9 mm in children, 13.0 ± 3.5 mmHg in adults and 13.6 ± 2.5 mm in the elderly group. Central corneal thickness values were not predictably different in relation to central corneal curvature values. Regression analyses indicated that the tonometry values were higher in both children and the elderly who had thicker corneas (and vice versa) (p , 0.003), with the measures increasing by 1.3 ± 0.4 and 2.6 ± 0.4 mmHg for a 10% difference in CCT in children and the elderly, respectively. For adults, no statistically significant difference in tonometry values could be demonstrated with respect to CCT (<1 mmHg for a 10% difference in CCT), and for no group were the CCT or tonometry values predictably different in relation to central corneal curvature values. Conclusions:,The results of these studies, albeit relatively small scale, indicate that in young or elderly individuals with essentially normal IOP and CCT measures, the tonometry values show only small differences with respect to CCT. The slope in the observed relationship was not that different from an average of 1.5 mmHg for a 10% different in CCT, as obtained from a literature analysis over a 30-year period. The magnitude of the effect does not provide evidence that pachometry needs to be routinely performed in glaucoma screening protocols based on tonometry. Notwithstanding, the finding of higher than expected tonometry values should be further investigated, by pachometry, especially in very young children and in the elderly. [source]


    Timing of infection and development of wheeze, eczema, and atopic sensitization during the first 2 yr of life: The KOALA Birth Cohort Study

    PEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 6 2010
    Monique Mommers
    Mommers M, Thijs C, Stelma F, Penders J, Reimerink J, van Ree R, Koopmans M. Timing of infection and development of wheeze, eczema, and atopic sensitization during the first 2 yr of life: The KOALA Birth Cohort Study. Pediatr Allergy Immunol 2010: 21: 983,989. © 2010 The John Wiley & Sons A/S To investigate if infections in pregnancy and very early in life present a risk for wheezing, eczema, or atopic sensitization in later infancy. A total of 2319 children enrolled before birth in the KOALA Birth Cohort Study were followed during their first 2 yr of life using repeated questionnaires. Information was obtained on common colds, fever, and diarrhea with fever as well as on wheeze and eczema at ages 3 and 7 months and 1 and 2 yr, respectively. Blood samples were collected from 786 children at age 2 yr for specific immunoglobulin E analyses. Children with a common cold [adjusted odds ratio (aOR) 2.03 95% CI 1.21,3.41] or fever episode (aOR 1.81 95% CI 1.10,2.96) in the first 3 months of life had a higher risk of new onset wheeze in the second year of life compared to children who had not. For children with diarrhea with fever in the first 3 months of life, the aOR for new onset wheeze in the second year of life was 3.94 (95% CI 1.36,11.40) compared to children without diarrhea. Infections becoming clinically manifest during the first 3 months of life may be a general marker for a wheezy phenotype. [source]


    Propofol or propofol,alfentanil anesthesia for painful procedures in the pediatric oncology ward

    PEDIATRIC ANESTHESIA, Issue 8 2004
    Margareta von Heijne MD PhD
    Summary Background :,For children with cancer receiving curative treatment, the pain of diagnostic and therapeutic procedures is often worse than that of the disease itself. In order to evaluate if light propofol anesthesia in the pediatric oncology ward (POW) could improve the management of procedure pain and anxiety, a questionnaire was developed. Methods :,After prolonged EMLA application, 65 propofol anesthetics were performed successfully in 28 children during lumbar puncture and/or bone marrow aspiration in the POW, with short recovery time and without major adverse events. The questionnaire was mailed to the parents of the 28 children who were included in the survey. Results :,The return of questionnaire compliance was 89% (25 of 28), 12 females and 13 males, mean age was 7 years (range 2,16). Among those who replied, the diagnoses were acute lymphatic leukemia in 21, lymphoma in two and tumor in the other two. In the questionnaire, all parents/patients reported advantages with anesthesia in the POW compared with the operating room. In the list of stated advantages, 88% marked ,familiar nurses and doctors', 84%,familiar environment', 80%,closer to own room', 68%,the child more calm', 72%,shorter waiting-time', 60%,faster recovery', 44%,shorter fasting-time' and 44%,parents more calm', as benefits. For future procedures requiring anesthesia to reduce pain, discomfort and/or anxiety, 92% of the parents/patients preferred anesthesia in the POW. Conclusions :,If anesthesia is chosen for invasive procedures, this study suggest that propofol anesthesia in the POW is preferred by parents and children. [source]


    Identification of children with the same level of impairment as children on the autistic spectrum, and analysis of their service use

    THE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 6 2010
    Ginny Russell
    Background:, Data from epidemiology have consistently highlighted a disparity between the true prevalence of childhood psychiatric disorders and their recognition as defined by receiving a clinical diagnosis. Few studies have looked specifically at the level of unidentified autistic spectrum disorder (ASD) in the population. Method:, Logistic regression was used to determine the behavioural traits associated with receiving a diagnosis of ASD using data from the Avon Longitudinal Study of Parents and Children (ALSPAC). A composite score was derived to measure levels of autistic traits; undiagnosed children with scores matching those diagnosed with ASD were identified. Levels of educational provision beyond that provided by standard schooling were examined. Results:, Fifty-five percent of children with autistic traits at the same levels as those who had an autism diagnosis had not been identified as needing extra support from education or specialised health services. Of those who were identified as having special needs, 37.5% had been formally diagnosed with an ASD. For children with impairment at the same level as that associated with Asperger's syndrome, 57% had no special provision at school, and were not accessing specialised health services. Twenty-six percent of those who did have special provision at school had an ASD diagnosis. Conclusions:, The results suggest that there may be a substantial proportion of children on the autistic spectrum who are never identified by services. [source]


    Ophthalmological follow-up at 2 years of age of all children previously screened for retinopathy of prematurity: is it worthwhile?

    ACTA OPHTHALMOLOGICA, Issue 5 2006
    Anna-Lena Hård
    Abstract. Purpose:, To evaluate the extent to which ophthalmological follow-up at 2 years of age of children born before 32 weeks gestation identifies obvious visual problems, strabismus and significant ametropia (target conditions). Methods:, Of 172 children born during a period of 2.5 years from January 2000, 142 underwent an ophthalmological examination at a median age of 2.33 years. This included evaluation of visual behaviour, cover testing and autorefractometry in cycloplegia. For children with the target conditions, we investigated whether the child had been followed in the eye clinic or referred before 2 years of age, or whether the abnormality was detected as a result of the follow-up examination. Results:, None of the target conditions were found in 117 children. None of four children with obviously abnormal visual behaviour, two of 10 children with strabismus and four of 11 with large refractive errors were detected in the follow-up examination. Thus the target conditions were detected at the follow-up examination in only six of 142 children (4.2%). Conclusions:, Although ophthalmic abnormalities are common in children born prematurely, most of them are identified because high-risk children are followed regularly in eye clinics and because parents and primary health care personnel detect strabismus. Ophthalmological follow-up of all children born before 32 weeks appears not to be worthwhile and is therefore only recommended for high-risk children. [source]


    Change in Family Income-to-Needs Matters More for Children with Less

    CHILD DEVELOPMENT, Issue 6 2001
    Eric Dearing
    Hierarchical linear modeling was used to model the dynamics of family income-to-needs for participants of the National Institute of Child Health and Human Development Study of Early Child Care (N= 1,364) from the time that children were 1 through 36 months of age. Associations between change in income-to-needs and 36-month child outcomes (i.e., school readiness, receptive language, expressive language, positive social behavior, and behavior problems) were examined. Although change in income-to-needs proved to be of little importance for children from nonpoor families, it proved to be of great importance for children from poor families. For children in poverty, decreases in income-to-needs were associated with worse outcomes and increases were associated with better outcomes. In fact, when children from poor families experienced increases in income-to-needs that were at least 1 SD above the mean change for poor families, they displayed outcomes similar to their nonpoor peers. The practical importance and policy implications of these findings are discussed. [source]


    Audit of local performance compared with standards recommended by the national guidelines for aetiologic investigation of permanent childhood hearing impairment

    CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 6 2005
    S. Yoong
    Abstract Background National guidelines for aetiologic investigation of childhood deafness were developed as the Newborn Hearing Screening Program (NHSP) was being implemented in the United Kingdom. This guidance document was expected to be incorporated into the operational procedure of the NHSP. Method This criterion-based audit compared local care set against developed guidelines that can be used to assess the appropriateness of specific investigations, services and outcomes. Data on children diagnosed to have sensorineural deafness from March 2002,2004 were extracted from an established computerized database for analysis. Results Forty-seven children were included; 17 have bilateral severe to profound hearing loss, 25 have bilateral mild to moderate loss and 5 with unilateral loss. A high proportion of Pakistani children were from consanguineous marriages with a family history of deafness. Total 29.8% of children were diagnosed through newborn screening and 70.2% detected through hearing surveillance programmes. For children with bilateral severe to profound deafness, 53.0% accepted, 5.9% declined and 41.2% were not offered imaging of their inner ears. A total of 47.1% accepted and 52.9% declined electrocardiograph (ECG) evaluation. Total 70.6% accepted and 29.4% declined connexin mutations testing. Parental requests were required for those with lesser degree of hearing loss. Total 24% accepted, 28% declined and 48% were not offered connexin testing. None were offered ECG and imaging. Testing for congenital infections was inappropriate for children over 1 year old. Ten subjects accepted and five declined this investigation. In the total group, 63.8% accepted, 17.0% declined and 19.1% were not offered referral to the ophthalmic service. Total 46.8% accepted, 44.7% declined and 8.5% were not offered referral to genetics service. Investigations resulted in two connexin-positive children with moderate loss. Conclusion Our study identified key areas where guidelines were not followed. These were related to lack of funding and parental choice. This sample has a higher connexin ,hit' rate for lesser degree deafness. [source]


    Trauma Center Utilization for Children in California 1998,2004: Trends and Areas for Further Analysis

    ACADEMIC EMERGENCY MEDICINE, Issue 4 2007
    N. Ewen Wang MD
    Abstract Background: While it is known that trauma systems improve the outcome of injury in children, there is a paucity of information regarding trauma system function amid changes in policies and health care financing that affect emergency medical systems for children. Objectives: To describe the trends in the proportion of pediatric trauma patients acutely hospitalized in trauma-designated versus non,trauma-designated hospitals. Methods: This was a retrospective observational study of a population-based cohort obtained by secondary analysis of a publicly available data set: the California Office of Statewide Health Planning and Development Patient Discharge Database from 1998 to 2004. Patients were included in the analysis if they were 0,19 years old, had International Classification of Disease, Ninth Revision (ICD-9) diagnostic codes and E-codes indicative of trauma, had an unscheduled admission, and were discharged from a general acute care hospital (N= 111,566). Proportions of patients hospitalized in trauma-designated hospitals versus non,trauma-designated hospitals were calculated for Injury Severity Score and death. Injury Severity Scores were calculated from ICD-9 codes. Primary outcomes were hospitalization in a trauma center and death two or more days after hospitalization. Results: Over the study period, the proportion of children aged 0,14 years with acute trauma requiring hospitalization and who were cared for in trauma-designated hospitals increased from 55% (95% confidence interval [CI] = 54% to 56%) in 1998 to 66% (95% CI = 65% to 67%) in 2004 (p < 0.01). For children aged 15,19 years, the proportion increased from 55% (95% CI = 54% to 57%) in 1998 to 74% (95% CI = 72% to 75%) in 2004 (p < 0.0001). When trauma discharges were stratified by injury severity, the proportion of children with severe injury who were hospitalized in trauma-designated hospitals increased from 69% (95% CI = 66% to 72%) in 1998 to 84% (95% CI = 82% to 87%) in 2004, a rate higher than in children with moderate injury (59% [95% CI = 58% to 61%] in 1998 and 75% [95% CI = 74% to 76%] in 2004) and mild injury (51% [95% CI = 50% to 52%] in 1998 and 63% [95% CI = 62% to 64%] in 2004) (p < 0.0001 for each injury severity category and both age groups). Of the hospitalized children who died two or more days after injury (n= 502), 18.1% died in non,trauma-designated hospitals (p < 0.002 for children aged 0,14 years; p = 0.346 for children aged 15,19 years). Conclusions: An increasing majority of children with trauma were cared for in trauma-designated hospitals over the study period. However, 23% of children with severe injuries, and 18.1% of pediatric deaths more than two days after injury, were cared for in non,trauma-designated hospitals. These findings demonstrate an important opportunity for improvement. If we can characterize those children who do not access the trauma system despite severe injury or death, we will be able to design clinical protocols and implement policies that ensure access to appropriate regional trauma care for all children in need. [source]


    Investigation of the eotaxin gene ,426C,T, ,384A,G and 67G,A single-nucleotide polymorphisms and atopic dermatitis in Italian children using family-based association methods

    CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 3 2008
    L. Rigoli
    Summary Background., Eotaxin plays an important role in atopic dermatitis (AD) as a potent chemoattractant and activator of eosinophils and T-helper 2 lymphocytes. Aim., To investigate whether single-nucleotide polymorphisms of the eotaxin gene are associated with AD, we investigated the genotype and allelic frequencies of ,426C,T, ,384A,G, and 67G,A SNPs in 130 Italian families. Methods., In total, 130 children with either the extrinsic allergic or intrinsic nonallergic forms of AD (EAD and IAD) were recruited from 130 families. Genotyping was performed using PCR and restriction fragment length polymorphism analysis. Results., A significant difference was observed in the genotype frequency of the ,426C,T SNP between children with EAD and those with IAD (P = 0.01), and between children with EAD and controls (P = 0.01). The allele frequencies of the ,426C,T SNP were significantly different between children with EAD and those with IAD (P < 0.01), and between children with EAD and controls (P < 0.01). For children with EAD, the genotype frequency of the ,426C,T SNP was no different between the groups with mild, moderate and severe SCORAD (P = NS). No significant association was observed between the ,384A,G and 67G,A SNPs and the two groups of children with EAD and IAD compared with the control group. In 32 trios selected from 68 EAD families, the transmission disequilibrium test showed a preferential transmission of the ,426T allele from the parents to affected offspring (P < 0.01). Conclusions., Our results suggest that in our group of children with AD, the eotaxin gene may play a crucial role in the development of extrinsic AD, probably with other genetic factors. [source]


    Home-based therapy for oedematous malnutrition with ready-to-use therapeutic food

    ACTA PAEDIATRICA, Issue 8 2006
    Michael A. Ciliberto
    Abstract Background: Standard recommendations are that children with oedematous malnutrition receive inpatient therapy with a graduated feeding regimen. Aim: To investigate exclusive home-based therapy for children with oedematous malnutrition. Methods: Children with oedematous malnutrition, good appetite and no complications were treated at home with ready-to-use therapeutic food (RUTF) and followed up fortnightly for up to 8 wk. Setting and participants: 219 children aged 1,5 y with oedema enrolled in one of two therapeutic nutritional studies in Malawi in 2003,2004. Results: The overall recovery rate was 83% (182/219), and the case-fatality rate was 5% (11/219). For children with wasting and oedematous malnutrition, 65% (55/85) recovered and 7% (6/85) died. The average weight gain was 2.8±3.2 g/kg/d (mean±SD). Conclusion: This preliminary observation suggests that children with oedematous malnutrition and good appetite may be successfully treated with home-based therapy; a randomized, controlled trial to evaluate this is warranted. [source]


    Geriatric Emergency Medicine and the 2006 Institute of Medicine Reports from the Committee on the Future of Emergency Care in the U.S. Health System

    ACADEMIC EMERGENCY MEDICINE, Issue 12 2006
    Scott T. Wilber MD
    Abstract Three recently published Institute of Medicine reports, Hospital-Based Emergency Care: At the Breaking Point, Emergency Medical Services: At the Crossroads, and Emergency Care for Children: Growing Pains, examined the current state of emergency care in the United States. They concluded that the emergency medicine system as a whole is overburdened, underfunded, and highly fragmented. These reports did not specifically discuss the effect the aging population has on emergency care now and in the future and did not discuss special needs of older patients. This report focuses on the emergency care of older patients, with the intent to provide information that will help shape discussions on this issue. [source]


    Dental trauma in children presenting for treatment at the Department of Dentistry for Children and Orthodontics, Budapest, 1985,1999

    DENTAL TRAUMATOLOGY, Issue 3 2001
    Katalin Gábris
    Abstract , Data on children with dental trauma who presented for treatment at the Department of Dentistry for Children and Orthodontics in Budapest over a period of 15 years were analysed. The WHO guidelines were used to classify the traumatic injuries. A total of 590 children were involved, 810 teeth being affected. Children aged 7,14 years made up 88% of the cohort. The male:female ratio was 58:42. The permanent:primary ratio for the affected teeth was 90:10. The teeth most commonly affected were the maxillary central incisors. In 70% of the cases, only one tooth was traumatised. The incidence of dental trauma peaked at 10 years of age. The most common injury type observed was enamel-dentin crown fracture. The decreasing sequence of frequency of etiological factors was playing, sports, falls, cycling, road accidents and fighting. Of the accidents, 65% occurred at school or at home. Seventy seven per cent of the patients presented for medical care in the first 3 days after the accident. [source]


    Psychometric evaluation of a measure of Beck's negative cognitive triad for youth: applications for African,American and Caucasian adolescents

    DEPRESSION AND ANXIETY, Issue 4 2005
    Leilani Greening
    Abstract A measure of Beck's negative cognitive triad, the Cognitive Triad for Children (CTI-C), was evaluated for its psychometric properties and utility with a community sample of 880 African,American and Caucasian adolescents. High-school students ranging from 14 to 17 years of age completed the CTI-C, the Children's Depression Inventory (CDI) and the Children's Attributional Style Questionnaire-Revised (CASQ-R) on two occasions 4 months apart. The CTI-C was found to be internally consistent, Cronbach's ,=.90, to have acceptable test-retest reliability, r=.70, and concurrent validity as demonstrated by a significant correlation with the CASQ-R, r=.53. A principal factor analysis with promax rotation did not yield support for Beck's tripartite model of negative cognitions about the self, world, and future but rather yielded three factors with a combination of cognitions from all three domains. African American adolescents who reported more maladaptive cognitions on the CTI-C reported fewer depressive symptoms on the CDI 4 months later compared to their Caucasian counterparts, suggesting some limitation to using the CTI-C to predict depressive symptoms in African,American youth; however, Factor 1 derived from a factor analysis with the sample was more consistent in predicting future symptoms among both African,American and Caucasian adolescents. This factor consisted largely of positively worded items, offering some support for low positive affect as a predictor of depressive symptoms in adolescents. Depression and Anxiety 21:161,169, 2005. © 2005 Wiley-Liss, Inc. [source]


    General measures of cognition for the preschool child

    DEVELOPMENTAL DISABILITIES RESEARCH REVIEW, Issue 3 2005
    Elizabeth O. LichtenbergerArticle first published online: 13 SEP 200
    Abstract Preschool-age children who are experiencing delays in physical, cognitive, communication, social, emotional, or adaptive development are often referred for a comprehensive assessment to make diagnostic determinations and to help develop appropriate interventions. Typically cognitive assessment has a key role in a comprehensive evaluation of a young child. In this article, five individually administered tests of cognitive ability, normed for the preschool-age child, are reviewed. These specific tests include the Bayley Scales of Infant Development, 2nd edition, the Kaufman Assessment Battery for Children, 2nd edition, the Wechsler Preschool and Primary Scale of Intelligence, 3rd edition, the Stanford-Binet Intelligence Scale, 5th edition, and the Differential Abilities Scales. The following is provided for these cognitive instruments: a description of the test procedures, information on scoring systems, highlights of the technical qualities, and a summary of the general meaning of test results. The article concludes with strengths and limitations of the instruments. © 2005 Wiley-Liss, Inc. MRDD Research Reviews 2005;11:197,208. [source]


    Level of purposeful hand function as a marker of clinical severity in Rett syndrome

    DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 9 2010
    JENNY DOWNS
    Aim, We investigated relationships between hand function and genotype and aspects of phenotype in Rett syndrome. Method, Video assessment in naturalistic settings was supplemented by parent-reported data in a cross-sectional study of 144 females with a mean age of 14 years 10 months (SD 7y 10mo; range 2y,31y 10mo), 110 of whom had a mutation of the methyl CpG binding protein 2 (MECP2) gene. Ordinal logistic regression was used to assess relationships between hand function and MECP2 mutation, age, a modified Kerr score, Functional Independence Measure for Children (WeeFIM), ambulation level, and frequency of hand stereotypies. Results, Approximately two-thirds of participants demonstrated purposeful hand function, ranging from simple grasping skills to picking up and manipulating small objects. In participants with a confirmed MECP2 mutation, those with the p.R168X mutation had the poorest hand function on multivariate analysis with C-terminal deletion as the baseline (odds ratio [OR] 0.19; 95% confidence interval [CI] 0.04,0.95), whereas those with the p.R133C or p.R294X mutation had better hand function. Participants aged 19 years or older had lower hand function than those aged less than 8 years (OR 0.36; 95% CI 0.14,0.92). Factors that were associated with better hand function were lower Kerr scores for a 1-point increase in score (OR 0.77; 95% CI 0.69,0.86), higher WeeFIM scores for a 1-point increase in score (OR 1.08; 95% CI 1.04,1.12), and greater ambulation than those completely dependent on carers for mobility (OR 22.64; 95% CI 7.02,73.08). The results for participants with a confirmed pathogenic mutation were similar to results obtained when participants without a mutation were also included. Interpretation, Our novel assessment of hand function in Rett syndrome correlated well with known profiles of common MECP2 mutations and overall clinical severity. This promising assessment could measure clinical responses to therapy. [source]


    The relationship between quality of life and functioning for children with cerebral palsy

    DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 3 2008
    A Shelly BSc (Hons)
    Given that quality of life (QOL) is commonly confused with functioning, the aim of this study was to examine the association between functioning and QOL domains for children with cerebral palsy (CP). Two hundred and five parents of children aged 4 to 12 years with CP and 53 children aged 9 to 12 years with CP, completed the Cerebral Palsy Quality of Life Questionnaire for Children. Children were distributed reasonably evenly between sex (male, 54.6%) and Gross Motor Function Classification System levels (I 17.8%, II 28.3%, III 14.1%, IV 11.2%, and V 27.3%). For parent proxy-report, all domains of QOL were significantly associated with functioning level except access to services. For child self-report, feelings about functioning, participation and physical health, and pain and feelings about disability, were significantly associated with functioning level. Physical type domains of QOL accounted for more of the variance in functioning than psychosocial type domains. Children with CP have the potential to report a high psychosocial QOL score even if they have poor functioning. [source]


    Developmental coordination disorder in children with attention-deficit,hyperactivity disorder and physical therapy intervention

    DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 12 2007
    Nathan Watemberg MD
    Although physical therapy (PT) is effective in improving motor function in children with developmental coordination disorder (DCD), insufficient data are available on the impact of this intervention in children with combined attention-deficit,hyperactivity disorder (ADHD) and DCD. This prospective study aimed to establish the prevalence of DCD among a cohort of patients with ADHD, characterize the motor impairment, identify additional comorbidities, and determine the role of PT intervention on these patients. DCD was detected in 55.2% of 96 consecutive children with ADHD (81 males, 15 females), mostly among patients with the inattentive type (64.3% compared with 11% of those with the hyperactive/impulsive type, p<0.05). Mean age was 8 years 4 months (SD 2y). Individuals with both ADHD and DCD more often had specific learning disabilities (p=0.05) and expressive language deficits (p=0.03) than children with ADHD only. Twenty-eight patients with ADHD and DCD randomly received either intensive group PT (group A, mean age 9y 3mo, SD 2y 3mo) or no intervention (group B, mean age 9y 3mo, SD 2y 2mo). PT significantly improved motor performance (assessed by the Movement Assessment Battery for Children; p=0.001). In conclusion, DCD is common in children with ADHD, particularly of the inattentive type. Patients with both ADHD and DCD are more likely to exhibit specific learning disabilities and phonological (pronunciation) deficits. Intensive PT intervention has a marked impact on the motor performance of these children. [source]


    Immediate effects of methylphenidate on cognitive attention skills of children with attention-deficit-hyperactivity disorder

    DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 6 2005
    Jane Hood MSc
    This study investigated the immediate effects of stimulant medication (methylphenidate) on cognitive attention processes in children with attention-deficit-hyperactivity disorder (ADHD). Thirteen males and two females (mean age 9y 5mo, SD 18.3mo) with a diagnosis of ADHD and who were to be prescribed methylphenidate were assessed twice on one day with the Test of Everyday Attention for Children, a neuropsychological battery designed to tap different aspects of cognitive attention. Between assessments, the children were administered methylphenidate (10mg). Each child had at least average intelligence (IQ 80 or over, as measured by the Wechsler Intelligence Scale for Children - III UK) and was on no other medication. A group of 16 children, who were matched for age, sex, and intelligence, also performed the cognitive tests twice on the same day to control for practice effects of testing. At the first assessment, children with ADHD demonstrated significant impairments in several aspects of cognitive attention in comparison with the control group, particularly sustained attention. After administration of methylphenidate for the children with ADHD, they showed significant improvements in their performance on measures of cognitive attention compared to controls. The immediate effects of methylphenidate and the significance of measuring cognitive aspects of attention as well as behavioural measures are discussed. [source]


    Maternal fever at birth and non-verbal intelligence at age 9 years in preterm infants

    DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 3 2003
    Olaf Dammann MD MS
    To test the hypothesis that characteristics of perinatal infection are associated with long-term cognitive limitations among preterm infants, we analyzed data from 294 infants (142 females, 152 males) ,1500g birthweight and <37 completed weeks of gestation who were examined at age 9 years. We identified 47 children (20 females, 27 males) who had a non-verbal Kaufman Assessment Battery for Children (K-ABC) scale standard value below 70, i.e. more than 2 SDs below the age-adjusted mean. The 247 children (122 females, 125 males) with a score ,70 served as control participants. Maternal nationality and education, and low gestational age were significantly associated with a K-ABC non-verbal standard value <70. Both neonatal brain damage (intraventricular hemorrhage) and long-term sequelae (cerebral palsy [CP], diagnosed at age 6 years) were significantly associated with a below-normal non-verbal K-ABC score. Maternal fever at birth was present in five cases (11%) and eight controls (3%; odds ratio 3.6, 95% confidence interval 1.1 to 11.4). Clinical chorioamnionitis and preterm labor and/or premature rupture of membranes (as opposed to toxemia and other initiators of preterm delivery) were also more common among cases than control participants. When adjusting for potential confounders such as gestational age, maternal education and nationality, and CP, the risk estimate for maternal fever remained unchanged (3.8, 0.97 to 14.6). We conclude that perinatal infection might indeed contribute to an increased risk for long-term cognitive deficits in preterm infants. [source]