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Toddlers
Selected AbstractsHypersensitivity Myocarditis Presenting as Atrioventricular Block and Wide Complex Tachycardia in a ToddlerCONGENITAL HEART DISEASE, Issue 5 2008Neil Bhogal MD ABSTRACT A 13-month-old boy presented with acute onset of complete atrioventricular block and wide complex tachycardia but normal hemodynamics. Endomyocardial biopsy disclosed active myocarditis with eosinophils, suggesting a hypersensitivity reaction. With no treatment, the rhythm disturbance resolved within days of onset. Our patient's presentation and self-limited illness is unique. To our knowledge, this is only the second reported case of eosinophilic myocarditis in a young child or infant. [source] Assessment of motor development and function in preschool childrenDEVELOPMENTAL DISABILITIES RESEARCH REVIEW, Issue 3 2005Beth L. Tieman Abstract The process of identification of children with delays or disorders in motor development includes developmental screening, examination, and reexamination. Throughout this process, various types of measures are used, including discriminative and evaluative measures. Discriminative and evaluative measures of motor development and function that are commonly used for preschool-aged children include the Bayley Scales of Infant Development II, Peabody Developmental Motor Scales, 2nd edition, Toddler and Infant Motor Evaluation, Pediatric Evaluation of Disability Inventory, and Gross Motor Function Measure. Selecting an appropriate measure is a crucial part of the examination process and should be geared toward the purpose of testing and characteristics of the child. Evidence of reliability and validity are important considerations for selection of a measure. © 2005 Wiley-Liss, Inc. MRDD Research Reviews 2005;11:189,196. [source] Vulvar Mass in a ToddlerPEDIATRIC DERMATOLOGY, Issue 3 2001B.A., Fiona D. Behr B.S. No abstract is available for this article. [source] Toddlers can adaptively change how they categorize: same objects, same session, two different categorical distinctionsDEVELOPMENTAL SCIENCE, Issue 1 2009Jessica S. Horst Two experiments demonstrate that 14- to 18-month-old toddlers can adaptively change how they categorize a set of objects within a single session, and that this ability is related to vocabulary size. In both experiments, toddlers were presented with a sequential touching task with objects that could be categorized either according to some perceptually salient dimension corresponding to a taxonomic distinction (e.g. animals vs. vehicles) or to some less obvious dimension (e.g. rigid vs. deformable). In each experiment, children with larger productive vocabularies responded to both dimensions, showing evidence of sensitivity to each way of categorizing the items. Children with smaller productive vocabularies attended only to the taxonomically related categorical grouping. These experiments confirm that toddlers can adaptively shift the basis of their categorization and highlight the dynamic interaction between the child and the current task in early categorization. [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] What's in View for Toddlers?INFANCY, Issue 3 2008Using a Head Camera to Study Visual Experience This article reports 2 experiments using a new method to study 18-to 24-month-olds' visual experiences as they interact with objects. Experiment 1 presents evidence on the coupling of head and eye movements and thus the validity of the head camera view of the infant's visual field in the geometry of the task context. Experiment 2 demonstrates the use of this method in the naturalistic context of toy play with a parent. The results point to the embodied nature of toddlers' attentional strategies and to importance of hands and hand actions in their visual experience of objects. The head camera thus appears to be a promising method that, despite some limitations, will yield new insights about the ecology and content of young children's experiences. [source] A preliminary study of screening for risk of autism in children with fragile X syndrome: testing two risk cut-offs for the Checklist for Autism in ToddlersJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 4 2007D. J. Scambler Abstract Objective Risk criteria for the Checklist for Autism in Toddlers (CHAT) and modified risk criteria (i.e. the Denver Criteria) were compared in a group of children with fragile X syndrome (FXS) and autism. Method Participants were 17 children aged 2,4 years with DNA confirmation of FXS. Four children had autism and 13 children did not. Results Preliminary findings regarding the sensitivity and specificity of the CHAT for detecting risk for autism in children with FXS are as follows: using the original CHAT risk criteria, sensitivity and specificity were 50% and 100%, respectively; and using the Denver Criteria, sensitivity and specificity were 75% and 92%, respectively. Conclusions The CHAT and the Denver Criteria resulted in preliminary findings suggesting high levels of sensitivity to autism in children with FXS. [source] When the Bough Breaks the Cradle Will Fall: Promoting the Health and Well Being of Infants and Toddlers in Juvenile CourtJUVENILE AND FAMILY COURT JOURNAL, Issue 4 2001JUDGE CINDY S. LEDERMAN ABSTRACT Approximately one-third of the children in the child welfare system are under the age of six. These children are almost invisible in our juvenile courts. It is now clear from the emerging science of early childhood development that during the first few years of life children develop the foundation and capabilities on which all subsequent development builds. Living in emotional and environmental impoverishment and deprivation provides a poor foundation for healthy development. These very young and vulnerable children are exhibiting disproportionate developmental and cognitive delays, medical problems, and emotional disorders. However, there is growing evidence that early planned interventions can help. The juvenile court must take a leadership role in focusing on the very young child and learning more about risk, prevention, and early intervention in order to facilitate the healing process. [source] Lung Transplantation in Infants and Toddlers from 1990 to 2004 at St. Louis Children's HospitalAMERICAN JOURNAL OF TRANSPLANTATION, Issue 4 2009A. Elizur In a retrospective, single-center cohort study, outcomes of infants and toddlers undergoing lung transplant at St. Louis Children's Hospital between 1990 and 2004 were compared to older children. Patients with cystic fibrosis (exclusively older children) and those who underwent heart,lung, liver,lung, single lung or a second transplantation were excluded from comparisons. One hundred nine lung transplants were compared. Thirty-six were in infants <1 year old, 26 in toddlers 1,3 years old and 47 in children >3 years old. Graft survival was similar for infants and toddlers (p = 0.35 and p = 0.3, respectively) compared to children over 3 years old at 1 and 3 years after transplant. Significantly more infants (p < 0.0001 and p = 0.003) and toddlers (p = 0.002 and p = 0.03) were free from acute rejection and bronchiolitis obliterans compared to older patients. While most infants and toddlers had only minimal lung function impairment, and achieved normal to mildly delayed developmental scores, somatic growth remained depressed 5 years after transplant. Lung transplantation in infants and young children carries similar survival rates to older children and adults. Further insights into the unique immunologic aspects of this group of patients may elucidate strategies to prevent acute and chronic rejection in all age groups. [source] The Head Bone's Connected to the Neck Bone: When Do Toddlers Represent Their Own Body Topography?CHILD DEVELOPMENT, Issue 3 2010Celia A. Brownell Developments in very young children's topographic representations of their own bodies were examined. Sixty-one 20- and 30-month-old children were administered tasks that indexed the ability to locate specific body parts on oneself and knowledge of how one's body parts are spatially organized, as well as body-size knowledge and self-awareness. Age differences in performance emerged for every task. Body-part localization and body spatial configuration knowledge were associated; however, body topography knowledge was not associated with body-size knowledge. Both were related to traditional measures of self-awareness, mediated by their common associations with age. It is concluded that children possess an explicit, if rudimentary, topographic representation of their own body's shape, structure, and size by 30 months of age. [source] "So Big": The Development of Body Self-Awareness in ToddlersCHILD DEVELOPMENT, Issue 5 2007Celia A. Brownell Early development of body self-awareness was examined in 57 children at 18, 22, or 26 months of age, using tasks designed to require objective representation of one's own body. All children made at least one body representation error, with approximately 2.5 errors per task on average. Errors declined with age. Children's performance on comparison tasks that required them to reason about the relative size of objects and about objects as obstacles, without considering their own bodies, was unrelated to performance on the body awareness tasks. Thus, the ability to represent and reflect on one's own body explicitly and objectively may be a unique dimension of early development, a distinct component of objective self-awareness that emerges in this age period. [source] Flexible and Context-Dependent Categorization by Eighteen-Month-OldsCHILD DEVELOPMENT, Issue 1 2007Denis Mareschal One hundred 18-month-olds were tested using sequential touching and following 4 different priming contexts using sets of toys that could be simultaneously categorized at either the basic or global level. An exact expression of the expected mean sequence length for arbitrary categories was derived as a function of the number of touches made, and a finite mixture model analytic method was also used to explore individual variability in categorization. Toddlers could categorize flexibly and spontaneously selected the level of categorization as a function of the prior prime. Perceptual Variability emerged as a predictor of the level at which infants subsequently categorized. The infants were also able to classify objects as members of both basic- and global-level categories simultaneously. [source] Toddlers' Use of Force against Familiar Peers: A Precursor of Serious Aggression?CHILD DEVELOPMENT, Issue 2 2000Dale F. Hay Possible precursors of serious aggression were identified in toddlers' use of force against peers. Instances of grabbing objects and hitting peers were recorded in a sample of 66 British 18- to 30-month-olds, observed at home with familiar peers and seen again 6 months later. Mothers rated aggressiveness in the context of other personality traits. Girls and boys did not differ in average levels of aggression, nor were they rated differently by the mothers. However, the observed rate of hitting peers and mothers' ratings of aggressiveness were stable over 6 months for girls, but not for boys. Toddlers who were especially sensitive to peers' possible intentions hit their peers more often. They were also more likely to use force proactively, 6 months later. [source] Early working memory and maternal communication in toddlers born very low birth weightACTA PAEDIATRICA, Issue 4 2009Jean Lowe Abstract Aim: Early working memory is emerging as an important indicator of developmental outcome predicting later cognitive, behavioural and academic competencies. The current study compared early working memory in a sample of toddlers (18,22 months) born very low birth weight (VLBW; n = 40) and full term (n = 51) and the relationship between early working memory, mental developmental index (MDI), and maternal communication in both samples. Methods: Early working memory, measured by object permanence; Bayley mental developmental index; and maternal communication, coded during mother-toddler play interaction, were examined in 39 toddlers born VLBW and 41 toddlers born full term. Results: Toddlers born VLBW were found to be 6.4 times less likely to demonstrate attainment of object permanence than were toddlers born full term, adjusting for age at testing. MDI and maternal communication were found to be positively associated with attainment of object permanence in the VLBW group only. Conclusion: The difference found in the early working memory performance of toddlers born VLBW, compared with those born full term, emphasizes the importance of assessing early working memory in at-risk populations, while the maternal communication finding highlights potential targets of intervention for improving working memory in toddlers born VLBW. [source] Self,other awareness and peer relationships in toddlers: gender comparisonsINFANT AND CHILD DEVELOPMENT, Issue 5 2010Laura E. Levine Abstract Toddlers' growing self,other awareness has been linked with their ability to interact with peers, but there is reason to think that self,other awareness may relate to different aspects of peer relationships for boys and girls. We hypothesized that boys would express self,other awareness by separating self from other through claiming toys, while girls would express self,other awareness by creating similarities between self and other through use of the duplicate of a partner's toy. For 52 22,26,month olds, self,other awareness was assessed through four tasks: mirror self recognition, perceptual role taking, pronoun recognition and pronoun use. Each child subsequently interacted with a same-sex peer for 30,min. Girls high in self,other awareness, and their partners were more likely to engage in duplicate toy use than girls low in self,other awareness. No differences in toy claiming were found. Future longitudinal research would clarify how the onset of self,other awareness relates to developments in peer interaction for girls and boys. Copyright © 2010 John Wiley & Sons, Ltd. [source] Focused attention in toddlers: measurement, stability, and relations to negative emotion and parentingINFANT AND CHILD DEVELOPMENT, Issue 4 2008Bridget M. Gaertner Abstract This longitudinal study examined individual differences and correlates of focused attention when toddlers were approximately 18 months old (T1; n=256) and a year later (T2; n=230). Toddlers' attention and negative emotionality were reported by mothers and non-parental caregivers and rated globally by observers. Toddlers' focused attention also was observed during two mother,child interactions and an independent play task. Measures of maternal emotional support and control were obtained via self-report and observation. Some contemporaneous relations among indices of toddlers' attention were obtained, particularly for observed measures. Moreover, all measures of attention demonstrated stability across time. Negative emotionality was negatively related to toddlers' observed attention at both ages, whereas maternal praise had positive concurrent associations. Maternal control was negatively related to observed attention at T2 and also predicted longitudinally, but only for children who initially had low or moderate attention. The findings suggest that individual differences in focused attention evidence stability early in life but can be influenced by adult socialization. Copyright © 2008 John Wiley & Sons, Ltd. [source] Prenatal maternal emotional complaints are associated with cortisol responses in toddler and preschool aged girlsDEVELOPMENTAL PSYCHOBIOLOGY, Issue 7 2009Anouk T.C.E. de Bruijn Abstract Associations between prenatal maternal emotional complaints and child behavioral and cognitive problems have been reported, with different relations for boys and girls. Fetal programming hypotheses underline these associations and state that the early development of the HPA-axis of the children may have been affected. In the present study, differences in cortisol responses of prenatally exposed and nonexposed children are examined for both sexes separately. Cortisol response patterns of a group preschool aged children that were prenatally exposed to high levels of maternal emotional complaints (N,=,51) were compared to a nonexposed group (N,=,52). Child saliva was collected at the start of a home visit (T1), 22,min after a mother,child interaction episode (T2), and 22,min after a potentially frustrating task (T3). Repeated measures analyses showed that prenatally exposed girls showed higher cortisol levels across the three episodes compared to nonexposed girls. No differences were found in boys. Maternal prenatal emotional complaints might be related to child HPA-axis functioning differently for boys and girls. © 2009 Wiley Periodicals, Inc. Dev Psychobiol 51: 553,563, 2009. [source] Age-related differences in neural correlates of face recognition during the toddler and preschool yearsDEVELOPMENTAL PSYCHOBIOLOGY, Issue 2 2003Leslie J. Carver Abstract Research on the development of face recognition in infancy has shown that infants respond to faces as if they are special and recognize familiar faces early in development. Infants also show recognition and differential attachment to familiar people very early in development. We tested the hypothesis that infants' responses to familiar and unfamiliar faces differ at different ages. Specifically, we present data showing age-related changes in infants' brain responses to mother's face versus a stranger's face in children between 18 and 54 months of age. We propose that these changes are based on age-related differences in the perceived salience of the face of the primary caregiver versus strangers. © 2003 Wiley Periodicals, Inc. Dev Psychobiol 42: 148,159, 2003 [source] When infants grow up in multiperson relationship systemsINFANT MENTAL HEALTH JOURNAL, Issue 4 2007James P. Mchale Despite prompts from the field of family therapy since its inception, contemporary infant mental health theory and practice remain firmly rooted in and guided by dyadic-based models. Over the past 10 years, a groundswell of new empirical studies of triadic and family group dynamics during infancy have substantiated that which family theory has contended for decades: looking beyond mother-infant or father-infant dyads reveals a myriad of critically important socialization influences and dynamics that are missed altogether when relying on informant reports or dyad-based interactions. Such family-level dynamics emerge within months after infants are born, show coherence through time, and influence the social and emotional adjustment of children as early as the toddler and preschool years. This report summarizes key findings from the past decade of empirical family studies, highlights several areas in need of further conceptual development and empirical study by those who work with infants and their families, and outlines important implications of this body of work for all practicing infant mental health professionals. [source] Maternal limit-setting in toddlerhood: Socialization strategies for the development of self-regulationINFANT MENTAL HEALTH JOURNAL, Issue 4 2006Elizabeth LeCuyer Early findings from the Prohibition Coding Scheme (PCS; Houck & LeCuyer, 1995; LeCuyer-Maus & Houck, 2002; Medvin & Spieker, 1985) revealed that maternal limit-setting styles with toddlers were differentially related to later child social competence, self-concept, and delay of gratification. For this study, the PCS was revised to provide more information about the specific strategies mothers used during limit-setting in relation to those outcomes. Results from the PCS-Revised (PCS-R; LeCuyer & Houck, 2004) included that the more time mothers spent actively distracting their toddlers away from a prohibited object during limit-setting, as early as 12 months, the longer their children could delay gratification at age 5 years. Mothers who spent more time sensitively following and being engaged in their toddler's own interests (other than the prohibited object), again as early as 12 months, had more socially competent children with more developed self-concepts at age 3 years. Maternal use of reasoning statements later in toddlerhood also related to higher levels of social competence. Maternal limits and prohibitions were not related to these outcomes, and appeared to contribute to the development of self-regulation mainly by creating the opportunity for the use of other, less directive strategies. The findings indicate that these strategies may be important to include in intervention programs for the promotion of toddler and child development of self-regulation. [source] ,ALL CHILDREN ARE DWARFS'.OXFORD JOURNAL OF ARCHAEOLOGY, Issue 1 2008MEDICAL DISCOURSE AND ICONOGRAPHY OF CHILDREN'S BODIES Summary. Ancient medical discourse conveys a mainly negative view of children's bodies. From Hippocrates to Galen, newborn children are defined as imperfect and ugly beings, associating an excessive softness and weakness with various anomalies. Aristotle links their physical disproportions with those of dwarfs and animals. These disproportions induce physiological troubles and mental incapacities. Hot-tempered and moist, children are dominated by their emotions and sensations. Often authors group them with other beings regarded as inferior, such as women, the old, the sick, the insane, the drunk. How are mythical and human children rendered in iconography? Do their characteristics correspond to the medical discourse? The image of children's bodies changes with the passing of time; the miniature adult of archaic Greece gradually turns into the plump toddler of the Hellenistic period. How can we interpret these transformations? Does the evolution of iconography reflect the transformation of society or does it mirror the progress of medical knowledge? [source] Recurrent idiopathic thrombocytopenic purpura in childhoodPEDIATRIC BLOOD & CANCER, Issue 2 2008Maria Vranou MD Abstract Background Idiopathic thrombocytopenic purpura (ITP) is a common haematological disease during childhood, that usually has a benign course; however, literature on the recurrent form of the disease (rITP) is limited. Procedure rITP was characterized by intermittent episodes of thrombocytopenia (TP) followed by periods of recovery, unrelated to therapeutic intervention. We retrospectively reviewed features of patients with rITP, diagnosed and systematically followed up at our center, during the period 1975,2004. Results Forty-eight of 795 children with ITP (6.0 %) presented with rITP. The majority of patients (68.8%) had only one recurrence, whereas only one patient had four. A time interval between two episodes longer than 3 months (up to 96) was identified in 2/3 of episodes and <3 months in 1/3. The initial episode and the first recurrence mostly shared features of acute ITP; however, 22.9% of the episodes appeared with a chronic self-limited course. Bleeding manifestations were rare (18.6% of episodes) and mild, and they tended to occur in severely thrombocytopenic patients, mainly at the onset of the initial episode; intracranial hemorrhage (ICH) occurred in a toddler with short duration thrombocytopenia. Intravenous , globulin (IVIG) or corticosteroids were administered in 24.5% of episodes. None of the patients needed splenectomy. Conclusion: rITP is a rare, mild, self-limited type of ITP, although ICH may occur in a profoundly TP child. Recurrence may occur close or far apart to a previous isolated TP episode. The duration of episodes varies considerably from patient to patient and from episode to episode in the same patient. The pathogenesis of rITP still remains unclear. Pediatr Blood Cancer 2008;51:261,264. © 2008 Wiley-Liss, Inc. [source] Case study: Providing evidence-based behavioral and nutrition treatment to a toddler with cystic fibrosis and multiple food allergies via telehealth,PEDIATRIC PULMONOLOGY, Issue 10 2006Carrie Piazza-Waggoner PhD Abstract Barriers to successful outcome for cystic fibrosis (CF) therapies can include distance from a CF care center, co-morbid conditions that require individualized alterations to the prescribed treatment, and patient-provider interactions, among others. We present the case of a 21-month-old female with CF for whom modifications of an efficacious behavioral and nutrition treatment were made due to food allergies and distance from the CF care center. She was classified as at-risk nutritionally. Following treatment a significant increase in energy intake (calories) was observed in addition to her meeting weight and height growth rates for a child of this age and gender who is growing normally at the 50th percentile. Pediatr Pulmonol. 2006, 41:1001,1004. © 2006 Wiley-Liss, Inc. [source] Interplay of genes and early mother,child relationship in the development of self-regulation from toddler to preschool ageTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 11 2009Grazyna Kochanska Background:, A broad capacity for deliberate self-regulation plays a key role in emotion regulation. This longitudinal investigation from infancy to preschool age examines genotype by environment (G × E) interaction in the development of self-regulation, using molecular measures of children's genotypes and observed measures of the quality of early mother,child relationship, as reflected in attachment organization in infancy. Methods:, In 89 children, we assessed the polymorphism in the serotonin transporter gene (5-HTTLPR, ss/sl vs. ll allele status), security of attachment to mothers at 15 months in the Strange Situation, and children's ability for self-regulation at 25, 38, and 52 months, using behavioral batteries of tasks that called for deliberately suppressing a dominant response and performing instead a sub-dominant response. Results:, There was a robust G × E interaction between genetic risk and the quality of early relationship. Among children who carried a short 5-HTTLPR allele (ss/sl,), those who were insecurely attached developed poor regulatory capacities, but those who were securely attached developed as good regulatory capacities as children who were homozygotic for the long allele (ll,). There was no effect of security for ll homozygotes. Conclusions:, Those findings, consistent with diathesis-stress model, bridge research on self-regulation in typically developing children with research on non-human primates and research on psychopathology. They also indicate that a secure attachment relationship can serve as a protective factor in the presence of risk conferred by a genotype. [source] Emanuel Miller Lecture Developmental Risks (Still) Associated with Early Child CareTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 7 2001Jay Belsky In the mid to late 1980s a major controversy erupted when Belsky's (1986, 1988, 1990) analysis of research produced the conclusion that early and extensive nonmaternal care carried risks in terms of increasing the probability of insecure infant-parent attachment relationships and promoting aggression and noncompliance during the toddler, preschool, and early primary school years. Widespread critiques of Belsky's analysis called attention to problems associated with the Strange Situation procedure for measuring attachment security in the case of day-care reared children and to the failure of much of the cited research to take into consideration child-care quality and control for background factors likely to make children with varying child-care experiences developmentally different in the first place. In this lecture, research concerning the developmental effects of child care and maternal employment initiated in the first year of life that has emerged since the controversy broke is reviewed. Evidence indicating that early, extensive, and continuous nonmaternal care is associated with less harmonious parent-child relations and elevated levels of aggression and noncompliance suggests that concerns raised about early and extensive child care 15 years ago remain valid and that alternative explanations of Belsky's originally controversial conclusion do not account for seemingly adverse effects of routine nonmaternal care that continue to be reported in the literature. [source] Unusual CNS infection from a subtorcular dermal sinusACTA PAEDIATRICA, Issue 4 2010PM Kanev Abstract A 14-month-old toddler with a previously unrecognized dermal sinus tract presented with hydrocephalus and raised intracranial pressure. CT and MRI revealed a large posterior fossa dermoid mass. Cultures obtained from CSF and posterior fossa subdural empyema were positive for both Staphylococcus aureus and Escherichia coli. To the authors's knowledge, this is the first such report. Conclusion:, This case suggests that children who present with CNS infections with unusual pathogens should be carefully evaluated for the presence of anatomic abnormalities including dermal sinus tracts. [source] Procedural Pain Management Patterns in Academic Pediatric Emergency DepartmentsACADEMIC EMERGENCY MEDICINE, Issue 5 2007Rishi Bhargava MD ObjectivesTo describe the current state of the art for pain and sedation management for five common pediatric emergency department (ED) procedure scenarios. MethodsFellowship directors of U.S. EDs with a pediatric emergency medicine fellowship training program were surveyed by mail and asked to choose the one most commonly used pain or sedation management option for five clinical scenarios: facial laceration repair, cranial computed tomography in a toddler, closed fracture reduction, neonatal lumbar puncture, and intravenous catheter insertion. Results were analyzed by using descriptive statistics, and the differences between high and low volume departments were compared by using a chi-square test. ResultsThirty-eight of 51 fellowship programs responded (75%). The majority of respondents were fellowship directors (76%). Topical anesthetics were most commonly reported as used for a simple facial laceration (84%), whereas ketamine sedation was most popular for fracture reduction (86%). Pain management for the other scenarios was more variable. More than half of the respondents (53%) would not sedate at all for cranial computed tomography, and only 38% reported use of pharmacologic pain management for intravenous catheter insertion. The majority (74%) reported use of anesthetic (topical or injected local) for neonatal lumbar puncture. High volume departments were more likely to use pain management for intravenous catheter insertions. ConclusionsPain and sedation management methods for pediatric procedures continue to evolve. Despite gains, there is still room for improvement, particularly regarding intravenous catheter insertions. [source] Audience-Contingent Variation in Action Demonstrations for Humans and ComputersCOGNITIVE SCIENCE - A MULTIDISCIPLINARY JOURNAL, Issue 6 2008Jonathan S. Herberg Abstract People may exhibit two kinds of modifications when demonstrating action for others: modifications to facilitate bottom-up, or sensory-based processing; and modifications to facilitate top-down, or knowledge-based processing. The current study examined actors' production of such modifications in action demonstrations for audiences that differed in their capacity for intentional reasoning. Actors' demonstrations of complex actions for a non-anthropomorphic computer system and for people (adult and toddler) were compared. Evidence was found for greater highlighting of top-down modifications in the demonstrations for the human audiences versus the computer audience. Conversely, participants highlighted simple perceptual modifications for the computer audience, producing more punctuated and wider ranging motions. This study suggests that people consider differences in their audiences when demonstrating action. [source] Use of the Broselow Tape May Result in the Underresuscitation of ChildrenACADEMIC EMERGENCY MEDICINE, Issue 10 2006ACNP, Carolyn T. Nieman MSN Abstract Objectives The purpose of this study was to determine the concordance of the Broselow tape with the measured heights and weights of a community-based population of children, especially in light of the increase in obesity in today's children. Methods The authors examined more than 7,500 children in a cross-sectional, descriptive study in two different cohorts of children to compare their actual weight with their predicted weight by a color-coded tape measure. Results In all patients, the percent agreement and , values of the Broselow color predicted by height versus the actual color by weight for the 2002A tape were 66.2% and 0.61, respectively. The concordance was best in infants, followed by school-age children, toddlers, and preschoolers (,= 0.66, 0.44, 0.39, and 0.39, respectively; percent agreement, 81.3%, 58.2%, 60.7%, and 64.0%, respectively). The tapes accurately predicted (within 10%) medication dosages for resuscitation in 55.3%,60.0% of the children. The number of children who were underdosed (by ,10%) exceeded those who were overdosed (by ,10%) by 2.5 to 4.4 times (p < 0.05). The tapes accurately predicted uncuffed endotracheal tube sizes when compared with age-based guidelines in 71% of the children, with undersizing (,0.5 mm) exceeding oversizing by threefold to fourfold (p < 0.05). Conclusions The Broselow tape color-coded system inaccurately predicted actual weight in one third of children. Caregivers need to take into consideration the accuracy of this device when estimating children's weight during the resuscitation of a child. [source] Neurophysiologic evaluation of early cognitive development in high-risk infants and toddlersDEVELOPMENTAL DISABILITIES RESEARCH REVIEW, Issue 4 2005Raye-Ann deRegnier Abstract New knowledge of the perceptual, discriminative, and memory capabilities of very young infants has opened the door to further evaluation of these abilities in infants who have risk factors for cognitive impairments. A neurophysiologic technique that has been very useful in this regard is the recording of event-related potentials (ERPs). The event-related potential (ERP) technique is widely used by cognitive neuroscientists to study cognitive abilities such as discrimination, attention, and memory. This method has many attractive attributes for use in infants and children as it is relatively inexpensive, does not require sedation, has excellent temporal resolution, and can be used to evaluate early cognitive development in preverbal infants with limited behavioral repertories. In healthy infants and children, ERPs have been used to gain a further understanding of early cognitive development and the effect of experience on brain function. Recently, ERPs have been used to elucidate atypical memory development in infants of diabetic mothers, difficulties with perception and discrimination of speech sounds in infants at risk for dyslexia, and multiple areas of cognitive differences in extremely premature infants. Atypical findings seen in high-risk infants have correlated with later cognitive outcomes, but the sensitivity and specificity of the technique has not been studied, and thus evaluation of individual infants is not possible at this time. With further research, this technique may be very useful in identifying children with cognitive deficits during infancy. Because even young infants can be examined with ERPs, this technique is likely to be helpful in the development of focused early intervention programs used to improve cognitive function in high-risk infants and toddlers. © 2005 Wiley-Liss, Inc. MRDD Research Reviews 2005;11:317,324. [source] | |||||||||||||||||||