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Newborn Auditory Brainstem Responses in Children with Developmental Disabilities. J Autism Dev Disord 2023; 53:776-788. [PMID: 34181140 PMCID: PMC9549590 DOI: 10.1007/s10803-021-05126-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2021] [Indexed: 12/30/2022]
Abstract
We integrated data from a newborn hearing screening database and a preschool disability database to examine the relationship between newborn click evoked auditory brainstem responses (ABRs) and developmental disabilities. This sample included children with developmental delay (n = 2992), speech impairment (SI, n = 905), language impairment (n = 566), autism spectrum disorder (ASD, n = 370), and comparison children (n = 128,181). We compared the phase of the ABR waveform, a measure of sound processing latency, across groups. Children with SI and children with ASD had greater newborn ABR phase values than both the comparison group and the developmental delay group. Newborns later diagnosed with SI or ASD have slower neurological responses to auditory stimuli, suggesting sensory differences at birth.
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Logan JW, Bapat R, Ryshen G, Bagwell G, Eisner M, Kielt M, Hanawalt M, Payne K, Alt-Coan A, Tatad M, Krendl D, Jebbia M, Reber KM, Halling C, Osman AAF, Bonachea EM, Nelin LD, Fathi O. Use of a Quality Scorecard to Enhance Quality and Safety in Community Hospital Newborn Nurseries. J Pediatr 2022; 247:67-73.e2. [PMID: 35358590 DOI: 10.1016/j.jpeds.2022.03.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/22/2022] [Accepted: 03/10/2022] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To implement a quality improvement (QI) scorecard as a tool for enhancing quality and safety efforts in level 1 and 2 community hospital nurseries affiliated with Nationwide Children's Hospital. STUDY DESIGN A QI scorecard was developed for data collection, analytics, and reporting of neonatal quality metrics and cross-sector collaboration. Newborn characteristics were included for risk stratification, as were clinical and process measures associated with neonatal morbidity and mortality. Quality and safety activities took place in community hospital newborn nurseries in Ohio, and education was provided in both online and in-person collaborations, followed by local team sessions at partner institutions. Baseline (first 12 months) and postbaseline comparisons of clinical and process measures were analyzed by logistic regression, adjusting for potential confounders. RESULTS In logistic regression models, at least 1 center documented improvements in each of the 4 process measures, and 3 of the 4 centers documented improvements in compliance with glucose checks obtained within 90 minutes of birth among at-risk infants. CONCLUSION Collaborative QI projects led to improvements in perinatal metrics associated with important outcomes. Formation of a center-driven QI scorecard is feasible and provides community hospitals with a framework for collecting, analyzing, and reporting neonatal QI metrics.
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Affiliation(s)
- J Wells Logan
- Department of Pediatrics, University of Florida College of Medicine and Wolfson Children's Hospital, Jacksonville, FL
| | - Roopali Bapat
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH
| | - Greg Ryshen
- Quality Improvement Services, Nationwide Children's Hospital, Columbus, OH
| | - Gail Bagwell
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH
| | - Mariah Eisner
- Biostatistics Resource at Nationwide Children's Hospital, Nationwide Children's Hospital, The Ohio State University, Columbus, OH
| | - Matthew Kielt
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH
| | - Martin Hanawalt
- Pediatric Hospitalist Program, Nationwide Children's Hospital, Ohio Health Mansfield, Mansfield, OH
| | - Kelly Payne
- Pediatric Hospitalist Program, Nationwide Children's Hospital, Ohio Health Mansfield, Mansfield, OH
| | - Amy Alt-Coan
- Pediatric Hospitalist Program, Blanchard Valley Health System, Findlay, OH
| | - Magdalino Tatad
- Pediatric Hospitalist Program, St. Rita's Health System, Lima, OH
| | - Debbie Krendl
- Pediatric Hospitalist Program, St. Rita's Health System, Lima, OH
| | - Maria Jebbia
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH
| | - Kristina M Reber
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH
| | - Cecilie Halling
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH
| | - Ahmed A F Osman
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH
| | | | - Leif D Nelin
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH
| | - Omid Fathi
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH.
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Giachero A, Quadrini A, Pisano F, Calati M, Rugiero C, Ferrero L, Pia L, Marangolo P. Procedural Learning through Action Observation: Preliminary Evidence from Virtual Gardening Activity in Intellectual Disability. Brain Sci 2021; 11:766. [PMID: 34207553 PMCID: PMC8226894 DOI: 10.3390/brainsci11060766] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/04/2021] [Accepted: 06/08/2021] [Indexed: 12/23/2022] Open
Abstract
Intellectual disability (ID) compromises intellectual and adaptive functioning. People with an ID show difficulty with procedural skills, with loss of autonomy in daily life. From an embodiment perspective, observation of action promotes motor skill learning. Among promising technologies, virtual reality (VR) offers the possibility of engaging the sensorimotor system, thus, improving cognitive functions and adaptive capacities. Indeed, VR can be used as sensorimotor feedback, which enhances procedural learning. In the present study, fourteen subjects with an ID underwent progressive steps training combined with VR aimed at learning gardening procedures. All participants were trained twice a week for fourteen weeks (total 28 sessions). Participants were first recorded while sowing zucchini, then they were asked to observe a virtual video which showed the correct procedure. Next, they were presented with their previous recordings, and they were asked to pay attention and to comment on the errors made. At the end of the treatment, the results showed that all participants were able to correctly garden in a real environment. Interestingly, action observation facilitated, not only procedural skills, but also specific cognitive abilities. This evidence emphasizes, for the first time, that action observation combined with VR improves procedural learning in ID.
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Affiliation(s)
- Alberto Giachero
- Aphasia Experimental Laboratory-Fondazione Carlo Molo Onlus, 10121 Turin, Italy; (A.G.); (M.C.); (C.R.)
- Dipartimento di Psicologia, University of Turin, 10124 Turin, Italy;
| | | | - Francesca Pisano
- Dipartimento di Studi Umanistici, University Federico II, 80133 Naples, Italy;
| | - Melanie Calati
- Aphasia Experimental Laboratory-Fondazione Carlo Molo Onlus, 10121 Turin, Italy; (A.G.); (M.C.); (C.R.)
| | - Cristian Rugiero
- Aphasia Experimental Laboratory-Fondazione Carlo Molo Onlus, 10121 Turin, Italy; (A.G.); (M.C.); (C.R.)
| | - Laura Ferrero
- Fondazione Agape dello Spirito Santo Onlus-Villa Lauro, 10132 Turin, Italy;
| | - Lorenzo Pia
- Dipartimento di Psicologia, University of Turin, 10124 Turin, Italy;
| | - Paola Marangolo
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy;
- Dipartimento di Studi Umanistici, University Federico II, 80133 Naples, Italy;
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Yasseen DG, Waly NE, Abdulghani KO. Polyunsaturated fatty acids supplementation can improve specific language impairment in preschool children: a pilot study. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2020. [DOI: 10.1186/s41983-020-0158-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Speech and language are one of the higher cognitive brain functions. Language delay is one of the major concerns of child health in Egypt. Speech therapy is the standard management in language delay.
Objective
We aimed to investigate the potential role of dietary supplementation with polyunsaturated fatty acids (PUFAs) in improving specific language impairment.
Subjects and methods
A total of 220 children (ages 3–4) were included in this study at the Phonetics Department, Helwan School of Medicine, Egypt, during the period from 2015 to 2018. Children received comprehensive neurological examination and intelligence quotient (IQ) test to exclude the other causes of language delay. Language evaluation was performed using the Arabic language test. They either received family counseling, speech therapy (45 min; 3 times a week for 16 weeks), and PUFA supplementation 500 mg twice daily (group A) or only counseling and speech therapy (group B). Language quotient (LQ) was calculated before and after treatment.
Results
Our results show that LQ significantly improved in group A compared with group B (p < 0.004).
Conclusion
Dietary supplementation with PUFA has a beneficial role in the management of specific language impairment along with speech therapy.
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History Information's are Indispensable in Developmental Assessment of Children. Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2020; 41:33-45. [PMID: 32573475 DOI: 10.2478/prilozi-2020-0021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
For achieving the good health and wellbeing for all children, the main role of pediatrician and other health care professionals is to follow their development. We implemented developmental monitoring for 465 children at the age of 12 - 60 months, in the period of 4 years (2016 - 2019), using standard algorithm in which start is always with child history. It should be comprehensive, and must include a detailed prenatal, perinatal, and postnatal history. Obtained results showed that 16.13% of participants have some serious illness in family history, and the same percentage (16.13%) manifested serious perinatal problems which imposed the support in intensive care unit. Breastfeed are 49,46 % of children. Only 7,53 % are not completely vaccinated. About the parameters for the development, we obtained that 11,83 % were not walking at the time of the assessment, and 65,81 % were not speaking. Toilet control was negative, and in 75,27 % they still were wearing diapers. Allergic manifestations at the time when the assessment was done is present in 8,60%. Finally, serious illness in child past history was positive in 19.35 % of evaluated sample. We concluded that a good history is needed and indispensable in the assessment process, particularly when exogenous causes are identified as the risk for the developmental delay. Obtained positive answers are directory for further investigation as well to correlate risk-consequences relationship.
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Ornoy A, Koren G. Selective serotonin reuptake inhibitor use in pregnant women; pharmacogenetics, drug-drug interactions and adverse effects. Expert Opin Drug Metab Toxicol 2018; 14:247-259. [PMID: 29345153 DOI: 10.1080/17425255.2018.1430139] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Possible negative effects of selective serotonin reuptake inhibitors (SSRIs) in pregnancy relate to congenital anomalies, negative perinatal events and neurodevelopmental outcome. Many studies are confounded by the underlying maternal disease and by pharmacogenetic and pharmacokinetic differences of these drugs. Areas covered: The possible interactions of SSRIs and serotonin and norepinephrine reuptake inhibitors with other drugs and the known effects of SSRIs on congenital anomalies, perinatal and neurodevelopmental outcome. Expert opinion: SSRIs should be given with caution when combined with other drugs that are metabolized by cytochrome P450 enzymes. SSRIs apparently increase the rate of severe cardiac malformations, induce neonatal adaptation problems in up to 30% of the offspring, increase the rate of persistent pulmonary hypertension of the newborn and possibly slightly increase the rate of prematurity and low birth weight. Most neurodevelopmental follow up studies did not find significant cognitive impairments except some transient gross motor delay, slight impairment of language abilities and possibly behavioral changes. The literature on the possible association of SSRIs with autism spectrum disorder is inconsistent; if an association exists, it is apparently throughout pregnancy. The risk associated with treatment discontinuation seems to outweigh the risk of treatment, as severe maternal depression may negatively affect the child's development. If needed, treatment should continue in pregnancy with the minimal effective dose.
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Affiliation(s)
- Asher Ornoy
- a Laboratory of Teratology, Department of Medical Neurobiology , Hebrew University Hadassah Medical School , Jerusalem , Israel
| | - Gideon Koren
- b Morris Kahn- Maccabi Institute of Research and Innovation, and Tel Aviv University , TEl - AVIV , Israel
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Neurobehavioral risks of SSRIs in pregnancy: Comparing human and animal data. Reprod Toxicol 2017; 72:191-200. [DOI: 10.1016/j.reprotox.2017.05.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 04/20/2017] [Accepted: 05/04/2017] [Indexed: 12/19/2022]
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Abou-Elsaad T, Abdel-Hady H, Baz H, ElShabrawi D. Language and cognitive outcome for high-risk neonates at the age of 2-3 years - experience from an Arab Country. World J Clin Pediatr 2017; 6:24-33. [PMID: 28224092 PMCID: PMC5296626 DOI: 10.5409/wjcp.v6.i1.24] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 08/11/2016] [Accepted: 10/27/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the effect of different neonatal risk factors on different language parameters as well as cognitive abilities among Arabic speaking Egyptian children at the age of two to three years of life and to find out which risk factor(s) had the greatest impact on language and cognitive abilities.
METHODS This retrospective cohort study was conducted on 103 children with age range of 2-3 years (median age 31 mo). They were 62 males and 41 females who were exposed to different high-risk factors in the perinatal period, with exclusion of metabolic disorders, sepsis/meningitis, congenital anomalies and chromosomal aberrations. The studied children were subjected to a protocol of language assessment that included history taking, clinical and neurological examination, audiological evaluation, assessment of language using modified preschool language scale-4, IQ and mental age assessment and assessment of social age.
RESULTS The studied children had a median gestational age of 37 wk, median birth weight of 2.5 kg. The distribution of the high-risk factors in the affected children were prematurity in 25 children, respiratory distress syndrome in 25 children, hypoxic-ischemic encephalopathy in 15 children, hyperbilirubinemia in 10 children, hypoglycemia in 13 children, mixed risk factors in 15 children. The results revealed that high-risk neonatal complications were associated with impairment of different language parameters and cognitive abilities (P < 0.05). The presence of prematurity, in relation to other risk factors, increases the risk of language and cognitive delay significantly by 3.9 fold.
CONCLUSION Arabic-speaking children aged 2-3 years who were exposed to high-risk conditions in the perinatal period are likely to exhibit delays in the development of language and impairments in cognitive abilities. The most significant risk factor associated with language and cognitive impairments was prematurity.
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Haller S, Deindl P, Cassini A, Suetens C, Zingg W, Abu Sin M, Velasco E, Weiss B, Ducomble T, Sixtensson M, Eckmanns T, Harder T. Neurological sequelae of healthcare-associated sepsis in very-low-birthweight infants: Umbrella review and evidence-based outcome tree. ACTA ACUST UNITED AC 2016; 21:30143. [PMID: 26940884 DOI: 10.2807/1560-7917.es.2016.21.8.30143] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 09/30/2015] [Indexed: 01/08/2023]
Abstract
Sepsis is a frequent cause of death in very-low-birthweight infants and often results in neurological impairment. Its attributable risk of sequelae has not been systematically assessed. To establish an outcome tree for mapping the burden of neonatal sepsis, we performed systematic literature searches to identify systematic reviews addressing sequelae of neonatal sepsis. We included cohort studies and performed meta-analyses of attributable risks. Evidence quality was assessed using GRADE. Two systematic reviews met inclusion criteria. The first included nine cohort studies with 5,620 participants and five outcomes (neurodevelopmental impairment, cerebral palsy, vision impairment, hearing impairment, death). Pooled risk differences varied between 4% (95% confidence interval (CI):2-10) and 13% (95% CI:5-20). From the second review we analysed four studies with 472 infants. Positive predictive value of neurodevelopmental impairment for later cognitive impairment ranged between 67% (95% CI:22-96) and 83% (95% CI:36-100). Neonatal sepsis increases risk of permanent neurological impairment. Effect size varies by outcome, with evidence quality being low to very low. Data were used to construct an outcome tree for neonatal sepsis. Attributable risk estimates for sequelae following neonatal sepsis are suitable for burden estimation and may serve as outcome parameters in interventional studies.
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Affiliation(s)
- Sebastian Haller
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
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Hadders-Algra M. Social and biological determinants of growth and development in underprivileged societies. J Pediatr (Rio J) 2016; 92:217-9. [PMID: 26944780 DOI: 10.1016/j.jped.2016.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Mijna Hadders-Algra
- Beatrix Children's Hospital, University Medical Center Groningen, Groningen, The Netherlands.
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11
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Conde-Agudelo A, Rosas-Bermudez A, Norton MH. Birth Spacing and Risk of Autism and Other Neurodevelopmental Disabilities: A Systematic Review. Pediatrics 2016; 137:peds.2015-3482. [PMID: 27244802 DOI: 10.1542/peds.2015-3482] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/22/2016] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Both short and long interpregnancy intervals (IPIs) have recently been associated with increased risk of autism spectrum disorder (ASD). However, this association has not been systematically evaluated. OBJECTIVE To examine the relationship between birth spacing and the risk of ASD and other neurodevelopmental disabilities. DATA SOURCES Electronic databases from their inception to December 2015, bibliographies, and conference proceedings. STUDY SELECTION Observational studies with results adjusted for potential confounding factors that reported on the association between IPIs or birth intervals and neurodevelopmental disabilities. DATA EXTRACTION Two reviewers independently extracted data on study characteristics, IPIs/birth intervals, and outcome measures. RESULTS Seven studies (1 140 210 children) reported an association between short IPIs and increased risk of ASD, mainly the former subtype autistic disorder. Compared with children born to women with IPIs of ≥36 months, children born to women with IPIs of <12 months had a significantly increased risk of any ASD (pooled adjusted odds ratio [OR] 1.90, 95% confidence interval [CI] 1.16-3.09). This association was stronger for autistic disorder (pooled adjusted OR 2.62, 95% CI 1.53-4.50). Three of these studies also reported a significant association between long IPIs and increased risk of ASD. Short intervals were associated with a significantly increased risk of developmental delay (3 studies; 174 940 children) and cerebral palsy (2 studies; 19 419 children). LIMITATIONS Substantial heterogeneity, and few studies assessing neurodevelopmental disabilities other than ASD. CONCLUSIONS Short IPIs are associated with a significantly increased risk of ASD. Long IPIs also appear to increase the risk of ASD.
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Affiliation(s)
- Agustín Conde-Agudelo
- World Health Organization Collaborating Centre in Human Reproduction, Universidad del Valle, Cali, Colombia; and
| | - Anyeli Rosas-Bermudez
- World Health Organization Collaborating Centre in Human Reproduction, Universidad del Valle, Cali, Colombia; and
| | - Maureen H Norton
- Office of Population and Reproductive Health, Bureau for Global Health, US Agency for International Development, Washington, District of Columbia
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Social and biological determinants of growth and development in underprivileged societies. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2016. [DOI: 10.1016/j.jpedp.2016.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Guralnick MJ. Early Intervention for Children with Intellectual Disabilities: An Update. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2016; 30:211-229. [DOI: 10.1111/jar.12233] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2015] [Indexed: 12/22/2022]
Affiliation(s)
- Michael J. Guralnick
- Center on Human Development and Disability; University of Washington; Seattle WA USA
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