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Blasco P, Saxton S, Gullion LM, Oo TZ, Amukune S, Józsa K. Assessment of Mastery Motivation and Neurodevelopment of Young Children at High Risk for Developmental Delays. J Intell 2023; 11:115. [PMID: 37367517 DOI: 10.3390/jintelligence11060115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/01/2023] [Accepted: 06/06/2023] [Indexed: 06/28/2023] Open
Abstract
Young children's mastery motivation and neurodevelopmental evaluation can contribute to overall early assessment for early intervention evaluation. At present, children born preterm (<37 weeks gestation) and with a low birth weight (LBW; <2500 g) are at increased risk of experiencing developmental delays and more nuanced cognitive and language challenges. The main objective of this exploratory study was to examine the connection between preterm children's mastery motivation and their neurodevelopment, as well as to determine whether assessing mastery motivation can enhance assessment practices for early intervention (EI) programs. Parents of children born preterm completed the revised Dimensions of Mastery Motivation Questionnaire (DMQ18). Neurodevelopment was measured on the Bayley Scales of Infant and Toddler Development (BSID-III). Results revealed significant correlations between DMQ18 and BSID-III measures. Multivariate analysis showed that infants and toddlers born with a very low birth weight (VLBW; <1500 g) scored significantly lower on the infant DMQ18 and the BSID-III measures. Regression analyses revealed that birth weight and home environment were significant predictors of the children's eligibility for EI programs. Infants' social persistence with other children, gross motor persistence, and mastery pleasure, as well as toddlers' objective cognitive persistence, social persistence with adults, gross motor persistence, mastery pleasure, and negative reaction to frustration, were important markers for evidenced-based practices in EI programs. This study demonstrates the utility of the DMQ18 as a contributory assessment measure and the importance of birth weight and home environment in predicting EI enrollment.
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Affiliation(s)
- Patricia Blasco
- Institute on Development and Disability, Department of Pediatrics, School of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Sage Saxton
- Institute on Development and Disability, Department of Pediatrics, School of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Lily Marie Gullion
- Division of Occupational Science and Occupational Therapy, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Tun Zaw Oo
- MTA-MATE Early Childhood Research Group, 7400 Kaposvár, Hungary
- Institute of Education, Hungarian University of Agriculture and Life Sciences, 7400 Kaposvár, Hungary
| | - Stephen Amukune
- MTA-MATE Early Childhood Research Group, 7400 Kaposvár, Hungary
- School of Education, Pwani University, Kilifi 80108, Kenya
| | - Krisztián Józsa
- Institute of Education, Hungarian University of Agriculture and Life Sciences, 7400 Kaposvár, Hungary
- Institute of Education, University of Szeged, 6722 Szeged, Hungary
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2
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Cizmeci MN, Groenendaal F, van der Aa NE, Vandewouw MM, Young JM, Han K, Benders MJNL, Taylor MJ, de Vries LS, Woerdeman PA. Corpus callosum injury after neurosurgical intervention for posthemorrhagic ventricular dilatation and association with neurodevelopmental outcome at 2 years. J Neurosurg Pediatr 2022; 30:31-38. [PMID: 35395637 DOI: 10.3171/2022.2.peds21577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 02/21/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Direct injury to the corpus callosum (CC) due to neurosurgical interventions in infants with posthemorrhagic ventricular dilatation (PHVD) has not been reported in the literature. The authors observed a subset of infants who had suffered penetrating CC injury after neurosurgical interventions for PHVD and hypothesized that this pattern of injury may result in suboptimal CC maturation and neurodevelopmental impairment. METHODS In this multicenter, retrospective, observational study, 100 preterm and 17 full-term infants with PHVD were included and compared with 23 preterm controls. Both neonatal and postneonatal brain MRI scans were assessed for injury, and measurements were performed on postneonatal MRI scans at 2 years' corrected age. Neurodevelopmental outcome was assessed at 2 years' corrected age. RESULTS A total of 269 brain MRI scans of 140 infants were included. Of infants with PHVD, 48 (41%) had penetrating CC injury following neurosurgical interventions. The median (IQR) CC midsagittal surface area was smaller in infants with CC injury when compared with infants with PHVD who had intact CC and controls (190 mm2 [149-262 mm2] vs 268 mm2 [206-318 mm2] vs 289 mm2 [246-320 mm2], respectively; p < 0.001). In the univariate analysis, the area of the CC was associated with cognitive Z score (coefficient 0.009 [95% CI 0.005-0.012], p < 0.001) and motor Z score (coefficient 0.009 [95% CI 0.006-0.012], p < 0.001). In the multivariable model, CC injury was not independently associated with cognitive and motor Z score after adjusting for gestational age and presence of periventricular hemorrhagic infarction (coefficient 0.04 [95% CI -0.36 to 0.46] and -0.37 [95% CI -0.83 to 0.09], p = 0.7 and 0.1, respectively). CONCLUSIONS CC injury was not uncommon following neurosurgical interventions for PHVD in both preterm and full-term infants. At the age of 2 years, the CC midsagittal surface area was smaller in infants with injury, but CC injury was not independently associated with cognitive and motor outcomes at 2 years' corrected age.
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Affiliation(s)
- Mehmet N Cizmeci
- 1Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, and Utrecht University
- 2University Medical Center Utrecht, Utrecht Brain Center, Utrecht, The Netherlands
- 3Division of Neonatology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto
| | - Floris Groenendaal
- 1Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, and Utrecht University
- 2University Medical Center Utrecht, Utrecht Brain Center, Utrecht, The Netherlands
| | - Niek E van der Aa
- 1Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, and Utrecht University
- 2University Medical Center Utrecht, Utrecht Brain Center, Utrecht, The Netherlands
| | - Marlee M Vandewouw
- 4Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto
- 5Program in Neurosciences and Mental Health, The Hospital for Sick Children, University of Toronto
- 6Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto
- 7Institute of Biomedical Engineering, University of Toronto
| | - Julia M Young
- 5Program in Neurosciences and Mental Health, The Hospital for Sick Children, University of Toronto
- 8Department of Psychology, The Hospital for Sick Children, University of Toronto, Ontario, Canada
| | - Kuosen Han
- 9Department of Neurosurgery, Wilhelmina Children's Hospital, University Medical Center Utrecht, and Utrecht University, Utrecht; and
| | - Manon J N L Benders
- 1Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, and Utrecht University
- 2University Medical Center Utrecht, Utrecht Brain Center, Utrecht, The Netherlands
| | - Margot J Taylor
- 4Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto
- 5Program in Neurosciences and Mental Health, The Hospital for Sick Children, University of Toronto
| | - Linda S de Vries
- 1Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, and Utrecht University
- 2University Medical Center Utrecht, Utrecht Brain Center, Utrecht, The Netherlands
- 10Department of Neonatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Peter A Woerdeman
- 9Department of Neurosurgery, Wilhelmina Children's Hospital, University Medical Center Utrecht, and Utrecht University, Utrecht; and
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3
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Heterogeneous development of children with Congenital Zika Syndrome-associated microcephaly. PLoS One 2021; 16:e0256444. [PMID: 34525107 PMCID: PMC8443077 DOI: 10.1371/journal.pone.0256444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 08/08/2021] [Indexed: 11/19/2022] Open
Abstract
Objective To describe the neurological and neurodevelopmental outcomes of children with Congenital Zika Syndrome (CZS) associated microcephaly beyond 2 years of age. Method We followed children with CZS-associated microcephaly in an outpatient clinic in Salvador, Brazil. Neurological and neurodevelopmental assessments were performed using the Hammersmith Infant Neurological Examination (HINE) and Bayley Scales of Infant and Toddler Neurodevelopment (Bayley-III) respectively. Results Of the 42 children included, 19 were male (45.2%); median (interquartile range) age at neurological evaluation was 28 (25–32) months, and 36 (85.7%) had severe microcephaly. HINE and Bayley-III results were completed for 35/42 (83.3%) and 33/42 (78.5%) children respectively. Bayley-III identified a severe developmental delay in 32/33 (97.0%) children while 1/33 (3.0%) had only a mild delay. In the multivariable analysis, we found that Bayley-III and HINE scores were correlated. Better HINE scores were associated with higher Bayley-III cognitive raw scores (β = 0.29; CI 95% = 0.02–0.57) and motor raw scores (β = 0.43; CI 95% = 0.04–0.82) after adjusting for head circumference, prematurity, and age at neurodevelopmental evaluation. Furthermore, we found that greater head circumference at follow up was associated with higher cognitive (β = 1.27; CI 95% = 0.01–2.53) and motor raw scores (β = 2.03; CI 95% = 0.25–3.81). Conclusion Children with CZS-associated microcephaly demonstrate severe neurodevelopmental delays and slower growth rates than their peers over time. Still, they have remarkably heterogeneous neurodevelopmental profiles according to neurological exam scores which correlate with their long-term outcomes. We found that HINE scores effectively captured the heterogeneity of neurological capabilities among these children and could be predictive of cognitive and motor development progress.
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Cizmeci MN, Groenendaal F, Liem KD, van Haastert IC, Benavente-Fernández I, van Straaten HLM, Steggerda S, Smit BJ, Whitelaw A, Woerdeman P, Heep A, de Vries LS. Randomized Controlled Early versus Late Ventricular Intervention Study in Posthemorrhagic Ventricular Dilatation: Outcome at 2 Years. J Pediatr 2020; 226:28-35.e3. [PMID: 32800815 DOI: 10.1016/j.jpeds.2020.08.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 07/16/2020] [Accepted: 08/06/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To compare the effect of intervention at low vs high threshold of ventriculomegaly in preterm infants with posthemorrhagic ventricular dilatation on death or severe neurodevelopmental disability. STUDY DESIGN This multicenter randomized controlled trial reviewed lumbar punctures initiated after either a low threshold (ventricular index of >p97 and anterior horn width of >6 mm) or high threshold (ventricular index of >p97 + 4 mm and anterior horn width of >10 mm). The composite adverse outcome was defined as death or cerebral palsy or Bayley composite cognitive/motor scores <-2 SDs at 24 months corrected age. RESULTS Outcomes were assessed in 113 of 126 infants. The composite adverse outcome was seen in 20 of 58 infants (35%) in the low threshold group and 28 of 55 (51%) in the high threshold (P = .07). The low threshold intervention was associated with a decreased risk of an adverse outcome after correcting for gestational age, severity of intraventricular hemorrhage, and cerebellar hemorrhage (aOR, 0.24; 95% CI, 0.07-0.87; P = .03). Infants with a favorable outcome had a smaller fronto-occipital horn ratio (crude mean difference, -0.06; 95% CI, -0.09 to -0.03; P < .001) at term-equivalent age. Infants in the low threshold group with a ventriculoperitoneal shunt, had cognitive and motor scores similar to those without (P = .3 for both), whereas in the high threshold group those with a ventriculoperitoneal shunt had significantly lower scores than those without a ventriculoperitoneal shunt (P = .01 and P = .004, respectively). CONCLUSIONS In a post hoc analysis, earlier intervention was associated with a lower odds of death or severe neurodevelopmental disability in preterm infants with progressive posthemorrhagic ventricular dilatation. TRIAL REGISTRATION ISRCTN43171322.
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Affiliation(s)
- Mehmet N Cizmeci
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center; Utrecht; University Medical Center Utrecht, Utrecht Brain Center, Utrecht, the Netherlands; Division of Neonatology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Floris Groenendaal
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center; Utrecht; University Medical Center Utrecht, Utrecht Brain Center, Utrecht, the Netherlands
| | - Kian D Liem
- Department of Neonatology, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ingrid C van Haastert
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center; Utrecht; University Medical Center Utrecht, Utrecht Brain Center, Utrecht, the Netherlands
| | | | | | - Sylke Steggerda
- Department of Neonatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Bert J Smit
- Directorate Quality & Patient Care, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Andrew Whitelaw
- Neonatal Intensive Care Unit, Southmead Hospital and Neonatal Neuroscience, University of Bristol, Bristol, United Kingdom
| | - Peter Woerdeman
- Division of Neuroscience, Department of Neurosurgery, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Axel Heep
- Neonatal Intensive Care Unit, Southmead Hospital and Neonatal Neuroscience, University of Bristol, Bristol, United Kingdom
| | - Linda S de Vries
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center; Utrecht; University Medical Center Utrecht, Utrecht Brain Center, Utrecht, the Netherlands.
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Luyt K, Jary SL, Lea CL, Young GJ, Odd DE, Miller HE, Kmita G, Williams C, Blair PS, Hollingworth W, Morgan M, Smith-Collins AP, Walker-Cox S, Aquilina K, Pople I, Whitelaw AG. Drainage, irrigation and fibrinolytic therapy (DRIFT) for posthaemorrhagic ventricular dilatation: 10-year follow-up of a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed 2020; 105:466-473. [PMID: 32623370 PMCID: PMC7547901 DOI: 10.1136/archdischild-2019-318231] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 01/21/2020] [Accepted: 01/27/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Progressive ventricular dilatation after intraventricular haemorrhage (IVH) in preterm infants has a very high risk of severe disability and death. Drainage, irrigation and fibrinolytic therapy (DRIFT), in a randomised controlled trial (RCT), reduced severe cognitive impairment at 2 years. OBJECTIVE To assess if the cognitive advantage of DRIFT seen at 2 years persisted until school age. PARTICIPANTS The RCT conducted in four centres recruited 77 preterm infants with IVH and progressive ventricular enlargement over specified measurements. Follow-up was at 10 years of age. INTERVENTION Intraventricular injection of a fibrinolytic followed by continuous lavage, until the drainage was clear, and standard care consisting of control of expansion by lumbar punctures and if expansion persisted via a ventricular access device. PRIMARY OUTCOME Cognitive quotient (CQ), derived from the British Ability Scales and Bayley III Scales, and survival without severe cognitive disability. RESULTS Of the 77 children randomised, 12 died, 2 could not be traced, 10 did not respond and 1 declined at 10-year follow-up. 28 in the DRIFT group and 24 in the standard treatment group were assessed by examiners blinded to the intervention. The mean CQ score was 69.3 (SD=30.1) in the DRIFT group and 53.7 (SD=35.7) in the standard treatment group (unadjusted p=0.1; adjusted p=0.01, after adjustment for the prespecified variables sex, birth weight and IVH grade). Survival without severe cognitive disability was 66% in the DRIFT group and 35% in the standard treatment group (unadjusted p=0.019; adjusted p=0.003). CONCLUSION DRIFT is the first intervention for posthaemorrhagic ventricular dilatation to objectively demonstrate sustained cognitive improvement. TRIAL REGISTRATION NUMBER ISRCTN80286058.
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Affiliation(s)
- Karen Luyt
- Neonatal Neurology, Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, UK .,Neonatal Intensive Care Unit, St Michael's Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Sally L Jary
- Neonatal Neurology, Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - Charlotte L Lea
- Neonatal Neurology, Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - Grace J. Young
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK,Bristol Randomised Trials Collaboration (BRTC), Bristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UK
| | - David E Odd
- Neonatal Neurology, Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, UK,Neonatal Intensive Care Unit, Southmead Hospital, North Bristol NHS Trust, Westbury on Trym, Bristol, UK
| | - Helen E Miller
- Neonatal Neurology, Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - Grazyna Kmita
- Faculty of Psychology, University of Warsaw, Warszawa, Poland
| | - Cathy Williams
- Ophthalmology, Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK,Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - Peter S Blair
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK,Bristol Randomised Trials Collaboration (BRTC), Bristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UK
| | - William Hollingworth
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Michelle Morgan
- Child Psychology, Community Children’s Health Partnership, Bristol, UK
| | - Adam P Smith-Collins
- Neonatal Neurology, Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, UK,Neonatal Intensive Care Unit, St Michael's Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Steven Walker-Cox
- Neonatal Neurology, Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - Kristian Aquilina
- Department of Neurosurgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Ian Pople
- Paediatric Neurosurgery, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Andrew G Whitelaw
- Neonatal Neurology, Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, UK
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Nielsen-Saines K, Brasil P, Kerin T, Vasconcelos Z, Gabaglia CR, Damasceno L, Pone M, Abreu de Carvalho LM, Pone SM, Zin AA, Tsui I, Salles TRS, da Cunha DC, Costa RP, Malacarne J, Reis AB, Hasue RH, Aizawa CYP, Genovesi FF, Einspieler C, Marschik PB, Pereira JP, Gaw SL, Adachi K, Cherry JD, Xu Z, Cheng G, Moreira ME. Delayed childhood neurodevelopment and neurosensory alterations in the second year of life in a prospective cohort of ZIKV-exposed children. Nat Med 2019; 25:1213-1217. [PMID: 31285631 PMCID: PMC6689256 DOI: 10.1038/s41591-019-0496-1] [Citation(s) in RCA: 182] [Impact Index Per Article: 36.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 05/22/2019] [Indexed: 12/14/2022]
Abstract
We report neurodevelopmental outcomes in 216 infants followed since the time of PCR-confirmed maternal Zika virus (ZIKV) infection in pregnancy during the Rio de Janeiro epidemic of 2015-2016 (refs. 1,2). Neurodevelopment was assessed by Bayley Scales of Infant and Toddler Development, third edition (Bayley-III; cognitive, language and motor domains) in 146 children and through neurodevelopment questionnaires/neurological examinations in 70 remaining children. Complete eye exams (n = 137) and hearing assessments (n = 114) were also performed. Below-average neurodevelopment and/or abnormal eye or hearing assessments were noted in 31.5% of children between 7 and 32 months of age. Among children assessed by Bayley-III, 12% scored below -2 s.d. (score <70; a score of 100 ± 2 s.d. is the range) in at least one domain; and 28% scored between -1 and -2 s.d. in any domain (scores <85-70). Language function was most affected, with 35% of 146 children below average. Improved neurodevelopmental outcomes were noted in female children, term babies, children with normal eye exams and maternal infection later in pregnancy (P = 0.01). We noted resolution of microcephaly with normal neurodevelopment in two of eight children, development of secondary microcephaly in two other children and autism spectrum disorder in three previously healthy children in the second year of life.
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Affiliation(s)
| | | | - Tara Kerin
- David Geffen UCLA School of Medicine, CA, Los Angeles, USA
| | | | | | | | - Marcos Pone
- Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | | | | | - Irena Tsui
- David Geffen UCLA School of Medicine, CA, Los Angeles, USA
| | | | | | | | | | | | | | | | | | | | - Peter B Marschik
- Medical University of Graz, Graz, Austria
- University Medical Center, Göttingen, Germany
| | | | | | | | - James D Cherry
- David Geffen UCLA School of Medicine, CA, Los Angeles, USA
| | - Zhiheng Xu
- State Key Laboratory of Molecular Developmental Biology, CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China
- Parkinson's Disease Center, Beijing Institute for Brain Disorders, Beijing, China
| | - Genhong Cheng
- David Geffen UCLA School of Medicine, CA, Los Angeles, USA
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7
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Kerstjens JM, Nijhuis A, Hulzebos CV, van Imhoff DE, van Wassenaer-Leemhuis AG, van Haastert IC, Lopriore E, Katgert T, Swarte RM, van Lingen RA, Mulder TL, Laarman CR, Steiner K, Dijk PH. The Ages and Stages Questionnaire and Neurodevelopmental Impairment in Two-Year-Old Preterm-Born Children. PLoS One 2015; 10:e0133087. [PMID: 26193474 PMCID: PMC4508030 DOI: 10.1371/journal.pone.0133087] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 06/22/2015] [Indexed: 11/18/2022] Open
Abstract
Objective To test the ability of the Ages and Stages Questionnaire, Third Edition (ASQ3) to help identify or exclude neurodevelopmental impairment (NDI) in very preterm-born children at the corrected age of two. Methods We studied the test results of 224 children, born at <32 postmenstrual weeks, who had scores on ASQ3 and Bayley Scales of Infant and Toddler Development, Third Edition (BSIDIII) and neurological examination at 22–26 months’ corrected age. We defined NDI as a score of <70 on the cognitive—or motor composite scale of BSIDIII, or impairment on neurological examination or audiovisual screening. We compared NDI with abnormal ASQ3 scores, i.e., < -2SDs on any domain, and with ASQ3 total scores. To correct for possible overestimation of BSIDIII, we also analyzed the adjusted BSIDIII thresholds for NDI, i.e., scores <80 and <85. Results We found 61 (27%) children with abnormal ASQ3 scores, and 10 (4.5%) children who had NDI with original BSIDIII thresholds (<70). Twelve children had NDI at BSIDIII thresholds at <80, and 15 had <85. None of the 163 (73%) children who passed ASQ3 had NDI. The sensitivity of ASQ3 to detect NDI was excellent (100%), its specificity was acceptable (76%), and its negative predictive value (NPV) was 100%. Sensitivity and NPV remained high with the adjusted BSIDIII thresholds. Conclusion The Ages and Stages Questionnaire is a simple, valid and cost-effective screening tool to help identify and exclude NDI in very preterm-born children at the corrected age of two years.
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Affiliation(s)
- Jorien M. Kerstjens
- Division of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, Groningen, The Netherlands
| | - Ard Nijhuis
- Division of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, Groningen, The Netherlands
| | - Christian V. Hulzebos
- Division of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, Groningen, The Netherlands
| | - Deirdre E. van Imhoff
- Division of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Ingrid C. van Haastert
- Department of Neonatology, Wilhelmina Children's Hospital/University Medical Center Utrecht, Utrecht, The Netherlands
| | - Enrico Lopriore
- Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Titia Katgert
- Department of Medical Psychology, Máxima Medical Center, Veldhoven, The Netherlands
| | - Renate M. Swarte
- Department of Neonatology, Erasmus MC-Sophia, Rotterdam, The Netherlands
| | - Richard A. van Lingen
- Princess Amalia Department of Pediatrics, Department of Neonatology, Isala, Zwolle, The Netherlands
| | - Twan L. Mulder
- Department of Pediatrics, Maastricht University Medical Center, GROW–School for Oncology and Developmental Biology, Maastricht, The Netherlands
| | - Céleste R. Laarman
- Division of Neonatology, Department of Pediatrics, VU University Medical Center, Amsterdam, The Netherlands
| | - Katerina Steiner
- Division of Neonatology, Department of Pediatrics, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands
| | - Peter H. Dijk
- Division of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, Groningen, The Netherlands
- * E-mail:
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8
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Fosi T, Chu C, Chong WK, Clark C, Scott RC, Boyd S, De Haan M, Neville B. Quantitative magnetic resonance imaging evidence for altered structural remodeling of the temporal lobe in West syndrome. Epilepsia 2015; 56:608-16. [PMID: 25802930 PMCID: PMC5006860 DOI: 10.1111/epi.12907] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2014] [Indexed: 12/05/2022]
Abstract
Objective To explore the structure–function relation of the temporal lobe in newly diagnosed West syndrome of unknown cause (uWS). Methods Quantitative magnetic resonance imaging (three‐dimensional [3D] structural MRI and diffusion tensor imaging [DTI]) was analyzed using voxel‐based morphometry (VBM) and tract‐based spatial statistics (TBSS) in 22 patients and healthy age‐matched controls. The electrophysiologic responsiveness of the temporal lobe was measured using the N100 auditory event‐related potential (aERP) to a repeated 1,000 Hz tone. Neurocognitive function was assessed using the Bayley Scales of Infant Development, Second Edition (BSID‐II). Tests followed first‐line treatment with vigabatrin (17 patients) or high‐dose oral prednisolone (5 patients). Results Total temporal lobe volume was similar in patients and controls. Patients had a smaller temporal stem (TS) (p < 0.0001) and planum temporale (PT) (p = 0.029) bilaterally. TS width asymmetry with a larger right‐sided width in controls was absent in patients (p = 0.033). PT asymmetry was present in both groups, being larger on the right (p = 0.048). VBM gray matter volume was increased at the left temporal lobe (superior and middle temporal gyri, the peri‐rhinal cortex, and medial temporal lobe) (p < 0.005, family wise error‐corrected). VBM gray matter volume correlated with the duration of infantile spasms (Pearson's r = −0.630, p = 0.009). DTI metrics did not differ between patients and controls on TBSS. Mean BSID‐II scores were lower (p < 0.001) and auditory N100 ERP attenuated less in patients than in controls (p = 0.002). Significance The functional networking and white matter development of the temporal lobe are impaired following infantile spasms. Treatment may promote structural plasticity within the temporal lobe following infantile spasms, manifest as increased gray matter volume on VBM. It remains to be investigated further whether this predicts patients' long‐term cognitive difficulties.
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Affiliation(s)
- Tangunu Fosi
- Young Epilepsy, Surrey, United Kingdom; Department of Clinical Neurophysiology, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom; Neurosciences Unit, University College London Institute of Child Health, London, United Kingdom
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Milne SL, McDonald JL, Comino EJ. Alternate scoring of the Bayley-III improves prediction of performance on Griffiths Mental Development Scales before school entry in preschoolers with developmental concerns. Child Care Health Dev 2015; 41:203-12. [PMID: 25040260 DOI: 10.1111/cch.12177] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/17/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Bayley-III is widely used as an assessment tool in young children; however, its standard composite scores appear to under-estimate delay, severe and profound delay cannot be identified, and the lack of an overall score makes it difficult to compare results with later assessments. AIMS To explore the use of Bayley-III quotient subtest and average scores, compared with composite subtest and average scores for both clinical and research purposes, comparing their ability to predict performance on the Griffiths Mental Development Scales (Griffiths) before school entry. METHOD One hundred preschoolers referred for a diagnosis were assessed on the Bayley-III before 3.5 years. They were reassessed before school entry on the Griffiths. Composite and quotient scores were calculated and their ability to predict outcome compared across the score range. RESULTS Averaging the three subscale quotient scores (Bayley-AQS) gave a similar mean score for this sample (61.1, SD 16.2) as for the Griffiths general quotient (Griffiths-GQ) (61.1, SD 19.6). The average composite scores (Bayley-ACS) had a significantly higher mean (74.2, SD 12.1). Correlations between the average scores on the Bayley-III and the Griffiths-GQ (0.8) were at least as strong as any of the individual subscale scores. Kappa coefficients showed that Bayley-AQS was superior to Bayley-ACS for predicting moderate and severe delay. Average change in scores was -0.1 for Bayley-AQS, and -13.2 for Bayley-ACS. Improvement in category of delay was seen in 28% of children using Bayley-AQS, and deterioration in 22%. In contrast, 5% improvement was seen using Bayley-ACS, and 65% deterioration. CONCLUSIONS The three directly assessed subscales of the Bayley-III can be averaged to give an overall score. Bayley-AQS are a better measure of development in young children with delay than Bayley-ACS, and most children maintain their developmental classification using this method of scoring when re-assessed before school entry.
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Affiliation(s)
- S L Milne
- Paediatric Allied Health Unit, Campbelltown Hospital, Campbelltown, NSW, Australia
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Neurodevelopmental outcome after extreme prematurity: a review of the literature. Pediatr Neurol 2015; 52:143-52. [PMID: 25497122 DOI: 10.1016/j.pediatrneurol.2014.10.027] [Citation(s) in RCA: 159] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 10/28/2014] [Accepted: 10/28/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND Advances in obstetric and neonatal medical care and assisted reproductive technology have increased the rates of preterm birth, decreased preterm mortality rates, and lowered the limit of viability. However, morbidity in survivors, including neurodevelopmental disabilities, has increased, especially in extremely preterm infants born at ≤25 weeks' gestation. A better understanding of the prevalence and patterns of adverse neurodevelopmental outcomes in extremely preterm infants is important for patient care, counseling of families, and research. METHODS The PubMed and Ovid Medline databases were searched for full text articles published between 1999 and 2013 in English that reported neurodevelopmental outcomes after extreme prematurity, and a review of identified relevant cohort studies was performed. RESULTS Extreme prematurity of 22 to 25 weeks' gestation is associated with an overall high mortality of ≥50%. High rates (17% to 59%) of severe neurodevelopmental disabilities occur among survivors on short-term follow-up. The rates of surviving unimpaired or minimally impaired are 6% to 20% for live-born infants at ≤25 weeks' gestation and <5% for infants born at 22 and 23 weeks' gestation. Long-term adverse outcomes after extreme prematurity include intellectual disability (5% to 36%), cerebral palsy (9% to 18%), blindness (0.7% to 9%), and deafness (2% to 4%). Milder degrees of disability involving cognition, behavior, and learning are increasingly recognized among older preterm children, teens, and young adults. CONCLUSIONS Infants who are born at ≤25 weeks' gestation, especially those born at 22 and 23 weeks' gestation, have a very low likelihood of surviving little or no impairment. Nearly half of surviving extremely premature infants have significant neurodevelopmental disabilities on short- and long-term follow-up. Instituting early intervention programs, providing family support, and establishing special educational school programs can pay high dividends and lead to brighter futures and, hence, help improve neurodevelopmental outcome of preterm infants.
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de Haan TR, Beckers L, de Jonge RCJ, Spanjaard L, van Toledo L, Pajkrt D, van Wassenaer-Leemhuis AG, van der Lee JH. Neonatal gram negative and Candida sepsis survival and neurodevelopmental outcome at the corrected age of 24 months. PLoS One 2013; 8:e59214. [PMID: 23527140 PMCID: PMC3601057 DOI: 10.1371/journal.pone.0059214] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 02/07/2013] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To evaluate the long term neurodevelopmental outcome of premature infants exposed to either gram- negative sepsis (GNS) or neonatal Candida sepsis (NCS), and to compare their outcome with premature infants without sepsis. METHODS Historical cohort study in a population of infants born at <30 weeks gestation and admitted to the Neonatal Intensive Care Unit (NICU) of the Academic Medical Center in Amsterdam during the period 1997-2007. Outcome of infants exposed to GNS or NCS and 120 randomly chosen uncomplicated controls (UC) from the same NICU were compared. Clinical data during hospitalization and neurodevelopmental outcome data (clinical neurological status; Bayley-test results and vision/hearing test results) at the corrected age of 24 months were collected. An association model with sepsis as the central determinant of either good or adverse outcome (death or severe developmental delay) was made, corrected for confounders using multiple logistic regression analysis. RESULTS Of 1362 patients, 55 suffered from GNS and 29 suffered from NCS; cumulative incidence 4.2% and 2.2%, respectively. During the follow-up period the mortality rate was 34% for both GNS and NCS and 5% for UC. The adjusted Odds Ratio (OR) [95% CI] for adverse outcome in the GNS group compared to the NCS group was 1.4 [0.4-4.9]. The adjusted ORs [95% CI] for adverse outcome in the GNS and NCS groups compared to the UC group were 4.8 [1.5-15.9] and 3.2 [0.7-14.7], respectively. CONCLUSIONS We found no statistically significant difference in outcome at the corrected age of 24 months between neonatal GNS and NCS cases. Suffering from either gram-negative or Candida sepsis increased the odds for adverse outcome compared with an uncomplicated neonatal period.
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Affiliation(s)
- Timo R de Haan
- Department of Neonatology, Emma Children's Hospital, Academic Medical Center Amsterdam, The Netherlands.
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Jary S, De Carli A, Ramenghi LA, Whitelaw A. Impaired brain growth and neurodevelopment in preterm infants with posthaemorrhagic ventricular dilatation. Acta Paediatr 2012; 101:743-8. [PMID: 22452585 DOI: 10.1111/j.1651-2227.2012.02686.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To correlate volumetric magnetic resonance imaging at term with neurodevelopmental outcome at 2 years in infants with posthaemorrhagic ventricular dilatation. Preterm infants with posthaemorrhagic ventricular dilatation have high risk of disabilities, but the range is wide and predicting severity of motor and mental disability is difficult. METHODS Twenty-five preterm infants with posthaemorrhagic ventricular dilatation had cerebral magnetic resonance imaging at term age. Total and regional brain volumes were calculated using a manual segmentation technique. Bayley Scales of Infant Development II were assessed at 2 years post-term. Developmental Quotients (DQ) were calculated from Developmental Age Equivalent scores. RESULTS Total cerebral volume, excluding ventricles, correlated positively with Motor (r = 0.7, p < 0.0001) and Mental DQ (r = 0.4, p = 0.02). Only three of 16 infants with cerebral volume <336 cm(3) were ambulant at 2 years. Cerebellar volumes correlated strongly with Motor DQ (r = 0.6, p = 0.002) but only with Mental DQ after adjustment. Thalamic volumes correlated strongly with Motor DQ (r = 0.7, p = 0.0002). CONCLUSION Brain growth is significantly impaired in posthaemorrhagic ventricular dilatation. Volumetric measurements at term of total cerebral and cerebellar volume may have a role in predicting severity of disability.
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Affiliation(s)
- Sally Jary
- School of Clinical Science, University of Bristol, UK.
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