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Karyadiguna N, Bernie C, Barnes EH, Williams K, Lo BH. Does pre-school developmental assessment agree with later intellectual assessment? A retrospective cohort study. J Paediatr Child Health 2023; 59:962-967. [PMID: 37226978 DOI: 10.1111/jpc.16428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/28/2023] [Accepted: 05/06/2023] [Indexed: 05/26/2023]
Abstract
AIM This study sought to assess the association between early developmental assessment of toddlers with idiopathic global developmental delay (GDD) and their later intelligence test scores. METHODS Toddlers with idiopathic GDD attending a community clinic over a 6-year period were assessed initially using the Griffiths Mental Development Scales - Extended Revised version (GMDS-ER) and later completing formal intelligence testing using the Stanford-Binet Intelligence Scale - 5th Edition (SB5) at age 4-6 years. Spearman's correlation was used to assess the association of quotient scores across the tools. The composite quotient (GQ) and the subscale quotients of GMDS-ER were correlated with the full-scale IQ (FSIQ), verbal and non-verbal IQ scores from the SB5. RESULTS Thirty of 153 children assessed at the clinic were eligible for the study. The correlation between GMDS-ER GQ and later SB5 FSIQ was strong (r = 0.86, P < 0.001). The subscales' associations were moderate to strong (0.48-0.71). Eighty-six percent (86%) of children with delay on GMDS-ER GQ were found later to be in the impaired category based on the FSIQ of the SB5. CONCLUSION There was a strong association between toddlers' early developmental quotients and later IQ scores for children with idiopathic GDD, though agreement between early GDD diagnoses and later intellectual disability is not absolute. Individualised care is needed around prognostic advice and recommendations to caregivers and families in the early years, so they may effectively plan for interventions, supports and later reassessment to optimise their child's development and learning.
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Affiliation(s)
- Nugroho Karyadiguna
- Department of Paediatrics and Neonatology, Blacktown and Mount Druitt Hospital, Sydney, New South Wales, Australia
| | - Charmaine Bernie
- Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
- Faculty of Health, Southern Cross University, Gold Coast, Queensland, Australia
| | - Elizabeth H Barnes
- NHMRC Clinical Trials Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Katrina Williams
- Department of Paediatrics and Neonatology, Blacktown and Mount Druitt Hospital, Sydney, New South Wales, Australia
- Developmental Paediatrics, Monash Children's Hospital, Melbourne, Victoria, Australia
| | - Bee Hong Lo
- Developmental Paediatrics, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
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Danks M, Flynn EJ, Gray PH, Hurrion EM. 'Low-normal' motor skills in infants at high risk for poor developmental outcomes: A prevalence and prognostic study. Dev Med Child Neurol 2022; 64:1517-1523. [PMID: 35598100 DOI: 10.1111/dmcn.15267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 04/11/2022] [Accepted: 04/15/2022] [Indexed: 01/31/2023]
Abstract
AIM To investigate the prevalence and prognostic value of 'low-normal' motor skills in infants at high-risk for poor developmental outcomes. METHOD Infants born extremely low-birthweight and extremely preterm discharged from neonatal intensive care between 2015 and 2018 completed the Alberta Infant Motor Scale (AIMS), Neuro-Sensory Motor Developmental Assessment (NSMDA) at corrected age 4, 8, and 12 months, and Griffiths Mental Development Scale at corrected age 12 months. RESULTS Participating infants (n = 191) with a mean gestational age (95% confidence interval [CI]) of 26.80 weeks (26.60, 27.1) and mean birthweight (95% CI) of 869 grams (843, 895) included 45 (23.80%) infants small for gestational age. AIMS rated 50.32%, 35.37%, and 14.86% of infants within the 'low-normal' motor skills range (1-2 SD below the mean for age) at 4, 8, and 12 months respectively. Of the infants within the AIMS 'low-normal' skills range, 55.70%, 88.46%, and 59.10% were classified as having impairment by NSMDA at 4, 8, and 12 months respectively. Griffiths assessment at 12 months identified only 7.33% of infants with 'low-normal' skills and 3.33% with motor disability. Minimal motor impairment rating on the NSMDA at 4 or 8 months significantly predicted general development at 12 months. INTERPRETATION High-risk infants with 'low-normal' motor skills may warrant referral to early intervention as associated impairment represents increased risk for poorer general development outcomes. WHAT THIS PAPER ADDS High prevalence of 'low-normal' motor skill exists in high-risk infants. Clinical motor assessment validly identifies infants with motor impairment. Minimal motor impairment in high-risk infants is prognostic of general development. High-risk infants with 'low-normal' motor skills may warrant early intervention. Griffiths Scales of Child Development, Third Edition assessment at 12-months age may under-identify motor difficulties.
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Affiliation(s)
- Marcella Danks
- School of Allied Health, Australian Catholic University, Brisbane, Australia
| | - Emma J Flynn
- School of Allied Health, Australian Catholic University, Brisbane, Australia
| | - Peter H Gray
- Mater Research Institute-The University of Queensland, Brisbane, Australia
| | - Elizabeth M Hurrion
- Mater Research Institute-The University of Queensland, Brisbane, Australia.,Department of Newborn Services, Mater Mothers' Hospital, Brisbane, Australia
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Giangiacomo E, Visaggi MC, Aceti F, Giacchetti N, Martucci M, Giovannone F, Valente D, Galeoto G, Tofani M, Sogos C. Early Neuro-Psychomotor Therapy Intervention for Theory of Mind and Emotion Recognition in Neurodevelopmental Disorders: A Pilot Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9081142. [PMID: 36010032 PMCID: PMC9406700 DOI: 10.3390/children9081142] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 11/22/2022]
Abstract
The aim of the present study is to explore the effect of early neuro-psychomotor therapy to improve theory of mind skills and emotion recognition in children with neurodevelopmental disorders. A pilot study was set up, consisting of in-group training activities based on the neuro-psychomotor approach. Children were evaluated using Neuropsychological Assessment for Child (Nepsy-II), Test of Emotion Comprehension (TEC), and Social Communication Questionnaire (SCQ). For data analysis, one-sample Wilcoxon signed rank test was used with a significance of p < 0.05. Two children with a developmental language disorder and four children with autism spectrum disorders participated in a 3-month training program. Our findings revealed significant improvement in emotion recognition, as measured with Nepsy-II (p = 0.04), while no statistical improvement was found for theory of mind. Despite the limited sample, early neuro-psychomotor therapy improves emotion recognition skills in children with neurodevelopmental disorders. However, considering the explorative nature of the study, findings should be interpreted with caution.
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Mura E, Nicita F, Masnada S, Battini R, Ticci C, Montomoli M, Berardinelli A, Pantaleoni C, Ardissone A, Foiadelli T, Tartara E, Salsano E, Veggiotti P, Ceccherini I, Moroni I, Bertini E, Tonduti D. Alexander disease evolution over time: data from an Italian cohort of pediatric-onset patients. Mol Genet Metab 2021; 134:353-358. [PMID: 34865968 DOI: 10.1016/j.ymgme.2021.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 11/12/2021] [Accepted: 11/18/2021] [Indexed: 11/26/2022]
Abstract
Alexander disease (AxD) is a leukodystrophy that primarily affects astrocytes and is caused by dominant variants in the Glial Fibrillary Acidic Protein gene. Three main classifications are currently used, the traditional one defined by the age of onset, and two more recent ones based on both clinical features at onset and brain MRI findings. In this study, we retrospectively included patients with genetically confirmed pediatric-onset AxD. Twenty-one Italian patients were enrolled, and we revised all their clinical and radiological data. Participants were divided according to the current classification systems. We qualitatively analyzed data on neurodevelopment and neurologic decline in order to identify the possible trajectories of the evolution of the disease over time. One patient suffered from a Neonatal presentation and showed a rapidly evolving course which led to death within the second year of life (Type Ia). 16 patients suffered from the Infantile presentation: 5 of them (here defined Type Ib) presented developmental delay and began to deteriorate by the age of 5. A second group (Type Ic) included patients who presented a delay in neuromotor development and started deteriorating after 6 years of age. A third group (Type Id) included patients who presented developmental delay and remained clinically stable beyond adolescence. In 4 patients, the age at last evaluation made it not possible to ascertain whether they belonged to Type Ic or Id, as they were too young to evaluate their neurologic decline. 4 patients suffered from the Juvenile presentation: they had normal neuromotor development with no or only mild cognitive impairment; the subsequent clinical evolution was similar to Type Ic AxD in 2 patients, to Id group in the other 2. In conclusion, our results confirm previously described findings about clinical features at onset; based on follow-up data we might classify patients with Type I AxD into four subgroups (Ia, Ib, Ic, Id). Further studies will be needed to confirm our results and to better highlight the existence of clinical and neuroradiological prognostic factors able to predict disease progression.
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Affiliation(s)
- Eleonora Mura
- Unit of Pediatric Neurology, V. Buzzi Children's Hospital, Milan, Italy; C.O.A.L.A (Center for Diagnosis and Treatment of Leukodystrophies), V. Buzzi Children's Hospital, Milan, Italy
| | - Francesco Nicita
- Genetics and Rare Diseases Research Division, Unit of Neuromuscular and Neurodegenerative Disorders, Department of Neurosciences, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Silvia Masnada
- Unit of Pediatric Neurology, V. Buzzi Children's Hospital, Milan, Italy; C.O.A.L.A (Center for Diagnosis and Treatment of Leukodystrophies), V. Buzzi Children's Hospital, Milan, Italy
| | - Roberta Battini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; Stella Maris Foundation, IRCCS, Calambrone, Pisa, Italy
| | - Chiara Ticci
- Stella Maris Foundation, IRCCS, Calambrone, Pisa, Italy
| | - Martino Montomoli
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories, Department of Neuroscience, A. Meyer Children's Hospital, University of Florence, Florence, Italy
| | - Angela Berardinelli
- Department of Child Neurology and Psychiatry, Mondino Foundation, IRCCS, Pavia, Italy
| | - Chiara Pantaleoni
- Department of Pediatric Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Anna Ardissone
- Department of Pediatric Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Thomas Foiadelli
- Pediatric Clinic, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, IRCCS Policlinico San Matteo Foundation - University of Pavia, Pavia, Italy
| | - Elena Tartara
- Epilepsy and EEG Unit, IRCCS Mondino Foundation, Pavia, ERN Epicare full member, Italy
| | - Ettore Salsano
- Unit of Rare Neurodegenerative and Neurometabolic Disease, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Pierangelo Veggiotti
- Unit of Pediatric Neurology, V. Buzzi Children's Hospital, Milan, Italy; C.O.A.L.A (Center for Diagnosis and Treatment of Leukodystrophies), V. Buzzi Children's Hospital, Milan, Italy; Department of Biomedical and Clinical Science "L. Sacco", University of Milan, Milan, Italy
| | - Isabella Ceccherini
- UOSD Laboratory of Genetics and Genomics of Rare Diseases, Istituto Giannina Gaslini, IRCCS, Genoa, Italy
| | - Isabella Moroni
- Department of Pediatric Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Enrico Bertini
- Genetics and Rare Diseases Research Division, Unit of Neuromuscular and Neurodegenerative Disorders, Department of Neurosciences, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Davide Tonduti
- Unit of Pediatric Neurology, V. Buzzi Children's Hospital, Milan, Italy; C.O.A.L.A (Center for Diagnosis and Treatment of Leukodystrophies), V. Buzzi Children's Hospital, Milan, Italy.
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Mura E, Masnada S, Antonello C, Parazzini C, Izzo G, Garau J, Sproviero D, Cereda C, Orcesi S, Veggiotti P, Zuccotti G, Dilillo D, Penagini F, Tonduti D. Ruxolitinib in Aicardi-Goutières syndrome. Metab Brain Dis 2021; 36:859-863. [PMID: 33721182 DOI: 10.1007/s11011-021-00716-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/10/2021] [Indexed: 12/31/2022]
Abstract
Aicardi-Goutières Syndrome (AGS) is a monogenic leukodystrophy with pediatric onset, clinically characterized by a variable degree of neurologic impairment. It belongs to a group of condition called type I interferonopathies that are characterized by abnormal overproduction of interferon alpha, an inflammatory cytokine which action is mediated by the activation of two of the four human Janus Kinases. Thanks to an ever-increasing knowledge of the molecular basis and pathogenetic mechanisms of the disease, Janus Kinase inhibitors (JAKIs) have been proposed as a treatment option for selected interferonopathies. Here we reported the 24 months follow-up of the fifth AGS patient treated with ruxolitinib described so far in literature. The treatment was globally well tolerated; clinical examinations and radiological images demonstrated a progressively improving course. It is however to note that patients presenting with mild and spontaneously improving course have been reported. Large natural history studies on AGS spectrum are strongly required in order to get a better understanding of the results emerging from ongoing therapeutic trials on such rare disease.
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Affiliation(s)
- Eleonora Mura
- Department of Pediatric Neurology, V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy
- C.O.A.L.A (Center for diagnosis and treatment of leukodystrophies), V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy
| | - Silvia Masnada
- Department of Pediatric Neurology, V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy
- C.O.A.L.A (Center for diagnosis and treatment of leukodystrophies), V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy
| | - Clara Antonello
- C.O.A.L.A (Center for diagnosis and treatment of leukodystrophies), V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy
- Department of Pediatric Orthopedics, V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy
| | - Cecilia Parazzini
- C.O.A.L.A (Center for diagnosis and treatment of leukodystrophies), V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy
- Department of Pediatric Radiology and Neuroradiology, V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy
| | - Giana Izzo
- C.O.A.L.A (Center for diagnosis and treatment of leukodystrophies), V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy
- Department of Pediatric Radiology and Neuroradiology, V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy
| | - Jessica Garau
- Genomic and Post-Genomic Center, IRCCS Mondino Foundation, Via Mondino 2, 27100, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Via Bassi 21, 27100, Pavia, Italy
| | - Daisy Sproviero
- Genomic and Post-Genomic Center, IRCCS Mondino Foundation, Via Mondino 2, 27100, Pavia, Italy
| | - Cristina Cereda
- Genomic and Post-Genomic Center, IRCCS Mondino Foundation, Via Mondino 2, 27100, Pavia, Italy
| | - Simona Orcesi
- Department of Brain and Behavioral Sciences, University of Pavia, Via Bassi 21, 27100, Pavia, Italy
- Department of Child Neurology and Psychiatry, IRCCS Mondino Foundation, Via Mondino 2, 27100, Pavia, Italy
| | - Pierangelo Veggiotti
- Department of Pediatric Neurology, V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy
- C.O.A.L.A (Center for diagnosis and treatment of leukodystrophies), V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy
- Department of Biomedical and Clinical Science "L. Sacco", University of Milan, Via Giovanni Battista Grassi 74, 20157, Milan, Italy
| | - Gianvincenzo Zuccotti
- C.O.A.L.A (Center for diagnosis and treatment of leukodystrophies), V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy
- Department of Biomedical and Clinical Science "L. Sacco", University of Milan, Via Giovanni Battista Grassi 74, 20157, Milan, Italy
- Department of Pediatrics, V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy
| | - Dario Dilillo
- C.O.A.L.A (Center for diagnosis and treatment of leukodystrophies), V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy
- Department of Pediatrics, V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy
| | - Francesca Penagini
- C.O.A.L.A (Center for diagnosis and treatment of leukodystrophies), V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy
- Department of Pediatrics, V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy
| | - Davide Tonduti
- Department of Pediatric Neurology, V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy.
- C.O.A.L.A (Center for diagnosis and treatment of leukodystrophies), V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy.
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