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Popit S, Serod K, Locatelli I, Stuhec M. Prevalence of attention-deficit hyperactivity disorder (ADHD): systematic review and meta-analysis. Eur Psychiatry 2024; 67:e68. [PMID: 39381949 DOI: 10.1192/j.eurpsy.2024.1786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2024] Open
Abstract
BACKGROUND The estimates of attention-deficit hyperactivity disorder (ADHD) prevalence across various studies are significantly variable, contributing to uncertainty in ADHD prevalence estimation. Previous systematic reviews and meta-analyses have attributed this variability primarily to the methodological characteristics of the studies, including the diagnostic criteria, source of information, and impairment requirement for the diagnosis. METHODS Review identified studies reporting ADHD prevalence in representative samples of children and adults in Europe and worldwide. Studies that were conducted in the general population were included. We focused on studies that report ADHD prevalence based on clinical diagnosis (clinical diagnostic criteria based on the Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases criteria, other diagnostic tools, such as various scales or interviews based on clinical diagnostic criteria). PubMed/Medline was searched to identify relevant articles published until 2024/2/01. The study was registered in PROSPERO (CRD42020200220) and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines for systematic review and meta-analysis. RESULTS In total, 117 studies were subjected to full evaluation. In the meta-analysis, 103 studies representing 159 independent datapoints were included. The overall prevalence of ADHD in register studies was 1.6%, 95% CI [0.9; 3.0], in survey studies 5.0%, 95% CI [2.9; 8.6], in one-stage clinical studies 4.2%, 95% CI [2.9; 6.0], and in two-stage clinical studies 4.8%, 95% CI [4.0; 5.8]. CONCLUSIONS Exact comparisons among studies with different diagnostic criteria and types of sampling can impact prevalence estimates. When comparing data from methodologically different studies, these factors need to be considered.
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Affiliation(s)
- Sara Popit
- University of Ljubljana, Faculty of Pharmacy, Ljubljana, Slovenia
- Pomurske lekarne, Murska Sobota, Slovenia
| | - Klara Serod
- University of Ljubljana, Faculty of Pharmacy, Ljubljana, Slovenia
| | - Igor Locatelli
- University of Ljubljana, Faculty of Pharmacy, Ljubljana, Slovenia
| | - Matej Stuhec
- Department of Pharmacology, Faculty of Medicine Maribor, University of Maribor, Maribor, Slovenia
- Department of Clinical Pharmacy, Ormoz Psychiatric Hospital, Ormoz, Slovenia
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Michelini G, Carlisi CO, Eaton NR, Elison JT, Haltigan JD, Kotov R, Krueger RF, Latzman RD, Li JJ, Levin-Aspenson HF, Salum GA, South SC, Stanton K, Waldman ID, Wilson S. Where do neurodevelopmental conditions fit in transdiagnostic psychiatric frameworks? Incorporating a new neurodevelopmental spectrum. World Psychiatry 2024; 23:333-357. [PMID: 39279404 PMCID: PMC11403200 DOI: 10.1002/wps.21225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/18/2024] Open
Abstract
Features of autism spectrum disorder, attention-deficit/hyperactivity disorder, learning disorders, intellectual disabilities, and communication and motor disorders usually emerge early in life and are associated with atypical neurodevelopment. These "neurodevelopmental conditions" are grouped together in the DSM-5 and ICD-11 to reflect their shared characteristics. Yet, reliance on categorical diagnoses poses significant challenges in both research and clinical settings (e.g., high co-occurrence, arbitrary diagnostic boundaries, high within-disorder heterogeneity). Taking a transdiagnostic dimensional approach provides a useful alternative for addressing these limitations, accounting for shared underpinnings across neurodevelopmental conditions, and characterizing their common co-occurrence and developmental continuity with other psychiatric conditions. Neurodevelopmental features have not been adequately considered in transdiagnostic psychiatric frameworks, although this would have fundamental implications for research and clinical practices. Growing evidence from studies on the structure of neurodevelopmental and other psychiatric conditions indicates that features of neurodevelopmental conditions cluster together, delineating a "neurodevelopmental spectrum" ranging from normative to impairing profiles. Studies on shared genetic underpinnings, overlapping cognitive and neural profiles, and similar developmental course and efficacy of support/treatment strategies indicate the validity of this neurodevelopmental spectrum. Further, characterizing this spectrum alongside other psychiatric dimensions has clinical utility, as it provides a fuller view of an individual's needs and strengths, and greater prognostic utility than diagnostic categories. Based on this compelling body of evidence, we argue that incorporating a new neurodevelopmental spectrum into transdiagnostic frameworks has considerable potential for transforming our understanding, classification, assessment, and clinical practices around neurodevelopmental and other psychiatric conditions.
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Affiliation(s)
- Giorgia Michelini
- Department of Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Christina O Carlisi
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Nicholas R Eaton
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Jed T Elison
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - John D Haltigan
- Department of Psychiatry, Division of Child and Youth Mental Health, University of Toronto, Toronto, ON, Canada
| | - Roman Kotov
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | | | - James J Li
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | | | - Giovanni A Salum
- Child Mind Institute, New York, NY, USA
- Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Instituto Nacional de Psiquiatria do Desenvolvimento para a Infância e Adolescência, São Paulo, Brazil
| | - Susan C South
- Department of Psychological Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN, USA
| | - Kasey Stanton
- Department of Psychology, University of Wyoming, Laramie, WY, USA
| | - Irwin D Waldman
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Sylia Wilson
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
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Chandy BR, Davey C, Oswald WE, Kaliappan SP, Aruldas K, Banks LM, Jasper S, Nagarajan G, Galagan S, Kennedy DS, Walson JL, Koshy B, Ajjampur SSR, Kuper H. Prevalence of Functional Difficulty Among School-Aged Children and Effect on School Enrolment in Rural Southern India: A Cross-Sectional Analysis. J Epidemiol Glob Health 2024:10.1007/s44197-024-00293-7. [PMID: 39298111 DOI: 10.1007/s44197-024-00293-7] [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: 03/23/2024] [Accepted: 08/22/2024] [Indexed: 09/21/2024] Open
Abstract
Despite the large number of children in India, there is little information on the impact of children's disability on school enrolment, and how this differs by population. We estimated the prevalence of childhood disability in two sites in Tamil Nadu, southern India, and the effect of functional difficulty on school enrolment. We used a parent-reported survey containing the UNICEF-Washington Group questions to identify children aged 5 to 17 years with functional difficulty during a census conducted for an ongoing trial. We estimated pooled- and gender-specific prevalence of functional difficulty among 29,044 children. We fitted regression models to identify subgroups with higher rates of functional difficulty and the effect of functional difficulty on reported school enrolment. We estimated the modification of the effect of functional difficulty by age, gender, socioeconomic status, household education, and sub-site, on additive and multiplicative scales. We found of 29,044 children, 299 (1.0%) had any functional difficulty, equal among boys and girls. Being understood (0.5%) and walking (0.4%) were the most common difficulties. Functional difficulty was strongly associated with non-enrolment in school (Prevalence ratio [PR] 4.59, 95% CI: 3.87, 5.43) after adjusting for age, gender, and site. We show scale-dependent differences between age and socioeconomic groups in the effect of functional difficulty on enrolment. This study shows that at least one in a hundred children in this region have severe functional difficulties and nearly half of these children are not enrolled in school, highlighting the need for further efforts and evidence-based interventions to increase school enrolment among these groups.
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Affiliation(s)
- Bobeena Rachel Chandy
- Department of Physical Medicine and Rehabilitation, Christian Medical College, Vellore, TN, India
| | | | - William E Oswald
- Global Health Division, International Development Group, RTI International, Research Triangle Park, NC, USA
| | | | - Kumudha Aruldas
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, TN, India
| | - Lena Morgon Banks
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
| | - Smitha Jasper
- Department of Ophthalmology, Christian Medical College, Vellore, TN, India
| | - Guru Nagarajan
- Department of Physical Medicine and Rehabilitation, Christian Medical College, Vellore, TN, India
| | - Sean Galagan
- Departments of Global Health, Medicine, Pediatrics and Epidemiology, University of Washington, Seattle, USA
| | - David S Kennedy
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Judd L Walson
- Departments of Global Health, Medicine, Pediatrics and Epidemiology, University of Washington, Seattle, USA
| | - Beena Koshy
- Department of Developmental Paediatrics, Christian Medical College, Vellore, TN, India
| | - Sitara S R Ajjampur
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, TN, India
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
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Gulati S, Narayan CL, Mahesan A, Kamila G, Kapoor S, Chaturvedi PK, Scaria V, Velpandian T, Jauhari P, Chakrabarty B, Datta SKR, Pandey RM. Transmethylation and Oxidative Biomarkers in Children with Autism Spectrum Disorder: A Cross Sectional Study. J Autism Dev Disord 2024:10.1007/s10803-024-06542-9. [PMID: 39230783 DOI: 10.1007/s10803-024-06542-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2024] [Indexed: 09/05/2024]
Abstract
We aimed to investigate the potential role of biomarkers of transmethylation, oxidative stress, and mitochondrial dysfunction in children with Autism Spectrum Disorder (ASD) by comparing them with that of typically developing children (TDC) controls. We also tried to correlate them with severity of autism, sensory issues, behavioural comorbidities and developmental quotients 119 with ASD and 52 age and sex matched typically developing children (TDC) controls were enrolled excluding those with chronic-illness or on any antioxidant therapy/multivitamins/anti-epileptic drugs. Median levels of biomarkers - serum homocysteine, cysteine, methionine, urine uric acid-to-creatinine ratio, arterial lactate, serum vitamin E, vitamin B12, folate, Nε-carboxymethyllysine, Nω- carboxymethylarginine (CMA), dityrosine and MTHFR C677T polymorphism were calculated. Children with ASD were further characterised using Childhood Autism Rating Scale-2, Childhood behavioural checklist, child sensory profile 2 caregiver questionnaire, Developmental Profile 3 for any correlation with the various biomarker levels. The median level of serum homocysteine in ASD group was 9 μmol/L(Range, 7- 16μmol/L), which was significantly higher than controls 7 μmol/L(Range, 4- 11μmol/L)(p=0.01). The prevalence of hyper-homocystinemia(>15μmol/L) was 13.4% in ASD as compared to 3.8% in controls with a significant difference(p=0.04). Dityrosine level was higher among ASD children when compared to TDC (9.8 vs 2.2 counts per second(cps), p<0.001). No significant correlation was found between prevalence of hyperhomocysteinemia and severity of autism/DQ/behavioural issues. No significant difference was found between the median levels of other biomarkers. Results support possible role of transmethylation defects and oxidative stress in ASD pathogenesis. Further studies are warranted for a better understanding of ASD pathogenesis.
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Affiliation(s)
- Sheffali Gulati
- Centre of Excellence & Advanced Research for Childhood Neurodevelopmental Disorders, Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
| | - Chinthana L Narayan
- Centre of Excellence & Advanced Research for Childhood Neurodevelopmental Disorders, Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Aakash Mahesan
- Centre of Excellence & Advanced Research for Childhood Neurodevelopmental Disorders, Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Gautam Kamila
- Centre of Excellence & Advanced Research for Childhood Neurodevelopmental Disorders, Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Kapoor
- Division of Genetics, Department of Pediatrics, Maulana Azad Medical College, New Delhi, India
| | | | - Vinod Scaria
- Institue of Genomics and Integrative Biology, New Delhi, India
| | | | - Prashant Jauhari
- Centre of Excellence & Advanced Research for Childhood Neurodevelopmental Disorders, Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Biswaroop Chakrabarty
- Centre of Excellence & Advanced Research for Childhood Neurodevelopmental Disorders, Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | | | - R M Pandey
- Department of Biostatistics, AIIMS, New Delhi, India
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Aldakhil AF. Prevalence of developmental dyslexia among primary school children in Arab countries: a systematic review and meta-analysis. RESEARCH IN DEVELOPMENTAL DISABILITIES 2024; 152:104812. [PMID: 39079361 DOI: 10.1016/j.ridd.2024.104812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Accepted: 07/23/2024] [Indexed: 08/21/2024]
Abstract
BACKGROUND Dyslexia is one of the most common learning disabilities. It poses challenges in reading skills development and can have a lasting impact in other areas of learning. AIMS To investigate the prevalence of developmental dyslexia among primary school children aged 6-13 in Arab countries, and to explore associations with gender and residency. METHOD Following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, we included studies up to December 2023 that were found in English and Arabic research database searches. Random-effects proportional meta-analyses determined the prevalence of dyslexia in Arab countries, with a direct comparison between girls and boys using odds ratios. RESULTS The meta-analysis included 18 studies with 30,243 participants: eight studies (44 %) from Egypt, four (22 %) from Saudi Arabia, and six (34 %) from other Arab countries. The pooled prevalence of dyslexia for children aged 6-13 in these studies was 11 %. The odds ratio for girls vs. boys was 0.85 (95 %). Geographical variations were notable, with eight studies (44 %) from Asia and ten (56 %) from Africa. Eight studies (44 %) were from the Gulf region, while ten (56 %) were from non-Gulf region. Prevalence of dyslexia was significantly higher in Arab countries in Asia (24 %) than in Africa (12 %), and the prevalence in non-Gulf countries was 13 % which was nearly half in comparison to Gulf countries (24 %). CONCLUSIONS The prevalence rates of dyslexia in primary school children varies across the Arab world, with higher rates among boys, Arab countries in Asia, and Gulf countries. Further research is needed to include both genders and standardized diagnostics across more Arab countries to understand and address dyslexia effectively.
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Affiliation(s)
- Ali Fahad Aldakhil
- Department of Special Education, College of Education, Majmaah University, Majmaah 11952, Saudi Arabia.
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Krupa M, Boominathan P, Sebastian S, Raman PV. Joint Engagement in Mother-Child Dyads of Autistic and Non-Autistic Children Among Asian Indian Tamil Speaking Families. J Autism Dev Disord 2024; 54:3436-3448. [PMID: 37642866 DOI: 10.1007/s10803-023-06062-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2023] [Indexed: 08/31/2023]
Abstract
This study profiled various levels of engagement and related communication behaviours among 50 Asian Indian Tamil autistic children (AUT) and their mothers. The interaction was compared with two groups of mother-child dyads of non-autistic (NA) children, 50 in each group, matched for chronological age (CA), and for language level (LL). Results indicated that despite mother's efforts to engage with their children, autistic children were often 'engaged with objects' or remained 'unengaged' due to children's preference for solitary play, while NA children were often engaged in 'co-ordinated' and 'people engagement'. Across the three groups, mothers predominantly took the lead and dominated the interaction, irrespective of children's language levels. These initiations by the mothers were often to provide instructions and to ask 'What' questions. Autistic children initiated communication predominantly to ask for an object and responded often in the form of negations and protests with limited verbal output or non-verbally. Most of the communication behaviours of both children and mothers in AUT group was quantitatively and qualitatively different when compared to those in both the NA groups, indicating unique nature of interactions despite matching for CA or LL. The observations from the study highlights the need for considering adult's contingent behaviours also, while assessing communication skills of autistic children in order to provide effective intervention.
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Affiliation(s)
- Murugesan Krupa
- Department of Speech Language Pathology, Sri Ramachandra Faculty of Audiology and Speech Language Pathology, Sri Ramachandra Institute of Higher Education & Research (Deemed University, Porur, Chennai, 600 116, Tamil Nadu, India.
| | - Prakash Boominathan
- Department of Speech Language Pathology, Sri Ramachandra Faculty of Audiology and Speech Language Pathology, Sri Ramachandra Institute of Higher Education & Research (Deemed University, Porur, Chennai, 600 116, Tamil Nadu, India
| | - Swapna Sebastian
- Audiology & Speech Language Pathology Services, Department of ENT, Christian Medical College, Vellore, Tamil Nadu, India
| | - Padmasani Venkat Raman
- Department of Paediatric Medicine, Sri Ramachandra Institute of Higher Education & Research (Deemed University, Porur, Chennai, Tamil Nadu, India
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Paracha SA, Nawaz S, Tahir Sarwar M, Shaheen A, Zaman G, Ahmed J, Shah F, Khwaja S, Jan A, Khan N, Kamal MA, Alam Q, Abbas S, Farman S, Waqas A, Alkathiri A, Hamadi A, Santoni F, Ullah N, Khalid B, Antonarakis SE, Fakhro KA, Umair M, Ansar M. The genetic cause of neurodevelopmental disorders in 30 consanguineous families. Front Med (Lausanne) 2024; 11:1424753. [PMID: 39281811 PMCID: PMC11392838 DOI: 10.3389/fmed.2024.1424753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Accepted: 08/02/2024] [Indexed: 09/18/2024] Open
Abstract
Objective This study aims to clinically and genetically assess 30 unrelated consanguineous Pakistani families from various ethnic backgrounds, all exhibiting features of neurodevelopmental disorders (NDDs). Methods We conducted clinical, genetic, biochemical, and molecular analyses on 30 consanguineous families with NDDs enrolled from various regions of Pakistan. The likely molecular causes of primary microcephaly and NDDs were identified. Detailed clinical investigations and molecular diagnoses were performed using whole exome sequencing (WES) of the proband, followed by Sanger sequencing for validation and segregation in the available family members of the affected families. Results WES identified likely disease-causing homozygous variants in 30 unrelated consanguineous families. Six families presented newly described variants in known NDD-related genes: ABAT (c.1439 T > G; p.Phe480Cys) [OMIM613163], SLC12A6 (c.2865_2865insT; p.Glu955Asnfs*5) [OMIM 218000], SHANK3 (c.1305-3_1,305-2delTT; p.Gln29-_Gly305del) [OMIM 606232], BCKDK (c.356_356insC; p.Gly119Alafs*24) [OMIM 614923], DDHD2 (c.2065G > T; p.Asp689Tyr) [OMIM 615033], ERCC2 (c.1255G > A; p.Glu419Lys) [OMIM 610756]. Additionally, 12 families had previously reported disease-causing variants associated with different types of NDDs: ATRX (c.109C > T; p.Arg37*) [OMIM 309580], GPR56 [ADGRG1] (c.1423C > T; p.Arg475*) [OMIM 606854], NAGLU (c.1694G > A; p.Arg565Gln) [OMIM 252920], DOLK (c.3G > A; p.Met1Ile) [OMIM 610768], GPT2 (c.815C > T; p.Ser272Leu) [OMIM 616281], DYNC1I2 (c.607 + 1G > A; p.?) [OMIM 618492], FBXL3 (c.885delT; p.Leu295Phefs25*) [OMIM 606220], LINGO1 (c.869G > A; p.Arg290His) [OMIM 618103], and ASPM (c.3978G > A; Trp1326*, c.9557C > G; p.Ser3186*, c.6994C > T; p.Arg2332*) [OMIM 608716]. All the identified variants showed segregation compatible with autosomal recessive inheritance. Conclusion In the present study, we observed a high frequency of ASPM variants in the genetic analysis of 30 consanguineous families exhibiting features of NDDs, particularly those associated with autosomal recessive primary microcephaly. These findings contribute to studies on genotype-phenotype correlation, genetic counseling for families, and a deeper understanding of human brain function and development.
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Affiliation(s)
- Sohail Aziz Paracha
- Department of Anatomy, Institute of Medical Sciences (KIMS), Khyber Medical University, Kohat, Pakistan
| | - Shoaib Nawaz
- Department of Human Genetics, Sidra Medicine, Doha, Qatar
| | - Muhammad Tahir Sarwar
- Department of Molecular Biology and Genetics, Khyber Medical University, Institute of Basic Sciences, Peshawar, Pakistan
| | - Asmat Shaheen
- Department of Biochemistry, Institute of Medical Sciences (KIMS), Khyber Medical University, Kohat, Pakistan
| | - Gohar Zaman
- Department of Computer Science, Abbottabad University of Science and Technology, Havelin, Pakistan
| | - Jawad Ahmed
- Department of Microbiology, Khyber Medical University, Institute of Basic Sciences, Peshawar, Pakistan
| | - Fahim Shah
- Department of Medicine, District Headquarter Hospital, K.D.A, Kohat, Pakistan
| | - Sundus Khwaja
- Department of Biotechnology, University of Azad Jammu and Kashmir, Muzaffarabad, Pakistan
| | - Abid Jan
- Department of Biotechnology and Genetic Engineering, Kohat University of Science and Technology, Kohat, Pakistan
| | - Nida Khan
- Department of Obstetrics and Gynecology, Hayatabad Medical Complex, Peshawar, Pakistan
| | - Mohammad Azhar Kamal
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Qamre Alam
- Molecular Genomics and Precision Medicine, Express Med Diagnostics and Research, Manama, Bahrain
| | - Safdar Abbas
- Department of Biological Science, Dartmouth College, Hanover, NH, United States
| | - Saman Farman
- Faculty of Biosciences, COMSATS University, Islamabad, Pakistan
| | - Ahmed Waqas
- Department of Zoology, Emerson University, Multan, Pakistan
| | - Afnan Alkathiri
- Medical Genetics, Laboratory Medicine Department, Faculty of Applied Medical Sciences, Albaha University, Albaha, Saudi Arabia
| | - Abdullah Hamadi
- Faculty of Applied Medical Sciences, Department of Medical Laboratory Technology, University of Tabuk, Tabuk, Saudi Arabia
| | - Federico Santoni
- Service of Endocrinology, Diabetes, and Metabolism, University Hospital of Lausanne, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- National Research Council (CNR), Rome, Italy
| | - Naseeb Ullah
- Institute of Biochemistry, University of Balochistan, Quetta, Pakistan
| | - Bisma Khalid
- Faculty of Biosciences, COMSATS University, Islamabad, Pakistan
| | - Stylianos E Antonarakis
- Department of Genetic Medicine and Development, School of Medicine, University of Geneva, Geneva, Switzerland
| | - Khalid A Fakhro
- Department of Human Genetics, Sidra Medicine, Doha, Qatar
- Department of Genetic Medicine, Weill Cornell Medical College, Doha, Qatar
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Muhammad Umair
- King Abdullah International Medical Research Center (KAIMRC), Department of Medical Genomics Research, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs (MNGH), Riyadh, Saudi Arabia
- Department of Life Sciences, School of Science, University of Management and Technology (UMT), Lahore, Pakistan
| | - Muhammad Ansar
- Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile Des Aveugles, Lausanne, Switzerland
- Advanced Molecular Genetics and Genomics Disease Research and Treatment Centre, Dow University of Health Sciences, Karachi, Pakistan
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Cullenward J, Curtin M, Dos Santos V. Characteristics of effective parent-mediated interventions for parents of children with neurodevelopmental disorders in rural areas: a systematic review protocol. BMJ Open 2024; 14:e083464. [PMID: 39142676 PMCID: PMC11331994 DOI: 10.1136/bmjopen-2023-083464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 06/17/2024] [Indexed: 08/16/2024] Open
Abstract
INTRODUCTION Parent-mediated interventions are therapeutic approaches that use parent training to enable parents to provide primary support and intervention to their child through the development of necessary skills, knowledge, and resources.Parent-mediated interventions can be broadly divided into two stages: (1) Clinicians educating, training and coaching parents in the implementation of an intervention and relevant information regarding their child's condition and (2) Parent(s) mediating and implementing the intervention based on the coaching and education received. These interventions can act as the primary intervention for children or supplement clinical interventions. This review will include both stages of the implementation process as well as both primary and supplementary interventions. Outcomes of parent-mediated interventions include long-term symptom reduction, improved prognosis for a wide range of behavioural and brain functions and enhanced parent-child dyadic social communication. METHODS AND ANALYSIS This systematic review aims to synthesise existing evidence and identify the characteristics of effective parent-mediated intervention for parents of children with neurodevelopmental disorders residing in rural areas. Systematic searches of CINAHL, PsycINFO, ProQuest allied health and nursing database, Ebscohost Psych and Behavioural database and SocINDEX were conducted twice with the latest completed on 5 March 2024 using preidentified search terms. Citations will be imported into EndNote V.20.6 (Clarivate Analytics, Pennsylvania, USA) to organise and de-duplicate and then Covidence to complete screening and extraction. The articles will be screened and reviewed following the Joanna Briggs Institute (JBI) guidelines for systematic reviews of Mixed methods. The JBI appraisal tools for systematic reviews will be used to assess the trustworthiness, relevance and results of qualitative, quantitative and mixed-methods studies. The scope of the literature analysed will include articles published between 2013 and 2024 in English. Literature was limited to the last 10 years to ensure the relevance of results as the intention is to report on current evidence. The start date of the study was March 2023 and the planned completion date is October 2024. ETHICS AND DISSEMINATION This study will neither involve human nor animal subjects and does not require ethics approval. Results will be disseminated to relevant groups in peer-reviewed journal(s) and at relevant children and parent health conferences or rural conferences. The key outcomes will also be shared on social media to support access for non-research audiences.
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Affiliation(s)
- Julia Cullenward
- School of Allied Health, Exercise & Sport Sciences, Charles Sturt University, Albury/Port Macquarie, New South Wales, Australia
| | - Michael Curtin
- School of Allied Health, Exercise & Sport Sciences, Charles Sturt University, Albury/Port Macquarie, New South Wales, Australia
| | - Vagner Dos Santos
- School of Allied Health, Exercise & Sport Sciences, Charles Sturt University, Albury/Port Macquarie, New South Wales, Australia
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Sheth J, Nair A, Sheth F, Ajagekar M, Dhondekar T, Panigrahi I, Bavdekar A, Nampoothiri S, Datar C, Gandhi A, Muranjan M, Kaur A, Desai M, Mistri M, Patel C, Naik P, Shah M, Godbole K, Kapoor S, Gupta N, Bijarnia-Mahay S, Kadam S, Solanki D, Desai S, Iyer A, Patel K, Patel H, Shah RC, Mehta S, Shah R, Bhavsar R, Shah J, Pandya M, Patel B, Shah S, Shah H, Shah S, Bajaj S, Shah S, Thaker N, Kalane U, Kamate M, Kn VR, Tayade N, Jagadeesan S, Jain D, Chandarana M, Singh J, Mehta S, Suresh B, Sheth H. Burden of rare genetic disorders in India: twenty-two years' experience of a tertiary centre. Orphanet J Rare Dis 2024; 19:295. [PMID: 39138584 PMCID: PMC11323464 DOI: 10.1186/s13023-024-03300-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 07/31/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Rare disorders comprise of ~ 7500 different conditions affecting multiple systems. Diagnosis of rare diseases is complex due to dearth of specialized medical professionals, testing labs and limited therapeutic options. There is scarcity of data on the prevalence of rare diseases in different populations. India being home to a large population comprising of 4600 population groups, of which several thousand are endogamous, is likely to have a high burden of rare diseases. The present study provides a retrospective overview of a cohort of patients with rare genetic diseases identified at a tertiary genetic test centre in India. RESULTS Overall, 3294 patients with 305 rare diseases were identified in the present study cohort. These were categorized into 14 disease groups based on the major organ/ organ system affected. Highest number of rare diseases (D = 149/305, 48.9%) were identified in the neuromuscular and neurodevelopmental (NMND) group followed by inborn errors of metabolism (IEM) (D = 47/305; 15.4%). Majority patients in the present cohort (N = 1992, 61%) were diagnosed under IEM group, of which Gaucher disease constituted maximum cases (N = 224, 11.2%). Under the NMND group, Duchenne muscular dystrophy (N = 291/885, 32.9%), trinucleotide repeat expansion disorders (N = 242/885; 27.3%) and spinal muscular atrophy (N = 141/885, 15.9%) were the most common. Majority cases of β-thalassemia (N = 120/149, 80.5%) and cystic fibrosis (N = 74/75, 98.7%) under the haematological and pulmonary groups were observed, respectively. Founder variants were identified for Tay-Sachs disease and mucopolysaccharidosis IVA diseases. Recurrent variants for Gaucher disease (GBA:c.1448T > C), β-thalassemia (HBB:c.92.+5G > C), non-syndromic hearing loss (GJB2:c.71G > A), albinism (TYR:c.832 C > T), congenital adrenal hyperplasia (CYP21A2:c.29-13 C > G) and progressive pseudo rheumatoid dysplasia (CCN6:c.298T > A) were observed in the present study. CONCLUSION The present retrospective study of rare disease patients diagnosed at a tertiary genetic test centre provides first insight into the distribution of rare genetic diseases across the country. This information will likely aid in drafting future health policies, including newborn screening programs, development of target specific panel for affordable diagnosis of rare diseases and eventually build a platform for devising novel treatment strategies for rare diseases.
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Affiliation(s)
- Jayesh Sheth
- FRIGE Institute of Human Genetics, FRIGE House, Ahmedabad, India.
| | - Aadhira Nair
- FRIGE Institute of Human Genetics, FRIGE House, Ahmedabad, India
| | - Frenny Sheth
- FRIGE Institute of Human Genetics, FRIGE House, Ahmedabad, India
| | - Manali Ajagekar
- FRIGE Institute of Human Genetics, FRIGE House, Ahmedabad, India
| | | | - Inusha Panigrahi
- Postgraduate Institute of Medical Education and Research, PGIMER, Chandigarh, India
| | | | | | - Chaitanya Datar
- Bharati Hospital and Research Centre, Dhankawadi, Pune, India
| | | | - Mamta Muranjan
- Department of Pediatrics, KEM Hospital, Parel, Mumbai, India
| | - Anupriya Kaur
- Postgraduate Institute of Medical Education and Research, PGIMER, Chandigarh, India
| | - Manisha Desai
- FRIGE Institute of Human Genetics, FRIGE House, Ahmedabad, India
| | - Mehul Mistri
- FRIGE Institute of Human Genetics, FRIGE House, Ahmedabad, India
| | - Chitra Patel
- FRIGE Institute of Human Genetics, FRIGE House, Ahmedabad, India
| | - Premal Naik
- Rainbow Super speciality Hospital, Ahmedabad, India
| | | | - Koumudi Godbole
- Deenanath Mangeshkar Hospital & Research Centre, Pune, India
| | - Seema Kapoor
- Division of Genetics & Metabolism Department of Pediatrics, Lok Nayak Hospital and Maulana Azad Medical College, New Delhi, India
| | - Neerja Gupta
- Division of Genetics, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Sunita Bijarnia-Mahay
- Institute of Medical Genetics and Genomics, Sir Ganga Ram Hospital, New Delhi, India
| | - Sandeep Kadam
- Department of Pediatrics, K.E.M Hospital, Pune, India
| | | | - Soham Desai
- Shree Krishna Hospital, Karamsad, Anand, India
| | | | - Ketan Patel
- Himalaya Arcade, Homeopathy Clinic, Vastrapur, Ahmedabad, India
| | - Harsh Patel
- Zydus Hospital & Healthcare Research Pvt Ltd, Ahmedabad, India
| | - Raju C Shah
- Ankur Neonatal Hospital, Ashram Road, Ahmedabad, India
| | | | | | - Riddhi Bhavsar
- FRIGE Institute of Human Genetics, FRIGE House, Ahmedabad, India
| | - Jhanvi Shah
- FRIGE Institute of Human Genetics, FRIGE House, Ahmedabad, India
| | - Mili Pandya
- FRIGE Institute of Human Genetics, FRIGE House, Ahmedabad, India
| | | | | | - Heli Shah
- Ansa Clinic, S. G. Highway, Ahmedabad, India
| | - Shalin Shah
- Ansa Clinic, S. G. Highway, Ahmedabad, India
| | - Shruti Bajaj
- The Purple Gene Clinic, Simplex Khushaangan, SV Road, Malad West, Mumbai, India
| | | | | | - Umesh Kalane
- Deenanath Mangeshkar Hospital & Research Centre, Pune, India
| | | | - Vykunta Raju Kn
- Department of Pediatric Neurology, Indira Gandhi Institute of Child Health, Bangalore, India
| | - Naresh Tayade
- Department of Paediatrics, Dr. Panjabrao Deshmukh Memorial Medical College, Amravati, India
| | - Sujatha Jagadeesan
- Department of Clinical Genetics & Genetic Counselling, Mediscan Systems, Chennai, India
| | - Deepika Jain
- Shishu Child Development and Early Intervention Centre, Ahmedabad, India
| | - Mitesh Chandarana
- Medisquare Superspeciality Hospital and Research Institute, Ahmedabad, India
| | - Jitendra Singh
- Neurology Clinic, Shivranjini Cross Road, Satellite, Ahmedabad, India
| | | | - Beena Suresh
- Department of Clinical Genetics & Genetic Counselling, Mediscan Systems, Chennai, India
| | - Harsh Sheth
- FRIGE Institute of Human Genetics, FRIGE House, Ahmedabad, India.
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Bahal M, Pande V, Salunkhe S, Dua J, Mane S, Gupta A, Kumar G, Kale S, Garlapati S, Shaligram R. Clinical Profile of Neurodevelopmental Disorders in Children at a Tertiary Care Center. Cureus 2024; 16:e67819. [PMID: 39323725 PMCID: PMC11423788 DOI: 10.7759/cureus.67819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2024] [Accepted: 08/26/2024] [Indexed: 09/27/2024] Open
Abstract
Background Neurodevelopmental disorders (NDDs) encompass intricate interactions among genetic, brain, cognitive, emotional, and behavioral processes. These disorders, which are influenced by hereditary and environmental factors, impair personal, social, intellectual, or occupational functioning. Typically emerging early in life, NDDs include conditions such as attention deficit hyperactivity disorder (ADHD), intellectual disability, autism spectrum disorders (ASDs), vision and hearing impairments, motor disorders, and specific learning disabilities. Children from impoverished and low-income neighborhoods are particularly vulnerable. The lack of comprehensive health data and public awareness about these conditions results in limited information regarding the prevalence of neurological illnesses in developing countries. India, with its large and ethnically diverse population, exemplifies this gap. Methods It is a prospective study to detect the prevalence and risk factors of neurodevelopmental disorders in children aged six months to nine years at a tertiary care center. Patient details, clinical findings, and relevant history were recorded on a pre-designed pro forma and analyzed statistically. Results Among the 1000 children in the study, 91 (9.1%) tested positive for NDDs. Among the 91 children who tested positive for NDD, the highest frequency is in the three to four years age group (17.6%), males were found to be in a higher ratio with 75.82%, with the male: female ratio being 3:1. Among the 91 children with NDD, intellectual disability was the most common disorder (20.9%), followed by ADHD (17.6%) and vision impairment (14.3%). Autism spectrum disorders, including autism and Asperger syndrome, and communication disorders, including stuttering and speech disorders, accounted for 13.2% each. Hearing loss was seen in 9.9% of children and multiple disorders were seen in 8.8% of the children from among 91 children. Conclusion Neurodevelopmental disorders are common and often coexist with other conditions. Children from low-income backgrounds are more affected. This study provides valuable insights into the prevalence and characteristics of NDDs in a specific population.
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Affiliation(s)
- Mridu Bahal
- Pediatrics, Dr. D.Y. Patil Medical College, Hospital and Research Center, Dr. D.Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
| | - Vineeta Pande
- Pediatrics, Dr. D.Y. Patil Medical College, Hospital and Research Center, Dr. D.Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
| | - Shradha Salunkhe
- Pediatrics, Dr. D.Y. Patil Medical College, Hospital and Research Center, Dr. D.Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
| | - Jasleen Dua
- Pediatrics, Dr. D.Y. Patil Medical College, Hospital and Research Center, Dr. D.Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
| | - Shailaja Mane
- Pediatrics, Dr. D.Y. Patil Medical College, Hospital and Research Center, Dr. D.Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
| | - Aryan Gupta
- Pediatrics, Dr. D.Y. Patil Medical College, Hospital and Research Center, Dr. D.Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
| | - Gaurav Kumar
- Pediatrics, Dr. D.Y. Patil Medical College, Hospital and Research Center, Dr. D.Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
| | - Shivani Kale
- Pediatrics, Dr. D.Y. Patil Medical College, Hospital and Research Center, Dr. D.Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
| | - Srinija Garlapati
- Pediatrics, Dr. D.Y. Patil Medical College, Hospital and Research Center, Dr. D.Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
| | - Ruhi Shaligram
- Pediatrics, Dr. D.Y. Patil Medical College, Hospital and Research Center, Dr. D.Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
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11
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Schuchert SA, Khattar S, Tekkar P, Rathour A, Dawar S, Gupta P. Exploring social stages of play through eye to I© intervention model. Clin Child Psychol Psychiatry 2024; 29:928-948. [PMID: 37236668 PMCID: PMC11188555 DOI: 10.1177/13591045231177477] [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] [Indexed: 05/28/2023]
Abstract
The study explores the role of the Eye to I© intervention model in facilitating advancement through social stages of play in which skills contribute to the quality of social interaction and communication in children with autism. Data were collected on 11 participants, ages of 2-6 years, formally diagnosed with autism, receiving Eye to I© Social Communication therapy at Potentials Therapy Center, New Delhi, India. Eye to I© is developed in-house at Potentials and is further discussed in the paper. All participants attended a form of group intervention. A mixed-method design included quantitative measures administered pre and post intervention (Communication DEALL Developmental Checklist, Communication Matrix) and video coding of Social Communication sessions. Qualitative measures were semi-structured parent interviews conducted at the end of intervention. Thematic analysis and quantitative statistical analysis results show that by the end of the Eye to I© intervention period children engaged in social stages of play of greater developmental complexity and showed increased scores in assessments of social skills as well as generalization of skills. This suggests that skill acquisition necessary to directly support two diagnostic criteria areas of autism as per DSM-V; i.e., communication and social interaction occurred during the period of intervention.
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Affiliation(s)
| | | | - Purva Tekkar
- Tata Institute of Social Sciences, Mumbai, India
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12
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Williams EH, Thompson NM, McCray G, Crespo-Llado MM, Bhavnani S, Gajria D, Mukherjee D, Del Bianco T, Lockwood-Estrin G, Mason L, Ngoma V, Namathanga C, Nkhata R, Bennie A, Ranjan A, Kawelama U, Midha N, Singh A, Mpakiza I, Gautam A, Gulati S, Johnson MH, Lancaster G, Belmonte MK, Jones E, Patel V, Chandran S, Mbale E, Divan G, Gladstone M, Chakrabarti B. Scalable Transdiagnostic Early Assessment of Mental Health (STREAM): a study protocol. BMJ Open 2024; 14:e088263. [PMID: 38871663 DOI: 10.1136/bmjopen-2024-088263] [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] [Indexed: 06/15/2024] Open
Abstract
INTRODUCTION Early childhood development forms the foundations for functioning later in life. Thus, accurate monitoring of developmental trajectories is critical. However, such monitoring often relies on time-intensive assessments which necessitate administration by skilled professionals. This difficulty is exacerbated in low-resource settings where such professionals are predominantly concentrated in urban and often private clinics, making them inaccessible to many. This geographic and economic inaccessibility contributes to a significant 'detection gap' where many children who might benefit from support remain undetected. The Scalable Transdiagnostic Early Assessment of Mental Health (STREAM) project aims to bridge this gap by developing an open-source, scalable, tablet-based platform administered by non-specialist workers to assess motor, social and cognitive developmental status. The goal is to deploy STREAM through public health initiatives, maximising opportunities for effective early interventions. METHODS AND ANALYSIS The STREAM project will enrol and assess 4000 children aged 0-6 years from Malawi (n=2000) and India (n=2000). It integrates three established developmental assessment tools measuring motor, social and cognitive functioning using gamified tasks, observation checklists, parent-report and audio-video recordings. Domain scores for motor, social and cognitive functioning will be developed and assessed for their validity and reliability. These domain scores will then be used to construct age-adjusted developmental reference curves. ETHICS AND DISSEMINATION Ethical approval has been obtained from local review boards at each site (India: Sangath Institutional Review Board; All India Institute of Medical Science (AIIMS) Ethics Committee; Indian Council of Medical Research-Health Ministry Screening Committee; Malawi: College of Medicine Research and Ethics Committee; Malawi Ministry of Health-Blantyre District Health Office). The study adheres to Good Clinical Practice standards and the ethical guidelines of the 6th (2008) Declaration of Helsinki. Findings from STREAM will be disseminated to participating families, healthcare professionals, policymakers, educators and researchers, at local, national and international levels through meetings, academic journals and conferences.
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Affiliation(s)
- Elin H Williams
- Centre for Autism, School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Nicholas M Thompson
- Centre for Autism, School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
- Faculty of Health, Education and Society, University of Northampton, Northampton, UK
| | | | - Maria M Crespo-Llado
- Department of Women and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | | | | | - Debarati Mukherjee
- Indian Institute of Public Health, Bengaluru, Public Health Foundation of India, Kamataka, India
| | - Teresa Del Bianco
- Centre for Brain & Cognitive Development, Birkbeck University of London, London, UK
- School of Social Sciences and Professions, London Metropolitan University, London, UK
| | | | - Luke Mason
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Vukiwe Ngoma
- Kamuzu University of Health Sciences, Blantyre, Malawi
| | | | | | - Allan Bennie
- Kamuzu University of Health Sciences, Blantyre, Malawi
| | | | | | | | | | | | - Akshat Gautam
- Indian Institute of Technology Bombay, Mumbai, Maharashtra, India
| | - Sheffali Gulati
- Center of Excellence & Advanced Research for Childhood Neurodevelopmental Disorders, Child Neurology Division, Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Mark H Johnson
- Department of Psychology, University of Cambridge, Cambridge, UK
| | | | - Matthew K Belmonte
- The Com DEALL Trust, Bengaluru, Karnataka, India
- Department of Psychology, Nottingham Trent University, Nottingham, UK
| | - Emily Jones
- Centre for Brain & Cognitive Development, Birkbeck University of London, London, UK
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Sharat Chandran
- Indian Institute of Technology Bombay, Mumbai, Maharashtra, India
| | - Emmie Mbale
- Department of Paediatrics, Kamuzu University of Health Sciences, Blantyre, Malawi
| | | | - Melissa Gladstone
- Department of Women and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Bhismadev Chakrabarti
- Centre for Autism, School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
- Department of Psychology, Ashoka University, Sonipat, India
- India Autism Center, Kolkata, India
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13
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Kumar MA, N S. Effect of Video Modeling With Simulation on Improving Menstrual Hygiene Skills for Adolescents With Autism Spectrum Disorder. Cureus 2024; 16:e62847. [PMID: 39040730 PMCID: PMC11260660 DOI: 10.7759/cureus.62847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 06/21/2024] [Indexed: 07/24/2024] Open
Abstract
Background Menstruation is a biological process experienced by women every month. This project intends to improve menstrual hygiene skills using video modeling with simulation. Educating adolescent girls with autism spectrum disorder to engage in personal care during their menstrual cycle, particularly sanitation and hygiene, is essential. It is important to develop the knowledge and skills necessary for effective self-care during menstruation to prevent sexual health problems. Additionally, the project aims to provide a safe environment for adolescents to practice their menstrual hygiene routines and relieve the stress from their caregivers. Aim and objective The study aims to evaluate the effect of video modeling with simulation to improve menstrual hygiene skills in adolescents with autism. The ultimate objective of the study is to determine whether video modeling with simulation in the experimental group enhances the practice of menstrual hygiene among adolescent girls with autism, as well as the impact of traditional occupational therapy intervention on improving menstrual hygiene in this population. Methodology This is a quasi-experimental design with convenience sampling and selected samples (n=50), who were then split into two groups: an experimental group (n=25) and a control group (n=25) based on the inclusion and exclusion criteria. The experimental group received video modeling and simulation, while the control group did not receive any specific intervention except parent education and pictorial representations. Pre- and post-tests were conducted to measure the changes. Indian Scale for Assessment of Autism was the screening tool used and the Menstrual Practice Needs Scale (MNPS) was administered. The duration of the study was six months, three sessions per week, lasting 45 minutes to an hour each. The statistical analysis was done with significance at a 1% alpha level using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, NY, USA). Results The pre-test and post-test data were analyzed using the Wilcoxon signed-rank test and the Mann-Whitney test. The results demonstrated the comparison of the pre-test and post-test mean scores of the MNPS scores were highly statistically significant (p-value of 0.000) when compared to the control group. Following the implementation of video modeling with simulation, the experimental group's post-test scores were significantly higher than the control group's (p-value of 0.000). Thus, the study showed that video modeling with simulation improved menstrual hygiene in adolescents with autism spectrum disorder. Conclusion The clinical significance of this study was that the adolescents were excited to watch the videos and perform the activities; furthermore, after video modeling with simulation was implemented, there was a significant improvement in the experimental group when compared to the control group. This enhances the practice of the menstrual hygiene skills independently by the adolescents. Video modeling with simulation has paved the way for improving menstrual hygiene in adolescents with autism. Although the findings from the study are positive, more clinical trials are needed to prove that video modeling with simulation can be used as a therapeutic modality.
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Affiliation(s)
- M Arun Kumar
- Occupational Therapy, Saveetha College of Occupational Therapy, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Shweta N
- Occupational Therapy, Saveetha College of Occupational Therapy, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Ranjan R, Jain M, Sinha M, Kumar P, Ahmad S, Maharshi V. Comparative efficacy of family mediated intervention versus early intensive behavioural intervention on symptom domains in children with autism spectrum disorder: A randomized controlled trial. Asian J Psychiatr 2024; 96:104052. [PMID: 38688101 DOI: 10.1016/j.ajp.2024.104052] [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: 02/07/2024] [Revised: 04/10/2024] [Accepted: 04/13/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Family Mediated Intervention (FMI) and Early Intensive Behavioural Intervention (EIBI) are found to be standard of care for children with Autism Spectrum Disorder (ASD). Comparison of their efficacy were assessed using ISAA as primary outcome measure. METHODS This study was a parallel arm, open label, randomized active- controlled non-inferiority clinical trial. 50 Children diagnosed with ASD were randomized into FMI and EIBI groups. Clinical status was checked by using Indian scale for assessment of autism (ISAA), Oro- motor and sensory profile at baseline, after three and six months. RESULTS Difference between change in mean ISAA score between FMI and EIBI group at the end of 6 months as per protocol (PP) analysis was -7.23 (CI=-18.41, 3.94), which was within pre-defined clinically relevant non-inferiority (NI) margin of - 24. FMI was found to be non-inferior to EIBI at the end of 6 months as the lower bound of 95% CI (-18.41) for ISAA score was higher than NI margin. ISAA scores were found to be statistically lower in both FMI and EIBI groups at the end point compared to baseline which indicated improvement in symptom severity. CONCLUSION FMI was non-inferior to EIBI as therapy for children with ASD at the end of six months. Finding also indicated longer duration of treatment is required for FMI to be superior. FMI can be recommended for children with ASD in view of improved ISAA scores reported in our study. CLINICAL TRIAL REGISTRATION NUMBER CTRI/2020/08/027099 (Registered with Clinical Trials Registry- India).
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Affiliation(s)
- Rajeev Ranjan
- Department of Psychiatry, All India Institute of Medical Sciences, Patna 801507, India.
| | - Meha Jain
- Department of Psychiatry, All India Institute of Medical Sciences, Patna 801507, India; Amity Institute of Clinical Psychology, Amity University, Jaipur-303002 India
| | - Muskan Sinha
- All India Institute of Medical Sciences, Patna 801507, India
| | - Pankaj Kumar
- Department of Psychiatry, All India Institute of Medical Sciences, Patna 801507, India
| | - Shamshad Ahmad
- Department of Community & Family Medicine, All India Institute of Medical Sciences, Patna 801507, India
| | - Vikas Maharshi
- Department of Pharmacology, All India Institute of Medical Sciences, Patna 801507, India
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Choi A, Lee H, Jeong HE, Lee SY, Kwon JS, Han JY, Choe YJ, Shin JY. Association between exposure to antibiotics during pregnancy or early infancy and risk of autism spectrum disorder, intellectual disorder, language disorder, and epilepsy in children: population based cohort study. BMJ 2024; 385:e076885. [PMID: 38777351 PMCID: PMC11109903 DOI: 10.1136/bmj-2023-076885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/11/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE To evaluate the association between antibiotic use during pregnancy or early infancy and the risk of neurodevelopmental disorders in children. DESIGN Nationwide population based cohort study and sibling analysis. SETTING Korea's National Health Insurance Service mother-child linked database, 2008-21. PARTICIPANTS All children live born between 2009 and 2020, followed up until 2021 to compare those with and without antibiotic exposure during pregnancy or early infancy (first six months of life). MAIN OUTCOMES MEASURES Autism spectrum disorder, intellectual disorder, language disorder, and epilepsy in children. After 1:1 propensity score matching based on many potential confounders, hazard ratios with 95% confidence interval were estimated using Cox proportional hazard models. A sibling analysis additionally accounted for unmeasured familial factors. RESULTS After propensity score matching, 1 961 744 children were identified for the pregnancy analysis and 1 609 774 children were identified for the early infancy analysis. Although antibiotic exposure during pregnancy was associated with increased risks of all four neurodevelopmental disorders in the overall cohort, these estimates were attenuated towards the null in the sibling analyses (hazard ratio for autism spectrum disorder 1.06, 95% confidence interval 1.01 to 1.12; intellectual disorder 1.00, 0.93 to 1.07; language disorder 1.05, 1.02 to 1.09; and epilepsy 1.03, 0.98 to 1.08). Likewise, no association was observed between antibiotic exposure during early infancy and autism spectrum disorder (hazard ratio 1.00, 0.96 to 1.03), intellectual disorder (1.07, 0.98 to 1.15), and language disorder (1.04, 1.00 to 1.08) in the sibling analyses; however, a small increased risk of epilepsy was observed (1.13, 1.09 to 1.18). The results generally remained consistent across several subgroup and sensitivity analyses, except for slightly elevated risks observed among children who used antibiotics during very early life and those who used antibiotics for more than 15 days. CONCLUSIONS In this large cohort study, antibiotic exposure during pregnancy or early infancy was not associated with an increased risk of autism spectrum disorder, intellectual disorder, or language disorder in children. However, elevated risks were observed in several subgroups such as children using antibiotics during very early life and those with long term antibiotic use, which warrants attention and further investigation. Moreover, antibiotic use during infancy was modestly associated with epilepsy, even after control for indications and familial factors. When prescribing antibiotics to pregnant women and infants, clinicians should carefully balance the benefits of use against potential risks.
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Affiliation(s)
- Ahhyung Choi
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
- Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA, USA
| | - Hyesung Lee
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
- Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, South Korea
| | - Han Eol Jeong
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
- Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, South Korea
| | - Seo-Young Lee
- Department of Neurology, College of Medicine, Kangwon National University, Chuncheon, South Korea
- Interdisciplinary Graduate Program in Medical Bigdata Convergence, Kangwon National University, Chuncheon, South Korea
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, South Korea
- Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, South Korea
| | - Jung Yeol Han
- Korean Mothersafe Counselling Center, Department of Obstetrics and Gynecology, Inje University Ilsan Paik Hospital, Goyang, South Korea
| | - Young June Choe
- Department of Pediatrics, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Ju-Young Shin
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
- Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, South Korea
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, South Korea
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Farheen N, Shahid S, Lalani KRA, Azam I, Khalid F, Fatima B, Islam MS, Saha SK, Qazi SA, Jehan F, Nisar MI. Neurodevelopmental outcomes following possible serious bacterial infection in early infancy in Karachi, Pakistan: a prospective cohort study. BMC Pediatr 2024; 24:336. [PMID: 38750481 PMCID: PMC11094884 DOI: 10.1186/s12887-024-04780-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 04/22/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Pakistan reports a significant burden of neonatal mortality, with infections as one of the major causes. We aim to assess the long-term impact of early infancy infections on neurodevelopmental outcomes during later childhood. METHODS We conducted a prospective follow-up study of the cohort enrolled at the Karachi site of the Aetiology of Neonatal Infection in South Asia (ANISA) during 2019-2020. Children with a possible serious bacterial infection (based on the WHO IMCI algorithm) at early infancy were assessed for neurodevelopment at 6-9 years of age and compared with healthy controls. The Ten Questions (TQS) questionnaire, Strengths and Difficulties Questionnaire (SDQ), and Parent's Evaluation of Developmental Stage Assessment Level (PEDS: DM-AL) neurodevelopmental assessment tools, were administered and scored by the research staff who were blinded to the child's exposure status. Generalized Structural Equation Modelling (GSEM) was employed to verify relationships and associations among developmental milestones, anthropometry, and sociodemographic variables. RESULTS A total of 398 children (241 cases and 157 controls) completed neurodevelopmental and growth assessments. Cases had a significantly higher rate of abnormal TQS scores (54.5% vs. 35.0%, p-value 0.001), greater delays in motor milestones (21.2% vs. 12.1%, p-value 0.02), lower fine motor skills (78.4 ± 1.4 vs. 83.2 ± 1.5, p-value 0.02). The receptive language skills were well-developed in both groups. According to the logistic regression model, exposure to infection during the first 59 days of life was associated with delayed TQS milestones (β = -0.6, 95% CI -1.2,-0.04), TQS hearing domain (β = -0.3, 95% CI: -1.2 to 0.7), PEDS: DM-AL fine motor domain (β = -1.3, 95% CI: -4.4 to 1.7), PEDS: DM-AL receptive language development (β = -1.1, 95% CI: -3.7 to 1.4) and child anthropometric measurements such as weight and height (β = -0.2, 95% CI: -0.4 to 0.01 and β = -0.2, 95% CI: -0.4 to -0.01, respectively). Early pSBI exposure was positively associated with PEDS: DM-AL self-help domain (β = 0.6, 95% CI: -1.2 to 2.4) and SDQ-P overall score (β = 0.02, 95% CI: -0.3 to 0.3). CONCLUSION Children exposed to PSBI during early infancy have higher rates of abnormal development, motor delays, and lower fine motor skills during later childhood in Pakistan. Socioeconomic challenges and limited healthcare access contribute to these challenges, highlighting the need for long-term follow-ups with integrated neurodevelopment assessments.
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Affiliation(s)
- Nudrat Farheen
- Department of Pediatrics and Child Health, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan
| | - Shahira Shahid
- Department of Pediatrics and Child Health, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan
| | - Kiran Ramzan Ali Lalani
- Department of Pediatrics and Child Health, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan
| | - Iqbal Azam
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Farah Khalid
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Batool Fatima
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | | | - Samir K Saha
- Child Health Research Foundation, Dhaka, Bangladesh
| | | | - Fyezah Jehan
- Department of Pediatrics and Child Health, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan
| | - Muhammad Imran Nisar
- Department of Pediatrics and Child Health, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan.
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Chandy BR, Davey C, Oswald WE, Kaliappan SP, Aruldas K, Banks LM, Jasper S, Nagarajan G, Galagan S, Kennedy DS, Walson JL, Koshy B, Ajjampur SS, Kuper H. Prevalence of functional difficulty among school-aged children and effect on school enrolment in rural southern India: A cross-sectional analysis. RESEARCH SQUARE 2024:rs.3.rs-4154190. [PMID: 38746354 PMCID: PMC11092848 DOI: 10.21203/rs.3.rs-4154190/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Despite the large number of children in India, there is little information on the impact of children's disability on school enrolment, and how this differs by population. We estimated the prevalence of childhood disability in two sites in Tamil Nadu, southern India, and the effect of functional difficulty on school enrolment. We used a parent-reported survey containing the UNICEF-Washington Group questions to identify children aged 5 to 17 years with functional difficulty during a census conducted for an ongoing trial. We estimated pooled- and gender-specific prevalence of functional difficulty among 29,044 children. We fitted regression models to identify subgroups with higher rates of functional difficulty and the effect of functional difficulty on reported school enrolment. We estimated the modification of the effect of functional difficulty by age, gender, socioeconomic status, household education, and sub-site, on additive and multiplicative scales. We found of 29,044 children, 299 (1.0%) had any functional difficulty, equal among boys and girls. Being understood (0.5%) and walking (0.4%) were the most common difficulties. Functional difficulty was strongly associated with non-enrolment in school (Prevalence ratio [PR] 4.59, 95% CI: 3.87, 5.43) after adjusting for age, gender, and site. We show scale-dependent differences between age and socioeconomic groups in the effect of functional difficulty on enrolment. This study shows that at least one in a hundred children in this region have severe functional difficulties and nearly half of these children are not enrolled in school, highlighting the need for further efforts and evidence-based interventions to increase school enrolment among these groups.
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18
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Ranjan JK, Kumari R, Choudhary A. Prevalence of attention deficit and hyperactive disorders in South Asian countries: A systematic review and meta-analysis of cross-sectional surveys from 1980 to 2023. Asian J Psychiatr 2024; 94:103970. [PMID: 38401384 DOI: 10.1016/j.ajp.2024.103970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 02/05/2024] [Accepted: 02/09/2024] [Indexed: 02/26/2024]
Affiliation(s)
- Jay Kumar Ranjan
- Department of Psychology, Banaras Hindu University, Varanasi, India
| | - Rajbala Kumari
- Ranchi Women's College, Ranchi University, Ranchi, India
| | - Amrita Choudhary
- Department of Psychology, St. Xavier's University, Kolkata, India.
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19
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Dubey I, Bishain R, Dasgupta J, Bhavnani S, Belmonte MK, Gliga T, Mukherjee D, Lockwood Estrin G, Johnson MH, Chandran S, Patel V, Gulati S, Divan G, Chakrabarti B. Using mobile health technology to assess childhood autism in low-resource community settings in India: An innovation to address the detection gap. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:755-769. [PMID: 37458273 PMCID: PMC10913299 DOI: 10.1177/13623613231182801] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
LAY ABSTRACT Autism is diagnosed by highly trained professionals- but most autistic people live in parts of the world that harbour few or no such autism specialists and little autism awareness. So many autistic people go undiagnosed, misdiagnosed, and misunderstood. We designed an app (START) to identify autism and related conditions in such places, in an attempt to address this global gap in access to specialists. START uses computerised games and activities for children and a questionnaire for parents to measure social, sensory, and motor skills. To check whether START can flag undiagnosed children likely to have neurodevelopmental conditions, we tested START with children whose diagnoses already were known: Non-specialist health workers with just a high-school education took START to family homes in poor neighbourhoods of Delhi, India to work with 131 two-to-seven-year-olds. Differences between typically and atypically developing children were highlighted in all three types of skills that START assesses: children with neurodevelopmental conditions preferred looking at geometric patterns rather than social scenes, were fascinated by predictable, repetitive sensory stimuli, and had more trouble with precise hand movements. Parents' responses to surveys further distinguished autistic from non-autistic children. An artificial-intelligence technique combining all these measures demonstrated that START can fairly accurately flag atypically developing children. Health workers and families endorsed START as attractive to most children, understandable to health workers, and adaptable within sometimes chaotic home and family environments. This study provides a proof of principle for START in digital screening of autism and related conditions in community settings.
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Affiliation(s)
- Indu Dubey
- University of Reading, UK
- University of Nottingham, UK
| | | | | | | | - Matthew K Belmonte
- University of Reading, UK
- The Com DEALL Trust, India
- Nottingham Trent University, UK
| | - Teodora Gliga
- University of East Anglia, UK
- University of London, UK
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20
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Lockwood Estrin G, Mason L, Arora R, Bhavnani S, Dasgupta J, Gulati S, Gliga T, Johnson MH. Attention control in autism: Eye-tracking findings from pre-school children in a low- and middle-income country setting. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:43-57. [PMID: 36700615 DOI: 10.1177/13623613221149541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
LAY ABSTRACT The development of cognitive processes, such as attention control and learning, has been suggested to be altered in children with a diagnosis of autism spectrum disorder. However, nearly all of our understanding of the development of these cognitive processes comes from studies with school-aged or older children in high-income countries, and from research conducted in a controlled laboratory environment, thereby restricting the potential generalisability of results and away from the majority of the world's population. We need to expand our research to investigate abilities beyond these limited settings. We address shortcomings in the literature by (1) studying attention control and learning in an understudied population of children in a low- and middle-income country setting in India, (2) focusing research on a critical younger age group of children and (3) using portable eye-tracking technology that can be taken into communities and healthcare settings to increase the accessibility of research in hard-to-reach populations. Our results provide novel evidence on differences in attention control and learning responses in groups of children with and without a diagnosis of autism spectrum disorder. We show that learning responses in children that we assessed through a portable eye-tracking task, called the 'antisaccade task', may be specific to autism. This suggests that the methods we use may have the potential to identify and assess autism-specific traits across development, and be used in research in low-resource settings.
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Affiliation(s)
| | | | | | | | | | | | | | - Mark H Johnson
- Birkbeck, University of London, UK
- University of Cambridge, UK
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21
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Sreenivas N, Maes M, Padmanabha H, Dharmendra A, Chakkera P, Paul Choudhury S, Abdul F, Mullapudi T, Gowda VK, Berk M, Vijay Sagar Kommu J, Debnath M. Comprehensive immunoprofiling of neurodevelopmental disorders suggests three distinct classes based on increased neurogenesis, Th-1 polarization or IL-1 signaling. Brain Behav Immun 2024; 115:505-516. [PMID: 37972879 DOI: 10.1016/j.bbi.2023.11.013] [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: 07/10/2023] [Revised: 09/18/2023] [Accepted: 11/11/2023] [Indexed: 11/19/2023] Open
Abstract
Neurodevelopmental disorders (NDDs) are a spectrum of conditions with commonalities as well as differences in terms of phenome, symptomatome, neuropathology, risk factors and underlying mechanisms. Immune dysregulation has surfaced as a major pathway in NDDs. However, it is not known if neurodevelopmental disorders share a common immunopathogenetic mechanism. In this study, we explored the possibility of a shared immune etiology in three early-onset NDDs, namely Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD) and Intellectual Disability Disorder (IDD). A panel of 48 immune pathway-related markers was assayed in 135 children with NDDs, represented by 45 children with ASD, ADHD and IDD in each group, along with 35 typically developing children. The plasma levels of 48 immune markers were analyzed on the Multiplex Suspension Assay platform using Pro Human cytokine 48-plex kits. Based on the cytokine/chemokine/growth factor levels, different immune profiles were computed. The primary characteristics of NDDs are depletion of the compensatory immune-regulatory system (CIRS) (z composite of IL-4, IL-10, sIL-1RA, and sIL-2R), increased interleukin (IL)-1 signaling associated with elevated IL-1α and decreased IL-1-receptor antagonist levels, increased neurogenesis, M1/M2 macrophage polarization and increased IL-4 as well as C-C Motif Chemokine Ligand 2 (CCL2) levels. With a cross-validated sensitivity of 81.8% and specificity of 94.4%, these aberrations seem specific for NDDs. Many immunological abnormalities are shared by ASD, ADHD and IDD, which are distinguished by minor differences in IL-9, IL-17 and CCL12. In contrast, machine learning reveals that NDD group consists of three immunologically distinct clusters, with enhanced neurogenesis, Th-1 polarization, or IL-1 signaling as the defining features. NDD is characterized by immune abnormalities that have functional implications for neurogenesis, neurotoxicity, and neurodevelopment. Using machine learning, NDD patients could be classified into subgroups with qualitatively distinct immune disorders that may serve as novel drug targets for the treatment of NDDs.
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Affiliation(s)
- Nikhitha Sreenivas
- Department of Human Genetics, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok 10330, Thailand; Department of Psychiatry, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria; Research Center, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria; Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea; Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China; Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, 610072, China
| | - Hansashree Padmanabha
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Apoorva Dharmendra
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Priyanka Chakkera
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Saptamita Paul Choudhury
- Department of Human Genetics, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Fazal Abdul
- Department of Human Genetics, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Thrinath Mullapudi
- Department of Human Genetics, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Vykuntaraju K Gowda
- Department of Paediatric Neurology, Indira Gandhi Institute of Child Health, Bangalore, India
| | - Michael Berk
- Deakin University, IMPACT Institute for Innovation in Physical and Mental Health and Clinical Translation, School of Medicine, Geelong, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, The Department of Psychiatry, and the Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Australia
| | - John Vijay Sagar Kommu
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Monojit Debnath
- Department of Human Genetics, National Institute of Mental Health and Neurosciences, Bangalore, India.
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22
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Kalra S, Shah D. Care Beyond Newborn Survival Including Child Health and Early Childhood Development; Mental and Psychological Health. Indian J Pediatr 2023; 90:37-46. [PMID: 37458975 DOI: 10.1007/s12098-023-04701-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 04/19/2023] [Indexed: 12/17/2023]
Abstract
Last couple of decades have witnessed a substantial decline in child mortality. Now, the need of the hour is to ensure the quality survival of children beyond infancy. Adverse events in the first few years of life have a long-lasting effect on child's development, behavior and personality; and effective interventions during this time have maximum impact to prevent these consequences. Nurturing Care for Early Childhood Development (NC-ECD) is a concept adapted worldwide by health agencies to improve the level of optimum care to children in the first 1000 days as promotion of Early Childhood Development (ECD) is integral for overall social and financial progress of the country and its population. The five components of NC-ECD include good health, adequate nutrition, responsive caregiving, safety and security, and opportunities for early learning. This five-pillar approach emphasizes upon providing quality care by catering to needs like responsive caregiving, safe and secure environment and better learning opportunities apart from health and nutrition, which are already addressed by various health programs. Taking care of mental health of child as well as caregiver is another important aspect of providing optimum care to these children. To accomplish these goals, there is a need to integrate ECD with existing public health programmes with additional focus on elements of early learning opportunities, safety and security, and responsive caregiving.
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Affiliation(s)
- Swati Kalra
- Department of Pediatrics, BSA Medical College and Hospital, Delhi, India
| | - Dheeraj Shah
- Department of Pediatrics, University College of Medical Sciences and GTB Hospital, Delhi, 110095, India.
- National Institute of Health & Family Welfare, New Delhi, 110067, India.
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23
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Emerson E, Llewellyn G. The prevalence of significant cognitive delay among 3- to 4-year-old children growing up in low- and middle-income countries: results from 126 nationally representative surveys undertaken in 73 countries. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:1200-1215. [PMID: 36109168 DOI: 10.1111/jir.12976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND We sought to (1) update estimates of the prevalence of significant cognitive delay (SCD) among nationally representative samples of young children overall, and in upper-middle, lower-middle and low-income countries; (2) investigate whether variation in prevalence between countries was systematically associated with national wealth and other country characteristics; (3) investigate the stability of prevalence estimates over time; (4) examine the correlation between SCD and 2019 Global Burden of Disease estimates on the prevalence of the impairment of developmental intellectual disability under 5 years of age; and (5) investigate the extent to which risk of SCD within countries varies with child age and gender, maternal education and household wealth. METHODS Secondary analysis of data collected in 126 nationally representative Multiple Cluster Indicators Surveys (MICS) conducted under the supervision of UNICEF in 73 countries involving a total of 396 596 3- to 4-year-old children. RESULTS The overall prevalence of SCD was 9.7% (95% CI 8.6-10.9%). Between-country variation in prevalence was strongly related to national wealth, the Human Development Index, the Human Inequality-adjusted Development Index and the Multidimensional Poverty Index, but not income inequality. In the 46 countries in which more than one survey was available prevalence estimates were reasonably stable over time (r = 0.80, P < 0.001). There were strong independent associations between increased risk of cognitive delay and younger child age, lower levels of maternal education and lower levels of household wealth (but not male gender). There was only a weak association across countries between the estimated prevalence of SCD and Global Burden of Disease estimates of the under 5 prevalence of the impairment of developmental intellectual disability. CONCLUSIONS UNICEF's MICS data are readily (and freely) available to researchers and provide a cost-effective opportunity for researchers who are concerned about better understanding the situation of young children growing up in the world's LMICs with a marked loss of developmental potential in areas of cognition and learning.
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Affiliation(s)
- E Emerson
- Centre for Disability Research and Policy, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - G Llewellyn
- Centre for Disability Research and Policy, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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24
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Antony N, Roy A, Chakraborty S, Balsavar A, Sahay A, Brar JS, Iyengar S, Bhatia T, Nimgaonkar VL, Deshpande SN. Feasibility and acceptability of the Indian Autism Screening Questionnaire in clinical and community settings. PLoS One 2023; 18:e0292544. [PMID: 38032983 PMCID: PMC10688706 DOI: 10.1371/journal.pone.0292544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 09/22/2023] [Indexed: 12/02/2023] Open
Abstract
We developed and tested the Indian Autism Screening Questionnaire (IASQ), which was reported to be reliable and valid as compared to the Indian Scale for Assessment of Autism (ISAA) and the Childhood Autism Rating Scale -2 (CARS2). The present study describes the feasibility, acceptability, sociodemographic and developmental details of IASQ study participants in 5 settings- a psychiatry outpatients' clinic (n = 145), a specialised paediatric clinic (n = 24), a speciality disability centre (n = 174), a primary school (n = 41) and a government housing colony (n = 255). The IASQ could be easily administered and understood. Consistent with prior reports, the male-female ratio of participants with autism was 3.8:1. Developmental complications were reported more frequently in clinical settings, while delivery by Caesarean section was commoner among community-dwelling higher socioeconomic status mothers (53% of the officers' sample). Mothers of participants with autism more frequently reported Caesarean section birth for the proband (χ2 = 41.61, p < .0001) and prenatal and postnatal complications. Binary logistic regression confirmed that perinatal complications in the mother and father's (older) age at birth of the participant were associated with autism. The IASQ is a reliable, practical tool for screening for autism in clinical and non-clinical settings in India.
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Affiliation(s)
- Nitin Antony
- ICMR Project ‘Development and Validation of the Screening Version of Indian Scale for Assessment of Autism’, Centre of Excellence in Mental Health, Dept. of Psychiatric Social Work, ABVIMS-Dr. RML. Hospital, New Delhi, India
| | - Aratrika Roy
- ICMR Project ‘Development and Validation of the Screening Version of Indian Scale for Assessment of Autism’, Centre of Excellence in Mental Health, Dept. of Psychiatric Social Work, ABVIMS-Dr. RML. Hospital, New Delhi, India
| | - Satabdi Chakraborty
- Dept. of Psychiatric Social Work, Institute of Human Behaviour and Allied Sciences, New Delhi, India
| | - Aparajita Balsavar
- Bidar Institute of Medical Sciences, Rajiv Gandhi University of Health Sciences, Bengaluru, Karnataka, India
| | - Amrita Sahay
- National Institute for the Empowerment of Persons with Intellectual Disabilities (NIEPID), Noida, UP, India
| | - Jaspreet S. Brar
- Department of Psychiatry and Consultant, Community Care Behavioural Health Organization, Western Psychiatric Hospital of UPMC, Pittsburgh, Pennsylvania, United States of America
| | - Satish Iyengar
- Department of Statistics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Triptish Bhatia
- Indo-US Projects and NCU-ICMR, Centre of Excellence in Mental Health, Department of Psychiatry and De-addiction, ABVIMS-Dr. RML Hospital, New Delhi, India
| | - Vishwajit L. Nimgaonkar
- Department of Psychiatry and Department of Human Genetics, University of Pittsburgh School of Medicine and Graduate School of Public Health, Pittsburgh, Pennsylvania, United States of America
| | - Smita Neelkanth Deshpande
- Centre of Excellence in Mental Health, Department of Psychiatry, ABVIMS-Dr. RML Hospital, New Delhi, India
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25
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Cao X, Tang X, Feng C, Lin J, Zhang H, Liu Q, Zheng Q, Zhuang H, Liu X, Li H, Khan NU, Shen L. A Systematic Investigation of Complement and Coagulation-Related Protein in Autism Spectrum Disorder Using Multiple Reaction Monitoring Technology. Neurosci Bull 2023; 39:1623-1637. [PMID: 37031449 PMCID: PMC10603015 DOI: 10.1007/s12264-023-01055-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 02/02/2023] [Indexed: 04/10/2023] Open
Abstract
Autism spectrum disorder (ASD) is one of the common neurodevelopmental disorders in children. Its etiology and pathogenesis are poorly understood. Previous studies have suggested potential changes in the complement and coagulation pathways in individuals with ASD. In this study, using multiple reactions monitoring proteomic technology, 16 of the 33 proteins involved in this pathway were identified as differentially-expressed proteins in plasma between children with ASD and controls. Among them, CFHR3, C4BPB, C4BPA, CFH, C9, SERPIND1, C8A, F9, and F11 were found to be altered in the plasma of children with ASD for the first time. SERPIND1 expression was positively correlated with the CARS score. Using the machine learning method, we obtained a panel composed of 12 differentially-expressed proteins with diagnostic potential for ASD. We also reviewed the proteins changed in this pathway in the brain and blood of patients with ASD. The complement and coagulation pathways may be activated in the peripheral blood of children with ASD and play a key role in the pathogenesis of ASD.
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Affiliation(s)
- Xueshan Cao
- College of Life Science and Oceanography, Shenzhen University, Shenzhen, 518060, China
- College of Physics and Optoelectronics Engineering, Shenzhen University, Shenzhen, 518060, China
| | - Xiaoxiao Tang
- College of Life Science and Oceanography, Shenzhen University, Shenzhen, 518060, China
| | - Chengyun Feng
- Maternal and Child Health Hospital of Baoan, Shenzhen, 518100, China
| | - Jing Lin
- College of Life Science and Oceanography, Shenzhen University, Shenzhen, 518060, China
| | - Huajie Zhang
- College of Life Science and Oceanography, Shenzhen University, Shenzhen, 518060, China
| | - Qiong Liu
- College of Life Science and Oceanography, Shenzhen University, Shenzhen, 518060, China
- College of Physics and Optoelectronics Engineering, Shenzhen University, Shenzhen, 518060, China
| | - Qihong Zheng
- College of Life Science and Oceanography, Shenzhen University, Shenzhen, 518060, China
| | - Hongbin Zhuang
- College of Life Science and Oceanography, Shenzhen University, Shenzhen, 518060, China
| | - Xukun Liu
- College of Life Science and Oceanography, Shenzhen University, Shenzhen, 518060, China
| | - Haiying Li
- Department of Endocrinology, Guiyang First People's Hospital, Guiyang, 550002, China
| | - Naseer Ullah Khan
- College of Life Science and Oceanography, Shenzhen University, Shenzhen, 518060, China
| | - Liming Shen
- College of Life Science and Oceanography, Shenzhen University, Shenzhen, 518060, China.
- Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, 518055, China.
- Shenzhen Key Laboratory of Marine Biotechnology and Ecology, Shenzhen, 518060, China.
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26
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Dhiman V, Menon GR, Tiwari RR. A systematic review and meta-analysis of prevalence of seven psychiatric disorders in India. Indian J Psychiatry 2023; 65:1096-1103. [PMID: 38249146 PMCID: PMC10795670 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_539_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 08/29/2023] [Accepted: 10/28/2023] [Indexed: 01/23/2024] Open
Abstract
Background After the National Mental Health Survey in 2016, multiple individual studies showed inconsistencies in the prevalence rates of psychiatric disorders in India. We performed a meta-analysis to estimate an up-to-date pooled estimate of the prevalence of depression, alcohol use disorder (AUD), anxiety disorder (AD), intellectual disability, suicidal attempt/death, autism, and bipolar disorder (BD) in India. Materials and Methods We performed a systematic bibliographic search in Pub Med, Global Health Data Exchange (GHDx), and Google Scholar, along with a manual search for peer-reviewed epidemiological studies reporting the prevalence of depression, AUD, AD, MR, suicidal attempt/death, autism, and BD in India from January 1980 till March 2022. Adopting a random-effects model, we performed the meta-analysis using "MetaXL" software. Results A total of 79 studies were included: depression (n = 28), AUD (n = 14), AD (n = 12), intellectual disability (n = 8), suicidal attempt/death (n = 7), autism (n = 6) and BD (n = 4). The pooled prevalence of depression and AUD was 12.4% (95% CI 9.4-15.9) (P < 0.001, I2 = 100%) and 21.5% (95% CI 14.1-30.0) (P < 0.001, I2 = 100%), respectively. AD, intellectual disability and suicidal attempt/death showed a prevalence of 11.6% (95% CI 8.1-15.7) (P < 0.001, I2 = 99%), 1% (95% CI 0.5-1.6) (P < 0.001, I2 = 98%) and 0.5% (95% CI 0.3-0.8) (P < 0.001, I2 = 100%), respectively. The meta-analysis in autism and BD showed pooled prevalence of 0.3% (95% CI 0.1-0.6) (P < 0.001, I2 = 96%) and 0.3% (95% CI 0.2-0.4) (P < 0.001, I2 = 78%), respectively. Subgroup analysis showed an increased prevalence of AD in the urban [24.3% (95% CI 3.7-52.9)] and younger [16.7% (95% CI 5.1-32.7)] population. The prevalence of depression and AD increased during the last two decades on decadal prevalence analysis. Discussion The findings could be used for appropriate policy measures and guiding subsequent national mental health surveys.
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Affiliation(s)
- Vikas Dhiman
- Department of Environmental Health and Epidemiology, ICMR-National Institute for Research in Environmental Health (NIREH), Bhopal, Madhya Pradesh, India
| | - Geetha R. Menon
- ICMR-National Institute of Medical Statistics (NIMS), Ansari Nagar, New Delhi, Delhi, India
| | - Rajnarayan R. Tiwari
- Department of Environmental Health and Epidemiology, ICMR-National Institute for Research in Environmental Health (NIREH), Bhopal, Madhya Pradesh, India
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Lockwood Estrin G, Bhavnani S, Goodwin A, Arora R, Divan G, Haartsen R, Mason L, Patel V, Johnson MH, Jones EJ. From the lab to the field: acceptability of using electroencephalography with Indian preschool children. Wellcome Open Res 2023; 7:99. [PMID: 37953927 PMCID: PMC10632594 DOI: 10.12688/wellcomeopenres.17334.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 11/14/2023] Open
Abstract
Background: Measurement of social and cognitive brain development using electroencephalography (EEG) offers the potential for early identification of children with elevated risk of developmental delay. However, there have been no published reports of how acceptable EEG technology is to parents and children within communities, especially in low-resource contexts such as in low and middle income countries (LMICs), which is an important question for the potential scalability of these assessments. We use a mixed-methods approach to examine whether EEG assessments are acceptable to children and their caregivers in a low resource community setting in India. Methods: We assessed the acceptability of neurophysiology research and Braintools (a novel neurodevelopmental assessment toolkit using concurrent EEG and eye-tracking technology) using: 1) a child engagement measure, 2) interviews with caregivers (n=8); 3) survey about caregiver's experience (n=36). Framework analysis was used to analyse interview data. Results: A high level of child engagement in EEG tasks was demonstrated, with children's gaze at the screen during the task averaging at 85.4% (±12.06%) of the task time. External distractions and noise during the tasks were measured, but not found to significantly effect child's attention to the screen during EEG tasks. Key topics were examined using the framework analysis: 1) parental experience of the assessment; and 2) the acceptability of research. From topic 1, four sub-themes were identified: i) caregivers' experience of the assessment, ii) caregivers' perception of child's experience of assessment, iii) logistical barriers and facilitators to participation, and iv) recommendations for improvement. Results from interviews and the survey indicated acceptability for gaze-controlled EEG research for parents and children. From topic 2, three themes were identified: i) caregivers' understanding of the research, ii) barriers to participation, and iii) facilitators to participation. Barriers to participation mainly included logistical challenges, such as geographic location and time, whereas involvement of the wider family in decision making was highlighted as an important facilitator to partake in the research. Conclusions: We demonstrate for the first time the acceptability of conducting neurodevelopmental assessments using concurrent EEG and eye-tracking in preschool children in uncontrolled community LMIC settings. This kind of research appears to be acceptable to the community and we identify potential barriers and facilitators of this research, thus allowing for future large scale research projects to be conducted investigating neurodevelopment and risk factors for suboptimal development in LMICs.
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Affiliation(s)
- Georgia Lockwood Estrin
- Centre for Brain and Cognitive Development, Department of Psychological Sciences, Birkbeck, University of London, London, WC1E 7JL, UK, UK
- School of Psychology, University of East London, London, E16 2RD, UK, UK
| | - Supriya Bhavnani
- Child Development Grou, Sangath, House 451 BhatkarWaddo, Succor, Bardez, Goa, 403501, India
| | - Amy Goodwin
- Institute of Psychology, Psychiatry and Neurosciences, King's College London SE1 1UL, London, UK
| | - Rashi Arora
- Child Development Grou, Sangath, House 451 BhatkarWaddo, Succor, Bardez, Goa, 403501, India
| | - Gauri Divan
- Child Development Grou, Sangath, House 451 BhatkarWaddo, Succor, Bardez, Goa, 403501, India
| | - Rianne Haartsen
- Centre for Brain and Cognitive Development, Department of Psychological Sciences, Birkbeck, University of London, London, WC1E 7JL, UK, UK
| | - Luke Mason
- Centre for Brain and Cognitive Development, Department of Psychological Sciences, Birkbeck, University of London, London, WC1E 7JL, UK, UK
| | - Vikram Patel
- Child Development Grou, Sangath, House 451 BhatkarWaddo, Succor, Bardez, Goa, 403501, India
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, USA
| | - Mark H. Johnson
- Centre for Brain and Cognitive Development, Department of Psychological Sciences, Birkbeck, University of London, London, WC1E 7JL, UK, UK
- Department of Psychology, University of Cambridge, Cambridge, CB2 3EB, UK
| | - Emily J.H. Jones
- Centre for Brain and Cognitive Development, Department of Psychological Sciences, Birkbeck, University of London, London, WC1E 7JL, UK, UK
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Iffland M, Livingstone N, Jorgensen M, Hazell P, Gillies D. Pharmacological intervention for irritability, aggression, and self-injury in autism spectrum disorder (ASD). Cochrane Database Syst Rev 2023; 10:CD011769. [PMID: 37811711 PMCID: PMC10561353 DOI: 10.1002/14651858.cd011769.pub2] [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] [Indexed: 10/10/2023]
Abstract
BACKGROUND Pharmacological interventions are frequently used for people with autism spectrum disorder (ASD) to manage behaviours of concern, including irritability, aggression, and self-injury. Some pharmacological interventions might help treat some behaviours of concern, but can also have adverse effects (AEs). OBJECTIVES To assess the effectiveness and AEs of pharmacological interventions for managing the behaviours of irritability, aggression, and self-injury in ASD. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, 11 other databases and two trials registers up to June 2022. We also searched reference lists of relevant studies, and contacted study authors, experts and pharmaceutical companies. SELECTION CRITERIA We included randomised controlled trials of participants of any age with a clinical diagnosis of ASD, that compared any pharmacological intervention to an alternative drug, standard care, placebo, or wait-list control. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Primary outcomes were behaviours of concern in ASD, (irritability, aggression and self-injury); and AEs. Secondary outcomes were quality of life, and tolerability and acceptability. Two review authors independently assessed each study for risk of bias, and used GRADE to judge the certainty of the evidence for each outcome. MAIN RESULTS We included 131 studies involving 7014 participants in this review. We identified 26 studies as awaiting classification and 25 as ongoing. Most studies involved children (53 studies involved only children under 13 years), children and adolescents (37 studies), adolescents only (2 studies) children and adults (16 studies), or adults only (23 studies). All included studies compared a pharmacological intervention to a placebo or to another pharmacological intervention. Atypical antipsychotics versus placebo At short-term follow-up (up to 6 months), atypical antipsychotics probably reduce irritability compared to placebo (standardised mean difference (SMD) -0.90, 95% confidence interval (CI) -1.25 to -0.55, 12 studies, 973 participants; moderate-certainty evidence), which may indicate a large effect. However, there was no clear evidence of a difference in aggression between groups (SMD -0.44, 95% CI -0.89 to 0.01; 1 study, 77 participants; very low-certainty evidence). Atypical antipsychotics may also reduce self-injury (SMD -1.43, 95% CI -2.24 to -0.61; 1 study, 30 participants; low-certainty evidence), possibly indicating a large effect. There may be higher rates of neurological AEs (dizziness, fatigue, sedation, somnolence, and tremor) in the intervention group (low-certainty evidence), but there was no clear evidence of an effect on other neurological AEs. Increased appetite may be higher in the intervention group (low-certainty evidence), but we found no clear evidence of an effect on other metabolic AEs. There was no clear evidence of differences between groups in musculoskeletal or psychological AEs. Neurohormones versus placebo At short-term follow-up, neurohormones may have minimal to no clear effect on irritability when compared to placebo (SMD -0.18, 95% CI -0.37 to -0.00; 8 studies; 466 participants; very low-certainty evidence), although the evidence is very uncertain. No data were reported for aggression or self -injury. Neurohormones may reduce the risk of headaches slightly in the intervention group, although the evidence is very uncertain. There was no clear evidence of an effect of neurohormones on any other neurological AEs, nor on any psychological, metabolic, or musculoskeletal AEs (low- and very low-certainty evidence). Attention-deficit hyperactivity disorder (ADHD)-related medications versus placebo At short-term follow-up, ADHD-related medications may reduce irritability slightly (SMD -0.20, 95% CI -0.40 to -0.01; 10 studies, 400 participants; low-certainty evidence), which may indicate a small effect. However, there was no clear evidence that ADHD-related medications have an effect on self-injury (SMD -0.62, 95% CI -1.63 to 0.39; 1 study, 16 participants; very low-certainty evidence). No data were reported for aggression. Rates of neurological AEs (drowsiness, emotional AEs, fatigue, headache, insomnia, and irritability), metabolic AEs (decreased appetite) and psychological AEs (depression) may be higher in the intervention group, although the evidence is very uncertain (very low-certainty evidence). There was no evidence of a difference between groups for any other metabolic, neurological, or psychological AEs (very low-certainty evidence). No data were reported for musculoskeletal AEs. Antidepressants versus placebo At short-term follow-up, there was no clear evidence that antidepressants have an effect on irritability (SMD -0.06, 95% CI -0.30 to 0.18; 3 studies, 267 participants; low-certainty evidence). No data for aggression or self-injury were reported or could be included in the analysis. Rates of metabolic AEs (decreased energy) may be higher in participants receiving antidepressants (very low-certainty evidence), although no other metabolic AEs showed clear evidence of a difference. Rates of neurological AEs (decreased attention) and psychological AEs (impulsive behaviour and stereotypy) may also be higher in the intervention group (very low-certainty evidence) although the evidence is very uncertain. There was no clear evidence of any difference in the other metabolic, neurological, or psychological AEs (very low-certainty evidence), nor between groups in musculoskeletal AEs (very low-certainty evidence). Risk of bias We rated most of the studies across the four comparisons at unclear overall risk of bias due to having multiple domains rated as unclear, very few rated as low across all domains, and most having at least one domain rated as high risk of bias. AUTHORS' CONCLUSIONS Evidence suggests that atypical antipsychotics probably reduce irritability, ADHD-related medications may reduce irritability slightly, and neurohormones may have little to no effect on irritability in the short term in people with ASD. There was some evidence that atypical antipsychotics may reduce self-injury in the short term, although the evidence is uncertain. There was no clear evidence that antidepressants had an effect on irritability. There was also little to no difference in aggression between atypical antipsychotics and placebo, or self-injury between ADHD-related medications and placebo. However, there was some evidence that atypical antipsychotics may result in a large reduction in self-injury, although the evidence is uncertain. No data were reported (or could be used) for self-injury or aggression for neurohormones versus placebo. Studies reported a wide range of potential AEs. Atypical antipsychotics and ADHD-related medications in particular were associated with an increased risk of metabolic and neurological AEs, although the evidence is uncertain for atypical antipsychotics and very uncertain for ADHD-related medications. The other drug classes had minimal or no associated AEs.
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Affiliation(s)
- Michelle Iffland
- Senior Practitioner Branch, NDIS Quality and Safeguards Commission, Penrith, Australia
| | - Nuala Livingstone
- Cochrane Evidence Production and Methods Directorate , Cochrane, London, UK
| | - Mikaela Jorgensen
- Senior Practitioner Branch, NDIS Quality and Safeguards Commission, Penrith, Australia
| | - Philip Hazell
- Speciality of Psychiatry, University of Sydney School of Medicine, Sydney, Australia
| | - Donna Gillies
- Senior Practitioner Branch, NDIS Quality and Safeguards Commission, Penrith, Australia
- Sydney, Australia
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Cuppens T, Kaur M, Kumar AA, Shatto J, Ng ACH, Leclercq M, Reformat MZ, Droit A, Dunham I, Bolduc FV. Developing a cluster-based approach for deciphering complexity in individuals with neurodevelopmental differences. Front Pediatr 2023; 11:1171920. [PMID: 37790694 PMCID: PMC10543689 DOI: 10.3389/fped.2023.1171920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 09/01/2023] [Indexed: 10/05/2023] Open
Abstract
Objective Individuals with neurodevelopmental disorders such as global developmental delay (GDD) present both genotypic and phenotypic heterogeneity. This diversity has hampered developing of targeted interventions given the relative rarity of each individual genetic etiology. Novel approaches to clinical trials where distinct, but related diseases can be treated by a common drug, known as basket trials, which have shown benefits in oncology but have yet to be used in GDD. Nonetheless, it remains unclear how individuals with GDD could be clustered. Here, we assess two different approaches: agglomerative and divisive clustering. Methods Using the largest cohort of individuals with GDD, which is the Deciphering Developmental Disorders (DDD), characterized using a systematic approach, we extracted genotypic and phenotypic information from 6,588 individuals with GDD. We then used a k-means clustering (divisive) and hierarchical agglomerative clustering (HAC) to identify subgroups of individuals. Next, we extracted gene network and molecular function information with regard to the clusters identified by each approach. Results HAC based on phenotypes identified in individuals with GDD revealed 16 clusters, each presenting with one dominant phenotype displayed by most individuals in the cluster, along with other minor phenotypes. Among the most common phenotypes reported were delayed speech, absent speech, and seizure. Interestingly, each phenotypic cluster molecularly included several (3-12) gene sub-networks of more closely related genes with diverse molecular function. k-means clustering also segregated individuals harboring those phenotypes, but the genetic pathways identified were different from the ones identified from HAC. Conclusion Our study illustrates how divisive (k-means) and agglomerative clustering can be used in order to group individuals with GDD for future basket trials. Moreover, the result of our analysis suggests that phenotypic clusters should be subdivided into molecular sub-networks for an increased likelihood of successful treatment. Finally, a combination of both agglomerative and divisive clustering may be required for developing of a comprehensive treatment.
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Affiliation(s)
- Tania Cuppens
- Département de Médecine Moléculaire de L'Université Laval, Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada
| | - Manpreet Kaur
- Department of Pediatric Neurology, University of Alberta, Edmonton, AB, Canada
| | - Ajay A. Kumar
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Hinxton, United Kingdom
| | - Julie Shatto
- Department of Pediatric Neurology, University of Alberta, Edmonton, AB, Canada
| | - Andy Cheuk-Him Ng
- Department of Pediatric Neurology, University of Alberta, Edmonton, AB, Canada
| | - Mickael Leclercq
- Département de Médecine Moléculaire de L'Université Laval, Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada
| | - Marek Z. Reformat
- Department of Electrical and Computer Engineering, University of Alberta, Edmonton, AB, Canada
| | - Arnaud Droit
- Département de Médecine Moléculaire de L'Université Laval, Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada
| | - Ian Dunham
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Hinxton, United Kingdom
| | - François V. Bolduc
- Department of Pediatric Neurology, University of Alberta, Edmonton, AB, Canada
- Department of Medical Genetics, University of Alberta, Edmonton, AB, Canada
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
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Mujoo H, Bowden N, Thabrew H, Kokaua J, Audas R, Taylor B. Identifying neurodevelopmental disabilities from nationalised preschool health check. Aust N Z J Psychiatry 2023; 57:1140-1149. [PMID: 36748102 PMCID: PMC10363952 DOI: 10.1177/00048674231151606] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Models of psychometric screening to identify individuals with neurodevelopmental disabilities (NDDs) have had limited success. In Aotearoa/New Zealand, routine developmental surveillance of preschool children is undertaken using the Before School Check (B4SC), which includes psychometric and physical health screening instruments. This study aimed to determine whether combining multiple screening measures could improve the prediction of NDDs. METHODS Linked administrative health data were used to identify NDDs, including attention deficit hyperactivity disorder, autism spectrum disorder and intellectual disability, within a multi-year national cohort of children who undertook the B4SC. Cox proportional hazards models, with different combinations of potential predictors, were used to predict onset of a NDD. Harrell's c-statistic for composite models were compared with a model representing recommended cutoff psychometric scores for referral in New Zealand. RESULTS Data were examined for 287,754 children, and NDDs were identified in 10,953 (3.8%). The best-performing composite model combining the Strengths and Difficulties Questionnaire, the Parental Evaluation of Developmental Status, vision screening and biological sex had 'excellent' predictive power (C-statistic: 0.83) compared with existing referral pathways which had 'poor' predictive power (C-statistic: 0.68). In addition, the composite model was able to improve the sensitivity of NDD diagnosis detection by 13% without any reduction in specificity. CONCLUSIONS Combination of B4SC screening measures using composite modelling could lead to significantly improved identification of preschool children with NDDs when compared with surveillance that rely on individual psychometric test results alone. This may optimise access to academic, personal and family support for children with NDDs.
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Affiliation(s)
- Himang Mujoo
- A Better Start National Science Challenge, Liggins Institute, University of Auckland, Auckland, New Zealand
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
| | - Nicholas Bowden
- A Better Start National Science Challenge, Liggins Institute, University of Auckland, Auckland, New Zealand
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
| | - Hiran Thabrew
- A Better Start National Science Challenge, Liggins Institute, University of Auckland, Auckland, New Zealand
- The Werry Centre, Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Jesse Kokaua
- A Better Start National Science Challenge, Liggins Institute, University of Auckland, Auckland, New Zealand
- Va’a O Tautai – Centre for Pacific Health, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Richard Audas
- Faculty of Medicine, Memorial University of Newfoundland and Labrador, St. John’s, NL, Canada
| | - Barry Taylor
- A Better Start National Science Challenge, Liggins Institute, University of Auckland, Auckland, New Zealand
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
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Gulati S, Hameed B, Olusanya BO, Newton CR. Neurodiversity and humanism in autism: An LMIC health care setting perspective. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:1173-1176. [PMID: 37354034 DOI: 10.1177/13623613231181477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2023]
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Kamila G, Gulati S. Navigating the Frontiers in Childhood Neurodevelopmental Disorders: Unravelling Challenges in South-East Asia. WHO South East Asia J Public Health 2023; 12:81-84. [PMID: 38848526 DOI: 10.4103/who-seajph.whoseajph_6_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 11/24/2023] [Indexed: 06/09/2024]
Affiliation(s)
- Gautam Kamila
- Department of Pediatrics, Child Neurology Division, Centre of Excellence and Advanced Research for Childhood Neurodevelopmental Disorders, All India Institute of Medical Sciences, New Delhi, India
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Tsao PC, Lin HC, Chiu HY, Chang YC. Maternal, Perinatal, and Postnatal Predisposing Factors of Hearing Loss in Full-Term Children: A Matched Case-Control Study. Neonatology 2023; 120:607-614. [PMID: 37321203 DOI: 10.1159/000530646] [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: 11/03/2022] [Accepted: 03/21/2023] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Studies on risk factors for childhood hearing loss (HL) are usually based on questionnaires or small sample sizes. We conducted a nationwide population-based case-control study to comprehensively analyze the maternal, perinatal, and postnatal risk factors for HL in full-term children. METHODS We retrieved data from three nationwide databases related to maternal characteristics, perinatal comorbidities, and postnatal characteristics and adverse events. We used 1:5 propensity score matching to include 12,873 full-term children with HL and 64,365 age-, sex-, and enrolled year-matched controls. Conditional logistic regression was used to evaluate the risk factors for HL. RESULTS Among the various maternal factors, maternal HL (adjusted odds ratio [aOR]: 8.09, 95% confidence interval [95% CI]: 7.16-9.16) and type 1 diabetes (aOR: 3.79, 95% CI: 1.98-7.24) had the highest odds of childhood hearing impairment. The major perinatal risk factors for childhood hearing impairment included ear malformations (aOR: 58.78, 95% CI: 37.5-92.0) and chromosomal anomalies (aOR: 6.70, 95% CI: 5.25-8.55), and the major postnatal risk factors included meningitis (aOR: 2.08, 95% CI: 1.18-3.67) and seizure (aOR: 3.71, 95% CI: 2.88-4.77). Other factors included acute otitis media, postnatal ototoxic drug use, and congenital infections. CONCLUSIONS Many risk factors for childhood HL identified in our study are preventable, such as congenital infection, meningitis, ototoxic drug use, and some maternal comorbidities. Accordingly, more effort is required to prevent and control the severity of maternal comorbidities during pregnancy, initiate genetic diagnostic evaluation for high-risk children, and aggressive screening for neonatal infections.
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Affiliation(s)
- Pei-Chen Tsao
- Department of Pediatrics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan,
- Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan,
| | - Hung-Chih Lin
- Division of Neonatology, China Medical University Children's Hospital, Taichung, Taiwan
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Pediatrics, Asia University Hospital, Asia University, Taichung, Taiwan
| | - Hsiao-Yu Chiu
- Division of Neonatology, China Medical University Children's Hospital, Taichung, Taiwan
| | - Yu-Chia Chang
- Department of Long Term Care, College of Health and Nursing, National Quemoy University, Kinmen County, Jinning, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Shih P, Chiang TL, Wu CD, Shu BC, Lung FW, Guo YL. Air pollution during the perinatal period and neurodevelopment in children: A national population study in Taiwan. Dev Med Child Neurol 2023; 65:783-791. [PMID: 36349526 DOI: 10.1111/dmcn.15430] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 09/06/2022] [Accepted: 09/08/2022] [Indexed: 11/11/2022]
Abstract
AIM To evaluate the association between ambient particulate matter no larger than 2.5 μm in diameter (PM2.5 ) during the prenatal and postnatal periods and infant neurodevelopmental parameters. METHOD We conducted a population-based birth cohort study using the Taiwan Birth Cohort Study. Participants were assessed for developmental conditions through home interviews at 6 months and 18 months of age. Exposure to PM2.5 of mothers and infants during perinatal periods was estimated using hybrid kriging/land-use regression. The exposure was linked to each participant by home address. Logistic regression was then conducted to determine the risk of neurodevelopmental delay in relation to PM2.5 . RESULTS A total of 17 683 term singletons without congenital malformations were included in the final analysis. PM2.5 during the second trimester was associated with increased risks of delays in gross motor neurodevelopmental milestones (adjusted odds ratio [aOR] 1.09 per 10 μg/m3 increase in exposure to PM2.5 ). Delayed fine motor development was also found to be related to exposure to PM2.5 in the second and third trimesters (aOR 1.06), as was personal-social skill (aOR 1.11 for the second trimester and 1.06 for the third). These neurodevelopmental parameters were unrelated to postnatal PM2.5 exposure. INTERPRETATION Exposure to ambient PM2.5 during pregnancy was significantly related to delay in gross motor, fine motor, and personal-social development in this population-based study. WHAT THIS PAPER ADDS Prenatal exposure to higher PM2.5 was associated with increased risk of delayed early neurodevelopment. The critical period for delayed gross motor development was the second trimester. The critical period for fine motor and personal-social development was the second and third trimesters.
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Affiliation(s)
- Ping Shih
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Environmental and Occupational Medicine, National Taiwan University, Taipei, Taiwan
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Tung-Liang Chiang
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chih-Da Wu
- Department of Geomatics, National Cheng Kung University, Tainan, Taiwan
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Bih-Ching Shu
- Institute of Allied Health Sciences, Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - For-Wey Lung
- Calo Psychiatric Center, Pingtung, Taiwan
- Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan
| | - Yue Leon Guo
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Environmental and Occupational Medicine, National Taiwan University, Taipei, Taiwan
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
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Adejuyigbe EA, Agyeman I, Anand P, Anyabolu HC, Arya S, Assenga EN, Badhal S, Brobby NW, Chellani HK, Chopra N, Debata PK, Dube Q, Dua T, Gadama L, Gera R, Hammond CK, Jain S, Kantumbiza F, Kawaza K, Kija EN, Lal P, Mallewa M, Manu MK, Mehta A, Mhango T, Naburi HE, Newton S, Nyanor I, Nyako PA, Oke OJ, Patel A, Phlange-Rhule G, Sehgal R, Singhal R, Wadhwa N, Yiadom AB. Evaluation of the impact of continuous Kangaroo Mother Care (KMC) initiated immediately after birth compared to KMC initiated after stabilization in newborns with birth weight 1.0 to < 1.8 kg on neurodevelopmental outcomes: Protocol for a follow-up study. Trials 2023; 24:265. [PMID: 37038239 PMCID: PMC10088121 DOI: 10.1186/s13063-023-07192-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 02/20/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND Preterm birth or low birth weight is the single largest cause of death in newborns, however this mortality can be reduced through newborn care interventions, including Kangaroo Mother Care (KMC). Previously, a multi-country randomized controlled trial, coordinated by the World Health Organization (WHO), reported a significant survival advantage with initiation of continuous KMC immediately after birth compared with initiation of continuous KMC a few days after birth when the baby is considered clinically stable. Whether the survival advantage would lead to higher rates of neurodevelopmental morbidities, or the immediate KMC will also have a beneficial effect on cognitive development also, has not been investigated. We therefore propose to test the hypothesis that low-birth-weight infants exposed to immediate KMC will have lower rates of neurodevelopmental impairment in comparison to traditional KMC-treated infants, by prospectively following up infants already enrolled in the immediate KMC trial for the first 2 years of life, and assessing their growth and neurodevelopment. METHODS This prospective cohort study will enroll surviving neonates from the main WHO immediate KMC trial. The main trial as well as this follow-up study are being conducted in five low- and middle-income countries in South Asia and sub-Saharan Africa. The estimated sample size for comparison of the risk of neurodevelopmental impairment is a total of 2200 children. The primary outcome will include rates of cerebral palsy, hearing impairment, vision impairment, mental and motor development, and epilepsy and will be assessed by the age of 3 years. The analysis will be by intention to treat. DISCUSSION Immediate KMC can potentially reduce low-birth-weight-associated complications such as respiratory disease, hypothermia, hypoglycemia, and infection that can result in impaired neurocognitive development. Neuroprotection may also be mediated by improved physiological stabilization that may lead to better maturation of neural pathways, reduced risk of hypoxia, positive parental impact, improved sleep cycles, and improved stress responses. The present study will help in evaluating the overall impact of KMC by investigating the long-term effect on neurodevelopmental impairment in the survivors. TRIAL REGISTRATION Clinical Trials Registry-India CTRI/2019/11/021899. Registered on 06 November 2019. Trials registration of parent trial: ACTRN12618001880235; Clinical Trials Registry-India: CTRI/2018/08/015369.
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Affiliation(s)
- E A Adejuyigbe
- Department of Paediatrics and Child Health, Obafemi Awolowo University, Ile-Ife, 220005, Nigeria
| | - I Agyeman
- Komfo Anokye Teaching Hospital, P.O. Box 1934, Adum, Kumasi, Ghana
| | - P Anand
- Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India
| | - H C Anyabolu
- Department of Paediatrics and Child Health, Obafemi Awolowo University, Ile-Ife, 220005, Nigeria
| | - S Arya
- Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India
| | - E N Assenga
- Department of Paediatrics and Child Health, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, 255, Tanzania
| | - S Badhal
- Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India
| | - N W Brobby
- Department of Child Health, Komfo Anokye Teaching Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - H K Chellani
- Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India.
| | - N Chopra
- Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India
| | - P K Debata
- Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India
| | - Q Dube
- Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - T Dua
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - L Gadama
- Department of Obstetrics and Gynaecology, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - R Gera
- Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India
| | - C K Hammond
- Department of Child Health, Komfo Anokye Teaching Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - S Jain
- Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India
| | - F Kantumbiza
- Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - K Kawaza
- Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - E N Kija
- Department of Paediatrics and Child Health, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, 255, Tanzania
| | - P Lal
- Atal Bihari Vajpayee Institute of Medical Sciences &, Dr Ram Manohar Lohia Hospital, New Delhi, 110001, India
| | - M Mallewa
- Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - M K Manu
- Komfo Anokye Teaching Hospital, P.O. Box 1934, Adum, Kumasi, Ghana
| | - A Mehta
- Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India
| | - T Mhango
- Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - H E Naburi
- Department of Paediatrics and Child Health, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, 255, Tanzania
| | - S Newton
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - I Nyanor
- Research and Development, Komfo Anokye Teaching Hospital, P.O. Box 1934, Adum, Kumasi, Ghana
| | - P A Nyako
- Department of Psychiatry, Child And Adolescent Mental Health, Komfo Anokye Teaching Hospital, P.O. Box 1934, Adum, Kumasi, Ghana
| | - O J Oke
- Department of Paediatrics and Child Health, Obafemi Awolowo University, Ile-Ife, 220005, Nigeria
| | - A Patel
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
- Division of Epilepsy & Clinical Neurophysiology, Boston Children's Hospital, Harvard Medical School, Boston, USA
| | - G Phlange-Rhule
- Clinical Development Services Agency (CDSA), Translational Health Science and Technology Institute (THSTI), NCR Biotech Science Cluster, PO Box #04, Faridabad, 121001, India
| | - R Sehgal
- Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India
| | - R Singhal
- Translational Health Science and Technology Institute (THSTI), NCR Biotech Science Cluster, PO Box #04, 121001, Faridabad, India
| | - N Wadhwa
- Faridabad-Gurgaon Expressway, Translational Health Science and Technology Institute, NCR Biotech Science Cluster, 3Rd MilestonePost Box #04, Faridabad, Haryana, 121001, India.
| | - A B Yiadom
- Department of Child Health, Komfo Anokye Teaching Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Practical Aspects of ASD Management-What Pediatricians Should Know. Indian J Pediatr 2023; 90:369-376. [PMID: 36795273 DOI: 10.1007/s12098-023-04476-1] [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: 08/08/2022] [Accepted: 01/05/2023] [Indexed: 02/17/2023]
Abstract
The increasing prevalence of autism spectrum disorder (ASD) warrants higher levels of clinical attention to optimally manage children with ASD. There is mounting evidence that early intervention programs can help improve developmental functioning, maladaptive behaviors, and core ASD symptoms. The most thoroughly investigated and evidence-based therapies have been developmental, behavioral, and educational interventions mediated by either professionals or parents. Other commonly available interventions include speech and language therapy, occupational therapy, and social skills training. Pharmacological interventions, where needed, are used as an adjunct to treat severe problem behaviors and manage medical and psychiatric comorbidities. Complementary or alternative medicine (CAM) approaches have not proven to be of any benefit, and some of them may be harmful to the child. As the child's first point of contact, the pediatrician is well-positioned to effectively guide the families to therapies that are evidence-based and safe and also collaborate with various specialists to provide seamless, coordinated care for these children so as to improve their developmental outcomes and social functioning.
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Mahajan R, Sagar R. Adequate Management of Autism Spectrum Disorder in Children in India. Indian J Pediatr 2023; 90:387-392. [PMID: 36173539 DOI: 10.1007/s12098-022-04352-4] [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: 10/18/2021] [Accepted: 08/04/2022] [Indexed: 11/05/2022]
Abstract
Despite the significant burden of neurodevelopmental disorders such as autism spectrum disorder (ASD) in India, there are areas of unmet needs at every level of the health care system. This includes screening and recognition, reliable and valid tools to evaluate, and to adequately manage ASD. There are also gaps in education and training of medical professionals, paraprofessionals, special education teachers and the related services. Lack of public awareness and cultural factors contribute to delays in early recognition and interventions. A framework is suggested to address these unmet needs at various levels to improve the care of these children with ASD. These include a) a focus on education of medical professionals, paraprofessionals, and teachers; b) setting up infrastructure at community, regional, and statewide levels, with adequate funding; and c) use of audiovisual technology and collaboration with international expertise.
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Affiliation(s)
- Rajneesh Mahajan
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD, USA. .,Department of Psychiatry, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
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Bhatia D. Neuroscience Engagement and Outreach on Neurodevelopmental Disorders: A Report from India. Ann Neurosci 2023; 30:119-123. [PMID: 37706103 PMCID: PMC10496791 DOI: 10.1177/09727531231176122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 04/20/2023] [Indexed: 09/15/2023] Open
Abstract
The current project was funded by the Global Engagement Seed Grant from the International Brain Research Organisation (IBRO) as part of the IBRO-led Global Engagement Initiative. The project was focused on public awareness about neurodevelopmental disorders (NDDs) as well as neuroscience engagement. Thus, the project had two specific aims: (a) public awareness about epidemiology, diagnosis, risk factors, prevention of NDDs and relevant government guidelines and available policies (b) public engagement in neuroscience. Therefore, the current project report with an emphasis on the requirement of neuroscience engagement and outreach at the societal level, highlights several activities such as population-based workshops and webinars, carried out as part of the project in both rural and urban areas to enhance the public engagement in neuroscience and awareness on several NDDs. Key message India is an extremely diverse country with significant variations in cultural, educational, financial, socioeconomic status and linguistic aspects. With about 27% of its population living below the poverty line, India accounts for about 23 million children suffering from a disability, most of whom do not seek medical help. These data highlight the gravity of the situation which calls for urgent actions from governments, healthcare professionals, researchers and policymakers to design adequate public awareness programs regarding several prevalent NDDs. Therefore, the current project was an effort to bring public awareness about brain health and the epidemiology, diagnosis and prevention of NDDs and relevant government guidelines and available policies.
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Affiliation(s)
- Divya Bhatia
- E-Cog: Emotion & Cognition Psychology Research Centre, Jindal School of Psychology and Counselling, O.P. Jindal Global University, Sonipat, Haryana, India
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Singhi P, Smith-Hicks C. Early Diagnosis and Management of Autism Spectrum Disorder (ASD) in Low-Resource Countries-Challenges and Strategies. Indian J Pediatr 2023; 90:362-363. [PMID: 36800162 DOI: 10.1007/s12098-023-04481-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 01/09/2023] [Accepted: 01/09/2023] [Indexed: 02/18/2023]
Affiliation(s)
- Pratibha Singhi
- Department of Pediatric Neurology, Amrita Hospital, Faridabad, Haryana, India.
| | - Constance Smith-Hicks
- Center for Synaptic Disorders, Kennedy Krieger Institute, Baltimore, MD, USA.,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Lockwood Estrin G, Bhavnani S, Arora R, Gulati S, Divan G. Caregiver Perceptions of Autism and Neurodevelopmental Disabilities in New Delhi, India. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5291. [PMID: 37047907 PMCID: PMC10094583 DOI: 10.3390/ijerph20075291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/24/2023] [Accepted: 03/06/2023] [Indexed: 06/19/2023]
Abstract
Evidence suggests that parenting an autistic child or a child with neurodevelopmental disabilities can be more challenging than parenting a child meeting their developmental milestones, especially when there is a dearth of support services, such as in low- and middle-income countries (LMICs). Despite the majority of the world's children residing in LMICs, there are limited studies examining the understanding of developmental disorders and autism in these regions. We therefore aim to investigate perceptions of autism and developmental disabilities in caregivers of children in an urban setting in New Delhi, India. Thirteen semi-structured interviews with parents/caregivers of children were conducted in three groups: (1) caregivers with a child with a diagnosis of autism spectrum disorder (ASD); (2) caregivers with a child with a diagnosis of intellectual disability (ID); (3) and caregivers with children meeting their developmental milestones. Transcripts were analysed using framework analysis. Three themes on the impact of cultural and contextual factors on the recognition, interpretation, and reporting of autistic symptoms are discussed, and additional themes focus on the impact of diagnosis and family support. Our findings highlighted a vital need for greater community awareness and recognition of autism in India, for example through community and healthcare training, which may help to reduce stigma and facilitate wider family support.
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Affiliation(s)
- Georgia Lockwood Estrin
- School of Psychology, University of East London, Arthur Edwards Building, Water Lane, London E15 4LZ, UK
- Child Development Group, Sangath, Bardez 403501, India; (S.B.); (G.D.)
| | - Supriya Bhavnani
- Child Development Group, Sangath, Bardez 403501, India; (S.B.); (G.D.)
| | - Rashi Arora
- Child Development Group, Sangath, Bardez 403501, India; (S.B.); (G.D.)
| | - Sheffali Gulati
- Center of Excellence and Advanced Research on Childhood Neurodevelopmental Disorders, Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India;
| | - Gauri Divan
- Child Development Group, Sangath, Bardez 403501, India; (S.B.); (G.D.)
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Olusanya BO, Smythe T, Ogbo FA, Nair MKC, Scher M, Davis AC. Global prevalence of developmental disabilities in children and adolescents: A systematic umbrella review. Front Public Health 2023; 11:1122009. [PMID: 36891340 PMCID: PMC9987263 DOI: 10.3389/fpubh.2023.1122009] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/24/2023] [Indexed: 02/18/2023] Open
Abstract
Aim The provisions of the United Nation's Sustainable Development Goals (SDGs) for disability-inclusive education have stimulated a growing interest in ascertaining the prevalence of children with developmental disabilities globally. We aimed to systematically summarize the prevalence estimates of developmental disabilities in children and adolescents reported in systematic reviews and meta-analyses. Methods For this umbrella review we searched PubMed, Scopus, Embase, PsycINFO, and Cochrane Library for systematic reviews published in English between September 2015 and August 2022. Two reviewers independently assessed study eligibility, extracted the data, and assessed risk of bias. We reported the proportion of the global prevalence estimates attributed to country income levels for specific developmental disabilities. Prevalence estimates for the selected disabilities were compared with those reported in the Global Burden of Disease (GBD) Study 2019. Results Based on our inclusion criteria, 10 systematic reviews reporting prevalence estimates for attention-deficit/hyperactivity disorder, autism spectrum disorder, cerebral palsy, developmental intellectual disability, epilepsy, hearing loss, vision loss and developmental dyslexia were selected from 3,456 identified articles. Global prevalence estimates were derived from cohorts in high-income countries in all cases except epilepsy and were calculated from nine to 56 countries. Sensory impairments were the most prevalent disabilities (approximately 13%) and cerebral palsy was the least prevalent disability (approximately 0.2-0.3%) based on the eligible reviews. Pooled estimates for geographical regions were available for vision loss and developmental dyslexia. All studies had a moderate to high risk of bias. GBD prevalence estimates were lower for all disabilities except cerebral palsy and intellectual disability. Conclusion Available estimates from systematic reviews and meta-analyses do not provide representative evidence on the global and regional prevalence of developmental disabilities among children and adolescents due to limited geographical coverage and substantial heterogeneity in methodology across studies. Population-based data for all regions using other approaches such as reported in the GBD Study are warranted to inform global health policy and intervention.
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Affiliation(s)
| | - Tracey Smythe
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa
| | - Felix A. Ogbo
- Riverland Academy of Clinical Excellence (RACE), Riverland Mallee Coorong Local Health Network, SA Health | Government of South Australia, Berri, SA, Australia
- Translational Health Research Institute (THRI), Campbelltown Campus, Western Sydney University, Penrith, NSW, Australia
| | - M. K. C. Nair
- NIMS-Spectrum-Child Development Research Centre, NIMS Medicity, Thiruvananthapuram, Kerala, India
| | - Mark Scher
- Department of Pediatrics, Division of Pediatric Neurology, Fetal-Neonatal Neurology Program, Rainbow Babies and Children's Hospital, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
- MacDonald Hospital for Women, Case Western Reserve University School of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
| | - Adrian C. Davis
- Department of Population Health, London School of Economics, London, United Kingdom
- Vision and Eye Research Institute, School of Medicine Anglia Ruskin University, Cambridge, United Kingdom
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Wadhera T, Bedi J, Sharma S. Autism spectrum disorder prediction using bidirectional stacked gated recurrent unit with time-distributor wrapper: an EEG study. Neural Comput Appl 2023. [DOI: 10.1007/s00521-023-08218-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Francés L, Caules J, Ruiz A, Soler CV, Hervás A, Fernández A, Rodríguez-Quiroga A, Quintero J. An approach for prevention planning based on the prevalence and comorbidity of neurodevelopmental disorders in 6-year-old children receiving primary care consultations on the island of Menorca. BMC Pediatr 2023; 23:32. [PMID: 36670411 PMCID: PMC9852795 DOI: 10.1186/s12887-023-03844-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 01/10/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Few studies have estimated the real prevalence of neurodevelopmental disorders according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) in Spain and worldwide. However, there are disparate prevalence figures. We consider research in this field essential to improve early detection, secondary prevention, and health planning. METHODS The Minikid ADHD and TICS-Mini International Neuropsychiatric Interview for Children and Adolescents, the Autism Spectrum Quotient (Children's version, AQ- Child) and a protocol of general medical questions were administered for screening purposes. The PROLEXIA battery for children aged from 4 to 6 years was used for direct assessments. Parents provided information on emotional, medical, and school aspects. The final population evaluated using these tools consisted of 291 6-year-old subjects. RESULTS The overall risk of presenting with a neurodevelopmental disorder was 55.4%. A 23.4% risk of presenting with attention-deficit/hyperactivity disorder (ADHD) in any modality (inattentive, hyperactive-impulsive and combined), a 2.8% risk of developing autism spectrum disorder (ASD), a 30.6% risk of presenting with a learning disorder with reading difficulties, a 5.5% risk of tics and a 22.5% risk of language problems (incomprehensible language or minor language problems) were detected in the sample. The most common combination of disorders was learning and language difficulties, accounting for 6.9% of the sample. The second most frequent combination was the presence of learning and language difficulties and ADHD, accounting for 4.5% of the sample. CONCLUSIONS The prevalence of risks detected in our sample seems to be consistent with national and international studies. A significant proportion of our sample had never been previously diagnosed (85%), so early detection programs are recommended.
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Affiliation(s)
- Lorena Francés
- Child and Adolescent Psychiatrist, Menorca (Balearic Islands, Spain), Av. Del Metge Camps 20, 07740 Es Mercadal, Balearic Islands Spain
| | | | - Antoni Ruiz
- grid.5841.80000 0004 1937 0247University of Barcelona, Barcelona, Spain
| | - Catalina Virgínia Soler
- grid.487143.d0000 0004 1807 8885Dalt Sant Joan Center (Mahón), Servei de Salut de les Illes Balears, Mahón, Illes Balears Spain
| | - Amaia Hervás
- grid.410458.c0000 0000 9635 9413Child–Adolescent Mental Health Unit at the Mutua Terrasa University Hospital, Barcelona, Catalonia Spain ,grid.7080.f0000 0001 2296 0625the Autonomous University of Barcelona, Barcelona, Catalonia Spain ,Saint George Hospital in London, London, UK ,grid.439833.60000 0001 2112 9549Child–Adolescent Psychiatry at Maudsley Hospital, London, UK
| | - Alberto Fernández
- grid.4795.f0000 0001 2157 7667Department of Legal Medicine, Psychiatry and Pathology at the Complutense University of Madrid, Madrid, Spain
| | | | - Javier Quintero
- Psychiatry Service of the Infanta Leonor Hospital, Madrid, Spain ,grid.4795.f0000 0001 2157 7667Psychiatry Department of the Complutense University of Madrid, Leading Expert in Child and Adolescent Psychiatry, Madrid, Spain
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Esakki B, Kandasamy S, Mahadevan R, Subbiah P, Jayaraman Y, Gopal M, Kalyanaraman S. Methodology for the early identification of neurodevelopmental disorders in the primary and preschool children in rural India by applying intervention module developed for teachers. J Neurosci Rural Pract 2023; 14:165-169. [PMID: 36891089 PMCID: PMC9944657 DOI: 10.25259/jnrp-2022-2-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/05/2022] [Indexed: 12/24/2022] Open
Abstract
Objective Neurodevelopmental disorders NDD are neurologic processing problems that interfere with learning in children. Primary and preschool teachers who are essential links in public health reach out to such children do not receive any formal training to identify these disorders. Hence, a primary and preschool level intervention addressing the issue is proposed. Materials and Methods Primary and preschool teachers of government and government-aided schools and Anganwadi/preschools in the Model Rural Health Research Unit Tirunelveli field practice area will be assigned into two groups. The training module will be developed and validated using neurodevelopmental screening tool (NDST). Before identifying the students using the NDST, the teachers in Group A will get training using the module. Group B is the control group, in which untrained teachers administer the NDST to the children and then will be trained. Neurologists will assess the same children over 1 year. Results The effectiveness of teacher training for the early detection of children with NDD will be assessed. Thus, the validity of the screening for NDD by the teachers will be estimated. Conclusion If successful, the module can be incorporated into the Rashtriya Bal Swasthya Karyakram program of India for the early identification of children with NDD.
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Affiliation(s)
- Bobby Esakki
- Department of Community Medicine, Tirunelveli Medical college, Tirunelveli, Tamil Nadu, India
| | - Sunitha Kandasamy
- Department of Community Medicine, Tuticorin Medical College, Thoothukudi, Tamil Nadu, India
| | - Radha Mahadevan
- Department of Neurology, Tirunelveli Medical College, Tirunelveli, Tamil Nadu, India
| | | | | | - Muthu Gopal
- Model Rural Health Research Unit, Tirunelveli, Tamil Nadu, India
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Significant regional inequalities in the prevalence of intellectual disability and trends from 1990 to 2019: a systematic analysis of GBD 2019. Epidemiol Psychiatr Sci 2022; 31:e91. [PMID: 36539341 PMCID: PMC9805697 DOI: 10.1017/s2045796022000701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
AIMS Policymakers and researchers have little evidence on prevalence rates of intellectual disability (ID) or their changes over time to tailor healthcare interventions. Prevalence rates and trends of ID are especially lacking in regions with lower socio-demographic development. Additionally, the assessment of inequalities in the prevalence of ID across regions with varying socio-demographic development is understudied. This study assessed variations in prevalence rates of ID from 1990 to 2019 and the related inequalities between low and high socio-demographic index (SDI) regions. METHODS This study used global data from 1990 to 2019 for individuals with ID from the 2019 Global Burden of Diseases study. Data analyses were performed from September 2021 to January 2022. Prevalence for individuals with ID was extracted by sex, age groups and SDI regions. Annual percentage change (APC) was estimated for each demographic group within SDI regions to assess their prevalence trends over 30 years. Relative and absolute inequalities were calculated between low and high SDI regions for the various age groups. RESULTS In 2019, there were 107.62 million (1.74%) individuals with ID, with an APC of -0.80 (-0.88 to -0.72). There was a slightly higher prevalence among males (1.42%) than females (1.37%). The highest prevalence rates were found in the low-middle SDI regions (2.42%) and the lowest prevalence rates were in the high SDI regions (0.33%). There was a large reduction in the prevalence rate between the youngest age group v. the oldest age group in all the SDI regions and at all time points. The relative inequalities between low and high SDI regions increased over three decades. CONCLUSIONS While an overall decrease in global prevalence rate for ID was found, relative inequalities continue to increase with lower SDI regions needing more comprehensive support services. The demographic trends indicate a significantly higher mortality rate among those with ID v. the rest of the population. Our study highlights the necessity for policies and interventions targeting lower SDI regions to mobilise resources that better support individuals with ID and achieve sustainable development goals proposed by the United Nations.
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Yang Y, Zhao S, Zhang M, Xiang M, Zhao J, Chen S, Wang H, Han L, Ran J. Prevalence of neurodevelopmental disorders among US children and adolescents in 2019 and 2020. Front Psychol 2022; 13:997648. [PMID: 36507037 PMCID: PMC9730394 DOI: 10.3389/fpsyg.2022.997648] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 10/31/2022] [Indexed: 11/25/2022] Open
Abstract
Background Concerning the changes in the prevalence of neurodevelopmental disorders (NDDs), we estimate the prevalence of attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), intellectual disorder (ID), and learning disability (LD) among US children and adolescents aged 3-17 years in 2019 and 2020. Methods The study includes 14,983 US children and adolescents aged 3-17 years in 2019 and 2020 from the National Health Interview Survey (NHIS). Parents were interviewed about whether their children ever and/or currently had NDDs diagnosed. Prevalence estimates of NDDs were calculated with a survey-based weighting scheme. Logistic regression models were used to estimate the associations between NDDs prevalence and subgroups. Results The weighted prevalence of ADHD, ASD, ID, and LD was 8.5% (95% CI: 7.9-9.2%), 2.9% (95% CI: 2.6-3.4%), 1.4% (95% CI: 1.2-1.7%), and 6.4% (95% CI: 5.8-7.0%), respectively. A higher prevalence of ADHD, ASD, ID, and LD was observed in boys, those who ever had anxiety or depression symptoms, those with lower family income, those living in a rented house, ever been bullied, and ever lived with anyone mentally ill. Conclusion The study found the prevalence of ADHD, ASD, ID, and LD was different by demographics, comorbidity/mental problems, household/parental characteristics, and stressful life events.
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Affiliation(s)
- Yiwei Yang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shi Zhao
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Meihui Zhang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mi Xiang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jian Zhao
- MOE-Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shucheng Chen
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Hui Wang
- MOE-Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lefei Han
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China,*Correspondence: Lefei Han,
| | - Jinjun Ran
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China,Jinjun Ran,
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Mengi M, Malhotra D. A systematic literature review on traditional to artificial intelligence based socio-behavioral disorders diagnosis in India: Challenges and future perspectives. Appl Soft Comput 2022. [DOI: 10.1016/j.asoc.2022.109633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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48
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Tiwari R, Chakrabarty B. Autism Spectrum Disorder and Epilepsy: Exploring the Missing Links. Indian J Pediatr 2022; 89:962-963. [PMID: 35819702 DOI: 10.1007/s12098-022-04294-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 05/23/2022] [Accepted: 05/26/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Richa Tiwari
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Biswaroop Chakrabarty
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India.
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Chaudhary D, Bhat B, Shields GE, Davies LM, Green J, Verghis T, Roy R, Kumar D, Kakra M, Vajaratkar V, Lall G, Pandey S, Johri S, Shakeel S, Patel V, Juneja M, Gulati S, Divan G. Development of a cost of illness inventory questionnaire for children with autism spectrum disorder in South Asia. BMC Health Serv Res 2022; 22:1137. [PMID: 36076224 PMCID: PMC9461098 DOI: 10.1186/s12913-022-08508-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 08/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The economic burden of autism is substantial and includes a range of costs, including healthcare, education, productivity losses, informal care and respite care, among others. In India, approximately, 2 million children aged 2-9 years have autism. Given the likely substantial burden of illness and the need to identify effective and cost-effective interventions, this research aimed to produce a comprehensive cost of illness inventory (COII) suitable for children with autism in South Asia (India) to support future research. METHODS A structured and iterative design process was followed to create the COII, including literature reviews, interviews with caregivers, pilot testing and translation. Across the development of the COII, thirty-two families were involved in the design and piloting of the tool. The COII was forward translated (from English to Hindi) and back translated. Each stage of the process of development of the COII resulted in the further refinement of the tool. RESULTS Domains covered in the final COII include education, childcare, relocation, healthcare contacts (outpatient, inpatient, medical emergencies, investigations and medication), religious retreats and rituals, specialist equipment, workshops and training, special diet, support and care, certification, occupational adjustments and government rebates/schemes. Administration and completion of the COII determined it to be feasible to complete in 35 minutes by qualified and trained researchers. The final COII is hosted by REDCap Cloud and is a bilingual instrument (Hindi and English). CONCLUSIONS The COII was developed using experiences gathered from an iterative process in a metropolitan area within the context of one low- and middle-income country (LMIC) setting, India. Compared to COII tools used for children with autism in high-income country settings, additional domains were required, such as complimentary medication (e.g. religious retreats and homeopathy). The COII will allow future research to quantify the cost of illness of autism in India from a broad perspective and will support relevant economic evaluations. Understanding the process of developing the questionnaire will help researchers working in LMICs needing to adapt the current COII or developing similar questionnaires.
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Affiliation(s)
- Divya Chaudhary
- Sangath, House No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India
| | - Bhargav Bhat
- Sangath, House No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India
| | | | | | | | - Tara Verghis
- Sangath, House No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India
| | - Reetabrata Roy
- Sangath, House No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India
| | - Divya Kumar
- Sangath, House No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India
| | - Minal Kakra
- Sangath, House No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India
| | | | - Gitanjali Lall
- Sangath, House No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India
| | - Sonakshi Pandey
- Sangath, House No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India
| | - Sanchita Johri
- Sangath, House No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India
| | - Saani Shakeel
- Sangath, House No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA
| | - Monica Juneja
- Maulana Azad Medical College and Assoc. Lok Nayak Hospital (MAMC), New Delhi, India
| | | | - Gauri Divan
- Sangath, House No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India.
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50
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Olusanya BO, Gladstone M, Wright SM, Hadders-Algra M, Boo NY, Nair MKC, Almasri N, Kancherla V, Samms-Vaughan ME, Kakooza-Mwesige A, Smythe T, del Castillo-Hegyi C, Halpern R, de Camargo OK, Arabloo J, Eftekhari A, Shaheen A, Gulati S, Williams AN, Olusanya JO, Wertlieb D, Newton CRJ, Davis AC. Cerebral palsy and developmental intellectual disability in children younger than 5 years: Findings from the GBD-WHO Rehabilitation Database 2019. Front Public Health 2022; 10:894546. [PMID: 36091559 PMCID: PMC9452822 DOI: 10.3389/fpubh.2022.894546] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/12/2022] [Indexed: 01/22/2023] Open
Abstract
Objective Children with developmental disabilities are associated with a high risk of poor school enrollment and educational attainment without timely and appropriate support. Epidemiological data on cerebral palsy and associated comorbidities required for policy intervention in global health are lacking. This paper set out to report the best available evidence on the global and regional prevalence of cerebral palsy (CP) and developmental intellectual disability and the associated "years lived with disability" (YLDs) among children under 5 years of age in 2019. Methods We analyzed the collaborative 2019 Rehabilitation Database of the Global Burden of Disease (GBD) Study and World Health Organization for neurological and mental disorders available for 204 countries and territories. Point prevalence and YLDs with 95% uncertainty intervals (UI) are presented. Results Globally, 8.1 million (7.1-9.2) or 1.2% of children under 5 years are estimated to have CP with 16.1 million (11.5-21.0) or 2.4% having intellectual disability. Over 98% resided in low-income and middle-income countries (LMICs). CP and intellectual disability accounted for 6.5% and 4.5% of the aggregate YLDs from all causes of adverse health outcomes respectively. African Region recorded the highest prevalence of CP (1.6%) while South-East Asia Region had the highest prevalence of intellectual disability. The top 10 countries accounted for 57.2% of the global prevalence of CP and 62.0% of the global prevalence of intellectual disability. Conclusion Based on this Database, CP and intellectual disability are highly prevalent and associated with substantial YLDs among children under 5 years worldwide. Universal early detection and support services are warranted, particularly in LMICs to optimize school readiness for these children toward inclusive education as envisioned by the United Nations' Sustainable Development Goals.
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Affiliation(s)
- Bolajoko O. Olusanya
- Centre for Healthy Start Initiative, Lagos, Nigeria,*Correspondence: Bolajoko O. Olusanya
| | - Melissa Gladstone
- Department of Women and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Scott M. Wright
- Division of General Internal Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Mijna Hadders-Algra
- Division of Developmental Neurology, Department of Paediatrics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Nem-Yun Boo
- Department of Population Medicine, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Selangor, Malaysia
| | - M. K. C. Nair
- Child Development Centre, Thiruvananthapuram Medical College, Thiruvananthapuram, Kerala, India
| | - Nihad Almasri
- Department of Physiotherapy, The University of Jordan, Amman, Jordan
| | - Vijaya Kancherla
- Department of Epidemiology Epidemiologist, Center for Spina Bifida Prevention Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | | | - Angelina Kakooza-Mwesige
- Department of Pediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Tracey Smythe
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Ricardo Halpern
- Child Development Outpatient Clinic, Hospital da Criança Santo Antônio, Santa Casa de Porto Alegre, Porto Alegre, RS, Brazil
| | - Olaf K. de Camargo
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Jalal Arabloo
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Aziz Eftekhari
- Department of Toxicology and Pharmacology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amira Shaheen
- Division of Public Health, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Sheffali Gulati
- Center of Excellence & Advanced Research on Childhood Neurodevelopmental Disorders, Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Andrew N. Williams
- Virtual Academic Unit, Children's Directorate, Northampton General Hospital, Northampton, United Kingdom
| | | | - Donald Wertlieb
- Eliot-Pearson Department of Child Development, Tufts University, Medford, MA, United States
| | - Charles R. J. Newton
- Kenya Medical Research Institute–Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, KiIifi, Kenya
| | - Adrian C. Davis
- Department of Population Health Sciences, London School of Economics, London, United Kingdom,Vision and Eye Research Institute, School of Medicine, Anglia Ruskin University, Cambridge, United Kingdom
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