Intellectual outcome in children with fetal hypothyroidism

Eighty children with congenital hypothyroidism detected by newborn screening were grouped for presence of fetal hypothyroidism using skeletal maturity at the time of diagnosis as the index. Forty-five children with bone age less than 36 weeks were assigned to the delayed group; 35 with bone age 37 weeks to term were assigned to the nondelayed group. Although most children with athyrosis were found in the delayed group, the groups did not differ in birth weight, hormone levels, or family background. Assessments of intellectual and behavioral characteristics at 1, 2, 3, 4, and 5 years of age revealed that, although children in the delayed group performed within the normal range, their scores were significantly lower than those of the nondelayed group from age 2 years on. Perceptual-motor, visuospatial, and language areas were most affected. There were no differences in behavior or temperamental characteristics.     

Concerning specific language impairment: intelligibility in expressive language

BACKGROUND: Even in the age of two years toddlers with Expressive Language Impairment (SLI-E) differ regarding their phonetic inventories compared with an age-matched group developing normally. METHOD AND PATIENTS: PCC-R scores of 19 children with expressive language disorder, aged between four and six years, are compared with age and sex matched controls with normal language acquisition. RESULTS: There are significant differences between PCC-R scores, children with expressive language disorder show lower scores than children with normal language acquisition. Age, sex and nonverbal intelligence do not influence performance measured with PCC-R. Analysis regarding early, middle and late consonants shows, that expressive language disordered children show bigger problems in aquiring late than early and middle consonants.     

Assessing Child Symptom Severity and Stress in Parents of Autistic Children

Parents of 44 autistic children rated their children's symptom severity and their own stress on a 14-item symptom scale. Thirteen child and family characteristics were also examined to assess how they affected symptom perception and stress. Preschoolers were rated less symptomatic by their parents than by clinicians. Lower functioning, nonverbal, odd-looking, self-abusive, seizuring and hyperirritable children were rated more symptomatic than their peers. Best predictor of stress for both parents was a child's self-abuse; for mothers hyperirritability and older age were also associated with elevated stress scores. Compared with parents of matched normal children, mothers of autistic children reported the most aggravations and expressed the need for additional support from their spouses.     

Language development in children with congenital heart disease aged 12–24 months

This longitudinal study aims to describe the trajectory of language development in children with CHD aged 12–24 months assessed through an early monitoring and individualized intervention program. We also sought to determine whether early language performances, at 12 months of age, predict 24-month language abilities.We conducted developmental assessments of 49 children with CHD using the Bayley Scales of Infant and Toddler Developmental, third edition (Bayley-III) at 12 and 24 months, and the MacArthur-Bates Communicative Development Inventories (MBCDI) at 12, 18 and 24 months.Compared to normative populations, CHD patients showed significantly lower mean scores in both receptive and expressive language scales of the Bayley-III and the MBCDI at 12 months, whereas at 18 and 24 months only expressive language scores were reduced. No differences were found in the cognitive scale. Communicative gestures at 12 months were significantly predictive of language skills at 24 months of age.Our findings indicate specific vulnerability of language outcome, especially in expressive skills, rather than a global cognitive impairment in our patients with CHD. We recommend using communicative gestures as an early marker of language development to improve our ability to detect language delays in this population.     

Preschool language outcomes of children with history of bronchopulmonary dysplasia and very low birth weight

A prospective follow-up of very low birth weight (VLBW) infants with and without bronchopulmonary dysplasia (BPD) and term control infants was conducted. The effects of BPD and VLBW on speech-language development and specific language impairment at 3 years of age were investigated, controlling for the effects of sociodemographic and other medical risk factors. Groups were compared on cognitive and speech-language outcomes using the Battelle Language and Bayley Mental Scales of Infant Development. Children with a history of BPD had lower receptive language skills than VLBW children without BPD, who in turn had lower receptive skills than term children. Children with a history of BPD also had lower expressive skills than the two comparison groups, whereas VLBW children without BPD did not differ in expressive language from term children. When IQ score was controlled, children with BPD demonstrated specific language impairment in receptive language. The presence of patent ductus arteriosis (PDA) was the best predictor of language deficits and the combined occurrence of PDA and BPD resulted in differentially lower language scores. Neurologic complications, low socioeconomic status, and minority race were also significant predictors of language delay. The findings emphasize the importance of considering both medical and sociodemographic factors in evaluating the risk of VLBW infants for poorer speech-language outcomes.     

Temperamental traits associated with conversion disorder

The aim of this study was to analyze the temperamental traits associated with conversion disorder in children. Thirty children with conversion disorder attending a child guidance clinic were compared with an age and sex matched control group of normal children for life stresses and temperament dimensions. The temperament measurement schedule (TMS) and the life event scale for Indian children (LESIC) were used for evaluating the temperament dimensions and life stresses respectively. Children with conversion disorder experienced significantly more stressful life events compared to the children in the control group. The stress factors included scholastic difficulties, examination failures, punishment by teacher, conflict with peers, parental disharmony and family problems and sibling rivalry. The characteristic temperamental traits associated with conversion disorder were low emotionality and low threshold of responsiveness.     

哮喘儿童气质及哮喘危险因素的研究

目的：哮喘被认为是一种典型的心身疾病。为了探讨儿童的哮喘与气质和其他危险因素之间的关系,更好地开展对哮喘高危儿童的疾病监测和干预,该文对哮喘儿童气质及危险因素进行了研究。方法：采用Carry气质量表,通过病例对照研究方法, 调查了南京地区106例哮喘儿童和106例正常儿童的气质类型、维度和哮喘危险因素。结果：哮喘组与对照组相比,气质适应性、心境、持久性分值较高;哮喘儿童中气质类型,平易型少,中间偏烦型多,差别均有统计意义。同时多因素分析,3～7岁期间每年患感冒次数、过敏史、特应性体质、父母哮喘史、家庭装修及气质心境、持久性与儿童哮喘有关。结论：应该把中间偏烦型气质的儿童作为重点对象,并结合其他危险因素对哮喘儿童进行早期干预和管理。［中国当代儿科杂志,2007,9（5）：411-414］     

Hypochloremic metabolic alkalosis from ingestion of a chloride-deficient infant formula: outcome 9 and 10 years later

In 1978 and 1979 two infant formulas, Neo-Mull-Soy and Cho-Free, were found to be deficient in chloride. The Centers for Disease Control received reports that hypochloremic metabolic alkalosis (HMA) had developed in 141 children as a result of exposure to these formulas. Thirty-five of these children were examined at 9 and 10 years of age and compared with a group of 32 children who were exposed to the chloride-deficient formulas but were not reported to experience HMA and a group of 61 children who received chloride-sufficient soy formulas in infancy. The control children were matched to the HMA children on sex, race, age, and maternal education. Growth characteristics, performance on the Wechsler Intelligence Scale for Children-Revised (WISC-R), the Boston Naming Test, the Rey-Osterrieth Test, the Clinical Evaluation of Language Fundamentals-Revised (CELF-R), and subtests from several other speech and language tests were compared across the groups. After adjustment for family income and the level of the father's education, significantly lower scores were observed in the HMA children on the WISC-R Arithmetic subtest (mean = 10.5) compared with the soy control children (mean = 12.0, P less than .05) and on the WISC-R Coding subtest (mean = 9.0) compared with the soy control children (mean = 10.8, P less than .01). All the WISC-R subtest scores were, however, within the normal range. Although no significant differences occurred on the CELF-R between groups, the risk of an HMA child falling below the range expected for a standard population was increased on the CELF-R Composite Total, Receptive, and Expressive Language scores: risk ratios = 2.14, 2.14, and 3.03 respectively. Significant differences were observed between the children exposed, both HMA and non-HMA children, and the soy control children for behavioral problems as determined by the Achenbach Childhood Behavioral Checklist. It is concluded that as a group, children with documented HMA appear to have recovered from their growth failure and have normal cognitive development. They may, however, be at risk for deficits in language skills that require expressive language abilities.     

The effect of very low birth weight and social risk on neurocognitive abilities at school age.

We tested the hypothesis that very low birth weight (VLBW < 1.5 kg) children would have significantly poorer neurocognitive abilities at school age than would normal birth weight full-term age mates, that differences would persist after control for neurologic impairment and social risk, and that VLBW would interact with social risk. Two hundred forty-nine VLBW children and a randomly selected sample of 363 normal birth weight age mates born 1977 through 1979 were tested at 8 years. A neurologic examination and tests of intelligence, language, speech, reading, mathematics, spelling, visual and fine motor abilities, and behavior were performed. Twenty-four (10%) VLBW had a major neurologic abnormality compared with none of the controls. VLBW had significantly poorer scores on all tests, with the exception of speech and the total behavior score. These differences persisted among VLBW children without major neurologic abnormality, with the exception of social competence, reading, and spelling. Even normal IQ, neurologically normal VLBW had significantly poorer scores than did controls in expressive language, memory, visuomotor, and fine motor function, and measures of hyperactivity. When social risk was controlled in multiple regression analyses, VLBW still had an adverse effect on all outcome measures with the exception of speech. Social risk was, however, the major determinant of outcome. We found an interaction between VLBW and social risk only in verbal IQ and in the opposite direction than hypothesized.     

Arithmetic skills in kindergarten children with developmental language disorders.

Although arithmetic is not a language-based skill, a specific learning disability in arithmetic--dyscalculia--is commonly seen in children with developmental language disorders (DLD). The object of this study was to assess whether kindergarten children with DLD have impaired arithmetic skills and, if so, to correlate the pattern of dysfunction with language syndromes. Forty-two children with DLD attending mainstream kindergartens, and their matched controls, underwent an arithmetic battery, neurological examination, intelligence quotient (IQ) test (WPPSI/WISC-R) and language assessment (CELF-R).* Attention deficit hyperactivity disorder (ADHD) was diagnosed by psychological assessment and behaviour questionnaires. Results showed that children with DLD were similar to controls on performance IQ (104.2+/-12.1 and 109.4+/-12.7 respectively, p = NS), but inferior on both the CELF-R expressive (74.8+/-9.3 vs 95.2+/-15.1, p < 0.01) and receptive (77.5+/-10.0 vs 87.8+/-12.3, p < 0.01) language scores. Their performance on the arithmetic battery was also significantly poorer: 61.2+/-17.7 vs 77.4+/-13.7, p < 0.01. Low scores in reasoning principles and arithmetic operations were associated with both receptive and expressive language impairment, while poor performance on counting principles was primarily associated with expressive deficits. Mild motor signs and ADHD were more frequent in children with DLD (p < 0.01 and < 0.05, respectively). We concluded that the arithmetic impairment in children with DLD is pervasive, affecting a broad spectrum of skills. Whereas impairment of most arithmetic skills is associated with global language disturbances, counting correlates primarily with expressive language deficits. Anticipatory guidance by physicians will better prepare parents and educators for the multiple challenges facing children with DLD.     

Prenatal isolated mild ventriculomegaly is associated with persistent ventricle enlargement at ages 1 and 2

Background

Enlargement of the lateral ventricles is thought to originate from abnormal prenatal brain development and is associated with neurodevelopmental disorders. Fetal isolated mild ventriculomegaly (MVM) is associated with the enlargement of lateral ventricle volumes in the neonatal period and developmental delays in early childhood. However, little is known about postnatal brain development in these children.

Methods

Twenty-eight children with fetal isolated MVM and 56 matched controls were followed at ages 1 and 2 years with structural imaging on a 3T Siemens scanner and assessment of cognitive development with the Mullen Scales of Early Learning. Lateral ventricle, total gray and white matter volumes, and Mullen cognitive composite scores and subscale scores were compared between groups.

Results

Compared to controls, children with prenatal isolated MVM had significantly larger lateral ventricle volumes at ages 1 and 2 years. Lateral ventricle volume at 1 and 2 years of age was significantly correlated with prenatal ventricle size. Enlargement of the lateral ventricles was associated with increased intracranial volumes and increased gray and white matter volumes. Children with MVM had Mullen composite scores similar to controls, although there was evidence of delay in fine motor and expressive language skills.

Conclusions

Children with prenatal MVM have persistent enlargement of the lateral ventricles through the age of 2 years; this enlargement is associated with increased gray and white matter volumes and some evidence of delay in fine motor and expressive language development. Further study is needed to determine if enlarged lateral ventricles are associated with increased risk for neurodevelopmental disorders.     

22q11.2DS deletion syndrome: developmental milestones in infants and toddlers

BACKGROUND: The majority of children with 22q11.2DS deletion syndrome (22q11.2DS) have learning disabilities, and a substantial number have mental retardation. Although cognitive data have been reported on several samples of children with 22q11.2DS, data on their early developmental milestones are limited. METHODS: The present study used a retrospective design and asked parents to recall developmental milestones. The participants were 88 children with 22q11.2DS, 47 community controls, and 29 sibling controls. RESULTS: Although very early gross motor and expressive language milestones did not differ significantly from comparison groups, subsequent gross motor and expressive language milestones did, suggesting that children with 22q11.2DS may begin to lag behind their peers sometime after the first year of life in these two domains. These patterns were also apparent when a subset of intellectually comparable children (22q11.2DS, n = 40 vs community controls, n = 24) was analyzed. We further found that receptive language and social adaptive milestones did not differ from comparison samples in either the early or later period. Receptive language delays were predictive of later Wechsler Intelligence Scale for Children-Third Edition Perceptual Organization Index scores, particularly in girls with 22q11.2DS. CONCLUSIONS: This suggests that although receptive language may be an area of relative strength in the developmental profile of young children with 22q11.2DS, even mild receptive delays should not be overlooked in early interventions with children with this disorder.     

A Prospective Study of the Relationship between Specific Language Impairment, Phonological Disorders and Reading Retardation

Language and literacy skills were assessed in 83 8 1/2-year olds whose language development had been impaired at 4 years of age. Provided that language problems had resolved by age 5 1/2 years, literacy development was normal, but many of the children who still had verbal deficits at 5 1/2 years of age did have reading difficulties and persisting oral language impairments later on. In these children, reading comprehension tended to be poor relative to reading accuracy. Syntactic competence in the preschool period accounted for a substantial proportion of the variance in literacy attainments, after allowing for the effects of non-verbal ability. There were only weak links between expressive phonological disorders and later ability to read either meaningful text or non-words.     

Early vocabulary development in deaf native signers: a British Sign Language adaptation of the communicative development inventories

Background: There is a dearth of assessments of sign language development in young deaf children. This study gathered age‐related scores from a sample of deaf native signing children using an adapted version of the MacArthur‐Bates CDI ( Fenson et al., 1994 ). Method: Parental reports on children’s receptive and expressive signing were collected longitudinally on 29 deaf native British Sign Language (BSL) users, aged 8–36 months, yielding 146 datasets. Results: A smooth upward growth curve was obtained for early vocabulary development and percentile scores were derived. In the main, receptive scores were in advance of expressive scores. No gender bias was observed. Correlational analysis identified factors associated with vocabulary development, including parental education and mothers’ training in BSL. Individual children’s profiles showed a range of development and some evidence of a growth spurt. Clinical and research issues relating to the measure are discussed. Conclusions: The study has developed a valid, reliable measure of vocabulary development in BSL. Further research is needed to investigate the relationship between vocabulary acquisition in native and non‐native signers.     

Language and social cognition in children with specific language impairment

This study explored the links between the development of language and the development of social cognition. Measures of language, phonological short-term memory, social cognition, and social competence of two groups of children with specific language impairment (SLI), one group attending a special school, the other attending integrated educational placements, were compared with those of chronological and language age-matched normally developing peers (N = 8 in each group). Significant differences between the scores of normally developing children and the scores of the group of children with SLI who attended the special school were found for social cognition and ratings of social competence. Children with SLI from integrated placements did not differ significantly from other groups on these measures. Assessments of language development and phonological short-term memory were not related to social cognition and social competence. Models of the possible relationship between social cognition and language development in children with SLI are discussed.     

Effects of placement type on the language developmental trajectories of maltreated children from infancy to early childhood

This study describes the developmental trajectories of language skills in infants with substantiated maltreatment histories over a 5-year period and evaluates the effect of three different custodial placements on their language trajectories over time: in-home (remaining in the care of the biological parent/parents), nonkin foster care, and nonparental kinship care. Participants included 963 infants reported to child protective services prior to their first birthday and whose maltreatment was substantiated. Results from covariate-controlled growth modeling revealed no significant placement effects. Across all groups, children's auditory and expressive communication scores decreased significantly from Wave 1 (intake) in the infants' first year to Wave 4, when children were about 3.5 years of age, then improved to baseline levels by Wave 5, when children were about 6 years old. Despite these fluctuations, children's average language scores in each placement group remained below the population mean at each wave of the study.     

Parents' ratings of everyday cognitive abilities in very low birth weight children

Parents' ratings of everyday cognitive functioning in very low birth weight (VLBW) children free of sensorineural impairments and normal birth weight (NBW) children were compared with the children's actual performance on psychometric measures of cognitive and motor skills. Subjects included 19 VLBW children identified at age 3 years as "suspect" for developmental problems, 19 VLBW children identified at age 3 years as "developing normally," and 30 NBW full-term peers. Results indicated that parents of the suspect VLBW group rated their children as having significant impairments in memory, language, cognitive, and motor skills, findings which were consistent with the results of concurrent psychometric assessments. When compared with psychometric test results, parents identified more children as displaying difficulties in memory, language, and cognitive skills, but fewer children with coordination difficulties. These findings suggest that the parents' ratings and the psychometric measures may be assessing somewhat different aspects of the children's functioning.     

Early childhood development and stunting: Findings from the MAL‐ED birth cohort study in Bangladesh

Information on the association between stunting and child development is limited from low‐income settings including Bangladesh where 36% of children under‐ 5 are stunted. This study aimed to explore differences in early childhood development (ECD) between stunted (length‐for‐age z‐score [LAZ] < ?2) and nonstunted (LAZ ≥ ?2) children in Bangladesh. Children (n = 265) aged 6–24 months who participated in the MAL‐ED birth cohort study were evaluated by trained psychologists at 6, 15, and 24 months of age using the Bayley Scales of Infant and Toddler Development‐III; child length and weight were measured using standard procedures. ECD scores (z‐scores derived from cognitive, motor, language and socio‐emotional skills) were compared between stunted, underweight (weight‐for‐age z‐score < ?2), and wasted (weight‐for‐length z‐score < ?2) children, controlling for child age and sex and maternal age, education, body mass index (BMI), and depressive symptoms. Stunted children had significantly lower ECD scores than their nonstunted peers on cognitive (P = .049), motor (P < .001), language (P < .001) and social–emotional (P = .038) scales where boys had significantly lower fine motor skills compared with girls (P = .027). Mother's schooling and BMI were significant predictors of ECD. Similar to stunting, underweight children had developmental deficits in all domains (cognitive: P = .001; fine motor: P = .039, and P < .001 for both gross motor and total motor; expressive communication: P = .032; total language: P = .013; social–emotional development: P = .017). Wasted children had poor motor skills (P = .006 for the fine motor; P < .001 for both gross motor and total motor development) compared with the nonwasted peers. Early childhood stunting and underweight were associated with poor developmental outcomes in Bangladesh.     

Sensitivity of the Denver Developmental Screening Test in speech and language screening

A retrospective study was undertaken to determine whether the Denver Developmental Screening Test (DDST) language sector is a sensitive screen of speech and language development. Seventy-one children between 18 and 66 months of age with suspected developmental problems were referred to screening clinics conducted by a child evaluation team. Each child was screened using the DDST (revised) and another screening measure of speech and language development. Statistically significant differences were found between the DDST language sector and the speech-language screening in identification of expressive language and articulation problems. No significant difference was found with receptive language. The DDST failed to identify more than one half of the children with expressive language and/or articulation problems. These results demonstrate that the DDST may fail to identify children with speech and language impairment. Professionals involved in developmental screening need to be advised of alternative speech and language screening measures.     

Theory-of-mind development in oral deaf children with cochlear implants or conventional hearing aids

BACKGROUND: In the context of the established finding that theory-of-mind (ToM) growth is seriously delayed in late-signing deaf children, and some evidence of equivalent delays in those learning speech with conventional hearing aids, this study's novel contribution was to explore ToM development in deaf children with cochlear implants. Implants can substantially boost auditory acuity and rates of language growth. Despite the implant, there are often problems socialising with hearing peers and some language difficulties, lending special theoretical interest to the present comparative design. METHODS: A total of 52 children aged 4 to 12 years took a battery of false belief tests of ToM. There were 26 oral deaf children, half with implants and half with hearing aids, evenly divided between oral-only versus sign-plus-oral schools. Comparison groups of age-matched high-functioning children with autism and younger hearing children were also included. RESULTS: No significant ToM differences emerged between deaf children with implants and those with hearing aids, nor between those in oral-only versus sign-plus-oral schools. Nor did the deaf children perform any better on the ToM tasks than their age peers with autism. Hearing preschoolers scored significantly higher than all other groups. For the deaf and the autistic children, as well as the preschoolers, rate of language development and verbal maturity significantly predicted variability in ToM, over and above chronological age. CONCLUSIONS: The finding that deaf children with cochlear implants are as delayed in ToM development as children with autism and their deaf peers with hearing aids or late sign language highlights the likely significance of peer interaction and early fluent communication with peers and family, whether in sign or in speech, in order to optimally facilitate the growth of social cognition and language.