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Neuropsychopharmacology : Official... Jan 2015Behavioral inhibition (BI) is an early-appearing temperament characterized by strong reactions to novelty. BI shows a good deal of stability over childhood and... (Review)
Review
Behavioral inhibition (BI) is an early-appearing temperament characterized by strong reactions to novelty. BI shows a good deal of stability over childhood and significantly increases the risk for later diagnosis of social anxiety disorder (SAD). Despite these general patterns, many children with high BI do not go on to develop clinical, or even subclinical, anxiety problems. Therefore, understanding the cognitive and neural bases of individual differences in developmental risk and resilience is of great importance. The present review is focused on the relation of BI to two types of information processing: automatic (novelty detection, attention biases to threat, and incentive processing) and controlled (attention shifting and inhibitory control). We propose three hypothetical models (Top-Down Model of Control; Risk Potentiation Model of Control; and Overgeneralized Control Model) linking these processes to variability in developmental outcomes for BI children. We argue that early BI is associated with an early bias to quickly and preferentially process information associated with motivationally salient cues. When this bias is strong and stable across development, the risk for SAD is increased. Later in development, children with a history of BI tend to display normative levels of performance on controlled attention tasks, but they demonstrate exaggerated neural responses in order to do so, which may further potentiate risk for anxiety-related problems. We conclude by discussing the reviewed studies with reference to the hypothetical models and make suggestions regarding future research and implications for treatment.
Topics: Anxiety; Child; Child Development; Developmental Disabilities; Humans; Inhibition, Psychological; Phobic Disorders
PubMed: 25065499
DOI: 10.1038/npp.2014.189 -
Seizure May 2015The objective of this paper is to provide a synopsis of benefits and potential harmful effects of exposure to antiepileptic drugs (AEDs) via breastmilk, and present... (Review)
Review
PURPOSE
The objective of this paper is to provide a synopsis of benefits and potential harmful effects of exposure to antiepileptic drugs (AEDs) via breastmilk, and present recommendations for breastfeeding in women with epilepsy.
METHODS
The article is based on a discretionary selection of English language articles retrieved by a literature search in the PubMed database, the LactMed database, and the authors' clinical experience.
RESULTS
Breastfeeding is associated with benefits for the infant, including nutrition, protection against infectious and immunological disease, and promotion of development and psychological attachment. Exposure to AEDs via breastmilk could potentially produce side effects or negatively affect development. Most studies on AED transfer through breastmilk report infant serum levels well below the limit of an expected pharmacological effect. Some drugs have the potential to reach significant serum levels in breastfed infants, such as barbiturates, benzodiazepines, lamotrigine, and ethosuximide. Thus, breastfed infants should be monitored for side effects. Still, adverse symptoms are rarely reported in breastfed infants of mothers taking AEDs, and prospective studies have failed to demonstrate any negative developmental effects in children that have been exposed to AEDs via breastmilk. The nursing infant's degree of drug exposure can be minimized by breastfeeding when drug concentrations in the milk are low, reducing maternal AED dosage to prepregnancy levels, and administering mixed nutrition.
CONCLUSION
Most AEDs are considered safe or moderately safe during breastfeeding. Mothers with epilepsy should be encouraged to breastfeed, provided careful monitoring of the infant.
Topics: Anticonvulsants; Breast Feeding; Developmental Disabilities; Epilepsy; Female; Humans; Pregnancy; Prospective Studies
PubMed: 25837494
DOI: 10.1016/j.seizure.2015.02.013 -
International Journal of Qualitative... Dec 2024For children with neurodevelopmental disabilities (CWNDs), early diagnosis that leads to early intervention with regular targeted therapies is critical. In Qatar,...
PURPOSE
For children with neurodevelopmental disabilities (CWNDs), early diagnosis that leads to early intervention with regular targeted therapies is critical. In Qatar, private therapy centres that address this demand often have highly exclusive prices restricting families from availing them. This paper examines the challenges faced by families with CWNDs, as well as various financial and systemic obstacles, from the vantage point of these centres, all of which culminate in an extraordinarily high disability price tag for disability families in Qatar.
METHODS
This study is based on qualitative, semi-structured, and in-depth interviews with private therapy centres and developmental paediatricians.
RESULTS
Therapy centre representatives expressed common struggles in lengthy and cumbersome administration and licencing procedures, difficulty in hiring and retaining high quality staff, and expenses that need to be paid to the state. From their experience, families largely struggle with delayed diagnoses that significantly slow down intervention plans and therapies as well as staggeringly high financial costs with a dearth of funding options.
CONCLUSIONS
We recommend sincere engagement, dialogue, and cooperation between multiple stakeholders; a supportive ecosystem to balance and distribute the demand that includes schools and parents; as well more efficient administrative procedures and recruitment strategies.
Topics: Humans; Child; Qatar; Developmental Disabilities; Disabled Children; Qualitative Research; Male; Female; Parents; Child, Preschool; Early Diagnosis; Neurodevelopmental Disorders
PubMed: 38657277
DOI: 10.1080/17482631.2024.2345816 -
BMC Pediatrics Mar 2022Early support for children with developmental disabilities is crucial but frequently unavailable in low-resource settings. We conducted a mixed-methods evaluation to...
BACKGROUND
Early support for children with developmental disabilities is crucial but frequently unavailable in low-resource settings. We conducted a mixed-methods evaluation to assess the feasibility, acceptability, and impact of a programme of early detection and intervention for young children with developmental disabilities in Western Uganda.
METHODS
Early child development training for healthcare workers (HCWs) was implemented in three rural districts, and attendance was tracked. HCW knowledge and confidence were assessed pre-/post-intervention, and referral numbers tracked to evaluate impact. Facilitators were trained and mentored to deliver a participatory, group, early intervention programme (EIP) for young children with developmental disabilities and their families. Facilitators were tracked as they were identified, trained, and delivered the intervention, and attendance of families was tracked. Pre-/post-intervention assessments evaluated changes in family quality of life (PedsQL 2.0, Family Impact Module), and child nutritional outcomes. Focus group discussions with stakeholders also assessed feasibility, acceptability and impact.
RESULTS
Overall, 93 HCWs from 45 healthcare facilities received training. In the pre-/post-evaluation, median knowledge and confidence scores increased significantly (from 4.0 to 7.0 and from 2.7 to 4.7, respectively (p < 0.001)). HCWs reported feeling empowered to refer and offer care for families with a young child with disability. Referral rates increased significantly from 148 to 251 per annum (70%; p = 0.03). Eleven EIP facilitators were trained, and all delivered the intervention; 84 families were enrolled, of which 78% attended at least 6 out of 10 modules. Amongst those with paired pre-/post-intervention data (n = 48), total family quality of life scores increased significantly (21%, p < 0.001). Improvements were seen across all domains of quality of life, with the largest impacts on emotional functioning and social functioning (p < 0.001). The programme was acceptable to caregivers and facilitators. Caregivers reported improved knowledge, family relationships, hope, emotional wellbeing, and reduced self-stigma.
CONCLUSIONS
A programme of early detection and intervention for children with early developmental disabilities and their families was feasible and acceptable in a rural community-based Ugandan setting. HCW training positively impacted knowledge, confidence, attitudes, and referral rates. Families enrolled to the EIP reported significant improvements in quality of life. Important programmatic barriers identified included geographical spread, poverty, gender inequality, and stigma.
Topics: Caregivers; Child; Child, Preschool; Developmental Disabilities; Family; Humans; Quality of Life; Uganda
PubMed: 35346133
DOI: 10.1186/s12887-022-03184-7 -
Journal of Public Health Management and... 2018Lead is a preventable environmental toxin that has been previously associated with deficits in cognition, academic performance, attention, and behavior in children. Very...
CONTEXT
Lead is a preventable environmental toxin that has been previously associated with deficits in cognition, academic performance, attention, and behavior in children. Very few studies, however, have examined the relationship between exposure to lead and documented developmental disabilities.
OBJECTIVE
This study examined the relative risk of lead exposure on developmental disabilities in preschool-aged children.
DESIGN
A statewide lead surveillance data set containing blood lead level (BLL) was integrated with another statewide data set containing developmental disability classifications for special education placement for preschool-aged children.
PARTICIPANTS
The participants were the 85 178 children (average age 2.6 years) whose records in both data sets were able to be linked. Forty-six percent of the participants had an identified developmental disability.
MAIN OUTCOME MEASURE
Developmental disability classification served as the main outcome measure.
RESULTS
A high BLL, defined as 5 μg/dL or more, was associated with significantly increased risk for developmental disabilities (risk ratio [RR] = 1.04; 95% CI = 1.01-1.08), particularly intellectual disability (RR = 1.58, 95% CI = 1.10-2.25) and developmental delay (DD; RR = 1.11, 95% CI = 1.06-1.17).
CONCLUSIONS
The results of this study are consistent with previous research identifying an association between lead exposure and numerous intellectual and educational outcomes and demonstrate that high BLL is associated with meeting eligibility criteria for developmental disabilities in young children. Continued research, surveillance, and prevention efforts are needed to further reduce the negative impacts of lead on individuals and society. Reducing or eliminating lead exposure would improve outcomes for individual children (eg, better academic performance) and reduce the burden to society (eg, lower enrollments in special education systems).
Topics: Child, Preschool; Developmental Disabilities; Environmental Exposure; Female; Humans; Lead; Male
PubMed: 28257404
DOI: 10.1097/PHH.0000000000000556 -
Handbook of Clinical Neurology 2018The cerebellar system is a series of axonal projections and synaptic circuits as networks, similar to those of the limbic system and those subserving the propagation and... (Review)
Review
The cerebellar system is a series of axonal projections and synaptic circuits as networks, similar to those of the limbic system and those subserving the propagation and spread of seizures. Three principal cerebellar networks are identified and cerebellar disease often affects components of the networks other than just the cerebellar cortex. Contemporary developmental neuropathology of the cerebellum is best considered in the context of alterations of developmental processes: embryonic segmentation and genetic gradients along the three axes of the neural tube, individual neuronal and glial cell differentiation, migration, synaptogenesis, and myelination. Precisely timed developmental processes may be delayed or precocious rhombencephalosynapsis and pontocerebellar hypoplasia exemplify opposite gradients in the horizontal axis. Chiari II malformation may be reconsidered as a disorder of segmentation rather than simply due to mechanical forces upon normally developing hindbrain structures. Cellular nodules in the roof of the fourth ventricle are heterotopia of histologically differentiated but architecturally disoriented and disorganized neurons and glial cells; they often are less mature immunocytochemically than similar cells in adjacent normal folia. Cell rests are nodules of undifferentiated neuroepithelial cells. Both are frequent in human fetuses and neonates. Axonal projections from heterotopia to adjacent cerebellar folia or nuclei are few or absent, hence these nodules are clinically silent despite neuronal differentiation.
Topics: Animals; Cerebellar Diseases; Developmental Disabilities; Humans; Nerve Net; Neural Pathways; Neurons
PubMed: 29903435
DOI: 10.1016/B978-0-444-63956-1.00007-2 -
Seminars in Pediatric Neurology Oct 2018Socioeconomic status (SES) is an important risk factor for many neurological disorders and a determinant of health outcomes and quality of life, especially for... (Review)
Review
Socioeconomic status (SES) is an important risk factor for many neurological disorders and a determinant of health outcomes and quality of life, especially for individuals with neurologic disorders and developmental disabilities. This article focuses on the relationship between SES and pediatric epilepsy, cerebral palsy, autism spectrum disorder, and intellectual disability. Disparities in the prevalence and long-term impact of SES on functioning in persons with disabilities are observed worldwide. Clinicians can use the information presented in the article to target early identification and interventions for improving outcomes in populations most at risk for these disorders and for poor health, social, and economic outcomes.
Topics: Developmental Disabilities; Humans; Nervous System Diseases; Pediatrics; Prevalence; Social Class
PubMed: 30293586
DOI: 10.1016/j.spen.2018.03.003 -
Community Mental Health Journal Aug 2023People with intellectual and developmental disabilities (IDD) have higher incidences of mental health conditions and behavioral support needs than people without IDD but...
People with intellectual and developmental disabilities (IDD) have higher incidences of mental health conditions and behavioral support needs than people without IDD but may not receive needed care from community providers. We examined rates of co-occurring conditions in a representative sample of adults with IDD who use state funded services in Virginia. Using data from two datasets, we identified four categories of mental health and behavioral conditions. We used these categories to examine differences in individual- and system-level factors in people with and without co-occurring conditions. We found high rates of co-occurring conditions in our sample. We found important disability factors and system-level characteristics that were associated with having a diagnosed mental health condition or behavioral support needs. Differing patterns of diagnosis and treatment for co-occurring conditions suggests more work needs to be done to support people with IDD and co-occurring mental health conditions living in the community.
Topics: Adult; Humans; Child; Developmental Disabilities; Intellectual Disability; Mental Health; Virginia
PubMed: 36739327
DOI: 10.1007/s10597-023-01091-4 -
Child Neuropsychology : a Journal on... 2015Pregnancy complications elevate risk of associated adverse medical, socioenvironmental, and behavioral outcomes in children. These are likely to have a substantial... (Review)
Review
Pregnancy complications elevate risk of associated adverse medical, socioenvironmental, and behavioral outcomes in children. These are likely to have a substantial impact on neuropsychological functioning and mental health across the child's lifespan. Thus, an understanding of the complex relationships between pregnancy complications and neuropsychological outcomes is critical for both practitioners and researchers. This review summarizes prevalent pregnancy complications and the associated psychological and neuropsychological findings, highlighting methodological challenges that have restricted investigations of these outcomes and identifying opportune areas for future study.
Topics: Adolescent; Child; Child Development; Developmental Disabilities; Female; Humans; Neuropsychology; Pregnancy; Pregnancy Complications; Prevalence; Social Environment
PubMed: 24801883
DOI: 10.1080/09297049.2014.910301 -
Research in Developmental Disabilities Oct 2018Preterm infants are at risk for neuro-developmental impairments and atypical developmental trajectories. The aims of this study were to delineate early developmental...
BACKGROUND AND OBJECTIVES
Preterm infants are at risk for neuro-developmental impairments and atypical developmental trajectories. The aims of this study were to delineate early developmental trajectories of preterm and full-term infants.
METHODS
The cognitive, language, and motor development of 149 infants - 19 extremely preterm (EPT), 34 very preterm (VPT), 57 moderately preterm (MPT), and 39 full-term (FT) - was evaluated using Mullen Scales at 1, 4, 8, 12, and 18 months. Mixed models were applied to examine group differences. Gender, maternal education, and neurobehavior were included as predictors of developmental trajectories.
RESULTS
The EPT and VPT infants achieved significantly lower scores than the FT infants in all domains, with a significantly increasing gap over time. The MPT infants' trajectories were more favorable than those of the EPT and VPT infants yet lower than the FT infants on the Visual Reception, Gross, and Fine Motor subscales. Male gender and lower maternal education were associated with lower scores that declined over time. Abnormal neonatal neurobehavior was associated lower Mullen scores and with less stability in scores over time.
CONCLUSIONS
The EPT and VPT infants were found to have disadvantages across all domains. The MPT infants revealed more favorable developmental trajectories yet displayed vulnerability compared to the FT infants. Gender, maternal education, and neonatal neurobehavior are important in predicting the developmental outcomes of preterm infants.
Topics: Child Development; Cognition; Correlation of Data; Developmental Disabilities; Educational Status; Female; Humans; Infant; Infant, Extremely Premature; Infant, Newborn; Infant, Premature; Language Development; Male; Mental Status and Dementia Tests; Motor Skills; Risk Factors; Sex Factors
PubMed: 29113755
DOI: 10.1016/j.ridd.2017.10.018