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JAMA Jan 2024
Topics: Child, Preschool; Humans; Child Development; Developmental Disabilities
PubMed: 38165411
DOI: 10.1001/jama.2023.23652 -
Reproductive Toxicology (Elmsford, N.Y.) Apr 2023Analyses were conducted of the occurrence of eight general categories of birth defects and developmental disabilities for children fathered by participants of the Air...
Analyses were conducted of the occurrence of eight general categories of birth defects and developmental disabilities for children fathered by participants of the Air Force Heath Study (AFHS). Participants were male Air Force veterans of the Vietnam War. Children were categorized into conceived before and after the start of the participant's Vietnam War service. Analyses accounted for correlation between outcomes for multiple children fathered by each of the participants. For each of the eight general categories of birth defects and developmental disabilities, the probability of its occurrence increased substantially for children conceived after compared to before the start of Vietnam War service. These results support the conclusion of an adverse effect on reproductive outcomes due to Vietnam War service. Data for children conceived after the start of Vietnam War service for participants with measured dioxin values were used to estimate dose-response curves for the effect of dioxin exposure on the occurrence of each of the eight general categories of birth defects and developmental disabilities. These curves were assumed to be constant up to a threshold and then monotonic after that threshold. For seven of the eight general categories of birth defects and developmental disabilities, the estimated dose-response curves increased nonlinearly after associated thresholds. These results support the conclusion that the adverse effect to conception after the start of Vietnam War service may be attributable to high enough exposures to dioxin, a toxic contaminant of Agent Orange used for herbicide spraying in the Vietnam War.
Topics: Humans; Male; Child; Female; Dioxins; 2,4-Dichlorophenoxyacetic Acid; Developmental Disabilities; 2,4,5-Trichlorophenoxyacetic Acid; Agent Orange; Polychlorinated Dibenzodioxins; Environmental Exposure
PubMed: 36813141
DOI: 10.1016/j.reprotox.2023.108355 -
World Journal of Pediatrics : WJP Aug 2023Neurodevelopmental disorders are a heterogeneous group of conditions that manifest as delays or deviations in the acquisition of expected developmental milestones and... (Review)
Review
BACKGROUND
Neurodevelopmental disorders are a heterogeneous group of conditions that manifest as delays or deviations in the acquisition of expected developmental milestones and behavioral changes. Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in communication and social interaction and by repetitive and restricted patterns of behavior, interests and activities. The aim of this review is to discuss the clinical features of the differential diagnoses of ASD that are prevalent among preschoolers, focusing on their similarities and disparities.
DATA SOURCES
The international medical literature search was conducted using PubMed and was revised regarding the subject using single and/or combined keywords as follows: differential diagnosis, preschoolers, diagnostic challenge, attention deficit hyperactivity disorder, intellectual disability, high abilities/giftedness, childhood apraxia of speech, social communication disorder, Landau-Kleffner syndrome, stereotyped movement disorder and excessive screen time.
RESULTS
We describe conditions commonly found in clinical practice, taking ASD as a reference. We addressed converging and divergent aspects of behavior, cognition, communication, language, speech, socialization, and stereotypes for the diagnosis of ASD and other disorders identified as potential differential or comorbid diagnoses.
CONCLUSIONS
The ranking and characterization of symptoms appear to be essential for better understanding the underlying common ground between children with developmental disorders and children with ASD, thus properly diagnosing and directing social, professional, or medication interventions. This detailed discussion adds to the literature since, although ASD differential diagnoses are frequently mentioned and discussed in textbooks and journal articles, they rarely occupy a prominent place as we aimed herein.
Topics: Child; Child, Preschool; Humans; Autism Spectrum Disorder; Diagnosis, Differential; Developmental Disabilities; Comorbidity; Cognition
PubMed: 36282408
DOI: 10.1007/s12519-022-00629-y -
Neurochemistry International Dec 2019Air pollution is an important contributor to the global burden of disease, particularly to respiratory and cardiovascular diseases. In recent years, evidence is... (Review)
Review
Air pollution is an important contributor to the global burden of disease, particularly to respiratory and cardiovascular diseases. In recent years, evidence is accumulating that air pollution may adversely affect the nervous system as shown by human epidemiological studies and by animal models. Age appears to play a relevant role in air pollution-induced neurotoxicity, with growing evidence suggesting that air pollution may contribute to neurodevelopmental and neurodegenerative diseases. Traffic-related air pollution (e.g. diesel exhaust) is an important contributor to urban air pollution, and fine and ultrafine particulate matter (PM) may possibly be its more relevant component. Air pollution is associated with increased oxidative stress and inflammation both in the periphery and in the nervous system, and fine and ultrafine PM can directly access the central nervous system. This short review focuses on the adverse effects of air pollution on the developing brain; it discusses some characteristics that make the developing brain more susceptible to toxic effects, and summarizes the animal and human evidence suggesting that exposure to elevated air pollution is associated with a number of behavioral and biochemical adverse effects. It also discusses more in detail the emerging evidence of an association between perinatal exposure to air pollution and increased risk of autism spectrum disorder. Some of the common mechanisms that may underlie the neurotoxicity and developmental neurotoxicity of air pollution are also discussed. Considering the evidence presented in this review, any policy and legislative effort aimed at reducing air pollution would be protective of children's well-being.
Topics: Air Pollutants; Air Pollution; Animals; Autism Spectrum Disorder; Brain; Child; Developmental Disabilities; Female; Humans; Male; Neurotoxicity Syndromes; Pregnancy
PubMed: 31626830
DOI: 10.1016/j.neuint.2019.104580 -
FP Essentials Nov 2021Between 5% and 12% of children ages 2 to 5 years are diagnosed with a speech or language delay. Fifty percent of these children experience delays that persist into...
Between 5% and 12% of children ages 2 to 5 years are diagnosed with a speech or language delay. Fifty percent of these children experience delays that persist into adolescence, and face educational and occupational challenges later in life. The causes of speech and language delay vary. Some children are born with physical or physiologic conditions that impede speech and language development, whereas others have cognitive or developmental conditions, such as autism spectrum disorder. Risk factors include male sex, prematurity, low birth weight, late birth order, larger family size, and maternal intimate partner (ie, domestic) violence. Although there is no required screening or universally recommended screening tool for speech or language delay, reliable milestone indicators and parent and physician questionnaires can help identify children in need of diagnostic evaluation. If further screening is warranted or if parental concern exists beyond the well-child visit, local resources are available for evaluation and intervention. These include agencies and school districts, as well as speech and language pathology subspecialists.
Topics: Adolescent; Autism Spectrum Disorder; Child; Child, Preschool; Developmental Disabilities; Humans; Language Development Disorders; Male; Schools; Speech
PubMed: 34709025
DOI: No ID Found -
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 -
Clinical Psychology Review Jun 2022Self-injurious behavior (SIB) by individuals with intellectual and developmental disabilities including autism (I/DD) is among the most clinically disturbing, socially... (Review)
Review
Self-injurious behavior (SIB) by individuals with intellectual and developmental disabilities including autism (I/DD) is among the most clinically disturbing, socially costly, and scientifically challenging behavior disorders. Forty years of clinical research has produced a knowledge base supporting idiographic behavioral assessment and treatment approaches. Despite the treatment progress, from a public health and population perspective, we argue it is less clear that we have reduced the disorder's burden. The developmental course of the disorder is mostly unknown and empirically informed population-level models of risk are absent. In this review, we systematically examined the published scientific literature specific to risk for SIB in the I/DD population. We reviewed study methodology in detail intentionally informed by an epidemiological perspective with a set of questions intended to test the quality of the inferences about risk. Results are discussed in terms of conceptual, methodological, and translational issues with respect to what needs to be done to create credible and useful clinical models for SIB risk in the I/DD population.
Topics: Child; Developmental Disabilities; Humans; Self-Injurious Behavior
PubMed: 35580423
DOI: 10.1016/j.cpr.2022.102158 -
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 Child Health Care : For... Jun 2022Narrative therapy is a respectful and culturally relevant form of psychotherapy. Internationally, there is an increasing use of narrative therapy with diverse...
Narrative therapy is a respectful and culturally relevant form of psychotherapy. Internationally, there is an increasing use of narrative therapy with diverse populations; however, there is limited documentation within the Indian context. The intention of the study was to understand experiences of children and their families during their participation in narrative therapy at Ummeed Child Development Center in Mumbai, India. Twelve participants were recruited for individual interviews: four children, who received counseling at Ummeed Child Development Center for a minimum of 6 months, and eight family members. Thematic analysis of data revealed three themes: Working In Partnership reflected the value of therapy being a collaborative process; Practices That Open Up Possibilities highlighted skills of children and their families that became visible through counseling; and Taking Control And Advocacy revealed how families experienced a sense of control over their own lives and an interest in advocating for others with similar lived experiences. The study has brought to light how narrative therapy can make possible change in lives of children and their families and wider society. In an international context, these findings serve to document narrative therapy as a beneficial modality for mental health practitioners to use with children experiencing developmental disabilities and their families.
Topics: Child; Developmental Disabilities; Family; Humans; India; Narrative Therapy; Qualitative Research
PubMed: 33913357
DOI: 10.1177/13674935211014739 -
The Canadian Journal of Neurological... May 2021In Ontario, there are approximately 66,000 adults living with a diagnosis of intellectual and developmental disabilities (IDD). These individuals are nearly twice as...
BACKGROUND
In Ontario, there are approximately 66,000 adults living with a diagnosis of intellectual and developmental disabilities (IDD). These individuals are nearly twice as likely to experience an injury compared to the general population. Falls are an important contributor to injuries in persons with IDD and in the general population, and are consistently found to be the leading cause of traumatic brain injury (TBI). There is currently no literature that quantitatively examines TBI among persons with IDD. The purpose of this study was to compare the risk of TBI for adults with and without IDD in Ontario over time and by demographic information.
METHODS
Using administrative health databases, two main cohorts were identified: (1) adults with IDD, and (2) a random 10% sample of adults without IDD. Within each cohort, annual crude and adjusted incidence of TBI were calculated among unique individuals for each fiscal year from April 1, 2002 to March 31, 2017.
RESULTS
Over the 15-year study period, the average annual adjusted incidence of TBI was approximately 2.8 new cases per 1000 among Ontario adults with IDD, compared to approximately 1.53 per 1000 among those without IDD. In both cohorts, a higher proportion of TBI cases were younger (19-29 years) and male.
CONCLUSIONS
During the study period, persons with IDD experienced a significantly higher risk of TBI compared to the general population indicating the possibility, and need, for targeted TBI prevention.
Topics: Adult; Brain Injuries, Traumatic; Cohort Studies; Developmental Disabilities; Female; Humans; Incidence; Intellectual Disability; Male
PubMed: 32814611
DOI: 10.1017/cjn.2020.181