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Research in Developmental Disabilities Jan 2021Children with developmental disabilities experience disparately high rates of obesity yet there are few reports detailing clinical outcomes for this population.
BACKGROUND
Children with developmental disabilities experience disparately high rates of obesity yet there are few reports detailing clinical outcomes for this population.
AIM
To describe outcomes of obesity treatment for children with developmental disabilities and a comparison group of children without developmental disabilities.
METHODS AND PROCEDURES
We examined weight outcomes of children with and without developmental disabilities seen in a family-centered, multidisciplinary treatment center over a ten-year period. We stratified by age and developmental disability diagnosis. We assessed whether intake demographic or health behavior data was associated with successful reduction of adiposity over six and twelve month follow-up periods, using a ≥5% absolute reduction in percent over the 95th percentile body mass index (BMIp95) as the primary outcome.
OUTCOMES AND RESULTS
Over a ten-year period, 148 of 556 children in the obesity clinic (27 %) had a developmental disability. In children <12 years of age, 36 % of children with developmental disabilities reduced their adiposity compared with 18 % of children without developmental disabilities at six months, p = .01. This pattern continued at twelve months. Active transport to school was associated with reduced adiposity for those without a disability. Older children with disabilities rarely had a significant reduction (2 of 26 children), and they took more medications with weight-related side effects.
CONCLUSIONS AND IMPLICATIONS
Younger children with developmental disabilities experienced relative success in reducing their adiposity. Challenges to addressing obesity in this population include structural barriers to physical activity and medications for behavioral management with weight-related side effects.
Topics: Adiposity; Adolescent; Adult; Body Mass Index; Child; Developmental Disabilities; Exercise; Humans; Obesity
PubMed: 33220529
DOI: 10.1016/j.ridd.2020.103809 -
Developmental Medicine and Child... Feb 2022To summarize developmental delay among infants and toddlers with sickle cell disease (SCD).
AIM
To summarize developmental delay among infants and toddlers with sickle cell disease (SCD).
METHOD
This systematic review included studies that reported developmental outcomes of children with SCD between 0 months and 48 months of age and followed standards set forth by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
RESULTS
Ten studies were included, describing 596 unique developmental assessments. The rate of developmental delay ranged from 17.5% to 50% and increased with age. Cognition was the only domain included in all studies and the most frequently identified delay. One study reported that more severe SCD genotypes predicted worse development, while five studies reported no difference in rates of developmental delay across genotypes.
INTERPRETATION
These findings emphasize the need for standardized screening to identify children with SCD at risk of delay at a young age to facilitate appropriate referrals for therapeutic intervention. Frequent and comprehensive developmental screening is necessary among all SCD genotypes.
Topics: Anemia, Sickle Cell; Child, Preschool; Developmental Disabilities; Humans; Infant; Infant, Newborn
PubMed: 34535892
DOI: 10.1111/dmcn.15048 -
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 -
Current Biology : CB Apr 2020Childhood learning difficulties and developmental disorders are common, but progress toward understanding their underlying brain mechanisms has been slow. Structural...
Childhood learning difficulties and developmental disorders are common, but progress toward understanding their underlying brain mechanisms has been slow. Structural neuroimaging, cognitive, and learning data were collected from 479 children (299 boys, ranging in age from 62 to 223 months), 337 of whom had been referred to the study on the basis of learning-related cognitive problems. Machine learning identified different cognitive profiles within the sample, and hold-out cross-validation showed that these profiles were significantly associated with children's learning ability. The same machine learning approach was applied to cortical morphology data to identify different brain profiles. Hold-out cross-validation demonstrated that these were significantly associated with children's cognitive profiles. Crucially, these mappings were not one-to-one. The same neural profile could be associated with different cognitive impairments across different children. One possibility is that the organization of some children's brains is less susceptible to local deficits. This was tested by using diffusion-weighted imaging (DWI) to construct whole-brain white-matter connectomes. A simulated attack on each child's connectome revealed that some brain networks were strongly organized around highly connected hubs. Children with these networks had only selective cognitive impairments or no cognitive impairments at all. By contrast, the same attacks had a significantly different impact on some children's networks, because their brain efficiency was less critically dependent on hubs. These children had the most widespread and severe cognitive impairments. On this basis, we propose a new framework in which the nature and mechanisms of brain-to-cognition relationships are moderated by the organizational context of the overall network.
Topics: Adolescent; Brain Mapping; Child; Child, Preschool; Cognition; Developmental Disabilities; England; Female; Humans; Learning; Male
PubMed: 32109389
DOI: 10.1016/j.cub.2020.01.078 -
Disability and Health Journal Jan 2022Therapy services can support developmental needs, improve social emotional outcomes, and reduce persistent health inequities for children with developmental disabilities...
BACKGROUND
Therapy services can support developmental needs, improve social emotional outcomes, and reduce persistent health inequities for children with developmental disabilities (DD). Receipt of therapy services may be especially timely when children with DD are school-aged, once diagnosis has often occurred. Yet limited knowledge exists on geographic variability and determinants of therapy use among school-aged U.S. children with DD.
OBJECTIVES
We aimed to (1) determine if therapy use varies significantly by state and (2) examine associations of health determinants with therapy use among U.S. school-aged children with DD.
METHODS
This was a secondary analysis of 2016 and 2017 National Survey of Children's Health data. The sample included 9984 children with DD ages 6-17 years. We obtained odds ratios and predicted margins with 95% confidence intervals from multilevel logistic regression models to examine therapy use variation and determinants.
RESULTS
Overall, 34.6% of children used therapy services. Therapy use varied significantly across states (σ = 0.11, SE = 0.04). Younger age, public insurance, functional limitations, individualized education program, frustration accessing services, and care coordination need were associated with higher adjusted odds of therapy access. In states with Medicaid Home and Community-Based Services waivers, higher estimated annual waiver cost was associated with lower adjusted odds of therapy use.
CONCLUSIONS
Results highlight geographic disparities in therapy use and multilevel targets to increase therapy use for school-aged children with DD.
Topics: Adolescent; Child; Developmental Disabilities; Disabled Persons; Humans; Logistic Models; Medicaid; Odds Ratio; United States
PubMed: 34489204
DOI: 10.1016/j.dhjo.2021.101198 -
International Health Apr 2021In the last two decades, the global community has made significant progress in saving the lives of children <5 y of age. However, these advances are failing to help all...
In the last two decades, the global community has made significant progress in saving the lives of children <5 y of age. However, these advances are failing to help all children to thrive, especially children with disabilities. Most early child development research has focussed on the impact of biological and psychosocial factors on the developing brain and the effect of early intervention on child development. Yet studies typically exclude children with disabilities, so relatively little is known about which interventions are effective for this high-risk group. In this article we provide an overview of child development and developmental disabilities. We describe family-centred care interventions that aim to provide optimal stimulation for development in a safe, stable and nurturing environment. We make the case for improving opportunities for children with developmental disabilities to achieve their full potential and thrive, including through inclusive early childhood development intervention. Finally, we call for the global research community to adopt a systematic approach for better evidence for and implementation of early interventions for children with developmental disabilities in low-resource settings.
Topics: Child; Child Development; Child, Preschool; Developing Countries; Developmental Disabilities; Disabled Persons; Humans; Income
PubMed: 32780826
DOI: 10.1093/inthealth/ihaa044 -
International Journal of Molecular... Aug 2020Ataxia is a common clinical feature in inherited metabolic disorders. There are more than 150 inherited metabolic disorders in patients presenting with ataxia in... (Review)
Review
Ataxia is a common clinical feature in inherited metabolic disorders. There are more than 150 inherited metabolic disorders in patients presenting with ataxia in addition to global developmental delay, encephalopathy episodes, a history of developmental regression, coarse facial features, seizures, and other types of movement disorders. Seizures and a history of developmental regression especially are important clinical denominators to consider an underlying inherited metabolic disorder in a patient with ataxia. Some of the inherited metabolic disorders have disease specific treatments to improve outcomes or prevent early death. Early diagnosis and treatment affect positive neurodevelopmental outcomes, so it is important to think of inherited metabolic disorders in the differential diagnosis of ataxia.
Topics: Ataxia; Developmental Disabilities; Genetic Predisposition to Disease; Genetic Testing; High-Throughput Nucleotide Sequencing; Humans; Metabolic Diseases; Seizures; Treatment Outcome
PubMed: 32752260
DOI: 10.3390/ijms21155519 -
Lakartidningen Sep 2021Adults with developmental disabilities, e.g. intellectual disability, autism, cerebral palsy or neuromuscular diseases ,have an increased risk of somatic and psychiatric...
Adults with developmental disabilities, e.g. intellectual disability, autism, cerebral palsy or neuromuscular diseases ,have an increased risk of somatic and psychiatric disorders and of premature death. Many are dependent on others to communicate symptoms and access health care, and standard treatments often need to be individually adapted. The services offered these adults vary between regions. Physicians are scarce and of varying medical background. Adults with developmental disabilities should be entitled to equivalent specialized services, regardless of region of residence. Preventable morbidity and mortality should be minimized. To achieve this: Nurses and physicians should be included in the specialized services in all regions A curriculum for physicians in specialized services is needed The knowledge of developmental disabilities and accompanying health conditions needs to be enhanced throughout the health care system.
Topics: Adult; Autistic Disorder; Cerebral Palsy; Child; Developmental Disabilities; Health Services Accessibility; Humans; Intellectual Disability
PubMed: 34498239
DOI: No ID Found -
Infancy : the Official Journal of the... May 2023Traditional methods do not capture the multidimensional domains and dynamic nature of infant behavioral patterns. We aim to compare full-day, in-home leg movement data...
Barcoding, linear and nonlinear analysis of full-day leg movements in infants with typical development and infants at risk of developmental disabilities: Cross-sectional study.
Traditional methods do not capture the multidimensional domains and dynamic nature of infant behavioral patterns. We aim to compare full-day, in-home leg movement data between infants with typical development (TD) and infants at risk of developmental disabilities (AR) using barcoding and nonlinear analysis. Eleven infants with TD (2-10 months) and nine infants AR (adjusted age: 2-14 months) wore a sensor on each ankle for 7 days. We calculated the standard deviation for linear variability and sample entropy (SampEn) of leg acceleration and angular velocity for nonlinear variability. Movements were also categorized into 16 barcoding states, and we calculated the SampEn and proportions of the barcoding. All variables were compared between the two groups using independent-samples t-test or Mann-Whitney U test. The AR group had larger linear variability compared to the TD group. SampEn was lower in the AR group compared to TD group for both acceleration and angular velocity. Two barcoding states' proportions were significantly different between the two groups. The results showed that nonlinear analysis and barcoding could be used to identify the difference of dynamic multidimensional movement patterns between infants AR and infants with TD. This information may help early diagnosis of developmental disabilities in the future.
Topics: Child; Humans; Infant; Cross-Sectional Studies; Leg; Developmental Disabilities; Movement; Acceleration
PubMed: 36921012
DOI: 10.1111/infa.12537 -
BMC Medicine Feb 2024There are over 53million children worldwide under five with developmental disabilities who require effective interventions to support their health and well-being....
BACKGROUND
There are over 53million children worldwide under five with developmental disabilities who require effective interventions to support their health and well-being. However, challenges in delivering interventions persist due to various barriers, particularly in low-income and middle-income countries.
METHODS
We conducted a global systematic umbrella review to assess the evidence on prevention, early detection and rehabilitation interventions for child functioning outcomes related to developmental disabilities in children under 5 years. We focused on prevalent disabilities worldwide and identified evidence-based interventions. We searched Medline, Embase, PsychINFO, and Cochrane Library for relevant literature from 1st January 2013 to 14th April 2023. A narrative synthesis approach was used to summarise the findings of the included meta-analyses. The results were presented descriptively, including study characteristics, interventions assessed, and outcomes reported. Further, as part of a secondary analysis, we presented the global prevalence of each disability in 2019 from the Global Burden of Disease study, identified the regions with the highest burden and the top ten affected countries. This study is registered with PROSPERO, number CRD42023420099.
RESULTS
We included 18 reviews from 883 citations, which included 1,273,444 children under five with or at risk of developmental disabilities from 251 studies across 30 countries. The conditions with adequate data were cerebral palsy, hearing loss, cognitive impairment, autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder. ASD was the most prevalent target disability (n = 8 reviews, 44%). Most reviews (n = 12, 67%) evaluated early interventions to support behavioural functioning and motor impairment. Only 33% (n = 10/30) of studies in the reviews were from middle-income countries, with no studies from low-income countries. Regarding quality, half of reviews were scored as high confidence (n = 9/18, 50%), seven as moderate (39%) and two (11%) as low.
CONCLUSIONS
We identified geographical and disability-related inequities. There is a lack of evidence from outside high-income settings. The study underscores gaps in evidence concerning prevention, identification and intervention, revealing a stark mismatch between the available evidence base and the regions experiencing the highest prevalence rates of developmental disabilities.
Topics: Child; Child, Preschool; Humans; Attention Deficit Disorder with Hyperactivity; Autism Spectrum Disorder; Developmental Disabilities; Family; Meta-Analysis as Topic
PubMed: 38302917
DOI: 10.1186/s12916-024-03265-7