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Neurotoxicology Jan 2011Polybrominated diphenyl ether (PBDE) flame retardants have become ubiquitous environmental pollutants. The relatively higher body burden in toddlers and children has... (Review)
Review
Polybrominated diphenyl ether (PBDE) flame retardants have become ubiquitous environmental pollutants. The relatively higher body burden in toddlers and children has raised concern for their potential developmental neurotoxicity, which has been suggested by animal studies, in vitro experiments, and recent human epidemiological evidence. While lower brominated PBDEs have been banned in several countries, the fully brominated decaBDE (BDE-209) is still utilized, though manufacturers will discontinue production in the U.S.A. in 2013. The recent decision by the U.S. Environmental Protection Agency to base the reference dose (RfD) for BDE-209 on a developmental neurotoxicity study has generated some controversy. Because of its bulky configuration, BDE-209 is poorly absorbed and does not easily penetrate the cell wall. Its acute and chronic toxicities are relatively low, with the liver and the thyroid as the primary targets, though there is some evidence of carcinogenicity. A few animal studies have indicated that BDE-209 may cause developmental neurotoxicity, affecting motor and cognitive domains, as seen for other PBDEs. Limited in vivo and in vitro studies have also evidenced effects of BDE-209 on thyroid hormone homeostasis and direct effects on nervous cells, again similar to what found with other lower brominated PBDEs. In contrast, a recent developmental neurotoxicity study, carried out according to international guidelines, has provided no evidence of adverse effects on neurodevelopment, and this should be considered in a future re-evaluation of BDE-209. While estimated exposure to BDE-209 in children is believed to be several orders of magnitude below the most conservative RfD proposed by the USEPA, questions remain on the extent and relevance of BDE-209 metabolism to lower brominated PBDEs in the environment and in humans.
Topics: Animals; Developmental Disabilities; Environmental Exposure; Flame Retardants; Halogenated Diphenyl Ethers; Humans
PubMed: 21182867
DOI: 10.1016/j.neuro.2010.12.010 -
Archivos Argentinos de Pediatria Jun 2019The developmental coordination disorder is a common neurodevelopmental condition about which health professionals know very little. Consequently, children often go... (Review)
Review
The developmental coordination disorder is a common neurodevelopmental condition about which health professionals know very little. Consequently, children often go undiagnosed and are rarely treated. An updated synthesis of the topic is presented to provide recommendations for the diagnosis and treatment from the perspective of the clinician and from a public health approach. Theories explaining motor difficulties present in this disorder are briefly included. Clinical features and reasons rendering the diagnosis difficult are described as follows. Some of the existing recommendations are underscored and tools that could be used for the evaluation are described. Finally, treatment approaches for these children are determined considering that the disorder affects not only the child's motor performance, but also his or her academic, social and emotional performance and even his or her physical health.
Topics: Child; Developmental Disabilities; Humans; Motor Skills Disorders; Public Health
PubMed: 31063311
DOI: 10.5546/aap.2019.eng.199 -
Developmental Medicine and Child... Nov 2019To describe the baseline developmental profile and influence of clinical and demographic factors on the developmental skills of infants diagnosed with infantile spasms.
AIM
To describe the baseline developmental profile and influence of clinical and demographic factors on the developmental skills of infants diagnosed with infantile spasms.
METHOD
Ninety-five infants (55 males, 40 females) newly diagnosed with infantile spasms were recruited for a cross-sectional, longitudinal study. All infants underwent Bayley Scales of Infant and Toddler Development assessments in the cognitive, receptive communication, expressive communication, and fine and gross motor developmental domains; they also underwent visual, auditory, and social behaviour assessments. Infants were categorized as 'early' (<6mo) or 'late' (≥6mo) presenters; if presented within 28 days, this was considered as 'early presentation', whereas a delay greater than 28 days was considered as a 'delay in presentation'. Antenatal, perinatal, and postnatal risk factors were identified.
RESULTS
Over 90% of infants showed impairment in all domains, with the majority having severe delay; 99% showed cognitive impairment. Delayed presentation was significantly associated with receptive communication delay (odds ratio [OR]=5.35; 95% confidence interval [CI]=1.05-27.32). Onset at 6 months or less influenced auditory (OR=2.8; 95% CI=1.16-6.8) and visual (OR=3.03; 95% CI=1.22-7.57) behaviours. Neonatal infections impacted both receptive (OR=1.12; 95% CI=1.04-1.2) and expressive communication (OR=1.08; 95% CI=1.02-1.14) delay. Neonatal seizures significantly influenced visual, auditory, and social impairments. Expressive communication and gross motor development shared common perinatal risk factors.
INTERPRETATION
Adverse developmental status at presentation, associated with delayed presentation and neonatal risk factors should alert clinicians to the surveillance of at-risk infants and seek out timely interventions.
WHAT THIS PAPER ADDS
Ninety per cent of infants showed impaired cognitive, communication, and motor skills at presentation. Visual, auditory, and social behaviour impairments were significantly associated with perinatal risks. Visual, auditory, and social behaviour impairments were significantly associated with neonatal seizures.
Topics: Child Development; Child, Preschool; Cross-Sectional Studies; Developmental Disabilities; Female; Humans; Infant; Longitudinal Studies; Male; Spasms, Infantile
PubMed: 30854631
DOI: 10.1111/dmcn.14205 -
Advances in Nutrition (Bethesda, Md.) Mar 2016Poor nutrition (substandard diet quantity and/or quality resulting in under- or overnutrition) and the lack of early learning opportunities contribute to the loss of... (Review)
Review
Poor nutrition (substandard diet quantity and/or quality resulting in under- or overnutrition) and the lack of early learning opportunities contribute to the loss of developmental potential and life-long health and economic disparities among millions of children aged <5 y. Single-sector interventions representing either early child development (ECD) or nutrition have been linked to positive child development and/or nutritional status, and recommendations currently advocate for the development and testing of integrated interventions. We reviewed the theoretical and practical benefits and challenges of implementing integrated nutrition and ECD interventions along with the evidence for best practice and benefit-cost and concluded that the strong theoretical rationale for integration is more nuanced than the questions that the published empirical evidence have addressed. For example, further research is needed to 1) answer questions related to how integrated messaging influences caregiver characteristics such as well-being, knowledge, and behavior and how these influence early child nutrition and development outcomes; 2) understand population and nutritional contexts in which integrated interventions are beneficial; and 3) explore how varying implementation processes influence the efficacy, uptake, and cost-benefit of integrated nutrition and ECD interventions.
Topics: Child Development; Child Nutrition Disorders; Child Nutritional Physiological Phenomena; Child, Preschool; Combined Modality Therapy; Congresses as Topic; Cost-Benefit Analysis; Delivery of Health Care, Integrated; Developing Countries; Developmental Disabilities; Evidence-Based Medicine; Family Health; Holistic Health; Humans; Infant; Learning Disabilities
PubMed: 26980819
DOI: 10.3945/an.115.010363 -
Maternal and Child Health Journal May 2020This project employed Boot Camp Translation (BCT) to engage community stakeholders in the translation of developmental screening guidelines and early intervention...
OBJECTIVES
This project employed Boot Camp Translation (BCT) to engage community stakeholders in the translation of developmental screening guidelines and early intervention service recommendations into locally-relevant, family-centered messaging.
METHODS
A subject matter expert provided an overview of development, developmental delay, developmental screening and referral processes, and early intervention to BCT participants. BCT participants and facilitators met in-person and via teleconferencing over the course of 12 months to co-develop locally-relevant messages and materials.
RESULTS
BCT participants focused on defining development, developmental delay, and early intervention, rather than describing developmental screening and referral processes. They proposed several dissemination strategies, and focused much of their effort on the creation of an informational booklet designed to educate and empower caregivers.
CONCLUSIONS FOR PRACTICE
BCT is a useful approach for translating developmental screening guidelines and early intervention recommendations into locally-relevant, family-centered messaging.
Topics: Community Participation; Community-Based Participatory Research; Developmental Disabilities; Female; Guidelines as Topic; Humans; Language; Male; Pamphlets; Referral and Consultation; Stakeholder Participation; Translating; United States
PubMed: 31845067
DOI: 10.1007/s10995-019-02853-x -
Journal of Developmental and Behavioral... Apr 2022To test the association of parents' concerns with early intervention (EI) developmental services outcomes including evaluation, eligibility, and enrollment in services.
OBJECTIVE
To test the association of parents' concerns with early intervention (EI) developmental services outcomes including evaluation, eligibility, and enrollment in services.
METHOD
We collected survey data on parents' concerns and EI service use data from a sample of 428 children referred to EI from 2016 to 2018 in 6 Oregon primary care clinics serving lower-income families as part of a developmental and autism spectrum disorder screening intervention. We assessed EI service use trajectories and associations of the presence of parent concern, age of child at the time of parents' concerns, number of concerns, and type of provider concern, with EI evaluation, EI eligibility, and enrollment in EI services, using bivariate testing and multivariable logistic regression.
RESULTS
Only 22.9% of children referred to EI were enrolled in services 6 months later. Children whose parents had developmental and/or behavioral concerns were more likely to receive an EI evaluation and were also more likely to be eligible for services, compared with children whose parents had no concerns. There was no association between age, number of concerns, and type of concern with EI evaluation, eligibility, or services enrollment.
CONCLUSION
Although only a minority of children referred to EI enrolled in services, the presence of parent concern is strongly associated with EI services evaluation and eligibility outcomes. Study results suggest that providers should assess the presence of parent concern when deciding on EI referrals and provide more support to parents who are not concerned at all.
Topics: Autism Spectrum Disorder; Child; Developmental Disabilities; Early Intervention, Educational; Humans; Income; Infant; Parents; Referral and Consultation
PubMed: 35703857
DOI: 10.1097/DBP.0000000000001003 -
Developmental Medicine and Child... Jun 2019
Topics: Developmental Disabilities; Humans; Terminology as Topic
PubMed: 31049943
DOI: 10.1111/dmcn.14216 -
Lancet (London, England) Jul 2015It has been more than 80 years since researchers in child psychiatry first documented developmental delays among children separated from family environments and placed... (Review)
Review
It has been more than 80 years since researchers in child psychiatry first documented developmental delays among children separated from family environments and placed in orphanages or other institutions. Informed by such findings, global conventions, including the 1989 UN Convention on the Rights of the Child, assert a child's right to care within a family-like environment that offers individualised support. Nevertheless, an estimated 8 million children are presently growing up in congregate care institutions. Common reasons for institutionalisation include orphaning, abandonment due to poverty, abuse in families of origin, disability, and mental illness. Although the practice remains widespread, a robust body of scientific work suggests that institutionalisation in early childhood can incur developmental damage across diverse domains. Specific deficits have been documented in areas including physical growth, cognitive function, neurodevelopment, and social-psychological health. Effects seem most pronounced when children have least access to individualised caregiving, and when deprivation coincides with early developmental sensitive periods. Offering hope, early interventions that place institutionalised children into families have afforded substantial recovery. The strength of scientific evidence imparts urgency to efforts to achieve deinstitutionalisation in global child protection sectors, and to intervene early for individual children experiencing deprivation.
Topics: Brain; Child; Child Development; Child Welfare; Child, Institutionalized; Deinstitutionalization; Developmental Disabilities; Humans; Institutionalization; Orphanages; Social Support
PubMed: 25638660
DOI: 10.1016/S0140-6736(14)61131-4 -
Neuropsychology Review Dec 2010Children raised in the profound deprivation associated with institutionalization are at elevated risk for negative outcomes across a host of social and cognitive... (Review)
Review
Children raised in the profound deprivation associated with institutionalization are at elevated risk for negative outcomes across a host of social and cognitive domains. This risk appears to be mitigated by early foster care or adoption into a family setting. Although pervasive developmental problems have been noted in a substantial proportion of previously institutionalized children, marked variation exists in the nature and severity of these deficits. Increasing evidence suggests that institutional deprivation impacts the developing brain, potentially underlying the wide range of outcomes with which it is associated. In the current review we examine the neural consequences of institutionalization and genetic factors associated with differences in outcome in an effort to characterize the consequences of early deprivation at a neurobiological level. Although the effects of institutional deprivation have been studied for more than 50 years much remains unanswered regarding the pathways through which institutionalization impacts child development. Through a more complete and nuanced assessment of the neural correlates of exposure and recovery as well as a better understanding of the individual factors involved we will be better able to delineate the impact of early adversity in the setting of severe social deprivation.
Topics: Adoption; Child; Child, Institutionalized; Cognition Disorders; Developmental Disabilities; Genetic Variation; Humans; Mental Disorders; Neurobiology; Psychosocial Deprivation; Romania
PubMed: 21042937
DOI: 10.1007/s11065-010-9152-8 -
Current Psychiatry Reports Feb 2020Although treatment algorithms and parameters for best practice are readily available for all major syndromes of psychiatric impairment, the occurrence of psychiatric... (Review)
Review
Toward Actionable Practice Parameters for "Dual Diagnosis": Principles of Assessment and Management for Co-Occurring Psychiatric and Intellectual/Developmental Disability.
PURPOSE OF REVIEW
Although treatment algorithms and parameters for best practice are readily available for all major syndromes of psychiatric impairment, the occurrence of psychiatric syndromes in individuals with intellectual and developmental disability (IDD) invokes serious contextual challenges for interpretation of symptoms, diagnosis, and optimization of treatment, both for clinicians and for the service sectors in which care and support of individuals with IDD are delivered. Recognizing that there exist very few definitive resources for best practice under the circumstance of this form of "dual diagnosis," the Missouri Department of Mental Health convened an expert panel to conduct a focused review and synthesis of the relevant scientific literature from which to develop guidance in the form of decision support to clinicians. This article summarizes the findings for three of the most common and impairing clusters of psychiatric symptoms that co-occur with IDD-aggression, depression, and addictions.
RECENT FINDINGS
Individuals with IDD are at high risk for the development of psychiatric symptoms (PS), which often manifest uniquely in IDD and for which evidence for effective intervention is steadily accruing. Interventions that are commonly implemented in the IDD service sector (e.g., functional communication training and positive behavioral support planning) are capable of mitigating severe behavioral impairment, yet rarely invoked when dual diagnosis patients are seen in the psychiatric service sector. Conversely, state-of-the-art interventions for traumatic stress, pharmacotherapy, and psychotherapy have proven capable of improving behavioral impairments in IDD but are typically restricted to the psychiatric service sector, where there exist significant barriers to access for patients with IDD, including limitations imposed by diagnostic eligibility and practitioner experience. Bridging these gaps in knowledge and clinical capacity across the respective IDD and PS service sectors should be of very high priority in strategizing the care and support of IDD patients with serious co-occurring psychiatric conditions.
Topics: Developmental Disabilities; Humans; Intellectual Disability; Mental Disorders
PubMed: 32008108
DOI: 10.1007/s11920-020-1127-8