24-months Of Age Research Articles

Early-life Upper Airway Microbiota are Associated with Decreased Lower Respiratory Tract Infections

Microbial interactions mediating colonization resistance play key roles within the human microbiome, shaping susceptibility to infection from birth. To gain insight into microbiome-mediated defenses and respiratory pathogen colonization dynamics, we sequenced and analyzed nasal (n=229) and oral (n=210) microbiomes with associated health/environmental data from our Wisconsin Infant Study Cohort at age 24-months. Participants with early-life lower respiratory tract infection (LRTI) were more likely to be formula-fed, attend daycare, and experience wheezing. Shotgun metagenomic sequencing with detection of viral and bacterial respiratory pathogens revealed nasal microbiome composition to associate with prior LRTI – namely lower alpha diversity, depletion of Prevotella, and enrichment of Moraxella catarrhalis including drug-resistant strains. Prevotella originating from healthy microbiomes had higher biosynthetic gene cluster abundance and exhibited contact-independent inhibition of M. catarrhalis, suggesting interbacterial competition impacts nasal pathogen colonization. This work advances understanding of protective host-microbial interactions occurring in airway microbiomes that alter infection susceptibility in early-life.

Neonatal Seizures and Associated Neurobehavioral Profiles in Preschool Age Children

BackgroundNeonatal seizures are common with acute brain injury. Up to 25% of survivors develop post-neonatal epilepsy. We hypothesized post-neonatal epilepsy diagnosed by age 24-months would increase risk for early markers of neurobehavioral disorders than acute provoked neonatal seizures alone. MethodsNeonates with acute provoked seizures born 7/2015-3/2018 enrolled at 9 Neonatal Seizure Registry sites. Composite scores from parent-completed standardized ratings assessed Adaptive, Social, Externalizing, Internalizing, Self-Regulation, and Sensory Seeking domains. Linear regression demonstrated relationships between composite scores for children who developed post-neonatal epilepsy compared with those who did not. Results were adjusted for seizure etiology, sex, gestational age, and cerebral palsy (CP) severity. Results151 children (n=20, 13% with post-neonatal epilepsy), 4.1 years median age participated. Children with epilepsy had impaired adaptive (Cohen’s d = 1.62, p<.0001), social (Cohen’s d = 0.86, p=0.004), and executive functioning (Cohen’s d = 0.56, p=0.06) compared to children without epilepsy. Mean neurobehavioral scores for children without epilepsy were within normative average range. Risk for impairment among children with epilepsy persisted after adjusting for neonatal seizure etiology, sex, and gestational age, but not when adjusting for CP severity. ConclusionsIn this cohort of survivors of provoked neonatal seizures, there was higher incidence of adverse neurobehavioral outcomes among preschool children diagnosed with post-neonatal epilepsy compared with those without epilepsy. CP severity was associated with greater impairment, results also suggest that epilepsy is an independent predictor of adaptive functioning. Children with post-neonatal epilepsy should be screened for neurobehavioral problems to facilitate early identification and developmental support.

Distinct, common and synergistic effects of insulin and IGF-1 receptors on healthy murine ageing

ObjectiveReduced IGF-1 signalling is an evolutionarily conserved mediator of longevity, yet the magnitude of this effect is substantially larger in organisms retaining a common insulin and IGF-1 receptor. Whether this reflects the failure to simultaneously reduce IGF-1 and insulin signalling in mammalian model systems remains unexplored, as is the associated impact on markers of healthy ageing. We set out to address these uncertainties. MethodsWe compared the duration of healthy life (healthspan) in male mice with haploinsufficiency of the insulin receptor (IRKO), IGF-1 receptor (IGF-1RKO), or both (DKO), versus wildtype (WT) littermates. Cognitive performance was defined using nesting studies at 3- and 24-months of age. Brain transcriptome was characterised at 3- and 18-months of age using RNA-seq. ResultsHealthspan was longer in DKO versus WT, with IRKO and IGF-1RKO being intermediate. At 2 years of age, DKO also exhibited preserved nesting behaviour in contrast with all other genotypes. Differential insulin sensitivity or weight gain during ageing did not explain the preserved healthspan of DKO, since these were comparable to IRKO littermates. Brain transcriptomics at 18 months of age revealed lower expression of canonical ageing-associated genes in DKO versus WT, although many of these findings were replicated in IRKO versus WT or IGF-1RKO vs WT. ConclusionsReduced insulin and IGF-1 receptor expression have both common and synergistic effects upon elements of healthy mammalian ageing, suggesting future ageing studies should consider targeting both insulin and IGF-1 signalling.

Performance and metabolic evaluation in primiparous beef cows under grazing at different breeding ages.

We aimed to evaluate the metabolic and performance differences in primiparous Nellore cows, which became pregnant at 14 or 24-mo old. Thirty-eight cows with 202 ± 5 days of gestation were divided into two treatments according to breeding age: 14 or 24-mo. Cows were evaluated for body weight (BW), body condition score (BCS), carcass characteristics, milk yield, calves's performance, and blood characteristics. The animals were managed in eight paddocks under continuous grazing and evaluated from 90 d before parturition until 240 d after calving. We observed an interaction between breeding age and time (P < 0.01) for cow BW. Both breeding age categories experienced BW loss during parturition, with a concurrent decrease in BCS. However, following their first calving, the BW of 24-mo cows remained stable (P > 0.05), whereas 14-mo cows exhibited a gradual recovery in BW after parturition (P < 0.05). Milk yield was greater in 24-mo animals (P < 0.01), but decreased with increasing milking days (p < 0.05) for both groups. The weight gain calves from the heifers bred at 24-mo was greater (P < 0.01), which reflected in greater BW at weaning. The beta-hydroxybutyrate (β-OHB) concentration was greater before calving and a marked decrease after parturition (P < 0.05). The 24-mo cows had greater blood β-OHB (P < 0.01) at prepartum and 30 days after calving. Blood progesterone was greater in 24-mo cows (P > 0.05). Primiparous beef cows that conceive at either 14 or 24-months of age exhibit distinct nutritional requirements and metabolic profiles. Notably, cows that conceive at 24-months of age have the advantage of weaning heavier calves and displaying a more consistent reproductive cycle following their first calving than cows that conceive at 14-months.

Predicting externalizing behaviors in typically developing toddlers at 24 months: Insights from parenting at 12 months

Early observational assessment of parent and child behaviors may identify risk factors associated with the development of early child externalizing behaviors. This study aimed to examine factors associated with child externalizing behaviors at 24-months of age, including early maternal depression, family social risk and the parent-child relationship. Using a longitudinal design in 89 mother-child dyads (n = 43 female), maternal depressive symptoms and social risk were measured post-birth, and 12-months later parent-child interaction was assessed using the Emotional Availability Scales. To assess child externalizing behaviors, a parent-report questionnaire was administered when children were 24-months old. Increased early maternal depressive symptoms (p = .03), but not higher social risk (p = 0.17), were associated with higher child externalizing behaviors in children at age 24-months. After adjusting for early maternal depressive symptoms and familial social risk, lower levels of observed maternal structuring (β = −2.60, 95 %CI = −4.56, −0.64, p = .01) and lower levels of non-hostility (β = −3.39, 95 %CI −6.64, −0.14, p = .04) when the child was 12-months old were associated with higher parent-report of externalizing behaviors. However, the child’s observed interaction behavior was not associated with the mother’s report of child externalizing behavior. Interventions targeting specific post-natal maternal mental health and early parenting behaviors may reduce the risk for the development of later child externalizing problems.

Social and Communication Development in Infants with Isolated Agenesis of the Corpus Callosum

ObjectiveTo evaluate the development of social behavior, communication, emotion regulation, and repetitive behaviors in infants with congenital malformation of the corpus callosum, specifically those with isolated Agenesis of the Corpus Callosum (ACC) in comparison to typically developing infants. Study DesignThis case-control longitudinal observation study examined parent report of social behavior, social-communication, emotion regulation, and repetitive behavior development in community ascertained infants (n = 156) and infants with isolated ACC (n = 57) between 12 and 24 months of age. ResultsInfants with isolated ACC produced fewer words at 12- (p = 0.003) 18- (p < 0.001), and 24-months of age (p = 0.003), and fewer gestures at 12- (p < 0.001), 18- (p < 0.001), and 24-months of age (p < 0.001). In addition, the ACC group demonstrated delays in reciprocal social behavior at 18-months (p = 0.01) and social competence at 12- (p < 0.001) and 18-months (p = 0.01). No concerns were noted in emotion regulation or restricted and repetitive behavior and social behavior appears to normalize at 24 months. ConclusionsExisting data suggests heterogeneity in developmental outcomes among individuals with isolated ACC. The current findings fill a gap in knowledge about development in the second year of life. Surveillance of social and communication ability in infants with ACC may be warranted. The role of the corpus callosum in facilitating rapid interhemispheric information processing impacts skills beyond the motor system. More work is needed to identify intervention targets for infants and toddlers with ACC.

Association between prenatal exposure to rare earth elements and the neurodevelopment of children at 24-months of age: A prospective cohort study

The increasing consumption of rare earth elements (REEs) has resulted in a considerable risk of environmental exposure. However, the adverse effects of prenatal REEs exposure on children's neurodevelopment are not yet fully recognized. Therefore, we investigated the individual and joint effects of prenatal exposure to 13 REEs on children's neurocognitive development based on 809 mother-child pairs from a large birth cohort in Wuhan, China. Maternal urinary concentrations of 13 REEs were repeatedly measured by inductively coupled plasma mass spectrometry. Children's neurodevelopment [e.g., mental and psychomotor development index (MDI/PDI)] at 24-months was assessed using Bayley Scales of Infant Development of Chinese Revision. GEE and BKMR models were applied to estimate the individual and joint effects of prenatal REE exposure on child neurodevelopment level. After controlling for typical confounders, we observed that exposure to 9 REEs during the first trimester were significantly associated with decreased MDI scores [βs and 95% confidence intervals (CIs) ranging from −2.24 (−3.86 ∼ −0.63) to −1.44 (−2.26∼ −0.26)], and 7 REEs during third trimester were significantly associated decreased PDI scores [β and 95% CIs ranging from −1.95 (−3.19 ∼ −0.71) to −1.25 (−2.34 ∼ −0.16)]. Higher quantiles of REE mixture in first and third trimester were associated with decreased MDI and PDI score. Thulium, erbium in the first trimester and cerium, lanthanum in the third trimester accounted most importance to joint effects on MDI and PDI, respectively. In conclusion, prenatal exposure to higher concentrations of REEs during the first and third trimester were negative associated with children's neurodevelopment.

0765 Enlarged perivascular spaces in infancy: associations with autism diagnosis, cerebrospinal fluid volume, and later sleep problems

Abstract Introduction Since the re-discovery of the glymphatic system, there has been an increased interest in perivascular spaces (PVS) and cerebrospinal fluid (CSF) characteristics in relation to sleep. Enlarged PVS (ePVS) are associated with neurological disorders and sleep problems, and excessive extra-axial CSF (EA-CSF) volume is associated with autism spectrum disorder (ASD). However, ePVS has not been studied in infancy in relation to autism, EA-CSF volume, or sleep problems. The objectives of this study, therefore, are to examine whether ePVS is 1) more prevalent in infants who later develop ASD, 2) related to EA-CSF volume, and 3) associated with later sleep problems. Methods The study was conducted on a prospective, longitudinal cohort from the Infant Brain Imaging Study (IBIS). Participants underwent neuroimaging at 6-, 12-, and 24-months of age, and parent-reported Children’s Sleep Habits Questionnaires (CSHQ) were collected at a follow-up visit at school age (age range = 7-12 years, M = 10.0). A total of 311 participants were included: 47 infants at high familial likelihood for ASD who were later diagnosed with ASD (HL+), 180 high likelihood infants not diagnosed with ASD (HL-), and 84 low likelihood control infants (LL-). The CSHQ was available on a subset of 109 participants. Results Significant group differences in ePVS rates were found at 24 months of age (p=0.041), with 44.7% of the HL+ group having ePVS, compared to 26.7% in the HL- group (p=0.017) and 26.2% in the LL- group (p=0.031). ePVS at 24 months was associated with greater EA-CSF volume from 6-24 months (p=0.002) and greater sleep disturbances at school-age (p=0.006), regardless of ASD diagnosis. Conclusion The presence of ePVS during infancy was associated with ASD diagnosis, elevated EA-CSF volume, and more frequent sleep disturbances. Results suggest that infants with ePVS should be monitored for early signs of ASD and potential long-term sleep problems, particularly sleep disturbances. Further examination is needed to establish whether early ePVS is ASD-specific or an indication of early glymphatic system dysfunction that can put infants and children at risk for atypical brain development and later sleep problems. Support (if any)

Impact of feeding habits on the development of language-specific processing of phonemes in brain: An event-related potentials study.

Infancy is a stage characterized by multiple brain and cognitive changes. In a short time, infants must consolidate a new brain network and develop two important properties for speech comprehension: phonemic normalization and categorical perception. Recent studies have described diet as an essential factor in normal language development, reporting that breastfed infants show an earlier brain maturity and thus a faster cognitive development. Few studies have described a long-term effect of diet on phonological perception. To explore that effect, we compared the event-related potentials (ERPs) collected during an oddball paradigm (frequent /pa/80%, deviant/ba/20%) of infants fed with breast milk (BF), cow-milk-based formula (MF), and soy-based formula (SF), which were assessed at 3, 6, 9, 12, and 24 months of age [Mean across all age groups: 127 BF infants, Mean (M) 39.6 gestation weeks; 121 MF infants, M = 39.16 gestation weeks; 116 SF infants, M = 39.16 gestation weeks]. Behavioral differences between dietary groups in acoustic comprehension were observed at 24-months of age. The BF group displayed greater scores than the MF and SF groups. In phonological discrimination task, the ERPs analyses showed that SF group had an electrophysiological pattern associated with difficulties in phonological-stimulus awareness [mismatch negativity (MMN)-2 latency in frontal left regions of interest (ROI) and longer MMN-2 latency in temporal right ROI] and less brain maturity than BF and MF groups. The SF group displayed more right-lateralized brain recruitment in phonological processing at 12-months old. We conclude that using soy-based formula in a prolonged and frequent manner might trigger a language development different from that observed in the BF or MF groups. The soy-based formula's composition might affect frontal left-brain area development, which is a nodal brain region in phonological-stimuli awareness.

Longitudinal profiles of the fecal metabolome during the first 2 years of life

During the first 2 years of life, the infant gut microbiome is rapidly developing, and gut bacteria may impact host health through the production of metabolites that can have systemic effects. Thus, the fecal metabolome represents a functional readout of gut bacteria. Despite the important role that fecal metabolites may play in infant health, the development of the infant fecal metabolome has not yet been thoroughly characterized using frequent, repeated sampling during the first 2 years of life. Here, we described the development of the fecal metabolome in a cohort of 101 Latino infants with data collected at 1-, 6-, 12-, 18-, and 24-months of age. We showed that the fecal metabolome is highly conserved across time and highly personalized, with metabolic profiles being largely driven by intra-individual variability. Finally, we also identified several novel metabolites and metabolic pathways that changed significantly with infant age, such as valerobetaine and amino acid metabolism, among others.

Early Life Nutrition Research Supported by the U.S. National Institutes of Health from 2018–2020

ObjectivesThe Dietary Guidelines for Americans, 2020–2025 includes guidelines for pregnancy, lactation, and children from birth to age 24-months (B-24) to reflect the growing body of evidence about appropriate nutrition during the earliest stages of life. Guidelines are based on a thorough review of the existing scientific evidence by the 2020 Dietary Guidelines Advisory Committee (DGAC). The Scientific Report of the 2020 Dietary Guidelines Advisory Committee pointed to the need for additional research during these life stages. The objective of this study was to enumerate early life (pregnancy, lactation, and B-24) nutrition research needs that are already being addressed by the scientific community and to identify remaining research gaps.MethodsThe 2020 DGAC Scientific Report was reviewed, and 138 research gaps relevant to early life were identified. Research gaps were consolidated into 13 topic areas. A total of 1,632 nutrition and early life focused research projects funded by the National Institutes of Health (NIH) between 2018–2020 were manually coded using the title, abstract, and public health relevance statement available on NIH RePORTER. Projects were coded to determine if they addressed a research gap within one of the 13 research gap topic areas. The main outcome was the percentage of NIH funded (NIH) nutrition and early life focused research projects with potential to address known early life dietary guidelines research gaps.ResultsOf the reviewed and coded projects, 235 (14.4%) addressed any early life nutrition research gap. Between Fiscal Years 2018 to 2020, total costs of projects addressing any gap represented only 15% of total costs for all projects reviewed. Complementary foods, breastfeeding (never versus ever), and frequency of eating were research gap areas most frequently coded as being addressed by a funded project. Iron supplementation, seafood consumption, and maternal diet food allergens were research gap areas least frequently coded as being potentially addressed by a funded project.ConclusionsThis analysis highlights multiple opportunities for changes in the federal government investment in maternal and child nutrition research to support development of effective evidence-based dietary guidelines for the improvement of early life nutrition practices and overall public health.Funding SourcesNone.

Autophagy Impairment and Sarcopenia in Type‐Identified Muscle Fibers of Aging Extensor Digitorum Longus Muscle

Sarcopenia is the aging‐related loss of force‐generating capacity and atrophy of skeletal muscles and is a major contributor to morbidity and mortality in the elderly. The molecular mechanisms underlying sarcopenia remain to be elucidated. Skeletal muscles exhibit different rates of sarcopenia, generally reflecting their specific muscle fiber type composition. Muscles primarily composed of type IIx and/or IIb muscle fibers (i.e., extensor digitorum longus; EDLm) develop sarcopenia at a faster rate than other muscles. In the diaphragm, muscle fiber cross‐sectional area (CSA) is reduced in old age, predominantly in type IIx and/or IIb fibers. Autophagy is a multistep, catabolic process that targets dysfunctional cytoplasmatic structures including proteins and organelles for degradation and recycling. Autophagy is impaired in old age across several tissues, including motor neurons and skeletal muscle. Expression of core autophagy proteins can indicate changes in autophagy, e.g., LC3 reflects initiation/elongation steps and p62 clearance reflects degradation. We hypothesize that impaired autophagy is associated with the development of sarcopenia in type‐identified muscle fibers of the EDLm. Indeed, at 24‐months of age, the CSA of type I and IIa fibers was not reduced, whereas the CSA of type IIx and/or IIb fibers was ~25% smaller (p&lt;0.01 in both cases), compared to 6‐month‐old mice. These findings are consistent with fiber type selective sarcopenia in the EDLm. Expression of LC3 and p62 in the EDLm of mice at 6‐ and 24‐ months of age was evaluated via immunofluorescence by quantification of the number of LC3 and p62 puncta per muscle fiber type. In type I and IIa fibers, the number of LC3 puncta increased by ~30% and of p62 increased three‐fold in 24‐ compared to 6‐month‐old mice (p&lt;0.01 in both cases). In type IIx and/or IIb fibers, the number of LC3 puncta decreased by ~60% and p62 puncta increased by ~50% in 24‐ compared to 6‐month‐old mice (p&lt;0.01 in both cases). Accordingly, compared to 6 month‐old mice, autophagic degradation is impaired across muscle fiber types in 24‐month old mice, but likely to a greater extent in type I and IIa fibers of old mice given the increase in both LC3 and p62. Autophagic initiation is primarily reduced in type IIx and/or IIb fibers in the EDL as indicated by the reduced LC3 expression. Taken together these findings indicate that fiber type selective sarcopenia may reflect differences in autophagy across muscle fiber types.

Serum testosterone concentrations are not associated with frailty in naturally ageing and testosterone-deficient older C57Bl/6 mice

This study investigated how serum testosterone related to frailty in ageing male C57Bl/6 mice with or without lifelong testosterone deficiency. Mice underwent a sham surgery (n = 10) or gonadectomy (n = 11, GDX) at 4-weeks and then aged. Frailty scores (31-item frailty index) and testosterone were measured between 18- to 24-months of age. Age predicted frailty (p < 0.0001), but serum testosterone did not (p = 0.357). Life expectancy (AFRAID clock) and biologic age (FRIGHT clock) were not significantly different between groups (p = 0.485 and 0.142). The fact that lifelong testosterone deficiency did not exacerbate frailty suggests that low testosterone alone does not potently drive frailty in males.

Neonatal hypoxic-ischaemic encephalopathy: Motor impairment beyond cerebral palsy

Research investigating neuromotor function in the absence of cerebral palsy (CP) for children who had neonatal HIE is limited.To investigate school-age neurological and neuromotor function, and correlations with attention, neonatal Magnetic Resonance Imaging (MRI), and neuromotor assessments at toddler age.Twenty-seven children with neonatal HIE without CP who underwent hypothermia treatment and a comparison group of 20 children were assessed at age 5-7 years for Minor Neurological Dysfunction (MND; simplified Touwen), motor skills (Movement Assessment Battery for Children-2; MABC-2), parental concern over motor function (MABC Checklist), general cognition (Wechsler Preschool and Primary Scale of Intelligence-IV, WPPSI), and attention (DuPaul ADHD Rating Scale). Neurological examination and motor development, using Bayley-3 scales, at age 24-months was extracted from the clinical database. Clinical neonatal MRI was assessed for hypoxic-ischaemic injury.In the HIE group, MND was more prevalent (p = 0.026) and M-ABC performance (total score p = 0.006; balance subtest p = 0.008) was worse; parents were more concerned about children's motor function (p = 0.011). HIE group inattention scores were higher (p = 0.032), which correlated with lower MABC-2 scores (rs = -0.590, p = 0.004). Neurological examination at 24-months correlated with MND (rs = 0.437, p = 0.033); Bayley-3 motor scores did not correlate with M-ABC-2 scores (rs = 368, p = 0.133). Neonatal MRI findings were not associated with school-age MND (rs = 0.140, p = 0.523) or MABC-2 (rs = 0.300, p = 0.165).Children with neonatal HIE, without CP, treated with hypothermia may be more likely to develop MND and motor difficulties than typically developing peers. Inattention may contribute to motor performance. In the absence of CP, neonatal MRI and toddler age assessment of motor development have limited predictive value for school-age outcome. Since this was an exploratory study with a small sample size, findings should be confirmed by a definite larger study.

Early Life Exposure to Ambient Air Pollutants is Associated with Decreased Cognitive Development in Hispanic Infants from Southern California

BACKGROUND AND AIM: Previous research has established an association between postnatal ambient air pollution (AAP) exposure and cognitive development in preschoolers and school-aged children. However, this association has not been examined during infancy, a critical neurodevelopmental window. The purpose of this study was to explore relationships between postnatal AAP exposure and cognitive development in infants. METHODS: This study examined 118 Hispanic mother-infant pairs from the longitudinal Mother’s Milk Study in Southern California. Average individual residential exposure to AAP, including nitrogen dioxide (NO2) and particulate matter smaller than 2.5 and 10 microns in diameter (PM2.5 and PM10 respectively), in the first month of life was estimated from central site monitors. Infant cognitive outcomes at 24-months were measured using the Bailey-III Scales of Infant and Toddler Development. Multivariate linear regression was used to examine relationships between postnatal AAP exposure and age scaled cognitive scores, adjusting for socioeconomic status, breastfeeding frequency, time of delivery (early/late/on-time) as a proxy for gestational age, pre-pregnancy BMI, birthweight, and sex. Effects are reported for each standard deviation increase in exposure. RESULTS:NO2 was negatively associated with fine motor score (β=-0.55, p=0.006), motor score (β=-0.90, p =0.007), and cognitive score (β=-0.55, p=0.01). PM2.5 and PM10 were negatively associated with social emotional scores (β=-0.77, p=0.009 and β=-0.66, p=0.01 respectively). The association between NO2 and cognitive score varied by infant sex (p-interaction = 0.046), where NO2 was negatively associated with cognitive score among females (β=-0.16, p=0.0006) but not males (β=-0.01, p=0.81). CONCLUSIONS:Higher postnatal exposure to AAP in the first month of life was inversely associated with scaled motor, cognitive, and social-emotional scores at 24-months of age. Sex-specific findings for scaled cognitive score may suggest differential impacts of AAP exposure among females. These results indicate that AAP may negatively impact neurodevelopment in early life. KEYWORDS: Air Pollution, Neurodevelopmental Outcomes, Multi-pollutant, Environmental Disparities, Short-term Exposure

Within-person changes in basal cortisol and caregiving modulate executive attention across infancy.

One pathway by which environments of socioeconomic risk are thought to affect cognitive development is through stress physiology. The biological systems underpinning stress and attention undergo a sensitive period of development during infancy. Psychobiological theory emphasizes a dynamic pattern of context-dependent development, however, research has yet to examine how basal cortisol and attention dynamically covary across infancy in ecologically valid contexts. Thus, to address these gaps, we leveraged longitudinal, multilevel analytic methods to disentangle between- from within-person associations of hypothalamic-pituitary-adrenal (HPA) axis activity and executive attention behaviors across infancy. We use data from a large longitudinal sample (N = 1,292) of infants in predominantly low-income, nonurban communities at 7-, 15-, and 24-months of age. Using multilevel models, we investigated longitudinal associations of infant attention and basal cortisol levels and examined caregiving behaviors as moderators of this relationship. Results indicated a negative between- and within-person association between attention and cortisol across infancy and a within-person moderation by caregiver responsiveness. In other words, on the within-person level, higher levels of cortisol were concomitantly associated with lower infant attention across the first 2 years of life. However, variation in the caregiver's level of responsiveness either buffered or sensitized the executive attention system to the negative effects of physiological stress.

Early-life epilepsy after acute symptomatic neonatal seizures: A prospective multicenter study.

We aimed to evaluate early-life epilepsy incidence, seizure types, severity, risk factors, and treatments among survivors of acute neonatal seizures. Neonates with acute symptomatic seizures born 7/2015-3/2018 were prospectively enrolled at nine Neonatal Seizure Registry sites. One-hour EEG was recorded at age three months. Post-neonatal epilepsy and functional development (Warner Initial Developmental Evaluation of Adaptive and Functional Skills - WIDEA-FS) were assessed. Cox regression was used to assess epilepsy-free survival. Among 282 infants, 37 (13%) had post-neonatal epilepsy by 24-months [median age of onset 7-months (IQR 3-14)]. Among those with post-neonatal epilepsy, 13/37 (35%) had infantile spasms and 12/37 (32%) had drug-resistant epilepsy. Most children with post-neonatal epilepsy had abnormal neurodevelopment at 24-months (WIDEA-FS >2SD below normal population mean for 81% of children with epilepsy vs 27% without epilepsy, RR 7.9, 95% CI 3.6-17.3). Infants with severely abnormal neonatal EEG background patterns were more likely to develop epilepsy than those with mild/moderate abnormalities (HR 3.7, 95% CI 1.9-5.9). Neonatal EEG with ≥3days of seizures also predicted hazard of epilepsy (HR 2.9, 95% CI 1.4-5.9). In an adjusted model, days of neonatal EEG-confirmed seizures (HR 1.4 per day, 95% CI 1.2-1.6) and abnormal discharge examination (HR 3.9, 95% CI 1.9-7.8) were independently associated with time to epilepsy onset. Abnormal (vs. normal) three-month EEG was not associated with epilepsy. In this multicenter study, only 13% of infants with acute symptomatic neonatal seizures developed post-neonatal epilepsy by age 24-months. However, there was a high risk of severe neurodevelopmental impairment and drug-resistant seizures among children with post-neonatal epilepsy. Days of EEG-confirmed neonatal seizures was a potentially modifiable epilepsy risk factor. An EEG at three months was not clinically useful for predicting epilepsy. These practice changing findings have implications for family counseling, clinical follow-up planning, and future research to prevent post-neonatal epilepsy.

Cataloguing and characterizing interests in typically developing toddlers and toddlers who develop ASD.

Intense interests are common in children with and without autism spectrum disorder (ASD), and little research has characterized aspects of interests that are unique to or shared among children with and without ASD. We aimed to characterize interests in a sample of infants at high-familial-risk (HR) and low-familial-risk (LR) for ASD using a novel interview. Participants included HR siblings who were diagnosed with ASD at 24 months (HR-ASD, n=56), HR siblings who did not receive an ASD diagnosis at 24 months (HR-Neg, n=187), and a LR comparison group (n=109). We developed and collected data with the Intense Interests Inventory at 18- and 24-months of age, a semi-structured interview that measures intensity and peculiarity of interests in toddlers and preschool-aged children. Intensity of interests differed by familial risk at 24 months, with HR-ASD and HR-Neg groups demonstrating equivalent intensity of interests that were higher than the LR group. By contrast, peculiarity of interest differed by ASD diagnosis, with the HR-ASD group showing more peculiar interests than the HR-Neg and LR groups at 24 months. At 18 months the HR-ASD group had more peculiar interests than the LR group, though no differences emerged in intensity of interests. This measure may be useful in identifying clinically-relevant features of interests in young children with ASD. We also replicated previous findings of males showing more intense interests at 18 months in our non-ASD sample. These results reveal new information about the nature of interests and preoccupations in the early autism phenotype. LAY SUMMARY: Intense interests are common in young children with autism and their family members. Intense interests are also prevalent among typically-developing children, and especially boys. Here we catalog interests and features of these interests in a large sample of toddlers enriched for autism risk. Children who had family members with autism had more intense interests, and those who developed autism themselves had more unusual interests at 24 months. These results highlight the importance of different aspects of interest in autism.

Congenital Right Hand Syndactyly in a child: Plain Radiographic Features and Case Report

Syndactyly is a Greek word meaning fused digits, may involve fusion of the soft tissues with or without bony fusion. It is regarded as the most common congenital defect of the hand, detected in 1 out of every 2000 live births, twice as common in males, and more among the Caucasians. This is a 10-month-old male infant that was referred for plain radiograph of the right hand on account of completely fused 2nd to 5th digits and an incompletely fused 1st digit with medial deviation since birth. The plain radiograph showed soft tissue fusion of the 2nd to 4th web spaces completely with a partially fused 1st web space. There is associated fusion of the distal phalanges of the 4th and 5th digit, foreshortening of the 3rd and 4th metacarpals with the middle phalanges of the 2nd and 5th digits. There is flexion of the interphalangeal joint and medial deviation of the 1st digit. There is also haphazard arrangement of the metacarpals and phalanges most especially the 3rd and 4th digits. Prominence of the thenar and hypothenar eminences with mild ulnar deviation of the entire right hand were also demonstrated. The contralateral left hand appears within normal limits, a complementary ultrasound showed normal abdominal organ situs. A diagnosis of congenital syndactyly most likely the complex-complicated form in a 10-month-old infant was established. The surgical repair to establish function and achieve excellent aesthetics was deferred until the child clocks about 24-months of age. We report a case of congenital syndactyly of the right hand due to its radiographic form of presentation in this 10-month-old infant.

Prosocial television and prosocial toddlers: A multi-method, longitudinal investigation

How screen use might affect early childhood outcomes is an important question for parents, but existing research is patchy. In particular, screen time is often examined in relation to sleep and aggression, but much less is known about its links with prosocial behaviour. To address this gap, we conducted semi-structured observations and interviews / questionnaires with both mothers and fathers in a sample of 195 (predominantly affluent and educated) British families tracked across three time-points, when the first-born child was 14-, 24-, and 36-months old. We also applied an objective coding scheme to assess the relative frequency of prosocial behaviour in the programmes and films children were watching at age 24-months. While our results showed no overall associations between prosocial behaviour and either screen time or screen content, there were interaction effects. Specifically, children whose favourite programmes were slow-paced and rich in prosocial content were particularly likely to show developmental gains in sharing. We discuss these findings in terms of their implications for parents, researchers, and policy makers.