System In Children Research Articles

Maturation of the Central Auditory Nervous System in Children with Auditory Processing Disorder.

Neurodevelopmental delay has been proposed as the underlying cause of the majority of cases of auditory processing disorder (APD). The current study employs the cortical auditory evoked potential (CAEP) to assess if maturational differences of the central auditory nervous system (CANS) can be identified between children who do and do not meet the diagnostic criterion for APD. The P1-N1 complex of the CAEP has previously been used for tracking development of the CANS in children with hearing impairment. Twenty-seven children (7 to 12 years old) who failed an APD behavioral test battery were age-matched (within 3 months) to children who had passed the same battery. CAEP responses to 500-Hz tone burst stimuli were recorded and analyzed for latency and amplitude measures. The P1-N1 complex of the CAEP, which has previously been used for tracking development of the CANS in children with hearing impairment, showed significant group differences. The children diagnosed with APD showed significantly increased latency (∼10 milliseconds) and significantly reduced amplitude (∼10 μV) of the early components of the CAEP compared with children with normal auditory processing. No significant differences were seen in the later P2 wave. The normal developmental course is for a decrease in latency and increase in amplitude as a function of age. The results of this study are, therefore, consistent with an immaturity of the CANS as an underlying cause of APD in children.

The Michigan Caries Prevention Program: Transforming the System of Children's Oral Health

The Michigan Caries Prevention Program: Transforming the System of Children's Oral Health

Genetic Syndromes Predisposing to Tumors of Central Nervous System in Children

The overall incidence of childhood malignancies is rather low. Central nervous system tumours constitute the largest group of solid tumours among children. In contrast to adult population, a genetic predisposition is frequently associated with these malignancies (it is assumed to occur in approximately 15-25% of all childhood tumours) and there is also a number of monogenic hereditary syndromes known to be associated with brain tumours. The purpose of this article is to present an overview of genetic syndromes reported to increase the risk of childhood central nervous system tumours. The outlined tumour predispositions are divided into two groups. Firstly, syndromes with multisystem manifestation, where neoplasia is one of the components, whereas the distinguishing symptom is usually non-oncological. Secondly, there are syndromes that are diagnosed by the associated neoplasm withou any other noticeable phenotypic manifestation. A brief description of particular diseases is provided with a focus on associated central nervous system tumours. Detection of a tumour predisposition in a child is important not only for the child itself, but also for its family relatives. Often, a modification of treatment is necessary in regards to a genetic diagnosis. With the evolution of personalised medicine the possibility of "tailored" therapy will probably be a demanded solution. Last but not least, it is crucial to provide the child with a specialised preventive care owing to the risk of another potential malignancy. The diagnosis of hereditary cancer predisposition has also a big impact on the relatives of the patient. It enables to specify their oncological risk and arrange a specialised preventive care program, if needed. For high-risk parents planning another pregnancy there is a possibility to prevent the transfer of a certain disposition with the aid of preimplantation and prenatal genetic testing.

Patient-Reported Outcomes Measurement Information System in Children with Crohn's Disease

Patient-Reported Outcomes Measurement Information System in Children with Crohn's Disease

Intra- and Intersession Repeatability of an Optical Quality and Intraocular Scattering Measurement System in Children.

PurposeTo evaluate intra- and intersession repeatability of objective optical quality and intraocular scattering measurements with a double-pass system in children.MethodsForty-two eyes of 42 children were included in the study. An optical quality analysis system (OQAS) was used to measure optical quality parameters, including modulation transfer function cutoff frequency (MTFcutoff), Strehl ratio (SR), OQAS values (OV) at 3 different contrasts and objective scatter index (OSI). Three measurement sessions with 10-min intervals were operated by the same technician, and in each session four consecutive measurements were obtained.ResultsMean values for MTFcutoff, SR and OSI were 46.85 ± 7.45cpd, 0.27 ± 0.06 and 0.34 ± 0.22 respectively. 1) The intraclass correlation coefficients were ranged from 0.89 to 0.97 and coefficients of variation from 0.06 to 0.16 for all the parameters in the first session; the relative repeatability were 11.1% (MTFcutoff), 22.5% (SR), 10.9% (OV100%), 16.6% (OV2%), 22.4% (OV9%) and 56.3% (OSI). Similar results were found in the second and third sessions. 2) Bland-Altman analysis showed that narrow 95% confidence intervals (compared between the first and second sessions) ranged from -5.42 to 5.28 (MTFcutoff), -0.05 to 0.07 (SR), -0.18 to 0.18 (OV100%), -0.26 to 0.29 (OV20%), -0.33 to 0.39 (OV9%) and -0.11 to 0.09 (OSI); the comparison between any two of the three sessions showed similar results.ConclusionMeasurements of optical quality and intraocular scattering in children by the double-pass system showed good intra- and intersession repeatability. Retinal image quality is high and intraocular scattering is low in children.

Social Competence and Language Skills in Mandarin–English Bilingual Preschoolers: The Moderation Effect of Emotion Regulation

Research Findings: The main aim of this study was to examine whether language skills and emotion regulation are associated with social competence and whether the relationship between English skills and social competence is moderated by emotion regulation in Mandarin–English bilingual preschoolers. The language skills of 96 children ages 36–69 months from Australian child care centers were assessed using standardized English and Mandarin tests. Social competence was assessed using teacher reports on the Behavior Assessment System for Children–2 (BASC-2) with 4 composite scales: Externalizing, Internalizing, Behavioral Symptoms, and Adaptive Skills. Positive emotion regulation and emotion dysregulation were assessed using the disappointing gift task and teacher report on the Emotion Regulation Checklist. The results show that positive emotion regulation, emotion dysregulation, English skills, and Mandarin skills were associated with different composites of the BASC-2; the relationships between English skills and Behavioral Symptoms were moderated by positive emotion regulation; and English skills and Adaptive Skills were moderated by emotion dysregulation. Practice or Policy: Discussion of the results includes new considerations for a focus on emotion regulation as well as language to promote social competence in bilingual children.

Hope mediates the relationship between depression and quality of life among youths enrolled in a family-based pediatric obesity intervention

ABSTRACTThis study examined the hypothesis that hope mediates the relationship between depressive symptoms and health-related quality of life (QOL) among youths with obesity. Children (N = 93; aged 7–17) enrolled in the “Positively Fit” treatment study completed the Children’s Hope Scale, Behavior Assessment System for Children—Second Edition, Self-Report of Personality Depression Subscale (BASC-2, SRP), and the PedsQLTM to operationalize the hypothesized constructs. A bias corrected bootstrap of the indirect effect was conducted to assess the study hypothesis. There was an indirect effect of depression on QOL through hope. The 95% confidence interval ([CI] = −0.34 to −0.07) had an effect size (standardized indirect effect of −0.14). Hope is a significant mediator of the relationship between depression and QOL. Future research should examine this effect with a longitudinal study design and should test other possible mediators.

A Pilot Study of Integrated Listening Systems for Children With Sensory Processing Problems

This pilot study explored the effects of Integrated Listening Systems (iLs) Focus Series on individualized parent goals for children with sensory processing impairments. A nonconcurrent multiple baseline, repeated measure across participants, single-case study design was employed (n = 7). The 40-session intervention was delivered at home and in the clinic. Individualized family goals served as the repeated measure. Exploratory analyses included the evaluation of physiological arousal. Participants showed improvement in home and education-related goals. Changes in physiologic arousal were noted in five of seven participants. Standardized scales demonstrated sensitivity to change. Thus, the iLs program may be beneficial for school- or clinic-based intervention.

Neurophysiological Characteristics and Methods of Correcting Somatic Dysfunctions in Sensory Auditory System in Children with Perinatal Pathology of the Central Nervous System

The study showed how the severe health condition at birth has influence on manifestation rate of the peripheral and central hearing disorders in patients with perinatal pathology of the central nervous system. The algorithm for correcting somatic dysfunctions reduces frequency and degree of neurosensory hearing disorders at the earliest child development stage, thereby promoting the integration of these patients into society.

A Randomized Crossover Study to Assess Overnight Glucose Control with Single-Hormone and Dual-Hormone Artificial Pancreas Systems in Children with Type 1 Diabetes in a Diabetes Camp

A Randomized Crossover Study to Assess Overnight Glucose Control with Single-Hormone and Dual-Hormone Artificial Pancreas Systems in Children with Type 1 Diabetes in a Diabetes Camp

Outpatient Management of Intra-Corporeal Left Ventricular Assist Device System in Children: A Multi-Center Experience

Little is known about the outcomes of children supported on intracorporeal left ventricular assist device (HVAD), and the feasibility of outpatient management. All centers with pediatric patients discharged from the hospital on the device were identified using company database. A total of 14 centers were contacted, with 9 centers, contributing data retrospectively. From 2011 to 2013, 12 pediatric patients (7 females), mean aged 11.9 ± 2.3 years (range 8-15), mean weight 43 ± 19 kg (range 18-81), mean body surface area 1.3 ± 0.3 m(2) (range 0.76-1.96) were identified. Diagnosis included: dilated cardiomyopathy (CMP) (n = 5), noncompaction CMP (n = 4), toxic CMP (n = 2) and viral CMP (n = 1). Indications for support were permanent support (n = 1), bridge to recovery (n = 1) and bridge to transplantation (n = 10). Prior to HVAD implantation, all patients received intravenous inotropes and two patients were on temporary mechanical support. Overall mortality was 0%. Mean duration of inpatient and outpatient support were 56 (range: 19-95 days) and 290 days (range: 42-790), respectively. Mean readmission rate was 0.02 per patient month (2.1 per patient). No adverse events involving emergency department occurred. Eight children resumed local schooling. Home discharge of children supported on HVAD is feasible and safe. School integration can be achieved. There is wide center variability to discharge practice for children.

Abstract T P363: A Pilot Study: Parents Show Evidence of PTSD while Children Display Anxiety following Childhood Stroke

Objectives: Post-traumatic stress disorder (PTSD) is commonly found in parents and child following life-threatening pediatric illness or injury including cancer, organ transplant, traumatic brain injury, and admission to the pediatric intensive care unit. It can be diagnosed months to years after the event. The prevalence and significance of PTSD in parents and children following a childhood stroke are unknown. We examine the emotional outcomes of a cohort of 33 parents and 10 children following recent stroke in the child. Methods: We prospectively enrolled children with stroke of ages 7-18 years and parents of children with stroke ages 0-18 years whose stroke occurred in 2013 or 2014. Parents were screened for PTSD using the PTSD checklist and children with stroke ≥ 7 years of age were screened with the University of California Los Angeles PTSD Reaction Index. Emotional outcome of the child was examined with the Behavior Assessment System for Children (BASC-2). Parents were surveyed on their child’s stroke outcome with the Recurrence and Recovery Questionnaire (RRQ). Results: Of the 33 parents (10 fathers, 23 mothers) 18 (55%) met one or more of the 3 PTSD criteria and 8 (24%) met all criteria for PTSD. Although not yet reaching significance, RRQ is higher in the group of parents with PTSD (RRQ M= 1.2, SD=1.4) compared to parents without PTSD (M=0.6, SD=1.0). The subsample of children enrolled ranged in age from 7 to 17 years old at time of stroke. Although preliminary, of the children who were surveyed none met criteria for PTSD while 2 of the 9 (22%) had clinically significant levels of anxiety. Conclusion: Preliminary findings reveal a rate of PTSD in parents of children with childhood stroke similar to that found in parents of other critically ill children. We did not yet detect PTSD in our small sample of children. However, emotional ratings revealed that over 20% experience anxiety. The children of parents with PTSD had higher RRQ scores reflecting increased disability which may be related to the parent’s PTSD. PTSD in parents of a child with stroke and children with anxiety following stroke could impede compliance with therapeutic interventions and, consequently, lead to poorer functional outcome in the child.

Effectiveness of Play Therapy on Problematic Behaviors of Preschool Children With Somatization

Child-centered play therapy (CCPT) is an evidence-based intervention for children with a variety of presenting problems and diagnoses. However, the effectiveness of CCPT for young children with somatization has not been explored. Thus, in this study, two preschool children with clinical levels of somatization, as rated by parents or teachers on the Behavior Assessment System for Children, Second Edition (BASC-2), participated in 14 sessions of CCPT. The participants’ problematic classroom behaviors were monitored prior to and during participation in play therapy. After participation in play therapy, both children displayed decreased symptoms of somatization and decreased problematic classroom behaviors. The results of this single-case research design are reviewed and implications for counselors are discussed.

Nutrition and Immune System in Children with Simple Obesity.

The purpose of this study was to evaluate dietary factors in nutrition influencing the immune system of children and teenagers suffering from simple obesity. The study involved 100 children and teenagers aged 7-18 with simple obesity. Nutritional data were obtained from 3-day food records. The consumed nutrients, including immunomodulators and immunostimulants, were estimated based on the nutrition interview. The results were compared with the nutritional norms. On average, the proportion of n-6:n-3 fatty acids equalled 10:1. Among the amino acids, the highest intake values in the diet were observed for glutamine (13,694.6 mg/day). The study demonstrates inadequate intake levels of iron (73% of recommended dietary allowance, RDA), vitamin C (65% of RDA), and vitamin D (11% of RDA) taking into account the median values for the entire study group. The median daily intake of other nutrients exceeded the RDA values. The diets of the participants in this study were not properly balanced with respect to immunomodulators, which may contribute to the occurrence of immunological disorders and immunodeficiency in this group of patients.

Clinical Efficacy Assessment of Cefteram Pivoxil Using Clinical Scoring Systems in Children with Acute Rhinosinusitis

Clinical Efficacy Assessment of Cefteram Pivoxil Using Clinical Scoring Systems in Children with Acute Rhinosinusitis

METHODS USED BY MOTHERS TO HELP CHILDREN DURING SOLVING COGNITIVE PROBLEM TASKS: COMPARISON BETWEEN MOTHERS OF SECURELY AND INSECURELY ATTACHED PRESCHOOL CHILDREN

Abstract: Attachment is a permanent emotional bond activated in children by signals that they perceive as frightening, dangerous or stressful, while in the parents' attachment system of care, it is activated by the goal of satisfying children's needs. The aim of this research was to determine which strategies mothers use in their interaction with children, aged 5 to 7 (N = 80) during their cognitive problem solving. More specifically, the goal was to ascertain if there is a difference in the sensitivity to children's cognitive needs on the part of mothers of securely and mothers of insecurely attached children. Compared to mothers of insecurely attached children, mothers of securely attached children more often help their child by giving it appropriate instructions (scaffolding). Mothers of insecurely attached children, in situations when the child's solution is incorrect, more often help their children by giving them long explanations, regardless whether the child listens or understands what is been said (a monologue).Key words: attachment, preschool children, mothers, social interactions, strategy useIntroductionIntegrating the results of research by Lorenz and Harlow and conclusions from the field of evolutionary biology, ethology and psychoanalysis, Bowlby (1969/82) developed the theory of attachment between children and mothers. In his theory, he defines attachment as a strong emotional bond with the object of attachment. This bond is characterized by closeness and proximity to the particular person, especially during times of threat and distress. Bowlby believes the attempt of getting close to a particular person to be a basic form of human behavior, which increases the probability of protection and survival. Parental behavior is organized and managed by a behavioral system of care and protection, and it is connected to the attachment behavior system of a child.In 1969, Mary Ainsworth further elaborated on Bowlby's theory by drafting a method for evaluation of attachment (The Strange Situation) for children aged 12 to 20 months. In research using these techniques, children's reactions are described through two forms of behavior with the parent, which the author classifies as follows: securely attached children and insecurely attached children (anxious-ambivalent and anxious-avoidant). Main & Solomon (1986) also developed guidelines for classification of a third insecurely attached form of behavior, and they named it disorganized/disorientated.Later development of measures that use pictorial material and puppets, has enabled the evaluation of attachment for older children as well. In this research, we used the MCAST (The Manchester Child Attachment Story Task) techniques (Green, Stanley, Smith, & Goldwyn, 2000).According to the attachment theory, one of the parent's important roles is that the child's behavior, such as protection seeking and closeness (the role and goal of attachment for the child) changes into offering protection, comfort and care for the child (the role and goal for the parent). The parent's system of care is activated by internal and external signals associated with situations, which the parent perceives as frightening, dangerous or stressful for the child (George & Solomon, 2008).When this system is activated, the parent needs to decide how to behave. This behavior depends on the evaluation of information from different sources. One of the sources is the evaluation of the child's signal and the other is the parent's evaluation of the threat or danger. There are also situations when the parent's care system is activated while the child's system is not. For example, situations when the parent believes the child is in danger while child does not see the same situation as dangerous. In that case, the parent's behavior could be controlling or intrusive (George & Solomon, 2008). Moreover, the parent is constantly required to accommodate each of the developmental stages of the child (Moss & Dubois-Comtois, 2004). …

Treatment for Morphosyntactic Deficits: From Specific Strategies to a Holistic Approach

Clinicians have a wide-variety of therapy materials, activities, techniques, and procedures available for treatment of children with morphosyntax deficits. This clinically-focused article describes strategies that highlight the critical features of morphosyntactic targets, reviews, techniques, and procedures available to clinicians for their mindful use, and advocates for the addition of distributed learning in daily contexts by involving caregivers in language facilitation. It concludes with a proposal for a holistic approach that encompasses three levels of language intervention. At the first level, the clinician overtly primes the child's system; at the second level, the clinician sets up multiple opportunities to use the target in context; at the third level, the clinician engages caregivers as agents of intervention for distributed learning and sends the child out into a language-facilitating environment.

Promoting Children's Rights in Social Work and Social Care: A Guide to Participatory Practice By MargaretBell London: Jessica Kingsley Publishers, 2011 ISBN 9781843106074, 224 pp, £19.99 (pb)

Participatory work in child care draws on two broad currents of theory and practice: an older tradition of individually focused social work and psychological therapies, sensitive to children's needs and wishes and with an emphasis on empathic communication; and a newer tradition of empowerment, based on theories of children's rights and responsiveness to service users, and to some extent on new thinking about the social status and capabilities of children. Both traditions are reflected in this book (number 14 in the ‘Children in Charge’ series edited since the late 1990s by Mary John) which represents the fruit of the author's work over many years as a practitioner, a teacher and a researcher in social work with children. The first half of the book introduces and reviews children's participation in theory, policy and practice. The first chapter offers a broad overview of underpinning principles and how they have been expressed in different arenas. This is followed by a review of methods and means by which children can participate in decision-making — direct presence, representation, advocacy, consultation — and of the different factors that require to be taken into account. A little more could have been said here about the issue of age. Chapter 3 gives a thorough review of policy and guidance in the UK (or rather England). Chapter 4 is devoted to the different theoretical perspectives on which practitioners are encouraged to draw, eclectically but not uncritically. This account is more confident in handling psychological theories (cognitive development, attachment, etc.) than in relation to sociological paradigms. The final chapter in Part I is a very helpful review of the barriers to children's participation, particularly in relation to adult attitudes — at cultural, individual and organisational levels. On the last, a reference back to Shier's ‘pathways’ might have been helpful. Part II is devoted to four pieces of empirical research conducted by the author, singly or with colleagues. The first was a study of family group conferences, whose conclusions were broadly positive in that children did have a real sense of participation and influence. The second was a study of initial child protection investigations in which, perhaps unsurprisingly, there was little evidence of children being effectively engaged or even, in some cases, having much of a clue as to what was going on, and where for the few children who did participate the experience was not necessarily positive. Both studies were conducted more than a decade ago, but are still highly relevant. The third was a more recent study of electronic case recording under the Integrated Children's System, which focused in part on children's perspectives on the process and the scope for children's input. The fourth study looked broadly at children's involvement in service evaluation, on both an individual and a collective level. Each of these studies offers useful learning about the ways in which children can be supported to participate in their care and protection, and the author draws this out very clearly in each chapter. Because the focus is so much on her own research, at times less is made of other research than might have been helpful — in particular the (admittedly small) body of work that directly addresses children's participation in care, most of which is mentioned here but not discussed at much length. A slightly fuller review of some of this work could have added value to what is already a very useful text. There is a very good summing up of the learning from all four studies; although I was struck by the repeated statement that ‘the child must be seen alone’, i.e. presumably without parents or carers — but is it not sometimes helpful to see children together, whether they are siblings or sharing a place of residence? This book is primarily aimed at the thinking practitioner or manager who wants to make their work more responsive to children's claims for inclusion in the decisions that affect their lives. It offers them a sound review of the underpinning theories and principles, and an excellent research-based analysis of the barriers in practice and how they can be overcome. Although the foregrounding of ‘children's rights’ in the title is not really followed through in much of the writing, which tends to be couched more in terms of children's needs and best interests, the author does return to this theme in the conclusion. This book will certainly help those practitioners and organisations who want to adopt a rights-based approach to working with children, especially at the individual level. For children and young people's collective participation, it should probably be read alongside Mike Stein's gritty history of the development of Who Cares?, NAYPIC and A National Voice (Stein, 2011).

Bullying Participant Behaviors Questionnaire (BPBQ): Establishing a Reliable and Valid Measure

The current study further establishes the reliability and validity of the Bullying Participant Behaviors Questionnaire (BPBQ), a self-report survey that allows for an examination of participation in various bullying participant role behaviors including bully, assistant to the bully, victim, defender of the victim, and outsider. The study included 801 sixth- through eighth-grade students. The results of the study confirmed a five-factor structure (Bully, Assistant, Victim, Defender, and Outsider). Internal consistency of the subscales was high and item-subscale correlations were all significant and moderate to high. Correlations among the BPBQ subscales and with additional measures, including the Behavior Assessment System for Children, Second Edition, Self-Report of Personality (Reynolds & Kamphaus, 2004), the Social Skills Rating System (Gresham & Elliott, 1990), and an unpublished victim measure (Demaray & Malecki, 2003), provided evidence of concordant, convergent, and divergent validity. Gender and grade level differences were also investigated among the bullying participant behaviors.

Evaluation of Selected Markers of the Immune System in Children of Renal Transplant Recipients

ObjectiveThe aim of this study was to evaluate whether chronic use of immunosuppressive drugs during pregnancy in women after renal transplantation affects the concentration of immunoglobulin G (IgG) and IgM in the serum of their children. MaterialSeventy-eight children aged 1 day to 15 years were enrolled. The study group consisted of 39 children born to renal transplant recipient mothers. The control group comprised 39 children whose mothers had not received immunosuppressive medications during pregnancy and were born at similar gestational age. MethodsSerum concentrations of IgG and IgM were evaluated with the use of agglutination immunoassays on Siemens or Cobas device. Age-adjusted reference values for immunoglobulins formulated by Wolska-Kusnierz et al were used. Statistical analysis was performed with the use of Statistica 10.0 software with P value <.05 considered significant. ResultsNormal IgG concentrations were found in 82.05% (32) of children from the study group and 79.49% (31) of the control group. IgG concentrations below normal range were observed in 12.82% (5) of children from the study group and in 15.38% (6) of the control group. Normal concentrations of IgM were found in 53.85% (21) of children from the study group and in 61.54% (24) of the control group. Decreased levels of IgM were observed in 38.46% (15) of children from the study group and 35.9% (14) of the control group. There were no significant differences regarding the analyzed values between the groups. ConclusionThe exposure to chronic intrauterine immunosuppression had no significant effect on the concentration of IgG or IgM in children born to kidney transplant recipients.