Comprehensive Developmental Inventory For Infants Research Articles

Association between interruption of intervention and language performance in young children with language delay-a cohort study during COVID-19 pandemic.

To assess the association between a three-month interruption of language intervention programs and the language performance of children with language delay during the COVID-19 pandemic, and to identify which children are more vulnerable to such interruptions. This is a retrospective study involving 33 children with language delay who experienced a three-month suspension of language interventions due to the COVID-19 pandemic. We collected their demographic data and language performance scores from the Comprehensive Developmental Inventory for Infants and Toddlers-Diagnostic test (CDIIT-DT) at four different time points. The scores were analyzed using a Wilcoxon Signed Ranks test. The median scores of language comprehension and overall language ability showed a decreasing trend during the interruption period. However, resuming interventions post-interruption showed a statistically significant increase in all language domains. Children in the borderline delay group (CDIIT-DT DQ scores between 71 and 85) were more likely to experience a decline in their language abilities during the interruption. This is the first study to reveal a decreasing trend in language performance during interruption periods, and highlighting the significance of post-interruption language interventions in facilitating improvements. Furthermore, our study brings attention to the heightened vulnerability of children exhibiting borderline language delay in overall language ability tests when faced with interruptions in language interventions.

Prenatal chlorpyrifos exposure in association with PPARγ H3K4me3 and DNA methylation levels and child development.

Chlorpyrifos, one of the most widely used pesticides, can penetrate the placenta and affect fetal growth and neurodevelopment. Epigenetic regulation of peroxisome proliferator-activated receptor gamma (PPARγ), such as DNA methylation and trimethylation of lysine 4 of H3 (H3K4me3), may provide a potential mechanism for how fetal growth and development are impacted by chlorpyrifos exposure. The aims of the study were to investigate whether prenatal chlorpyrifos exposure was associated with H3K4me3 and DNA methylation levels of the PPARγ gene in the placenta and the related effects on birth outcomes and neurodevelopment. Among 425 mother-infant pairs from the Taiwan Birth Panel Study, chlorpyrifos levels were measured in cord blood by using online SPE-LC/HESI/MS/MS; placental PPARγ H3K4me3 and DNA methylation levels were measured by ChIP-qPCR and pyrosequencing, respectively; the neonates' health outcomes were extracted from the medical records; and childhood neurodevelopment was evaluated by using the Comprehensive Developmental Inventory for Infants and Toddlers in 2-year-old children. Multivariable regression models were used to adjust for potential confounders. After controlling for potential confounders, each unit increase in the natural log-transformed prenatal chlorpyrifos exposure level was associated with an increase in the PPARγ DNA methylation level (adjusted β (aβ)=0.77, p=0.032) and poorer performance in the cognitive and language domains at 2 years old, especially in boys (aβ=-1.66, p=0.016, and aβ=-1.79, p=0.023, respectively). PPARγ H3K4me3 levels were positively associated with gestational age (aβ=0.16, p=0.011), birth weight (aβ=30.52, p=0.013), birth length (aβ=0.18, p=0.003 and aβ=0.15, p=0.042), and gross-motor performance (aβ=1.67, p=0.036). Our findings suggested that prenatal chlorpyrifos exposure affected PPARγ DNA methylation levels and performance in the cognitive and language domains.

Maternal H. pylori seropositivity is associated with gestational hypertension but is irrelevant to fetal growth and development in early childhood

BackgroundHelicobacter pylori infection is known to alter growth-related hormones and affect growth in young children. However, it is still unknown whether maternal H. pylori infection has an impact on the levels of cord blood growth-related hormones and whether this can predict intrauterine growth restriction and poor physical and neurodevelopmental outcomes in children. This study aimed to examine associations between maternal H. pylori infection and pregnancy-related adverse events, fetal growth and early childhood development.MethodsIn this prospective cohort study, we recruited singleton pregnant women without major medical illnesses from January 2014 to January 2015. Seropositivity for H. pylori was defined as > 12 U/ml of anti-H. pylori IgG in maternal serum. Demographic data and pregnancy-related medical issues of the cohort were documented. Cord blood levels of insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3), insulin, and ghrelin were determined using ELISA. The growth of the included neonates was monitored annually for up to 3 years, and cognitive development was assessed using the comprehensive developmental inventory for infants and toddlers (CDIIT) test 3 years after birth.ResultsOf the 106 enrolled women, 25 (23.6%) were H. pylori-seropositive. Maternal H. pylori seropositivity was correlated with a higher risk of developing gestational hypertension (GH) (12% vs. 1.2%, p = 0.04) and lower cord blood levels of IGF-1 (< 35 ng/ml, 70.0% vs. 40.7%, p = 0.02) and IGFBP-3 (< 1120 ng/ml, 100.0% vs. 76.3%, p = 0.02) compared with the seronegative women. No significant impacts on birth weight, childhood growth and cognitive development were found to be correlated with maternal H. pylori seropositivity during pregnancy.ConclusionsMaternal H. pylori infection during pregnancy was more likely to lead to the development of GH, but was not correlated with fetal and childhood growth and development. In addition to close monitoring of hypertension, H. pylori eradication can be considered for mothers with H. pylori infection.

Is Mastery Motivation a Mediator of Relations between Maternal Teaching Behavior and Developmental Abilities in Children with Global Developmental Delay?

Aims: Mastery motivation refers to a child’s persistent attempts to solve problems and learn skills. The purpose of this longitudinal study was to examine whether children’s mastery motivation-mediated relationships between early maternal teaching behavior and later developmental abilities in children with global developmental delay (GDD). Methods: Fifty-six dyads of mothers and their children with GDD (aged 24–42 months) were assessed two times, at study entry and 6-months later. Maternal teaching behaviors were assessed using the Nursing Child Assessment Teaching Scale. Children’s developmental abilities and mastery motivation were measured using the Comprehensive Developmental Inventory for Infants and Toddlers and the revised Individualized Moderately Challenging Mastery Tasks, respectively. A Pearson correlation matrix was used to propose hypothetical models, and path analysis was used to examine the mediation effect. Results: Mastery motivation significantly mediated the relationship between maternal teaching behavior and children’s cognitive, fine motor, and gross motor abilities 6 months later. Conclusions: Mothers’ teaching predicted their children’s development directly and also indirectly through the child’s mastery motivation. The findings support the importance of the quality of mothers teaching behaviors and the mastery motivation of children with GDD on development.

IQ discrepancy differentiates levels of fine motor skills and their relationship in children with autism spectrum disorders.

PurposeWe investigated 1) the impact of differences in intelligence quotient discrepancy (IQD) on motor skills of preschool-aged children with autism spectrum disorders (ASD); 2) the relationships between IQD and motor skills in preschool-aged children with ASD.MethodsA total of 127 ASD preschool-aged children were divided into three groups according to the size of the IQD: IQD within 1 standard deviation (1SD; EVENIQ; n=81), discrepantly higher verbal intelligence quotient (VIQ; n=22; VIQ>performance intelligence quotient [PIQ] above 1SD [≥15 points]), and discrepantly higher PIQ (n=24; PIQ>VIQ above 1SD [≥15 points]). Children’s IQD and motor skills were determined with the Wechsler Preschool and Primary Scale of Intelligence™ – Fourth Edition and the motor subtests of the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT), respectively.ResultsOne-way analysis of variance revealed significant group differences for the fine motor domain of the CDIIT and the visual–motor coordination subtest (F=3.37–4.38, p<0.05). Children with discrepantly higher PIQ were associated with better fine motor skills than were children with even IQD and those with discrepantly higher VIQ, and vice versa. IQD (PIQ – VIQ) had significant positive correlations with the fine motor domain and fine motor subtests of the CDIIT (r=0.18–0.29, p<0.05).ConclusionThe IQD can identify different levels of fine motor skills in preschool-aged children with ASD. This study suggests important implications for clinicians, therapists, and researchers: discrepantly higher PIQ could be related to better visual–motor coordination, and discrepantly higher VIQ could be related to poor visual–motor coordination. Furthermore, the results support that when therapists are working with preschool-aged children with ASD who are developing fine motor skills or undertaking fine motor tasks related to visual–motor coordination, they may need to pay attention to the children’s IQD.

Development of a Computerized Adaptive Test of Children's Gross Motor Skills

ObjectivesTo (1) develop a computerized adaptive test for gross motor skills (GM-CAT) as a diagnostic test and an outcome measure, using the gross motor skills subscale of the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT-GM) as the candidate item bank; and (2) examine the psychometric properties and the efficiency of the GM-CAT. DesignRetrospective study. SettingA developmental center of a medical center. ParticipantsChildren with and without developmental delay (N=1738). InterventionsNot applicable. Main Outcome MeasuresThe CDIIT-GM contains 56 universal items on gross motor skills assessing children's antigravity control, locomotion, and body movement coordination. ResultsThe item bank of the GM-CAT had 44 items that met the dichotomous Rasch model's assumptions. High Rasch person reliabilities were found for each estimated gross motor skill for the GM-CAT (Rasch person reliabilities =.940-.995, SE=.68-2.43). For children aged 6 to 71 months, the GM-CAT had good concurrent validity (r values =.97-.98), adequate to excellent diagnostic accuracy (area under receiver operating characteristics curve =.80-.98), and moderate to large responsiveness (effect size =.65-5.82). The averages of items administered for the GM-CAT were 7 to 11, depending on the age group. ConclusionsThe results of this study support the use of the GM-CAT as a diagnostic and outcome measure to estimate children's gross motor skills in both research and clinical settings.

Improving the utility of the fine motor skills subscale of the comprehensive developmental inventory for infants and toddlers: a computerized adaptive test

Aim: This study aimed at improving the utility of the fine motor subscale of the comprehensive developmental inventory for infants and toddlers (CDIIT) by developing a computerized adaptive test of fine motor skills.Methods: We built an item bank for the computerized adaptive test of fine motor skills using the fine motor subscale of the CDIIT items fitting the Rasch model. We also examined the psychometric properties and efficiency of the computerized adaptive test of fine motor skills with simulated computerized adaptive tests.Results and conclusions: Data from 1742 children with suspected developmental delays were retrieved. The mean scores of the fine motor subscale of the CDIIT increased along with age groups (mean scores = 1.36–36.97). The computerized adaptive test of fine motor skills contains 31 items meeting the Rasch model’s assumptions (infit mean square = 0.57–1.21, outfit mean square = 0.11–1.17). For children of 6–71 months, the computerized adaptive test of fine motor skills had high Rasch person reliability (average reliability >0.90), high concurrent validity (rs = 0.67–0.99), adequate to excellent diagnostic accuracy (area under receiver operating characteristic = 0.71–1.00), and large responsiveness (effect size = 1.05–3.93). The computerized adaptive test of fine motor skills used 48–84% fewer items than the fine motor subscale of the CDIIT. The computerized adaptive test of fine motor skills used fewer items for assessment but was as reliable and valid as the fine motor subscale of the CDIIT.Implications for RehabilitationWe developed a computerized adaptive test based on the comprehensive developmental inventory for infants and toddlers (CDIIT) for assessing fine motor skills.The computerized adaptive test has been shown to be efficient because it uses fewer items than the original measure and automatically presents the results right after the test is completed.The computerized adaptive test is as reliable and valid as the CDIIT.

Prenatal phenolic compounds exposure and neurobehavioral development at 2 and 7 years of age

BackgroundPhenolic compounds such as bisphenol A (BPA), nonylphenol (NP), and octylphenol (OP) are known as endocrine-disrupting compounds and are commonly used. Their impacts on the neurodevelopment of children are inconclusive. The current study aims to investigate the association between umbilical cord blood levels of BPA, NP, OP and neurodevelopmental outcomes at 2 and 7years of age. MethodsThe study was based on the Taiwan Birth Panel Study, a prospective birth cohort. We collected cord blood plasma to measure phenolic compound levels using ultra-performance liquid chromatography-tandem mass spectrometry. In the follow-up, 208 mother-child pairs with 2-year-old children and 148 mother-child pairs with 7-year-old children were recruited in this study. We used the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) and the Wechsler Intelligence Scale for Children (WISC-IV) for neurodevelopmental assessments at 2 and 7years of age, respectively. Multiple linear regressions were used for statistical analysis. ResultsThe detection rates of BPA, NP, and OP were 55.9%, 77.6%, and 68.3%, respectively. In this study, the median BPA, NP, and OP levels in 2-year-olds were 3.3, 72.6, and 3.3 (ng/ml), respectively. However, the median levels of BPA, NP, and OP were 3.2, 49.3, and 6.6 (ng/ml), respectively. The levels of phenolic compounds were log10-transformed for statistical analysis. Gender stratification was performed. In the WISC-IV neurocognitive assessment, we found both a significant negative association and a trend between cord blood plasma BPA levels and full-scale IQ (p for trend<0.01), the verbal comprehension index (p for trend<0.01), and the perceptual reasoning index (p for trend<0.01) in the study population. After stratification by sex, significant associations were found in full-scale IQ (p for trend=0.03) and the verbal comprehension (p for trend<0.01) index in boys. In girls, prenatal BPA exposure had adverse effects on full-scale IQ (p for trend=0.02), perceptual reasoning index (p for trend<0.01), and working memory index (p for trend=0.02). None of the developmental quotients (DQs) of the CDIIT analysis were significantly associated with phenolic compound levels in cord blood based on continuous or categorical measures. ConclusionPrenatal exposure to BPA affects neurocognitive development, and this effect differs between 7-year-old boys and girls. More studies are needed to elucidate the relationship between phenolic compound exposure in utero and children's neurobehavioral development.

Selecting score types for longitudinal evaluations: the responsiveness of the Comprehensive Developmental Inventory for Infants and Toddlers in children with developmental disabilities.

ObjectiveThe objective of this study was to examine the responsiveness of the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) in children with developmental disabilities (DD).MethodsThe responsiveness of a measure is its ability to detect change over time, and it is fundamental to an outcome measure for detecting changes over time. We compared the responsiveness of four types of scores (ie, raw scores, developmental ages [DAs], percentile ranks [PRs], and developmental quotients [DQs]) in the five subtests of the CDIIT. The CDIIT was administrated three times at intervals of 3 months on 32 children with DD aged between 5 months and 64 months (mean =30.6, standard deviation [SD] =17.8). The CDIIT is a pediatric norm-referenced assessment commonly used for clinical diagnosis of developmental delays in five developmental areas: cognition, language, motor, social, and self-care skills. The responsiveness was analyzed using three methods: effect size, standardized response mean, and paired t-test.ResultsThe effect size results showed that at the 3-month and 6-month follow-ups, responsiveness was small or moderate in the raw scores and DAs of most of the subtest scores of the CDIIT, but the level of responsiveness varied in the PRs and DQs. The standardized response mean results of the 3-month and 6-month follow-ups showed that most of the subtest scores of the CDIIT had respectively moderate and large responsiveness in raw scores and DAs, but the responsiveness varied (from no to large) in PRs and DQs.ConclusionThe findings generally support the use of the CDIIT as an outcome measure. We also suggest using the raw scores and DAs when using a norm-referenced pediatric developmental assessment to evaluate developmental changes and program effectiveness in children with DD.

Intelligence quotient discrepancy indicates levels of motor competence in preschool children at risk for developmental delays.

PurposeThis study aimed to establish 1) whether a group difference exists in the motor competence of preschool children at risk for developmental delays with intelligence quotient discrepancy (IQD; refers to difference between verbal intelligence quotient [VIQ] and performance intelligence quotient [PIQ]) and 2) whether an association exists between IQD and motor competence.MethodsChildren’s motor competence and IQD were determined with the motor subtests of the Comprehensive Developmental Inventory for Infants and Toddlers and Wechsler Preschool and Primary Scale of Intelligence™ – Fourth Edition. A total of 291 children were included in three groups: NON-IQD (n=213; IQD within 1 standard deviation [SD]), VIQ>PIQ (n=39; VIQ>PIQ greater than 1 SD), and PIQ>VIQ (n=39; PIQ>VIQ greater than 1 SD).ResultsThe results of one-way analysis of variance indicated significant differences among the subgroups for the “Gross and fine motor” subdomains of the Comprehensive Developmental Inventory for Infants and Toddlers, especially on the subtests of “body-movement coordination” (F=3.87, P<0.05) and “visual-motor coordination” (F=6.90, P<0.05). Motor competence was significantly worse in the VIQ>PIQ group than in the NON and PIQ>VIQ groups. Significant negative correlations between IQD and most of the motor subtests (r=0.31–0.46, P<0.01) were found only in the VIQ>PIQ group.ConclusionThis study demonstrates that 1) IQD indicates the level of motor competence in preschoolers at risk for developmental delays and 2) IQD is negatively associated with motor competence in preschoolers with significant VIQ>PIQ discrepancy. The first finding was that preschoolers with VIQ>PIQ discrepancy greater than 1 SD performed significantly worse on motor competence than did preschoolers without significant IQD and preschoolers with PIQ>VIQ discrepancy greater than 1 SD. However, preschoolers with significant PIQ>VIQ discrepancy performed better on motor competence than did preschoolers without significant IQD, though the difference was not statistically significant. The second finding was that preschoolers with larger VIQ>PIQ discrepancy had worse motor competence in visual-motor integration and body-movement coordination. Professionals should pay attention to the motor development of children with VIQ>PIQ discrepancy and evaluate children’s IQD along with their motor competence.

Reliability and Validity of the Revised Individualized Structured Mastery Tasks in Children with Developmental Delay

Objective: Mastery motivation is an under-assessed resiliency factor that helps all children achieves their potential; it impels children to strive to master skills and to solve challenging problems. Because children with developmental delay (DD) are perceived to have lower motivation than children with typical development, it is important to have good behavioural measures of mastery motivation. This research describes psychometric properties of the revised individualized structured mastery tasks (ISMT-R), a behavioral assessment, which was updated based on empirical and theoretical feedback. The purposes of this study were: to examine the test-retest, inter-rater and inter-coding reliabilities of the ISMT-R and the relationships between the ISMT-R and both the Dimensions of Mastery Questionnaire (DMQ 18) and developmental ability measured by a standardized developmental test. Method: The design produced a cross-sectional study. Sixty-two mother-child dyads of children with DD aged 23-43 months were recruited. Children were tested with the ISMT-R (puzzles and cause-effect tasks) and the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT). DMQ 18 was filled out by mothers and produced scores for four persistence scales and mastery pleasure scale. Intraclass Correlation coefficient was used to examine reliabilities, and correlation analysis was used to estimate the validities (α=0.05; two-tailed). Results: The ISMT-R had well to excellent test-retest, inter-rater and inter-coding reliabilities. Children’s persistence at moderately difficult tasks positively correlated with the predicted dimensions of the maternal ratings of the child’s persistence on the DMQ 18 and the child’s development based on the CDIIT. Conclusion: The ISMT-R has acceptable reliability and convergent validity, and can be a useful tool for assessing mastery motivation of children with DD. It also can be used in clinical settings to help clinicians distinguish between motivation and developmental ability for each child with DD.

Do maternal interactive behaviors correlate with developmental outcomes and mastery motivation in toddlers with and without motor delay?

Maternal interactive behaviors theoretically affect developmental outcomes and mastery motivation in young children. However, these associations are inconsistent in the literature. The purposes of this study were: (1) to examine the differences in maternal behaviors between toddlers with motor delay (MD) and those with typical development (TD), (2) to investigate the correlation of maternal behaviors and developmental quotients (DQs) in toddlers with MD and TD, and (3) to examine the correlation of maternal behaviors and mastery motivation in toddlers with MD and TD. This was a sex- and mental age-matched case-control study. Twenty-two mother-child dyads of toddlers with MD (ages 23-47 months) and 22 dyads of sex- and mental age-matched toddlers with TD (ages 15-29 months) were recruited. Maternal scores from the Nursing Child Assessment Teaching Scale, 2 indicators of motivation (persistence and mastery pleasure) from individualized mastery tasks and the Dimensions of Mastery Questionnaire, and DQs from the Comprehensive Developmental Inventory for Infants and Children were assessed. Mothers of children in the MD group showed significantly lower cognitive growth fostering scores than mothers of children in the TD group. Maternal total scores were significantly correlated with whole DQs in both groups. In the MD group, maternal total scores correlated significantly with DMQ mastery pleasure but not with mastery task motivation. The study design makes it impossible to know the causal relationships between maternal behaviors and children's DQs and motivation. Mothers of toddlers with MD exhibited less adequate interactive behaviors than mothers of toddlers with TD. Because higher-quality maternal behaviors correlated with higher DQs in the MD group, clinicians should encourage parents to participate in early intervention programs and model high-quality parenting behavior to enhance parents' and children's outcomes.

Perfluorinated Compound Levels in Cord Blood and Neurodevelopment at 2 Years of Age

Epidemiologic data regarding the potential neurotoxicity of perfluorinated compounds (PFCs) are inconclusive. We investigated the associations between in utero exposure to perfluorooctanoic acid (PFOA) and perfluorooctyl sulfonate (PFOS) and early childhood neurodevelopment. We recruited 239 mother-infant pairs in northern Taiwan from the Taiwan Birth Panel Study, which was established in 2004. We examined the association between PFCs in cord blood and children's neurodevelopment at 2 years of age, using the Comprehensive Developmental Inventory for Infants and Toddlers. This tool contains cognitive, language, motor, social, and self-help domains; test scores were further transformed into developmental quotients according to standardized norms. All multivariate regression models were adjusted for infant sex and gestational age, maternal education, family income, cord blood cotinine levels, postnatal environmental tobacco smoke exposure, and breastfeeding. Prenatal PFOS concentrations in both untransformed and natural log (Ln)-transformed values were associated with adverse performance on the whole test and the domains related to development. A dose-response relationship was observed when PFOS levels were categorized into four groups. This association was most obvious in relation to the gross-motor subdomain. Across the PFOS interquartile range, the quotients of the gross-motor subdomain decreased by 3.7 points (95% confidence interval [CI] = -6.0 to -1.5), with an increasing odds ratio of poor performance (2.4; 95% CI = 1.3 to 4.2). In contrast, measures of association between PFOA concentrations and test scores were close to null. Prenatal exposure to PFOS, but not PFOA, may affect children's development, especially gross-motor development at 2 years of age.

A Structural Model of the Influence of Immigrant Mothers' Depressive Symptoms and Home Environment on Their Children's Early Developmental Outcomes in Taiwan

In this cross-sectional study of 61 immigrant mothers and their 6- to 24-month-old children in Taiwan, we examined the structure of relationships among maternal depressive symptoms, quality of the child-rearing home environment, and child development using a partial least squares approach. Maternal depressive symptoms as measured by the Edinburgh Postnatal Depression Scale had a direct and negative effect on the quality of the home environment as measured by the IT-HOME, which in turn had a direct and positive effect on child development as measured by the Comprehensive Developmental Inventory for Infants and Toddlers. Maternal depressive symptoms did not directly affect child development, suggesting that the quality of the home environment mediated the relationship between maternal depressive symptoms and child development.

Predictors for changes in various developmental outcomes of children with cerebral palsy—A longitudinal study

We aimed to identify predictors for the changes of various developmental outcomes in preschool children with cerebral palsy (CP). Participants were 78 children (49 boys, 29 girls) with CP (mean age: 3 years, 8 months; SD: 1 year, 7 months; range: 1 year to 5 years, 6 months). We examined eight potential predictors: age, sex, CP subtype, Gross Motor Function Classification System (GMFCS) level, selective motor control, Modified Ashworth Scale, and the spinal alignment (SA) and range of motion subscales of the Spinal Alignment and Range of Motion Measure (SAROMM). Developmental outcomes for cognition, language, self-help, and social and motor functions were measured at baseline and a 6-month follow-up with the Comprehensive Developmental Inventory for Infants and Toddlers. Regression model showed GMFCS level was a negative predictor for change of language (adjusted r(2)=0.30, p<.001), motor function (adjusted r(2)=0.26, p<.001), social function (adjusted r(2)=0.07, p=0.014), and self-help (adjusted r(2)=0.26, p<.001). Age was a negative predictor for change of cognition (adjusted r(2)=0.21, p<.001) and language functions (adjusted r(2)=0.26, p<.001). SAROMM-SA was a negative predictor for cognitive change (adjusted r(2)=0.30, p<.001). The GMFCS levels and age are robust negative predictors for change of most developmental domains in these children.

Mercury, APOE, and children's neurodevelopment

The benefit of the nutritious elements in fish is insufficient for explaining the controversial finding regarding prenatal mercury (Hg) exposure and neurodevelopment; the varying frequency of susceptible genes among these populations may shed light on these observations. However, limited studies have been reported on the association between genetic susceptibility of prenatal Hg exposure and child development. Apolipoprotein E (APOE, protein; Apoe, gene) is a major protein transporter expressed in the brain. The Apoe epsilon 4 (ɛ4) allele is associated with poor neural repair function and is a risk factor associated with Alzheimer disease. We conducted a prospective cohort study in 2004 and 2005. In this study, 168 subjects were recruited at delivery and followed up at two years of age, and genetic polymorphisms of Apoe were included to assess genetic susceptibility and to determine the relationship between Hg concentrations in cord blood and neurodevelopment. The results showed that adverse effects on neurodevelopment were consistently associated with prenatal Hg exposure in all subtests of Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) among ɛ4 carriers as assessed by both simple linear and multiple linear regression models. After controlling for confounding factors, statistical significance was found in the subtests of cognition tests (β=−8.47, 95% confidence interval (CI)=−16.10 to −0.84), social tests (β=−11.02, 95% CI=−20.85 to −1.19) and the whole test of CDIIT (β=−10.45, 95% CI=−17.36 to −3.54) in a multiple linear regression model. Additionally, the interaction effect between gene polymorphisms of Apoe and Hg levels was significant in the whole test CDIIT and subtests of cognition, language and fine motor tests. In conclusion, Apoe modifies the adverse effects of cord blood Hg on neurodevelopment at the age of two years.

In utero exposure to environmental lead and manganese and neurodevelopment at 2 years of age

Background and objectiveManganese, lead, arsenic and mercury are common neurotoxic metals in the environment. Nonetheless, the relationship between prenatal exposure to low doses of neurotoxic metals and neurodevelopment in children is not clear. The objective of this study was to explore the relationship between in utero exposure to environmental neurotoxic metals and neurodevelopment at 2 years of age. MethodsThe population of this study came from the Taiwan Birth Panel Study. We included 230 pairs of non-smoking mothers without any occupational exposure and their singleton full-term children. The information about exposure during pregnancy was obtained using a structured questionnaire, and the manganese, lead, arsenic and mercury levels in umbilical cord blood samples were analyzed using inductively coupled plasma mass spectrometry. We used the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) to evaluate the developmental status of each child at 2 years of age, and we examined the association of in utero exposure to environmental metals and neurodevelopment using linear regression models. ResultsThe median concentrations of manganese, lead, arsenic and mercury in the cord blood samples in this study were 47.90µg/L (range, 17.88–106.85µg/L), 11.41µg/L (range 0.16–43.22µg/L), 4.05µg/L (range, 1.50–12.88µg/L) and 12.17µg/L (range, 1.53–64.87µg/L), respectively. After adjusting for maternal age, infant gender, environmental tobacco smoke during pregnancy and after delivery, Home Observation for Measurement of the Environment Inventory results, and arsenic and mercury levels in cord blood, we found that manganese and lead levels above the 75th percentile had a significant adverse association with the overall (β=−7.03, SE=2.65, P=0.0085), cognitive (β=−8.19, SE=3.17, P=0.0105), and language quotients (β=−6.81, SE=2.73, P=0.0133) of the CDIIT. ConclusionsIn utero exposure to environmental manganese and lead may have an adverse association with neurodevelopment at 2 years of age, and there is an interaction effect between the manganese and lead levels in the cord blood that could aggravate the effect.

Maternal Mobile Phone Use and Children's Neurocognitive Development

Objectives: Today, mobile phone use is common and has increased rapidly in many countries. The health effects of exposure to mobile phone use on children are controversial. We described maternal mobile phone use from pregnancy until the 12 months post-birth and examined the association between exposure to mobile phone use and the children's neurocognitive development in the general population in Taipei, Taiwan. Methods: The study was a part of the Taiwan Birth Panel Study. A total of 133 pairs of parents and their singleton child were recruited into this study. We used the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) and Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) to assess child neurocognitive development. We also assessed the intelligence of the mothers using the Standard Progressive Matrices Plus (SPM+). Mothers completed questionnaires to report their mobile phone use. Regression modeling was used to estimate the association between mobile phone exposure and children's neurocognitive development. Results: Most of the mothers answered less than 3 phone calls per day, and the call duration was less than 3 minutes for each phone call from pregnancy until 12 months post-birth. We found no significant association between maternal mobile phone use and neurocognitive development in young children. Conclusions: There is no convincing evidence that maternal mobile phone use has an adverse effect on the neurocognitive development of young children. Prospective research using a personal exposure assessment is needed to elucidate a causal relationship.

Mobile phone use and early-childhood neurodevelopment at 2 years of age

Background and aims: This study was to examine the association between prenatal and postnatal mobile phone use exposure and early-childhood neurodevelopment in two-year-old children from the general population in Taipei, Taiwan. Methods: The study was a part of the Taiwan Birth Panel Study. A total of 150 pairs of parents and their singleton child were selected into this study. We used the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) to assess child neurodevelopment at two years of age. The CDIIT was used to assess development in the areas of cognition, language, motor (including gross motor and fine motor), social, and self-help of children. Exposure to mobile phone was reported on a questionnaire. Regression model was used to estimate the association between mobile phone exposure and children’s neurodevelopment. Results: In logistic regression models, there aren’t any significant associations in all the eight domains of the CDIIT. The adjusted OR was 1.1 (95% CI: 0.3-3.5) for motor during 7 months of gestation to birth, and the adjusted OR for gross motor and fine motor were 1.2 (95%CI: 0.4-3.6) and 0.7 (95%CI: 0.1-3.6), respectively in the early-childhood neurodevelopment at 2 years. Conclusions: In this study, we didn’t find any significant association between prenatal and postnatal mobile phone use exposure and early-childhood neurodevelopment in two-year-old children. However, research on the negative effect of mobile phone use and neurodevelopment is still scanty. Therefore, the further association of mobile phone use and neurodevelopment is needed to explore.

The stability of mastery motivation and its relationship with home environment in infants and toddlers

Mastery motivation (intrinsic drives to explore and master one's environment) is a key developmental element. The aims of this study were to investigate (1) the stability of mastery motivation between 2 and 3 years of age for two genders; and (2) the associations between early home environment and toddlers’ mastery motivation in children with typical development. Methods Data of 102 children developing typically from a birth cohort study at Northern Taiwan were analyzed in two parts: (1) stability part: mastery motivation of children were measured at 2 and 3 years of age; (2) environment part: child–parent dyads were assessed from birth, 4 months, 6 months, and 2–3 years of age. Outcomes variables were measured at ages 2 and 3 years by the Dimension of Mastery Questionnaire-17th version. Main predictive variables were measured by Home Observation for Measuring Environment Inventory (HOME) to collect data of the qualities of home environment at 6 months and 2 years; by the Revised Infant Temperament Questionnaire to obtain 4-month activity levels; and by the Comprehensive Developmental Inventory for Infants and Toddlers to obtain 2-year developmental quotient (DQ). Results There was moderate stability of mastery motivation from 2 to 3 years, and girls’ stability was higher than boys’. 6-Month HOME rather than 2-year HOME measures were positively and significantly correlated with instrumental mastery motivation even when controlling for gender, activity level, and DQ. Conclusion Mastery motivation had moderate stability during the toddler period. The quality of home environment in infancy appeared to have a significant impact on toddler's mastery motivation. To promote mastery motivation, caregivers should provide better quality of home environment for infants/toddlers during the very early years.