Childhood Developmental Disorders Research Articles

小児の発達障害の評価と支援に視能訓練士と言語聴覚士の連携が必要であった症例

【目的】発達障害の早期発見は、社会生活での自立の促進において重要である。視能訓練士（以下CO）は小児の視覚だけでなく他機能との関わりにも注目し、成長発達の支援に関わる必要がある。今回、COと他院耳鼻科言語聴覚士（以下ST）が連携し、発達障害の評価と支援が可能であった症例を報告する。【対象・方法】2004年6月～2012年6月にK眼科で弱視または斜視と診断された18歳未満の症例412例中、発達障害を疑いSTが所属する専門医療機関への受診を促した12例であった。症例は未就学児8例（2歳5か月～5歳8か月）、就学児4例（6歳6か月～14歳3か月）であった。発達評価には遠城寺式・乳幼児分析的発達検査表、同旧版（以下遠城寺式発達検査表）を使用した。【結果】生活年齢に相応した視機能検査ができなかったのは5例であった。発達障害を疑った視機能検査時の特徴は、発音不明瞭6例、多動4例、クレーン現象1例、コミュニケーション不良2例であった。12例全例の親が現状を否定する言動をし、ペアレントトレーニングを要した。STによる積極的訓練を開始できたのは7例、STによる6か月毎の経過観察を要しているものが2例だった。ST受診を拒否または一度受診したが訓練拒否したものが3例であった。【結論】遠城寺式発達検査表の項目を考慮して視機能検査を施行することは、小児の発達状態の評価に有用であった。COがSTと連携することで発達障害児の早期発見と就学前後での支援につながった。

11. Leveraging the Power of the Brain to Change Itself to Transform Clinical Outcomes with Adults and Children with Special Needs with the Anat Baniel Method

Focus Areas: Experiential Workshop, Supporting Behavioral ChangeThe brain can change in positive directions at all ages. The challenge is how to harness this potential. The Anat Baniel Method (ABM) offers a scientifically based clinical NeuroMovement approach for recovery of function that intentionally takes advantage of this remarkable potential. The method defines Nine Essentials–conditions the brain requires to reawaken the process of differentiation and integration to form new connections and create new and effective patterns of action.The method shifts the focus from “fixing” to “connecting” with the patient. Many traditional therapeutic modalities tackle the limitations and functional deficits by trying to have the patient perform the missing, lost, or diminished function, often times limiting the focus to a small part of the body and experience of the patient, leaving the brain without the neural resources to create a successful outcome. In this theoretical and experiential presentation, we will discuss the importance of viewing the brain as a large, nonlinear, dynamic information system that organizes the person as a whole—physically, emotionally, cognitively, and socially. We will demonstrate the potency of this approach resulting in functional outcomes that exceed common expectations.The method evolved from the observation of powerful and consistent outcomes in thousands of clients suffering lost function due to illness or trauma including brain damage, accidents, childhood developmental disorders, degenerative diseases, and aging. The method also has been applied successfully with high-performing athletes and musicians needing to overcome career-limiting pain and injury.As neuroscientist Michael Merzenich, wrote: “Scientists have defined the ‘rules’ governing brain plasticity. Anat Baniel, working in parallel along a completely different path, has defined almost exactly the same rules in practical and understandable human terms as the Nine Essentials that should contribute richly to clinical intervention.”

Major channels involved in neuropsychiatric disorders and therapeutic perspectives

Voltage-gated ion channels are important mediators of physiological functions in the central nervous system. The cyclic activation of these channels influences neurotransmitter release, neuron excitability, gene transcription, and plasticity, providing distinct brain areas with unique physiological and pharmacological response. A growing body of data has implicated ion channels in the susceptibility or pathogenesis of psychiatric diseases. Indeed, population studies support the association of polymorphisms in calcium and potassium channels with the genetic risk for bipolar disorders (BPDs) or schizophrenia. Moreover, point mutations in calcium, sodium, and potassium channel genes have been identified in some childhood developmental disorders. Finally, antibodies against potassium channel complexes occur in a series of autoimmune psychiatric diseases. Here we report recent studies assessing the role of calcium, sodium, and potassium channels in BPD, schizophrenia, and autism spectrum disorders, and briefly summarize promising pharmacological strategies targeted on ion channels for the therapy of mental illness and related genetic tests.

A Study of Psychological Assessment in Developmental Disorder Children (7)A Relation between Measures of WISC-IV and P-Fstudy

A Study of Psychological Assessment in Developmental Disorder Children (7)A Relation between Measures of WISC-IV and P-Fstudy

Pervasive developmental disorders in children of hyperandrogenic women with polycystic ovary syndrome: a longitudinal case–control study

Foetal exposure to high testosterone concentrations seems to be involved in the development of mammalian brain and related to pervasive developmental disorders (PDDs). The aim of the current study was to test the hypothesis that children born from hyperandrogenic women with polycystic ovary syndrome (PCOS) are at higher risk of PDDs. Longitudinal case-control study. Thirty pregnant PCOS patients with hyperandrogenaemia and other 45 pregnant healthy women were followed during pregnancy. All women had a healthy baby. Clinical evaluations and biochemical assays of the mothers during pregnancy and after delivery were performed. The children's versions of the Autism-Spectrum Quotient (AQ-C), the Empathy Quotient (EQ-C) and Systemizing Quotient (SQ-C) tests were administered. Total AQ-C and communication scores were significantly higher for children of PCOS patients. Stratifying our population according to sex, total AQ-C, communication and attention switching subscores were significantly higher only for daughters of PCOS patients. EQ-C and SQ-C scores resulted in significantly lower and higher scores, respectively, only in daughters of PCOS patients in comparison with those of healthy non-PCOS controls. AQ-C, EQ-C and SQ-C scores, irrespective of the studied group and/or subclassification by gender, were significantly influenced by amniotic testosterone levels. Daughters of mothers affected by hyperandrogenic PCOS seem to have a higher risk for PDDs probably due to an unbalanced prenatal exposure to high levels of testosterone.

Dispelling the “They’ll Grow Out of It” Myth: Implications for Intervention

Dispelling the “They’ll Grow Out of It” Myth: Implications for Intervention

Prévalence de l’autisme et autres troubles envahissants du développement : données des registres français de population. Générations 1995–2002

Aim and backgroundIn France, prevalence data of pervasive developmental disorders in children are rare despite recently dedicated public health plans aimed to improve the knowledge and types of care of these disorders. Within this context, the two French childhood disabilities registers of Haute-Garonne and Isere counties have been asked to provide recent prevalence data on autism spectrum disorders. MethodsThese two population-based registers record all the cases of pervasive developmental disorders in children residing in covered counties in their eighth year of life, after parental approval. Data are actively collected from the medical records available in various data sources. The main data source is the “county house for people with disabilities” i.e. the local authority which determines the orientation for special education and the decision of special allocation for disabled children. Other data sources are “autism resource centres” and psychiatric hospitals. Diagnoses were coded according to the International Classification of Disease (ICD 10). For this analyze, diagnoses selected were typical and atypical autism (F84.0 and F84.1), Asperger disorder (F84.5), other pervasive developmental disorders (F84.8) and pervasive developmental disorders not otherwise specified (F84.9). The data presented here concerned children born between 1995 and 2002. Prevalence rates were calculated for 10 000 children living in their eighth year of life in each counties. ResultsThe overall prevalence rate in the eighth year of life over the whole study period was 31.9 per 10,000 children in Haute-Garonne and 34.9 per 10,000 in Isere, with a significant increasing trend between 1995 and 2002 in Haute-Garonne county. The sex-ratio was 3.8 and 3.5 respectively in Haute-Garonne and Isere. In both counties, about half of the children had an associated intellectual deficiency and about one third if only severe impairment (defined by an IQ below 50) was considered. An epilepsy was more often present when an intellectual deficiency was associated. ConclusionData from the two French registers were quite comparable and demonstrated that prevalence rates of pervasive developmental disorders in the eighth year of life were in the lower range of those published in the international literature.

A Study of Psychological Assessment in Developmental Disorder Children (6) A Relation between Measures of WISC-Ⅳ and WISC-Ⅲ「Mazes」

A Study of Psychological Assessment in Developmental Disorder Children (6) A Relation between Measures of WISC-Ⅳ and WISC-Ⅲ「Mazes」

A Report of Perception of Difficulties of Nursery School Teachers involved in the care of Developmental disorder children

A Report of Perception of Difficulties of Nursery School Teachers involved in the care of Developmental disorder children

Use of the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood: Revised Edition (DC:0–3R) with Canadian Infants and Young Children Prenatally Exposed to Substances

AbstractThe current study examined the mental health diagnostic profiles of infants and young children prenatally exposed to substances using the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood, Revised (DC:0–3R) diagnostic system. Participants were 46 biological mother–infant dyads who were engaged in a clinical program for mothers with substance‐use problems and their young children (aged 10–41 months). Diagnostic information was reported for each of the five axes listed in the DC:0–3R diagnostic system based on file reviews. In addition, the children's socioemotional and adaptive behaviors were assessed using the Child Behavior Checklist, Infant–Toddler Social Emotional Assessment, the Social‐Emotional Scale, and the Adaptive Behavior Assessment System (2nd ed.). In this sample of young children with prenatal substance exposure, a broad range of socioemotional symptoms were evident, with almost one third of the children meeting criteria for at least one Axis I mental health diagnosis. In addition, the majority of dyads demonstrated features of a disordered relationship. Children in more problematic relationships demonstrated higher levels of socioemotional and adaptive functioning difficulties and were more likely to have an Axis I diagnosis than were children in adapted relationships. The importance of early intervention efforts aimed at infants with prenatal substance exposure and their biological mothers is highlighted, with a particular focus on enhancing the quality of the mother–child relationship.

Maternal quality of life and developmental disorders in children: A comparative study with mothers of pediatric inpatients

Maternal quality of life and developmental disorders in children: A comparative study with mothers of pediatric inpatients

The Role of Aldehyde Oxidase and Xanthine Oxidase in the Biotransformation of a Novel Negative Allosteric Modulator of Metabotropic Glutamate Receptor Subtype 5

Negative allosteric modulation (NAM) of metabotropic glutamate receptor subtype 5 (mGlu₅) represents a therapeutic strategy for the treatment of childhood developmental disorders, such as fragile X syndrome and autism. VU0409106 emerged as a lead compound within a biaryl ether series, displaying potent and selective inhibition of mGlu₅. Despite its high clearance and short half-life, VU0409106 demonstrated efficacy in rodent models of anxiety after extravascular administration. However, lack of a consistent correlation in rat between in vitro hepatic clearance and in vivo plasma clearance for the biaryl ether series prompted an investigation into the biotransformation of VU0409106 using hepatic subcellular fractions. An in vitro appraisal in rat, monkey, and human liver S9 fractions indicated that the principal pathway was NADPH-independent oxidation to metabolite M1 (+16 Da). Both raloxifene (aldehyde oxidase inhibitor) and allopurinol (xanthine oxidase inhibitor) attenuated the formation of M1, thus implicating the contribution of both molybdenum hydroxylases in the biotransformation of VU0409106. The use of ¹⁸O-labeled water in the S9 experiments confirmed the hydroxylase mechanism proposed, because ¹⁸O was incorporated into M1 (+18 Da) as well as in a secondary metabolite (M2; +36 Da), the formation of which was exclusively xanthine oxidase-mediated. This unusual dual and sequential hydroxylase metabolism was confirmed in liver S9 and hepatocytes of multiple species and correlated with in vivo data because M1 and M2 were the principal metabolites detected in rats administered VU0409106. An in vitro-in vivo correlation of predicted hepatic and plasma clearance was subsequently established for VU0409106 in rats and nonhuman primates.

Developmental Delays in Children With ADHD

Objective: ADHD is often comorbid with other disorders, but it is often assumed that academic, language, or motor c skills problems are secondary to ADHD rather than that attention problems are secondary to the other disorder or both disorders have a shared etiology. We assessed for comorbid developmental disorders and which cognitive processes were impaired in children with ADHD. Method: Measures of intelligence, language, motor skills, social cognition, and executive functions were administered to children with ADHD (n = 53) and age/sex-matched typical children. Results: Clinically significant deficits were 2 to 7 times as common in children with ADHD as in typical children, and the structure of ability differed in the two groups. Abilities were less differentiated in children with ADHD. Conclusion: The results indicate a need for comprehensive screening for developmental disorders in children with ADHD and imply that research needs to focus on how ADHD and developmental disorders may share an etiology.

Development of regulation disorders into specific psychopathology

Underlying deficits in self-regulation and sensory processing are seen in children with regulation disorders (RD) and might lead to emotional and behavioral problems as the child develops. However, little is known about the specific developmental course of RD. This follow-up study was conducted to investigate the development of a clinical sample of RD children, diagnosed by means of the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood, Revised (DC:0-3R; ZERO TO THREE, 1994), toward specific psychopathology 4 to 10 years later based on parent- and teacher-reports on the Child Behavior Checklist (T.M. Achenbach & L.A. Rescorla, 2007). Parental reports showed that 39 to 69% of children with RD had internalizing, externalizing, and total problems above borderline cutoffs, as compared to norm group data (16%). In addition, higher rates of affective, anxiety, attention deficit/hyperactivity, oppositional defiant, and conduct problems were reported. Analyses between RD subtypes showed significant differences on future attention problems and rule-breaking behavior, wherein less favorable results were found for the Hypersensitive subtype Type A (fearful/cautious) in comparison to the sensory stimulation-seeking/impulsive subtype. The current results indicate persistence of emotional and behavioral problems into middle childhood and adolescence in children with preschool RD diagnoses. More attention should be paid to differentiation of psychopathology in these children since developmental outcomes may differ between RD subtypes.

Olfactory classical conditioning in neonatal mouse pups using thermal stimuli

Mouse models are increasingly used to investigate genetic contributions to developmental disorders in children, especially newborns. In particular, early cognitive assessment in newborn mice is critical to evaluate pediatric drug efficacy and toxicity. Unfortunately, methods for behavioral tests in newborn mice are scarce. Therefore, developing such tests for newborn mice is a priority challenge for neurogenetics and pharmacological research. The aim of the present study was to develop a conditioning method well suited to high-throughput cognitive screening in newborn mice. To this end, we developed an odor-preference conditioning test using ambient temperature as an unconditioned stimulus (US) and artificial odors as conditioned stimuli (CS). First, we showed that mouse pups move toward the thermoneutral temperature when offered a choice between a thermoneutral and cold environment, thus showing thermotaxis. Second, we conducted a classical conditioning paradigm in pups aged six to ten days. In terms of central nervous system development, this period corresponds to extreme prematurity to early post-term period in humans. During acquisition, the pups were alternatively exposed to odor CS paired with either cold or warm temperatures. Immediately after acquisition, the pups underwent a two-odor choice test, which showed preference for the odor previously paired with the warm temperature, thus showing conditioning. The proposed paradigm is easy to conduct, and requires modest experimenter interference. The method is well suited for high-throughput screening of early associative disorders in newborn mice.

O-26 - Prevalence and clinical presentation of ADHD in first nationwide epidemiological survey in poland

Introduction ADHD is one of the most frequent developmental disorders in childhood. Adults also suffer from symptoms of attention-deficit/hyperactivity disorder. Prevalence estimates of ADHD in adult community samples (5%) are based on American and West-European studies. Most of research though is concentrated on early ADHD symptoms. There are no sufficient data on clinical manifestation and scale of this problem in Poland. Objectives To assess prevalence (life and 12-month), access to psychiatric care and other clinical and sociodemographic aspects of ADHD in adult population in Poland (both contemporary and retrospective). The first Polish nationwide survey, Epidemiology of Mental Disorders and Access to Care (EZOP, Poland)” was included in the WHO's WMH. Aims The aim of this paper is to present collected data on ADHD in community sample. Methods Composite International Diagnostic Interview (cidi capi v.3.1) was administered in random sample of Poles aged 18–65 (n = 10000). Data was collected from November 2010 to March 2011 by trained Millward Brown SMG/KRC interviewers. Results Response rate is 50.4%. Prevalence estimated on the basis of retrospective reports in Screening Section is 2.2% for attention-deficit symptoms (2.5% for men and 1.9% for women) and 2.8% for hyperactivity symptoms (respectively 3.2% and 2.8%). Further analysis are in progress and detailed results will be known till December 2011. Conclusions Presented study will allow to introduce data on relation between intensity of early ADHD symptoms and it's later clinical manifestation. The identification of demographic factors influencing the course of the disorder and patterns of treatment will be possible.

Estimating Bias From Loss to Follow-up in the Danish National Birth Cohort

Loss to follow-up in cohort studies may result in biased association estimates. Of 61,895 women entering the Danish National Birth Cohort and completing the first data-collection phase, 37,178 (60%) opted to be in the 7-year follow-up. Using national registry data to obtain end point information on all members of the cohort, we estimated associations in the baseline and the 7-year follow-up participant populations for 5 exposure-outcome associations: (a) size at birth and childhood asthma, (b) assisted reproductive treatment and childhood hospitalizations, (c) prepregnancy body mass index and childhood infections, (d) alcohol drinking in early pregnancy and childhood developmental disorders, and (e) maternal smoking in pregnancy and childhood attention-deficit hyperactivity disorder (ADHD). We estimated follow-up bias in the odds or rate ratios by calculating relative ratios. For all but one of the above analyses, the bias appeared to be small, between -10% and +8%. For maternal smoking in pregnancy and childhood ADHD, we estimated a positive bias of approximately 33% (95% bootstrap limits of -30% and +152%). The presence and magnitude of bias due to loss to follow-up depended on the nature of the factors or outcomes examined, with the most pronounced contribution in this study coming from maternal smoking. Our methods and results may inform bias analyses in future pregnancy cohort studies.

Altered brain activation during response inhibition in children with primary nocturnal enuresis: An fMRI study

Nocturnal enuresis is a common developmental disorder in children, and primary nocturnal enuresis (PNE) is the dominant subtype. The main purpose of this study was to investigate brain functional abnormalities specifically related to motor response inhibition in children with PNE using fMRI in combination with a Go/NoGo task. Twenty-two children with PNE and 22 healthy children, group-matched for age and sex, took part in this experiment. Although no significant between-group differences in task performance accuracy were observed, PNE patients showed significantly longer response times on average. There were several brain regions with reduced activation during motor response inhibition in children with PNE: the bilateral inferior frontal gyri, right superior and middle frontal gyri, right inferior parietal lobe, bilateral cingulate gyri and insula. Our data indicate that response inhibition in children with PNE is associated with a relative lack of or delay in the maturation of prefrontal cortex circuitry that is known to suppress inappropriate responses. This result might give clues to understanding the pathophysiology of PNE.

Magazine portrayal of attention deficit/hyperactivity disorder (ADD/ADHD): A post-modern epidemic in a post-trust society

One of the significantly increasing risks in modern society is that of childhood mental, developmental and behavioural disorders. Attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD) are cases in point. This paper uses a social constructionist and framing approach to investigate the portrayal of risks associated with ADD/ADHD in popular magazines directed towards mass audiences in English speaking North America from 1988–2008. Aqualitative content analysis examines how the magazine articles answer the following questions about ADD and ADHD portrayal: (1) what is it?; (2) what is said to cause it?; and (3) what can be done about it? The findings suggest that ADD and ADHD are portrayed in polarising and contradictory ways in this popular medium. Magazine stories demonstrate deep ambivalence about whether or not ADD/ADHD even exist. They question whether or not the associated behaviours constitute medical problems. Despite this, described research on the causes of ADD/ADHD is almost always authoritatively described as either genetic or biological. Treatment by medications is often portrayed as profoundly problematic. This contentious and confusing portrayal exacerbates uncertainty and underscores the perception of risk. It reflects the competing interests operating in the social environment of ADD/ADHD including an ongoing but inconsistent tendency to medicalise this as other childhood mental/developmental/behavioural disorders.

Childhood behavioural and developmental disorders: association with maternal alcohol consumption in Cape Town, South Africa.

Current maternal alcohol consumption, especially binge drinking, is strongly associated with childhood behavioural and/or developmental disorders (BDDs) in a population attending tertiary hospital ambulatory services. BDDs were also associated with maternal alcohol use 6 months before pregnancy. An association with BDDs could not be conclusively demonstrated for drinking during pregnancy, but this may have been influenced by under-reporting and reduced study power due to misclassification of exposure. We cannot rule out the a priori suspicion that some mild BDDs in children in the Western Cape could be undiagnosed fetal alcohol spectrum disorder. Nonetheless, the study highlighted the important impact of current maternal alcohol use on behaviour and development of children. Future research on the impact of maternal alcohol use on childhood development should include examination of environmental and social factors contributing to this increased risk. Upstream interventions aimed at reducing alcohol-related harms may also contribute to reducing the burden of BDDs.