Function In School-aged Children Research Articles

The effect of high-dose erythropoietin perinatally on retinal function in school-aged children born extremely or very preterm

PurposeTo investigate the long-term effects of high-dose recombinant human erythropoietin (rhEPO) administered during the perinatal period on retinal and visual function in children born extremely or very preterm. DesignRandomized, double-blind clinical trial follow-up plus cohort study. MethodsSetting: Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland. Study Populationextremely or very preterm-born children aged 7-15 years, previously randomized to receive either high-dose rhEPO or placebo in the perinatal period. Inclusion criteria: participation in an ongoing neuropediatric study (EpoKids), written informed consent (IC). Exclusion criteria: previous ocular trauma or surgery; retinal or developmental disease unrelated to prematurity. Healthy control (HC) children of comparable age were recruited. Inclusion criteria: term birth, IC. Exclusion criteria: any ocular/visual abnormality, high refractive error. Intervention status (rhEPO/placebo) was unknown to examiners and subjects at examination, with examiners unblinded only after completion of all analyses. Observation ProceduresElectroretinography (ERG) was performed with the RETeval device (LKC Technologies, Inc., Gaithersburg MD). Ophthalmological and orthoptic examinations excluded comorbidity in the prematurely born cohort and ocular diseases in the HC group. Main Outcome MeasuresScotopic and photopic ERG response amplitudes and peak times (6 amplitudes; 6 peak times). Secondary outcomes were habitual visual acuity and color discrimination performance (for descriptive summary only). ResultsNo differences in ERG parameters between EPO (n=52; 104 eyes) and placebo (n=35; 70 eyes) subgroups were observed (all corrected p>0.05). Two cone system-mediated peak times were slightly slower in the placebo than HC (n=52; 104 eyes) subgroup (coefficient/95% confidence interval (CI) = 0.53/0.21 to 0.85 and 0.36/0.13 to 0.60; p = 0.012 and 0.022); a predominantly rod system-mediated peak time was slightly faster in the EPO than the HC subgroup (coefficient/95% CI = -4.33/-6.88 to -1.78; p = 0.011). Secondary outcomes were comparable across subgroups. ConclusionsAdministration of high-dose rhEPO to infants born extremely or very preterm during the perinatal period has no measurable effects on retinal function in childhood compared to placebo. Premature birth may cause small, likely clinically insignificant effects on retinal function in childhood, which may be partially mitigated by administration of rhEPO during the perinatal period.

Impact of Elexacaftor/Tezacaftor/Ivacaftor Therapy on Lung Clearance Index and Magnetic Resonance Imaging in Children with Cystic Fibrosis and One or Two F508del Alleles.

We recently demonstrated that elexacaftor/tezacaftor/ivacaftor (ETI) improves the lung clearance index (LCI) and abnormalities in lung morphology detected by magnetic resonance imaging (MRI) in adolescent and adult patients with cystic fibrosis (CF). However, real-world data on the effect of ETI on these sensitive outcomes of lung structure and function in school-age children with CF have not been reported. The aim of this study was therefore to examine the effect of ETI on the LCI and the lung MRI score in children with CF and one or two F508del alleles aged 6 to 11 years. This prospective, observational, multicenter, post-approval study assessed the longitudinal LCI up to 12 months and the lung MRI score before and three months after initiation of ETI. A total of 107 children with CF including 40 heterozygous for F508del and a minimal function mutation (F/MF) and 67 homozygous for F508del (F/F) were enrolled in this study. Treatment with ETI improved the LCI in F/MF children (-1.0; IQR, -2.0 to -0.1; p<0.01) and F/F children (-0.8; IQR, -1.9 to -0.2; p<0.001) from 3 months onwards. Further, ETI improved the MRI global score in F/MF (-4.0; IQR, -9.0 to 0.0; p<0.01) and F/F children (-3.5; IQR, -7.3 to -0.8; p<0.001). ETI improves early abnormalities in lung ventilation and morphology in school-age children with CF and at least one F508del alleles in a real-world setting. Our results support early initiation of ETI to reduce or even prevent lung disease progression in school-age children with CF.

Association of screen-based sedentary behavior with executive function in school-aged children: A functional near-infrared spectroscopy study

Screen-based sedentary behavior (SSB) is a significant risk factor for the health of school-aged children, and guidelines recommend limiting SSB to 2 hr per day. This study aimed to examine association and potential mechanisms between SSB and executive function (EF) by comparing Stroop performance and frontal hemodynamic responses between children with and without excessive SSB. A total of 70 children aged 10 to 15 years were recruited and divided into two groups: excessive screen time (≥2 hr/day; n = 35; ES group) and normal screen time (<2 hr/day; n = 35; NS group). The Chinese version of the Adolescent Sedentary Activities Questionnaire was used to assess SSB, whereas EF was evaluated using the Stroop task. The frontal hemodynamic responses during the Stroop task were measured using functional near-infrared spectroscopy. The results indicated that the ES group had lower accuracy, longer reaction times, and greater activation in the bilateral dorsolateral prefrontal cortex (DLPFC) and left pre-supplementary motor area (Pre-SMA) compared with the NS group. Furthermore, significant correlations were observed between Stroop performance and cortical activation in the left DLPFC and Pre-SMA. These findings demonstrate that excessive SSB is associated with poor EF, which may be explained by a decrease in neural efficiency of the left DLPFC and Pre-SMA.

Executive functioning in child victims of sexual abuse: A multi-informant comparative study

BackgroundResearch examining the association between child sexual abuse and executive functions is limited. Yet, exposure to traumatic situations at a young age has been associated with changes in the prefrontal cortex, which hosts executive functions (Wesarg et al., 2020). These functions are crucial for social adaptation, as they make it possible to inhibit maladaptive behavior and respond flexibly to the demands of the environment. As middle childhood is a sensitive period for the development of self-regulatory abilities, exploring executive functioning in school-age children could provide potential intervention targets (Dajani & Uddin, 2015). ObjectiveUsing multiple informants, this study compared executive functioning of sexually abused children to that of non-sexually victimized children and examined whether the differences were moderated by sex. MethodsThe sample consisted of 225, 6-to-12 years old children with a history of child sexual abuse (CSA) and 97 children without a history of CSA. Children completed two executive functioning tasks measuring cognitive flexibility and inhibition. Parents and teachers completed questionnaires evaluating children's executive functioning. ResultsIn comparison to non-abused children, children with a history of CSA displayed greater executive functioning difficulties as assessed by both informant-reported questionnaires and self-completed tasks. Significant interaction effects were found, such as CSA predicting lower inhibition and executive functions at school in boys but not in girls. ConclusionThis study is a first step in understanding the association between CSA and executive functioning and offers a clearer picture of the differential impact of sexual trauma according to children's sex.

The Impact of Screen Time on Sleep Patterns in School-Aged Children: A Cross-Sectional Analysis.

In a world filled with technology, there's concern about the impact of screen time on children and teenagers. A recent study of 11,875 children aged nine to 10 in the US explored how screen time affects mental health, behaviour, school performance, sleep, and friendships. The results indicate that more screen time is mildly linked to worse mental health, more behaviour problems, lower academic performance, and poorer sleep, but slightly better peer relationships. However, these connections were weak, with socioeconomic status (SES) having a stronger influence on these outcomes. The study doesn't prove that screen time causes these issues, suggesting that increased screen time might not be directly harmful to children in this age group. The research adds to the understanding of how screen time impacts children's well-being and highlights the importance of promoting healthy habits. Our study aims to add to this literature by examining how screen time impacts sleep quality, dream recall, and academic performance in school-aged children. Understanding the potential consequences of screen time is crucial for promoting healthy habits and ensuring the overall well-being of children. Our research seeks to provide further insights into the relationship between screen time and key aspects of children's lives as its prevalence continues to rise. The research incorporates a cohort of 1000 school-aged children, bifurcated evenly into two categories based on their daily screen exposure: a low screen time group (less than one hour daily, n = 500) and a high screen time group (over three hours daily, n = 500). The study probes into the correlation between screen time and various health parameters, such as sleep patterns, dream recall, and academic prowess. The analysis showed that children with low screen time had better sleep efficiency (90% vs. 75%), more frequent dream recall (70% vs. 30%), fewer nocturnal awakenings (0.5 vs. 1.5 times weekly), less daytime sleepiness (20% vs. 60%), and higher physical activity levels (60 vs. 30 minutes per day) compared to those with high screen time. They also had less weekend sleep variability (1.2 hours) and a lower risk of circadian rhythm disturbances (20% increased risk in the high screen time group). Additionally, a screen-free bedroom was more common in the low screen time group (85% vs. 30%), and parental involvement in sleep routines was higher (90% vs. 40%). Academically, the low screen time group achieved higher grades ('A' to 'A+' vs. 'B'), and they had more face-to-face social interactions (two vs. one hour per day). Escalating screen time is correlated with detrimental impacts on sleep efficiency, dream recall, physical activity, circadian rhythms, and academic performance in school-aged children. Fostering a screen-free bedroom environment and augmenting parental involvement in sleep routines may alleviate these adverse effects.

Reading performance in school going children with visual function anomalies

To compare reading performance in children with and without visual function anomalies. This cross-sectional study was carried out from May 2021 to April 2022 in a tertiary eye hospital of Bangladesh. This study included patients with 6-15 years of age who visited at Vision Therapy clinic. CISS-score was used to identify the asthenopia complaints and reading difficulties while having a normal vision and normal retinal function only selected for recruitment. Reading error, accuracy and reading speed were assessed with an N-notation chart with an N6 target size and the time taken to complete the task was recorded with a stopwatch. Both univariate and bivariate tables are used for analysis. Statistics analysis was performed accordingly, and the level of significance used was at 0.05. Out of 200 subjects, 46.5% boys and 53.5% girls. Of the total, 15.5% had NVF. The mean age of the participants was 12.04 (±2.44) years. Children with AVF had a higher number of reading errors and non-significant negative correlation (AVF=7.64 (±5.19); NVF 6.55 (±3.67); (r = -1.00, p=0.157). Lower Reading accuracy was noted in AVF as correlated to NVF and non-significant negative correlation (AVF=86.11 (±14.84); NVF=86.43 (±13.12); (r= -0.008, p=0.912). Similarly, lower reading speed was noted in AVF as correlated to NVF and non-significant negative correlation (AVF=79.47 (±39.20) wpm; NVF=84.51±36.84 wpm; (r= -0.047, p=0.507). A statistically significant difference was seen between AVF and NVF (p=0.001 at a 95% Confidence Interval of the differences). Children in the 1 to 5 grades presented a higher risk of reading impairment than the 6 to 10grades. Higher reading speed (112±20.69wpm) was noted in 10 grade. In this study, it was observed that poor reading performance is linked to abnormal visual function in school-aged children, but visual function and reading performance are not positively related.

Altered functional connectivity in default mode network maintains attention task performance in school-age children with frontal lobe tumor

This study examines functional brain network changes in children with frontal lobe tumors (FLT). Ten pediatric FLT patients from Beijing Tiantan Hospital and 20 healthy children were compared in terms of cognitive performance and resting-state functional magnetic resonance imaging (rs-fMRI) connectivity. The FLT group showed lower cognitive performance, particularly in visual and working memory domains, but had comparable attention abilities to the healthy controls. There were notable differences in connectivity between the default mode network (DMN) and sensorimotor network (SMN) in both groups. The FLT group also displayed a significant reduction in local efficiency in the left lateral parietal area within the DMN. Importantly, reduced DMN-SMN connections and increased DMN-lateral prefrontal cortex connectivity may facilitate maintaining attention and memory tasks in FLT children. This study sheds light on how the brains of children with FLT adapt, preserving “normal” attention functions despite frontal lobe damage.

Relationships Between Sensory Processing, Temperament Characteristics for Effortful Control, and Executive Function in School-Age Children

Relationships Between Sensory Processing, Temperament Characteristics for Effortful Control, and Executive Function in School-Age Children

Assessment of Executive Functioning in School-Age Children With And Without Stuttering: A case-control study

Background: Stuttering is defined as a neurodevelopmental disorder, with disruptions in the normal fluency and time patterning of speech that are inappropriate for the individual's age and language skills. Executive functions (EF) include various cognitive skills, such as directing the attention required for planning and maintaining thoughts and behaviors, suppressing inappropriate stimuli, keeping the processed information active, and providing the transition between the information. This study was aimed at investigating whether there is a difference between school-age children with and without stuttering about executive functions (EF) skills and attention. Method: Twenty-six children with stuttering (14 boys; mean age=10.1±2.88) and twenty-five children without stuttering (14 boys; mean age=10.2±2.77) aged between 7 and 12 were admitted to the study. The participants were administered the Visual Aural Digit Span Test-B Form (VADS-B), which evaluates working memory and audiovisual attention, and the Cancellation Tests (CT), which evaluates sustained attention. The Parents of the participants were applied the Behavior Rating Inventory of Executive Function (BRIEF), which was developed to evaluate executive functions, problem-solving skills and adaptive behaviors. Differences in mean subscores of VADS-B, CT, and BRIEF were analyzed using univariate analysis of covariance (ANCOVA) with participant group as the factor and VADS-B, CT, and BRIEF subscores as the dependent variable; Chronological age (years) was designated as a covariate. Results: This study was conducted between two groups that were equal in terms of age, gender, developmental steps (walking, talking, toilet training), family structure, and socioeconomic status (p&gt;0.05). All subscales of VADS-B (aural-verbal, aural-written, visual-verbal, visual-written) were found to be significantly lower in children with stuttering (p&lt;0.05). In cancellation test results, there was a significant difference between the groups in terms of hit scores and total number of errors in organized letter and random letter forms (p&lt;0.05). No difference was found between the two groups in the BRIEF scale completed by the parents (p&gt;0.05). Conclusion: This study demonstrated that school-aged children with stuttering had weaker working memory and sustained attention performance in performance-based tests. Thus, we believe that in the evaluation and treatment of stuttering, comprehensive approaches should be adopted to evaluate attention and executive functions and to improve these functions. In this area, studies with larger samples are needed in which stuttering, attention, and executive functions are evaluated more comprehensively with different tasks (computer-based performance tests, parent-teacher scales, etc.) and neuroimaging (magnetic resonance imaging [MRI]). Lastly, the tasks used in our study (VADS-B, CT, and BRIEF) were applied to Turkish-speaking school-age children with stuttering for the first time. In this regard, we think that our study will contribute to the literature.

Effectiveness of a mixed cognitive intervention program (computer-based and home-based) on improving cognitive and academic functions in school-aged children with specific learning disorder (SLD): A pilot study

Effectiveness of a mixed cognitive intervention program (computer-based and home-based) on improving cognitive and academic functions in school-aged children with specific learning disorder (SLD): A pilot study

Preliminary Speech Perception Performance Profiles of School-Age Children With Childhood Apraxia of Speech, Speech Sound Disorder, and Typical Development.

Limited research exists assessing speech perception in school-age children with speech sound disorder (SSD) and childhood apraxia of speech (CAS); despite early evidence that speech perception may lead to error-prone motor planning/programming. In this study, we examine speech perception performance in school-age children with and without speech production deficits. Speech perception was assessed using the Wide Range Acoustic Accuracy Scale to determine the just-noticeable difference in discrimination for three consonant-vowel syllable contrasts (/bɑ/-/wɑ/, /dɑ/-/gɑ/, /ɹɑ/-/wɑ/), each varying along a single acoustic parameter for seven children with CAS with rhotic errors, seven children with SSD with rhotic errors, and seven typically developing (TD) children. Findings revealed statistically significant mean differences between perceptual performance of children with CAS when compared to TD children for discrimination of /ɹɑ/-/wɑ/ contrasts. Large effect sizes were also observed for comparisons of /ɹɑ/-/wɑ/ contrasts between children with CAS, SSD, and TD peers. Additionally, large effect sizes were observed for /dɑ/-/gɑ/ contrasts between children with CAS and SSD and TD children despite nonsignificant mean differences in group performance. Overall, mean outcome scores suggest that school-age children with CAS and persistent rhotic errors demonstrated less accurate speech perception skills relative to TD children for the /ɹɑ/-/wɑ/ contrasts. However, the relatively small sample sizes per group limit the extent to which these findings may be generalized to the broader population.

Sleep spindle activity is associated with state- and trait-based emotion in healthy school-aged children

BackgroundWhile connections between children's sleep and their daytime functioning are well established, less is known about the microstructural features of sleep that support emotional wellbeing. Investigating these relationships in healthy children may provide insight into adaptive emotional development. We therefore examined associations between non-rapid eye movement (N2) sleep spindles and both state- and trait-based measures of emotion. MethodsA sample of 30 children (7–11 years) without psychiatric disorders completed a baseline assessment, one night of at-home polysomnography (PSG), and an in-lab emotional state assessment the next day including self-reported arousal in response to affective images. Trait-based measures of anxiety and depression as well as savoring, a positive emotion regulatory strategy, were also completed. N2 sleep spindle parameters, including spindle density (number/min) and peak frequency in central regions, were detected using an automated algorithm. ResultsGreater spindle density was significantly associated with decreased state-based emotional arousal towards negative affective images, and greater spindle peak frequency was associated with greater trait-based use of savoring. However, neither spindle parameter was associated with child anxiety or depressive symptoms. ConclusionsFindings align with and expand on prior research to suggest that N2 sleep spindles support adaptive emotional functioning in school-aged children.

Subclinical neural hearing alterations in school children with type 1 diabetes mellitus

Background and objectivesEvidence has shown a cause-and-effect relationship between type 1 diabetes mellitus and auditory and cognitive dysfunctions. This study aimed to investigate the effect of type 1 diabetes mellitus (T1DM) on central auditory and cognitive functions in school-age children and adolescents. MethodsThe study sample consisted of 101 children and adolescents, 50 with T1DM, of both sexes, aged between 7 and 18 years. All participants were selected for a structured interview on hearing, behavioral, and cognitive health and assessment of brainstem auditory evoked potentials (BAEP) and event-related potentials (P300). ResultsSignificant differences were observed in memory (p=0.002) and attention (p=0.021) complaints between participants with and without T1DM. In the BAEP responses, there were differences between wave III latencies in the right (p=0.017) and left (p=0.019) ears and in wave V latencies in the left ear (p=0.001) between the evaluated groups. In addition, there was an association between BAEP findings and metabolic control in the T1DM group in the left ear in waves III (p=0.006) and V (p=0.005) and in the right ear in wave V (p=0.026). No differences were observed in the latencies of P300 between the evaluated groups. ConclusionThis study demonstrated the existence of a subclinical finding in the central auditory pathway, offering an increased risk for retrocollear alterations, which may be a consequence of poor metabolic control.

Schools: First Promoters of a Good Visual Health

Abstract Vision plays an important role in the physical, cognitive and social development of children. Uncorrected vision problems can harm a child's development and interfere with learning. Visual functioning is a strong predictor of academic performance in school-aged children. Early detection and treatment are essential. The objective of our work is to establish the prevalence of visual disorders in children and to investigate the motivations for a consultation. This is a descriptive study carried out at the Vision Clinic of Tetouan-Morocco, including all pediatric patients (&amp;lt;16 years old) who presented to the consultation of the same doctor, between July 2022 and December 2022. All patients underwent a complete ophthalmological examination with measurement of refraction after cycloplegia. The study involved 450 children, including 254 girls and 196 boys. The average age was 9 years old. One of two children was consulting for the first time in ophthalmology. The average age at the first consultation is 8.5 years. The ophthalmological examination was requested by the school in 46% of the cases. In 34%, it is requested following observations made by the parents. In 10%, it is the child who reports the visual disturbance (these children were all over 8 years old). In 3% of cases, the ophthalmological examination is requested by the attending physician. 93% of these children required optical correction after measurement of refraction under cycloplegia and 45% had amblyopia of variable importance. One out of three amblyopic children was over 10 years old when the visual impairment was diagnosed. This work highlights the essential role of schools in the detection of visual impairment in children. Routine vision screening and eye exams are critical to detect vision problems before a child's development is compromised. Schools and teachers are the first and essential actors in a solid public health approach to children's vision and eye health. Key messages • Systematic screening for ametropia in children of school age &amp; Awareness of parents for the recognition of visual disorders. • A child who does not complain is not necessarily in good visual health.

Family Functioning in School-Aged Children: A Systematic Review of Research in Türkiye Using the McMaster Family Model

Family Functioning in School-Aged Children: A Systematic Review of Research in Türkiye Using the McMaster Family Model

Behavioural Profile, Linguistic skills, Adaptive Behaviours and Intellectual Functioning of School aged Children with History of Early Language Delay

Introduction: Language is a fundamental skill and a foundation stone for multiple cognitive and socio-emotional aspects of development. Considering that well-developed language abilities enable children to negotiate the social-relational demands of school life and provide the foundational knowledge upon which academic skills are built, there is a higher chance of scholastic difficulties, social and, behavioural and emotional maladjustments resulting in poor mental health in those who have language delay.&#x0D; Methods: An ambispective study conducted at a tertiary centre after taking ethical approval from the institutional review board. Children with isolated early language delay were reassessed at school age for intelligence quotient, language development, adaptive behaviours and behavioural issues.&#x0D; Results: out of 57 children, persistence of poor language skills was seen in 65%, mean IQ score was 90 ( ± 17. 067) and mean VABS score was 94 ( ± 15). 61.4% children had significant behavioural issues. On interview, most worrisome issue reported by children was ‘being teased by friends’ due to poor language skills. Additionally, lower social competence level was noted in children who had poor language skills.&#x0D; Conclusions: persistence of language, cognitive and behavioural dysfunctions in children with seemingly benign ‘speech and language delay’ at an early age, emphasizes the importance of comprehensive reassessment of these children at school age for early recognition and management.

Using Community Engagement Methods to Guide Study Protocol Decisions for School-Aged Children With Type 1 Diabetes.

Many challenges exist in developing multisite protocols for newly diagnosed children with type 1 diabetes. Our research team engaged community members to increase the likelihood of study success during a planning grant for a longitudinal study aimed at understanding risk and protective factors for neurocognitive function in school-aged children newly diagnosed with type 1 diabetes. Two methods were used to obtain caregiver input into study protocol decisions. The first was a survey given to caregivers of children with diabetes (n = 21) about which aspects of the study protocol would make families more or less likely to participate. The second was a Community Engagement (CE) Studio to obtain recommendations from a diverse group of caregivers of children with diabetes (n = 7) on key aspects of recruitment and enrollment. Results from both the survey and the CE Studio indicated that caregivers were interested and willing to participate in a longitudinal study of this nature. Both methods resulted in similar preferences for the type and amount of compensation, convenient study visits, flexible scheduling options, and receipt of neurocognitive test results. Recommendations from the CE Studio included additional strategies to minimize participant burden and enhance communication around study participation. Both the feasibility survey and the CE Studio were useful mechanisms to obtain caregiver input during the study's planning and design phase. Uniquely, the CE Studio approach offers researchers the ability to gain valuable community member input with minimal staff effort.

Subclinical neural hearing alterations in school children with type 1 diabetes mellitus

Background and objectivesEvidence has shown a cause-and-effect relationship between type 1 diabetes mellitus and auditory and cognitive dysfunctions. This study aimed to investigate the effect of type 1 diabetes mellitus (T1DM) on central auditory and cognitive functions in school-age children and adolescents. MethodsThe study sample consisted of 101 children and adolescents, 50 with T1DM, of both sexes, aged between 7 and 18 years. All participants were selected for a structured interview on hearing, behavioral, and cognitive health and assessment of brainstem auditory evoked potentials (BAEP) and event-related potentials (P300). ResultsSignificant differences were observed in memory (p=0.002) and attention (p=0.021) complaints between participants with and without T1DM. In the BAEP responses, there were differences between wave III latencies in the right (p=0.017) and left (p=0.019) ears and in wave V latencies in the left ear (p=0.001) between the evaluated groups. In addition, there was an association between BAEP findings and metabolic control in the T1DM group in the left ear in waves III (p=0.006) and V (p=0.005) and in the right ear in wave V (p=0.026). No differences were observed in the latencies of P300 between the evaluated groups. ConclusionThis study demonstrated the existence of a subclinical finding in the central auditory pathway, offering an increased risk for retrocollear alterations, which may be a consequence of poor metabolic control.

Specific Language Impairment and Executive Functions in School-Age Children: A Systematic Review.

This systematic review examines the relationship between specific language impairment (SLI)and executive functions (EFs) in school-agechildren. The study investigates the impact of SLI on EF in comparison to children who develop normally. A total of2,658 articles from three databases (PubMed, Scopus, and Virtual Health Library)were assessed for inclusion. Ultimately, 22 articles were selected for analysis, which contained information on both SLI and EF. The findings indicate that children diagnosed with SLI exhibit deficits, low performance, and, in some cases, significant deterioration in the development of EF when compared to typically developing children in 62%-91% of cases as early as three to four years of age; the most commonly found alterations were in working memory (including phonological, auditory, and visual/verbal memory), followed by deficits in attention, processing speed, inhibition, planning, cognitive flexibility, and internalized speech. We also discuss the close relationship and importance between language and EF in SLI children.

Prenatal and childhood exposure to ambient air pollution and cognitive function in school-age children: Examining sensitive windows and sex-specific associations

BackgroundCombined effect of both prenatal and early postnatal exposure to ambient air pollution on child cognition has rarely been investigated and periods of sensitivity are unknown. This study explores the temporal relationship between pre- and postnatal exposure to PM10, PM2.5, NO2 and child cognitive function. MethodsUsing validated spatiotemporally resolved exposure models, pre- and postnatal daily PM2.5, PM10 (satellite based, 1 km resolution) and NO2 (chemistry-transport model, 4 km resolution) concentrations at the mother's residence were estimated for 1271 mother-child pairs from the French EDEN and PELAGIE cohorts. Scores representative of children's General, Verbal and Non-Verbal abilities at 5–6 years were constructed based on subscale scores from the WPPSI-III, WISC-IV or NEPSY-II batteries, using confirmatory factor analysis (CFA). Associations of both prenatal (first 35 gestational weeks) and postnatal (60 months after birth) exposure to air pollutants with child cognition were explored using Distributed Lag Non-linear Models adjusted for confounders. ResultsIncreased maternal exposure to PM10, PM2.5 and NO2, during sensitive windows comprised between the 15th and the 33rd gestational weeks, was associated with lower males’ General and Non-verbal abilities. Higher postnatal exposure to PM2.5 between the 35th and 52nd month of life was associated with lower males’ General, Verbal and Non-verbal abilities. Some protective associations were punctually observed for the very first gestational weeks or months of life for both males and females and the different pollutants and cognitive scores. DiscussionThese results suggest poorer cognitive function at 5–6 years among males following increased maternal exposure to PM10, PM2.5 and NO2 during mid-pregnancy and child exposure to PM2.5 around 3-4 years. Apparent protective associations observed are unlikely to be causal and might be due to live birth selection bias, chance finding or residual confounding.