Impairment In Infants Research Articles

Analysis of Serum Inflammatory Markers in Infants Under 6 Months of Age with Non-Syndromic Moderate and Severe Hearing Loss Associated with GJB2 Gene Mutations.

BACKGROUND The GJB2 gene is reported to be the main hereditary factor responsible for non-syndromic hearing impairment in infants. Several kinds of hearing loss have been linked to elevated inflammatory markers. This study aimed to evaluate serum levels of IL-2, IL-4, IL-6, IL-10, IL-17, alpha-TNF, and γ-IFN and the severity of hearing loss. MATERIAL AND METHODS Ninety newborns were divided into 3 groups: severe hearing impairment (31 infants), moderate hearing impairment (30 infants), and normal hearing (29 infants). Hearing screening was performed using otoacoustic emissions test. Mutations of the GJB2 gene were detected with Sanger sequencing. The patients had DNFB1 mutation. Seven blood inflammatory markers were tested using Cytometric Bead Array. We performed the t test to examine differences in expression of 7 inflammatory markers between sexes in the groups. The correlation between indicators within groups was studied using the Pearson correlation test. Correlation of different indicators among groups was studied using the Spearman correlation test. RESULTS When compared among the 3 groups (severe, moderate hearing impairment, and normal hearing group), we found that IL-10 had a positive correlation with the severity of GJB2-associated hearing loss, which was statistically significant (P<0.05). CONCLUSIONS This research aimed to assess the relationship of 7 serum inflammatory markers with GJB2-associated hearing loss in infants. Inflammatory marker IL-10 had a positive correlation with the severity of GJB2-associated infant hearing loss, and it might have the potential to become a future therapeutic target.

The Oxygen Saturation Index as Early Predictor of Outcomes in Congenital Diaphragmatic Hernia

Objective: The aim of the study was to evaluate the oxygen saturation index (OSI) as an early predictor of clinical deterioration in infants with congenital diaphragmatic hernia (CDH). Methods: A single-center retrospective cohort study was conducted in consecutive infants with isolated CDH with continuous OSI measurements collected in the first 24 h after birth between June 2017 and July 2021. Outcomes of interest were pulmonary hypertension, extracorporeal membrane oxygenation (ECMO)-therapy, and mortality. We evaluated the discriminative values of the maximum OSI value and of mean OSI values with receiver operator characteristic (ROC) analysis and the area under the ROC curve. Results: In 42 infants with 49,473 OSI measurements, the median OSI was 5.0 (interquartile range 3.1–10.6). Twenty-seven infants developed pulmonary hypertension on a median of day 1 (1-1), of which 15 infants had an indication for ECMO-therapy, and 6 infants died. Maximum OSI values were associated with pulmonary hypertension, ECMO-therapy, and mortality. Mean OSI values had an acceptable discriminative ability for pulmonary hypertension and an excellent discriminative ability for ECMO-therapy and mortality. Although OSI measurements were not always present in the first hours after birth, we determined discriminative cut-offs for mean OSI values already in these first hours for pulmonary hypertension, the need for ECMO-therapy, and mortality. Conclusions: Continuous OSI evaluation is a promising modality to identify those infants at highest risk for clinical deterioration already in the first hours after birth. This provides an opportunity to tailor postnatal management based on the individual patient’s needs.

Weight gain in children from birth to 10 years on antiretroviral treatment.

Inadequate weight gain could indicate clinical deterioration in infants and children living with HIV (CLHIV). The World Health Organization's (WHO) weight-for-age z-score (WAZ) growth standards and reference charts are currently used in South Africa to assess weight gain in CLHIV on antiretroviral treatment (ART). To assess weight gain patterns of infants and children initiated on ART and to compare weight gain patterns between the WHO WAZ growth standards and population-specific curves constructed from data of CLHIV on ART. A quantitative, retrospective and descriptive-comparative design was used. The weight gain patterns of 98 infants and children from birth to 10 years old during the 24-month period following ART initiation were recorded and assessed using two different growth charts. The children's rate of weight and length gain improved significantly over 24 months since ART initiation, but complete catch-up growth was never achieved. Most (69%) of the children had increased weight gain according to the WAZ growth standard and reference charts versus only 16% according to the HIV-specific weight gain curves. Antiretroviral treatment improved weight and height gain in CLHIV, but the interpretations of weight gain differed significantly between the WHO chart and HIV-specific weight gain curves. Population- and treatment-specific references could improve weight monitoring in CLHIV and assist in the timeous identification of malnutrition.

The Relationship Between Placental Pathology and Neurodevelopmental Outcomes in Complex Congenital Heart Disease.

Complex congenital heart disease (CCHD) is associated with impaired neurodevelopmental outcomes. Peri- and post-operative factors are known contributors while the impact of the prenatal environment is not yet delineated. Variations in fetal circulation, seen in transposition of the great arteries (TGA) and single ventricular physiology (SVP), are associated with placenta abnormalities. These abnormalities may be associated with placental insufficiency, a risk factor for poor neurodevelopmental outcomes. We hypothesized there is a correlation between placental pathology and impaired neurodevelopmental outcomes in patients with CCHD. We performed a single center retrospective cohort study with patients with TGA and SVP from 2010 to 2017 at Children's Wisconsin. Patient variables were obtained from the medical record. Bayley Scales of Infant Development Third Edition standard scores for cognitive, motor, and language performance were collected from neurodevelopmental visits. Placenta pathology reports were reviewed with tabulation of predetermined anatomical and pathological characteristics. We identified 79 patients in our cohort and 61 (77.2%) had abnormal placentas. There was no significant difference between the two groups in any demographic or clinical variables. For cognitive and motor performance, without adjusting for the covariates, infants with placental abnormalities had significantly lower scores compared to infants without (p = 0.026, p = 0.045 respectively). Conversely, there was no significant difference in language scores between the two groups (p = 0.12). Placenta abnormalities are common in patients with CCHD, and placenta abnormalities are associated with impaired neurodevelopmental outcomes. These results underscore the complex causal pathways of neurodevelopmental impairment in infants with CCHD and offer opportunities for targeted postnatal developmental interventions after discharge.

Therapeutic hypothermia for encephalopathic newborns with congenital heart defect: A cross-sectional survey on current practices and opinions in Germany.

BackgroundTherapeutic hypothermia (TH) reduces neonatal mortality and long-term neurodevelopmental impairment in infants with moderate-to-severe hypoxic-ischemic encephalopathy (HIE) caused by perinatal asphyxia. There is an increasing trend to apply TH in other indications and populations, such as infants with mild HIE or neonates with congenital heart defects (CHD), even though there is little evidence to support or refute this.ObjectiveThe aim of this survey was to analyze practice variations with respect to TH use in neonates with CHD and to assess expert opinions on this topic across tertiary neonatal departments in Germany.Methods/DesignA web-based survey was sent to all tertiary neonatal departments in Germany. The questionnaire contained 32 multiple-choice questions. The survey inquired current practices on TH in newborns with CHD and expert opinions on various clinical scenarios.Main resultsA total 80 (51.3%) neonatal departments partially completed the survey, and 69 (44.2%) respondents filled out the whole questionnaire. All 80 (100.0%) departments perform TH. TH is offered by 76 (95.0%) respondents to encephalopathic newborns with simple CHD. In infants with critical/complex CHD, TH is offered after perinatal asphyxial HIE and in newborns with encephalopathy after severe acidosis associated with cardiac complications by 25 (31.3%), or 17 (22.1%) respondents, respectively, whereas a clear majority of centers reject TH in these infants. Unclear effects of TH on any ongoing prostaglandin therapy (57.6 and 52.3%, respectively), an increased risk for adverse reactions during TH (51.6 and 52.3%, respectively) and lack of evidence (33.3 and 53.8%, respectively) are the most frequently cited reasons for not performing TH in these infants. The majority of experts from neonatal departments providing comprehensive care for neonates with severe CHD support the initiation of TH in encephalopathic neonates.DiscussionThe considerable heterogeneity in the use of TH in neonates with CHD emphasizes the need for further research to optimize treatment strategies for these patients.

Investigation of PTC124-mediated translational readthrough in a retinal organoid model of AIPL1-associated Leber congenital amaurosis.

SummaryLeber congenital amaurosis type 4 (LCA4), caused by AIPL1 mutations, is characterized by severe sight impairment in infancy and rapidly progressing degeneration of photoreceptor cells. We generated retinal organoids using induced pluripotent stem cells (iPSCs) from renal epithelial cells obtained from four children with AIPL1 nonsense mutations. iPSC-derived photoreceptors exhibited the molecular hallmarks of LCA4, including undetectable AIPL1 and rod cyclic guanosine monophosphate (cGMP) phosphodiesterase (PDE6) compared with control or CRISPR-corrected organoids. Increased levels of cGMP were detected. The translational readthrough-inducing drug (TRID) PTC124 was investigated as a potential therapeutic agent. LCA4 retinal organoids exhibited low levels of rescue of full-length AIPL1. However, this was insufficient to fully restore PDE6 in photoreceptors and reduce cGMP. LCA4 retinal organoids are a valuable platform for in vitro investigation of novel therapeutic agents.

The impact of early intervention on a child with vision loss in infancy - A parental perspective.

: To assess the impact of early intervention services provided to children with visual loss and to report how parents perceive them in terms of a child's development and the family dynamics. : A qualitative descriptive study was conducted on a purposively selected sample of 15 children with severe visual impairment, availing early intervention services at a tertiary care facility in Pune, Maharashtra. Data were collected by conducting in-depth interviews of the parents with the help of a semi-structured interview topic guide. Participants were asked in detail about how and whether various components of the early intervention program (EIP) had an impact on their child. The interviews were audio-recorded, transcribed, and translated into English, and the resultant textual data were analyzed using the qualitative research software NVIVO 12 to identify themes and sub-themes under each domain. : A total of 15 children were included in the study, with ages ranging from 13 months to 5 years. All the children included in the study suffered from severe visual impairment in infancy (Vision 3/60 - PL). In the course of this EIP, the majority of the children showed consistent progress in various aspects of child development. According to the parents, the most beneficial components of EIP were visual stimulation exercises, an improvised teaching methodology, and counseling services. : Almost all the parents included in the study reported a positive change in the behavior and development of the child as well as improved family dynamics after implementation of EIP.

Impact of Comorbid Prematurity and Congenital Anomalies: A Review.

Preterm infants are more likely to be born with congenital anomalies than those who are born at full-term. Conversely, neonates born with congenital anomalies are also more likely to be born preterm than those without congenital anomalies. Moreover, the comorbid impact of prematurity and congenital anomalies is more than cumulative. Multiple common factors increase the risk of brain injury and neurodevelopmental impairment in both preterm babies and those born with congenital anomalies. These include prolonged hospital length of stay, feeding difficulties, nutritional deficits, pain exposure and administration of medications including sedatives and analgesics. Congenital heart disease provides a well-studied example of the impact of comorbid disease with prematurity. Impaired brain growth and maturity is well described in the third trimester in this population; the immature brain is subsequently more vulnerable to further injury. There is a colinear relationship between degree of prematurity and outcome both in terms of mortality and neurological morbidity. Both prematurity and relative brain immaturity independently increase the risk of subsequent neurodevelopmental impairment in infants with CHD. Non-cardiac surgery also poses a greater risk to preterm infants despite the expectation of normal in utero brain growth. Esophageal atresia, diaphragmatic hernia and abdominal wall defects provide examples of congenital anomalies which have been shown to have poorer neurodevelopmental outcomes in the face of prematurity, with associated increased surgical complexity, higher relative cumulative doses of medications, longer hospital and intensive care stay and increased rates of feeding difficulties, compared with infants who experience either prematurity or congenital anomalies alone.

Clinical analysis of Terson syndrome in infants

Objective: To observe the clinical features, intervention and outcomes of anatomic and visual functions of Terson syndrome in infants, and to explore the appropriate timing for surgery. Methods: This retrospective study included 23 eyes of 14 infants diagnosed with vitreous hemorrhage related to Terson syndrome between May 2008 and March 2021 in Department of Ophthalmology, Peking University People's Hospital. There were 7 males (11 eyes) and 7 females (12 eyes). The age at the initial visit was (4.59±3.96) months. No obvious abnormality was observed in the anterior segment of both eyes of each patient. Data were collected, including demographics, causes of intracranial hemorrhage, characteristics of intraocular hemorrhage, intervention, outcomes of anatomic and visual functions. Results: The causes were craniocerebral trauma in 3 patients, idiopathic cysts in 8 patients, ependymal cyst rupture in 1 patient and respiratory distress in 2 patients. The chief complaint was behavior change in 9 patients, and hemorrhage was found in 5 patients on fundus examination. The rate of complications related to intraocular bleeding was 12/16 when the duration was less than 3 months and 6/7 when the duration was more than 3 months. Twenty eyes (86.96%) were treated by vitrectomy. The follow-up ranged from 6 to 160 months. Three eyes were atrophied, anatomical success was recorded in 18 eyes, and retinal detachment developed in 2 eyes. The visual acuity was improved in 12 eyes (60%), unchanged in 5 eyes (25%), and deteriorated in 3 eyes (15%), except 3 eyes that did not comply with visual acuity examination. Ten eyes showed an obvious myopic shift. Conclusions: The vitreous hemorrhage related to Terson syndrome can occlude the macula and cause severe structural and functional impairments in infants. Vitrectomy is an effective intervention technique, which can quickly remove blood accumulation and restore the anatomical structure, providing better conditions for the visual development of infants.

Risk factors for hearing impairment in infants and toddlers in the Gaza governorates: a case-control study

BackgroundThe risk factors for congenital or early-onset hearing loss vary across countries. This study aimed to explore the risk factors for hearing impairment in children younger than 3 years in Gaza governorates to inform preventive strategies. MethodsThis case-control study started in February, 2017, and ended in July, 2018. Ethical approval was obtained from the Helsinki Committee in Palestine, a national committee established in 1986 that reviews all proposals for heath research, and whose approval is a requirement before any health research in Palestine. Data were collected through face-to-face household interviews. Cases were defined as children diagnosed with moderate, severe, or profound sensorineural hearing impairment within the first 3 years of life (n=169), whereas controls were children who had been screened and found to have unimpaired hearing (n=169). Cases and controls were randomly selected through a systematic sampling approach from the screening lists of the Atfaluna Society for Deaf Children, a registered Palestinian non-governmental organisation that has been working in the field of deaf education and allied services since 1992 and that regularly leads hearing screening campaign for neonates and children younger than 5 years in primary health centres over all Gaza governorates. SPSS version 21 was used for data entry and logistic regression analysis with the chi-square test, odds ratio, and t test. FindingsMaternal unemployment was more prevalent in cases than in controls (p=0·025). Having a family history and consanguinity were more prevalent in cases than in controls (p=0·001 for both). Taking folic acid during the preconception period (p=0·007) and iron supplements during pregnancy (p=0·002) were associated with a lower prevalence of hearing loss. The proportion of mothers of cases who were registered as having received antenatal care during the first trimester was lower for cases than for controls (odds ratio 0·341 [95% CI 0·181–0·640]; p=0·002). Prematurity (p=0·006), low birthweight (p<0·0001), and admission to a neonatal intensive care unit (p=0·002) were strongly associated with hearing impairments. The study also showed that children with recurrent otitis media were at a greater risk of hearing impairment (p<0·0001), as were children who had been exposed to sporadic loud noises, such as nearby bombing, or continuous loud noise at home, such as from nearby factories. (p=0·01). InterpretationThe study concluded that hearing impairment among children younger than 3 years is associated with a wide array of socioeconomic, health, and environmental vulnerabilities. A health promotion programme should be established to address consanguinity, prematurity prevention, and timely and appropriate preconception and antenatal care, alongside universal screening for all children, particularly those at risk as identified in this study. FundingNone.

Diagnostic ability of otoacoustic emission and automated auditory brainstem response in hearing screening of high-risk newborn

Background: Early identification of hearing impairment in infants and appropriate intervention can prevent severe psychosocial, educational, and linguistic repercussions. Infants who are not identified before 6 months of age have delays in speech and language development.Methods: This was a prospective cohort study OAE and AABR were administered to high-risk neonates discharged from NICU and the diagnostic ability to pick up hearing loss was assessed by trained audiologist. Statistical analysis was interpreted by McNemar paired Chi-square test (χ2) test. Factors which correlated with deafness were interpreted by Pearson chi-square (χ2) test.Results: Among 144 babies screened, 26 failed OAE while 6 failed AABR. Referral rate was 18.1% with OAE and 4.2% with AABR. All 6 babies failed with 40db and 90 db screening. Mean duration of NICU stay had a positive correlation with AABR positivity. Babies with higher duration of NICU stay had greater probability of hearing loss. Age and gender had no significant correlation with hearing loss. Sensitivity of OAE as 16.7 % and the specificity was 81.9 %. Positive likelihood ratio with OAE was.923. Negative likelihood ratio with OAE was 1.02. One neonate out of 6 with jaundice had profound hearing loss. Conclusions: It was concluded that in high-risk neonates the diagnostic value of DPOAE for identification of hearing loss, when used alone, was limited since OAE has higher referral rate and lower specificity compared to AABR. Babies with higher duration of NICU stay had greater probability of hearing loss.

Incidence of hearing impairment in at risk babies

Babies treated in neonatal intensive care are prone for hearing problems and with the decrease in infant mortality, babies who survive many perinatal risk factors are increasing. Deafness in 1st three years of life may impair the full development &amp; maturation of auditory system &amp; it is well known that deafness in infancy &amp; childhood interferes with normal development of speech &amp; language. To prevent this &amp; to initiate rehabilitative procedure as early in life as possible a screening method to detect auditory disabilities in newborns is of great importance. Based on this background the present study determine to evaluate to know the incidence of hearing impairment in infants at risk.This is a prospective observational study conducted in JJM Medical College, Davanagere, Karnataka. A total 940 patients attended to JJM Medical College and Hospital and diagnosed with hearing impairment according to American Joint Committee statement on infant hearing screening (JCIH) criteria. All the patients under 2 years with history of high risk factors – pre–term, low birth weight, birth asphyxia, neonatal seizures, and hyperbilirubinemia were selected for the study. Those who failed in this test underwent repeated OAE after 6 weeks, followed by brain stem evoked response audiometry (BERA) if the second OAE was negative. Out of 940 high risk cases, 350 had profound hearing loss, 83 had severe hearing loss, 125 had moderate hearing impairment, 36 had mild hearing impairment &amp;346 had normal hearing sensitivity. Out of 48 patients with normal hearing sensitivity, 53 patients were preterm, 166 had hyperbilirubinemia, 23 had neonatal convulsions, 68 birth asphyxia, 89 were of low birth weight. Out of 147 cases 31 patients had mild/moderate hearing impairment.Neonatal jaundice carries the highest risk of hearing impairment followed by birth asphyxia, neonatal convulsions and low birth weight.BERA is the tool which can confirm the normal sensitivity of hearing whenever required &amp; is very useful in early detection of hearing loss and planning rehabilitative procedures.

Development of muscle tone impairments in high-risk infants: Associations with cerebral palsy and cystic periventricular leukomalacia.

To assess the prevalence and development of muscle tone impairments in infants at high risk of developmental disorders, and their associations with cerebral palsy (CP) and cystic periventricular leukomalacia (cPVL). Longitudinal exploration of muscle tone in 39 infants at high risk of CP (LEARN2MOVE 0-2 project) mostly due to an early lesion of the brain. Muscle tone was assessed ≥4 times between 0 and 21 months corrected age (CA) with the Touwen Infant Neurological Examination. Diagnosis of CP was determined at 21 months CA. Neonatal neuro-imaging was available. Developmental trajectories were calculated using generalized linear mixed effect models. Infants showed atypical muscle tone in three or four body parts in 93% (172/185) of the assessments. The most prevalent muscle tone pattern was hypotonia of neck and trunk with hypertonia of the limbs (28%). From 7 months CA onwards hypertonia of the arms was associated with CP. Asymmetric arm tone during infancy was associated with unilateral CP. At 18-21 months CA ankle hypertonia was associated with CP at 21 months; leg hypertonia in infancy was not associated with CP. Leg hypertonia was associated with cPVL, regardless of age. High-risk infants due to an early lesion of the brain often present with muscle tone impairment. In these infants, hypertonia and asymmetric muscle tone of the arms were from 7 months onwards associated with the diagnosis of CP at 21 months; hypertonia of the legs was not.

Hearing Impairment in Infants with Asphyxia

Hearing Impairment in Infants with Asphyxia

Hearing Impairment in Infants with Asphyxia.

In recent decades, despite significant advances in medicine and perinatal care, asphyxia remains a serious condition, leading to significant mortality and morbidity. The incidence of severe perinatal asphyxia varies from 1 to 3 per 1000 live births, in developed countries 5-10 per 1000 or more in developing countries, and is the third most common cause of neonatal death (23%) after preterm birth (28%) and severe infection (26%). Neonatal asphyxia is often accompanied by multiple organ failure, mainly involving the kidneys, brain, and heart. Asphyxia results in significant tissue hypoperfusion and reduced oxygen supply, which can cause neurological damage and damage to cochlear hair cells. Under our supervision were 35 (n=30) newborns who were in the neonatal intensive care unit of the Perinatal Center of the Khorezm region in the period from 2018 to 2019. Of these, 22 (I (main) group n=22), who were in the neonatal pathology department, had signs of perinatal CNS damage; The comparison group included 13 newborns (n=13), with Apgar scores >7 in the first minute. There is a clear correlation between the degree of hearing impairment in infants and the degree of pathology of the CNS. However, the degree of impairment of the auditory analyzer increased in parallel with the degree of asphyxia and severity (P≤0,05).

Parechovirus neonatal sepsis and meningitis – a (still) poorly recognised agent

Human parechovirus (HPeV), a Picornaviridae virus, is a microorganism associated with respiratory and gastrointestinal infections, in most cases with a benign clinical course. However, some serotypes have been recently associated with a more serious clinical outcome in young children, namely sepsis-like disease and meningitis. In this report, we describe the case of a previously healthy, 11-day-old infant in our Paediatric Emergency Department who presented with high fever, irritability and poor feeding. No other accompanying symptoms, such as respiratory, gastrointestinal or urinary, were shown by the patient. Family history unveiled an 18-month-old sibling with an upper respiratory tract infection. Physical examination was unremarkable. Laboratory testing revealed a normal total white cell count with lymphopenia and a maximum C-reactive protein value of 21.4 mg/L. Cerebrospinal fluid (CSF) analysis showed pleocytosis with high proteinorrachia and normal glycorrhachia. With the clinical suspicion of sepsis, she was hospitalized for clinical surveillance, and empirical antibiotics were administered. Although the bacteriological exams of blood and CSF were negative, RNA of an HPeV was detected in the CSF. She had a favourable clinical course, the cerebral ultrasound was normal, and the clinical follow-up showed adequate psychomotor development until today (18 months old). Recent publications suggested HPeV as one of the major agents of neonatal sepsis and meningitis. Similarly, several other studies reported significant neurological impairments in infants with HPeV infection. In line with these recent findings, we believe this clinical case further supports the need for more extensive research in viral aetiology and in particular of this, not so uncommon, agent in order to avoid unnecessary and potentially harmful interventions in newborns presenting with a sepsis-like clinical picture.

Motivating Spontaneous Infant Kicking Motions through Long Term Learning Utilizing a Robotic Mobile System.

Our research investigates methods and systems to allow for early detection of motor impairment in infants and innovative interventions with the goal of improving longterm outcomes. A robotic baby mobile is utilized to motivate spontaneous kicking motions, which is used as a marker for predicting the potential of motor development delays. Our previous work investigated how the different stimuli modalities of a baby mobile can encourage infant kicking. We utilized a 3D camera system to detect the kicking motions, as well as recorded specific metrics of each kicking episode. In this work, we investigate the possibility of an infant having a preference of baby mobile stimuli that results in increased and sustained kicking motions. This preference is learned over multiple sessions with one infant and utilizes a Markov Decision Process to develop a policy.

Prolyl Endopeptidase-like Deficiency Associated with Growth Hormone Deficiency

Prolyl endopeptidase-like (PREPL) deficiency (MIM#616224) is a rare congenital disorder characterised by neonatal hypotonia and feeding difficulties, growth hormone (GH) deficiency and hypergonadotropic hypogonadism. This syndrome is an autosomal recessive disease resulting from mutations in the PREPL gene (MIM#609557). Herein we report a 7-year-old female patient with biallelic mutations in PREPL (c.1528C>T in one allele and whole gene deletion in the other) with early growth impairment in infancy. GH deficiency was confirmed at 20 months of life. Recombinant GH treatment was introduced with a good response. Her clinical features were similar to those of previously reported cases. The description of new patients with PREPL deficiency syndrome is essential to better delineate the phenotypic and genotypic spectrum of the disease.

Role of Otoacoustic Emission Test in Early Diagnosis of Hearing Impairment in Infants.

Hearing impairment is most common congenital dissorder and undiagnosed hearing loss can cause disorder in speech, language with delay in social and emotional developments. Early detection of Hearing Impairment in Infants and too access the relationship between selected risk factor and hearing loss. Neonates age upto 15days randomly selected from pediatric and obstetrics and gynaecology department, born during this period were screened by OAE before their discharge from the hospital and after stabilizing high risk neonates. Informed consent of neonates parent/guardian was obtained before babies were subjected to OAE. A total of 400 neonates were screened for hearing loss by otoacoustic emission. Out of that 18 (4.5%) neonates failed the test in initial screening and were asked for follow up screening. Two neonates were lost to follow up. Out of 16 neonates, 2 (12.5%) neonate failed the test on follow up screening by otoacoustic emission and was referred for BERA. Neonates were classified as low and high risk basis of risk factors present. Out of 76 neonates having high risk of hearing loss, 16 failed the test. Similarly out of 324 neonates with low risk of hearing loss, only one neonate failed the test. Chi square analysis has revealed highly significant results (p < 0.001). Late identification of hearing loss presents a significant public health concern. However, without screening, children with hearing loss are usually not identified until 2years of age, which results in significant delays in voice communication, language communication, social, cognitive, and emotional development. In contrast, early recognition, and intervention prior to 3months of historic period has a significant positive impact on development.

Abnormal visual attention to simple social stimuli in 4-month-old infants at high risk for Autism

Despite an increasing interest in detecting early signs of Autism Spectrum Disorders (ASD), the pathogenesis of the social impairments characterizing ASD is still largely unknown. Atypical visual attention to social stimuli is a potential early marker of the social and communicative deficits of ASD. Some authors hypothesized that such impairments are present from birth, leading to a decline in the subsequent typical functioning of the learning-mechanisms. Others suggested that these early deficits emerge during the transition from subcortically to cortically mediated mechanisms, happening around 2–3 months of age. The present study aimed to provide additional evidence on the origin of the early visual attention disturbance that seems to characterize infants at high risk (HR) for ASD. Four visual preference tasks were used to investigate social attention in 4-month-old HR, compared to low-risk (LR) infants of the same age. Visual attention differences between HR and LR infants emerged only for stimuli depicting a direct eye-gaze, compared to an adverted eye-gaze. Specifically, HR infants showed a significant visual preference for the direct eye-gaze stimulus compared to LR infants, which may indicate a delayed development of the visual preferences normally observed at birth in typically developing infants. No other differences were found between groups. Results are discussed in the light of the hypotheses on the origins of early social visual attention impairments in infants at risk for ASD.