Outcome Of Therapy In Children Research Articles

Orthodontic aligner therapy outcomes in children with autism spectrum disorder.

Children with autism spectrum disorder (ASD) face unique challenges in oral care. Aligner therapy offers a promising alternative to conventional approaches for this patient group. To evaluate orthodontic aligner therapy outcomes in children with ASD using the Peer Assessment Rating (PAR) Index and the Index of Complexity, Outcome, and Need (ICON), and to investigate whether concomitant disorders affect ICON, PAR scores, and treatment duration. Two calibrated observers assessed digital dental casts and intraoral pictures of 37 children with ASD before (T0) and after (T1) their treatment. At T0, the participants' average age was 12.9 years (SD = 1.68); at T1, post-therapy, the average age was 14.9 years (SD = 1.51). All participants underwent orthodontic aligner therapy. Statistical methods employed in this study included descriptive analysis, Wilcoxon tests, and univariate linear regression. Posttreatment, median ICON scores decreased significantly from 74 to 14, and median PAR scores from 36 to 8 (p < .0001), demonstrating "excellent to substantial" improvement in 89.2% (n = 33) of the children. Comorbidities, present in 62% of patients, did not significantly affect treatment duration (22.6 ± 11.02 months). Children with ASD significantly benefit from orthodontic aligner therapy, emphasizing the need for tailored orthodontic care.

Effect of Cognitive Orientation to Daily Occupational Performance (CO-OP) on Motivation of Children with Cerebral Palsy: A Pilot Clinical Randomized Controlled Trial

ABSTRACT Children with cerebral palsy (CP) may experience challenges with motivation to engage in motor activities during rehabilitation sessions, which can impact therapy outcomes. This study investigated the effect of the Cognitive Orientation to daily Occupational Performance (CO-OP) intervention on the motivation and achievement of motor-based goals in rehabilitation sessions for children with CP. In this pilot randomized trial, eighteen children aged 8–13 years with CP participated and were randomly assigned to either the CO-OP or bottom-up usual care group. The CO-OP group received 12 performance-based cognitive intervention sessions. The CO-OP intervention significantly enhanced the motivation of children with CP to engage and participate in therapeutic activities, as evidenced by the Pediatric Motivation Scale (PMOT) and its four sub-scales (p < 0.05, based on repeated measures ANOVA). Moreover, the Goal Attainment Scale (GAS) T-scores were higher for both posttest and follow-up assessments in the CO-OP group compared to the bottom-up usual care group. Additionally, independent sample t-test results demonstrated a significant difference in the mean scores of the Canadian Occupational Performance Measure (COPM) between the two groups. The Cognitive Orientation to daily Occupational Performance (CO-OP) intervention successfully enhanced the motivation and facilitated the achievement of motor-based goals from the patient perspective in children with CP. The client-centered approach, focusing on meeting the basic psychological needs of the participants, contributed to improved therapy outcomes in terms of functional abilities, goal attainment, and engagement in daily activities. These findings highlight the potential of the CO-OP intervention as an effective approach for enhancing motivation and improving therapy outcomes in children with CP.

Objective tools in pediatric voice therapy: A path to improved outcomes

This is an invited presentation in the Special Session titled, “Voice therapy: objective measurement science and clinical efficacy.” Pediatric dysphonia (hoarseness) is a common condition with prevalence estimates ranging from 1.4% to 23.9%. Dysphonia can be detrimental to children both psychologically and academically; hence, early identification and restoration of optimal vocal health is critical. Direct visualization of vocal fold vibratory patterns is fundamental for appropriate diagnosis and treatment of vocal fold pathology. Thus, evaluation of vocal fold structure and cycle-to-cycle vibratory motion through techniques of direct visualization of the vocal fold is essential for clinical assessment and measurement of treatment outcomes. This session will discuss the most recent advances in objective voice assessment and measurement of voice therapy outcomes in children. The focus will be on discussing an innovative approach that leverages high-speed videoendoscopy and a cutting-edge custom developed laser projection system for quantitative evaluation of lesion size and comprehensive evaluation of opening and closing phase dynamics of the glottal cycle before and after voice therapy in children with vocal fold nodules.

The First Evaluation of Remote Magnetic Navigation-Guided Pediatric Ventricular Arrhythmia Ablation

Catheter ablation (CA) is an important treatment option for ventricular arrhythmias (VA) in pediatric cardiology. Currently, various CA techniques are available, including remote magnetic navigation (RMN)-guided radiofrequency (RF) ablation. However, no studies evaluate RMN-guided ablative therapy outcomes in children with VA yet. This study aimed to compare procedural and long-term outcomes between RMN-guided and manual (MAN)-guided VA ablation in children. This single-center, retrospective study included all CA procedures for VA performed in children with or without structural heart disease from 2008 until 2020. Two study groups were defined by CA technique: RMN or MAN. Primary outcome was recurrence of VA. Baseline clinical, procedural and safety data were also evaluated. This study included 22 patients, who underwent 30 procedures, with a median age of 15 (IQR 14–17; range 1–17) years and a mean weight of 57 ± 20 kg. In total, 14 procedures were performed using RMN and 16 using MAN (22 first and 8 redo procedures). Regarding first procedures, recurrence rates were significantly lower in RMN compared to MAN (20% versus 67%, P = 0.029), at a mean follow-up of 5.2 ± 3.0 years. Moreover, fluoroscopy dosages were significantly lower in RMN compared to MAN [20 (IQR 14–54) versus 48 (IQR 38–62) mGy, P = 0.043]. In total, 20 patients (91%) were free of VA following their final ablation procedure. This is the first study to investigate the use of RMN in pediatric VA ablation. RMN showed improved outcomes compared to MAN, resulting in lower VA recurrence and reduced fluoroscopy exposure.

Outcome of immunoglobulin replacement therapy in children with rhinosinusitis.

Outcome of immunoglobulin replacement therapy in children with rhinosinusitis.

Outcomes of Severe Seronegative Hepatitis-associated Aplastic Anemia: A Pediatric Case Series.

Hepatitis-associated aplastic anemia (HAAA) is a potentially life-threatening diagnosis without clear treatment guidelines. The goal of the study was to characterize the presentation, evaluation, histopathology, and outcomes of therapy in children with HAAA to guide future research and to develop standardized care guidelines for this rare disease. Retrospective chart review of 4 patients with HAAA who presented to Children's Hospital Colorado between 2016 and 2019 was conducted. Patient presentation, evaluation, bone marrow and liver pathology, interventions, and clinical course were collected. Immunohistochemistry of liver biopsies was performed. We treated 4 patients with HAAA without liver failure. All had evidence of systemic hyperinflammation and CD8+ T cell predominant liver tissue infiltration. One had a genetic mutation predisposing him to immune-mediated disease, but all other genetic testing was negative. In 3 of the 4 patients, hepatitis was poorly responsive to standard therapy with steroids, azathioprine, or tacrolimus; however, sustained biochemical remission of hepatitis was induced after more aggressive immunosuppressive therapies including Anti-Thymocyte Globulin (ATG) at standard immunosuppressive therapy (IST) dosing for severe Aplastic Anemia (sAA). Two patients underwent hematopoietic stem cell transplant (HSCT); 1 as first line therapy and 1 for refractory sAA. We found that ATG-based IST induced remission of hepatitis in patients with steroid-refractory HAAA. This is also an appropriate initial treatment for severe Aplastic Anemia, though may not prevent the need for HSCT. We propose that equine ATG based IST at standard dosing regimen for sAA is a therapy that in select cases can be considered early on in the treatment course and could lead to a sustained remission of both hepatitis and sAA. This should be considered in collaboration with a pediatric hematologist.

Imagination in Autism: A Chance to Improve Early Language Therapy.

Children with autism often have difficulties in imaginative play, Theory of Mind, and playing out different scenarios in their minds. Research shows that the root of these problems may be the voluntary imagination network that involves the lateral prefrontal cortex and its long frontoposterior connections to the temporal-parietal-occipital area. Previously disconnected visuospatial issues (stimulus overselectivity and tunnel vision) and language issues (lack of comprehension of spatial prepositions and complex recursive sentences) may be explained by the same voluntary imagination deficit. This review highlights the new insights into the mechanism of voluntary imagination, its difference from involuntary imagination, and its unusually strong critical period. Clearer developmental terminology and a better understanding of voluntary imagination have the potential to facilitate communication between therapists and parents, and improve therapy outcomes in children.

AYRES SENSORY INTEGRATION FOR THE CHILDREN WITH ATTENTION DEFICIT AND HYPERACTIVITY DISORDER (ADHD):A MIXED METHOD STUDY

For intervention of children with a diagnosis of Attention deficit hyperactivity disorder (ADHD), there are many modalities. Sensory Processing issues are present in children with ADHD. There is a wide use of Ayres Sensory Integration (ASI®) to treat children with ADHD. But effectiveness of ASI® in children with ADHD is unknown. The purpose of study was to examine the effects of ASI® Interventions on Participation of the child in addition to the parent’s perspective about the outcome of therapy in children with a diagnosis of ADHD. Method: Study was divided as 1. Development of the questionnaire for the evaluation of “Participation of the child with ADHD”. 2. Randomized controlled Pilot trial, double blind study. 3. Family perspective about the effect of intervention on children with ADHD using qualitative interview method. Eligible candidates were children having average intelligence with a diagnosis of ADHD, between age of 5 years and 12 years, sensory processing disorder. Children included in the study received occupational therapy with either protocol. Results: 1. Self-care, academics, interpersonal interactions and communication are important primacies for the parents of children with a diagnosis of ADHD. 2. Priorities of the parents of children with a diagnosis of ADHD change according to the culture they belong. 3. ADHD Participation Profile (APP) is a valid &amp; reliable questionnaire to monitor progress of children with a diagnosis of ADHD. The responsiveness of the ADHD Participation Profile questionnaire has been proven to be good. Herein, the ADHD Participation Profile can be used reliably to document the treatment progress of patients with ADHD for research and clinical purposes.The children in ASI® Group, made gains that were significantly greater than the children in the other group on Goal Attainment Scale and ADHD Participation Profile. Large Effect sizes were found between and within the on both the outcome measures (1.87 &amp; 0.939). Conclusion: ADHD does not have only represents sensory processing issues. It’s is complex disorder which embodies issues other than Sensory Processing and will be receptive to the other modes of intervention. If existing, the sensory processing issues needs to be addressed specifically, as it will influence the global performance.Occupational Therapy has brought a notable change in kids and parent’s life. Most of the caretakers were ready for new boundaries in their daily family occupations. Though some goals are met after the intervention, the list of apprehensions is unending. Many parents less worried after Occupational Therapy intervention, whereas the few were still doubtful about future of their kids. We would have overlooked this ironic data, if we should have given a verdict about the effect of the intervention though quantitative measure. Mixing the methods was a suitable solution.

Effect of screen time in the clinical outcome of therapy in children with Autism spectrum disorder and social communication disorder

Children of present day are exposed to excessive screen time from a very young age itself. Among the factors which contribute to this is easy accessibility to gadgets, nuclear families with less support for childrearing due to parental preoccupation, etc. Though there are studies addressing the association between screen time and health effects, there isn’t’ any study addressing the effect of screen time on progress of therapy session in children with special needs, especially Autism or social communication disorders. For the present study, we enrolled children between 2-5years with ASD / SCD and assessed their initial problems and improvement post interventions with ATEC scoring. They were questioned about the screen time their children were exposed initially as well as at the end of training duration and were grouped as &lt;1 hour and &gt;1 hour. Following complete assessment using all the required tools, the children were given all the required standardised therapies according to our unit protocol for ASD and SCD, respectively. This includes sessions of Occupational therapy, speech therapy, ABA, etc. for 6 months. The effect of the sessions in the form of improvement in ATEC scores- total and individual domain scores of both ASD and SCD children were correlated with the screen time exposure and assessed for significance. 70 % of the kids with special needs (ASD&amp; SCD) had media exposure &gt;1 hours in the first year itself and were continuing at &gt;2 hour/day. The present study showed that screen time has significant negative influence affecting improvement following therapies in both ASD and SCD. But ASD children seem to be more affected than SCD. ATEC scoring may be used in both ASD and SCD for follow-up assessment. However, this may require a larger sample for further validation. We caution the use of low quality Screen media intervention in therapy sessions or home for engaging these 2 groups of children.

Clinical, functional and quality of life outcomes of Burosumab therapy in children with X-linked hypophosphoataemia: a real world, London experience

Clinical, functional and quality of life outcomes of Burosumab therapy in children with X-linked hypophosphoataemia: a real world, London experience

Blood coagulation in venous thrombosis, complicating treatment of children, adolescents and young adults with lymphomas

Objective of the study was to compare blood clotting parameters in lymphoma patients with or without venous thrombosis (VT), as well as to analyze the duration and outcome of anticoagulant therapy in children, adolescents and young adults with lymphoma, whose program treatment was complicated by VT.Materials and methods . The analysis included 28 patients with lymphoma (Hodgkin lymphoma – 5, non-Hodgkin lymphoma – 23), aged from 2 to 25 years (median – 16.0 years), whose program treatment in 2005–2017 was complicated by VT. The case-control study was carried out to compare the parameters of blood coagulation. The control group consisted of 22 patients, aged from 2 to 20 years (median – 15.5 years) with the same diagnosis, age, therapy protocol and phase of treatment who had no thrombotic complications. The comparison group consisted of 35 healthy children aged from 3 to 18 years (median – 14.0 years).Results . There was no difference in majority of blood clotting parameters in lymphoma patients with or without VT. Hyperfibrinogenemia and an increased D-dimers level distinguished patients with lymphoma, regardless of the presence or absence of thrombosis, from healthy children of the same age (р&lt;0.05). Anticoagulant therapy up to 3 months received 10 patients, for 4–6 months – 4, for 7–12 months – 12, up to 18 months – 2. One adult patient with a homozygous mutation 20210G&gt;A gene of the factor II takes warfarin continuously for a long time after relapse of VT. Complete recanalization of the thrombosed vessel occurred within the first 3 months in 9 patients, within 4–6 months – in 1, within 7–12 months ‒ in 4. Partial recanalization within 3–12 months was confirmed in 8 patients. Vein obliteration, mainly the internal jugular vein, as the outcome of VT occurred in 6 patients within 4–12 months.Conclusion . Detection of routine blood clotting parameters does not allow identifying patients with thrombosis among children, adolescents and young adults with lymphoma. Fibrinogen and D-dimers levels were significantly higher in lymphoma patients, than in healthy children. Anticoagulant therapy for 3–12 months led to the complete or partial recanalization of VT in 79 % of patients. To detect blood clotting parameters by thrombosis development, as well as to reveal and monitor transient and permanent risk factors are necessary to specify the cause of VT and to determine the appropriate anticoagulant therapy.

P267 Long-term outcome of anti-TNF therapy in children with Crohn’s disease

P267 Long-term outcome of anti-TNF therapy in children with Crohn’s disease

Occurrence of ADHD in parents of ADHD children in a clinical sample.

BackgroundDespite the fact that there is a large amount of research on childhood attention deficit hyperactivity disorder (ADHD) treatment and an increasing amount of research on adult ADHD, little is known about the prevalence and influence of parental ADHD. Therefore, this study examined the frequency of parental ADHD in a clinical sample of German children suffering from ADHD. We also tried to find different levels of symptom severity for prognostic relevance. Furthermore, the association between subtypes of ADHD in children and their parents was investigated.MethodIn this study, parents of 79 ADHD children were screened for ADHD according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition and International Classification of Diseases, 10th edition. The Wender Utah Rating Scale and the ADHS-Self-Report were given to 75 mothers and 49 fathers for retrospective and current symptoms. Frequency of ADHD symptoms and severity groups was calculated and relationship between parental and children’s ADHD was tested.ResultsADHD occurrence for mothers of children with ADHD was 41.3%, for fathers 51.0%. About 16.0% of the mothers had a mixed type, 9.3% had a hyperactive-impulsive subtype, and 16.0% had an inattentive subtype. Of the fathers, 18.4% had a mixed type, 10.2% had a hyperactive-impulsive subtype, and 22.4% had an inattentive subtype; 61% of the mothers and 46.9% of the fathers had low symptom severity. Medium symptom severity was reported by 37.7% mothers and 46.9% fathers, while 1.3% of the mothers and 6.2% of the fathers showed severe symptoms. No significant correlation between parental and child diagnoses was observed.ConclusionAs nearly half of the parents suffered from ADHD, these results are a matter of concern in families with ADHD children. Besides parent–child interactions, parental ADHD symptoms might influence parental education style and also effects parent training as well as the child’s therapy outcome. In the future, parents should be screened for ADHD symptoms if they or their child receive treatment and to adjust processes and design of treatment to the symptoms.

Health-Related Quality of Life in Children and Adolescents with Cerebral Palsy: A Secondary Analysis of the DISABKIDS Questionnaire in the Field-Study Cerebral Palsy Subgroup.

Health-related quality of life (HRQOL) instruments are increasingly being used to evaluate interventions and therapy outcomes in children and adolescents with cerebral palsy (CP). A variety of psychometrically sound and validated generic and disease-specific instruments are available. A third type of instrument, the chronic-generic instrument, pertains to features of HRQOL that are shared by various chronic conditions.The DISABKIDS family of questionnaires consists of a chronic-generic core measure (DCGM-37) and several condition-specific modules, among these, a CP module (CPM). The objective of this article was to describe the performance and, specifically, the validity of the DCGM-37 and CPM in children and adolescents with CP. Psychometric properties of the DCGM-37 and the CPM are presented. The discriminant validity was assessed compared with generic measures of HRQOL regarding different levels of impairment (physical independence; developmental delay). A total of 86 patients with CP (mean age 13 years, range 7-19 years) and 78 main caretakers participated in this study. The DCGM-37 and CPM showed much better discriminative ability as compared with generic questionnaires. The DCGM-37 and CPM were able to differentiate between patients with different levels of impairment and can be recommended for treatment evaluation and group comparison in clinical studies of children and adolescents with CP.

PP06.9 – 2328: Gross motor outcome of intensive therapy in children with cerebral palsy and developmental delay

Objective Many physicians and parents of children with developmental delay expect some effect of intensive rehabilitative treatment, though the evidence of intensive intervention is not well defined. And indications of intensive therapy and factors that can have an influence on therapeutic effect are not well known. The aim of this study was to find out the short term effect of intensive therapy (3 hours daily x 5 days/week for 8 weeks physical and occupational therapy sessions) on gross motor function in miscellaneous developmental delay children. Methods Retrospectively 84 patients were reviewed and total GMFM score percentage was analyzed. Mean age was 35±17.17 months old (5 months to 7 years 8 months old) and 44 were boys. Forty six children were prematurity cerebral palsy (CP), 22 patients were full-term CP, 8 patients had genetic abnormality, and 8 patients had developmental delay of unknown origin. Numbers of patients according to GMFCS level were 11, 17, 12, 22, 22 on each GMFCS level 1 to 5, respectively. Results The GMFM score percentage change was significantly improved after 8 weeks of therapy (P Conclusion Intensive therapy was more effective in GMFCS level I-III children than GMFCS level IV-V children. And the younger age (36 months old or younger) had positive influence on the gross motor outcome and the children without seizure disorder had better effect than those with seizure disorder.

Auditory evoked potentials: predicting speech therapy outcomes in children with phonological disorders

OBJECTIVES:This study investigated whether neurophysiologic responses (auditory evoked potentials) differ between typically developed children and children with phonological disorders and whether these responses are modified in children with phonological disorders after speech therapy.METHODS:The participants included 24 typically developing children (Control Group, mean age: eight years and ten months) and 23 children clinically diagnosed with phonological disorders (Study Group, mean age: eight years and eleven months). Additionally, 12 study group children were enrolled in speech therapy (Study Group 1), and 11 were not enrolled in speech therapy (Study Group 2). The subjects were submitted to the following procedures: conventional audiological, auditory brainstem response, auditory middle-latency response, and P300 assessments. All participants presented with normal hearing thresholds. The study group 1 subjects were reassessed after 12 speech therapy sessions, and the study group 2 subjects were reassessed 3 months after the initial assessment. Electrophysiological results were compared between the groups.RESULTS:Latency differences were observed between the groups (the control and study groups) regarding the auditory brainstem response and the P300 tests. Additionally, the P300 responses improved in the study group 1 children after speech therapy.CONCLUSION:The findings suggest that children with phonological disorders have impaired auditory brainstem and cortical region pathways that may benefit from speech therapy.

Clinical Outcomes of Palliative Radiation Therapy for Children: Five-year Institutional Data

Clinical Outcomes of Palliative Radiation Therapy for Children: Five-year Institutional Data

An Exploratory Study of Member Attraction, Climate, and Behavioral Outcomes of Anger-Coping Group Therapy for Children with Emotional Disturbance

This exploratory study examined member attraction, group climate, and behavioral outcomes of anger-coping group therapy with children in an urban school. Two facilitators co-led a 6-week cognitive-behavioral group intervention with five children who were identified with either emotional disturbance (ED) or exhibited difficulty with anger management. Pretest and posttest ratings on the Behavioral Assessment System for Children (BASC) were gathered from children, parents, and teachers. Children also completed the Group Attitude Scale (GAS) after the first, middle, and last group session. All group sessions were videotaped, and three independent observers viewed the tapes and completed the Group Climate Questionnaire–Short Form (GCQ-S) following each session. Results indicated that the children formed a cohesive, healthy functioning group. Parents indicated significant improvement in children's behavior on the BASC, although teachers and children did not note these changes. Clinical implications for interventions for children with ED and directions for future research are discussed

Clinical and radiographic spectrum of septic pulmonary embolism

Aims: To review the clinical presentation, radiographic findings, and outcome of therapy in children with septic pulmonary embolism. Methods: Retrospective analysis of patients in a tertiary paediatric facility in northern...

Relationships between age at diagnosis, clinical features, and outcome of therapy in children treated in the Medical Research Council AML 10 and 12 trials for acute myeloid leukemia

AbstractBetween May 1988 and June 2000, 698 children were treated in the Medical Research Council acute myeloid leukemia 10 and 12 trials. The presenting features and outcomes of therapy in these children were compared by age. Although there was no single cutoff in age, younger children were more likely to have intermediate risk and less likely to have favorable cytogenetics (P < .001), and they had a higher incidence of translocations involving chromosome 11q23 (P < .001). The distribution of French-American-British (FAB) types also varied with age; FAB types M5 (P < .001) and M7 (P < .001) were more common in early childhood, whereas older children were more likely to have FAB types M0 (P = .03), M1 (P = .04), M2 (P = .005), and M3 (P < .001). Involvement of the central nervous system at diagnosis was also more common in the youngest children (P = .01). Younger children had more severe diarrhea (P = .002), whereas older children had worse nausea and vomiting (P = .01) after chemotherapy. When adjusted for other important factors, complete remission rates were similar (P = .5) and although there was less resistant disease in younger children (P = .003), this was partially balanced by a slight increase in deaths during induction therapy in younger patients (P = .06). On multivariate analysis overall survival (P = .02), event-free survival (P = .02), and disease-free survival were better (P = .06) in younger children due to a lower relapse rate (P = .02) especially in the bone marrow (P = .02).