Non-word repetition (NWR) is a frequently used task in speech and language assessments. This study investigated NWR performance in children with childhood apraxia of speech (CAS) and speech motor delay (SMD), examining its relation to auditory discrimination (AD) and oral motor performance. Participants were 54 children with persistent speech-sound disorders (SSD) (31 with CAS and 23 with SMD) and 39 children with typical speech development (TSD) aged 6-16 years. Assessments of word naming, NWR, AD, and oral-motor performance were conducted. Percentage consonants correct (PCC), and percentage vowels correct (PVC) were calculated from phonetic transcriptions. The results revealed a difference between children with SSD and children with TSD on all variables and also revealed some differences between children with CAS and children with SMD. Children with CAS had a lower PCC and PVC score on NWR and a lower AD score than those with SMD. More parents of children with CAS reported difficulties with reading and writing. A large proportion of both children with SMD and children with CAS were found to have orofacial dysfunction. Our findings suggest that assessing AD skills and oral-motor skills is important for understanding the underlying difficulties of motor speech disorders in children. Our results indicate differences related to motor planning and motor execution, underscoring the importance of broad assessment approaches to facilitate accurate diagnoses and tailored interventions.

To examine longitudinal changes in speech and gross motor function in children with cerebral palsy (CP) between 4 years and 14 years of age using the Viking Speech Scale (VSS) and the Gross Motor Function Classification System (GMFCS). In this longitudinal observational study, 44 children (26 male, 18 female) with CP were assessed at ages 4 years and 14 years. VSS and GMFCS classifications were analysed at both time points using polychoric correlations with confidence intervals generated using bootstrapping to identify patterns of stability and change. Classifications were strongly related at both ages. However, more children tended to change VSS levels (43%; 19/44) between 4 years and 14 years than GMFCS levels (34%; 15/44). Very few children demonstrated concurrent changes in both domains. Changes in VSS levels may reflect protracted speech development in children with CP. Results indicate that while speech and gross motor abilities are strongly related across development, their patterns of change differ descriptively over time. These findings support the idea that children with CP may benefit from ongoing speech intervention throughout childhood and adolescence, regardless of gross motor function.

Vestibular dysfunction has implications for cognitive function, which in turn is important for the development of speech and language. A vestibular dysfunction after cochlear implantat (CI) surgery is not uncommon and therefore may be implicated in less-than-optimal cognitive function, which in turn could lead to worse post-implantation outcomes. However, these relationships have remained largely unexplored. Hence, the present study aimed to examine the differences in cognitive function and outcomes with the device among pediatric cochlear implantees with and without saccular dysfunction and balance deficits. The study involved 51 participants, which included 17 children with unilateral CI (bimodal users) who had saccular dysfunction only on the implant side (CI-SD), 19 with unilateral CI (bimodal users) with normal balance and bilateral normal saccular function (CI-NF), and 15 typically developing children. All participants underwent a series of evaluations using the Nonverbal Index subtests of the Kaufman Assessment Battery for Children-Edition II, the Revised Categories of Auditory Performance, Infant-Toddler Meaningful Auditory Integration Scale, Integrated Scales of Development (ISD), and Modified Early Speech Perception Test in Kannada (MESP-K). The performance of the typically developing children group on the Kaufman Assessment Battery for Children-Edition II was significantly better than both the CI groups (p < 0.016). Furthermore, the CI-NF group had significantly better Nonverbal Index than the CI-SD group. The performance on MESP-K, Infant-Toddler Meaningful Auditory Integration Scale, and speech and cognition domains of ISD was significantly poorer in the CI-SD group than the CI-NF group (p < 0.05). Compared with hearing loss alone, the co-occurrence of saccular impairment is associated with more pronounced cognitive deficits and poorer outcomes. The study provides preliminary evidence for the adverse association of saccular dysfunction and balance deficits with cognition, speech perception, and overall outcomes in unilateral CI recipients.

Multiple system atrophy (MSA) is a neurodegenerative condition causing parkinsonism, cerebellar ataxia and/or dysautonomia. Typical survival is between 6-10 years, but some people die before five or after 15 years. This heterogeneity complicates advanced planning and clinical trial stratification. MSA prognostication studies have shown conflicting results, possibly due to diagnostic accuracy or study size. We report results from a study of survival prognostic factors in a cohort of 555 MSA patients (including the largest post-mortem confirmed cohort to date of 254 people) gathered through the Queen Square Brain Bank and the PROSPECT-M-UK multi-centre prospective cohort study. Through PROSPECT-M-UK, 318 clinically diagnosed MSA patients (17 overlapped with the QSBB cohort) were followed up annually over 5 years. The QSBB cohort clinical data was collected through retrospective review of primary and secondary care documentation. Survival analysis was performed using counting process Cox proportionate hazards modelling, Kaplan-Meier log-rank testing and landmark survival analysis to account for guarantee-time bias. Mean onset age in the combined cohort was 58.7±9.0y with median survival of 8.25y (95% CI:7.88-8.63). 28.8% were clinically diagnosed in-life with MSA-P, 23.8% MSA-C, 40.2% mixed and the rest as non-MSA diagnoses. Later disease onset was associated with shorter survival (HR=1.04, P<0.001). The commonest cause of death was respiratory infection (67%) followed by disease related decline (20%). Median survival from indoor wheelchair use, gastrostomy insertion or development of unintelligible speech was consistently <1.5 years (95% CI upper limits<2.4 years), making these reliable late-stage disease markers. Using landmark analysis, at 3 years from onset, negative prognostic factors included recurrent falls, unintelligible speech, use of catheters and of medication for orthostatic hypotension (HR = 1.57, 3.29, 1.76, 3.29;all P<0.05). At 5 years from onset, mobility milestones including walking aid use, outdoor and indoor wheelchair use (HR = 1.70, 1.93, 2.62;all P<0.01) became significant, whilst dysautonomia milestones (catheter and orthostatic support medication use) were no longer significant. Median individual Unified Multiple System Atrophy Rating Scale (UMSARS) progression rate (n=91) was 10.27 (IQR:5.31-14.30) points/year and did not correlate with symptom duration. Higher baseline UMSARS and faster UMSARS progression were negative prognostic factors of survival from baseline review (HR=1.03 and 1.07 respectively, both P<0.001). We show that in-clinic rating scales and clinical milestone assessment can aid MSA prognostication. Importantly, prognostic factors demonstrate time-dependent variability, which may contribute to previous heterogeneity observed in smaller studies. This knowledge is important for patient care and should inform future clinical trial stratification.

Universal newborn hearing screening (UNHS) is essential for early identification of congenital hearing loss to decrease the adverse effects of a child's speech and language development. Since 2021, Thailand has enforced newborn hearing screening, followed by the national health policy of the Ministry of Public Health. In order to meet this objective, the quality of these programs should be monitored using internationally recognized benchmarks. This study aimed to analyze the UNHS outcomes according to the national health policy and standard benchmarks. A retrospective study was conducted at Chiangrai Prachanukroh Hospital, a tertiary care hospital, from December 2021 to November 2022. All newborns delivered in a one-year period who underwent hearing screening were recruited. The coverage rate, rates of diagnostic hearing evaluation, and hearing rehabilitation were analyzed and compared between the well-baby newborns (WBN) and high-risk newborns (HRN). Of 4,216 newborns delivered, 3,363 (79.8%) were WBN, and 853 (20.2%) were HRN. The screening coverage rates before 1 month of age were 94.6% and 72.2%, and referral rates were 34.7% and 34.1% for WBN and HRN, respectively, showing significant differences. The follow-up return rates were 51.9% and 45.7%, audiological diagnosis within 3 months of age were 11.8% and 10.5%, considering diagnosis within 6 months of age were 52.7% and 42.1% for WBN and HRN, respectively, showing without significant differences. Eight children were diagnosed with sensorineural hearing loss, three from the WBN group and five from the HRN group. One child, in the high-risk group, received bilateral hearing aids and speech therapy. UNHS serves as a critical initial measure for the early identification of hearing loss, paving the way for timely interventions. Despite the preliminary indicators not meeting the standard benchmarks, there is a clear necessity for systematically developing implementation protocols to enhance the program's efficacy. The national health policy in Thailand should persist in its efforts, including providing resources such as manpower, money, and materials (3M's), to ensure the program's success.

Positional plagiocephaly is characterized by cranial asymmetry and can be the result of prolonged uneven pressure on the developing skull. Extrauterine causes include extended time in the supine position, one-sided feeding, or insufficient tummy time. Beyond cosmetic concerns, it can affect visual, auditory, dentofacial, and speech development. Following the "Back-to-Sleep Campaign," prevalence rose to 16% to 22.1% in 6-week-old infants ( Iran J Child Neurol. 2022;16(2):85-92). Despite its extensive impact on development and finances, many caregivers and parents lack awareness, underscoring the need for improved education and prevention strategies. In this 2-arm, partially blinded randomized controlled trial (June 2022 to April 2025) at UMass Memorial Medical Center, we compared standard care to an educational intervention for plagiocephaly prevention. The primary outcome was cephalic index (CI), measured at 2, 4, and 6 months, with higher values indicating greater deformity. Secondary outcomes included parent-reported adherence to prevention strategies. Group comparisons used unpaired t tests and difference-in-difference models. A total of 109 subjects were enrolled (intervention, 62; control, 47). The average CI differed significantly between groups at the 4-month mark (control, 89.84; intervention, 86.91; P = 0.05). Difference-in-difference analysis did not yield statistically significant results at any time point, but all intervention groups had a lower average CI. Survey data assessing parental adherence to plagiocephaly prevention behaviors showed a significant difference at 4 months (control, 15.87; intervention, 13.75; P = 0.03), with no significant differences at 2 or 6 months. The intervention was associated with reduced cranial deformation, reaching statistical significance by 4 months. This correlated with better parental compliance, suggesting early education as an effective preventive strategy.

Congenital Hydrocephalus in Central and Southern Tunisia: A 15-Year Retrospective Study of 102 Patients on the Clinical Spectrum, Management, and High Burden of Neural Tube Defects.

Cleft lip and palate, the most common craniofacial malformation, has a significant physical and psychological impact on affected individuals and their families. Early surgical correction provides an almost complete solution in most cases, allowing for normal speech development. However, palatoplasty remains a demanding surgical procedure with limited teaching opportunities due to the lack of animal or cadaveric models. A 3D model of a Veau II cleft palate can serve as an effective and affordable tool for improving surgical skills and confidence in performing palatoplasty using the modified Furlow technique. This study presents a series of 6 cases testing a 3D model of a Veau II cleft palate, developed by members of the Plastic Surgery Department at the National University of Colombia. A significant improvement in palatoplasty performance using the modified Furlow technique was observed in all participants. Additionally, participants reported an increase in self-confidence when performing the procedure. The 3D cleft palate model presented is shown to be an affordable and fully functional option for training in the surgical technique of palatoplasty. The findings indicate that the simulator is a useful learning tool for surgical education in cleft palate repair.

Decades of research have established links between speech input and children's vocabulary growth. However, it is unclear if input also facilitates phonological development. Phonology has a strong biological component-implicating fine motor development-so language socialization factors like speech input may matter less. Further complicating matters, children in many cultures are exposed to vastly different amounts of speech input, and yet these children still reach many major language development milestones on age-appropriate timelines. How does speech input relate to infant phonological development in the first years of life? We estimated infants' (1) speech input and (2) vocal maturity using daylong audio recordings taken in an Indigenous Quechua- and Spanish-speaking community in Bolivia (n = 10, M age = 12 months, 5 females, 5 males) and an immigrant Spanish- and English-speaking community in the United States (n = 10, M age = 9 months, 4 females, 6 males; all Hispanic or Latino). Although we found no differences in the overall amount of speech input to adults and children between communities, infants in the United States were 2.5× more likely to hear speech directed to them than the infants in Bolivia. When child-directed speech (CDS) was instead characterized to include all speech directed to any child within the infants' vicinity, there were no differences between communities. When employing these different definitions of CDS, we found positive relationships between quantity of speech input and different metrics of the Bolivian infants' vocal maturity. These results paint a nuanced picture showing that directed speech input, even when less common, is related to early phonological development, and that by expanding the definition of speech input to accommodate diverse cultural settings we can understand how infants' language development is resilient to differences in speech input.

The 15q26 deletion and duplication syndromes are rare chromosome diseases with growth deviation and structural anomalies such as facial abnormality, cardiac malformation and hand/foot/skeleton malformations. Insulin-like growth factor 1 receptor (IGF1R), located on chromosome 15q26, is key for pre- and postnatal growth. The present study aimed to determine whether IGF1R serves as a key factor in growth regulation in 15q26 deletion and duplication syndromes. Patients with 15q26 deletions and duplications enrolled in the China Neonatal Genomes Project (CNGP) were recruited. A systematic review of 15q26 deletion and duplication cases was performed, followed by meta-analysis to evaluate the roles of IGF1R and three other genes [myocyte enhancer factor 2A (MEF2A), leucine-rich repeat kinase 1 (LRRK1) and nuclear receptor subfamily 2 group F member 2] involved in growth regulation. A total of 10 eligible patients from the CNGP, including seven with deletions and three with duplications, were identified. The literature search and screening yielded 78 patients with 15q26 deletions and 10 with 15q26 duplications. Clinical features observed in >70% of the patients in the deletion group were facial abnormalities, developmental delay, short stature and hand/foot/skeleton malformations, whereas the duplication group exhibited facial abnormality, hand/foot/skeleton malformation and speech development delay. In 15q26 deletion, three candidate genes were associated with an increased risk of short stature: IGF1R [odds ratio (OR): 8.43; 95% confidence interval (CI): 2.22-32.00], LRRK1 (OR: 100.00; 95% CI: 11.86-843.23) and MEF2A (OR: 32.21; 95% CI: 3.81-272.47). In 15q26 duplication, none of the candidate genes significantly affected tall stature. Using meta-analysis, the present study revealed that IGF1R is not the only key gene responsible for growth abnormalities in 15q26 deletion and duplication syndromes.

Background: Gadgets are becoming increasingly popular among children under the age of three. Mothers often give their children electronic devices to help them relax or learn. On the other hand, there has been an increase in delayed speech development among children aged 12 to 36 months. Objective: The purpose of this study was to determine the relationship between the use of gadgets and speech delay in children aged 12-36 months. Methods: This study employed a correlational descriptive design with a cross-sectional approach. Ninety-two pairs of parents and their children with speech delays aged 12-36 months were purposively recruited from the XX Child Growth and Development Clinic. Data were collected through a valid and reliable gadget media questionnaire and Denver developmental screening tests. The data were analyzed using the Spearman Rho test at a significance level of &lt;0,05. Results: All respondents experienced a speech delay of less than one month and half of the respondents used gadgets more than two hours per day. The results of the Spearman rho test showed that there is a relationship between the use of gadgets and speech delay in children aged 12-36 months (p=0.033). Conclusion: The use of gadgets by children 12 to 36 months causes a delay in speech development. Children who use gadgets on a regular basis are more likely to have speech delays. A mother's most important role is to supervise and accompany her children while they use gadgets. This can help prevent speech delay by encouraging children to talk about what they see on the scree. This study suggests that mothers should limit their children's screen time and actively support them in developing their speaking skills at home.

Importance. A wide range of AI technologies on the digital product market creates an illusion of universality, behind which there are many potential risks and limitations. Neural networks, which have shown exponential growth in recent years, open up fundamentally new linguistic and didactic opportunities in the context of foreign language teaching, related to the lesson planning, the generation of authentic language content adapted to the level of language proficiency and individual interests and needs of students, the visualization of information, the designing of educational materials, and the automation of processes for monitoring and evaluating the development of speech and language skills. At the same time, there has been a significant growth of specialized neural networks aimed at solving methodological problems. The purpose of this study is to determine the status of methodological neural networks in the system of linguistic and methodological preservice training of foreign language educators and to assess the readiness of both students and teachers to use methodological neural networks. Research Methods. Theoretical methods: study and analysis of scientific and methodological works on the problems of digital transformation of education and the integration of AI technologies into the system of higher pedagogical education, as well as on the issues of linguistic and methodological pre-service training of foreign language educators in the context of a distributed format of interaction within the pedagogical triad “teacher – artificial intelligence – student”. Empirical methods: questionnaires to obtain data on the level of readiness of students and the level of readiness of current teachers to use AI in their professional activities. Definition of Concepts. The key concept in the study is a methodological neural network. The study developed a matrix of neural networks used in foreign language teaching methodology, divided into universal and methodological AI-based technological solutions. Results and Discussion. An inverse relationship has been empirically revealed between teaching experience and the level of readiness to use methodological neural networks. Students demonstrate a significantly higher level of readiness when developing training exercises and communication tasks – 94–97 %, developing control and measuring materials – 98 %, developing a lesson plan – 82–89 %. Among teachers, these indicators are significantly differentiated: 74–96 % with 0-2 years of experience, 63–89 % with 2–5 years of experience, 38–67 % with 5–10 years of experience, and 22–42 % with more than 10 years of experience. The percentage of teachers who are not ready to use methodological neural networks in their planning reaches 38-40 %, while the percentage of students is less than 2–4 %. Conclusion. Methodological neural network is a constructor of training sessions, which has prelaid lesson structure, typology of training exercises and communicative tasks, built in accordance with the specifics of teaching a foreign language, age and level of language differentiation, binding to specific topics of the curriculum, following the didactic principles of teaching. When working with methodological neural networks, there are much fewer hallucinations, which allows to talk about the quality of the generated content. The use of methodological neural networks does not imply the presence of special skills of prompting.

Cleft lip and/or palate (CL/P) is associated with increased risk for psychological and neurodevelopmental disorders. This study used a large, multicenter database to evaluate comorbidities associated with various CL/P subtypes. A retrospective analysis of the TriNetX database of 24,557 patients with cleft palate (CP), unilateral cleft lip and palate (UCLP), bilateral cleft lip and palate (BCLP), unilateral cleft lip (UCL), and bilateral cleft lip (BCL). Rates of psychological and neurodevelopmental disorders were evaluated. Rates of these disorders were compared with those of 20,521,361 patients without CL/P. Patients with CP had significantly greater rates of attention deficit hyperactivity disorder, intellectual disability, and autism spectrum disorder (ASD), as well as speech, scholastic, and motor development disorders, compared with most other cleft subtypes. Patients with UCLP were more likely than those with BCLP to have specific comorbidities, with significantly higher rates of ASD, anxiety, and depression, as well as speech and scholastic developmental disorders. In comparison to the control cohort, CL/P patients had significantly higher rates of anxiety, depression, intellectual disability, and developmental disorders. Patients with CP had the most pronounced increase in prevalence of these conditions compared with controls. Findings suggest differences in psychological and neurodevelopmental outcomes across CL/P subtypes. CP was associated with significantly higher rates of multiple psychological and neurodevelopmental comorbidities. Such comorbidities are also more prevalent in patients with CL/P overall compared with controls. These results underscore the need for psychosocial and developmental screening, as well as multidisciplinary care, in patients with CL/P.

Children with perinatally acquired HIV (CPHIV) are at increased risk of neurodevelopmental difficulties, including hearing-related impairments, despite early initiation of antiretroviral therapy (ART). Previous studies have reported a higher prevalence of hearing loss in CPHIV compared with uninfected children; however, the contribution of the central auditory system to these auditory differences remains unclear. Understanding central auditory processing in CPHIV is important, as even subtle auditory difficulties during childhood can negatively affect speech and language development, academic performance, and quality of life. Functional MRI was used to examine neural responses to auditory stimulation in 108 11-year-old children (60 CPHIV and 48 children without HIV). During scanning, participants listened to pure tones at low (500 Hz), middle (1,500 Hz), and high (4,000 Hz) frequencies. CPHIV demonstrated modestly elevated hearing thresholds (reflecting poorer hearing sensitivity) at several frequencies; however, the prevalence of clinically defined hearing loss did not differ between groups. Across all children, pure-tone stimulation elicited robust bilateral activation of the auditory cortices, with both the spatial extent and magnitude of activation decreasing as tone frequency increased. Relative to controls, CPHIV exhibited significantly reduced bilateral auditory cortex responses across frequencies. These group differences persisted after accounting for sex and handedness and after excluding children with hearing loss. Associations between hearing thresholds and auditory cortex activation were generally weak, except at 4,000 Hz in CPHIV, where poorer hearing was associated with stronger auditory cortex activation, consistent with a compensatory neural response. Despite largely normal peripheral hearing, CPHIV receiving ART exhibited reduced bilateral auditory cortex responses during pure-tone processing. These findings suggest that alterations within the central auditory system may contribute to auditory vulnerability in CPHIV.

Introduction: Recurrent otitis media, defined as ≥3 episodes in 6 months or ≥4 in 12 months, may lead to fluctuating conductive hearing loss during a critical period of phonological development (6-36 months), potentially affecting speech sound acquisition. Objectives: To analyze the association between recurrent otitis media and speech sound disorders in Portuguese preschool children (M=66.45 months, SD=4.39), hypothesizing higher phonological process prevalence in recurrent otitis media cases (n=30) versus controls (n=30) due to cumulative auditory deprivation affecting lingual and labial precision. Methodology: A case-control study was conducted with 60 Portuguese children aged 5-6years (n=39 with recurrent otitis media; n=30 controls). Speech production was assessed by the Psychology Center at the University of Porto Articulation Test. Statistical analyses included descriptive and inferential tests (χ² and Mann-Whitney U), with significance set at p&lt;0.05. Results: Children with recurrent otitis media showed a higher prevalence of speech sound disorders compared to controls (90% vs. 60%, p=0.007). Cluster reduction was the most frequent phonological process (87% vs. 57%, p=0.010). Other processes, including liquid omissions and substitutions, were also more frequent in the recurrent otitis media group. Conclusion: Recurrent otitis media is associated with a higher prevalence of speech sound disorder in preschool children. These findings highlight the importance of monitoring speech development in children with a history of recurrent otitis media. However, results should be interpreted with caution due to the limitations of the study design.

The development of coherent speech is one of the most essential aspects of language learning, especially in foreign language groups where learners are exposed to a non-native linguistic system. This article examines how the language environment influences the formation and improvement of coherent speech skills. It explores theoretical perspectives, types of language environments, key factors affecting speech development, and practical strategies to enhance communicative competence. The findings highlight that a rich, interactive, and immersive language environment significantly contributes to learners’ ability to produce structured, meaningful, and fluent speech.

The increasing incidence of speech development disorders is one of the most significant issues in pediatrics and child neurology. The aim of the study . To identify statistically significant differences in the influence of perinatal risk factors on the occurrence of specific and nonspecific speech development disorders. Materials and methods . The longitudinal study included 525 children with specific and nonspecific speech development disorders (324 boys, 201 girls, born between 2005 and 2021). The group with specific speech disorders consisted of 322 children, while the group with comorbid disorders included 203 children. The authors analyzed anamnesis data related to the prenatal and perinatal periods of development, the results of neurological examinations during the first year of life, and their relationship with data on the children's motor and subsequent speech development. A comparative analysis was conducted in the groups. Results . Statistically significant differences (higher incidence in the group with comorbid disorders) were revealed for the following risk factors: in vitro fertilization (p=0.02); threatened miscarriage (p&lt;0.00001), especially in the third trimester (p=0.0002); infectious diseases during pregnancy (p&lt;0.00001), especially acute respiratory viral infections (p&lt;0.00001) and influenza (p=0.002); sexually transmitted diseases (p=0.001); antibiotic therapy in the 3rd trimester of pregnancy (p=0.04); cerebral ischemia in the neonatal period (p=0.04); perinatal damage to the central nervous system in the form of pyramidal insufficiency syndrome (p&lt;0.00001) during the first year of life; hyperbilirubinemia (p&lt;0.00001), including prolonged variant, with bilirubin levels above 200 µmol/L (p&lt;0.00001). Conclusion . Pediatricians and neurologists should be vigilant in identifying these risk factors when assessing the development of a child under three years of age, since they may be harbingers of further delays in psychomotor development, and promptly refer children for neuropsychological diagnostics for the purpose of early intervention in the habilitation process.

To compare the incidence of neurodevelopmental disorders among children with prenatal exposure to buprenorphine versus methadone. Population based cohort study. US nationwide Medicaid data on >2.5 million live births from 2000 to 2018. 18 612 pregnancies exposed to buprenorphine or methadone, of which 587 were excluded from the analysis owing to exposure to the comparator drug. The primary outcome was a composite of neurodevelopmental disorders (autism spectrum disorder, attention deficit/hyperactivity disorder, developmental speech or language disorder, developmental coordination disorder, behavioural disorder, learning difficulty, or intellectual disability). Individual neurodevelopmental disorders were considered secondary outcomes. Cumulative incidences were obtained using Kaplan-Meier analyses, and hazard ratios using Cox proportional hazards regression. Propensity score overlap weighting was applied to adjust for confounding, including personal characteristics, maternal medical and mental health comorbidities, exposure to medications and other substances, proxies for severity of opioid use disorder, healthcare utilisation, and adequacy of prenatal care utilisation. 12 635 children were exposed to buprenorphine and 5390 to methadone prenatally. The crude cumulative incidence of any neurodevelopmental disorder at age 8 years among those exposed to buprenorphine was 34% (95% confidence interval (CI) 30% to 38%) and among those exposed to methadone was 33% (29% to 37%). Adjusted analyses suggested slightly lower hazards of any neurodevelopmental disorder associated with exposure to buprenorphine versus methadone (adjusted hazard ratio 0.81, 95% CI 0.70 to 0.94). Similar results were obtained for the individual neurodevelopmental disorders such as attention deficit/hyperactivity disorder (0.89, 0.65 to 1.21) and autism spectrum disorder (0.74, 0.46 to 1.21). With prevalent use, prenatal exposure to buprenorphine was associated with lower hazards of any neurodevelopmental disorder compared with prenatal exposure to methadone (adjusted hazard ratio 0.62, 0.51 to 0.76). This association was not observed with treatment initiation during pregnancy (adjusted hazard ratio 1.13, 0.90 to 1.42). Further sensitivity analyses indicated results consistent with no increased risk of neurodevelopmental disorders among pregnancies exposed to buprenorphine versus methadone. The findings of this study suggest no increased risk of long term adverse neurodevelopmental outcomes among children with prenatal exposure to buprenorphine versus methadone, further supporting buprenorphine as a safe treatment option for opioid use disorder during pregnancy.

Background:TNRC6B encodes a core effector of the RNA-induced silencing complex and is essential for miRNA-mediated gene silencing. Pathogenic variants in TNRC6B have recently been associated with a neurodevelopmental disorder characterised by developmental delay, intellectual disability, and behavioural difficulties. Methods: We report a three-generation family with a 22q13.1 deletion encompassing only exons 2-23 of TNRC6B. Clinical data were collected from medical records and family interviews, and the findings were compared with those of published cohorts. Results: Affected individuals presented with developmental delay, speech and language impairment, autism spectrum disorder, ADHD, oppositional defiant disorder, craniosynostosis, joint laxity, clinodactyly, and cardiac valve anomalies. The father and paternal grandmother had learning difficulties and neurobehavioral features, while the proband exhibited a more severe phenotype. Conclusions: This report expands the phenotypic spectrum of TNRC6B-related neurodevelopmental disorder, highlighting craniosynostosis, joint and connective tissue features, and cardiac involvement. Our findings also underscore variable expressivity across generations and emphasise the relevance of both copy-number and sequence variants in TNRC6B in patients with neurodevelopmental disorders.

Song, a human cultural universal, fuses music and speech into a single auditory signal, one of the first among infants' auditory experiences. While parents sing to their babies in all human cultures, we still know little about how this experience shapes babies' perception abilities and their neural correlates. This work, therefore, investigates how the newborn brain processes song compared to its two components, speech and hummed melody. Specifically, we test the hypothesis that by regularizing the rhythm of speech, song may support language acquisition. Using functional near-infrared spectroscopy (fNIRS), we found that newborns' (n = 40) showed stronger responses for both speech and song in the right temporoparietal regions than activation triggered by humming. Despite their clear acoustic distinctions, no significant differences were observed between the neural response of speech and song. This suggests that singing, just like speech, may represent a salient input for the newborn brain, potentially supporting early speech perception and language development.