Subgroup Of Children Research Articles

STM-Suite, an Online Platform for the Assessment of Memory Functions Discriminates among Subgroups of Children with Different Types of Specific Learning Disorders

A deficit in short-term memory (STM) functions characterizes many neurodevelopmental disorders, in particular, specific learning disorders. Hence, there is a need to develop a web-based platform capable of testing specific variables and administration conditions in a controlled manner. The platform herein presented allows for the assessment of short-term memory (STM) items and order components in a series of different conditions. Stimulus types, presentation, and response modalities were appropriately selected to assess the impact of those variables on memory performances. The usefulness of such a systematic, fine-grained analysis of STM functions was tested by applying the complete assessment in a group of 100 school-age children (47 Typically Developing children and 53 children with learning disorders) and evaluating the capacity of the software to highlight different specific memory processes activated during reading, writing, and calculation. A cluster analysis was applied to the learning performances of the whole group, and a four-cluster solution representing the best division into subgroups of learning disorders (affecting reading, writing, and mathematical skills, variously combined) also showed clear-cut differences in the children’s STM profiles. This confirms the potential and the usefulness of the tool for the characterization of STM in school-age children.

Analysis of Errors in Sentence Repetition by Subgroups of Children with Speech Sound Disorders

Objectives: Sentence repetition tasks (SRTs) are clinically useful tasks for examining working memory ability and discriminating residual language delay. This study aims to examine sentence repetition skills by groups of children with SSDs and analyze error types and morphosyntactic strengths and weaknesses in SRTs. Methods: Thirty-four children aged 5-7 years with SSDs were classified into groups with articulation disorders, phonological delays, and phonological disorders. SRTs were conducted, and errors in SRTs were analyzed in terms of lexical and grammatical morphemes and children’s sentence repetition (SR) skills were examined by two scoring systems including or excluding articulation errors. Results: In SRTs, children with phonological disorders showed more omission errors; in particular, omission of grammatical morphemes, and sentence paraphrase errors were more frequent. Children with phonological disorders showed more lexical grammatical morpheme errors than the other subgroups. Even in the scoring system that reflects both language and articulation errors, children with phonological disorders showed a lower performance than children with articulation disorders. Conclusion: Children with phonological disorders exhibited morphosyntactic weakness by showing greater difficulties in repeating grammatical morphemes accurately in SRTs. This finding suggests that systematic grammar intervention should be addressed for children with phonological disorders.

Evaluation of Lymphocyte Subgroups in Children with Glucose-6- Phosphate Dehydrogenase Deficiency.

Evaluation of Lymphocyte Subgroups in Children with Glucose-6- Phosphate Dehydrogenase Deficiency.

Neurocognitive Subgroups in Children at Familial High-risk of Schizophrenia or Bipolar disorder: Subgroup Membership Stability or Change From Age 7 to 11-The Danish High Risk and Resilience Study.

Subgroups with distinct levels of neurocognitive functioning exist in children of parents with schizophrenia or bipolar disorder. However, studies investigating the temporal stability of subgroup membership are currently lacking. We hypothesized that a minority of children at familial high-risk of schizophrenia (FHR-SZ) or bipolar disorder (FHR-BP) would transition to a different neurocognitive subgroup from age 7 to 11 and that most transitions would be to a more impaired subgroup. Latent profile analysis was used to identify subgroups at two assessments (age 7 and 11) based on the performance of 320 children at FHR-SZ or FHR-BP across eight neurocognitive functions. Temporal stability in subgroup membership was evaluated with latent profile transition analysis. Population-based controls (age 7, n = 199; age 11, n = 178) were included as a reference group. Children transitioning to a more impaired subgroup were compared with nontransitioning children on sex, FHR-status, global functioning, and psychopathology. At both assessment points, we identified three subgroups based on neurocognitive performance: a moderately-severely impaired, a mildly impaired, and an above-average subgroup. A total of 12.8% of children transitioned to a different subgroup, of which the majority (85.2%) moved to a more impaired subgroup. Parental diagnosis of schizophrenia, but neither parental diagnosis of bipolar disorder, global functioning at age 7, psychopathology, nor sex significantly differentiated children transitioning to a more impaired subgroup from nontransitioning children. During pre-adolescence, neurocognitive developmental lag is associated with being at FHR-SZ. Close attention to these children's neurocognitive development is indicated.

T Cells and Subgroups in Children with COVID-19

Amaç: COVID-19 hastalığında, T lenfositlerin sayısal olarak azaldığı, hem CD4+ hem de CD8+’in azalabildiği, bazen de CD8+ düzeyinin anlamlı arttığı görülmüştür. Virüse spesifik CD8+ T-hücrelerin Efektör bellek (TEM) veya RA+ Terminal diferansiye efektör bellek (TEMRA) hücrelerinin olduğu düşünülmektedir. Ancak bu hücrelerin özellikleri, özellikle SARS-CoV-2 enfeksiyonu veya COVID-19 hastalığının patogenezindeki rolleri belirsizdir. Bu araştırmada, SARS-CoV-2 PCR pozitifliği ile COVID -19 hastalığı tanısı alan çocuk hastalarda tanı sırasında yardımcı T, sitotoksik T hücreleri ve alt tiplerinde gözlenen değişiklikleri akım hücre ölçer ile irdelemeyi amaçladık. Yöntem: COVID-19 tanısı alan, 0-18 yaş arası 22 çocuğa flow sitometri ile; T Yardımcı Hücresi (TH), T Sitotoksik Hücresi (TC), T Naif Hücreleri (TN), Santral bellek (TCM), Efektör bellek (TEM), RA+ Terminal diferansiye efektör bellek (TEMRA) ve Son timik göçmen T hücreleri (RTEs) çalışılmıştır. Bulgular: T hücre sayıları tüm yaş gruplarında normal bulundu. CD4/CD8 oranı 5 yaş altı ve 16 yaş üstü grupta arttı. CD4+T hücreler içinde TCM 16 yaş üstü grupta azalırken, TEM tüm yaş gruplarında azaldı. RTEs, 16 yaş üstü grup hariç diğerlerinde azaldı. Naif CD8+T hücreleri (TN) tüm yaş gruplarında yüksek bulundu. Sonuç: Düşük sayıda saptanan CD4+ ve CD8+ lenfosit sayısı, 2019 Coronavirus hastalığında (COVID-19) ayırt edici bir laboratuvar bulgusu olarak bildirilmiştir. Yeterli sayıda naif T hücresine sahip olmak, bağışıklık sisteminin bilinmeyen patojenlere sürekli yanıt vermesi için gereklidir. Çocuklarda bu hücrelerin normalden yüksek olduğu bu çalışma tespit edilmiştir.

Pathological Internet Use, Aggression, and Cyberbullying in Children and Adolescents With Attention Deficit Hyperactivity Disorder.

The aim of this study was to evaluate the relationship between pathological internet use, aggression, and cyberbullying/victimization in children with attention deficit hyperactivity disorder. Male children (10-18 years old) with attention deficit hyperactivity disorder (n = 30) and without any diagnosis (n = 30) were evaluated using Questionnaire of Computer/Internet Use of Children and Adolescents (Children-Adolescent Form and Parent Form), Children's Aggression Scale-Parent Version, Young Internet Addiction Scale, and Cyber Bullying and Online Aggression Survey Instrument. Weekly internet/computer using time, Young Internet Addiction Scale scores, Children's Aggression Scale-Parent Version scores were higher in the attention deficit hyperactivity disorder group. When all participants included in the study were compared for the availability of rules related to the PC/internet use at their homes, it was determined that there were rules by 53.3%, and the rate of setting rules was higher in the control group than attention deficit hyperactivity disorder group. There is a high level of positive correlation between Internet Addiction Scale score and duration in internet use in the attention deficit hyperactivity disorder group. Those who experienced cyberbullying throughout their lives were at a higher rate in the attention deficit hyperactivity disorder group compared to the control group. "Physical aggression without provoking" subgroup of Children's Aggression Scale-Parent Version is correlated with cyberbullying in the attention deficit hyperactivity disorder group and cyber victimization in the control group. Children with attention deficit hyperactivity disorder have higher levels of aggression and pathological internet use than healthy controls, but there is no difference between cyberbullying and victimization. Cyberbullying/victimization is independent of diagnosis. For this reason, it is necessary to create awareness and preventive measures of cyberbullying.

Association of Initial Treatment With Antibiotics vs Surgery With Treatment Success and Disability in Subgroups of Children With Uncomplicated Appendicitis

This study investigates differences in 1-year outcomes by clinical and socioeconomic factors among US children with uncomplicated appendicitis who were treated with antibiotics vs surgery.

Subgroups of Children with Autism Spectrum Disorder without Intellectual Disability: A Longitudinal Examination of Executive and Socio-Adaptive Behaviors in Adolescence.

Within the autistic spectrum, there is remarkable variability in the etiology, presentation, and treatment response. This prospective study was designed to identify, through cluster analysis, subgroups of individuals with ASD without intellectual disability (ID) based on the severity of the core symptoms in childhood. The secondary aim was to explore whether these subgroups and a group with typical development (TD) differ in cognitive, adaptive, and social aspects measured in adolescence. The sample at baseline was comprised of 52 children with ASD without ID and 37 children with TD, aged 7–11. Among the ASD group, three clusters were identified. Cluster 1 (40%), ‘high severity’, presented high symptom severity on the DSM-5 criteria and the Social Communication Questionnaire. Cluster 2 (34%) showed ‘moderate severity’ on most of the scores. Cluster 3 (25%) corresponded to ‘low severity’, showing moderate social impairment and low restrictive, repetitive patterns of behavior, interests and activities. At 5-year follow-up, 45 adolescents with ASD without ID and 27 adolescents with TD were assessed. All clusters had significantly more difficulties in EF, ToM, socialization and adaptive behavior compared to TD. Social and adaptive trajectories between the ASD subgroups were relatively different; Cluster 3 showed poorer socialization and daily living skills than the other two subgroups. These findings highlight the importance of fully assessing social, cognitive, and adaptive profiles to develop care plans tailored to specific needs.

What Our Hands Tell Us: A Two-Year Follow-Up Investigating Outcomes in Subgroups of Children With Language Delay.

Purpose This study followed up children identified with expressive language delay (ELD) or receptive/expressive language delay (R/ELD) at 2 years of age, Time 1 (T1), in order to identify their language profiles at 4-5 years, Time 2 (T2), and explore relationships to T1 language, gesture use, and symbolic comprehension. Method Nineteen of 22 children were seen at follow-up (9 of 10 from R/ELD group, 10 of 12 from ELD group). T1 measures assessed receptive and expressive language, gesture use, and symbolic comprehension. At T2, we assessed receptive and expressive language, sentence repetition, and expressive phonology. Results Outcomes for the R/ELD group were significantly poorer, with all children continuing to have delay in receptive and/or expressive language compared to just 20% of the ELD group. Expressive phonology delay was common in both groups. T1 receptive language showed the most pervasive correlations with T2 language measures, but categorical performance on all three T1 measures correctly predicted language outcomes in 16-17 of the 19 children. Conclusion Findings add to evidence that receptive language is a strong predictor of outcomes. Gesture use and symbolic comprehension are also strong predictors and clinically valuable as part of play-based assessments with implications for theoretical understanding and intervention planning.

320 The Identification of a Subgroup of Children with Traumatic Subarachnoid Hemorrhage at Low Risk of Neuroworsening

Abstract INTRODUCTION Pediatric traumatic subarachnoid hemorrhage (tSAH) often results in intensive care unit (ICU) admission, the performance of additional diagnostic studies, and ICU-level therapeutic interventions to identify, and potentially prevent, episodes of neuroworsening (NW). Identification of a subgroup of children with tSAH at negligible risk for NW may avoid unnecessary escalation of care and potentially morbid interventions, with improvement in healthcare utilization. METHODS Data prospectively collected in an institutionally-specific trauma registry at Rady Children's Hospital between 2006–2015 was supplemented with a retrospective chart review of children admitted with isolated tSAH. Risk of blunt cerebrovascular injury (BCVI) was calculated using the BCVI clinical prediction score. Appropriate statistical analysis was performed. RESULTS >317 of 10,395 total pediatric trauma patients were admitted with tSAH. 51(16%, 23 female, 28 male) children were identified with isolated tSAH without midline shift on neuroimaging and a GCS of 13–15 at presentation. Median age was 4 years (18 days -15 years). 7 had modified Fisher grade 3 SAH; the remainder were grade 1. 26 (51%) had associated skull fractures; 4 involved the petrous temporal bone and 1 the carotid canal. 39 (76.5%) were admitted to the ICU; 12 (23.5%) to a standard surgical ward. 4 had an elevated BCVI score. 8 underwent CT angiography and no vascular injuries were identified. 6 were administered hypertonic saline in the ICU. The average length of stay for ICU patients was 77% longer (2.02 vs. 1.25 days). NW was not observed in any child. CONCLUSION Children with isolated tSAH without midline shift and GCS 13–15 at presentation appear to have minimal risk of NW, despite the finding in some children of vertex and basilar skull fractures, elevated modified Fisher grade, and elevated BCVI score. In this specific subgroup of children with tSAH, ICU-level care and additional ancillary diagnostic imaging may not be warranted.

Defective Number Sense or Impaired Access? Differential Impairments in Different Subgroups of Children With Mathematics Difficulties

Developmental dyscalculia (DD) is a specific learning disability in mathematics that affects around 6% of the population. Currently, the core deficit of DD remains unknown. While the number sense deficit hypothesis suggests that the core deficit of DD lies in the inability to represent nonsymbolic numerosity, the access deficit hypothesis suggests that the origin of this disability lies in the inability to associate numbers with the underlying magnitude representation. The present study compared the performance of DDs with their low-achieving (LA) and normally achieving peers in nonsymbolic numerosity processing and number-magnitude mapping over 1 year (from kindergarten to 1st grade). The results demonstrated differential impairments in different subgroups of children with mathematics difficulties. While DDs showed deficits in both nonsymbolic numerosity processing and number-magnitude mapping, LAs showed deficit only in the number-magnitude mapping. Furthermore, the deficit in number-magnitude mapping among the DD group was partially explained by their number sense deficit. The number sense deficit hypothesis is supported. Theoretical and practical implications are discussed.

An exploration of familial associations of two movement pattern-derived subgroups of chronic disabling low back pain; a cross-sectional cohort study

BackgroundAltered movement patterns with pain have been demonstrated in children, adolescents and adults with chronic disabling low back pain (CDLBP). A previously developed classification system has identified different subgroups including active extension and multidirectional patterns in patients with CDLBP. While familial associations have been identified for certain spinal postures in standing, it is unknown whether a familial relationship might exist between movement pattern-derived subgroups in families with CDLBP. ObjectivesThis study explored whether familial associations in movement pattern-derived subgroups within and between members of families with CDLBP existed. DesignCross-sectional cohort study. Method33 parents and 28 children with CDLBP were classified into two subgroups based on clinical analysis of video footage of postures and functional movements, combined with aggravating factors obtained from Oswestry Disability Questionnaire. Prevalence of subgroups within family members was determined, associations between parent and child's subgroup membership was evaluated using Fisher's exact test, and spearman's correlation coefficient was used to determine the strength of association between familial dyads. ResultsThe majority of parents were classified as active extenders, sons predominately multidirectional and daughters were evenly distributed between the two subgroups. No significant association was found when comparing subgroups in nine parent–child relationships. ConclusionsThe exploration of a small cohort of family dyads in this study demonstrated that children's movement pattern-derived subgroups could not be explained by their parents' subgroup membership. These results cannot be generalised to the CLBP population due to this study's small sample. Larger sample studies are needed to further elucidate this issue.

What Our Hands Say: Exploring Gesture Use in Subgroups of Children With Language Delay.

The aim of this study was to investigate whether children with receptive-expressive language delay (R/ELD) and expressive-only language delay (ELD) differ in their use of gesture; to examine relationships between their use of gesture, symbolic comprehension, and language; to consider implications for assessment and for the nature of problems underlying different profiles of early language delay. Twelve children with ELD (8 boys, 4 girls) and 10 children with R/ELD (8 boys, 2 girls), aged 2-3 years, were assessed on measures of gesture use and symbolic comprehension. Performance of the R/ELD group was significantly poorer than performance of the ELD group on measures of gesture and symbolic comprehension. Gesture use and symbolic comprehension were significantly associated with receptive language, but associations with expressive language were not significant. Findings of this study support previous research pointing to links between gesture and language development, and more specifically, between delays in gesture, symbolic understanding, and receptive rather than expressive language. Given potentially important implications for the nature of problems underlying ELD and R/ELD, and for assessment of children with language delay, this preliminary study invites further investigation comparing the use of different gesture types in samples of children matched on age and nonverbal IQ.

Detecting subgroups in children diagnosed with pervasive developmental disorder - not otherwise specified.

Hierarchical cluster analyses were used to detect three subgroups in a sample of children with pervasive developmental disorder--not otherwise specified (PDD-NOS) evaluated at ages 2 and 4. At age 2, Cluster 1 demonstrated few autism symptoms and high cognitive scores; 60% no longer met criteria for PDD at 4. Cluster 2 exhibited more autism symptoms and lower cognitive scores at 2; 89.5% met criteria for ASD at 4. Cluster 3 had the lowest cognitive scores and most impaired social/communication skills at 2, but no repetitive behaviors; 60% diagnosed with Autistic Disorder at 4. Results shed light on outcomes for different PDD-NOS types and raise questions regarding the increased importance of repetitive behaviors in DSM-5.

Asthma coalition effects on vulnerable sub groups of children: the most frequent users of health care and the youngest

Objective: To examine the impact of Allies Against Asthma, community-based coalitions working to improve asthma outcomes, on vulnerable children: those with the most urgent health care use and those of youngest age. Methods: Allies zip codes were matched with comparison communities on demographic factors. Five years of Medicaid data (n = 26,836) for significant health care events: hospitalizations, ED and urgent care facility visits, were analyzed. Longitudinal analyses using generalized estimating equations and proportional hazards models compared Allies and comparison group children. Results: In the two start-up years of Allies, odds of having a significant event were greater for Allies children than for comparison children (p < 0.05). During the third and fourth years when Allies activities were fully implemented, for frequent health care users at baseline, odds of an asthma event were the same for both Allies and comparison children, yet in the less frequent users, odds of an event were lower in Allies children (p < 0.0001). In the initial year of Allies efforts, among the youngest, the Allies children had greater odds than comparison children of an event (p < 0.01), but by the fourth year the Allies group had lower odds (p = 0.02) of an event. Hazard ratios over all years of the study for the youngest Allies children and most frequent baseline users of urgent care were lower than for comparison children (p = 0.01 and p = 0.0004). Conclusion: Mobilizing a coalition of diverse stakeholders focused on policy and system change generated community-wide reductions over the long-term in health care use for vulnerable children.

Clobazam: Effect on Frequency of Seizures and Safety Profile in Different Subgroups of Children With Epilepsy

BackgroundClobazam has been used in clinical practice as an adjunctive treatment for diverse seizure types and epilepsy syndromes. We evaluated the efficacy and safety of clobazam in a large sample of patients with refractory epilepsy at a tertiary pediatric center. MethodsWe retrospectively reviewed patients treated with clobazam between January 2001 and July 2013 who had a follow-up visit at least one month after starting clobazam. Response was defined as ≥50% reduction in seizure frequency compared with baseline seizure frequency during the 3 months before the introduction of clobazam. We examined the relationship between dose range and response rate. ResultsFour-hundred twenty-five patients were prescribed clobazam, of whom 300 (median age 9.1 years, interquartile range 4.7-13.3 years) had follow-up data greater than 1 month. Median follow-up was 5 months (interquartile range 3-11 months). Response to treatment with clobazam was observed in 203 of 300 (67.7%) patients, of whom 84 (28%) became seizure-free. The median starting dose was 0.2 (interquartile range 0.13-0.33) mg/kg/day with a target dose of 0.48 (0.26-0.80) mg/kg/day. Twenty-seven (9%) patients discontinued clobazam, 16 (59.3%) because adverse effects, 10 (37%) because of a lack of efficacy, and one (3.7%) because of a combination of adverse effects and lack of efficacy. The most common adverse effects were tiredness in 44 of 300 (14.6%) and mood or behavioral changes in 23 (7.7%). ConclusionsClobazam is a well-tolerated antiepileptic drug with good response rates in pediatric patients with refractory epilepsy.

Evaluation of Lymphocyte Subgroups in Children With Down Syndrome

In this study, lymphocyte subgroups including blood CD3, CD4, CD8, CD4/CD8, CD19, and CD16.56 values were analyzed in children with Down syndrome (DS). The study includes 85 children with DS, followed at Department of Pediatrics, Faculty of Medicine, Yüzüncü Yil University and 64 healthy age-matched control participants. Blood CD3, CD4, CD8, CD4/CD8, CD19, and CD16.56 values were examined in both the groups. Significantly decreased blood CD3, CD4, and CD19 values were found in the study group (P < .05) when compared with the control group. In conclusion, we would like to emphasize that blood CD3, CD4, and CD19 levels were found to be decreased in children with DS. Based on these finding, we think that these decreased lymphocyte subgroups might be responsible for increased susceptibility to infections in children with DS.

The Characteristics and Difference between Subgroups of Children with Reading Disabilities According to The double-deficit hypothesis

The Characteristics and Difference between Subgroups of Children with Reading Disabilities According to The double-deficit hypothesis

Oral Application Of Bacterial Lysate In Infancy Decreases The Risk Of Infantile Atopic Eczema In A Subgroup Of Children With Paternal Atopy

RATIONALE: High exposure to microbes or microbial compounds (e.g. lipopolysaccharides, LPS) is associated with lower prevalence rates of atopy in children from rural areas (“farm effect”). Aim of this trial was to evaluate the effect of an orally applied bacterial lysate in infancy on the prevalence of atopic eczema (AE) in the first year of life.METHODS: In a double-blind placebo-controlled trial, 553 healthy infants with at least single positive heredity for atopy were treated daily from week 5 until the end of month 7 by oral route with bacterial lysate (Pro-Symbioflor) containing heat-killed gram-negative E. coli and grampositive Enterococcus faecalis (1.5-4.5 × 107 bacteria/ml). Children were followed until 3 years of age. Primary outcome was the prevalence of atopic eczema (AE) at the end of the treatment period at 7 months of age.RESULTS: 526 completed the study until 7 months and 483 children until 3 years of age. At 7 months, 40 children in the treatment group (15.8%) and 55 children in the placebo group (20.1%) had developed eczema (n.s.). Only in the group of children with atopic fathers, there was a highly significant difference for the prevalence of AE (ITT set after worst prevalence imputation 7.4% and 29.8%, respectively; Fisher`s exact test p=0.00169).CONCLUSIONS: There was no treatment effect in the whole study group, however, in a subpopulation of children with only paternal heredity for atopy, feeding of bacterial lysates may prevent the development of AE, possibly indicating a preventive effect only in subjects with a ristricted risk for atopy. RATIONALE: High exposure to microbes or microbial compounds (e.g. lipopolysaccharides, LPS) is associated with lower prevalence rates of atopy in children from rural areas (“farm effect”). Aim of this trial was to evaluate the effect of an orally applied bacterial lysate in infancy on the prevalence of atopic eczema (AE) in the first year of life. METHODS: In a double-blind placebo-controlled trial, 553 healthy infants with at least single positive heredity for atopy were treated daily from week 5 until the end of month 7 by oral route with bacterial lysate (Pro-Symbioflor) containing heat-killed gram-negative E. coli and grampositive Enterococcus faecalis (1.5-4.5 × 107 bacteria/ml). Children were followed until 3 years of age. Primary outcome was the prevalence of atopic eczema (AE) at the end of the treatment period at 7 months of age. RESULTS: 526 completed the study until 7 months and 483 children until 3 years of age. At 7 months, 40 children in the treatment group (15.8%) and 55 children in the placebo group (20.1%) had developed eczema (n.s.). Only in the group of children with atopic fathers, there was a highly significant difference for the prevalence of AE (ITT set after worst prevalence imputation 7.4% and 29.8%, respectively; Fisher`s exact test p=0.00169). CONCLUSIONS: There was no treatment effect in the whole study group, however, in a subpopulation of children with only paternal heredity for atopy, feeding of bacterial lysates may prevent the development of AE, possibly indicating a preventive effect only in subjects with a ristricted risk for atopy.

Evaluation of Lymphocyte Subgroups in Children with Subacute Sclerosing Panencephalitis

The aetiology of subacute sclerosing panencephalitis (SSPE) remains to be fully elucidated, although it follows infection with a hypermutant defective M-protein measles virus. This study analysed peripheral blood lymphocyte subgroups to determine their role in the pathophysiology of SSPE. It included 22 children with SSPE aged 2 - 15 years (patient group) and 22 age- and gender-matched healthy children (control group). In children < 6 years old, there were no statistically significant differences between the two groups in the proportions of lymphocytes expressing the surface markers CD3, CD8, CD19 or CD16/56, or in CD4/CD8 ratio. The proportion of CD4(+) lymphocytes in SSPE patients < 6 years of age was significantly lower compared with the control group. In children >or= 6 years old, there were no significant differences in the lymphocyte subgroups. In conclusion, these findings suggest that a low CD4(+) lymphocyte count might be responsible for SSPE in younger children.