Comparison of diadochokinetic rate between deaf children and normal children

BACKGROUND: Diadochokinetic rate reflects the motion state and synergic level of oral, lingual and speech muscle group, and it is an important index to judge the speech articulation, it is also very significant in the training and evaluation of vocal ability and the correction and treatment of speech. OBJECTIVE: To compare the diadochokinetic rate between deaf children and normal children. DESIGN: A comparative observation. SETTING: College of Hearing and Speech Sciences, Zhejiang University of Traditional Chinese Medicine. PARTICIPANTS: Twenty deaf children and 20 normal children of 6-7 years old, half boys and half girls, were selected from Hangzhou Rehabilitation Center for Deaf Children and Hangzhou Fuxing Kindergarten between January and March, 2006. The influences of organic dysarthria on our study had been eliminated, including intellectual and oral diseases, etc. Informed consents were obtained from the guardians of all the enrolled children. METHODS: ① The deaf children all cooperated with the study after proper communication with them. They practiced to pronounce /pa/, /ta/, /ka/ clearly in order, then pronounced them together, that was /pataka/. They should slow down at first in order to pronounce clearly and cohere them together, then speeded up to practice, so that the results could not be affected by the unfamiliar pronunciation. After practice, the deaf children were tested by pronouncing /pataka/ for five time continuously, and they were asked to pronounce clearly and correctly with uniform intensity, loudness, speed, etc. They were tested for three times by the same methods, and the durations of the three times were recorded to obtain the average value, then the velocity was calculated. The tests for the normal children were the same as those mentioned above. ② The differences of the measurement data were compared by the t test. MAIN OUTCOME MEASURES: Results of diadochokinetic rate compared between deaf children and normal children. RESULTS: All the 20 normal children and 20 deaf children were involved in the analysis of results. The diadochokinetic rate was obviously lower in the deaf children than in the normal children [(0.64±0.18), (2.41±0.47) times/s, P < 0.01]. CONCLUSION: The diadochokinetic rate is lower in deaf children than in normal children. It is also suggested that the training of diadochokinetic function should be enhanced in the speech training of deaf children to improve their lingual and oral flexibility and speech articulation.     

“Borderline” children

Sixteen children said to be "borderline" were referred for comprehensive evaluation. None met DSM III criteria for borderline personality disorder. Referring psychiatrists and psychologists seemed to base their impressions on the child's disorganized thinking and irrational, erratic behavior, problems that were better understood and treated from a developmental perspective. The borderline label had a negative impact on some children, and was not helpful for treatment planning or disposition. Clear guidelines for the application of this ambiguous and controversial diagnostic term in child psychiatry are nonexistent.     

Guillain-Barré syndrome in children

In industrialized nations with widespread immunization programs, Guillain-Barré syndrome is the most common cause of acute paralytic illness in children and adults. The incidence of the disease has been estimated to range from 0.5 to 1.5 in 100,000 in individuals less than 18 years of age. Approximately 15% of children with Guillain-Barré syndrome develop respiratory failure and require mechanical ventilatory support. Prospective randomized treatment trials in childhood Guillain-Barré syndrome are wanting; however, smaller case series studies using historical controls suggest that both plasmapheresis and administration of human immunoglobulin could be helpful in reducing morbidity in children with Guillain-Barré syndrome. The prognosis for recovery in children is generally excellent, with the majority of children achieving a complete functional recovery within 6 months from the onset of illness. Studies using an animal model of human Guillain-Barré syndrome, experimental allergic neuritis, have expanded our understanding of the pathogenesis of the disease and suggest new directions for exploration in the treatment of this disorder.     

Factors affecting nightmares in children: parents’ vs. children’s ratings

Objective  The present study investigated the relationship between daytime symptomatology and nightmare frequency in school-aged children by eliciting daytime symptoms and nightmare frequency from children directly in addition to questionnaires completed by their parents. Methods  A sample of 4,834 parents and 4,531 of their children (age range: 8–11 years) completed each a sleep questionnaire and the strengths and difficulties questionnaire (SDQ). Results  The results of the study clearly indicate that there is an underestimation of nightmare frequency in the parents’ ratings compared to the children’s data (effect size: d = 0.30) and the closeness between influencing factors and nightmare frequency is considerably higher for the data based on the children’s responses; the proportion of explained variance was twice as high. Conclusions  Therefore, it seems important for research and clinical practice to not to rely on parents’ information but to ask the children about the occurrence of nightmares.     

“Occult” hydrocephalus in children

The authors describe 32 children between 2 and 15 years of age who had hydrocephalus that was only clinically manifest late in life. The clinical picture of these children did not suggest an obvious increase in intracranial pressure; instead, the presenting signs were rather nonspecific and included macrocrania, mild psychomotor retardation, unsteady gait, increased muscle tone and deep tendon reflexes in the lower limbs, impaired ocular movement, epilepsy, and endocrine dysfunction. Their histories suggest the possible causes of the ventricular dilation in about one third of the cases were: perinatal hemorrhage, leptomeningitis, neurofibromatosis, and untreated aneurysm of the great vein of Galen. In 20 patients, however, no positive anamnestic findings were reported. CT scan revealed triventricular dilation in more than half of the cases; tetraventricular dilation was present in 6 patients, and biventricular dilation in the remaining subjects. All children underwent CSF shunting, which resulted in complete recovery in all but 2 cases. The most frequently recorded surgical complication was postoperative subdural effusion (7 subjects), which required surgical treatment in only 2 cases.Presented at the 15th Annual Scientific Meeting of the International Society for Pediatric Neurosurgery, New York, 1987     

Are children with imaginary playmates and children said to remember previous lives cross-culturally comparable categories?

Some 15-66% of children in western countries talk about imaginary playmates; in India only 0.2% of children are said to remember a previous life. Both phenomena occur from the age of 30 months to 60-90 months. This article explores whether the two phenomena are cross-culturally comparable categories. The article describes a study of the psychological characteristics of a sample of 15 children said to remember a previous life in India, compared with a matched sample; and compares it with a sample of 15 children with imaginary playmates and a matched sample from Charlottesville, Virginia. No significant differences between the target group and the comparison group were found in either culture, suggesting that both phenomena are normal. One case of an American child with an imaginary playmate and one case of a child in India who is said to remember a previous life are described, using a video-recording of the child's dialogue.     

Medulloblastoma in children – the Ottawa experience

A retrospective review of 36 children diagnosed with medulloblastoma in the Ottawa area between 1974 and 1997 was completed (mean age 7.8±4.2 years, range 1.2–15.3 years). Via a suboccipital approach, complete tumor resection was achieved in 75% and subtotal resection (>90%) in 25%, without any operative mortality. The tumor was located in the vermis in 39% and in the cerebellar hemisphere in 11%; it occupied both locations in 50%. In 47% of the children a ventriculoperitoneal shunt was required. Postoperatively, craniospinal radiation at 3600 cGy with a boost to the posterior fossa was administered. Chemotherapy was used in 56%. The 1-year survival rate was 92%, and survival plateaued at 54% at 5 years. Children less than 3 years of age fared worse than those over 3 years old. While the male-to-female ratio was 1.6:1, there was no gender difference in survival. Chang’s classification was used to grade the tumors. T stage did not have an impact on survival, but M stage did. No statistically significant difference in survival was found between the patients who had a total resection and those who had a subtotal resection. There was no difference in survival in terms of tumor location, hydrocephalus or ventriculoperitoneal shunt. Chemotherapy showed no survival benefit. The recurrence rate was 26%, and its timing followed Collin’s law. Recurrence led to death within 1–9 months. GH deficiency was diagnosed in 5 patients and hypothyroidism in 4 patients. The mean follow-up time was 4.4±3.7 years, with a range of 2.5 months to 16.5 years. Fourteen patients died, 5 were lost to follow-up, and 7 were transferred to adult care without persistent disease. Ten children are presently being followed up by the Neuro-oncology Clinic. Four children continue to be followed through psychology services. Our results are comparable to those in larger series, and are similar to those of the Montreal Children’s Hospital. Received: 13 December 1999     

Does the speech of Turkish-speaking phonologically disordered children differ from that of children speaking other languages?

How phonological disorders should be categorized in Turkish children remained vague for a long period of time due to a lack of normative studies. This paper reports the phonological systems of 70 phonologically disordered children, aged 4;0-8;0, in comparison with the results of a normative study of 665 Turkish-speaking children, aged 1;3-8;0. The current focus is on two aspects of development, mainly the differences between disordered and normal consonant acquisition and phonological error patterns from both longitudinal and cross-sectional data. The second concern of the paper is to sub-classify phonological disorders as proposed in the existing literature by examining the applicability of these proposals to Turkish, a typologically different language. It has been indicated that similar developmental trends occur across languages but consonant acquisition is more rapid and developmental errors are more predictable in Turkish. There is evidence for ambient language influence. Mostly, the sub-classifications of phonological disorders are valid for Turkish-speaking children with apparent saliency to language.     

Can listeners hear the difference between children with normal hearing and children with a hearing impairment?

Acoustic measurements have shown that the speech of hearing-impaired (HI) children differs from that of normally hearing (NH) children, even after several years of device use. This study focuses on the perception of HI speech in comparison to NH children’s speech. The purpose of this study was to investigate whether adult listeners can identify the speech of NH and HI children. Moreover, it is studied whether listeners’ experience and the children’s length of device use play a role in that assessment. For this study, short utterances of 7 children with a cochlear implant (CI), 7 children with an acoustic hearing aid (HA) and 7 children with NH were presented to 90 listeners who were required to specify the hearing status of each speech sample. The judges had different degrees of familiarity with hearing disorders: there were 30 audiologists, 30 primary schoolteachers and 30 inexperienced listeners. The results show that the speech of children with NH and HI can reliably be identified. However, listeners do not manage to distinguish between children with CI and HA. Children with CI are increasingly identified as NH with increasing length of device use. For children with HA, there is no similar change with longer device use. Also, experienced listeners seem to display a more lenient attitude towards atypical speech, whereas inexperienced listeners are stricter and generally consider more utterances to be produced by children with HI.     

Attentional functioning in children with ADHD – predominantly hyperactive-impulsive type and children with ADHD – combined type

Summary. Although particular importance has been attributed to attention deficits in attention deficit hyperactivity disorder (ADHD), there is no consensus as to the exact nature of inattention in ADHD or which components of attention are affected. The present study was based on a neuropsychological model of attention and assessed various components of attention in 23 children with ADHD/predominantly hyperactive-impulsive type (ADHD-H), 32 children with ADHD/combined type (ADHD-C) and healthy children (N₁ = 23 and N₂ = 32). A computerized test battery consisting of reaction time tasks of low complexity was used for the assessment of attention (alertness task, vigilance task, divided attention task, visual scanning task, incompatibility task, test of crossmodal integration, flexibility task). In comparison to healthy participants, patient groups were impaired in measures of vigilance, divided attention, selective attention and flexibility but not in measures of alertness. Analysis of the test performance of patient groups revealed no differences between children with ADHD-H and children with ADHD-C. The results of the present study suggest that both children with ADHD-H and children with ADHD-C are seriously impaired in attentional functioning. Children with ADHD-H and children with ADHD-C produced comparable results in measures of attention.     

Development of postural control in typically developing children and children with cerebral palsy: possibilities for intervention?

The basic level of postural control is functionally active from early infancy onwards: young infants possess a repertoire of direction-specific postural adjustments. Whether or not direction-specific adjustments are used depends on the child's age and the nature of the postural task. The second level of control emerges after 3 months: children start to develop the capacity to adapt postural activity to environmental constraints. But the adult form of postural adaptation first emerges after adolescence.

Children with cerebral palsy (CP) in general have the ability to generate direction-specific adjustments, but they show a delayed development in the capacity to recruit direction-specific adjustments in tasks with a mild postural challenge. Children with CP virtually always have difficulties in the adaptation of direction-specific activity.

The limited data available on the effect of intervention on postural development suggest that intervention involving active trial and error experience may accelerate postural development in typically developing infants and may improve postural control in children with or at high risk for a developmental motor disorder.     

Does the speech of Turkish‐speaking phonologically disordered children differ from that of children speaking other languages?

How phonological disorders should be categorized in Turkish children remained vague for a long period of time due to a lack of normative studies. This paper reports the phonological systems of 70 phonologically disordered children, aged 4;0–8;0, in comparison with the results of a normative study of 665 Turkish‐speaking children, aged 1;3–8;0. The current focus is on two aspects of development, mainly the differences between disordered and normal consonant acquisition and phonological error patterns from both longitudinal and cross‐sectional data. The second concern of the paper is to sub‐classify phonological disorders as proposed in the existing literature by examining the applicability of these proposals to Turkish, a typologically different language. It has been indicated that similar developmental trends occur across languages but consonant acquisition is more rapid and developmental errors are more predictable in Turkish. There is evidence for ambient language influence. Mostly, the sub‐classifications of phonological disorders are valid for Turkish‐speaking children with apparent saliency to language.     

Are children affected by epileptic neuropsychiatric comorbidities?

Childhood-onset epilepsy is associated with psychiatric and cognitive difficulties and with poor social outcomes in adulthood. Some antiepileptic drugs adversely affect behavior in susceptible children with easy-to-control or refractory epilepsies, contributing to a high risk of psychological and psychiatric disturbance. Studies had demonstrated that patients with benign rolandic epilepsy and absence epilepsy had more aggressive behavior, depression, and anxiety disorders than control children. Psychiatric comorbidities are strongly associated with a poor long-term health-related quality of life in childhood-onset epilepsy, which suggests that comprehensive epilepsy care must include screening and long-term treatment for these conditions, even if seizures remit.This article is part of a Special Issue entitled “NEWroscience 2013”.     

What differentiates children visiting outpatient mental health services with bipolar spectrum disorder from children with other psychiatric diagnoses?

Fristad MA, Frazier TW, Youngstrom EA, Mount K, Fields BW, Demeter C, Birmaher B, Kowatch RA, Arnold LE, Axelson D, Gill MK, Horwitz SM, Findling RL. What differentiates children visiting outpatient mental health services with bipolar spectrum disorder from children with other psychiatric diagnoses? Bipolar Disord 2012: 14: 497–506. © 2012 The Authors. Journal compilation © 2012 John Wiley & Sons A/S. Objectives: To determine the contribution of parent‐reported manic symptoms, family history, stressful life events, and family environment in predicting diagnosis of bipolar spectrum disorders (BPSD) in youth presenting to an outpatient psychiatric clinic. Methods: A total of 707 6‐ to 12‐year‐old children [621 with elevated symptoms of mania (ESM+) based on screening via the Parent General Behavior Inventory 10‐item Mania Scale (PGBI‐10M) and 86 without ESM (ESM–)] received a comprehensive assessment. Results: Of the 629 with complete data, 24% (n = 148) had BPSD. Compared to those without BPSD (n = 481), children with BPSD: were older (Cohen’s d = 0.44) and more likely to be female (Cohen’s d = 0.26); had higher parent‐endorsed manic symptom scores at screening (Cohen’s d = 0.36) and baseline (Cohen’s d = 0.76), more biological parents with a history of manic symptoms (Cohen’s d = 0.48), and greater parenting stress (Cohen’s d = 0.19). Discriminating variables, in order, were: baseline PGBI‐10M scores, biological parent history of mania, parenting stress, and screening PGBI‐10M scores. Absence of all these factors reduced risk of BPSD from 24% to 2%. Conclusions: History of parental manic symptoms remains a robust predictor of BPSD in youth seeking outpatient care, even after accounting for parent report of manic symptoms in the child at screening. However, the risk factors identified as associated with BPSD, together had limited value in accurately identifying individual participants with BPSD, highlighting the need for careful clinical assessment.     

Intravenous immunoglobulin in children with Guillain-Barré syndrome

We report our experience with intravenous immunoglobulin (IVIG), plasmapheresis and supportive care in 13 patients with the Guillain-Barré syndrome. Seven of 13 patients received IVIG, 2 plasmapheresis and 4 supportive care. At 15th day after IVIG administration, all patients in this group had improved at least one disability grade. In the plasmapheresis group, 1 improved at 5th day after the procedure. Two of the 4 patients that received supportive care improved at 20th day of evaluation. In the IVIG group, the final scores were lower and had no relapses. These results suggest faster clinical improvement with IVIG when compared with supportive measures.