Error-related negativity in children: effect of an observer

This research assessed the effect of an observer upon error-related negativity (ERN) in 20 children (ages 7-11): 9 worked alone and 11 worked under the observation of a friend of theirs (alone/audience groups). Erroneous motor responses were recorded to Go and No-Go visual stimuli (triangles in different orientations) at three brain sites (Fz, Cz, and Pz). Results for children were consistent with past adult studies in showing a significantly larger ERN only to erroneous responses in both the alone and the audience groups. Children in the audience group produced larger ERNs than those in the alone group. Furthermore, older children (ages 9-11) produced larger ERNs than younger children (ages 7-8) in both groups. These findings were discussed in the context of an action monitoring system that regulates responses, detects errors, and entrains affective responses associated with correct and incorrect responses.     

学习障碍儿童视学——运动的研究

目的：探讨不同类型学习障碍儿童的视觉－－运动缺陷。方法：选取言语型学习障碍（VLD）、非言语型学习障碍（NLD）儿童和正常儿童各20名,进行镜画仪实验和本德尔视觉－－运动格式塔测验（BGT）测试。结果：在镜画仪实验中,NLD儿童错误次数更多,在时限内完成任务的人数明显不如其他两组;在BGT测试中,BLD儿童在总分,旋转、继画和缺画,分离,角外线条突出和未完成角度方面得分明显高于正常儿童,VLD儿童在总分,继画和缺画两项指标上的得分明显高于正常儿童。结论：NLD儿童在罗为明显的视觉－－运动缺陷,而VLD儿童在BGT测试中表现的不足可能与其内部语言调控不良有关。     

Neuropsychological Differences Among Children With Asperger Syndrome,Nonverbal Learning Disabilities,Attention Deficit Disorder,and Controls

Confusion is present as to possible diagnostic differences between Asperger syndrome (AS) and Nonverbal learning disabilities (NLD) and the relation of these disorders to attentional difficulties. Three-hundred and forty-five children participated in this study in 5 groups; NLD, AS, attention deficit hyperactivity disorder (ADHD): Combined type, ADHD: Inattentive type, and controls. The NLD group showed particular difficulty on visual-spatial, visual-motor, and fluid reasoning measures compared to the other groups. There was also a significant verbal-performance IQ split in this group related to difficulty in social functioning. This study extends the findings from previous studies and extends these findings to differences between AS and NLD groups.     

The letter digit substitution test: demographic influences and regression-based normative data for school-aged children

The Letter Digit Substitution Test (LDST) was administered to a sample of N=296 healthy children (aged between 8.03 and 15.87). The aim of the present study was to evaluate the impact of age, gender, and parental educational level on LDST performance and to establish demographically corrected normative data. The results showed that the relationship between age and LDST performance was curvilinear (i.e., improvements in test performance were more pronounced for younger children than for older children) and was moderated by gender (i.e., the gender differences were small at younger ages but increased as a function of age, with girls outperforming boys). Moreover, children who had parents with a higher level of education outperformed their counterparts who had parents with a lower level of education. Regression-based normative LDST data were established, and an automatic scoring program was provided.     

非言语型学习障碍儿童视觉空间认知特征与行为问题

目的:对我国汉族非言语型学习障碍(nonverbal learning disorder, NLD)儿童视觉空间认知特征以及行为问题进行分析,以探讨其相互之间关系。方法:三组儿童(NLD组,VLD组和正常对照,每组40人)进行智力测定、绘人测验和CBCL儿童行为量表测量,根据智力结构模型分析其视空间能力与行为问题。结果:NLD儿童在空间能力、视动协调、视动速度、图形认知、视觉记忆、非言语推理、视觉组合方面都比正常儿童和VLD儿童差(P<0.05),而VLD儿童则与正常儿童无差别(P>0.05)。NLD儿童在分裂焦虑、强迫性、社交退缩、多动、攻击性等行为方面较其他两组儿童多(P<0.05)。结论:我国汉族NLD儿童视觉空间认知存在缺陷,其行为问题可能与此有关。     

Public health monitoring of developmental disabilities with a focus on the autism spectrum disorders

Developmental disabilities (DDs) are conditions characterized by physical, cognitive, psychological, sensory, adaptive, and/or communication impairments manifested during development. Approximately 17% of individuals in the United States 18 years and younger have a DD, and for most children the cause of their condition is unknown. Of particular interest are the autism spectrum disorders (ASDs), characterized by unusual social, communication, and behavioral development. Previously autism was thought to be a rare condition, but the number of children receiving services for an ASD has increased dramatically in the last decade. Concerns about increases in DDs, particularly ASDs, their causes, and the high costs of intervention have highlighted the need for systematic public health monitoring. Service provider data, such as annual reporting of special education services or of state DD programs, do not provide a complete estimate of the rates for DDs, including ASDs. Unlike genetic metabolic disorders or congenital hearing loss (HL) for which newborn screening programs can provide accurate prevalence rates, there are currently no genetic or biologic markers for the ASDs to enable consistent and early identification of affected children. Centers for Disease Control and Prevention's (CDC) Metropolitan Atlanta Developmental Disabilities Surveillance Program (MADDSP) is a model for population monitoring of ASDs/DDs that has been implemented in other states. This article discusses the role of ASD/DD tracking in public health, as well as the challenges of ASD/DD tracking, including case definition and identification, associated conditions, linkages, and data access.     

Clinical characteristics of asthmatics who stop peak expiratory flow monitoring (PFM)--analysis of patients who continued PFM more than eight weeks]

To estimate the effect of treatment and for patient education, we recommend 8 weeks PFM for all asthmatics when we start their treatments. To elucidate clinical characteristics of asthmatics who stop PFM, we analyzed 311 patients (145 males aged 15-76 years and 166 females aged 17-79 years) who could measure their PEFs twice daily for more than 8 consecutive weeks. The analysis of cumulative continuation rate of PEF monitoring revealed that the patients' withdrawal rate was 19% per year. The sixty asthmatics who gave up monitoring their PEFs (group A) showed significantly younger present ages (38.8 +/- 14.2, mean +/- S.D.) and younger ages of onset of their asthma (29.8 +/- 19.6) than the other 251 asthmatics who could continue to monitor their PEFs (group B). The present ages and ages of onset of asthma of group B were 46.2 +/- 16.7 and 37.6 +/- 21.2 years, respectively. Despite no significant differences in the severity of the asthma based on both clinical symptoms and PEF between groups A and B, the asthma severity based only on the clinical symptoms of group A were significantly less than those of group B. The analysis of Cox's proportional hazards model revealed that major factors which influence patients' stopping of PFM were present age and severity of their asthma which was estimated by the patients' symptoms only, without PEF assessment. These results suggest that asthmatics whose present age is young and whose ability of perception of asthma is poor will be apt to stop PFM.     

The effect of influenza on hospitalizations, outpatient visits, and courses of antibiotics in children

BACKGROUND: Despite high annual rates of influenza in children, influenza vaccines are given to children infrequently. We measured the disease burden of influenza in a large cohort of healthy children in the Tennessee Medicaid program who were younger than 15 years of age. METHODS: We determined the rates of hospitalization for acute cardiopulmonary conditions, outpatient visits, and courses of antibiotics over a period of 19 consecutive years. Using the differences in the rates of these events when influenzavirus was circulating and the rates from November through April when there was no influenza in the community, we calculated morbidity attributable to influenza. There was a total of 2,035,143 person-years of observation. RESULTS: During periods when influenzavirus was circulating, the average number of hospitalizations for cardiopulmonary conditions in excess of the expected number was 104 per 10,000 children per year for children younger than 6 months of age, 50 per 10,000 per year for those 6 months to less than 12 months, 19 per 10,000 per year for those 1 year to less than 3 years, 9 per 10,000 per year for those 3 years to less than 5 years, and 4 per 10,000 per year for those 5 years to less than 15 years. For every 100 children, an annual average of 6 to 15 outpatient visits and 3 to 9 courses of antibiotics were attributable to influenza. In winter, 10 to 30 percent of the excess number of courses of antibiotics occurred during periods when influenzavirus was circulating. CONCLUSIONS: Healthy children younger than one year of age are hospitalized for illness attributable to influenza at rates similar to those for adults at high risk for influenza. The rate of hospitalization decreases markedly with age. Influenza accounts for a substantial number of outpatient visits and courses of antibiotics in children of all ages.     

Screening for learning disabilities: a neuropsychological approach

The ability of the Trail Making Test (TMT) and Tactual Performance Test (TPT) to discriminate between learning-disabled and normal children was examined. Twenty children aged 9 to 14 years who recently had been classified as learning disabled and 20 matched controls were administered individually the TPT, TMT, and two experimental forms of the TMT (parts X and Y). The data from the two groups were analyzed with a discriminant analysis. An overall accuracy rate of 82.5% was obtained when the measures were used to predict the classification status of individual children. A stepwise discriminant analysis procedure revealed an experimental form of the TMT (part X), Tactual Performance Test total time, and Tactual Performance Test localization to be the most sensitive measures. The use of such measures to screen for learning disabilities is discussed.     

Height and weight of Tokyo schoolchildren with and without intellectual handicaps.

The heights, weights and Rohrer Indices (W/H3; RIs) of Tokyo schoolchildren born in 1972/73 with and without intellectual handicaps were compared from 6 to 15 years. The samples of children consisted of 303 children with no intellectual handicaps ('controls') and 308 children with intellectual handicaps including subgroups with Down's syndrome (39 children), autism (49 children) and epilepsy (58 children). Boys and girls with no intellectual handicaps were at all ages significantly taller than schoolchildren with intellectual handicaps. However, there were few significant differences in mean weight between children with and without intellectual handicaps--only in boys at age 15 years and girls at 6, 7, 11 and 12 years. The mean RIs of boys and girls with intellectual handicaps were at all ages significantly higher than those of controls. The subgroup of children with Down's syndrome were the shortest and had the highest mean RI at all ages. Children with epilepsy were also significantly shorter than children with no intellectual handicaps but did not differ much in RI. Autistic children did not differ in height from controls, except for autistic boys who at the ages 6-12 years were significantly taller, indicating a comparatively earlier maturational rate of this specific sample. Autistic boys had a higher RI than controls at 9, 11, 12, 13 and 14 years but autistic girls did not differ significantly from controls at these ages.     

非言语型学习障碍儿童社会信息加工的特点

目的: 探讨非言语型学习障碍儿童社会信息加工特点.方法: 本研究为病例对照研究.根据确定学习障碍儿童的标准,先确定学习障碍儿童,然后对学习障碍儿童进行韦氏儿童智力测验,根据测验结果把学习障碍儿童进一步分为非言语型学习障碍组(23人)、言语型学习障碍组(28人),然后按1:1比例选取对照组(51人).设置儿童与同伴、成人相互作用的三类情景,每类情景又分为模糊和清晰两种情况,对三组儿童进行结构性访谈.结果: ①清晰权威情景下.非言语型学习障碍儿童的编码数显著低于对照组儿童[(2.35±1.15)vs.(3.25±1.27),P＜0.01];对人物意图的判断,非言语型学习障碍儿童选择"恶意"的比率(65%)高于言语型学习障碍儿童(29%)(P＜0.05);在工具效能感上,非言语型学习障碍儿童选择有效的比率(74%)高于言语型学习障碍儿童(36%)(P＜0.05).②非言语型学习障儿童在每个情景故事下的总反应数都显著低于对照组儿童[模糊同伴加入情景:(1.17±0.49)vs.(1.09±0.86).P＜0.01;清晰同伴加入情景:(1.09±0.28)vs.(1.69±0.96),P＜0.01;模糊同伴激惹情景:(1.09±0.41)V8.(1.49±0.78),P＜0.05;清晰同伴激惹情景:(1.17±0.49)vs.(1.65±0.95),P＜0.05:模糊权威情景:(0.96±0.36)vs.(1.37±0.72),P＜0.01;清晰权威情景:(1.00±0.30)vs.(1.37±0.59),P＜0.01].结论: ①清晰权威情景下,非言语型学习障碍儿童编码精确性不如对照组儿童;对他人意图的判断非言语型学习障碍儿童比言语型学习障碍儿童倾向于敌意归因;非言语型学习障碍儿童比言语型学习障碍儿童工具效能感高.②在每个情景下,非言语型学习障碍儿童比对照组儿童生成策略少,反应不灵活.     

Cockroach allergy appears early in life in inner-city children with recurrent wheezing.

BACKGROUND: Cockroach allergy and exposure to high levels of this allergen are important in the increasing asthma-related health problems among young inner-city children. However, there are very little data regarding the prevalence of cockroach allergy in infants and young children with asthma. OBJECTIVE: This retrospective study was designed to test the hypothesis that cockroach allergy appears early in life in young children with recurrent wheezing. METHODS: We reviewed the medical records of all 196 children (ages 5 months to 16 years) evaluated between January 1995 and September 1997 at the Cook County Hospital Pediatric Allergy Clinic for recurrent wheezing. The patients were assigned into two age groups, less than 4 years old and 4 to 16 years old. The percentages of IgE skin tests positive for common aeroallergens were compared within and between the two age groups. All children in the younger age group were tested for cockroach and dust mites, cat, and dog when indicated by positive environmental history. All children in the older age group were tested for indoor and outdoor allergens. RESULTS: Sixty-three children were younger than 4 years of age, and of these, 15 (23.8%) had cockroach allergen sensitivity, compared with only eight patients (12.7%) who were skin test positive to dust mite allergen (P = .01). The youngest patient with a positive reaction to cockroach allergen was 6 months old. Patients with a single allergen skin reactivity were considered as monosensitized. Nine children younger than 4 years of age (14.3%) were monosensitized only to cockroach allergen in contrast to three children (4.8%) who were monosensitized to house-dust mites (P < .05). CONCLUSIONS: Our data suggest that cockroach allergen sensitivity starts early in life and may be the only sensitizing allergen in many young inner-city children.     

Plans and the Control of Behavior in Boys With and Without Learning Disabilities

Examined planning in two groups of students representing two age periods. Boys with learning disabilities (LD) and without learning disabilities (NLD) in younger (8 to 9 years) and older (11 to 12 years) age ranges were compared on plan execution as measured by tasks and standardized tests of planning, and on a knowledge about planning questionnaire. Group differences between LD and NLD students were found, suggesting a developmental deficit in students with LD. Age differences were also found. In both groups, younger students did not do as well as older students on the task, standardized tests; or on the planning knowledge questionnaire. Planning knowledge was significantly related to both task and standardized tests of planning, but few significant correlations were found between task and standardized test scores.     

Respiratory syncytial viral infection in children with compromised immune function

For 10 winters, 608 children five years old or younger who were hospitalized with respiratory syncytial virus (RSV) infection were prospectively studied to evaluate the relation between their immune status and the severity of their infection. Forty-seven had been immunocompromised by chemotherapy, steroid therapy, or a primary immunodeficiency disorder. Among the immunocompromised children, those receiving chemotherapy for cancer and those with immunodeficiency disease had more severe RSV disease, with pneumonia occurring at all ages, and a higher mortality rate. Children receiving long-term steroid therapy did not appear to have more severe clinical manifestations than normal children. Viral shedding, however, was significantly greater and more prolonged in the children receiving steroid therapy, and particularly in those receiving chemotherapy or with an immunodeficiency disease. Giant-cell pneumonia was documented in one child with leukemia. Over half the immunocompromised children acquired the RSV infection nosocomially. These findings indicate that children receiving chemotherapy for cancer and those with immunodeficiency disease are at risk for complicated or fatal infections from RSV and should be considered for antiviral and other therapies as they become available. Efforts should also be made to protect compromised children if hospitalization cannot be avoided.     

Utility of QuantiFERON®-TB Gold In-Tube Test Compared with Tuberculin Skin Test in Diagnosing Tuberculosis in Indian Children with Malnutrition

This prospective cohort study was conducted to compare the accuracy of QuantiFERON®-TB (QFT) Gold In-Tube test and tuberculin skin test (TST) in diagnosing tuberculosis (TB) in predominantly bacille Calmette–Guerin-vaccinated children with a high incidence of malnutrition. The sensitivity of the QFT versus the TST was 69.6% versus 52.9% for WHO-defined TB, with specificity of 86% versus 78.3%, respectively. The concordance of the TST and QFT was 79% overall (κ = 0.430), 62.5% in those with WHO-defined TB and 85.7% in those without TB. Majority of the QFT+/TST − discordance was seen in children with TB, whereas majority of the TST+/QFT − discordance was seen in those without TB. The TST was more likely to be negative in children with moderate-to-severe malnutrition (P = 0.003) compared to the QFT, which was more likely to be positive in younger children. The significantly better performance of the QFT in malnourished children and those at younger ages supports its use for TB diagnosis in these subpopulations.     

非言语型学习障碍儿童右脑功能的研究

目的：探讨非言语型学习障碍（NLD）儿童的右脑功能状况。方法：选取正常儿童和言语型学习障碍（VLD）、NLD儿童各20名，进行速示下记忆实验和本顿视觉保持测验（VRT）测试。结果：在速示实验中，NLD儿童对规则图形和实物图形的再认成绩明显不如正常组：在VRT测试中，NLD儿童的正确分明显低于其他两组，且遗漏和变形错误分明显多于正常组。结论：与正常儿童相比，NLD儿童右脑功能相对薄弱。     

Error-Related Negativity in Children: Effect of an Observer

This research assessed the effect of an observer upon error-related negativity (ERN) in 20 children (ages 7–11): 9 worked alone and 11 worked under the observation of a friend of theirs (alone/audience groups). Erroneous motor responses were recorded to Go and No-Go visual stimuli (triangles in different orientations) at three brain sites (Fz, Cz, and Pz). Results for children were consistent with past adult studies in showing a significantly larger ERN only to erroneous responses in both the alone and the audience groups. Children in the audience group produced larger ERNs than those in the alone group. Furthermore, older children (ages 9–11) produced larger ERNs than younger children (ages 7–8) in both groups. These findings were discussed in the context of an action monitoring system that regulates responses, detects errors, and entrains affective responses associated with correct and incorrect responses.     

Serum and mucosal antibody responses to pneumococcal protein antigens in children: relationships with carriage status

Streptococcus pneumoniae causes significant morbidity and mortality especially in children. Some pneumococcal protein antigens can protect mice against infection. Little information is available concerning the nature of naturally acquired protective immunity to pneumococci in humans induced by these antigens. This study investigates the relationships between systemic and local antibody production and carriage in children. Children undergoing adenoidectomy (n=112, ages 2-12 years) were studied. Nasopharyngeal swabs were collected for pneumococcal culture. Serum and saliva were assayed for antibodies to several pneumococcal proteins: choline binding protein A (CbpA), pneumolysin (Ply), pneumococcal surface adhesin A (PsaA) and pneumococcal surface protein A (PspA). Adenoidal mononuclear cells (MNC) were cultured with pneumococcal culture supernatants or recombinant proteins. Cell culture supernatants were analyzed for antigen-specific antibodies. Carriage rates fell with age and serum levels of anti-CbpA, Ply and PspA rose. Anti-CbpA and -Ply serum and salivary IgG antibody levels were higher in children who were culture negative than those who were colonized. Antigen stimulation increased respective antigen-specific IgG production by adenoidal MNC and these responses were greater in those who were colonized than in culture-negative children. Antibodies to CbpA and Ply may protect children aged 2 years and older against pneumococcal colonization. Adenoids may be important local induction and effector sites for both mucosal and systemic antibody production to pneumococcal proteins in children.     

Signs of developmental stuttering up to age eight and at 12 plus

Clinicians who are familiar with the general DSM-IV-TR scheme may want to know how to identify whether a child does, or (equally importantly) does not, stutter and what differences there are in the presenting signs for children of different ages. This article reviews and discusses topics in the research literature that have a bearing on these questions. The review compared language, social-environmental and host factors of children who stutter across two age groups (up to age eight and 12 plus). Dysfluency types mainly involved repetition of one or more whole function words up to age eight whereas at age 12 plus, dysfluency on parts of content words often occurred. Twin studies showed that environmental and host factors were split roughly 30/70 for both ages. Though the disorder is genetically transmitted, the mode of transmission is not known at present. At the earlier age, there were few clearcut socio-environmental influences. There were, however, some suggestions of sensory (high incidence of otitis media with effusion) and motor differences (high proportion of left-handed individuals in the stuttering group relative to norms) compared to control speakers. At age 12 plus, socio-environmental influences (like state anxiety) occurred in the children who persist, but were not evident in the children who recover from the disorder. Brain scans at the older age show some replicable abnormality in the areas connecting motor and sensory areas in speakers who stutter. The topics considered in the discussion return to the question of how to identify whether a child does or does not stutter. The review identifies extra details that might be considered to improve the classification of stuttering (e.g. sensory and motor assessments). Also, some age-dependent factors and processes are identified (such as change in dysfluency type with age). Knowing the distinguishing features of the disorder allows it to be contrasted with other disorders which show superficially similar features. Two or more disorders can co-occur for two reasons: comorbidity, where the child has two identifiable disorders (e.g. a child with Down Syndrome whose speech has been properly assessed and classed as stuttering). Ambiguous classifications, where an individual suffering from one disorder meets the criteria for one or more other disorders. One way DSM-IV-TR deals with the latter is by giving certain classification axes priority over others. The grounds for such superordinacy seem circular as the main role for allowing this appears to be to avoid such ambiguities.     

Clinical use of the Benton Visual Retention Test for children and adolescents with learning disabilities.

This study examined the Benton Visual Retention Test (BVRT) with 130 children and adolescents with learning disabilities (LD) who were between the ages of 8 and 13 years of age. Results of factor analysis showed errors scores from the BVRT loaded on a visual processing/memory factor. The measure appears to be sensitive to developmental patterns which was supported by statistical analysis. Error and correct score patterns are also examined for different subgroups. The results of this study support the use of the BVRT with children and adolescents with LD.