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.     

Socio-emotional regulation in children with intellectual disability and typically developing children,and teachers’ perceptions of their social adjustment

This study examined the extent to which socio-emotional regulation displayed in three dyadic interactive play contexts (neutral, competitive or cooperative) by 45 children with intellectual disability compared with 45 typically developing children (matched on developmental age, ranging from 3 to 6 years) is linked with the teachers’ perceptions of their social adjustment. A Coding Grid of Socio-Emotional Regulation by Sequences (Baurain and Nader-Grosbois, 2011b, Baurain and Nader-Grosbois, 2011c) focusing on Emotional Expression, Social Behavior and Behavior toward Social Rules in children was applied. The Social Adjustment for Children Scale (EASE, Hugues, Soares-Boucaud, Hochman, & Frith, 1997) and the Assessment, Evaluation and Intervention Program System (AEPS, Bricker, 2002) were completed by teachers. Regression analyses emphasized, in children with intellectual disability only, a positive significant link between their Behavior toward Social Rules in interactive contexts and the teachers’ perceptions of their social adjustment. Children with intellectual disabilities who listen to and follow instructions, who are patient in waiting for their turn, and who moderate their externalized behavior are perceived by their teachers as socially adapted in their daily social relationships. The between-groups dissimilarity in the relational patterns between abilities in socio-emotional regulation and social adjustment supports the “structural difference hypothesis” with regard to the group with intellectual disability, compared with the typically developing group. Hierarchical cluster cases analyses identified distinct subgroups showing variable structural patterns between the three specific categories of abilities in socio-emotional regulation and their levels of social adjustment perceived by teachers. In both groups, several abilities in socio-emotional regulation and teachers’ perceptions of social adjustment vary depending on children's developmental age. Chronological age in children with intellectual disability had no impact on their socio-emotional regulation and social adjustment.     

Are the SSRIs and atypical antidepressants safe and effective for children and adolescents?

PURPOSE OF REVIEW: This article summarizes recent developments in the use of selective serotonin reuptake inhibitors and atypical antidepressants to treat children and adolescents with depression at a time when their use in this context has generated considerable controversy and confusion for clinicians, patients and their families. Recent reports and recommendations from drug regulators in the UK and the US are discussed, alongside other reviews and recently published randomized controlled trials. RECENT FINDINGS: It is now widely accepted that these drugs increase the risk of suicide-related behaviours and although recently published trials have been more positive, a meta-analysis of published and unpublished trials has cast doubt about efficacy. The evidence for publication bias in the studies considered is also raised and the implications discussed. There is some evidence, however, that the combination of psychological treatment with fluoxetine may be both effective and protective against the increased risk of suicide-related behaviours, although problems over blinding suggest further research is needed to clarify this potentially positive combination treatment. SUMMARY: Current evidence supports the conclusions of the UK drug regulator in warning against the use of all the newer antidepressants except fluoxetine in this age group, and alternative therapies should be sought in the first instance. Caution is needed in interpreting drug company sponsored trials given the evidence of selective reporting and publication bias. Combining fluoxetine with a psychological treatment such as cognitive-behavioural therapy is also worth considering.     

Parents’ mental health and children’s cognitive and social development

Background  

The development of children of parents who are experiencing mental health difficulties is a continuing cause of concern for professionals working in health, social care and education as well as policy makers. In light of this interest our study investigates the interplay between the mental health of mothers and fathers and family socioeconomic resources, and the impact for children’s cognitive and social development.     

Psychosocial problems and adjustment of children with β-thalassemia and their families

This study explores the psychosocial problems experienced by families with children aged 6 to 14 years suffering from -thalassemia major (N=188). The psychosocial problems and the family's adjustment to the effects of the illness were compared across a number of cultures where the disease is prevalent, namely Cyprus, Greece, and Italy. A small number of migrant children.in the United Kingdom was also included in the study. Semi-structured interviews were conducted with parents who also completed the Rutter Parental Questionnaire and the Goldberg General Health Questionnaire. Teachers were asked to complete a Children's Behaviour Questionnaire designed by Rutter. In all countries the disease seemed to have a binding effect on the family, thus mobilizing adaptive mechanisms. Father's low education level and the presence of major medical complications were predictors of poor family adjustment. Differences between and within countries may well reflect differences in health policies, existing level of socio-economic development, and in the cultural patterns in coping with a chronic illness.     

Guillain-Barré syndrome: perspectives with infants and children

An acute flaccid paraparesis or ascending quadriparesis in an infant or child constitutes a very important pediatric neurology emergency. The Guillain-Barré syndrome (GBS) is the most frequent cause. This is primarily an autoimmune, post-infectious, demyelinating, peripheral nervous system process. A small percentage of children develop a primary axonal process not unlike that identified more commonly in China. Because of the potential for acute respiratory compromise, any child suspected of having GBS needs immediate hospitalization. The major considerations in differential diagnosis include transverse myelitis, toxic neuropathies, tick paralysis, infantile botulism, myasthenia gravis, and dermatomyositis. On occasion, some younger children present with an acute severe pain syndrome that may mask as a pseudo-encephalopathy. Another clinical variant is the Miller-Fisher syndrome characterized by ataxia, ophthalmoparesis, and areflexia. This is associated with a high frequency of the anti-GQ-1-b antibodies. Although most children with GBS have a relatively benign clinical course, some become very ill and require intubation with intensive care monitoring. Immunomodulating treatment should be used for any child who loses the ability to walk. To date, no well-controlled study has been completed analyzing the relative merits of the two most commonly used therapies, namely plasmapheresis or intravenously administered immunoglobulin.     

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.     

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.     

The children’s services interview: validity and reliability

Background The Children Service Interview was designed as a brief measure of service use related to mental health problems in Great Britain. Method We validated the Children’s Services Interview against medical records from a sample of 87 children, and assessed test–retest reliability from 25 parents completing two interviews. We examined criterion validity by looking at the service use patterns of children attending clinics for different types of disorders. Results The Children’s Services Interview showed high levels of face validity and moderate or better concordance with medical records as far as contacts were recorded in the case notes. Test–retest reliability was moderate or better apart from contacts with the voluntary sector, teachers, and the number and duration of appointments with some professionals. Conclusion The study suggests the Children’s Services Interview can extract moderately valid and reliable data on service use. Declaration of interest Tamsin Ford was supported by a Wellcome Clinical Training Fellowship in Health Services Research while completing this work.     

Pictures and their colors: what do children remember?

Theories regarding children's reliability as witnesses suggest that children are more likely to confuse memories from different sources especially when the sources are highly similar. To investigate the developmental aspects of source retrieval, we measured brain electrical activity from children and adults while they retrieved content and source information. Similar brain responses among the age groups were found when participants were asked to retrieve content information. However, retrieval of source information improved with age and was accompanied by different patterns of brain potentials. The results implicate immaturity of frontal lobe structures in children's difficulty in retrieving source information.     

Self-perception of children and adolescents with Möbius sequence

Möbius sequence is a rare congenital disorder usually defined as a combination of facial weakness with impairment of ocular abduction. Some studies suggest that psychosocial and psychiatric problems might be increased among affected persons. So far, there have been no studies on the self-perception of children and adolescents with the sequence. Seventeen participants with Möbius sequence (9 male, 8 female) aged 9-15 (mean: 11.59) years were studied. None of the probands was mentally retarded or had a diagnosis of autism spectrum disorder. Participants filled out well standardized German questionnaires on depression (Depressionsinventar für Kinder und Jugendliche [DIKJ]), anxiety (Angstfragebogen für Schüler [AFS]) and personality aspects (Persönlichkeitsfragebogen für Kinder von 9-14 Jahren [PFK 9-14]). Additionally, their primary caregivers were asked to complete a special questionnaire to compile the probands’ personal, somatic and psychosocial history as well as the German version of the Strengths and Difficulties Questionnaire, Parent Form [SDQ-Deu]. According to the participants’ self-perception only one girl scored clinical (t-score ≥ 63) for manifest anxiety [AFS] and depression [DIKJ] (5.9% vs. 10% in the general population). Moreover, the whole sample reported significantly lower test anxiety (p = 0.000) and manifest anxiety (p = 0.005) [AFS] whereas general anxiety as a personality aspect [PFK 9-14] did not differ from the normative sample. Compared to normative data, subjects expressed significantly less depression (p = 0.023) and impulsivity (p = 0.042). One out of 17 subjects was rated abnormal for total problems on the SDQ-Deu (5.9% vs. 10% of the normative sample), five participants scored abnormal for social problems (29.4%) and three for emotional problems (17.6%). Social problems correlated significantly with the probands’ age (rho = 0.707; p = 0.002). As Möbius patients have severe difficulties with facial expression of feelings, and others might therefore falsely recognize them as serious or even depressed, the subjects’ self-perception is crucial for assessment and diagnosis, especially if it differs considerably from that of the primary caregivers.     

How many children and adolescents do receive a combined behavioral and psychopharmacological therapy?

So far in German literature no empirical data are present concerning parallel medications of behavioral therapy. Also the international research does not treat this topic sufficiently. For this reason this work examines on the basis from reports of requests for behavioral therapy, which medications or groups of substances were used for which child and adolescent psychiatric disorders treated by behavioral therapy. It examines additionally whether correlations of such combinations exist to specific socio-demographic or school-characteristics. Out of 1021 first and subsequent requests for behavioral therapy from the years 2001 variables were retrospectively evaluated regarding intear alia diagnosis, sociodemographic data, school situation, somatic comorbidities or therapies and therapy indication. Results reveal out of five children or adolescents one has an behavioral therapy plus an additional psychopharmacological treatment. 80% of these medications are psychostimulants. Half of the children and adolescents suffering from ADHD or conduct disorders are treated with such, while diagnosis of other domains contribute to combined therapies only with a small percentage. Differences between non-treated and psychopharmacologically treated children and adolescents with ADHD or conduct disorders are presented.     

Does pervasive developmental disorder protect children and adolescents against drug and alcohol use?

Aim The aim of this paper is (1) to compare the rates of reported drug and/or alcohol use (DAU) in treatment seeking adolescents with Pervasive Developmental Disorders (PDD), and those with other psychiatric diagnoses (psychiatric controls) seen in tertiary child and adolescent mental health services and (2) to explore the relationship of psychopathology, environmental stressors, and social communication difficulties to DAU. Method Data from the chart review of children and adolescents aged between 12 and 18 years with psychiatric diagnosis seen in tertiary child and adolescent mental health services between 1992 and 2001 (n=1484) was used to investigate the relationship between DAU, psychopathology, environmental stressors and items related to social communication. Results A total of 97 subjects (7%) met criteria for PDD. Subjects with PDD report significantly lower DAU than psychiatric controls, 3% vs. 17% respectively (P<0.000). Factors reflecting PDD such as speech and language difficulties, developmental difficulties, discordant peer relationships in adolescents are negatively associated with DAU, while conduct problems, affective symptoms, inadequate parental supervision or control have positive association with DAU. DAU was present in PDD only when comorbid with Attention Deficit Hyperactivity Disorder (ADHD). Conclusion Adolescents with speech and language difficulties, developmental difficulties and discordant peer relationships, all reflecting PDD, are less likely to have DAU.     

Preschool children with obsessive–compulsive disorder and fluoxetine treatment

Obsessive–compulsive disorder (OCD) is an anxiety disorder which can substantially disable children’s ability to function at home and school. Clinicians frequently rely on knowledge about symptoms that can be examined early in treatment to determine future treatment effectiveness. However, OCD in preschoolers has also received little attention in literature. To the best of our knowledge, there is only one retrospective chart review and one case report in the literature for preschool cases treated with SSRIs. Therefore, the effect of fluoxetine on preschool children was imprecisely understood. The aim of this case report was to examine the efficacy and safety of fluoxetine treatment for pediatric OCD. Four preschool children with OCD completed an 8-week fluoxetine (up to 20 mg) trial. We diagnosed OCD according to Diagnostic and statistical manual of mental disorders, 4th edition, text revision (DSM-IV-TR) criteria and symptoms of OCD were assessed with the Childrens’ Yale-Brown Obsessive Compulsive Scale (CY-BOCS). Initial and post-treatment symptom severity and improvement were assessed by using the severity (S) and improvement (I) scales of Clinical Global Impressions Scale (CGI). The CY-BOCS total, obsessions and compulsions subscale scores and CGI-S scores were significantly improved for all of the cases at the end of the eighth week. In this case report four preschool children, with severe OCD and resistant to the previous non-psychopharmacologic treatment responded well to fluoxetine monotherapy. On the other hand, the usage of SSRIs in preschool children remains highly controversial, due to the lack of data on safety and efficacy.     

Posterior fossa subdural empyema in children��management and outcome

Aims  

The aims of this study were to analyze the clinical features, radiologic findings, bacteriologic spectrum, and management protocols and outcomes in posterior fossa subdural empyemas in children.