Speech and non-speech processing in children with phonological disorders: an electrophysiological study

OBJECTIVE:

To determine whether neurophysiological auditory brainstem responses to clicks and repeated speech stimuli differ between typically developing children and children with phonological disorders.

INTRODUCTION:

Phonological disorders are language impairments resulting from inadequate use of adult phonological language rules and are among the most common speech and language disorders in children (prevalence: 8 ‐ 9%). Our hypothesis is that children with phonological disorders have basic differences in the way that their brains encode acoustic signals at brainstem level when compared to normal counterparts.

METHODS:

We recorded click and speech evoked auditory brainstem responses in 18 typically developing children (control group) and in 18 children who were clinically diagnosed with phonological disorders (research group). The age range of the children was from 7‐11 years.

RESULTS:

The research group exhibited significantly longer latency responses to click stimuli (waves I, III and V) and speech stimuli (waves V and A) when compared to the control group.

DISCUSSION:

These results suggest that the abnormal encoding of speech sounds may be a biological marker of phonological disorders. However, these results cannot define the biological origins of phonological problems. We also observed that speech‐evoked auditory brainstem responses had a higher specificity/sensitivity for identifying phonological disorders than click‐evoked auditory brainstem responses.

CONCLUSIONS:

Early stages of the auditory pathway processing of an acoustic stimulus are not similar in typically developing children and those with phonological disorders. These findings suggest that there are brainstem auditory pathway abnormalities in children with phonological disorders.     

Noise-induced tinnitus: auditory evoked potential in symptomatic and asymptomatic patients

OBJECTIVES:

We evaluated the central auditory pathways in workers with noise-induced tinnitus with normal hearing thresholds, compared the auditory brainstem response results in groups with and without tinnitus and correlated the tinnitus location to the auditory brainstem response findings in individuals with a history of occupational noise exposure.

METHOD:

Sixty individuals participated in the study and the following procedures were performed: anamnesis, immittance measures, pure-tone air conduction thresholds at all frequencies between 0.25–8 kHz and auditory brainstem response.

RESULTS:

The mean auditory brainstem response latencies were lower in the Control group than in the Tinnitus group, but no significant differences between the groups were observed. Qualitative analysis showed more alterations in the lower brainstem in the Tinnitus group. The strongest relationship between tinnitus location and auditory brainstem response alterations was detected in individuals with bilateral tinnitus and bilateral auditory brainstem response alterations compared with patients with unilateral alterations.

CONCLUSION:

Our findings suggest the occurrence of a possible dysfunction in the central auditory nervous system (brainstem) in individuals with noise-induced tinnitus and a normal hearing threshold.     

Formal auditory training in adult hearing aid users

INTRODUCTION

Individuals with sensorineural hearing loss are often able to regain some lost auditory function with the help of hearing aids. However, hearing aids are not able to overcome auditory distortions such as impaired frequency resolution and speech understanding in noisy environments. The coexistence of peripheral hearing loss and a central auditory deficit may contribute to patient dissatisfaction with amplification, even when audiological tests indicate nearly normal hearing thresholds.

OBJECTIVE

This study was designed to validate the effects of a formal auditory training program in adult hearing aid users with mild to moderate sensorineural hearing loss.

METHODS

Fourteen bilateral hearing aid users were divided into two groups: seven who received auditory training and seven who did not. The training program was designed to improve auditory closure, figure-to-ground for verbal and nonverbal sounds and temporal processing (frequency and duration of sounds). Pre- and post-training evaluations included measuring electrophysiological and behavioral auditory processing and administration of the Abbreviated Profile of Hearing Aid Benefit (APHAB) self-report scale.

RESULTS

The post-training evaluation of the experimental group demonstrated a statistically significant reduction in P3 latency, improved performance in some of the behavioral auditory processing tests and higher hearing aid benefit in noisy situations (p-value < 0,05). No changes were noted for the control group (p-value <0,05).

CONCLUSION

The results demonstrated that auditory training in adult hearing aid users can lead to a reduction in P3 latency, improvements in sound localization, memory for nonverbal sounds in sequence, auditory closure, figure-to-ground for verbal sounds and greater benefits in reverberant and noisy environments.     

Sensitivity and specificity of auditory steady-state response testing

INTRODUCTION:

The ASSR test is an electrophysiological test that evaluates, among other aspects, neural synchrony, based on the frequency or amplitude modulation of tones.

OBJECTIVE:

The aim of this study was to determine the sensitivity and specificity of auditory steady‐state response testing in detecting lesions and dysfunctions of the central auditory nervous system.

METHODS:

Seventy volunteers were divided into three groups: those with normal hearing; those with mesial temporal sclerosis; and those with central auditory processing disorder. All subjects underwent auditory steady‐state response testing of both ears at 500 Hz and 2000 Hz (frequency modulation, 46 Hz). The difference between auditory steady‐state response‐estimated thresholds and behavioral thresholds (audiometric evaluation) was calculated.

RESULTS:

Estimated thresholds were significantly higher in the mesial temporal sclerosis group than in the normal and central auditory processing disorder groups. In addition, the difference between auditory steady‐state response‐estimated and behavioral thresholds was greatest in the mesial temporal sclerosis group when compared to the normal group than in the central auditory processing disorder group compared to the normal group.

DISCUSSION:

Research focusing on central auditory nervous system (CANS) lesions has shown that individuals with CANS lesions present a greater difference between ASSR‐estimated thresholds and actual behavioral thresholds; ASSR‐estimated thresholds being significantly worse than behavioral thresholds in subjects with CANS insults. This is most likely because the disorder prevents the transmission of the sound stimulus from being in phase with the received stimulus, resulting in asynchronous transmitter release. Another possible cause of the greater difference between the ASSR‐estimated thresholds and the behavioral thresholds is impaired temporal resolution.

CONCLUSIONS:

The overall sensitivity of auditory steady‐state response testing was lower than its overall specificity. Although the overall specificity was high, it was lower in the central auditory processing disorder group than in the mesial temporal sclerosis group. Overall sensitivity was also lower in the central auditory processing disorder group than in the mesial temporal sclerosis group.     

Comparison of different speech tasks among adults who stutter and adults who do not stutter

OBJECTIVES:

In this study, we compared the performance of both fluent speakers and people who stutter in three different speaking situations: monologue speech, oral reading and choral reading. This study follows the assumption that the neuromotor control of speech can be influenced by external auditory stimuli in both speakers who stutter and speakers who do not stutter.

METHOD:

Seventeen adults who stutter and seventeen adults who do not stutter were assessed in three speaking tasks: monologue, oral reading (solo reading aloud) and choral reading (reading in unison with the evaluator). Speech fluency and rate were measured for each task.

RESULTS:

The participants who stuttered had a lower frequency of stuttering during choral reading than during monologue and oral reading.

CONCLUSIONS:

According to the dual premotor system model, choral speech enhanced fluency by providing external cues for the timing of each syllable compensating for deficient internal cues.     

Metabolic disorders prevalence in sudden deafness

OBJECTIVES:

The aim of the present study was to establish the frequency of metabolic disorders among patients with sudden deafness and to compare this frequency with data from population surveys.

INTRODUCTION:

No consensus has been reached regarding the prevalence of metabolic disorders among sudden deafness patients or their influence as associated risk factors.

METHODS:

This cross‐sectional study enrolled all sudden deafness patients treated in the Otolaryngology Department of the University of São Paulo between January 1996 and December 2006. Patients were subjected to laboratory exams including glucose and cholesterol levels, low‐density lipoprotein cholesterol fraction, triglycerides, free T4 and TSH.

RESULTS:

The sample comprised 166 patients. We observed normal glucose levels in 101 (81.5%) patients and hyperglycemia in 23 (18.5%) patients, which is significantly different (p < 0.0001) compared to the diabetes mellitus prevalence (7.6%) in the Brazilian population. Cholesterol levels were normal in 78 patients (49.7%) and abnormal in 79 (50.3%) patients, which is significantly different compared to the Brazilian population (p  =  0.0093). However, no differences were observed in low‐density lipoprotein cholesterol fraction (p  =  0.1087) or triglyceride levels (p  =  0.1474) between sudden hearing loss patients and the Brazilian population. Normal levels of thyroid hormones were observed in 116 patients (78.4%), and abnormal levels were observed in 32 (21.6%) patients. Compared with the prevalence of thyroid disorders in the general population (10%), statistical analysis revealed a significant difference (p  =  0.0132) between these two groups.

DISCUSSION:

Among sudden deafness patients, we observed frequencies of hyperglycemia and thyroid disorders that were more than twice those of the general population.

CONCLUSIONS:

Hyperglycemia and thyroid disorders are much more frequent in patients with sudden deafness than in the general population and should be considered as important associated risk factors.     

Modafinil Increases Arousal Determined by P13 Potential Amplitude: An Effect Blocked by Gap Junction Antagonists

Study Objectives:

We recorded the effects of administration of the stimulant modafinil on the amplitude of the sleep state-dependent auditory P13 evoked potential in freely moving rats, a measure of arousal thought to be generated by the cholinergic arm of the reticular activating system, specifically the pedunculopontine nucleus (PPN).

Design:

Groups of rats were implanted for recording auditory evoked responses and the effects on P13 potential amplitude of intracranial injections into the PPN of neuroactive agents determined.

Measurements and Results:

The effects of intracranial injections into the PPN of modafinil showed that P13 potential amplitude increased in a dose-dependent manner at doses of 100, 200, and 300 μM. The effect was blocked by pretreatment with either of the gap junction an-tagonists carbenoxolone (300 μM) or mefloquine (25 μM), which by themselves slightly decreased P13 potential amplitude.

Conclusions:

These results suggest that modafinil increases arousal levels as determined by the amplitude of the P13 potential, an effect blocked by gap junction antagonists, suggesting that one mechanism by which modafinil increases arousal may be by increasing electrical coupling.

Citation:

Beck P; Odle A; Wallace-Huitt T; Skinner RD; Garcia-Rill E. Modafinil Increases Arousal Determined by P13 Potential Amplitude: An Effect Blocked by Gap Junction Antagonists. SLEEP 2008;31(12):1647–1654.     

Acoustic analyses of diadochokinesis in fluent and stuttering children

OBJECTIVES:

The purpose of the study was to acoustically compare the performance of children who do and do not stutter on diadochokinesis tasks in terms of syllable duration, syllable periods, and peak intensity.

METHODS:

In this case-control study, acoustical analyses were performed on 26 children who stutter and 20 aged-matched normally fluent children (both groups stratified into preschoolers and school-aged children) during a diadochokinesis task: the repetition of articulatory segments through a task testing the ability to alternate movements. Speech fluency was assessed using the Fluency Profile and the Stuttering Severity Instrument.

RESULTS:

The children who stutter and those who do not did not significantly differ in terms of the acoustic patterns they produced in the diadochokinesis tasks. Significant differences were demonstrated between age groups independent of speech fluency. Overall, the preschoolers performed poorer. These results indicate that the observed differences are related to speech-motor age development and not to stuttering itself.

CONCLUSIONS:

Acoustic studies demonstrate that speech segment durations are most variable, both within and between subjects, during childhood and then gradually decrease to adult levels by the age of eleven to thirteen years. One possible explanation for the results of the present study is that children who stutter presented higher coefficients of variation to exploit the motor equivalence to achieve accurate sound production (i.e., the absence of speech disruptions).     

The effects of auditory stimulation with music on heart rate variability in healthy women

OBJECTIVES:

There are no data in the literature with regard to the acute effects of different styles of music on the geometric indices of heart rate variability. In this study, we evaluated the acute effects of relaxant baroque and excitatory heavy metal music on the geometric indices of heart rate variability in women.

METHODS:

We conducted this study in 21 healthy women ranging in age from 18 to 35 years. We excluded persons with previous experience with musical instruments and persons who had an affinity for the song styles. We evaluated two groups: Group 1 (n = 21), who were exposed to relaxant classical baroque musical and excitatory heavy metal auditory stimulation; and Group 2 (n = 19), who were exposed to both styles of music and white noise auditory stimulation. Using earphones, the volunteers were exposed to baroque or heavy metal music for five minutes. After the first music exposure to baroque or heavy metal music, they remained at rest for five minutes; subsequently, they were re-exposed to the opposite music (70-80 dB). A different group of women were exposed to the same music styles plus white noise auditory stimulation (90 dB). The sequence of the songs was randomized for each individual. We analyzed the following indices: triangular index, triangular interpolation of RR intervals and Poincaré plot (standard deviation of instantaneous beat-by-beat variability, standard deviation of the long-term RR interval, standard deviation of instantaneous beat-by-beat variability and standard deviation of the long-term RR interval ratio), low frequency, high frequency, low frequency/high frequency ratio, standard deviation of all the normal RR intervals, root-mean square of differences between the adjacent normal RR intervals and the percentage of adjacent RR intervals with a difference of duration greater than 50 ms. Heart rate variability was recorded at rest for 10 minutes.

RESULTS:

The triangular index and the standard deviation of the long-term RR interval indices were reduced during exposure to both music styles in the first group and tended to decrease in the second group whereas the white noise exposure decreased the high frequency index. We observed no changes regarding the triangular interpolation of RR intervals, standard deviation of instantaneous beat-by-beat variability and standard deviation of instantaneous beat-by-beat variability/standard deviation in the long-term RR interval ratio.

CONCLUSION:

We suggest that relaxant baroque and excitatory heavy metal music slightly decrease global heart rate variability because of the equivalent sound level.     

GABAergic Antagonism of the Central Nucleus of the Amygdala Attenuates Reductions in Rapid Eye Movement Sleep After Inescapable Footshock Stress

Study Objectives:

Rapid eye movement sleep (REM) appears to be especially susceptible to the effects of stress; inescapable footshock stress (IS) can produce reductions in REM that can occur without recovery sleep. The amygdala has well-established roles in stress and emotion; the central nucleus of the amygdala (CNA) projects to REM regulatory regions in the brainstem and has been found to play a key role in the regulation of REM. The objective of this study was to determine whether the reduction in REM induced by IS could be regulated by CNA and brainstem regions.

Design:

The GABAergic agonist muscimol (MUS) and GABAergic antagonist bicuculline (BIC) were microinjected into CNA before IS, and sleep was recorded for 20 h. In a second experiment using the same manipulations, sleep was recorded for 2 h, after which the rats were killed to evaluate Fos expression (a marker of neuronal activity) in the locus coeruleus (LC), a brainstem REM regulatory region.

Setting:

NA.

Patients or Participants:

The subjects were male, outbred Wistar rats.

Interventions:

The rats were surgically implanted with standard electrodes or with telemetry transmitters for determining arousal state.

Measurements and Results:

IS preceded by control or MUS microinjections selectively reduced REM and increased Fos expression in LC. By comparison, microinjection of BIC into CNA prior to IS attenuated both the reduction in REM and Fos expression in LC to levels seen in non-shocked controls.

Conclusions:

The results suggest that the effects of IS on REM may involve local GABAergic inhibition in CNA and activation of LC.

Citation:

Liu X; Yang L; Wellman LL; Tang X; Sanford LD. GABAergic antagonism of the central nucleus of the amygdala attenuates reductions in rapid eye movement sleep after inescapable footshock stress. SLEEP 2009;32(7):888-896.     

The influence of (central) auditory processing disorder on the severity of speech-sound disorders in children

OBJECTIVE:To identify a cutoff value based on the Percentage of Consonants Correct-Revised index that could indicate the likelihood of a child with a speech-sound disorder also having a (central) auditory processing disorder.METHODS:Language, audiological and (central) auditory processing evaluations were administered. The participants were 27 subjects with speech-sound disorders aged 7 to 10 years and 11 months who were divided into two different groups according to their (central) auditory processing evaluation results.RESULTS:When a (central) auditory processing disorder was present in association with a speech disorder, the children tended to have lower scores on phonological assessments. A greater severity of speech disorder was related to a greater probability of the child having a (central) auditory processing disorder. The use of a cutoff value for the Percentage of Consonants Correct-Revised index successfully distinguished between children with and without a (central) auditory processing disorder.CONCLUSIONS: The severity of speech-sound disorder in children was influenced by the presence of (central) auditory processing disorder. The attempt to identify a cutoff value based on a severity index was successful.     

Days out-of-role due to common physical and mental health problems: Results from the São Paulo Megacity Mental Health Survey,Brazil

OBJECTIVES:

To investigate the relative importance of common physical and mental disorders with regard to the number of days out-of-role (DOR; number of days for which a person is completely unable to work or carry out normal activities because of health problems) in a population-based sample of adults in the São Paulo Metropolitan Area, Brazil.

METHODS:

The São Paulo Megacity Mental Health Survey was administered during face-to-face interviews with 2,942 adult household residents. The presence of 8 chronic physical disorders and 3 classes of mental disorders (mood, anxiety, and substance use disorders) was assessed for the previous year along with the number of days in the previous month for which each respondent was completely unable to work or carry out normal daily activities due to health problems. Using multiple regression analysis, we examined the associations of the disorders and their comorbidities with the number of days out-of-role while controlling for socio-demographic variables. Both individual-level and population-level associations were assessed.

RESULTS:

A total of 13.1% of the respondents reported 1 or more days out-of-role in the previous month, with an annual median of 41.4 days out-of-role. The disorders considered in this study accounted for 71.7% of all DOR; the disorders that caused the greatest number of DOR at the individual-level were digestive (22.6), mood (19.9), substance use (15.0), chronic pain (16.5), and anxiety (14.0) disorders. The disorders associated with the highest population-attributable DOR were chronic pain (35.2%), mood (16.5%), and anxiety (15.0%) disorders.

CONCLUSIONS:

Because pain, anxiety, and mood disorders have high effects at both the individual and societal levels, targeted interventions to reduce the impairments associated with these disorders have the highest potential to reduce the societal burdens of chronic illness in the São Paulo Metropolitan Area.     

Evaluation of the quality of life and risk of suicide

OBJECTIVE:

To identify the socio-demographic profiles, suicidal ideation, the presence of mental disorders and the quality of life of patients using mental health services in Arapiraca, Alagoas, Brazil.

METHOD:

Interviews were conducted in family health units and the Psychosocial Attention Center. The sample included 202 mental disorder patients with a risk of suicide attempts, 207 mental disorder patients without a risk of suicide attempts and 196 controls. This study used an identification questionnaire, the abbreviated World Health Organization Quality of Life questionnaire, Beck‘s Suicidal Ideation Scale and the Mini International Neuropsychiatric Interview.

RESULTS:

Patients who had a mental disorder and a risk of suicide attempts tended to be single, had less education and lower family income, were not working and showed lower scores in quality of life domains; 73 of these patients had suicidal ideation in the previous week. Depressive disorders, manic episodes, hypomanic episodes, social phobias, obsessive compulsive disorder, post-traumatic stress disorder, psychotic syndromes and generalized anxiety disorder were more frequent and statistically significant for patients at risk for suicide attempts.

CONCLUSION:

The management of patients with a risk of suicide attempts must focus on individual patients because this risk is directly linked to changes in quality of life and the improvement of these patients'' prognosis.     

Sleep Problems and Disorders among Adolescents with Persistent and Subthreshold Attention-deficit/Hyperactivity Disorders

Study Objectives:

To investigate the sleep schedules, problems, and disorders among adolescents with persistent attention-deficit/hyperactivity disorder (ADHD) and those with partially remitted ADHD symptoms.

Design:

A case-control study.

Setting:

National Taiwan University and schools in Taipei

Patients or Participants:

The sample included 281 adolescents (male, 85.4%; 145 with persistent ADHD, 136 with subthreshold ADHD), aged 11 to 17, who were diagnosed with ADHD, according to DSM-IV criteria, at the mean age of 6.7 years (SD = 3.0) and 185 unaffected control subjects.

Interventions:

N/A.

Measurements and Results:

We conducted psychiatric interviews of participants and their mothers using the Chinese Kiddie-Schedule for Affective Disorders and Schizophrenia-Epidemiology version for making the diagnoses of ADHD, other psychiatric disorders, and sleep problems or disorders. We also collected the medication treatment data and parent and teacher reports of ADHD-related symptoms. Our results showed that adolescents with a childhood diagnosis of ADHD according to DSM-IV criteria, regardless of persistent ADHD, were more likely to have current and lifetime sleep problems and sleep disorders according to DSM-IV (insomnia, sleep terrors, nightmares, bruxism, and snoring). The presence of at least 1 psychiatric comorbid condition increased the risks for insomnia and nightmares. The use of methylphenidate was not associated with further increased risk of sleep problems, except bruxism.

Conclusions:

Our findings support a relationship between ADHD and sleep problems, which can be partially explained by the psychiatric comorbidities, but did not support a disturbed sleep schedule. Our study suggests that mental health professionals should screen for sleep problems and psychiatric comorbidities among adolescents with a childhood diagnosis of ADHD regardless of the severity of current ADHD symptoms.

Citation:

Gau SSF; Chiang HL. Sleep problems and disorders among adolescents with persistent and subthreshold attention-deficit/hyperactivity disorders. SLEEP 2009;32(5):671-679.     

Restless Legs Syndrome in a Community Sample of Korean Adults: Prevalence,Impact on Quality of Life,and Association with DSM-IV Psychiatric Disorders

Study Objectives:

Conflicting reports on prevalence of RLS exist in Asian countries due to differences in sampling strategies and assessment instruments. We assessed the prevalence, correlates, quality of life, and psychiatric comorbidity of RLS in South Korea.

Design/setting:

Cross-sectional nationwide survey.

Participants:

Nationally representative sample of 6,509 Korean adults aged 18–64.

Measurement & Results:

Face-to-face interviews based on the Korean translation of the four features of RLS defined by the International RLS Study Group (IRLSSG), the Korean version of Composite International Diagnostic Interview (K-CIDI), and EuroQol (EQ-5D) were conducted for all participants. The weighted prevalence of RLS in South Korea was 0.9% (men, 0.6%; women, 1.3%). Subjects with RLS had a lower quality of life according to EQ-5D than those without RLS. Adjusted odds ratio for lifetime diagnosis of DSM-IV major depressive disorder (2.57, 95% confidence interval [1.33, 4.96]), panic disorder (18.9 [4.72, 75.9]) and posttraumatic stress disorder (3.76 [1.32, 10.7]) suggest strong association between RLS and DSM-IV depression and anxiety disorders.

Conclusions:

Prevalence of RLS estimated based on the IRLSSG diagnostic criteria is substantially lower in South Korea than in Western countries. Differences in culture and risk factors that affect the expression of RLS may vary across the countries.

Citation:

Cho SJ; Hong JP; Hahm BJ; Jeon HJ; Chang SM; Cho MJ; Lee HB. Restless legs syndrome in a community sample of korean adults: prevalence, impact on quality of life, and association with DSM-IV psychiatric disorders. SLEEP 2009;32(8):1069-1076.     

Insomnia,Depression, and Physical Disorders in Late Life: A 2-year Longitudinal Community Study in Koreans

Study Objectives:

To investigate prevalence, incidence, and persistence of insomnia, and their bidirectional longitudinal associations with depression and physical disorders.

Design:

A community based longitudinal study.

Setting:

Elders living in private households in South Korea.

Participants:

1204 people ≥ 65 years of age were evaluated at baseline; 909 of them (75%) were re-interviewed after 2 years.

Measurements and Results:

Insomnia was defined as difficulty in initiation or maintenance of sleep ≥ 3 nights per week over the last month. Diagnosis of depression (Geriatric Mental State) and number of physical disorders were ascertained. Sociodemographic and clinical covariates included age, gender, education, housing, past occupation, current employment, living area, life events, social deficit, physical activity, cognitive impairment, anxiety, and daily drinking. Of those (27%) with insomnia at baseline, 40% had insomnia at follow-up. Of those without insomnia at baseline, 23% had insomnia at follow-up. Baseline depression was significantly associated with prevalence and incidence of insomnia. Baseline number of physical disorders was significantly associated with prevalence, incidence, and persistence of insomnia. Baseline insomnia was independently associated with incident depression and an increase in reported physical disorders.

Conclusions:

Insomnia was common and often persistent in this population. Insomnia was closely and reciprocally related to depression and physical disorders.

Citation:

Kim JM; Stewart R; Kim SW; Yang SJ; Shin IS; Yoon JS. Insomnia, depression, and physical disorders in late life: a 2-year longitudinal community study in Koreans. SLEEP 2009;32(9):1221-1228.     

Sleep and Sleep Disturbance in Children: Reliability and Validity of the Dutch Version of the Child Sleep Habits Questionnaire

Study Objectives:

The Child Sleep Habits Questionnaire (CSHQ) was developed in the US for measuring medical and behavioral sleep disorders in school-aged children. This study was conducted to assess the reliability and structural validity of the Dutch version of the CSHQ.

Design:

Population-based study

Setting:

Questionnaires (n = 2385) were distributed to children in primary schools and daycare centers to be completed by the parent/guardian. An identical second questionnaire was distributed for test-retest and interobserver reliability, which were assessed using intraclass correlation, and compared with published data. Internal consistency was assessed by Cronbach α (per subscale). Validity was analyzed by confirmatory and exploratory factor analysis.

Participants:

School-aged children.

Interventions:

None.

Measurements & Results:

The questionnaire was returned by 1502 (63%) parents, 47% returned the questionnaire for test-retest, and 32% for interobserver reliability. Test-retest reliability was moderate to good, ranging from 0.47 to 0.93. Interobserver reliability was moderate to good, ranging from 0.53 to 0.87, with the exception of Sleep duration. Cronbach α ranged from 0.47 to 0.68. In confirmatory factor analysis the domain structure of the original American CSHQ could not be confirmed. Exploratory factor analysis suggested a 4-factor structure rather than the original 8 domains.

Conclusions:

The CSHQ seems to have an adequate reliability and moderate internal consistency in a Dutch population with different sociocultural characteristics than the US population in which it was devised. Factor analysis suggests that translation, cultural background, or subscales of the original instrument may affect the performance of the CSHQ.

Citation:

Waumans RC; Terwee CB; Van den Berg G; Knol DL; Van Litsenburg RRL; Gemke RJBJ. Sleep and sleep disturbance in children: reliability and validity of the Dutch version of the Child Sleep Habits Questionnaire. SLEEP 2010;33(6):841-845.     

Sleep Disturbances in Prepubertal Children with Attention Deficit Hyperactivity Disorder: A Home Polysomnography Study

Study Objectives:

To examine sleep architecture and reported sleep problems in children with ADHD and normal controls, while considering the roles of pertinent moderating factors.

Design:

Overnight sleep recordings were conducted in 15 children diagnosed with ADHD (DSM-IV) without comorbid psychiatric problems and in 23 healthy controls aged 7 to 11 years. Children were on no medication, in good health and did not consume products containing caffeine ≥ 7 days prior to the polysomnography (PSG) study. PSG evaluation was performed at each child''s home; children slept in their regular beds and went to bed at their habitual bedtimes.

Measurements

Standard overnight multichannel PSG evaluation was performed using a portable polysomnography device. In addition, parents were asked to complete a sleep questionnaire.

Results:

Compared to controls, children in the ADHD group had significantly shorter duration of REM sleep, smaller percentage of total sleep time spent in REM sleep, and shorter sleep duration. In addition, the ADHD group had higher scores on the insufficient sleep and sleep anxiety factors than children in the control group.

Conclusions:

The present findings support the hypothesis that children with ADHD present sleep disturbances.

Citation:

Gruber R; Xi T; Frenette S; Robert M; Vannasinh P; Carrier J. Sleep disturbances in prepubertal children with attention deficit hyperactivity disorder: A home polysomnography study. SLEEP 2009;32(3):343-350.