全面性发育迟缓婴幼儿脑白质磁共振扩散张量成像特点研究及影响因素分析

目的 探究磁共振扩散张量成像对全面性发育迟缓婴幼儿脑白质的定量,目的在于为全面性发育迟缓婴幼儿的诊断提供一种可靠的影像学手段。方法 将深圳罗湖医院从2018年4月-2020年12月收治的全面性发育迟缓婴幼儿47例纳入研究,为发育迟缓组。另取50例发育正常儿童作为健康对照组。分别对所有受试者均开展常规MRI检查以及扩散张量成像,比较各测量部位的各向异性(FA)值以及平均扩散率(MD)值。此外,以单因素、多因素Logistic回归分析明确全面性发育迟缓婴幼儿的影响因素。结果发育迟缓组额叶、颞叶、枕叶以及半卵圆中心的FA值分别为(0.250±0.049)、(0.364±0.049)、(0.240±0.039)、(0.402±0.041),均低于健康对照组的(0.344±0.054)、(0.397±0.044)、(0.345±0.053)、(0.465±0.072),差异有统计学意义(P<0.05)。发育迟缓组额叶、颞叶、枕叶以及半卵圆中心的MD值分别为(0.928±0.062)、(0.994±0.087)、(0.955±0.047)、(0.916±0.049),均高于健康对照组的(0....     

精神发育迟缓和孤独症儿童家长的心理健康现状及影响因素

目的:调查精神发育迟缓、孤独症儿童家长的心理健康与应对方式现状以及相关影响因素。方法:采用简易心理状况评定量表Kessler10(中文版)和简易应对方式问卷对枣庄市精神卫生中心99名在训的精神发育迟缓和孤独症患儿家长进行问卷调查,通过t检验和线性回归对数据进行统计分析。结果:孤独症儿童家长和精神发育迟缓儿童家长存在中度的心理健康问题,并且应对倾向为正向应对。孤独症儿童家长和精神发育迟缓儿童家长在心理健康和应对方式方面差异无统计学意义。儿童是否独生、患病年龄对患儿家长心理健康影响显著。结论:儿童是否独生、患病年龄对孤独症儿童家长和精神发育迟缓儿童家长心理健康影响显著。     

儿童精神运动发育迟缓50例临床分析

目的探讨儿童运动发育迟缓的临床特点和干预措施。方法对50例儿童运动发育迟缓患儿的临床资料进行回顾性分析和总结。结果经过综合干预措施,对其中30例进行跟踪筛查,10例患儿运动发育水平恢复正常,10例未能达到正常儿童水平者,确诊为儿童运动发育迟缓,10例有明显姿势异常及运动障碍者,确诊为脑瘫。结论坚持跟踪、观察,早期发现及干预是预防儿童运动发育迟缓的关键,采取综合措施可降低儿童运动发育迟缓的发生率、改善治疗效果。     

骨盆控制训练对脑瘫患儿运动功能及智力发育指数的影响

目的探讨骨盆控制训练对脑瘫患儿运动功能及智力发育指数的影响。方法将94例脑瘫患儿随机分为观察组和对照组。2组患儿均接受常规康复训练,观察组在此基础上增加骨盆控制训练。采用贝利婴幼儿发展量表(BSID)对患儿运动功能(PDI)及患儿智力发育状况(MDI)评定。结果骨盆控制训练干预后观察组PDI评分、MDI评分优于对照组,差异有统计学意义(P0.05)。结论小儿脑瘫通过骨盆控制训练干预能够改善患儿运动功能及智力发育情况,有临床实际效果。     

385例儿童运动发育迟缓临床分析与护理干预

目的探讨儿童运动发育迟缓相关因素,以利于早期诊疗及护理干预。方法对385例以运动发育落后为主要症状而就诊的患儿临床检查,视患儿情况分别给予生化检查、头颅MRI检查、心脏超声检查,疑有代谢异常者进一步行氨基酸、有机酸代谢相关检查及染色体、微阵列等检查。运动功能评估采用Peaboty运动量表,CDCC量表评价智力发育水平,以及听觉、视觉诱发电位检查、脑电图检查。结果 385例运动迟缓中231例表现肌张力增高或不全、姿势异常诊断脑瘫,其中早产66例(28.69%)。92例运动发育迟缓原因不明,智力低下致运动落后30例,基因缺陷等遗传代谢性疾病32例。并发症中小头畸形54例(23.3%),精神发育迟滞46例(19.9%),听力障碍46例(19.9%),癫痫26例(11.2%),斜视20例(8.7%),皮质盲11例(4.8%),先天性心脏病17例(7.4%),白内障5例(2.2%),唇裂3例(1.3%),尿道下裂3例(1.3%)。结论运动发育迟缓由多种因素引起,通过早期筛查可以发现儿童发育及环境因素,及时护理干预;病因诊断对于治疗、预后以及持续合理的医学管理、同胞的再发风险、家庭风险咨询、残疾预防均有积极的作用。     

儿童精神运动发育迟缓5O例临床分析

目的探讨儿童运动发育迟缓的临床特点和干预措施。方法对50例儿童运动发育迟缓患儿的临床资料进行回顾性分析和总结。结果经过综合干预措施,对其中30例进行跟踪筛查,10例患儿运动发育水平恢复正常,10例未能达到正常儿童水平者,确诊为儿童运动发育迟缓,10例有明显姿势异常及运动障碍者,确诊为脑瘫。结论坚持跟踪、观察,早期发现及干预是预防儿童运动发育迟缓的关键,采取综合措施可降低儿童运动发育迟缓的发生率、改善治疗效果。     

高危儿运动发育迟缓的早期识别及低频脉冲电治疗对其运动功能的影响

目的 探讨高危儿运动发育迟缓的早期识别及低频脉冲电治疗对其运动功能的影响。方法 选取2016年1月～2017年1月本院出生的100例高危儿作为研究对象,将所有患儿随机分为2组,对照组(50例)进行常规肢体综合训练,观察组(50例)在常规肢体综合训练基础上根据需要增加低频脉冲电治疗,治疗1、2、3、6个月后,分别对2组患儿采用Alberta婴儿运动发育量表进行运动评估,观察干预后的变化。结果 干预前观察组与对照组仰卧位、俯卧位、坐位和立位的AIMS评分、AMIS 总分的差异不明显(P>0.05); 观察组患儿干预的时间越长,AIMS总分越高,而对照组的AIMS总分无显著差异,2组患儿在经过1、2、3、6个月的干预后有明显差异(P<0.05); 2组患儿在干预前的AIMS百分位数比较无明显差异(P>0.05),干预后观察组明显大于对照组,观察组的运动发育异常患儿发生率明显降低,2组的差异明显(P<0.05)。结论 早期发现高危儿存在运动发育迟缓并给予早期康复训练能改善患儿远期生存质量,低频脉冲电治疗是治疗运动发育迟缓患儿的有效治疗方法,能帮助患儿早期功能恢复。     

脑干听觉诱发电位在听阈正常的语言发育迟缓患儿中的意义

目的 探讨脑干听觉诱发电位（BAEP）在听阈正常而语言发育迟缓患儿中的变化规律及应用价值.方法 分析100例听阈正常而语言发育迟缓患儿BAEP的变化规律;按年龄分组比较两个年龄段之间各波的延长时间.结果 （1）BAEP正常10例,异常90例,BAEP表现为Ⅰ、Ⅴ波潜伏期（PL）延长,Ⅲ~Ⅴ、Ⅰ~Ⅴ波峰间期（IPL）延长;（2）随着年龄增长,Ⅴ波PL与Ⅲ~Ⅴ波IPL延长时间越长.结论 Ⅰ波、Ⅴ波延长对早期诊断听阈正常而语言发育迟缓患儿具有一定的意义,说明即使听阈正常也可能存在听觉传导通路异常,且随着年龄增加,脑干上段受损越严重.     

伴精神发育迟缓癫痫患者的CT及脑电图特征

目的探讨伴精神发育迟缓癫痫患者的CT及脑电图表现特征,为伴精神发育迟缓癫痫患者的诊断提供参考。方法选取佛山市第三人民医院2016年1月-2018年1月收治的符合《国际疾病分类(第10版)》(ICD-10)诊断标准的伴精神发育迟缓癫痫患者44例,对其行颅脑CT扫描和脑电图检查,收集并分析CT扫描和脑电图资料。结果 CT扫描表现异常24例,异常率为54. 55%;脑电图检查表现异常39例,异常率为88. 64%。不同性别、年龄及智力水平患者的CT扫描结果差异均有统计学意义(P均0. 05),但脑电图结果差异均无统计学意义(P均 0. 05)。结论 CT扫描对伴精神发育迟缓癫痫的诊断敏感性不高,脑电图检查对伴精神发育迟缓癫痫的诊断具有较高敏感性,不同性别、年龄和智力水平患者的CT扫描结果存在差异,脑电图检查结果无差异。     

The effect of methylphenidate on Internet video game play in children with attention-deficit/hyperactivity disorder

Objective

A number of studies about attention-deficit/hyperactivity disorder (ADHD) and Internet video game play have examined the prefrontal cortex and dopaminergic system. Stimulants such as methylphenidate (MPH), given to treat ADHD, and video game play have been found to increase synaptic dopamine. We hypothesized that MPH treatment would reduce Internet use in subjects with co-occurring ADHD and Internet video game addictions.

Methods

Sixty-two children (52 males and 10 females), drug-naive, diagnosed with ADHD, and Internet video game players, participated in this study. At the beginning of the study and after 8 weeks of treatment with Concerta (OROS methylphenidate HCl, Seoul, Korea), participants were assessed with Young's Internet Addiction Scale, Korean version (YIAS-K), Korean DuPaul's ADHD Rating Scale, and the Visual Continuous Performance Test. Their Internet usage time was also recorded.

Results

After 8 weeks of treatment, the YIAS-K scores and Internet usage times were significantly reduced. The changes in the YIAS-K scores between the baseline and 8-week assessments were positively correlated with the changes in total and inattention scores from the Korean DuPaul's ADHD Rating Scale, as well as omission errors from the Visual Continuous Performance Test. There was also a significant difference in the number of omission errors among non-Internet-addicted, mildly Internet addicted, and severely Internet addicted participants.

Discussion

We suggest that Internet video game playing might be a means of self-medication for children with ADHD. In addition, we cautiously suggest that MPH might be evaluated as a potential treatment of Internet addiction.     

The impact of instruction and response cost on the modulation of response-style in children with ADHD

Background  

The present study investigated the impact of divergent instructions and response cost on strategic cognitive control in children with ADHD.     

丙戊酸钠治疗儿童多发性抽动症的疗效分析

目的探讨丙戊酸钠治疗儿童多发性抽动症的疗效。方法将68例多发性抽动症患儿随机分为观察组和对照组,对照组给予氟哌啶醇治疗,观察组给予丙戊酸钠治疗,比较2组治疗总有效率、运动抽动及发声抽动评分及不良反应发生情况。结果 2组总有效比较差异无统计学意义(P>0.05)。观察组治疗后8周后运动抽动及发声抽动评分均优于对照组,差异有统计学意义(P<0.05)。2组不良反应发生情况相当(P>0.05)。结论丙戊酸钠对儿童多发性抽动症的疗效较好,可有效改善患儿运动抽动及发声抽动症状,且不良反应较小,值得临床推广。     

The effect of family therapy on the changes in the severity of on-line game play and brain activity in adolescents with on-line game addiction

We evaluated whether a brief 3-week family therapy intervention would change patterns of brain activation in response to affection and gaming cues in adolescents from dysfunctional families who met criteria for on-line game addiction. Fifteen adolescents with on-line game addiction and fifteen adolescents without problematic on-line game play and an intact family structure were recruited. Over 3 weeks, families were asked to carry out homework assignments focused on increasing family cohesion for more than 1 hour/day and 4 days/week. Before therapy, adolescents with on-line game addiction demonstrated decreased activity as measured by functional magnetic resonance imaging (fMRI) within the caudate, middle temporal gyrus, and occipital lobe in response to images depicting parental affection and increased activity of the middle frontal and inferior parietal in response scenes from on-line games, relative to healthy comparison subjects. Improvement in perceived family cohesion following 3 weeks of treatment was associated with an increase in the activity of the caudate nucleus in response to affection stimuli and was inversely correlated with changes in on-line game playing time. With evidence of brain activation changes in response to on-line game playing cues and images depicting parental love, the present findings suggest that family cohesion may be an important factor in the treatment of problematic on-line game playing.     

The draw a story game: An aid in understanding and working with children

Children are commonly encountered who are reluctant or unable to directly discuss their emotional or behavioral problems with a therapist. Numerous techniques have been employed in the attempt to learn more about the attitudes, traits, and characteristics that are part of these children's personalities, but about which they, themselves, may be unaware. These techniques include the use of drawings, storytelling, puppets and doll play. Described and illustrated is a technique (the Draw a Story game) adapted from D. W. Winnicott's Squiggle game, R. Gardner's storytelling techniques, and commonly accepted use of children's drawings that has proved helpful in the evaluation and treatment of children with emotional problems.     

Enhancing social problem solving in children with autism and normal children through computer-assisted instruction

Children with autism have difficulty in solving social problems and in generating multiple solutions to problems. They are, however, relatively skilled in responding to visual cues such as pictures and animations. Eight distinct social problems were presented on a computer, along with a choice of possible solutions, and an option to produce alternative solutions. Eight preschool children with autism and eight matched normal children went through 10 training sessions interleaved with 6 probe sessions. Children were asked to provide solutions to animated problem scenes in all the sessions. Unlike the probe sessions, in the training sessions problem solutions were first explained thoroughly by the trainer. Subsequently these explanations were illustrated using dynamic animations of the solutions. Although children with autism produced significantly fewer alternative solutions compared to their normal peers, a steady increase across probe sessions was observed for the autistic group. The frequency of new ideas was directly predicted by the diagnostic category of autism. Results suggest young children with autism and their normal peers can be taught problem-solving strategies with the aid of computer interfaces. More research is required to establish whether such computer-assisted instruction will generalize to nontrained problem situations in real-life contexts.     

The effect of depression on academic achievement in children with epilepsy

In this cross-sectional study our aim was to evaluate the effect of depression on academic achievement in children with epilepsy and low school performance. Fifty-one children with epilepsy and low school performance were evaluated with the Children's Depression Inventory (CDI) to measure depressive symptoms. School performance was evaluated with Achenbach's Child Behavior Checklist (CBCL) and the Teacher Report Form (TRF). Children diagnosed with depressive spectrum disorders received medical therapy. All tests were administered in the first interview and repeated at the end of 6 months of therapy. Forty-three children completed the study. The patients were evaluated with DSM-IV diagnostic criteria. Accordingly, 9 (20.9%) children had Major Depressive Disorder (MDD) and 4 (9.3%) had Depressive Disorder, Not Otherwise Specified (DD-NOS). All children with MDD and DD-NOS received antidepressant medication, but only seven of them completed treatment. Posttreatment CDI scores were significantly lower, and TRF scores also improved. Pediatric neurologists should be aware of the possibility of depressive disorders in children with epilepsy, especially in those with low school performance.     

The effect of context on imitation skills in children with autism

Children with autism exhibit deficits in imitation skills. Previous authors have suggested that they may have particular difficulty imitating in natural social interactions, but properly controlled experiments investigating this possibility have not been conducted. To investigate this possibility, children with autism and typically developing children were compared on a series of imitation tasks presented either in a structured-elicited or naturalistic-spontaneous condition. Modeled actions were counterbalanced across conditions. Results suggest children with autism imitated less than typically developing children overall; however, this difference was mainly evident when the imitation task was presented in a spontaneous context. In addition, they exhibited less coordinated joint attention during imitation than the typically developing children. These findings support the hypothesis that children with autism are particularly impaired in their ability to imitate spontaneously.     

家长培训对注意缺陷多动障碍儿童的干预

目的探讨家长培训对注意缺陷多动障碍(ADHD)儿童的干预效果。方法将30例符合DSM-Ⅳ诊断标准的ADHD患儿作为干预组,进行为期8周的家长培训;30例符合DSM-Ⅳ诊断标准的ADHD患儿作为对照组,不给予任何干预措施。干预前评诂Connem父母症状问卷(PSQ),干预8周后再次评诂Conners父母症状问卷、临床疗效总评和培训满意度调查问卷。结果干预组的PSQ各项因子分干预后比干预前均有下降,品行问题、学习问题、多动指数因子分改变有统计学显著性差异。主观评价家长认为培训方式容易接受、培训内容有帮助。结论家长培训对ADHD儿童干预效果较好,药物治疗结合家长培训可以增加干预效果,家长培训方式容易接受,方法值得推广。