改良婴幼儿孤独症量表与婴幼儿孤独症量表临床应用比较

目的:比较改良婴幼儿孤独症量表(M-CHAT)与婴幼儿孤独症量表(CHAT)在广泛性发育障碍(PDDs)儿童的早期筛查中的适用性。方法:对69例符合美国精神障碍诊断和统计手册第4版(DSM-Ⅳ-TR)诊断标准的广泛性发育障碍儿童(PDDs组),和年龄、性别匹配的32名其他发育障碍儿童(对照组),同时运用M-CHAT和CHAT对被试进行临床评估,比较两种工具在临床筛查时的差异。结果:M-CHAT的灵敏度高于CHAT(0.99 vs.0.81,P0.01);而特异度则低于CHAT(0.16 vs.0.51,P0.01)。两种工具筛查阳性人数和阴性人数不一致[(95/6)vs.(72/29),P0.05]。年龄分层比较,在24月以下儿童中M-CHAT阳性数(17/0)和CHAT阳性数(15/2)均与临床诊断(12/5)一致;在36月以上儿童中,M-CHAT阳性数(6/1)和CHAT阳性数(3/4)均与临床诊断(6/1)一致,总体一致率为0.71(P0.05),两种工具筛查结果差异不具有统计学意义(P0.05);而在24～36月年龄组儿童中,M-CHAT阳性数比临床诊断高[(72/5)vs.(51/26),P0.05],M-CHAT与CHAT阳性数比临床诊断高[(72/5)vs.(54/23),P0.05)],而CHAT阳性数与临床诊断一致率为0.73,差异无统计学意义(P0.05)。结论:改良婴幼儿孤独症量表较婴幼儿孤独症量表灵敏度高,更适于正常人群的筛查;而婴幼儿孤独症量表运用在儿童发育障碍门诊时,与临床诊断的一致性较高。     

Use of the Bayley Infant Neurodevelopmental Screener with an environmental risk group

OBJECTIVE: To determine predictive validity of the Bayley Infant Neurodevelopmental Screener (BINS) during the first 2 years of life with a group of children at risk for developmental delay due to environmental risk factors. METHOD: The setting consisted of home visits to participants. The BINS was administered to 106 children, ages 6 and 13 months, of low-income, African American, adolescent mothers. Three risk groups were identified: low, moderate, and high. The Bayley Scales of Infant Development, second edition (BSID-II), were administered at 24 months and served as the criterion standard. A cut score of 85 (1.00 SD below mean) represented a clinically meaningful indicator of delayed development on the mental and psychomotor developmental indices, as well as a composite of these indices. Two other cut scores on the BSID-II were also included for comparison: 90 (0.75 SD below mean) and 77 (1.50 SD below mean). RESULTS: Using BSID-II scores at 24 months as the criterion measure, 6- and 13-month BINS scores yielded low sensitivity values but high specificity values, regardless of how BINS risk groups were defined and which cut points on the BSID-II were used. Positive predictive value was higher when the cut score was set below 90 than when it was set below 85. CONCLUSIONS: Low predictive validity of the BINS with an environmental risk group highlights the difficulties inherent in developmental screening among infants who have environmental, but not biological, risk factors. Because infants at environmental risk tend to experience developmental declines after infancy, it may be beneficial for primary care providers to use psychosocial screening tools to identify which children need closer monitoring and referral to enrichment programs to prevent developmental declines during toddlerhood.     

新生儿及疑似听力障碍儿童听力筛查的病例分析

目的1.收取本地区新生儿听力障碍发病资料;2.分析听力筛查未通过的因素及临床听力学特征。方法选取2006年5月至2007年5月出生的286例新生儿,在出院前进行新生儿听力筛查;96例转诊至我科的疑似听力障碍患儿进行诊断性听力学检查。对未通过者进行声阻抗、耳声发射、听性脑干反应、听觉稳态诱发反应全面的综合检查以确定听力损失的性质和程度,给予相应干预措施。结果286例新生儿,其中初筛有40例（13.99%）未通过筛查,42天复筛DPOAE,最后有3例需行ABR检查,经过听力学初步评估发现2例（发病率为6.99‰）有听力损失,其中正常新生儿1例（发病率为3.94‰）,高危新生儿1例（发病率为31.25‰）并作相应诊断和干预;转诊疑似听力损失患儿96例,确认听力损失78例（81.25%）,其中轻度2例（2.5%）、中度7例（9.0%）、重度25例（32.1%）、极重度44例（56.4%）,发现确诊年龄在6个月～3岁范围内。结论3个月内早期诊断和6个月内早期干预是必要的,以便尽早发现患儿及时给予干预。推行新生儿及婴幼儿听力损失的早期筛查和干预,加强耳聋知识的宣传,提高家长的防聋治聋意识是非常必要的。     

Epidemiology of orofacial clefts in a Danish county over 35 years – Before and after implementation of a prenatal screening programme for congenital anomalies

In 2004 the Danish National Board of Health changed its screening recommendations. Since 2005 a first trimester screening for Down syndrome and a prenatal ultrasound screening for congenital anomalies in the second trimester of pregnancy has been offered to all pregnant women.The aim of this study was to describe the prevalence of cleft lip with or without cleft palate and cleft palate in a Danish area and to describe associated anomalies and the development in prenatal diagnosis over time. The study was based on data from the EUROCAT Registry for Funen County. The registry is based on multiple data sources and includes information about live births, fetal deaths with a gestational age >20 weeks and terminations of pregnancy after prenatal diagnosis of severe fetal anomaly. The study included all fetuses/infants out of a population of 182,907 births diagnosed with orofacial clefts born between 1980 and 2014. There were 271 cases diagnosed with cleft lip with or without cleft palate and 127 cases diagnosed with cleft palate, giving a prevalence of 14.8 per 10,000 births for cleft lip with or without cleft palate and 6.9 per 10,000 births for cleft palate. There were no significant changes in prevalence over time for the two anomalies, calculated with and without inclusion of genetic and chromosomal cases. Overall 66 cases were diagnosed prenatally (17% of total). For isolated cleft lip with or without cleft palate none of the 157 cases born before 2005 were diagnosed prenatally compared to 34 of 58 cases (59%) born in 2005–2014 (p?<?0.01). The proportion of liveborn infants with multiple congenital anomalies also changed after 2005 with 15% (39/266) of all liveborn infants with orofacial clefts born 1980–2004 having multiple anomalies compared to 7% (7/96) in 2005–2014 (p?<?0.05).The implementation of the new screening programme in 2005 has given a major change in prenatal detection rate and reduced the proportion of liveborn infants with orofacial clefts classified as multiple congenital anomaly cases. The prevalence of cleft lip with or without cleft palate was higher than reported from many other countries.     

Neural Correlates of Familiar and Unfamiliar Face Processing in Infants at Risk for Autism Spectrum Disorders

Examining the neural correlates associated with processing social stimuli offers a viable option to the challenge of studying early social processing in infants at risk for autism spectrum disorders (ASDs). The present investigation included 32 12-month olds at high risk for ASD and 24 low-risk control infants, defined on the basis of family history. Infants were presented with familiar and unfamiliar faces, and three components of interest were explored for amplitude and latency differences. The anticipated developmental effects of emerging hemispheric asymmetry for face-sensitive components (the N290 and P400) were observed, as were familiarity effects for a component related to attention (the Nc). Although there were no striking group differences in the neural response to faces, there was some evidence for a developmental lag in an attentional component for the high-risk group. The infant ASD endophenotype, though elusive, may be better defined through expanding the age of study and addressing change over time in response to varied stimuli.     

The incidence and prevalence of pervasive developmental disorders: a Danish population-based study

BACKGROUND: Based on prevalence studies and the few incidence studies of pervasive developmental disorders (PDDs) the prevalence and incidence of these disorders have been claimed to be increasing. METHOD: The annual and age-specific prevalence and incidence rates of childhood autism, atypical autism, Asperger's disorder, and pervasive developmental disorder not otherwise specified (PDD-NOS) in Denmark during the period 1971--2000 in children younger than 10 years were estimated using data from the Danish Psychiatric Central Register. RESULTS: A total of 2.4 million children younger than 10 years were followed and 2061 cases with the PDDs studied were identified. Generally, the prevalence and incidence rates of the PDDs studied were stable until the early 1990s after which an increase in the occurrence of all disorders was seen, until 2000. The annual incidence rate per 10000 children younger than 10 years was 2.0 for childhood autism, 0.7 for atypical autism, 1.4 for Asperger's disorder, and 3.0 for PDD-NOS in 2000. We calculated a 'corrected' prevalence of childhood autism at 11.8, atypical autism at 3.3, Asperger's disorder at 4.7, and PDD-NOS at 14.6 per 10,000 children younger than 10 years on 1 January 2001. CONCLUSIONS: We found that the estimated prevalences of the PDDs studied were probably underestimated. Furthermore, the increasing prevalence and incidence rates during the 1990s may well be explained by changes in the registration procedures and more awareness of the disorders, although a true increase in the incidence cannot be ruled out.     

Sensitive, stimulating caregiving predicts cognitive and behavioral resilience in neurodevelopmentally at-risk infants

Although neurodevelopmental impairment is a risk factor for poor cognitive and behavioral outcomes, associations between early and later functioning are only moderate in magnitude, and it is likely that other factors intervene to modify this trajectory. The current study tested the hypothesis that sensitive, stimulating caregiving would promote positive behavioral and cognitive outcomes among children who were at risk based on the results of a neurodevelopmental screener and a temperament inventory. The sample comprised 1,720 infants and toddlers from the National Survey of Child and Adolescent Well-Being, a longitudinal study of children who were involved with child welfare services. Children were first assessed between 3 and 24 months of age and subsequently 18 months later. Children who experienced improvements in the amount of sensitive, stimulating caregiving they received had positive cognitive and behavioral outcomes 18 months later, despite early levels of neurodevelopmental risk. The association between changes in caregiving quality and changes in children's functioning was stronger for children who were removed from the care of their biological parents before the follow-up assessment than for children who remained in the care of biological parents, suggesting a causal role for caregiving quality on children's outcomes.     

Second stage of Universal Neonatal Hearing Screening – A way for diagnosis and beginning of proper treatment for infants with hearing loss

PurposeTo analyze retrospectively the results of hearing testing in infants at the second stage of the Polish Universal Neonatal Hearing Screening Program carried out in the Department of Otolaryngology at the Medical University of Warsaw.Material/methodsA total of 351 infants referred to our Department for the second stage of UNHS were included in the study. There were 39.60% infants referred due to positive result of hearing screening at the first stage of the Program performed in neonatal units, 55.27% with negative screening but risk factors present, and 5.13% without any tests due to equipment failure in the maternity unit.ResultsRisk factors were identified in 86.61% of the infants. The most frequent ones were hyperbilirubinemia (71.51%), premature birth (63.25%), and ototoxic medication (62.11%). Otoacoustic emission test showed fail results in 17.66% of the infants, and auditory brainstem responses confirmed hearing loss in 16.81%. Correlation between risk factors and confirmed hearing loss was found for hyperbilirubinemia, low birth weight, intensive therapy for at least 7 days, low Apgar scores, and craniofacial abnormalities.ConclusionsThe early identification of infants with hearing loss is essential for early intervention. Not only infants who fail the initial screening but also the ones with risk factors of hearing impairment should be referred to the centers that are capable of providing the necessary diagnostic services required for the second stage of the UNHSP. Those two steps are needed to both minimize the risk of overlooking a child with hearing loss and properly diagnose hearing impairment.     

Population and family studies of dihydropyrimidinuria: Prevalence,inheritance mode,and risk of fluorouracil toxicity

To evaluate the prevalence of dihydropyrimidinuria (DHPuria), we analyzed urine samples from 21,200 healthy Japanese infants, and found two cases of DHPuria without clinical symptoms. Based on this result, we estimated the prevalence to be approximately 1/10,000 births in Japan. In addition, we analyzed pyrimidine catabolism on a previously reported family with an adult DHPuria case. We newly identified the sister of the propositus as the second case of DHPuria in this family, because she excreted large amounts of dihydrouracil and dihydrothymine. The parents and the child of the propositus showed slight increases of dihydrouracil and dihydrothymine. This is the first family with 2 cases of DHPuria, indicating that DHPuria is an inherited condition. To determine the inheritance of DHPuria in this family and to examine the risk of 5-fluorouracil (5-FU) toxicity, a uracil loading test was performed on the parents. Urinary dihydrouracil concentrations in the parents after the loading were several times higher than those in normal control persons, the finding being consistent with DHPuria heterozygotes. This, along with data on the propositus, his sister, and his child, indicates that DHPuria is an autosomal recessive condition. In addition, DHPuria homozygotes may have a high risk of 5-FU toxicity, while the risk is relatively low in heterozygotes. Am. J. Med. Genet. 78:336–340, 1998. © 1998 Wiley-Liss, Inc.     

Six-month and 12-month mental health outcome of medical and surgical patients admitted to general hospital

BACKGROUND: We have recently reported a two-phase study on psychiatric morbidity in a sample of general hospital patients. This paper reports the results of the 6-month and 12-month follow-up of these patients. METHODS: The screening questionnaire was the GHQ-12. The main diagnostic instrument used in the second phase was the CIDI-PHC. All patients who had been interviewed with CIDI-PHC (N = 363) were followed-up and the baseline assessment was compared with the scoring on questionnaires administered in the 6-month postal enquiry and with the psychopathological status at 12-month, elicited with a telephone structured interview. RESULTS: Sixty-two and 87% of patients completed the 6- and 12-month follow-up assessment respectively. The first follow-up indicated no significant decrease in the level of symptoms. The 12-month follow-up interview showed that 23% of males and 40% of females had poor/mostly poor mental health. The logistic model showed that females with a definite ICD-10 diagnosis, admitted to a medical department, who had consumed psychotropic drugs in the previous year, had the most unfavourable outcome. The risk of a poor/mostly poor outcome steadily increased with the severity of the psychopathology during hospitalization. CONCLUSION: In medical and surgical general hospital patients the risk factors associated with a poor mental health outcome are similar to those found in primary care patients. Greater attention should be paid in assessing routinely mental health status of general hospital patients during hospitalization.     

A short-term longitudinal study of correlates and sequelae of attachment security in autism

In this short-term longitudinal study, 30 preschool-aged children with autism were first observed in Ainsworth’s Strange Situation Procedure and, separately, interacting with the primary caregiver in the home. One year later, each child completed both a developmental assessment and an observational assessment of empathic responding. Behaviors typical for children with autism were distinguished from behaviors suggestive of relationally based attachment disorganization. Forty-five percent of the children were classified as securely attached. The secure group demonstrated language skills superior to those of the insecurely attached group, concurrently and during the follow-up. Compared to parents of children who were insecurely attached, parents of securely attached children were rated as more sensitive. Compared to both organized insecure and disorganized children, secure children were rated as more responsive to an examiner’s apparent distress during the follow-up relative to their ratings at intake, whereas empathy ratings of children with insecure classifications did not increase. Importantly, attachment security was associated with empathy above and beyond the contribution of children’s language level. These results indicate that the sequelae of attachment security in autism may be similar to those documented for typically developing children.     

Prevalence of autism spectrum disorders among children (1-10 years of age) – Findings of a mid-term report from Northwest India

Background:

India is the second most populous country of the world. A large portion of the population of this country is below 20 years of age but still there is a paucity of information about the prevalence and incidence of many developmental disorders. This study was planned to estimate the prevalence of autism spectrum disorders (ASDs) in the selected areas (tribal, rural, and urban) of a northern state of India, Himachal Pradesh.

Methods:

A cross-sectional two-phase study was conducted covering all the children in the range of 1-10 years of age. Phase one included screening of all the children in the age group of 1-10 years, with the help of an indigenous assessment tool for autism. The sociodemographic profile of the participants was also recorded during phase one. Phase two involved the clinical evaluation of individuals who were suspected of autism on screening.

Results:

The results show a prevalence rate of 0.9/1000. The highest prevalence rate was observed in the rural area.

Conclusions:

Socioeconomic status (SES) may be one of the fundamental indicators for ASDs in India.KEY WORDS: Autism, children, mid-term, prevalence     

山西省出生缺陷高发区重大体表出生缺陷的流行状况研究

目的了解山西省出生缺陷高发地区目前各种体表出生缺陷患病水平及流行特征.方法以人群为基础对山西省的4个县24种体表重大出生缺陷进行监测.结果 2003年四个县共监测到孕满20周以上的出生11534名,总出生缺陷患病率分别为232.4/万.神经管畸形患病率为138.7/万,占全部出生缺陷病例的59.7%.患病率高于10/万的出生缺陷有7种,依次为:无脑儿(65.9/万)、脊柱裂(58.1/万)、脑积水(47.7/万)、多指(26.0/万)、腭裂(21.7/万)、脑膨出(14.7/万)、唇裂(10.4/万).产妇文化程度低和女性胎婴神经管畸形的患病率显著增高.此外,居住在农村,妇女年龄不足20岁或30岁以上神经管畸形患病率有升高的趋势.结论神经管畸形仍然为山西省出生缺陷高发区最常见的先天畸形,目前其患病率仍然处于我国乃至世界最高的水平.居住在农村、文化程度低、怀孕年龄太小或较大的妇女生育出生缺陷儿的危险性较大.     

Is autism associated with the fragile X syndrome?

In addition to mental retardation (MR), fragile X [fra(X)] has been associated with other developmental disabilities, autism in particular. Recently, several studies have concluded that the association of fra(X) with autism is at best weak and perhaps nonexistent. This study examined reports of previously published data from an epidemiological perspective to determine if the prevalence of fra(X) among autistic males was significantly different from that among MR males. Nineteen studies of autistic males and 21 studies of MR males were analyzed from 59 examined. Of 5601 MR males tested, 307 (5.5%) were cytogenetically positive. Of 1006 autistic males, 54 (5.4%) were positive. Analysis indicated no statistical difference between these proportions (Z = 0.014; p greater than .50). An odds ratio (OR) was also computed to determine the risk of autism from fra(X). Estimated OR approximately 1.0 [0.73, 1.32]. Attributable risk (AR), the proportionate excess risk of autism associated with exposure to fra(X) was AR approximately 0.0. That is, there was no attributable risk of autism from fra(X). The association of fra(X) with autism may reflect the association with MR that generally accompanies autism, as several earlier reports have noted. However, the similarity in prevalence of fra(X) among autistic and MR males may be biased in the studies which find no instances of fra(X) among autistic males represent 12% of the pooled sample.     

Trisomy 13 and 18—Prevalence and mortality—A multi‐registry population based analysis

The aim of the study is to determine the prevalence, outcomes, and survival (among live births [LB]), in pregnancies diagnosed with trisomy 13 (T13) and 18 (T18), by congenital anomaly register and region. Twenty‐four population‐ and hospital‐based birth defects surveillance registers from 18 countries, contributed data on T13 and T18 between 1974 and 2014 using a common data‐reporting protocol. The mean total birth prevalence (i.e., LB, stillbirths, and elective termination of pregnancy for fetal anomalies [ETOPFA]) in the registers with ETOPFA (n = 15) for T13 was 1.68 (95% CI 1.3–2.06), and for T18 was 4.08 (95% CI 3.01–5.15), per 10,000 births. The prevalence varied among the various registers. The mean prevalence among LB in all registers for T13 was 0.55 (95%CI 0.38–0.72), and for T18 was 1.07 (95% CI 0.77–1.38), per 10,000 births. The median mortality in the first week of life was 48% for T13 and 42% for T18, across all registers, half of which occurred on the first day of life. Across 16 registers with complete 1‐year follow‐up, mortality in first year of life was 87% for T13 and 88% for T18. This study provides an international perspective on prevalence and mortality of T13 and T18. Overall outcomes and survival among LB were poor with about half of live born infants not surviving first week of life; nevertheless about 10% survived the first year of life. Prevalence and outcomes varied by country and termination policies. The study highlights the variation in screening, data collection, and reporting practices for these conditions.     

The Ages and Stages Questionnaires: feasibility of use as a screening tool for children in Canada

OBJECTIVE: To determine the accuracy and feasibility of a monitoring tool completed by parents for screening at-risk and community infants and children for developmental problems. METHODS: We assessed 43 children following open-heart surgery and 68 community children (aged 4-36 mo) at prescribed intervals using the Ages and Stages Questionnaires (ASQ). Subjects were followed 3 years later (at age 5-6 yr) via telephone interview with their parents concerning developmental delay identified by physicians. Responses were confirmed by telephone interviews with family physicians. We then compared the results of the ASQ with the physician assessments. RESULTS: Nine at-risk and 9 community children were lost to follow-up. The ASQ identified 4 of the 25 at-risk children as having developmental delay, while 2 of the 6 children assessed by a neurologist were identified as having developmental delay. The ASQ identified 2 of the 59 community children as having developmental delay, 1 of whom was assessed by a neurologist as having developmental delay. The ASQ had sensitivities of 75% in the at-risk group and 100% in the community group, and specificities of 95% and 90%, respectively. The parents were unanimous in their willingness to complete the assessments. CONCLUSION: The ASQ is feasible, inexpensive, easy to use, and was appreciated by the parents. It is a sufficiently sensitive and specific monitoring tool that its use in cardiac follow-up programs and in community programs for healthy children is warranted. Although this tool should not be used to replace clinical assessment, it can be used to rationalize access to specialist developmental assessment services.     

Estimation d’un risque transfusionnel émergent : l’exemple du VHE

BackgroundThe risk assessment for blood transfusion is an essential step that must precede any screening strategy of a pathogen transmitted by transfusion. After several cases of HEV transmission by transfusion in France, a risk assessment for this virus was performed.MethodsWe used a method based on the prevalence of HEV-RNA in plasmas collected for the preparation of SD-plasma. To estimate the rate of HEV-RNA positive among all blood donations, data on SD-plasma were adjusted on the following HEV risk factors: gender, age group and region of residence. We assumed that HEV risk factors were the same in plasma donors and whole blood donors.ResultsAmong 57,101 plasma donations tested for HEV-RNA in 2013, 24 were positive (crude rate of 4.2 per 10,000 donations). After adjustment, the total number of HEV-RNA positive blood donations was estimated at 788, accounting for a rate of 2.65 per 10,000 donations (95% CI: 1.6–3.7) or 1 in 3800 donations (1 in 6,200–1 in 2,700). This rate was 12 times higher in men than in women, increased with age, and varied according to region of residence.ConclusionThe risk of blood donation contamination by HEV has been estimated to be 1 in 3800 donations in 2013. An essential input is still missing to assess now the risk in recipients: the minimum infectious dose. Furthermore, the risk in recipients has to be analyzed according to characteristics of transfused patients: presence of anti-HEV immunity, existence of chronic liver disease or immunodeficiency.     

Discovering pattern in developing lives: reflections on the Minnesota study of risk and adaptation from birth to adulthood

The Minnesota Study of Risk and Adaptation was initiated in the mid-1970s as a short-term longitudinal study of infants at elevated risk for abuse and neglect. At the outset, the project leaders intended to characterize the infant, the caregiving environment, and the larger social milieu of the family in as comprehensive a manner as possible so as to test explicitly posed hypotheses about pathways leading from the child, the caregiving environment, and the social milieu to abuse or neglect. Paradoxically, only a minority of infants recruited to the study were ultimately abused or neglected over the 36-month period for which funding had been provided, but it proved possible to identify several antecedent indicators that predicted their outcome. It was also evident from the data that developmental casualty was elevated in this sample and the frequencies of suboptimal outcomes in social, emotional, and behavioral domains were greater than expected for less stressed samples. The study had yielded a wealth of information about infants and families from this at-risk sample and it was clear that the sample must be followed into childhood so as to describe the trajectories of developmental successes and casualties that were already apparent in the first 24 months of data. Alan Sroufe joined the project leaders in this endeavor and the childhood data supported the study of the sample into adolescence and now into adulthood. At this point, children of the original sample of infants are now being assessed using many of the protocols and procedures used with their parents. The study has produced hundreds of published reports about risk and its consequences, as well as about positive adjustment to life in a socio-cultural milieu that frequently can be non-supportive or even dangerous. This essay is a reflection on some accomplishments of the Minnesota study as these have helped shape how developmental scientists think about social and emotional development and more generally about how theory has guided the conceptual, empirical, and measurement plans for the study from its beginning.     

Discovering pattern in developing lives: Reflections on the Minnesota study of risk and adaptation from birth to adulthood

Abstract

The Minnesota Study of Risk and Adaptation was initiated in the mid-1970s as a short-term longitudinal study of infants at elevated risk for abuse and neglect. At the outset, the project leaders intended to characterize the infant, the caregiving environment, and the larger social milieu of the family in as comprehensive a manner as possible so as to test explicitly posed hypotheses about pathways leading from the child, the caregiving environment, and the social milieu to abuse or neglect. Paradoxically, only a minority of infants recruited to the study were ultimately abused or neglected over the 36-month period for which funding had been provided, but it proved possible to identify several antecedent indicators that predicted their outcome. It was also evident from the data that developmental casualty was elevated in this sample and the frequencies of suboptimal outcomes in social, emotional, and behavioral domains were greater than expected for less stressed samples. The study had yielded a wealth of information about infants and families from this at-risk sample and it was clear that the sample must be followed into childhood so as to describe the trajectories of developmental successes and casualties that were already apparent in the first 24 months of data. Alan Sroufe joined the project leaders in this endeavor and the childhood data supported the study of the sample into adolescence and now into adulthood. At this point, children of the original sample of infants are now being assessed using many of the protocols and procedures used with their parents. The study has produced hundreds of published reports about risk and its consequences, as well as about positive adjustment to life in a socio-cultural milieu that frequently can be non-supportive or even dangerous. This essay is a reflection on some accomplishments of the Minnesota study as these have helped shape how developmental scientists think about social and emotional development and more generally about how theory has guided the conceptual, empirical, and measurement plans for the study from its beginning.     

The importance of including dynamic social networks when modeling epidemics of airborne infections: does increasing complexity increase accuracy?

The ability to determine an infant's likelihood of developing autism via a relatively simple neurological measure would constitute an important scientific breakthrough. In their recent publication in this journal, Bosl and colleagues claim that a measure of EEG complexity can be used to detect, with very high accuracy, infants at high risk for autism (HRA). On the surface, this appears to be that very scientific breakthrough and as such the paper has received widespread media attention. But a close look at how these high accuracy rates were derived tells a very different story. This stems from a conflation between "high risk" as a population-level property and "high risk" as a property of an individual. We describe the approach of Bosl et al. and examine their results with respect to baseline prevalence rates, the inclusion of which is necessary to distinguish infants with a biological risk of autism from typically developing infants with a sibling with autism. This is an important distinction that should not be overlooked. Please see research article: http://www.biomedcentral.com/1741-7015/9/18 and correspondence article: http://www.biomedcentral.com/1741-7015/9/60