Neuropsychological functioning in children with immunodeficiency disorders

A small group of children with various types of immunodeficiency disorders, examined on a battery of neuropsychological and intellectual tests, was found to be impaired on perceptual speed, visuospatial sequencing, and visual attention span capacities when compared to a control group of closest aged siblings and normal children matched for age, education, and IQ. The results suggest that cerebral dysfunction may be associated with immunodeficiency disorders in children, although these findings are tentative since other factors, such as the effects of chronic illness, could not be excluded in this small cohort of patients.     

Effects of in utero exposure to polychlorinated biphenyls and related contaminants on cognitive functioning in young children

Because prenatal exposure to polychlorinated biphenyls (PCBs) and related contaminants has been associated with reduced birth weight, neonatal behavioral anomalies, and poorer recognition memory in infants born to women who have consumed Lake Michigan sports fish, 236 children, previously evaluated for PCB-related deficits in infancy, were assessed at 4 years of age. Prenatal exposure (indicated by umbilical cord serum PCB level) predicted poorer short-term memory function on both verbal and quantitative tests in a dose-dependent fashion. These effects cannot be attributed to a broad range of potential confounding variables, the impact of which was evaluated statistically. Although much larger quantities of PCBs are transferred postnatally via lactation than prenatally across the placenta, exposure from nursing was unrelated to cognitive performance. The data demonstrate the continuation of a toxic impact received in utero and observed initially during infancy on a dimension of cognitive functioning fundamental to learning.     

Motor profile and cognitive functioning in children with spina bifida

BackgroundSpina bifida is a complex neuroembryological disorder resulting from incomplete closure of the posterior neural tube. Morbidity in the different fields of motor and cognitive neurodevelopment is variable in nature and severity, and often hard to predict.AimsThe current study investigates the relationship between cognitive functioning, fine motor performance and motor quality in children with spina bifida myelomeningocele (SBM) and SB-only, taking into consideration the cerebral malformations.Material and methodsForty-one children were included (22 girls and 19 boys aged between 6 and 14 years, mean age 10;0 years) in the study. A comprehensive assessment was conducted of cognitive functioning and motor profile, including fine motor and visual-motor functioning, and motor quality. The performance outcomes were analyzed for the total group of children and separately for the nonretarded children (FSIQ ≥ 70, N = 30) to eliminate the influence of global intellectual impairment.ResultsAlthough the children with spina bifida showed increased incidence of cognitive and fine motor impairment, and impaired motor quality, after exclusion of the overall retarded children no associations were found between cognitive functioning and motor profile. In the comparison of SBM to SB-only specific differences were found for performance IQ, visual-motor functioning and motor quality, but not fine motor functioning.ConclusionOur findings underscore the role of cerebral malformation in spina bifida and its consequences for neuropsychological functioning. The complicated developmental interactions found strengthen the need for an individualized management of children with SB.     

Psychosocial functioning of young children with learning problems

BACKGROUND: In this study, psychosocial functioning of different groups of young children with learning problems was investigated using a diverse set of psychosocial variables (including behaviour problems, academic motivation, social preference, and self-concept). METHODS: For this purpose, children with low academic achievement, with a specific learning disability based on an IQ-achievement discrepancy, and with a specific learning disability based on an achievement discrepancy, were selected out of 276 children of the first grade of regular primary schools. By means of multivariate analyses, their psychosocial functioning was compared to the functioning of children without learning problems. RESULTS: The total set of psychosocial variables was able to discriminate between children with and without learning problems, with medium effect size. Attention problems as reported by the teachers turned out to be the most important single psychosocial predictor for group discrimination. However, results varied according to the type of learning problem and the type of psychosocial problem. Children with a specific reading/spelling disability and children with low general academic achievement differed most from their peers without learning problems with regard to their psychosocial functioning. Poor cognitive self-concept was related primarily to low academic achievement, poor learning motivation might be specific for math problems, and a low social preference score seemed most characteristic of children with a specific learning disability. CONCLUSIONS: Studying several psychosocial variables simultaneously in different groups of children with learning problems leads to a further refinement of the current knowledge.     

Sensory-motor and cognitive functioning in children who have undergone bone marrow transplantation

Sensory-motor and cognitive functioning was investigated in a group of 32 children treated with bone marrow transplantation (BMT), 1-6 years after treatment. Twenty-five of the patients had suffered from leukemia. The BMT procedure had involved a regimen of cytostatic drugs and, for leukemia patients, total body irradiation at a dose of 10 Gy, administered in one session. Cytostatic drugs and irradiation are known to be potentially neurotoxic, particularly when combined. The examination involved four neuropsychological tests of sensory-motor and cognitive functioning, as well as an age-appropriate intelligence test. For control the bone marrow donors (n = 32), siblings of the patients, were also investigated. A pronounced delay in motor development was found in four children, who had been treated with BMT including total body irradiation before 3 years of age. Patients between 3 and 11 years of age at BMT were at a slight disadvantage, compared to donors, on tasks involving perceptual and fine motor speed. In older patients no deficits were observed.     

Sensory processing in children with autism spectrum disorders and impact on functioning

Children with autism experience many challenges that affect their ability to function. Sensory processing disorder and, specifically, sensory modulation disorder can compound dysfunction and further inhibit participation in productive activities. Through detection of and referral for sensory modulation disorders, treatment can be accessed. Emerging treatment evidence points to functional gains for autism and sensory modulation disorder that can ease the burden that this combination of symptoms has on the everyday life of children with autism.     

Fatigue mediates the relationship between emotional and cognitive functioning in children post-cancer treatment

Background/objectives

Children treated for cancer are at risk to develop cognitive problems. Insight in underlying associations with emotional functioning and fatigue can be used to optimize interventions. We therefore aim to study emotional functioning, fatigue, and cognitive functioning in children postcancer treatment and investigate whether fatigue mediates the relationship between emotional and cognitive functioning.

Design/methods

Emotional functioning, fatigue, and cognitive functioning were assessed in children post-cancer treatment using subscales of the Pediatric Quality of Life Inventory (PedsQL) Generic Core Scales, Multidimensional Fatigue Scale and Cognitive Functioning Scale. A one sample t-test was used to compare outcomes with general population peers and mediation analysis was used to address the effect of fatigue on the relationship between emotional and cognitive functioning.

Results

A total of 137 children (mean age: 13.6, SD ± 3.3 years; mean time since end of treatment: 7.1 months, SD ± 5.9) participated. Lower scores on emotional functioning (Cohen's d [D]: 0.4), fatigue (D: 0.8) and cognitive functioning (D: 0.6) were found (p < .001) in children post-cancer treatment than in peers. A medium association was found between emotional and cognitive functioning (standardized regression coefficient [β]: 0.27, p < .001), which was mediated by fatigue (β = 0.16).

Conclusions

Outcomes on emotional and cognitive functioning are decreased and fatigue is increased in children postcancer treatment. Fatigue mediates the relationship between emotional and cognitive functioning. Our results show the importance to focus on fatigue amongst stress as a target for intervention to improve cognitive functioning.     

Piracetam therapy does not enhance cognitive functioning in children with down syndrome

BACKGROUND: Piracetam is widely used as a purported means of improving cognitive function in children with Down syndrome. Its efficacy, however, has not been rigorously assessed. OBJECTIVE: To determine whether 4 months of piracetam therapy (80-100 mg/kg per day) enhances cognitive function in children with Down syndrome. DESIGN: A randomized, double-blind, placebo-controlled crossover study. PARTICIPANTS AND METHODS: Twenty-five children with Down syndrome (aged 6.5-13 years) and their caregivers participated. After undergoing a baseline cognitive assessment, children were randomly assigned to 1 of 2 treatment groups: piracetam-placebo or placebo-piracetam. MAIN OUTCOME MEASURE: The difference in performance while taking piracetam vs while taking placebo on tests assessing a wide range of cognitive functions, including attention, learning, and memory. RESULTS: Eighteen children completed the study, 4 withdrew, and 3 were excluded at baseline. Piracetam therapy did not significantly improve cognitive performance over placebo use but was associated with central nervous system stimulatory effects in 7 children: aggressiveness (n = 4), agitation or irritability (n = 2), sexual arousal (n = 2), poor sleep (n = 1), and decreased appetite (n = 1). CONCLUSION: Piracetam therapy did not enhance cognition or behavior but was associated with adverse effects.     

儿童癫痫与镁代谢紊乱

目的：了解儿童癫痫与镁代谢之间的关系。方法：对75例癫痫儿童血清镁进行检测,并与50例健康儿童对照分析。结果：癫痫儿童血清镁明显低于对照组(P<0.01),低于对照组-2s者占29.33%;血镁的降低尤以婴幼儿及经抗癫痫药物(AED)治疗发作不易控制者为著,且病程越长,血镁越低(P<0.01)。结论：婴幼儿及经AED治疗发作难以控制的癫痫儿童可能存在低镁,应及时检测并予以纠正。     

Cognitive-behavioral management of sleep disorders in young children]

Sleep disorders are prevalent in young children, the most frequent being disturbances in initiating and maintaining sleep. Behavioral and cognitive approaches are interesting techniques for their management. They can be used either for solving sleep problems at home, or in severe forms as part of a 'deconditioning' during a short hospitalization.     

Factors affecting cognitive, motor, behavioral and executive functioning in children with phenylketonuria

We administered measures of cognitive, frontal lobe (executive), behavioral and motor functioning to 18 children with classical phenylketonuria, aged 12–101 months, in order to determine the relationship of age, current and lifetime average phenylalanine levels, and individual variation (standard deviation of lifetime average levels) to these functions. On measures of cognitive function, in children ≥ 3 y of age lower current phenylalanine levels were associated with higher cognitive functioning. On a behavioral temperament scale designed for normal children, we found that higher current and average phenylalanine levels correlated with more difficult temperament. Motor function was also poorer in children with phenylketonuria, and was most impaired in children with current phenylalanine levels >360μmol/l. We also identified a previously unreported correlation between increased individual variation and poorer executive function performance, a finding that may raise new management concerns about level fluctuations. Maintenance of phenylalanine levels μ 360 μml/l may be necessary for optimal performance in children with phenylketonuria.