Early clinical characteristics according to developmental stage in children with definite moyamoya disease

The objective is to clarify the early clinical characteristics in childhood moyamoya disease (MD). Epidemiologic characteristics, symptoms and diagnostic rates were assessed in 64 children (0–18 years) with definite MD according to developmental stage: infancy (5; 0–1 years); toddlerhood/preschool age (22; 2–5 years); school age (29; 6–10 years); and adolescence (8; 11–18 years). The median ages at onset was 6.25 years and the female to male ratio was 1.9 (?2.5 in toddlerhood/preschool age and in adolescence, P = 0.71). Previous headache was observed in 23% (14/64): frequently in school age (38%, P = 0.02) and within 6 months before main symptoms (6/11). As an initial symptom, weakness was observed in 78% (50/64) mainly as transient ischemic attack (TIA, 61%) in limbs (90%) and unilaterally (82%). TIA was less frequent in infancy (40%, P = 0.04). Seizure was observed in 27% (17/64): frequently in infancy (100%, P < 0.01), as the focal type (71%), and in the right extremity (3:1). Isolated seizures without other symptoms was frequent in children ?5 years (P < 0.01). Severe headache associated with MD was observed in 14% (9/64). Provoking events were positive in 42% (27/64): in school age, frequently during eating (28%); and in toddlerhood/preschool age, during crying (27%). The diagnostic rates at 3 and 12 months from symptom-onset were 39% (80% during infancy vs. 28% in school age, P = 0.14) and 67%, respectively. Symptomatic progression at diagnosis was observed in 38% (24/64). Initial clinical characteristics in childhood definite MD differed according to developmental stage and from at diagnosis.     

Mediated effects of perceived discrimination on adolescent academic achievement: A test of four models

Many adolescents feel they are subjected to acts of discrimination. Research shows that discrimination is associated with adverse outcomes including poor psychological adjustment, school adjustment, and academic achievement. This study investigated alternative pathways through which discrimination affects adolescents' academic achievement. A sample of 244 Year 7–10 Australian secondary school students (65% male; M_age = 13.6 years; SD = 1.24) completed questionnaires measuring discrimination, psychological adjustment, and sense of school membership. Both at the time of questionnaire completion and one semester later, absenteeism data, teacher ratings of classroom behavior, and academic grades were retrieved from school records. The fit of four competing structural models were compared. In the best fitting model, the effects of prior discrimination on academic achievement one semester later were serially mediated, first through psychological adjustment, and then through school adjustment. By elucidating these mechanisms, the study informs theory and practice regarding the effects of discrimination on adolescents.     

Aggressive behavior,emotional, and attention problems across childhood and academic attainment at the end of primary school

Purpose

To assess whether aggressive behavior and emotional problems from early childhood onwards are related to academic attainment at the end of primary education, and whether these associations are independent of attention problems.

Methods

Data on 2546 children participating in a longitudinal birth cohort in Rotterdam were analyzed. Aggressive behavior, attention and emotional problems at ages 1½, 3, 5 and 10 years were assessed with the Child Behavior Checklist. Academic attainment at the end of primary school (12 years of age) was measured with the CITO test, a national Dutch academic test score.

Results

Aggressive behavior from age 1½ to 10 years was negatively associated with academic attainment, but these associations attenuated to non-significance when accounting for comorbid attention problems. For emotional problems, first, only problems at 10 years were associated with poorer academic attainment. Yet, when accounting for attention problems, the association reversed: more emotional problems from 1½ to 10 years were associated with a better academic attainment. Attention problems at ages 1½ to 10 years were negatively associated with academic attainment, independent of comorbid emotional problems or aggressive behavior.

Conclusions

Attention problems across childhood are related to a poorer academic attainment, while emotional problems predicted better academic attainment. Moreover, the relationship between aggressive behavior and academic attainment was explained by comorbid attention problems. Future research should determine the mechanisms through which attention problems and emotional problems affect academic attainment, to inform strategies for the promotion of better educational attainment.

     

Fine and gross motor skills predict later psychosocial maladaptation and academic achievement

BackgroundDifficulties in fine and gross motor skills are often overlooked as developmental problems, although approximately 6–13% of all school-age children have poor motor coordination. Understanding motor coordination is important from the perspective of school adaptation. This longitudinal cohort study aimed to determine whether fine and gross motor skills in preschool children predict later academic achievement and psychosocial maladaptation.Methods & ProceduresParticipants were 2,501 children from nursery and elementary schools (5–13 years old). The motor skills of preschool children were assessed by their nursery teacher immediately before entering elementary school. The Strengths and Difficulties Questionnaire and a standardized Japanese test were administered annually throughout elementary school.ResultsEarly motor difficulties in preschool children had significant effects on their academic achievement and psychosocial maladaptation up until the sixth grade. Gross motor difficulties in preschool were associated with the later peer problems and worsened emotional symptoms.ConclusionsMotor skills in preschool children are useful as a predictor of later psychosocial maladaptation and academic achievement.     

Malnutrition at age 3 years and externalizing behavior problems at ages 8, 11, and 17 years

OBJECTIVE: Poor nutrition is thought to predispose to externalizing behavior problems, but to date there appear to have been no prospective longitudinal studies testing this hypothesis. This study assessed whether 1) poor nutrition at age 3 years predisposes to antisocial behavior at ages 8, 11, and 17 years, 2) such relationships are independent of psychosocial adversity, and 3) IQ mediates the relationship between nutrition and externalizing behavior problems. METHOD: The participants were drawn from a birth cohort (N=1,795) in whom signs of malnutrition were assessed at age 3 years, cognitive measures were assessed at ages 3 and 11 years, and antisocial, aggressive, and hyperactive behavior was assessed at ages 8, 11, and 17 years. RESULTS: In relation to comparison subjects (N=1,206), the children with malnutrition signs at age 3 years (N=353) were more aggressive or hyperactive at age 8 years, had more externalizing problems at age 11, and had greater conduct disorder and excessive motor activity at age 17. The results were independent of psychosocial adversity and were not moderated by gender. There was a dose-response relationship between degree of malnutrition and degree of externalizing behavior at ages 8 and 17. Low IQ mediated the link between malnutrition and externalizing behavior at ages 8 and 11. CONCLUSIONS: These results indicate that malnutrition predisposes to neurocognitive deficits, which in turn predispose to persistent externalizing behavior problems throughout childhood and adolescence. The findings suggest that reducing early malnutrition may help reduce later antisocial and aggressive behavior.     

Differentiating children with attention-deficit/hyperactivity disorder, conduct disorder, learning disabilities and autistic spectrum disorders by means of their motor behavior characteristics

The study was designed to investigate the discriminant validity of the Motor Behavior Checklist (MBC) for distinguishing four group of children independently classified with Attention-Deficit/Hyperactivity Disorder, (ADHD; N = 22), Conduct Disorder (CD; N = 17), Learning Disabilities (LD; N = 24) and Autistic Spectrum Disorders (ASD; N = 20). Physical education teachers used the MBC for children to rate their pupils based on their motor related behaviors. A multivariate analysis revealed significant differences among the groups on different problem scales. The results indicated that the MBC for children may be effective in discriminating children with similar disruptive behaviors (e.g., ADHD, CD) and autistic disorders, based on their motor behavior characteristics, but not children with Learning Disabilities (LD), when used by physical education teachers in school settings.     

Late bedtimes weaken school performance and predispose adolescents to health hazards

Study objectives

Our study explored if bedtimes influenced school performance and motivation, as well as the odds ratio (OR) for health-related concerns in adolescents.

Methods

The School Health Promotion Study was based on an anonymous self-report questionnaire conducted in 90% of the municipalities in Finland. The study was conducted during 2008 and 2010 in Southern Finland, Eastern Finland, and Lapland, and during 2009 and 2011 in Western Finland, Northern Finland, and Åland. Several indicators were used to measure school performance and motivation. Accidents and health-related complaints, such as depressive symptoms, sleep quality, neck or shoulder pains, lower back pains, stomachaches, anxiety or nervousness, irritation or tantrums, headaches, and tiredness or dizziness were analyzed in relation to the usual bedtime. Our study had a relatively large sample size (N = 384,076), consisting of students in the eighth and the ninth grades of secondary schools and the first and the second grades of upper secondary and vocational schools (ages 14–20 years) in Finland.

Results

All of the various indicators used to assess school performance and motivation suggest that the later the bedtime of adolescents, the lower their school performance and their motivation. Similarly later bedtimes increase the OR for depressive symptoms and other negative health consequences in adolescents as well as a tendency towards accidents. All of these problems were emphasized in students with bedtimes of 11:30 PM and later.

Conclusions

Late bedtimes, especially those after 11:30 PM, indicate poor sleep which deteriorates school performance and motivation and increases the OR for depressive symptoms and other health-related issues in adolescents.     

Gesture production in school vs. clinical samples of children with Developmental Coordination Disorder (DCD) and typically developing children

Dyspraxia, a difficulty in executing an operationalised act, has been associated with Developmental Coordination Disorder (DCD). However, issues relating to the area such as comparisons across modalities, comparisons of school vs. clinical populations, and developmental delay vs. pathology have not been addressed in the same, comprehensive study. In the current study, therefore, familiar gesture production in DCD was addressed in a comprehensive manner to follow-up outstanding issues from previous studies: The production of familiar gestures and praxis imagery in a school (n = 26) vs. clinic sample (n = 19) of children with DCD was examined in relation to typically developing age matched (n = 24) all aged from 9 to 11 years, and two groups of younger children within the age ranges of 5-6 (n = 23) and 4-5 (n = 26) years. Overall, children with Developmental Coordination Disorder showed an impaired ability to produce familiar gestures compared to their typical peers, and this was dependant on the type of gesture and presentation modality. Differences were found between school and clinic samples of children with DCD, suggestive of the recruitment of different underlying mechanisms in the two samples. The results have a bearing on our understanding of the relationship of developmental dyspraxia to DCD, as well as of the issue of developmental delay vs. pathology.     

Quick and easy self-rating of Generalized Anxiety Disorder: validity of the Dutch web-based GAD-7, GAD-2 and GAD-SI

Although psychometrically-defined executive function deficits (EFDs) and ecologically valid functional outcomes have been documented among youth with bipolar I (BP-I) disorder, little is known about their association. We hypothesized that EFDs would be associated with significant ecologically valid impairments beyond those predicted by having BP-I disorder. Youth with BP-I disorder were ascertained from psychiatric clinics and community sources. We defined EFDs as having at least two out of eight EF measures impaired from a battery of six tests. Significantly more youth with BP-I disorder had EFDs than controls (45% versus 17%). Comparisons were made between controls without EFDs (N = 81), controls with EFDs (N = 17), BP-I youth without EFDs (N = 76), and BP-I youth with EFDs (N = 62). EFDs were associated with an increased risk for placement in a special class and a decrease in academic achievement (WRAT-3 reading and arithmetic). EFDs in BP-I subjects were associated with an increased risk for speech/language disorder (as assessed in the K-SADS-E) relative to BP-I subjects without EFDs. Youth with BP-I disorder and EFDs are at high risk for significant impairments in academic functioning.     

Increased psychophysiological arousal and orienting at ages 3 and 11 years in persistently schizotypal adults

Abnormalities of psychophysiological arousal and orienting are thought to predispose to schizophrenia, but there have been no prior studies of early psychophysiological functioning in "persistent schizotypals" who remain stably schizotypal across time. This study assessed skin conductance (SC) arousal and orienting at ages 3 and 11 years, electroencephalography (EEG) at age 11 years, and behavior problems at age 17 years in 52 individuals who were stably schizotypal from ages 17 to 23 years, and 104 normal controls. Schizotypy was assessed at age 17 with the Schizophrenism scale, and at age 23 with the Schizotypal Personality Questionnaire (SPQ). Schizotypals had significantly increased SC arousal and increased SC amplitudes to neutral and aversive stimuli at both ages 3 and 11, and also reduced slow-wave left hemisphere EEG power at the beginning of the Continuous Performance Task (CPT) at age 11. Group differences in SC were greater for aversive than neutral stimuli. Schizotypals also had higher age 17 behavior ratings on psychotic behavior, anxiety-withdrawal, and conduct disorder. Findings indicate that heightened SC arousal and orienting in early childhood is a significant risk factor for later schizotypal personality, support a left hemisphere overactivation hypothesis of schizotypy, and illustrate the potential value of a longitudinal definition of persistent schizotypy.     

The impact of early-onset cannabis use on functional brain correlates of working memory

Cannabis is the most commonly used illicit drug. Prevalence rates are particularly high among adolescents. Neuropsychological studies have identified cannabis-associated memory deficits, particularly linked to an early onset of use. However, it remains unclear, whether the age of onset accounts for altered cortical activation patterns usually observed in cannabis users. Functional magnetic resonance imaging was used to examine cortical activation during verbal working memory challenge in (1) early-onset (onset before the age of sixteen; n = 26) and (2) late-onset cannabis users (age at onset at least sixteen; n = 17). Early-onset users showed increased activation in the left superior parietal lobe. Correlational analyses confirmed the association between an earlier start of use and increased activity. Contrariwise neither cumulative dose, frequency nor time since last use was significantly associated with cortical activity. Our findings suggest that an early start of cannabis use is associated with increased cortical activation in adult cannabis users, possibly reflecting suboptimal cortical efficiency during cognitive challenge. The maturing brain might be more vulnerable to the harmful effects of cannabis use. However, due to a lack of a non-using control group we cannot exclude alternative interpretations.     

Pilot study measuring the effects of therapeutic horseback riding on school-age children and adolescents with autism spectrum disorders

This preliminary study examined the effects of 10 weekly lessons of therapeutic horseback riding (THR) on 42 participants diagnosed with an autism spectrum disorder (ages 6-16 years) compared to a subset (n = 16) of the total study population who were first evaluated before and after a 10-week waitlist control condition. All participants received baseline and post-condition assessments in the areas of self-regulation (Irritability, Lethargy, Stereotypic Behavior, and Hyperactivity), adaptive living skills, and motor skills. Participants who completed 10 weeks of THR demonstrated significant improvements on measures of Irritability, Lethargy, Stereotypic Behavior, Hyperactivity, expressive language skills, motor skills, and verbal praxis/motor planning skills. When compared to the pre- and post-assessments of participants from the waitlist control condition, the THR group still showed significant improvements in self-regulation behaviors. The THR-specific change from the baseline to post-assessments suggests that the improvements are related to the THR treatment.     

Working Memory, Attention, Inhibition, and Their Relation to Adaptive Functioning and Behavioral/Emotional Symptoms in School-Aged Children

The present study investigated the development of executive functions (EFs) and their associations with performance and behavior at school in 8–12-year-old children. The EFs were measured by computer-based n-back, Continuous Performance and Go/Nogo tasks. School performance was evaluated by Teacher Report Form (TRF) and behavior by TRF and Child Behavior Checklist. The studied dimensions of EF were cognitive efficiency/speed, working memory/attention and inhibitory control. Strong age effects were found for these cognitive abilities (p values <0.01). Inhibitory control was associated with better adaptive functioning (learning, working hard and behaving well), academic performance and less psychiatric symptoms (p values <0.05), specially in 8–9-year-old children. In this youngest age group low inhibitory control was also associated with teacher-reported inattention (p = 0.042). Low inhibitory control was associated with teacher- and parent-reported internalizing symptoms (p < 0.01). These results suggest that maturational factors may underlie low adaptive functioning and psychiatric symptoms during early school years. Further studies are needed to evaluate the association between inhibition and emotional symptoms.     

Clinical Change in Adolescent Aggressive Behavior: A Group Therapy Approach

The effects of cognitive-behavioral group therapy on adolescent aggressive behavior were examined. Participants included 11 adolescent boys (6 African American and 5 white). The Youth Self Report, the Child Behavior Checklist, and the Piers-Harris Children's Self-Concept Scale were administered pretest (before group therapy) and posttest (after group therapy). Results revealed that adolescents reported statistically significant changes in aggressive behavior, attentional problems, somatic complaints, anxious/depressed behavior, and perceptions of intellectual and school achievement and status. Parents reported clinical changes in adolescent aggressive behavior, albeit not at the level of statistical significance. These findings suggest that group therapy can be an important mechanism to help adolescents examine their attributional biases and alter maladaptive patterns of interpersonal conflict.     

Social and clinical effects of a leisure program on adults with autism spectrum disorder

Using a pre-test, post-test experimental design, effects of a 1-year group leisure program were examined on 31 participants (20 male and 11 female), ages 27–38 (M = 32.05 at start of program), with an autism spectrum disorder (ASD) diagnosis randomly assigned to the experimental condition and a group of 20 adults with ASD randomly assigned to the control group (13 male and 7 female), ages 24–38 (M = 31.75, at the program start). The Facial Discrimination Battery (FDB)-Spanish version and the Vineland Adaptive Behavior Scales-Interview Edition Survey Form (VABS) were used to measure social–emotional cognition and the Color Trails Test (CTT) and the Tower of London-Drexel Edition were used to measure executive functioning cognitive. In consideration of the ecological perspective, the Dysexecutive Questionnaire (DEX) and the Frontal Systems Behavior Scale (FrSBe), were used. Mean scores for the experimental group were higher after completing the program than during baseline and compared to the control group across all social and emotional scales. Although statistical significance of results of the socio-emotional indicators and executive function was mixed, the VABS composite that focuses on social behavior of people with ASD was significant and demonstrated the largest difference between performance at baseline and performance after the 12-month intervention. Implications for future leisure service delivery are discussed.     

The acceleration of spoken-word processing in children's native-language acquisition: an ERP cohort study

Healthy adults can identify spoken words at a remarkable speed, by incrementally analyzing word-onset information. It is currently unknown how this adult-level speed of spoken-word processing emerges during children's native-language acquisition. In a picture-word mismatch paradigm, we manipulated the semantic congruency between picture contexts and spoken words, and recorded event-related potential (ERP) responses to the words. Previous similar studies focused on the N400 response, but we focused instead on the onsets of semantic congruency effects (N200 or Phonological Mismatch Negativity), which contain critical information for incremental spoken-word processing. We analyzed ERPs obtained longitudinally from two age cohorts of 40 primary-school children (total n = 80) in a 3-year period. Children first tested at 7 years of age showed earlier onsets of congruency effects (by approximately 70 ms) when tested 2 years later (i.e., at age 9). Children first tested at 9 years of age did not show such shortening of onset latencies 2 years later (i.e., at age 11). Overall, children's onset latencies at age 9 appeared similar to those of adults. These data challenge the previous hypothesis that word processing is well established at age 7. Instead they support the view that the acceleration of spoken-word processing continues beyond age 7.     

Family cohesion and children's behavior problems: a longitudinal investigation

We examine the association of family cohesion and conflict with childhood behavior problems. A stratified random sample of 823 children was evaluated at ages 6 and 11 years. Mothers rated the family environment at age 6 using the Family Environment Scale. Mothers and teachers rated children's behavior problems at ages 6 and 11, using the Child Behavior Checklist and the Teacher Report Form, respectively. Multiple regression analysis, applying generalized estimating equations, was used. Although results varied between mothers' and teachers' data, they converged in identifying family cohesion as a factor in children's mental health. Family cohesion, as rated by mothers, had a beneficial effect on children's internalizing and attention problems, as rated by both mothers and teachers, that was stable over time. The study highlights an important relationship between family cohesion and children's internalizing and attention problems.     

Discrepancies Between Academic Achievement and Intellectual Ability in Higher-Functioning School-Aged Children with Autism Spectrum Disorder

Academic achievement patterns and their relationships with intellectual ability, social abilities, and problem behavior are described in a sample of 30 higher-functioning, 9-year-old children with autism spectrum disorder (ASD). Both social abilities and problem behavior have been found to be predictive of academic achievement in typically developing children but this has not been well studied in children with ASD. Participants were tested for academic achievement and intellectual ability at age 9. Problem behaviors were assessed through parent report and social functioning through teacher report at age 6 and 9. Significant discrepancies between children’s actual academic achievement and their expected achievement based on their intellectual ability were found in 27 of 30 (90%) children. Both lower than expected and higher than expected achievement was observed. Children with improved social skills at age 6 demonstrated higher levels of academic achievement, specifically word reading, at age 9. No relationship was found between children’s level of problem behavior and level of academic achievement. These results suggest that the large majority of higher-functioning children with ASD show discrepancies between actual achievement levels and levels predicted by their intellectual ability. In some cases, children are achieving higher than expected, whereas in others, they are achieving lower than expected. Improved social abilities may contribute to academic achievement. Future studies should further explore factors that can promote strong academic achievement, including studies that examine whether intervention to improve social functioning can support academic achievement in children with ASD.     

Mental health and academic performance: a study on selection and causation effects from childhood to early adulthood

Purpose

An inverse relationship between mental health and academic achievement is a well-known phenomenon in the scientific literature. However, how and when this association develops is not fully understood and there is a lack of longitudinal, population-based studies on young children. Early intervention is important if associations are to be found already during childhood. The aim of the present study was to investigate the development of the association between mental health and academic performance during different developmental periods of childhood and adolescence.

Methods

Data from a longitudinal birth cohort study of 1700 children were used. Child mental health was assessed through mother’s reports at age 3, and self-reports at age 12 and 20. Academic performance was assessed through teacher reports on educational results at age 12 and final grades from compulsory school (age 15–16) and upper secondary school (age 18–19). The association between mental health and academic performance was assessed through regression models.

Results

The results indicate that social selection mechanisms are present in all three periods studied. Behavioral and emotional problems at age 3 were associated with performing below grade at age 12. Similarly, mental health problems at age 12 were associated with lack of complete final grades from compulsory school and non-eligibility to higher education. Academic performance at ages 15 and 19 did not increase the risk for mental health problems at age 20.

Conclusion

Mental health problems in early childhood and adolescence increase the risk for poor academic performance, indicating the need for awareness and treatment to provide fair opportunities to education.