Sleep and Behavior Problems in Children With Epilepsy

We designed a cross-sectional study to examine the association between sleep and behavior problems in toddlers and preschool-age children with epilepsy. We found that 71 (78.9%) children slept less than 10 hours in a 24-hour period according to the actigraphy, with 75 (83.3%) children waking for more than an hour during nocturnal sleep. Twenty-five (27.8%) children usually or sometimes had an inconsistent bedtime, and 24 (26.7%) did not sleep the same amount each day. Twenty-nine (32.2%) and 18 (20.0%) children had an internalizing and externalizing problem in clinical range, respectively. Sleep anxiety was significantly (p < .01) associated with increased internalizing and externalizing problems, even after the relevant epilepsy variables were controlled for. Findings from our study suggest that screening of sleep and behavior problems should be part of routine epilepsy care to identify children with problematic sleep and unrecognized sleep disorders and those at risk of behavioral dysfunction.     

Sleep Characteristics in Mothers of Children With Developmental Disabilities

Impaired sleep can contribute to conditions such as cardiometabolic disorders, depression, and decreased immune function. Mothers of children with developmental disabilities (DDs) may be at greater risk for impaired sleep due to the sleep problems of their children. This cross-sectional study described the self-reported sleep characteristics of mothers of children (ages 6-12) with DDs by using a sleep diary and the Pittsburgh Sleep Quality Index (PSQI) as quantitative and qualitative measures of sleep in these mothers. The Consensus Sleep Diary was modified to ascertain how the child's sleep and needs for care during the night impacted the mother's sleep. The results showed that mothers had short sleep duration (nearly 40% slept <7 hours per night), woke up an average of 2.2 times per night (most commonly due to caregiving needs of children), and had poor sleep quality (mean PSQI global score of 7.9 [SD=4.8]). The sleep problems of children with DDs may influence mothers’ sleep.     

Intellectual Problems Shown by 11-year-old Children Whose Mothers Had Postnatal Depression

The aim of the study was to examine long-term sequelae in the children of mothers who were depressed at 3 months postpartum. In a community sample from two general practices in South London. 149 women were given psychiatric interviews at 3 months postpartum and 132 of their children (89 %) were tested at 11 years of age. The children of women who were depressed at 3 months postpartum had significantly lower IQ scores. They also had attentional problems and difficulties in mathematical reasoning. and were more likely than other children to have special educational needs. Boys were more severely affected than girls, with the sex difference most pronounced on Performance IQ. The links between postnatal depression and the children's intellectual problems were not mediated by parental IQ and were not accounted for by measures of social disadvantage nor by the mother's later mental health problems. Breastfeeding did not remove the effect of the mother's illness on Full Scale IQ, but exerted its own influence on Verbal IQ and appeared to mediate the link with mathematical ability. The findings show that adverse experiences in infancy predict cognitive ability and academic performance a decade later.     

Behavioural Treatment for Sleep Problems in Children with Severe Learning Disabilities and Challenging Daytime Behaviour: Effect on Daytime Behaviour

The study aimed to investigate a group of children with severe learning disabilities, challenging daytime behaviour, and severe sleep problems to see if successful behavioural treatment of the children's sleep problems resulted in reduced daytime challenging behaviour as reported by mothers and teachers. A randomised controlled trial of behavioural interventions for the children's sleep problems was conducted (N = 30). The intervention group received an individually tailored behavioural programme and were supported by telephone calls from the therapist. Baseline assessments of the children's behaviour were made using the Aberrant Behavior Checklist and were repeated 1 month and 3 months after the start of intervention. There were no behavioural changes that were specific to children in the treatment group. However, improvements in some behaviours were seen in both the intervention and the control group at the 1-month and 3-month assessments and there was agreement between mothers' and teachers' reports for many of these changes. The results suggest that nonspecific effects of participating in the study (including an increased sleep duration, which was seen in both groups), rather than resolution of sleep problem per se, may have a beneficial effect on child behaviour and these factors need to be identified for therapeutic use.     

Differences Between Children of Depressed and Non-depressed Mothers: Locus of Control, Anxiety and Self-esteem: a Research Note

Fifty-six mothers (26 depressed and 30 non-depressed) and their children were assessed on three measures: locus of control, anxiety and self-esteem. T-tests of results indicated significant differences between the groups of mothers across all three measures. There were significant differences between the two groups of children on state anxiety, total score on the self-esteem measure and social self-esteem, with the children of non-depressed mothers being lower on state anxiety and showing higher levels of self-esteem. Other aspects of self-esteem and locus of control did not show significant differences between the groups. A correlation matrix revealed that trait anxiety in the children of depressed mothers was significantly correlated with the mothers' depression, but not the mothers' anxiety. An analysis of discriminant functions found that a more anxious mood state and feelings of fear and worry were associated with the children of the depressed mothers.     

新疆不同民族、不同地区6～14岁儿童睡眠状况流行病学调查

目的 了解新疆不同民族、不同地区6～14岁儿童睡眠状况及其相关因素.方法 2009年10-12月在新疆地区6个县、2个市随机抽取6～14岁不同民族儿童,由专人负责对其家长进行儿童家庭、社会环境与睡眠健康问卷调查,实际发放调查问卷总数为7 011份,回收问卷6 893份(回收率为98.00%),剔除＞14岁及＜6岁的儿童问卷,有效问卷6 833份.结果 新疆不同民族6～14岁儿童平时平均每天睡眠时间比较,哈萨克族、维吾尔族儿童睡眠时间较汉族、回族儿童睡眠时间长.在被调查的儿童中,睡眠障碍者占33.3%.其中哈萨克族儿童睡眠障碍发生率为45.85%,汉族为40.78%,维吾尔族为18.42%,回族为28.16%.不同民族常见的睡眠障碍表现亦有差别.影响儿童睡眠时间的主要因素有完成家庭作业所需时间、母乳喂养断乳时间、孩子吃晚餐时间、民族、是否用摇床等,而睡眠障碍发生的主要危险因素有曾长期或近期服用某些药物、民族、常患感冒、家庭人均住房面积、家族中有人有睡眠障碍、与父母同睡等.结论 新疆不同民族儿童普遍存在睡眠时间不足、睡眠质量差,睡眠障碍的发生率较高,其中哈萨克族及汉族儿童尤为显著.儿童睡眠状况应予以重视.     

Sleep patterns in children with attention-deficit/hyperactivity disorder, tic disorder, and comorbidity

BACKGROUND: In children, attention-deficit/hyperactivity disorder (ADHD), tic disorder (TD), and their coexistence (ADHD + TD comorbidity) are very common and clinically important. Associated sleep patterns and their clinical role are still insufficiently investigated. This study aimed at characterizing these sleep patterns in children with ADHD, TD, and ADHD + TD comorbidity and determining whether, in ADHD + TD, the factors ADHD and TD may affect the sleep pattern in an independent (additive) or in a complex (interactive) manner. METHOD: By means of polysomnography, sleep patterns were investigated in 4 groups of unmedicated 8.0-16.4-year-old children (healthy controls, ADHD-only, TD-only, and ADHD + TD). Each group consisted of 18 subjects matched for age, gender, and intelligence. RESULTS: ADHD was primarily characterized by increase in rapid eye movement (REM) sleep, whereas TD patients displayed lower sleep efficiency and elevated arousal index in sleep. In children with ADHD + TD, both effects appeared. No interaction between the ADHD and TD factors was found for any of the sleep parameters. Significant correlations between sleep patterns and clinical symptoms were found. CONCLUSIONS: ADHD and TD are characterized by specific sleep alterations. When coexisting, the two disorders alter the sleep pattern in an additive manner, suggesting a high impact on clinical and therapeutic perspectives.     

无锡市3～12岁儿童睡眠状况流行病学调查

目的　了解无锡市 3～ 1 2岁儿童睡眠时间及睡眠障碍发生率。方法　 2 0 0 3年 6～ 9月在无锡市 3个行政区随机抽取 2 376名 3～ 1 2岁健康儿童 ,由专人负责对其家长进行儿童睡眠状况问卷调查。结果　 3～ 1 2岁各年龄组儿童的平均每日睡眠时间分别为 1 1 .1 6 ,1 0 .91 ,1 0 .68,1 0 .2 7,9.81 ,9.67,9.61 ,9.57,9.60 ,9.61h。睡眠障碍总发生率为 2 5 .5 % ,其中睡眠频繁鼾症发生率为 7.8% ,磨牙 7.7% ,张口呼吸 6 .6 % ,喉头哽咽 0 .63 % ,睡眠呼吸暂停 0 .34 % ,梦呓 4 .2 % ,梦游 0 .63 % ,遗尿1 .4 % ,睡眠中肢体抽动 3 .2 % ,睡眠不安 6 .2 %。结论　无锡市儿童睡眠时间普遍减少 ,睡眠障碍发生率较高。     

Pre-school Children of Amphetamine-addicted Mothers: I. Somatic and Psychomotor Development

ABSTRACT. Sixty-five children whose mothers took amphetamine during pregnancy have been followed prospectively since birth. At 4 years of age their somatic growth and general health did not differ from that of another unselected Swedish population of the same age examined at the Child Health Centre. Developmental screening by the Terman Merrill method showed that the group as a whole had a significantly lower IQ (103) than a sampled Swedish group (110). The psychological assessment of the child's adaptation and emotional wellbeing showed that there were more disturbed children or "problem children" in the group that had lived partly or all the time with a mother who was still addicted to drugs     

阻塞性睡眠呼吸暂停低通气综合征及鼾症患儿多导睡眠图的特点

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)及鼾症患儿多导睡眠图(PSG)的特点及PSG对儿童睡眠障碍的临床价值。方法对74例OSAHS及62例同年龄组原发性鼾症儿童进行整夜多导睡眠监测,并进行比较,观察呼吸紊乱指数(AHI)、觉醒次数、周期性腿动指数、睡眠最低血氧饱和度等16项指标。结果与鼾症组相比,OSAHS患儿周期性腿动指数、AHI、平均血氧饱和度(%)、最低血氧饱和度(%)、发生在非快速动眼期(NREM)的AHI均有显著差异(P均<0.05)。结论PSG是鉴别诊断OSAHS与鼾症的重要方法,与鼾症组相比OSAHS患儿睡眠结构无明显改变.OSAHS在患儿中主要发生在NREM期。     

Maternal anxiety and depression,poverty and marital relationship factors during early childhood as predictors of anxiety and depressive symptoms in adolescence

BACKGROUND: This paper examines the degree to which symptoms of anxiety and depression at age 14 years are associated with early childhood experience of maternal anxiety and depression, poverty, and mother's marital relationship distress and break-up. METHODS: In a longitudinal study, 4434 families were followed-up from infancy to adolescence. RESULTS: Maternal anxiety and depression during early childhood were found to have small, but significant, influences upon the development of high anxiety-depression symptoms at age 14, after controlling for the effects of poverty and marital relationship factors. This effect was greater with repeated exposure to high maternal anxiety and depression. Poverty, distressed marital relationship and marital break-up during the child's first five years also produced small, but significant, increases in risk of high anxiety and depression symptoms in adolescence. Stable, single-parent status was not found to be a risk factor. There was no evidence of marked gender differences in risk factors, other than poverty, which had a stronger impact for girls than boys. CONCLUSIONS: Overall, the results suggest that maternal anxiety and depression, poverty, parent relationship conflict and marital break-up during early childhood are associated with small, but significant, increased risk of anxiety-depression symptoms in adolescence.     

乌鲁木齐市6-12岁儿童睡眠状况的流行病学研究

目的 了解乌鲁木齐市小学儿童的睡眠状况及其相关因素.方法 2005年11月-12月间在乌鲁木齐市3个行政区随机抽取l 853名6-12岁儿童,由专人负责对其家长进行家庭、社会环境与睡眠健康问卷调查.结果 乌鲁木齐市6-12岁儿童平均每天睡眠时间均明显低于国外标准,而各年龄组周末睡眠时间基本在正常范围;睡眠问题的发生率为55%.其中睡眠时辗转不安14.65%,梦呓4.76%,梦游1.47%,遗尿1.52%,磨牙5.72%,频繁打鼾12.85%,呼吸暂停0.49%,憋醒1.9%;影响儿童睡眠时间的主要因素有:完成家庭作业所需时间、母乳喂养断乳时间、孩子吃晚餐时间等;睡眠问题发生的主要危险因素有:曾长期或近期服用某些药物、常患感冒、家庭人均住房面积、家族中有人有睡眠障碍、与父母同睡等.结论 乌鲁木齐市小学儿童睡眠时间不足,睡眠质量差.睡眠问题的发生率较高,应引起社会及家长的重视.造成儿童睡眠时间不足和睡眠问题的因素较多,对其防治还需进一步深入研究. [临床儿科杂志,2008,26(4):320-324]     

Emotional and Behavioural Problems in Primary School Children from Nuclear and Extended Families in Korea

The changes occurring within Korean society provide an opportunity for studying the influence of family structure on children's emotional and behavioural problems. Children aged 7–13 years from two Korean cities were assessed for emotional and behavioural problems in school by their teachers, using the Children's Behaviour Questionnaire. In Study 1, 326 children from extended families were compared with demographically matched nuclear family children in the same school classes. In Study 2, a further sample of 204 extended family children was compared with pair-matched nuclear family children, in order to replicate the findings. Children from Study 1 were followed up 2.5 years later. Children from extended families had lower behaviour problems scores and the prevalence of serious problems was lower in extended family children. These differences were most marked in relation to externalising behaviour problems and were stable over the studies and time. Grandparents in extended families may increase children's resiliency by providing sources of attachment, affection, and knowledge, as well as having indirect effects through their support of parents. Consistent with recent ideas about the cognitive bases for behaviour problems, it may be that rules for behaviour derived from traditional cultural beliefs and values are internalised by children from extended families and generalise to prevent behaviour problems in school.     

Discourse Deficits Associated with Psychiatric Disorders and with Language Impairments in Children

The purpose of the current study was to examine whether types of discourse deficits were associated differentially with psychiatric disorders (PD) and with language impairments (LI) in children. Discourse analyses examining the occurrence of different types of discourse deficits in language structure, information structure, and flow of information were performed on the spoken narratives of 111 children aged 7 to 12 years who comprised 4 groups: (1) psychiatrically referred children with LI (PD + LI), (2) psychiatrically referred children with normally developing language (PD), (3) nonreferred children with language impairments (LI), and (4) nonreferred children with normally developing language (controls). Discourse deficits in language and information structure characterized children with LI, whereas disruptions in the flow of discourse characterized children with PD. Children with the comorbid condition exhibited deficits associated with both LI and PD; in addition, they displayed distinct deficits related to pronominal reference and causal cohesion. The findings provide a preliminary understanding of the associations among language, discourse, and psychopathology in children.     

Planning and Execution of Action in Children with and without Developmental Coordination Disorder

Ninety-five children from six English primary schools were identified on the basis of the Movement Assessment Battery for Children (Movement ABC) as having developmental coordination disorder (DCD) and, together with age- and ability-matched controls, were given three tasks that involved proprioception in the control and discrimination of limb position, and two tasks that involved planning for end state comfort after a bar was grasped and turned. The children in the DCD group performed less well on the majority of the proprioceptive tasks, but did not differ from controls in planning of grip selection. There was an improvement in grip planning with age. The results are contrasted with research indicating that people with autism do have a difficulty with planning grip selection.