IN MANY CHURCH-BODY DISPUTES OVER THE MORAL STATUS OF SAME-gender unions, the last line of defense against the affirmation of such unions is often an appeal to homosexual orientation as inherently "disordered," rendering same-gender unions unacceptable regardless of the loving and just qualities they may embody. On the basis of a biblical anthropology shaped by the eschatological orientation of the scriptures and further enhanced by contemporary Trinitarian discourse, this essay engages and challenges this traditional view as it has been developed (...) in the theological ethics of Helmut Thielicke. In so doing, the essay raises a key metaethical question of the theological foundations that inform Christian sexual ethics in general. (shrink)

This article presents the Islamic bioethical deliberation on the issue of sex assignment surgery for infants with disorders of sex development or intersexed as a case study. The main objective of this study is to present a different approach in assessing a biomedical issue within the medium of the Maqasid al-Shari’ah. Within the framework of the maqasidic scheme of benefits and harms, any practice where benefits are substantial is considered permissible, while those promoting harms are prohibited. The concept (...) of Maqasid al-Shari’ah which is the mechanistic interpretation of Qur’an and Hadith presents the holistic attention of Islam on many life activities, including healthcare. Indeed, this concept encompasses many aspects of worldly life, both for the human individual and collectively for the whole society. In healthcare, the practice of SAS on DSD newborns has presented an assortment of implications on the future livelihood of the affected individual. The process of decision-making seems to be very multifaceted since every element such as the determination of the ‘correct’ sex and the urgency of early surgery must consider the benefits and harms, as well as the child’s rights and best interest. The application of the concept of Maqasid al-Shari’ah, would convey a pragmatic approach that is often disregarded in Western medicine. This approach considers the right of the individual to live life optimally, individually and socially and practice his faith, precisely, in accordance with the assigned gender. (shrink)

Disorders of sexual development are a heterogeneous group of disorders in which chromosomal, gonadal or anatomical sex development is atypical. The majority of these children are recognized at birth by ambiguous genitalia. Legal and societal pressures require the physician and parents to assign sex rapidly. Though sex assignment is undebated in several disorders of sexual development, many others need an individualized approach to gender-related concerns. Gender dysphoria is prevalent in disorders of sexual (...) class='Hi'>development, and early gender-defining surgeries have potentially lifelong consequences. We use two cases, one of partial androgen insensitivity and another of simple virilizing congenital adrenal hyperplasia to illustrate that in disorders of sexual development, the ethical management principles remain the same at their core despite the vast differences in phenotypes. Sex assignment should maximize functional, psychological and sexual needs. Sex assigned should coincide with gender identity. We propose that we manage such children with the mutual participation of the physician, parents and the child. Though the parents and the physician have the child's best interests when making a decision, the child's developing autonomy should be protected. The communication of the health provider to the parent must be honest if early sex assignment is difficult. (shrink)

Though Jung's main researches have centred on the subject of individuation as an adult ideal he has a unique contribution to make to the psychology of childhood. Jung repeatedly underlined the importance of the psychology of parents and teachers in a child's development and he emphasized that an unsatisfactory psychological relationship between parents may be an important cause of disorders in childhood. He maintained that all real education of children needs teachers who not only know how to (...) learn but who can also develop their own personalities. Jung devotes a large part of the book to expounding his views on these important subjects. There is also an outline of the theory of child development, a delightful snapshot from the life of a girl called Anna and her parents, and a stimulating discussion of marriage as a psychological relationship. Finally there is a chapter on child development and individuation. (shrink)

Children with developmental language disorder (DLD) have significant deficits in language ability that cannot be attributed to neurological damage, hearing impairment, or intellectual disability. The symptoms displayed by children with DLD differ across languages. In English, DLD is often marked by severe difficulties acquiring verb inflection. Such difficulties are less apparent in languages with rich verb morphology like Spanish and Italian. Here we show how these differential profiles can be understood in terms of an interaction between properties of the input (...) language, and the child's ability to learn predictive relations between linguistic elements that are separated within a sentence. We apply a simple associative learning model to sequential English and Spanish stimuli and show how the model's ability to associate cues occurring earlier in time with later outcomes affects the acquisition of verb inflection in English more than in Spanish. We relate this to the high frequency of the English bare form (which acts as a default) and the English process of question formation, which means that (unlike in Spanish) bare forms frequently occur in third‐person singular contexts. Finally, we hypothesize that the pro‐drop nature of Spanish makes it easier to associate person and number cues with the verb inflection than in English. Since the factors that conspire to make English verb inflection particularly challenging for learners with weak sequential learning abilities are much reduced or absent in Spanish, this provides an explanation for why learning Spanish verb inflection is relatively unaffected in children with DLD. (shrink)

Whilst there have been serious attempts to locate the practice of male circumcision for religious motives in the context of the (respective) religion's narrative and community, the debate, when referring to a clinical context, is often more nuanced. This article will contribute further to the debate by contextualising the Islamic practice of male circumcision within the clinical setting typical of a contemporary hospital. It specifically develops an additional complication; namely, the child has a pre-existing blood disorder. As an approach (...) to contributing to the circumcision debate further, the ethics of a conscientious objection for secular motives towards a religiously-motivated clinical intervention will be explored. Overall, the discussion will provide relevance for such debates within the value-systems of a multi-cultural society. This article replicates several approaches to deconstructing a request for conscientious refusal of non-therapeutic circumcision by a Clinical Ethics Committee (CEC), bringing to light certain contradictions that occur in normatively categorizing motives for performing the circumcision. (shrink)

Though Jung's main researches have centred on the subject of individuation as an adult ideal he has a unique contribution to make to the psychology of childhood. Jung repeatedly underlined the importance of the psychology of parents and teachers in a child's development and he emphasized that an unsatisfactory psychological relationship between parents may be an important cause of disorders in childhood. He maintained that all real education of children needs teachers who not only know how to (...) learn but who can also develop their own personalities. Jung devotes a large part of the book to expounding his views on these important subjects. There is also an outline of the theory of child development, a delightful snapshot from the life of a girl called Anna and her parents, and a stimulating discussion of marriage as a psychological relationship. Finally there is a chapter on child development and individuation. (shrink)

Communication problems are often the first noticeable symptom of developmental abnormalities. About 15% of children at the age of 2 years demonstrate a lower level of speech expression than their peers. Speech development disorders may constitute either symptoms of global developmental delay or only isolated difficulties. One of the main challenges for professionals dealing with early development support is recognizing whether a child whose linguistic competence differs significantly from that of their peers suffers from a specific (...) language impairment, or whether they belong to the group of ‘late bloomers’ who at some point, without the intervention of a specialist, will achieve an appropriate level of communication skills. Although a differential diagnosis can be extremely difficult, the analysis of the literature leads to the conclusion that there are some markers that can aid a specialist in establishing an accurate diagnosis. (shrink)

Though Jung's main researches have centred on the subject of individuation as an adult ideal he has a unique contribution to make to the psychology of childhood. Jung repeatedly underlined the importance of the psychology of parents and teachers in a child's development and he emphasized that an unsatisfactory psychological relationship between parents may be an important cause of disorders in childhood. He maintained that all real education of children needs teachers who not only know how to (...) learn but who can also develop their own personalities. Jung devotes a large part of the book to expounding his views on these important subjects. There is also an outline of the theory of child development, a delightful snapshot from the life of a girl called Anna and her parents, and a stimulating discussion of marriage as a psychological relationship. Finally there is a chapter on child development and individuation. (shrink)

Depression is the principal cause of illness and disability in the world. Studies charting the prevalence of depression among children and adolescents report high percentages of youngsters in both groups with depressive symptoms. This review analyzes the construct and explanatory theories of depression and offers a succinct overview of the main evaluation instruments used to measure this disorder in children and adolescents, as well as the prevention programs developed for the school environment and the different types of clinical treatment provided. (...) The analysis reveals that in mental classifications, the child depression construct is no different from the adult one, and that multiple explanatory theories must be taken into account in order to arrive at a full understanding of depression. Consequently, both treatment and prevention should also be multifactorial in nature. Although universal programs may be more appropriate due to their broad scope of application, the results are inconclusive and fail to demonstrate any solid long-term efficacy. In conclusion, we can state that: (1) There are biological factors (such as tryptophan—a building block for serotonin-depletion, for example) which strongly influence the appearance of depressive disorders; (2) Currently, negative interpersonal relations and relations with one's environment, coupled with social-cultural changes, may explain the increase observed in the prevalence of depression; (3) Many instruments can be used to evaluate depression, but it is necessary to continue to adapt tests for diagnosing the condition at an early age; (4) Prevention programs should be developed for and implemented at an early age; and (5) The majority of treatments are becoming increasingly rigorous and effective. Given that initial manifestations of depression may occur from a very early age, further and more in-depth research is required into the biological, psychological and social factors that, in an interrelated manner, may explain the appearance, development and treatment of depression. (shrink)

Applying a necessary condition communication theory formalism roughly similar to that of Dretske, but focused entirely on the statistical properties of long sequences of signals emitted by the interacting cognitive modules of human biology, we explore the regularities apparent in comorbid psychiatric and chronic physical disorders using an extension of recent perspectives on autoimmune disease. We find that structured psychosocial stress can literally write a distorted image of itself onto child development, resulting in a life course trajectory (...) to characteristic forms of comorbid mind/body dysfunction affecting both dominant and subordinate populations within a pathogenic social hierarchy. (shrink)

What is attention? How does it go wrong? Do attention deficits arise from genes or from the environment? Can we cure it with drugs or training? Are there disorders of attention other than deficit disorders? The past decade has seen a burgeoning of research on the subject of attention. This research has been facilitated by advances on several fronts: New methods are now available for viewing brain activity in real time, there is expanding information on the complexities of (...) the biochemistry of neural activity, individual genes can be isolated and their functions identified, analysis of the component processes included under the broad umbrella of "attention" has become increasingly sophisticated, and ingenious methods have been devised for measuring typical and atypical development of these processes, from infancy into childhood, and then into adulthood. In this book, Kim Cornish and John Wilding are concerned with attention and its development, both typical and atypical, particularly in disorders with a known genetic etiology or assumed genetic linkage. Tremendous advances across seemingly diverse disciplines - molecular genetics, pediatric neurology, child psychiatry, developmental cognitive neuroscience, and education - have culminated in a wealth of new methods for elucidating disorders at multiple levels, possibly paving the way for new treatment options. Cornish and Wilding use three specific-yet-interlinking levels of analysis: genetic blueprint, the developing brain, and the behavioral-cognitive outcomes, as the basis for charting the attention profiles of six well-documented neurodevelopmental disorders: ADHD, autism, fragile X syndrome, Down syndrome, Williams syndrome, and 22q11 deletion syndrome. Their overarching aim in this book is to provide the most authoritative and extensive account to date of disorder-specific attention profiles and their development from infancy through adolescence. (shrink)

This book discusses and provides insight on the legal and ethical dilemmas of managing those with Fetal Alcohol Spectrum Disorder (FASD). This book provides a clear perspective for those clinicians and legal professionals who are working with those with this disorder, and correspondingly increases their understanding when arranging effective supports for this population. Historically, the primary focus on FASD has been on children. However, this is a lifelong disorder, and the implications of this disorder become even more prominent and complex (...) in adulthood. Those with this condition can struggle with impulsiveness, and a host of cognitive difficulties. This correspondingly impacts their independence and employability, and produces an elevated risk for homelessness and other residential issues, involvement in substance use, being exploited, development of behavioural issues, and subsequent legal difficulties. Their cognitive difficulties result in challenges for legal systems around the world to understand their issues, and to design appropriate remedial strategies, recommendations for treatments and supports, and even for understanding the failure of many of these individuals to be able to change their behaviours effectively. This produces various legal and ethical dilemmas, which are discussed in detail in this volume by 28 authors from Europe, New Zealand, and North America. These include discussions regarding the rights of the unborn child, the alcohol industry's duty to warn, whether small amounts of alcohol during pregnancy can be condoned, and even the current use of involuntary hospitalization for addicted mothers. Other chapters discuss the need for training on FASD for front line officers, use of lies during interrogation of those with FASD, medical and legal interventions for offenders with FASD, access to diagnostic services and follow-up supports, and whether FASD can be considered a mitigating factor for sentencing. Furthermore, caregivers also provide their stories regarding the daily dilemmas that are faced in raising those with FASD. (shrink)

Early intervention is developed following different types of service organization, which in turn require different professional and family roles. The aim of this study was to compare the perceived satisfaction and family quality of life amongst families receiving early intervention developed at centers in comparison to those receiving the routines-based early intervention in families’ homes, that is a family centered intervention in ecological environments. Under a transformative paradigm, a mixed methods design was used, using the Consumer Report Effectiveness Scale (CRES-4) (...) and the Beach Center Family Quality of Life Scale (FQOLS) and two focus groups as data collection instruments. The sample comprised 166 parents in the quantitative phase and 16 parents in the qualitative phase. Results showed that families receiving routines-based early intervention had greater satisfaction with the service although both groups showed similar scores for family quality of life in most of the analyzed domains. Three dimensions were identified throughout the qualitative phase: problem solving, professional team and service organization. Both the models analyzed have an impact on family quality of life and parents are in general satisfied. Strengths and weaknesses were found related to the problem-solving process, the role of the professional team, family empowerment and the service’s organization. The areas requiring further development are the effective training of professionals focused on family practices, the exchange of information with the family and a more participatory organization that takes parent’s perspectives into consideration. The value given to a combined model is another aspect highlighted in this study, as well as the need for a more agile assessment period to avoid unnecessary delays. (shrink)

This essay considers the moral status of certain practices that aim to enhance offspring traits. I develop an objection to offspring enhancement that draws on an account of the role morality of parents. I work out an account of parental ethics by reference to premises about child development and to observations about parenting culture in the United States. I argue that excellence in parenthood consists in a dual responsibility both to guide children toward the good life and to (...) accept them as they are. I conclude that prenatal manipulation of healthy and normal characteristics in human offspring fails to balance the dispositional extremes of control and restraint to which many parents today are susceptible. I apply this account of good parenting to the challenging case of height enhancement for short but otherwise healthy children. Finally, I reply to objections, first, about the phenomenology of bearing normative obligations to people who do not yet exist and, second, about the moral logic of criticizing embryo selection in the context of assisted reproduction when we accept child selection in the context of adoption. (shrink)

abstract This essay considers the moral status of certain practices that aim to enhance offspring traits. I develop an objection to offspring enhancement that draws on an account of the role morality of parents. I work out an account of parental ethics by reference to premises about child development and to observations about parenting culture in the United States. I argue that excellence in parenthood consists in a dual responsibility both to guide children toward the good life and (...) to accept them as they are. I conclude that prenatal manipulation of healthy and normal characteristics in human offspring fails to balance the dispositional extremes of control and restraint to which many parents today are susceptible. I apply this account of good parenting to the challenging case of height enhancement for short but otherwise healthy children. Finally, I reply to objections, first, about the phenomenology of bearing normative obligations to people who do not yet exist and, second, about the moral logic of criticizing embryo selection in the context of assisted reproduction when we accept child selection in the context of adoption. (shrink)

Since the advent of the women's movement, women have made unprecedented gains in almost every field, from politics to the professions. Paradoxically, doctors and mental health professionals have also seen a staggering increase in the numbers of young women suffering from an epidemic of depression, eating disorders, and other physical and psychological problems. In The Cost of Competence, authors Brett Silverstein and Deborah Perlick argue that rather than simply labeling individual women as, say, anorexic or depressed, it is time (...) to look harder at the widespread prejudices within our society and child-rearing practices that lead thousands of young women to equate thinness with competence and success, and femininity with failure. They argue that continuing to treat depression, anxiety, anorexia and bulimia as separate disorders in young women can, in many cases, be a misguided approach since they are really part of a single syndrome. Furthermore, their fascinating research into the lives of forty prominent women from Elizabeth I to Eleanor Roosevelt show that these symptoms have been disrupting the lives of bright, ambitious women not for decades, but for centuries. Drawing on all the latest findings, rare historical research, cross-cultural comparisons, and their own study of over 2,000 contemporary women attending high schools and colleges, the authors present powerful new evidence to support the existence of a syndrome they call anxious somatic depression. Their investigation shows that the first symptoms usually surface in adolescence, most often in young women who aspire to excel academically and professionally. Many of the affected women grew up feeling that their parents valued sons over daughters. They identified intellectually with their successful fathers, not with their traditional homemaker mothers. Disordered eating is one way of rejecting the feminine bodies they perceive as barriers to achievement and recognition. Silverstein and Perlick uncover medical descriptions matching their diagnosis in Hippocratic texts from the fourth century B.C., in anthropological studies of Africa, Asia, and Latin America, and in case studies of many noted psychologists and psychiatrists, including the "hysteric" patients Freud used to develop his theories on psychoanalysis. They have also discovered that statistics on disordered eating, depression, and a host of other symptoms soared in eras in which women's opportunities grew--particularly the 1920s, when record numbers of women entered college and the workforce, the boyish silhouette of the flapper became the feminine ideal, and anorexia became epidemic, and again from the 1970s to the present day. The authors show that identifying this devastating syndrome is a first step toward its prevention and cure. The Cost of Competence presents an urgent message to parents, educators, policymakers, and the medical community on the crucial importance of providing young women with equal opportunity, and equal respect. (shrink)

Safe stair negotiation is an everyday task that children with developmental coordination disorder are commonly thought to struggle with. Yet, there is currently a paucity of research supporting these claims. We investigated the visuomotor control strategies underpinning stair negotiation in children with and without DCD by measuring kinematics, gaze behavior and state anxiety as they ascended and descended a staircase. A questionnaire was administered to determine parents' confidence in their child's ability to safely navigate stairs and their child's (...) fall history. Kinematics were measured using three-dimensional motion capture, whilst gaze was measured using mobile eye-tracking equipment. The parents of DCD children reported significantly lower confidence in their child's ability to maintain balance on the stairs and significantly more stair-related falls in the previous year compared to the parents of typically developing children. During both stair ascent and stair descent, the children with DCD took longer to ascend/descend the staircase and displayed greater handrail use, reflecting a more cautious stair negotiation strategy. No differences were observed between groups in their margin of stability, but the DCD children exhibited significantly greater variability in their foot-clearances over the step edge, which may increase the risk of a fall. For stair descent only, the DCD children reported significantly higher levels of state anxiety than the TD children and looked significantly further along the staircase during the initial entry phase, suggesting an anxiety-related response that may bias gaze toward the planning of future stepping actions over the accurate execution of an ongoing step. Taken together, our findings provide the first quantifiable evidence that safe stair negotiation is a significant challenge for children with DCD, and that this challenge is reflected by marked differences in their visuomotor control strategies and state anxiety levels. Whilst it is currently unclear whether these differences are contributing to the frequency of stair-related falls in children with DCD, our findings pave the way for future research to answer these important questions. (shrink)

In this deeply probing, intellectually challenging work, Dr. JaanValsiner lays the groundwork for a dynamic new cultural-historicalapproach to developmental psychology. He begins by deconstructingtraditional developmental theory, exposing the conceptual confusionand epistemological blind spots that he believes continue toundermine the scientific validity of its methodologies. Hedescribes the ways in which embedded cultural biases shapeinterventional goals and influence both the direction researchtakes and the ways in which research data are interpreted. And hesuggests ways in which researchers and clinicians can become moreaware of (...) and transcend those biases. Dr. Valsiner then develops a hierarchical, systemic model thatportrays development as an open-ended, dialectical process. Centralto Valsiner's approach is the premise that, since each child isunique--as are his or her life conditions--deviations in functionor the rate of development from a prescribed norm are just aslikely to be constructive adaptations to changing environmentalpressures as symptoms of psychological disorder. Drawing uponsources as varied as linguistic philosophy, structuralanthropology, thermodynamics, and systems theory, as well as thework of many of the leading figures in twentieth-centurydevelopmental theory, Valsiner argues convincingly for an approachto developmental psychology mature enough to recognize thedifference between healthy variability and dysfunction. In later chapters the focus shifts from development in the abstractto the everyday challenges encountered by the developing child.Case histories illustrate the subtle interplay of cultural,physiological, and psychological factors in shaping childhoodbehavior. Called an "intellectual tour de force" by the Bulletin of theMenninger Clinic, Culture and the Development of Children's Actionis important reading for developmental psychologists, childpsychologists, and all child clinicians. "Of course, no science progresses in a linear fashion. It movesinterdependently with the society in which it is embedded, makinguse of the narrative forms in describing itself to its insiders andoutsiders. The rhetoric of scientists about their science istherefore necessarily inconsistent. Sciences are both socialinstitutions within a society and social organizations that attemptto build universal knowledge. It is a complicated task forpsychology to be both knowledge-constructing and self-reflexive atthe same time. Nevertheless, it is the latter kind of reflexivitythat guides the actual construction of knowledge." -- JaanValsiner "[This book] is a fascinating and important work that challengesmuch of contemporary developmental psychology. The Second Editionhas changed in a number of respects, and much new material has beenadded, but at root, Valsiner grapples with the question 'how shallwe understand development?' He continues to struggle also with whathe describes rather vividly as the 'epistemological windmills ofpsychology.' His challenge is summed up succinctly in two linesfrom a poem by T. S. Eliot: * Where is the wisdom we have lost in knowledge? * Where is the knowledge we have lost in information?" -- -- fromthe Foreword by Kevin Connolly. (shrink)

Background: This study developed a photo and video database of 4-to-6-year-olds expressing the seven induced and posed universal emotions and a neutral expression. Children participated in photo and video sessions designed to elicit the emotions, and the resulting images were further assessed by independent judges in two rounds. Methods: In the first round, two independent judges, experts in the Facial Action Coding System, firstly analysed 3,668 emotions facial expressions stimuli from 132 children. Both judges reached 100% agreement regarding 1,985 stimuli, (...) which were then selected for a second round of analysis between judges 3 and 4. Results: The result was 1,985 stimuli were produced from 124 participants. A Kappa index of 0.70 and an accuracy of 73% between experts were observed. Lower accuracy was found for emotional expression by 4-year-olds than 6-year-olds. Happiness, disgust and contempt had the highest agreement. After a sub-analysis evaluation of all four judges, 100% agreement was reached for 1,381 stimuli which compound the ChildEFES database with 124 participants and 51% induced photographs. The number of stimuli of each emotion were: 87 for neutrality, 363 for happiness, 170 for disgust, 104 for surprise, 152 for fear, 144 for sadness, 157 for anger 157, and 183 for contempt. Conclusions: The findings show that this photo and video database can facilitate research on the mechanisms involved in early childhood recognition of facial emotions in children, contributing to the understanding of facial emotion recognition deficits which characterise several neurodevelopmental and psychiatric disorders. (shrink)

Youth is a critical period in the development of maladaptive eating behaviors. Previous systematic reviews suggest the etiological significance of parent-child relationships for the onset of disordered eating in youth, but less is known about the role of parenting styles. This rapid scoping review aimed to identify whether research supports the role of parenting styles in the development of disordered eating symptoms among youths. Sixteen studies, retrieved from three databases, met the inclusion criteria: original studies, published in (...) English, examined the effect of parenting styles on cognitive and behavioral disordered eating outcomes, among young people up to 18 years of age. Studies supported an association between various youth disordered eating symptoms such as unhealthy weight control behaviors, and experiences of adverse parenting styles characterized by high levels of control and low levels of responsiveness. Associations between adverse parenting styles and youth disordered eating were frequently indirect and differed depending on the sex of the parent and offspring. Synthesis of findings was limited due to variation in the operationalization and measurement of parenting styles, family context and disordered eating across studies. Longitudinal and standardized research is required to better understand the dynamic associations between parenting styles and youth disordered eating. Implications for family-based care in clinical practice are discussed. (shrink)

In this deeply probing, intellectually challenging work, Dr. Jaan Valsiner lays the groundwork for a dynamic new cultural-historical approach to developmental psychology. He begins by deconstructing traditional developmental theory, exposing the conceptual confusion and epistemological blind spots that he believes continue to undermine the scientific validity of its methodologies. He describes the ways in which embedded cultural biases shape interventional goals and influence both the direction research takes and the ways in which research data are interpreted. And he suggests ways (...) in which researchers and clinicians can become more aware of and transcend those biases. Dr. Valsiner then develops a hierarchical, systemic model that portrays development as an open-ended, dialectical process. Central to Valsiner's approach is the premise that, since each child is unique--as are his or her life conditions--deviations function or not the rate of development from a prescribed norm are just as likely to be constructive adaptations to changing environmental pressures as symptoms of psychological disorder. Drawing upon sources as varied as linguistic philosophy, structural anthropology, thermodynamics, and systems theory, as well as the work of many of the leading figures in twentieth-century developmental theory, Valsiner argues convincingly for an approach to developmental psychology mature enough to recognize the difference between healthy variability and dysfunction. (shrink)

This is a phenomenological-hermeneutic case study of Tariq who initially presented with panic disorder. It documents how, as therapy proceeded, the underlying meaning of his initial panic deepened as its roots in traumatic memories of childhood emerged. There were four spaced phases of treatment over four years. The first focused on anxiety management; the second was conceptualized within schema-focused therapy, and evoked and worked with childhood memories using inner child guided imagery; in the third and fourth phases insights gained (...) led to an authentic re-engagement with family members in relationships that had been problematic. The panic attacks resolved and there were two dreams representing a reconfiguring of his relationship with his deceased father. The first two phases were the focus of an unpublished case study presented at a conference in 1995. This article incorporates material from that study and looks back at the case both in light of developments in phases two and three and also in light of theoretical developments in our understanding of complex trauma since the initial presentation. (shrink)

This study purposed to provide a bibliometric overview of child language research from 1900 to 2021 and identify major trends in CL. A total of 48,453 research articles related to the CL were identified from the Web of Science. Co-authorship, co-word, and co-citation analysis was conducted by using VOSviewer and CiteSpace. The following was analyzed: annual distribution of related papers; related disciplines; mainstream journals; geographical and institutional distribution; hot topics; keyword burst detection; and co-citation analysis of journals, authors, and (...) references. Results showed that, under the impact of new empirical methods and new theories, the field of CL is undergoing great changes. Research hotspot and the research trends mainly concentrated on autism spectrum disorder, school readiness, oral language, reading comprehension, exposure, bilingualism, vocabulary, input, skills, kindergarten, cochlear implants, and intervention. More and more pieces of research focus on the individual difference in CL development and the importance of intervention in language education by typically developing children and some children with disabilities or language disorders. Besides, child second language acquisition also attracted a lot of attention. This bibliometric analysis is of great reference significance for researchers to understand the progress and discipline development trend in this field. (shrink)

This study developed a cognitive behavioral therapy -based psychoeducation practice aimed at reducing obsessive-compulsive symptom levels in adolescents in Turkey and tested its effectiveness with a mixed-methods study. After the study was constructed as a pretest-posttest control group experimental application consisting of qualitative stages. The experimental application of the study was carried out with high school students in Turkey. In the sampling process, the schools, where the study will be carried out, were determined with the cluster sampling method. The experimental (...) and control groups were formed with 30 students with high obsessive-compulsive disorder symptoms from these schools, and the developed CBT-based psychoeducation practice was applied to the experimental group for 12 weeks. Quantitative data were collected through the “Child Version of the Obsessive-Compulsive Inventory,” and normality analysis, t-test for dependent samples, and Single Factor Analysis of Covariance were used. Qualitative data of the study were collected through document review, session evaluation forms, and semi-structured interview protocol; content and descriptive analysis techniques were used in the analysis. It was concluded that the developed CBT-based psychoeducation application was an effective approach in reducing OCD symptoms in the Turkish adolescent sample, except for the neutralizing dimension. It was also determined that the findings obtained from the analysis during the application and the interviews after the application are parallel with the findings obtained by quantitative methods, and the qualitative and quantitative findings adequately explained the quantitative documents findings. (shrink)

This study explores the emergence and productivity of word order usage in Mandarin-speaking typically-developing children and children with autism spectrum disorder, and examines how this emergence relates to frequency of use in caregiver input. Forty-two caregiver-child dyads participated in video-recorded 30-min semi-structured play sessions. Eleven children with ASD were matched with 10 20-month-old TD children and another 11 children with ASD were matched with 10 26-month-old TD children, on expressive language. We report four major findings: Preschool Mandarin-speaking children with (...) ASD produced word order structures with pervasive ellipsis at similar rates to language-matched TD children, but also displayed differences from TD children in their usage of SVt and VtO frames; Grammatical productivity was observed in both TD children and children with ASD; moreover, children with ASD with higher expressive language produced less stereotyped language; Both TD children and children with ASD heard a range of word orders in their caregivers’ input, with TD children’s input greater in amount and complexity; however, caregivers of both groups also showed no age/language-related changes in word order usage; Few word-order-specific correlations emerged between caregivers and their children; however, strong correlations were observed for mean length of utterances for both groups: Caregivers who produced longer/more complex utterances had children who did the same. Taken together, it seems that despite their pragmatic deficits, the early grammatical knowledge of word order in Mandarin-exposed children with ASD is well preserved and in general follows the typical developmental pattern. Moreover, caregiver input is broadly rather than finely tuned to the linguistic development of TD children and children with ASD, and plays a more important role in children’s general syntactic development than in specific word order acquisition. Thus, early word order usage in preschool Mandarin-speaking TD children and children with ASD may be influenced by both caregiver input and child abilities. (shrink)

Abstract:What is in the best interests of a child, and could that ever include interventions that we might regard as prima facie detrimental to a child’s physical well-being? This question is raised a fortiori by growth attenuation treatments in children with severe neurological disorders causing extreme developmental delay. I argue that two principles that provide guidance in generating a conception of best interests for each individual child yield the right results in such cases. The principles are (...) as follows: thepotentiality principle, whereby every child should be able to develop its potential and is entitled to receive certain help in doing so, and theprinciple of psychosomatic harmony, whereby every human being is entitled to treatment that is appropriate to or enables a life in which mind and body are in tune with each other. These principles indicate a certain response to what we can call Ashley-type cases and admit certain caveats. (shrink)

Developmental coordination disorder is a neurodevelopmental disorder that significantly impairs a child’s ability to learn motor skills and to perform everyday activities. The cause of DCD is unknown; however, evidence suggests that children with DCD have altered brain structure and function. While the cerebellum has been hypothesised to be involved in developmental coordination disorder, no studies have specifically examined cerebellar structure in this population. The purpose of our study was to examine cerebellar differences in children with DCD compared to (...) typically-developing children. Using voxel-based morphometry, we assessed cerebellar morphology in children 8–12 years of age. Forty-six children were investigated using high resolution T1-weighted images, which were then processed using the spatially unbiased atlas template of the cerebellum and brainstem toolbox for a region of interest-based examination of the cerebellum. Results revealed that children with DCD had reduced grey matter volume in several regions, namely: the brainstem, right/left crus I, right crus II, left VI, right VIIb, and right VIIIa lobules. Further, Pearson correlations revealed significant positive associations between the total motor percentile score on the Movement Assessment Battery for Children-2 and regions that had reduced grey matter volume in our cohort. These findings indicate that reductions in cerebellar grey matter volume are associated with poorer motor skills. Given the cerebellum’s involvement in internal models of movement, results of this study may help to explain why children with DCD struggle to learn motor skills. (shrink)

Parental mental disorders increase the risk for insecure attachment in children. However, the quality of caregiver–infant interaction plays a key role in the development of infant attachment. Dyadic interaction is frequently investigated via global scales which are too rough to uncover micro-temporal mechanisms. Prior research found that the latency to reparation of uncoordinated dyadic states is associated with infant behavioral and neuroendocrine regulation. We investigated the hypothesis that this interactive mechanism is critical in predicting secure vs. insecure attachment (...) quality in infancy. We also assessed the predictive quality of infant attachment regarding neuroendocrine reactivity later in childhood. A subsample of N = 58 dyads from a larger study were analyzed. At 3–8 months postpartum, maternal anxiety disorders were diagnosed via a structured clinical interview as well as dyadic interaction during the Face-to-Face-Still-Face was observed and coded on a micro-temporal scale. Infant attachment quality was assessed with the strange situation paradigm at 12–24 months of age. In an overlapping subsample of N = 39, we assessed child cortisol reactivity at 5 to 6 years of age. Generalized linear modeling revealed that longer latencies to interactive reparation during the reunion episode of the FFSF as well as maternal diagnosis at 3–8 months of age predict insecure attachment in children aged 12–24 months. Cox regressions demonstrated that dyads with infants who developed insecure attachment at 12–24 months of age were 48% less likely to achieve an interactive reparation at 3–8 months of age. Mixed models revealed that compared to securely attached children, children who had developed an insecure attachment at 12–24 months of age had an increased cortisol reactivity at 5 to 6 years of age during free play. The results confirm the hypothesis that the development of attachment is affected by experienced micro-temporal interactive patterns besides diagnostic categories. They also showed that infants of mothers with postpartum anxiety disorders have a more than fivefold increased risk of developing an insecure attachment than the infants of the control group. Moreover, results imply that these patterns may influence neurohormonal regulation even in preschool aged children. (shrink)

While several recent evaluation studies have shown the efficacy of parent training programs for children with neurodevelopmental disorders, manual-based training in German is still scarce. To address this gap, we developed a specific modularized training program for parents of children from preschool to pre-adolescent age with Autism Spectrum Disorder. The overarching purpose of the FETASS intervention is to enhance social communication behavior and quality of life of the child by coaching parents. As a proximal target, the FETASS training (...) aims to provide families with behavior management and communication strategies. The development of the training was influenced by published behavioral parent trainings and autism-specific interventions. The training comprises eight weekly sessions and targets families whose children have a diagnosis of Autism Spectrum Disorder without intellectual and language impairments. As a preliminary pilot study, the purpose was to evaluate the acceptability of the training. Furthermore, the study aimed at initially evaluating social communication behavior, quality of life of the child, parental stress level, and parenting after training in comparison to a treatment as usual group. Exploratively, long-term effects were investigated after 6 months of training as well. In total, 57 families participated. Questionnaires about social communication behavior and quality of life of the child, parental stress, and parenting were administered at three time points. Primary outcome measures were the social communication behavior of the child and the parent’s proxy report on quality of life of the child. Secondary outcome measures were changes in parental stress and parenting behavior. Acceptability of the training was very high and we had almost no dropouts during training. Results for the primary outcome measure of social communication behavior, overall quality of life of the child, and long-term effects on social communication behavior were not significant. While long-term findings for parent stress reduction and for the quality of life of the child are promising, further research has to be done in a future randomized controlled trial. (shrink)

Today, one out of every six children suffers from some form of neurodevelopmental abnormality. The causes are mostly unknown. Some environmental chemicals are known to cause brain damage and many more are suspected of it, but few have been tested for such effects. Philippe Grandjean provides an authoritative and engaging analysis of how environmental hazards can damage brain development and what we can do about it. The brain's development is uniquely sensitive to toxic chemicals, and even small deficits (...) may negatively impact our academic achievements, economic success, risk of delinquency, and quality of life. Chemicals such as mercury, polychlorinated biphenyls, arsenic, and certain pesticides pose an insidious threat to the development of the next generation's brains. When chemicals in the environment affect the development of a child's brain, he or she is at risk for mental retardation, cerebral palsy, autism, ADHD, and a range of learning disabilities and other deficits that will remain for a lifetime.We can halt chemical brain drain and protect the next generation, however, and Grandjean tells us how. First, we need to control all of the 200 industrial chemicals that have already been proven to affect brain functions in adults, as their effects on the developing brain are likely even worse. We must also push for routine testing for brain toxicity, stricter regulation of chemical emissions, and more required disclosure on the part of industries who unleash hazardous chemicals into products and the environment. Decisions can still be made to protect the brains of future generations."In his crisply written, deeply documented book, Dr. Philippe Grandjean, renowned physician and public health specialist, describes the exquisite vulnerability of the developing human brain to toxic chemicals in the environment, a vulnerability that he ascribes to the brain's almost unimaginable complexity. Today, nearly one in 6 children is born with a neurodevelopmental disorder - a birth defect of the brain. One in 8 has attention deficit disorder. One in 68 is diagnosed with autism spectrum disorder. These rates are far higher than those of a generation ago, and, although they are less publicized, the problems are more prevalent than those caused by thalidomide in the 1960's. The increases are far too rapid to be genetic. They cannot be explained by better diagnosis. How then could they have come to be? Dr. Grandjean has a diagnosis -- the thousands of toxic chemicals that have been released to the environment in the past 40 years with no testing for toxicity. David P. Rall, former Director of the US National Institute of Environmental Health Sciences, once stated that 'If thalidomide had caused a ten-point loss of IQ rather than obvious birth defects of the limbs, it would probably still be on the market'. This is the core message of Dr. Grandjean's 'must read' book." - Philip J. Landrigan, Dean for Global Health, Ethel H. Wise Professor and Chairman and Director, Children's Environmental Health Center, Mount Sinai School of Medicine. (shrink)

The well-known impairments in the social use of eye-gaze by children with autism have been chiefly explored through experimental methods. The present study aims to contribute to the naturalistic analysis of social eye-gaze by applying Conversation Analysis to video recordings of three Finnish children with a diagnosis of autism, each interacting with familiar others in ordinary settings. The analysis identifies two interactional environments where some children with autism show eye-gaze related competence with respect to gazing at their co-participants: these are (...) when the child carries out an initiating action or a responsive action. We discuss how this qualitative analysis of interactional structure could be extended using quantitative methods and eye-tracking technology in order to develop a better understanding of the disorder. Keywords: Autism; eye-gaze; conversation analysis; social interaction; interactional competence. (shrink)

The well-known impairments in the social use of eye-gaze by children with autism have been chiefly explored through experimental methods. The present study aims to contribute to the naturalistic analysis of social eye-gaze by applying Conversation Analysis to video recordings of three Finnish children with a diagnosis of autism, each interacting with familiar others in ordinary settings . The analysis identifies two interactional environments where some children with autism show eye-gaze related competence with respect to gazing at their co-participants: these (...) are when the child carries out an initiating action or a responsive action . We discuss how this qualitative analysis of interactional structure could be extended using quantitative methods and eye-tracking technology in order to develop a better understanding of the disorder. Keywords: Autism; eye-gaze; conversation analysis; social interaction; interactional competence. (shrink)

We propose that human self-domestication favored the emergence of a less aggressive phenotype in our species, more precisely phenotype prone to replace (reactive) physical aggression with verbal aggression. In turn, the (gradual) transition to verbal aggression and to more sophisticated forms of verbal behavior favored self-domestication, with the two processes engaged in a reinforcing feedback loop, considering that verbal behavior entails not only less violence and better survival, but also more opportunities to interact longer and socialize with more conspecifics, ultimately (...) enabling the emergence of more complex forms of language. Whereas in the case of self-domestication sexual selection has been proposed to work against physical aggression traits, in the case of verbal insult the selection has been proposed to work in favor of verbal aggression. The tension between these two seemingly opposing forces gets resolved/alleviated by a tendency to replace physical aggression with verbal aggression, and with verbal behavior more generally. This also helps solve the paradox of the Self Domestication Hypothesis regarding aggression, more precisely why aggression in humans has been reduced only when it comes to reactive aggression, but not when it comes to proactive aggression, the latter exhibiting an increase with the advent of modern language. We postulate that this feedback loop was particularly important during the time period before 50 kya, arguably between 200 kya and 50 kya, when humans were not fully modern, neither in terms of their skull/brain morphology and their behavior/culture, nor in terms of their self-domestication. The novelty of our approach lies (i) in giving an active role to early forms of language in interacting with self-domestication processes; (ii) in providing specific linguistic details and functions of this early stage of grammar (including insult and humor); (iii) in supplying neurobiological, ontogenetic, and clinical evidence of a link between (reactive) aggression and (reactive) verbal behavior; (iv) in identifying a variety of proxies of the earlier stages in evolution among cognitive disorders; and (v) in identifying specific points of contact and mutual reinforcement between these two processes (self-domestication and early language evolution), including reduction in physical aggression and stress/tension, as well as sexual selection. (shrink)

BackgroundThe present study examined the efficacy of the Michigan Model of Infant Mental Health-Home Visiting infant mental health treatment to promote the socioemotional wellbeing of infants and young children. Science illuminates the role of parental “co-regulation” of infant emotion as a pathway to young children’s capacity for self-regulation. The synchrony of parent–infant interaction begins to shape the infant’s own nascent regulatory capacities. Parents with a history of childhood adversity, such as maltreatment or witnessing family violence, and who struggle with symptoms (...) of post-traumatic stress may have greater challenges in co-regulating their infant, thus increasing the risk of their children exhibiting social and emotional problems such as anxiety, aggression, and depression. Early intervention that targets the infant–parent relationship may help buffer the effect of parental risk on child outcomes.MethodsParticipants were 58 mother–infant/toddler dyads enrolled in a longitudinal randomized control trial testing the efficacy of the relationship-based IMH-HV treatment model. Families were eligible based on child age and endorsement of at least two of four socio-demographic factors commonly endorsed in community mental health settings: elevated depression symptoms, three or more Adverse Childhood Experiences parenting stress, and/or child behavior or development concerns. This study included dyads whose children were born at the time of study enrollment and completed 12-month post-baseline follow-up visits. Parents reported on their own history of ACEs and current posttraumatic stress disorder symptoms, as well as their toddler’s socioemotional development.ResultsMaternal ACEs predicted more toddler emotional problems through their effect on maternal PTSD symptoms. Parents who received IMH-HV treatment reported more positive toddler socioemotional wellbeing at follow-up relative to the control condition. The most positive socioemotional outcomes were for toddlers of mothers with low to moderate PTSD symptoms who received IMH-HV treatment.ConclusionResults indicate the efficacy of IMH-HV services in promoting more optimal child socioemotional wellbeing even when mothers reported mild to moderate PTSD symptoms. Results also highlight the need to assess parental trauma when infants and young children present with socioemotional difficulties. (shrink)

This article elaborates on Putnam's ''discrete behavioral states'' model of dissociative identity disorder (Putnam, 1997) by proposing the involvement of the orbitalfrontal cortex in the development of DID and suggesting a potential neurodevelopmental mechanism responsible for the development of multiple representations of self. The proposed ''orbitalfrontal'' model integrates and elaborates on theory and research from four domains: the neurobiology of the orbitalfrontal cortex and its protective inhibitory role in the temporal organization of behavior, the development of emotion (...) regulation, the development of the self, and experience-dependent reorganizing neocortical processes. The hypothesis being proposed is that the experience-dependent maturation of the orbitalfrontal cortex in early abusive environments, characterized by discontinuity in dyadic socioaffective interactions between the infant and the caregiver, may be responsible for a pattern of lateral inhibition between conflicting subsets of self-representations which are normally integrated into a unified self. The basic idea is that the discontinuity in the early caretaking environment is manifested in the discontinuity in the organization of the developing child's self. (shrink)

Background: Losing one’s only child may lead to post-traumatic stress disorder, of which re-experiencing is the core symptom. However, neuroimaging studies of sex differences in re-experiencing in the context of the trauma of losing one’s only child and PTSD are scarce; comparisons of the functional networks from the hippocampal subfields to the thalamus might clarify the neural basis.Methods: Thirty couples without any psychiatric disorder who lost their only child, 55 patients with PTSD, and 50 normal controls underwent (...) resting-state functional magnetic resonance imaging. The functional connectivity from the hippocampal subregions to the thalamus and the correlations of FC with re-experiencing symptoms were analyzed within and between the sexes.Results: Compared with husbands without PTSD, wives without PTSD had higher re-experiencing symptoms and weaker FC between the right hippocampal cornu ammonis 3 and the right thalamus. Moreover, only the correlation between the RCA3-RT FC and re-experiencing in wives without PTSD was significant. Among the three groups, only the RCA3-RT FC in female subjects was markedly different. Additionally, the RCA3-RT FC in wives without PTSD was remarkably lower relative to female patients with PTSD.Conclusion: Wives without PTSD who lost their only child had worse re-experiencing symptoms relative to their husbands, which was associated with the FC alteration between the hippocampal subregions and the thalamus. Importantly, the low level of the RCA3-RT FC may play a potentially protective role against the development of PTSD in wives who have lost their only child. (shrink)

Amblyopia, or lazy eye, is a neurological vision disorder that studies have shown to affect two to five percent of the population. Current methods of treatment produce the best visual outcome, if the condition is identified early in the patient's life. Several early screening procedures are aimed at finding the condition while the patient is a child, including an automated vision screening system. This paper aims to use artificial intelligence techniques to automatically identify children who are at risk for (...) developing the amblyopic condition and should therefore be referred to a specialist, i.e., pediatric ophthalmologist. Three techniques, namely, decision tree learning, random forest, and artificial neural network, are studied in this paper in terms of their effectiveness, using metrics of sensitivity, specificity, and accuracy. The features used by the techniques are extracted from images of patient eyes and are based on the color information. The efficacy of pixel color data is investigated with respect to the measurement of the rate of change of the color in the iris and pupil, i.e., color slope features. A 10-fold stratified cross validation procedure is used to compare the effectiveness of the three AI techniques in this medical application domain. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Personal Narratives: Parenting Children With Autism Spectrum Disorders Through the Transition to AdulthoodCatherine Cornell, Julie Herren, Susan Osborne, and Kelly WeissTransition years: From Learning, Living and Loving to Maintenance and MediocrityCatherine CornellWhat does every parent of an autistic child worry about the most? For those of us with severely affected children, the answer to that question is: “Who will care for my child and keep her (...) safe when I am gone?”I drove my daughter back to her “group home” for a scheduled drop off on Saturday. There was only one car in the driveway and the house van was gone. Lily was not happy about returning “home.” Agitated, she opened the door to the car, almost before it was stopped, ran to the back of the house, and up the fire escape stairs to the door of her third floor bathroom, as if she was avoiding going through the main living rooms of the house. I called up to her that there was no one at home and she came back down and pushed through the unlocked door. Racing ahead of me, she was already shed of her clothes and in the shower: her self–calming method that she used whenever returning to the house. Thirty minutes later, after three attempts to leave the shower and throwing up in the shower, she dressed and ran back out to our car. I played her favorite music, attempting to calm her anxiety. This transition, from home to “group home,” was increasingly difficult due to recent changes in staff and housemates. Having no one there to greet her was ratcheting up the anxiety level for both of us.When the on–call manager came, Lily was so distraught that I asked for her medications and took her back home with me. Two days later she was calm enough and I was reassured enough to return her to the house. Somehow the house manager made the incident my fault. Perhaps I did react strongly, but on reflection, what triggered the strong reaction in me was the insecurity I felt at finding no one home. It seemed like a breach of trust. Like we were left, abandoned, our plans shattered and at the mercy of fate. Strong emotions for a little mix–up in communications (if that is what it was) but, nevertheless, there it is—how I felt and more to the point how my daughter felt.I relate this story because it illustrates what has changed the most about our lives since Lily left her school and entered the world of adult services: missing is the feeling of trust and security that responsible caring people would keep Lily safe when my husband and I cannot.My 25–year–old daughter Lily has severe autism. She was the most beautiful and easy baby imaginable and appeared to develop normally until she began to lose speech and have night terrors at 15 months of age. She was diagnosed initially with atypical autism, then pervasive developmental disorder not otherwise specified, and finally with autism at age four.From age four to twenty–two, she attended a specialized school for autism where she received age level academics, therapies for speech, and training in self–care and independent living. She did not do well in academics nor did she regain her lost speech. She did learn to care for herself with assistance and, as important, she gained social and behavioral skills and learned to live with others in a social way. She [End Page E1] also learned recreational and vocational skills that would be transferrable to the community, such as bicycle riding, rollerblading, swimming and jogging. The philosophy of her school was to build self–esteem and confidence by teaching music, art and physical skills—in small steps, ensuring success, and then building on those skills.In her last year at school, Lily was a happy and well–adjusted member of her small group of five young women living in a town house with support from trained school staff. She participated in job programs, earning money by recycling and working for Meals–On–Wheels. She went out into the community with her group... (shrink)

BackgroundThe increased risk of developing attention-deficit hyperactivity disorder (ADHD) in extremely preterm infants is well-documented. Better understanding of perinatal risk factors, particularly those that are modifiable, can inform prevention efforts.MethodsWe examined data from the Extremely Low Gestational Age Newborns (ELGAN) Study. Participants were screened for ADHD at age 10 with the Child Symptom Inventory-4 (N = 734) and assessed at age 15 with a structured diagnostic interview (MINI-KID) to evaluate for the diagnosis of ADHD (N = 575). We studied (...) associations of pre-pregnancy maternal body mass index (BMI), pregestational and/or gestational diabetes, maternal smoking during pregnancy (MSDP), and hypertensive disorders of pregnancy (HDP) with 10-year and 15-year ADHD outcomes. Relative risks were calculated using Poisson regression models with robust error variance, adjusted for maternal age, maternal educational status, use of food stamps, public insurance status, marital status at birth, and family history of ADHD. We defined ADHD as a positive screen on the CSI-4 at age 10 and/or meeting DSM-5 criteria at age 15 on the MINI-KID. We evaluated the robustness of the associations to broadening or restricting the definition of ADHD. We limited the analysis to individuals with IQ ≥ 70 to decrease confounding by cognitive functioning. We evaluated interactions between maternal BMI and diabetes status. We assessed for mediation of risk increase by alterations in inflammatory or neurotrophic protein levels in the first week of life.ResultsElevated maternal BMI and maternal diabetes were each associated with a 55–65% increase in risk of ADHD, with evidence of both additive and multiplicative interactions between the two exposures. MSDP and HDP were not associated with the risk of ADHD outcomes. There was some evidence for association of ADHD outcomes with high levels of inflammatory proteins or moderate levels of neurotrophic proteins, but there was no evidence that these mediated the risk associated with maternal BMI or diabetes.ConclusionContrary to previous population-based studies, MSDP and HDP did not predict ADHD outcomes in this extremely preterm cohort, but elevated maternal pre-pregnancy BMI, maternal diabetes, and perinatal inflammatory markers were associated with increased risk of ADHD at age 10 and/or 15, with positive interaction between pre-pregnancy BMI and maternal diabetes. (shrink)

What is attention? How does it go wrong? Do attention deficits arise from genes or from the environment? Can we cure it with drugs or training? Are there disorders of attention other than deficit disorders? The past decade has seen a burgeoning of research on the subject of attention. This research has been facilitated by advances on several fronts: New methods are now available for viewing brain activity in real time, there is expanding information on the complexities of (...) the biochemistry of neural activity, individual genes can be isolated and their functions identified, analysis of the component processes included under the broad umbrella of "attention" has become increasingly sophisticated, and ingenious methods have been devised for measuring typical and atypical development of these processes, from infancy into childhood, and then into adulthood. In this book, Kim Cornish and John Wilding are concerned with attention and its development, both typical and atypical, particularly in disorders with a known genetic etiology or assumed genetic linkage. Tremendous advances across seemingly diverse disciplines - molecular genetics, pediatric neurology, child psychiatry, developmental cognitive neuroscience, and education - have culminated in a wealth of new methods for elucidating disorders at multiple levels, possibly paving the way for new treatment options. Cornish and Wilding use three specific-yet-interlinking levels of analysis: genetic blueprint, the developing brain, and the behavioral-cognitive outcomes, as the basis for charting the attention profiles of six well-documented neurodevelopmental disorders: ADHD, autism, fragile X syndrome, Down syndrome, Williams syndrome, and 22q11 deletion syndrome. Their overarching aim in this book is to provide the most authoritative and extensive account to date of disorder-specific attention profiles and their development from infancy through adolescence. (shrink)

False belief tasks have enjoyed a monopoly in the research on children’s development of a theory of mind. They have been granted this status because they promise to deliver an unambiguous assessment of children’s understanding of the representational nature of mental states. Their poor cousins, true belief tasks, have been relegated to occasional service as control tasks. That this is their only role has been due to the universal assumption that correct answers on true belief tasks are inherently ambiguous (...) regarding the level of the child’s understanding of mental states. It has also been due to the universal assumption that nothing in the child’s developing theory of mind would lead to systematically incorrect answers on true belief tasks. We review new findings that 4- and 5-year-olds do err, systematically and profoundly, on the true belief versions of all the extant belief tasks. This reveals an intermediate level of understanding in the development of children’s theory of mind. Researchers have been unaware of this intermediate level because it produces correct answers in false belief tasks. A simple two-task battery—one true belief task and one false belief task—is sufficient to remove the ambiguity from each task. The new findings show that children do not acquire an understanding of beliefs, and hence a representational theory of mind, until after 6 years of age, or 2 years later than most developmental psychologists have concluded. This raises the question of how to interpret other new findings that infants are able to pass false belief tasks. We review these new infant studies, as well as recent studies on chimpanzees, in light of older children’s failure on true belief tasks, and end with some speculation about how all of these new findings might be reconciled. (shrink)

Scientific and technological advances are lending pressure to expand the scope of newborn screening. Whereas this has great potential for improving child health, it also challenges our current perception of such programmes. Standard newborn screening programmes are clearly justified by the fact that early detection and treatment of affected individuals avoids significant morbidity and mortality. However, proposals to expand the scope and complexity of such testing are not all supported by a similar level of evidence for unequivocal benefit. We (...) argue that screening for genetic susceptibility to complex disorders is inherently different from standard screening and, while of potential value, must be considered separately from conventional testing. (shrink)

Today, one out of every six children suffers from some form of neurodevelopmental abnormality. The causes are mostly unknown. Some environmental chemicals are known to cause brain damage and many more are suspected of it, but few have been tested for such effects. Philippe Grandjean provides an authoritative and engaging analysis of how environmental hazards can damage brain development and what we can do about it. The brain's development is uniquely sensitive to toxic chemicals, and even small deficits (...) may negatively impact our academic achievements, economic success, risk of delinquency, and quality of life. Chemicals such as mercury, polychlorinated biphenyls, arsenic, and certain pesticides pose an insidious threat to the development of the next generation's brains. When chemicals in the environment affect the development of a child's brain, he or she is at risk for mental retardation, cerebral palsy, autism, ADHD, and a range of learning disabilities and other deficits that will remain for a lifetime.We can halt chemical brain drain and protect the next generation, however, and Grandjean tells us how. First, we need to control all of the 200 industrial chemicals that have already been proven to affect brain functions in adults, as their effects on the developing brain are likely even worse. We must also push for routine testing for brain toxicity, stricter regulation of chemical emissions, and more required disclosure on the part of industries who unleash hazardous chemicals into products and the environment. Decisions can still be made to protect the brains of future generations."In his crisply written, deeply documented book, Dr. Philippe Grandjean, renowned physician and public health specialist, describes the exquisite vulnerability of the developing human brain to toxic chemicals in the environment, a vulnerability that he ascribes to the brain's almost unimaginable complexity. Today, nearly one in 6 children is born with a neurodevelopmental disorder - a birth defect of the brain. One in 8 has attention deficit disorder. One in 68 is diagnosed with autism spectrum disorder. These rates are far higher than those of a generation ago, and, although they are less publicized, the problems are more prevalent than those caused by thalidomide in the 1960's. The increases are far too rapid to be genetic. They cannot be explained by better diagnosis. How then could they have come to be? Dr. Grandjean has a diagnosis -- the thousands of toxic chemicals that have been released to the environment in the past 40 years with no testing for toxicity. David P. Rall, former Director of the US National Institute of Environmental Health Sciences, once stated that 'If thalidomide had caused a ten-point loss of IQ rather than obvious birth defects of the limbs, it would probably still be on the market'. This is the core message of Dr. Grandjean's 'must read' book." - Philip J. Landrigan, Dean for Global Health, Ethel H. Wise Professor and Chairman and Director, Children's Environmental Health Center, Mount Sinai School of Medicine. (shrink)

Dementia accompanies aging in certain susceptible individuals. The chemical function of the brain remains normal, but certain neurotransmitter-selective diseases, such as Parkinson's disease, Huntington's disease, and Alzheimer's disease occur more commonly with age.There are at least two issues troubling researchers of senile dementia at the moment. One is the contribution of cell death, as opposed to selective neuronal atrophy, to the pathology of degenerative disorders. The other is how early the onset of dementia might be detected. The resolution of (...) such issues is important for the design of therapies for the common and most serious chronic, rather than acute, neurodegenerative disease.Alzheimer's disease is one of the most devastating neurological disorders. The ethical debate is often related to when human biological life ceases or when a person ceases to exist. If the elder is still a person, he/she is no more the same person. Huntington's disease is inherited as a highly penetrant, autosomal dominant neuronal disorder. A genetic test can accurately predict a person's risk and that of the children. As the knowledge of the genetic basis is increasing and prenatal diagnosis gets easier, the possibilities to avoid child disorders will become greater, but genetic testing raises problematic ethical issues. Ethical action involves the right to know and the right not to know, it involves freedom of choice and freedom implies knowledge. It is ethical that relatives in age of procreation should be informed. In any case, efficacy and safety of the procedure, the risk-benefit ratio for a particular disease must be judged to be acceptable and understood through informed consent by the patient or the family or both. (shrink)

Parental substance use is a major risk factor for child development, heightening the risk of drug problems in adolescence and young adulthood, and exposing offspring to several types of traumatic event. First, prenatal drug exposure can be considered a form of trauma itself, with subtle but long-lasting sequalae at the neuro-behavioural level. Second, parents’ addiction often entails a childrearing environment characterised by poor parenting skills, disadvantaged contexts and adverse childhood experiences, leading to dysfunctional outcomes. Young adults born from/raised (...) by parents with drug problems and who develop a Substance Used Disorder (SUD) themselves might display a particularly severe condition in terms of cognitive deficits and impaired personality function. This preliminary study aims to investigate the role of early exposure to drugs as a traumatic event, capable of affecting the psychological status of young drug addicts. In particular, it intends to examine the neuropsychological functioning and personality profile of young adults with severe SUDs who were exposed to drugs early in their family context. The research involved 3 groups each consisting of 15 young adults (aged 18-24): a group of inpatients diagnosed with SUDs and exposed to drugs early, a comparison group of non-exposed inpatients and a group of non-exposed youth without SUDs. A neuropsychological battery (Esame Neuropsicologico Breve-2), an assessment procedure for personality disorders (Shedler-Westen Assessment Procedure-200) and the Symptom CheckList-90-Revised were administered. According to present preliminary results, young drug addicts exposed to drugs during their developmental age were characterised by elevated rates of neuropsychological impairments, especially at the expense of attentive and executive functions; personality disorders were also common but did not differentiate them from non-exposed young people with SUDs. Alternative multi-focused prevention and intervention programs are needed for children of drug-misusing parents, addressing executive functions and adopting a trauma-focused approach. (shrink)

Dementia accompanies aging in certain susceptible individuals. The chemical function of the brain remains normal, but certain neurotransmitter-selective diseases, such as Parkinson's disease, Huntington's disease, and Alzheimer's disease occur more commonly with age.There are at least two issues troubling researchers of senile dementia at the moment. One is the contribution of cell death, as opposed to selective neuronal atrophy, to the pathology of degenerative disorders. The other is how early the onset of dementia might be detected. The resolution of (...) such issues is important for the design of therapies for the common and most serious chronic, rather than acute, neurodegenerative disease.Alzheimer's disease is one of the most devastating neurological disorders. The ethical debate is often related to when human biological life ceases or when a person ceases to exist. If the elder is still a person, he/she is no more the same person. Huntington's disease is inherited as a highly penetrant, autosomal dominant neuronal disorder. A genetic test can accurately predict a person's risk and that of the children. As the knowledge of the genetic basis is increasing and prenatal diagnosis gets easier, the possibilities to avoid child disorders will become greater, but genetic testing raises problematic ethical issues. Ethical action involves the right to know and the right not to know, it involves freedom of choice and freedom implies knowledge. It is ethical that relatives in age of procreation should be informed. In any case, efficacy and safety of the procedure, the risk-benefit ratio for a particular disease must be judged to be acceptable and understood through informed consent by the patient or the family or both. (shrink)