Abnormal brain structure in preschool and school-aged children with autism spectrum disorder / 中国当代儿科杂志

OBJECTIVE@#To investigate the prevalence and type of abnormal brain structure in preschool and school-aged children with autism spectrum disorder (ASD).@*METHODS@#A total of 74 252 preschool and school-aged children aged 3-12 years in Shanghai were enrolled as subjects. A questionnaire survey was performed to collect basic information, and their parents and teachers completed the Social Communication Questionnaire (SCQ) based on the children's conditions. ASD was diagnosed by specialist physicians according to the DSM-5 criteria. Brain magnetic resonance imaging (MRI) was performed according to their parents' desires.@*RESULTS@#The overall prevalence rate of ASD was 2.59‰ (192/74 252) in the preschool and school-aged children. Brain MRI data were collected from 73 children with ASD and 185 healthy children. Among the 73 children with ASD, 40 (55%) had abnormal brain structure, and the most common types were unilateral or bilateral ventriculomegaly in 32 children (80%) and unilateral or bilateral deep frontotemporal sulci in 12 children (30%). Children with ASD showed lower white matter signal in bilateral ventricular and unilateral or bilateral deep frontotemporal sulci, compared to their normal peers (P<0.05).@*CONCLUSIONS@#There is a high prevalence rate of abnormal brain structure in preschool and school-aged children with ASD, with major types of unilateral or bilateral ventriculomegaly and unilateral or bilateral deep frontotemporal sulci. It is speculated that abnormal brain structure might be associated with the pathogenesis of ASD, and further studies are needed to clarify the association between abnormal brain structure and symptoms in children with ASD.

The association of sleep hygiene and sleep quality among school-age children / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the association between sleep hygiene and sleep duration and quality among school-age children, and to explore the risk factors related to poor sleep hygiene.</p><p><b>METHODS</b>Totally 2019 grade-five children were sampled by stratified cluster random sampling from 10 primary schools in Shanghai, during November and December 2009. Questionnaires were used to investigate children and their parents. Adolescent Sleep Hygiene Scale (ASHS) was used to inquiry sleep hygiene of children; Children Sleep Habits Questionnaire (CSHQ) was used to assess their sleep duration and quality; Family and Social Environment Questionnaire was used to collect demographic and socio-economic information. T-test, one-way ANOVA and multiple linear regression model were established to identify the risk factors for sleep hygiene.</p><p><b>RESULTS</b>The age of subjects was (10.81 ± 0.38) years old, 49.0% (989/2019) were boys. The ASHS total score was 125.43 ± 15.17, girls with better sleep hygiene than boys (127.05 ± 14.41 vs 123.74 ± 15.75, P < 0.05). The sleep duration was (9.47 ± 0.58)h/d, children slept less than 9 h/d had lower ASHS total score than those slept 9 - 10 h/d or over 10 h/d (121.69 ± 16.09 vs 126.17 ± 14.62 vs 126.50 ± 15.36, P < 0.05). Children with poor sleep quality had worse sleep hygiene than those with good sleep quality (121.00 ± 15.84 vs 128.36 ± 13.92, P < 0.05). Children with television set in bedroom had lower ASHS total score than the others (122.40 ± 15.76 vs 126.74 ± 14.66, P < 0.05). Children from single parent family had lower ASHS total score (117.90 ± 16.80 vs 125.94 ± 14.89, P < 0.05). Children whose father had irregular sleep or wake pattern had lower ASHS total score (122.65 ± 15.30 vs 125.89 ± 14.90 vs 127.79 ± 14.71, P < 0.05). The regression model confirmed that existence of television set in children's bedroom, single-parent family and father's irregular sleep pattern were the risk factors of poor sleep hygiene.</p><p><b>CONCLUSION</b>Sleep hygiene was closely associated with sleep duration and quality among school-age children. Children with television set in bedroom, male, from single parent family and whose father had irregular sleep or wake pattern had worse sleep quality.</p>

Comparative study of children's sleep evaluation methods / 中华儿科杂志

<p><b>OBJECTIVE</b>To compare the compliance of using Actiwatch, parent report of sleep diary and sleep questionnaire in school age children, and to further evaluate agreement rates between actigraphy, diary, and questionnaire for children's sleep patterns.</p><p><b>METHOD</b>Two primary schools in Luwan District were selected and first grade students without obvious physical and mental illnesses or sleep disorders were enrolled in the study. Each student was home-monitored with an Actiwatch for 7 days, meanwhile parents were asked to complete a detailed sleep diary during the Actiwatch monitoring days. Sleep questionnaires were distributed to their parents who were asked to fill in these on the last monitoring day.</p><p><b>RESULT</b>Forty-five children participated in the study, 36 children completed sleep assessments by all the three methods, and among them 20 were boys and 16 were girls. The mean age of those children was (7.26±0.42) years. The completion rate of questionnaire was 100%, of diary was 86.7% (39/45) and of Actiwatch was 93.3% (42/45). The completion rate between sleep diary and sleep questionnaire was significantly different (P<0.05). The satisfactory agreement between Actiwatch and sleep diary was reached with sleep diary overestimating weekday and weekend sleep duration by 26 minutes and 25 minutes respectively. The agreement rates between Actiwatch and questionnaire was insufficient for all variables with sleep questionnaire overestimating weekday and weekend sleep duration by 37 minutes and 38 minutes respectively.</p><p><b>CONCLUSION</b>Sleep questionnaire is an easy and high compliance method for evaluating children's sleep pattern while sleep diary showed high agreement with Actiwatch. Using either of these methods for evaluating children's sleep pattern should be judged by research aim and sample size, and limitation of those methods should be considered when they are used in practice.</p>

Prospective, naturalistic study of open-label OROS methylphenidate treatment in Chinese school-aged children with attention-deficit/hyperactivity disorder / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Attention deficit hyperactivity disorder (ADHD) is one of the most common mental disorders during childhood, characterized by the core symptoms of hyperactivity, impulsivity and inattention and puts great burden on children themselves, their families and the society. Osmotic release oral system methylphenidate (OROS-MPH) is a once-daily controlled-release formulation developed to overcome some of the limitations associated with immediate-release methylphenidate (IR-MPH). It has been marketed in China since 2005 but still lacks data from large-sample clinical trials on efficacy and safety profiles. The aim of this study was to evaluate the effectiveness and safety of OROS-MPH in children aged 6 to 16 years with ADHD under naturalistic clinical setting.</p><p><b>METHODS</b>This 6-week, multi-center, prospective, open-label study enrolled 1447 ADHD children to once-daily OROS-MPH (18 mg, 36 mg or 54 mg) treatment. The effectiveness measures were parent-rated Inattention and Overactivity With Aggression (IOWA) Conners I/O and O/D subscales, physician-rated CGI-I and parent-rated global efficacy assessment scale. Blood pressure, pulse rate measurement, adverse events (AEs) and concomitant medications and treatment review were conducted by the investigator and were served as safety measures.</p><p><b>RESULTS</b>A total of 1447 children with ADHD (mean age (9.52 ± 2.36) years) were enrolled in this trial. Totally 96.8% children received an OROS-MPH modal dose of 18 mg, 3.1% with 36 mg and 0.1% with 54 mg at the endpoint of study. The parent IOWA Conners I/O score at the end of week 2 showed statistically significant (P < 0.001) improvement with OROS-MPH (mean: 6.95 ± 2.71) versus the score at baseline (10.45 ± 2.72). The change in the parent IOWA Conners O/D subscale, CGI-I and parent-rated global efficacy assessment scale also supported the superior efficacy for OROS-MPH treatment. Fewer than half of 1447 patients (511(35.3%)) reported AEs, and the majority of the events reported were mild (68.2%). No serious adverse events were reported during the study.</p><p><b>CONCLUSION</b>This open-label, naturalistic study provides further evidence of effectiveness and safety of OROS-MPH in school-aged children under routine practice.</p>

Follow-up study of school-age children's sleep quality in Shanghai / 中华儿科杂志

<p><b>OBJECTIVE</b>China has undergone massive socioeconomic change during the past several years, and its impact on children's sleep is still unrecognized. Shanghai, as one of typical economically fast-developing cities, was chosen as observational city in this study, which was designed to explore trends in sleep quality in Shanghai school-aged children and related high risk factors on sleep quality.</p><p><b>METHOD</b>Totally 884 fifth grade school-aged students were sampled by stratified cluster random sampling method from 10 primary schools of Shanghai in 2005, then four years later in 2009, 2161 same grade students were sampled from the same schools. Chinese version of Children's Sleep Habits Questionnaire (CSHQ) was used to evaluate 8 sleep quality parameters among those children, and high risk factors on school-aged children's sleep quality were investigated as well.</p><p><b>RESULT</b>The prevalence of poor sleep quality decreased from 29.2% in 2005 to 27.9% in 2009, and among 8 sleep quality parameters, bedtime resistance decreased from 33.1% to 28.7%, sleep anxiety from 50.6% to 39.8%, night waking from 25.2% to 21.5%, and parasomnia from 51.2% to 45.8%. The factors, such as heavier homework burden, longer daily computer use, bright light during sleep, cosleeping, existence of chronic disease and irregular sleep habits of parents, were associated with poor sleep quality of school-aged children after adjusting for children's age, gender, and family social-economic status.</p><p><b>CONCLUSION</b>Part of sleep quality parameters improved during the past 4 years, but current situation is still tough with more than 1/4 poor sleep quality children. Helping children to develop good sleep hygiene as well as educating parents how to shape children's regular sleep habits might be effective methods to improve children's sleep quality.</p>

Feasibility of clinical application of language sample analysis / 上海第二医科大学学报

Objective To explore the feasibility of language sample analysis in assessment of language development in children in order to provide evidences for its clinical application. Methods The study population consisted of a cross-sectional sample of 50 preschool Putonghua-speaking children aged 4 to 6 years. The data on measurement of utterance length (MLU) and lexical diversity (D) were computed from 20 minutes' conversational language samples, and correlation analysis was conducted among MLU, D, age, Wechsler Preschool and Primary Scale of Intelligence (WPPSI) and Peabody Picture Vocabulary Test (PPVT). Splited sample analysis by comparing MLU of first one hundred utterances and MLU of last one hundred utterance, D of odd lexicals and D of even lexicals were conducted to test the validity of language sample indictors. Results MLU and D development of the preschool Putonghua-speaking children were positively related to age. MLU, D, age, verbal intelligence quotient (VIQ) and PPVT were associated with each other (P<0.05 or P≤0.01) except age and VIQ(P>0.05). There were significant correlations between MLU of first one hundred utterances and MLU of last one hundred utterances and between D of odd lexicals and D of even lexicals(P=0.000). Conelusion Language sample analysis proves to be feasible in assessment of language development in preschool children aged 4 to 6 years.

Analysis of family environment of children with attention deficit hyperactivity disorder in clinics / 上海第二医科大学学报

Objective To investigate the characteristics of family environment in children with attention deficit hyperactivity disorder (ADHD) in clinics, and analyse the risk factors for ADHD. Methods Two thousand two hundred and ninety-six children with inattention, hyperactivity or unfavourable school performance were subjected to diagnosis with DSM-Ⅳ criteria in clinics. The characteristics of family environment were investigated by self-prepared questionnaires. The risk factors for ADHD were explored by univariate analysis and noneonditioned multivariate Logistic regression analysis. Results Seven hundred and twenty children were diagnosed with ADHD. There were significant differences in family environment between children with ADHD and those without(P<0.05 or P<0.01). The risk factors for ADHD included discord between parents, parental smoking and maternal depression during pregnancy and after delivery, while older age, female, paternal higher educational background were protective factors for ADHD. Conclusion Unfavourable family environment may be associated with the prevalence of ADHD, and special attention should be paid to the family environment in the treatment of ADHD.

Study of influential factors in family on late talkers / 上海第二医科大学学报

Objective To identify the influential factors in family on late talkers. Methods A cluster sampling survey was conducted on Shanghai healthy children aged 24 months to 35 months from 10 districts. Children with vocabularies less than 30 were identified as late talkers. Univariate analysis and Logistic stepwise regression analysis were performed to analyse the related environmental factors. Results There were 2 774 effective samples, and 115 late talkers (4.1%) were identified. Nine risk factors were found out from 26 environmental factors by univariate analysis, among which 5 were further identified by Logistic stepwise regression analysis as significant risk factors: urban life, education of father lower than middle school, using one language, male caregiver and lack of communication between child and caregiver. Conclusion Avoiding risk factors and providing favourable language environment may help to prevent language delay in children.

Functional improvement in children with attention deficit hyperactivity disorder after methylphenidate treatment / 上海第二医科大学学报

Objective To explore the improvement of core symptoms and detailed function in children with attention deficit hyperactivity disorder (ADHD) after treatment with methylphenidate extended-release tablets, and analyse the relationship between core symptoms reduction and detailed function improvement. Methods One hundred and fifty-six children with confirmed ADHD were rated with Swanson, Nolan, and Pelham, Version Ⅳ (SNAP-Ⅳ)Scale before treatment, then methylphenidate extended-release tablets were orally administered 18 mg once daily for 1 month, and children were rated again by means of SNAP-Ⅳ Scale and detailed function improvement questionnaire. The core symptoms reduction and detailed function improvement were observed, and their relationship was analysed. Results The primary mean scores of each factor in SNAP-Ⅳ Scale decreased significantly after treatment with methylphenidate extended-release tablets(P< 0.001). The reduction rate of factor IOWA/I/O was the most significant (>50%), followed by ADHD-H/Im and ADHD-In. The performance of school study, homework doing and social behavioral function was improved, and the detailed function was significantly improved. The reduction rate in ADHD-In factor was significantly correlated with improvement of school study and homework doing (P<0.01). The reduction rate in ADHD-H/Im factor was significantly correlated with improvement of social behavioral function(P<0.05). Conclusion Methylphenidate extended-release tablets play a role in both core symptoms reduction and detailed function improvement in children with ADHD, and core symptoms reduction is related to detailed function improvement to some degree. Methylphenidate extended-release tablets exert different effects on different detailed function.

Investigations on status and requirement of knowledge of reproduction in pregnant adolescents with abortion / 上海第二医科大学学报

Objective To investigate the status and requirement of knowledge of reproduction and acquired immunodeficiency syndrome (AIDS)/sexually transmited disease (STD) in pregnant adolescents with abortion in order to conduct proper interventions. Methods Two hundred and ninety-one unmarried pregnant adolescents below 22 years old with abortion completed questionnaires which involved the information on individual social-demographics characteristics, knowledge of reproduction, AIDS/STD and sex-related beliefs, attitudes and partners. Results Among these 291 adolescents, 37.7% experienced first sexual intercourse before 19 years old, 69.1% performed well in the knowledge of reproduction, and 62.6% and 43.5% did well in the knowledge of AIDS and the knowledge of the other STD, respectively. The rate of implementation of contraception was far less than that of awarenesss of contraception(P<0.05). These pregnant adolescents were not enthusiastic for seeking reproductive knowledge, and 45.0% would like to acquire the knowledge from professionals. Conclusion The knowledge of reproduction and AIDS/STD in the pregnant adolescents is not adequate, and they fail to carry out the proper behaviors of contraception. More education should be conducted on AIDS/STD prevention and contraception among pregnant adolescents.

Effects of forepaw sensorimotor deprivation in early life on spatial learning and memory in rats / 上海第二医科大学学报

Objective To explore the effects of forepaw sensorimotor deprivation in early life on hippocampus-dependent spatial reference learning and memory in rats. Methods Newborn SD rats were randomly assigned to experiment group (deprivation of forepaw sensorimotor function, n=53) and control group(n=55). Rats of postnatal day 13 (PN13) in experiment group were seleeted, and models of forepaw sensorimotor deprivation were established by microsurgical technique. Open field tests and Morris water maze tests were performed during the time periods of PN25(PN21-31), PN35 (PN31-39), PN45(PN41-50) and PN60(PN56-64) to evaluate the locomotor activity and spatial reference learning and memory, respectively. Results In open field tests, there was no significant difference in parameters of locomotor activity and exploratory behavior between the two groups (P>0.05). In Morris water maze tests, eontrol group performed significantly better than experiment group during training sessions and probe tests on PN25 and PN35 (P<0.05). While on PN45, although there was no significant difference between the two groups during training sessions, control group performed significantly better than experiment group during probe tests (P<0.05). Conclusion The deprivation of forepaw sensorimotor in early life has no signifieant effect on the locomotor activity and exploratory behavior of rats, but can impair the spatial reference learning and memory.

Impact of television-watching and computer-using on sleep patterns and sleep problems of school-aged children in Shanghai / 上海第二医科大学学报

Objective To investigate the effects of television-watching and computer-using on sleep/wake patterns, sleep duration and sleep problems of school-aged children in Shanghai. Methods A total of 4 108 school-aged children from 10 primary schools of Shanghai were enrolled by multi-stage cluster sampling and surveyed by questionnaires. The information of television-watching and computer-using, family and personal condition was investigated by self-prepared questionnaire, and the Chinese version of Children's Sleep Habits Questionnaire was employed to survey the sleep behaviors of children. The effects of television-watching and computer-using on sleep/wake patterns, sleep duration and sleep problems were analyzed by multiple linear regression analysis and Logistic regression analysis. Results The percentage of children who watched television≥2 h per day was 4.1% during weekdays, and that came to 49.2% during weekends. In terms of frequency of computer-using, most children reported "rarely" (88.2%, 0-1 time/week), followed by "often" (11.0%, 2-4 times/ week) and "usually" (0.8%, 5-7 times/week). With the age increase, the percentages of children who watched television≥2 h per day and those who "often" used computer gradually increased. It was revealed by multiple linear regression analysis and Logistic regression analysis that television-watching and computer-using were not only positively correlated with later bedtime, later wake time and shorter sleep duration but also significantly associated with sleep problems such as bedtime resistance, sleep onset delay, sleep duration disorder, sleep anxiety and parasomnia. Conclusion Television-watching and computer-using exert influences on sleep behaviors of sleep/wake patterns, sleep duration and sleep problems. Concerns about the potential negative effects of television-watching and computer-using on sleep behaviors may help to promote healthy sleep patterns and improve sleep quality.

Internet addiction among Shanghai adolescents: prevalence and epidemiological features / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the prevalence of internet use and internet addiction in adolescents of Shanghai.</p><p><b>METHOD</b>From September to October 2007, a total of 5135 adolescents from 16 middle schools of 6 districts of Shanghai took part in the epidemiological study by a cross-sectional survey and 5123 adolescents finally enrolled in the study. A questionnaire of "DRM Adolescent Internet Use 52 Scale" was administrated to investigate the prevalence of internet use and internet addiction in adolescents of Shanghai. On this scale of 5-point rating, the scale includes seven parts of contents as tolerance, abstinence reaction, planning ability, self-control ability, whenness, sociability and hazard.</p><p><b>RESULTS</b>The rate of internet use among the surveyed adolescents was 94.32% (4673/5123), among which the incidence rate of internet addiction was 8.78% (450/5123). Boys, senior middle-school students were more susceptible to internet addiction than girls and junior middle-school students (male scores 122.42+/-43.46, female scores 116.92+/-38.10, F=23.22, P=0.00; senior middle-school students 125.24+/-39.02, junior middle-school students 110.30+/-42.35, F=164.68, P=0.00). Students from vocational senior middle-school were most susceptible (junior middle-school students 110.30+/-42.35, ordinary senior middle-school students 122.83+/-40.99, key senior middle-school students 120.05+/-37.87, vocational senior middle-school students 133.37+/-36.84, F=34.44, P=0.00). The 2nd grade students of senior middle-school have the highest risk for internet-addiction.</p><p><b>CONCLUSION</b>The prevalence of internet use and internet addiction in adolescents of Shanghai should be comparatively high in China, which indicates that great attention should be paid to the prevention and control.</p>

Sleep habits and sleep disturbance in school-age children of China / 中华儿科杂志

<p><b>OBJECTIVE</b>To survey the sleep habits (bedtime, wake time), sleep duration, and sleep problems in school-age children of China.</p><p><b>METHOD</b>From November to December, 2005, a total of 19,299 school-age children from 55 elementary schools of 9 cities entered the study by a cross-sectional survey. A parent-administered questionnaire and the Chinese version of the Children's Sleep Habits Questionnaire were applied to investigate children's sociodemographic characteristics and sleep behaviors, respectively.</p><p><b>RESULTS</b>The mean sleep duration was 9 hours and 10 minutes (9:10, SD:48 min) during the weekdays and 9:48 (SD: 63 min) during the weekends. In about 71.4% and 41.8% school-aged children the sleep duration per day did not reach the lowest criterion of 10 hours recommended by the Ministry of Education of China during weekdays and weekends, respectively. Sleep problems were common with prevalence ranging from 14.5% for sleep-disordered breathing to 75.3% for daytime sleepiness. Parasomnia (chi(2) = 13.76, P < 0.01) and sleep-disordered breathing (chi(2) = 119.83, P < 0.01) were more prevalent in boys than in girls; however, sleep anxiety was more prevalent in girls than in boys (chi(2) = 19.42, P < 0.01). Except for night waking, other types of sleep problems were significantly associated with age.</p><p><b>CONCLUSIONS</b>Inadequate sleep duration and sleep problems prevail among school-age children, which indicates that children's sleep health may be a major public health concern in China.</p>

Application of bilingual education in child health care curriculum / 上海第二医科大学学报

Objective To prove the application of bilingual teaching in the child health care curriculum. MethodsEnglish dubbing and Chinese subtitling DVD coursewares of child growth and development were played to medical interns.The interns were asked to do questionnaires to examine feasibility and effectiveness. Results In 8-year program medical students,77.8% of them and 64.8% of the 5-year nutrition professional students could understand the contents of more than 90%.If there was no Chinese subtitles,the ratio were only 5.6% and 6.4%.Most students preferred English subtitles and dubbing,and endorsed the model of bilingual teaching. Conclusion DVD coursewares with Chinese subtitles and English dubbing can be widely used in the teaching of child health care.

A randomized controlled clinical trial for treatment of children with primary nocturnal enuresis / 中华儿科杂志

<p><b>OBJECTIVE</b>Applying three treatment methods for enuresis in children with primary nocturnal enuresis (PNE) in a randomized controlled clinical trial (RCT) to compare the curative effects and characteristics of the three methods.</p><p><b>METHODS</b>If the parents and children consented to accept the treatment for 4 months and to keep on follow-up, the children diagnosed as primary nocturnal enuresis in the department of developmental and behavioral pediatrics in Shanghai Children's Medical Center from April 2003 to August 2004 were randomized into three groups: 52 children were in physio-psychological treatment group and were treated by utilizing the conditioning training role of alarm and other psychological and behavioral training programs; 46 children were in drug treatment group and were treated by taking DDAVP tablets orally; 40 children were in combined treatment group who were treated by applying the former two methods simultaneously. If the parents and children did not accept treatment, they were enrolled into the control group and were followed-up. Then, the curative effects of the four groups were compared statistically when the 4-month treatment was over and compared again 3 months later.</p><p><b>RESULTS</b>Applying the physio-psychological treatment for 4 months, the short-term cure rate of children with enuresis was 75.0%. Three months after the end of the treatment, the long-term cure rate was 71.2%. As for drug treatment group, the short-term cure rate of children with enuresis was 47.8%, the long-term cure rate was 28.3%; As for combined treatment group, the short-term cure rate of children with enuresis was 85.0%, the long-term cure rate was 80.0%. The short-term and long-term curative effects of physio-psychological treatment group and combined treatment group were better than that of drug treatment group (P < 0.01). However, the short-term and long-term curative effects were not significantly different between physio-psychological treatment and combined treatment group (P > 0.05). Physio-psychological treatment exerts effects slowly, but showed sustained curative effects. While Drug treatment exerts effects rapidly, but the relapse rate was very high after discontinuation of the medication.</p><p><b>CONCLUSIONS</b>Physio-psychological treatment and drug treatment are currently generally recognized the best ways to treat enuresis, both of them are suitable for Chinese enuresis children, both of them showed good curative effects. Physio-psychological treatment develops children's ability to control nocturnal micturition, its curative effects were better than that of the drug treatment whilst its relapse rate is lower as compared to drug treatment. So, physio-psychological treatment is more suitable for widespread use to treat PNE in China.</p>

Early intervention for children with language developmental delay / 中华儿科杂志

<p><b>OBJECTIVE</b>To explore the mode of intervention for children with language developmental delay under the current condition of China.</p><p><b>METHOD</b>The study population consisted of a cross-sectional convenience sample of 206 children, ages 13 - 24 months, from six communities of Qingpu in Shanghai. Parents were asked to complete detailed questionnaires about their child's spontaneous use of vocabularies. Fourteen children with vocabularies less than 5 percentile of every age group were identified as having language developmental delay. During the 12-month intervention, developmental pediatricians did the developmental assessment for every child and set goals of intervention for everybody according to their language abilities and family situation. Then kindergarten teachers who got the training in language therapy carried out the intervention. Gesell development scale was used for developmental assessment before and after the intervention.</p><p><b>RESULTS</b>The developmental quotient (DQ) in areas of language and personal-social behavior was elevated significantly after 12 months of intervention (P < 0.01). The developmental quotient (DQ) in the area of adaptive behavior was also elevated (P < 0.05). There was an obvious catching up effect in both areas of language and personal-social behavior. Increased developmental age in both areas was (18.0 +/- 5.3) months and (16.2 +/- 5.9) months, respectively. The language ability of 71.4% samples was in the normal range at the end.</p><p><b>CONCLUSIONS</b>The mode of medical and educational cooperation to give early intervention for children with language developmental delay is feasible. It can significantly improve the abilities in language and communication of children 1 - 2 years of age.</p>

Development and psychometric properties of the Chinese version of Children's Sleep Habits Questionnaire / 中华儿科杂志

<p><b>OBJECTIVE</b>To develop the Chinese version of Children's Sleep Habits Questionnaire (CSHQ) by translating and retranslating the English version of CSHQ and to examine the reliability, content validity, construct validity of the Chinese version in a general population of school-age children.</p><p><b>METHODS</b>During November and December 2005, a total of 20 457 school-age children from 55 primary schools of 9 cities were recruited through cluster-stratified selection, using geographic location, economic standard, and population density as criteria. A parent-administered questionnaire and the Chinese version of CSHQ were completed to quantify sociodemographic characteristics and to characterize sleep patterns and sleep disturbances, respectively.</p><p><b>RESULTS</b>The internal consistency of overall questionnaire and the eight subscales of the Chinese version of CSHQ was good (Cronbach's alpha coefficient was 0.73 and ranged from 0.42 to 0.69, respectively). The consistency between mother and father was ICCs = 0.89 for overall questionnaire and ranged from ICCs = 0.83 to ICCs = 0.92 for subscales. The test-retest reliability was ICCs = 0.85 for overall questionnaire and range from ICCs = 0.60 to ICCs = 0.88 for subscales. Factor analysis revealed a three-factor structure, which could represent bedtime behavior problems, sleep disturbance, sleep duration and daytime sleepiness, respectively, and the three factors could be used to explain 58.63% of the total variance. The factor loading was above 0.5 for the corresponding subscale.</p><p><b>CONCLUSIONS</b>Reliability, content validity and construct validity of the Chinese version of CSHQ in a general population of school-age children are good. It appears to be a suitable instrument for measuring sleep patterns and screening for sleep problems in school-aged children.</p>

Association between vitamin D receptor gene polymorphism and vitamin D deficiency rickets / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To explore the genetic susceptibility of children to vitamin D deficiency rickets through studying the association between Vitamin D receptor (VDR) gene polymorphism and vitamin D deficiency rickets.</p><p><b>METHODS</b>One hundred and fifty-nine children (100 boys and 59 girls, aged 0 to 2 years), with new-onset vitamin D deficiency rickets were enrolled. The patients sampled from a community of Jiamusi City, Heilongjiang Province. Seventy-eight healthy age-matched children (46 boys and 32 girls) were used as the controls. VDR gene polymorphism (cleaved by restriction endonuclease Fok I) was analyzed by polymerase chase reaction-restriction fragment length polymorphism (PCR-RFLP). The frequencies of the VDR genotype and allele were compared between the two groups.</p><p><b>RESULTS</b>The frequencies of FF, Ff and ff genotypes were 37%, 51% and 12% in the Rickets group, and 18%, 55% and 27% in the Control group. A significant difference was found in the frequency distribution of the VDR genotype between the two groups (chi(2)(0.01(2))=9.210, chi(2)=13.3880, P < 0.01). In the Rickets group, f allele frequency was lower (37% vs 54%), while the F allele was more common than the Control group (63% vs 46%).</p><p><b>CONCLUSIONS</b>There is an association between the VDR gene Fok I polymorphism and vitamin D deficiency rickets. The individuals with the F allele are more susceptible to vitamin D deficiency rickets.</p>

Clinical characteristics and speech therapy of lingua-apical articulation disorder / 中华儿科杂志

<p><b>OBJECTIVE</b>To explore the clinical characteristics and speech therapy of 62 children with lingua-apical articulation disorder.</p><p><b>METHODS</b>Peabody Picture Vocabulary Test (PPVT), Gesell development scales (Gesell), Wechsler Intelligence Scale for Preschool Children (WPPSI) and speech test were performed for 62 children at the ages of 3 to 8 years with lingua-apical articulation disorder. PPVT was used to measure receptive vocabulary skills. GESELL and WPPSI were utilized to represent cognitive and non-verbal ability. The speech test was adopted to assess the speech development. The children received speech therapy and auxiliary oral-motor functional training once or twice a week. Firstly the target sound was identified according to the speech development milestone, then the method of speech localization was used to clarify the correct articulation placement and manner. It was needed to change food character and administer oral-motor functional training for children with oral motor dysfunction.</p><p><b>RESULTS</b>The 62 cases with the apical articulation disorder were classified into four groups. The combined pattern of the articulation disorder was the most common (40 cases, 64.5%), the next was apico-dental disorder (15 cases, 24.2%). The third was palatal disorder (4 cases, 6.5%) and the last one was the linguo-alveolar disorder (3 cases, 4.8%). The substitution errors of velar were the most common (95.2%), the next was omission errors (30.6%) and the last was absence of aspiration (12.9%). Oral motor dysfunction was found in some children with problems such as disordered joint movement of tongue and head, unstable jaw, weak tongue strength and poor coordination of tongue movement. Some children had feeding problems such as preference of eating soft food, keeping food in mouths, eating slowly, and poor chewing. After 5 to 18 times of therapy, the effective rate of speech therapy reached 82.3%.</p><p><b>CONCLUSION</b>The lingua-apical articulation disorders can be classified into four groups. The combined pattern of the articulation errors is the most common one. Most of the apical sounds are replaced by velar sounds. The speech localization method is very useful in the therapy of apical articulation disorder. For children with feeding problems and oral motor dysfunction, it is needed to improve food texture and administer oral motor skill training.</p>