Effect of foot reflexology on an infant with sensorineural hearing loss: A case report.

BACKGROUND: Our study contributes to the further understanding of the mechanism of foot reflexology. Foot reflexology has been reported to affect hearing recovery, but no physiological evidence has been provided. This lack of evidence hampers the acceptance of the technique in clinical practice. CASE SUMMARY: A girl was taken to North Sichuan Medical University Affiliated Hospital for a hearing screen by her parents. Her parents reported that her hearing level was the same as when she was born. The girl was diagnosed with sensorineural hearing loss (SNHL) by a doctor in the otolaryngology department. After we introduced the foot reflexology project, the parents agreed to participate in the experiment. After 6 months of foot reflexology treatment, the hearing threshold of the girl recovered to a normal level, below 30 dB. CONCLUSION: Foot reflexology should be encouraged in clinical practice and for families of infants with SNHL.

A relação entre a oralidade e escrita e sua implicação na clínica fonoaudiológica sob diferentes perspectivas teóricas: revisão integrativa / The relationship between orality and writing and its implication in the speech therapy from different theoretical perspectives: integrative review / La relación entre oralidad y escritura y su implicación en la clínica logopédica desde diferentes perspectivas teóricas: revisión integradora

Introdução: Este trabalho diferencia três abordagens teóricas que, comumente, sustentam a prática fonoaudiológica na área da linguagem. O foco é a relação entre oralidade e escrita e sua implicação nos procedimentos clínicos nos distúrbios ou dificuldades de leitura e escrita. Objetivo: apresentar e analisar a relação entre a oralidade e a escrita e discutir como a clínica fonoaudiológica conduz o tratamento ou o acompanhamento de crianças com distúrbios na linguagem escrita em diferentes perspectivas teóricas. Método: Trata-se de uma revisão integrativa da literatura. Foram selecionados dezesseis artigos que respondem às questões de pesquisa nas seguintes abordagens: Cognitivo-Linguística, Enunciativo-Discursiva e Clínica de Linguagem (Linguístico-Discursiva). Resultados: Nota-se diferentes interpretações clínicas para a prevenção, os critérios diagnósticos, nomenclatura e método de tratamento. Conclusão: As diferentes posições teóricas definem modelos de clínicas distintos, considerando como a oralidade pode afetar a escrita. (AU)

Introduction: This work differentiates three theoretical approaches about language that are used by Brazilian speech therapists. The focus is the relationship between orality and writing and its implication in clinical procedures in disorders or difficulties in reading and writing. Objective: to produce and analyze the relationship between orality and writing and to discuss how the speech therapy clinic conducts the treatment or follow-up of children with written language disorders in different theoretical perspectives. Method: This is an integrative literature review. Sixteen articles were selected that answer the research questions in the following approaches: Cognitive-Linguistic, Enunciative-Discursive and Language Clinic (Linguistic-Discursive). Results: There are different clinical interpretations for prevention, nomenclature, diagnosis, and treatment method. Conclusion: The different theoretical positions define different clinical models, considering how orality can affect writing. (AU)

Introducción: Este trabajo diferencia tres enfoques teóricos que comúnmente sustentan la práctica de la patología del habla y el lenguaje en el área del lenguaje. El enfoque es la relación entre la oralidad y la escritura y su implicación en los procedimientos clínicos en los trastornos o dificultades en la lectura y la escritura. Objetivo: presentar y analizar la relación entre la oralidad y la escritura y discutir cómo la clínica de logopedia realiza el tratamiento o seguimiento de niños con trastornos del lenguaje escrito en diferentes perspectivas teóricas. Método: Esta es una revisión integradora de la literatura. Se seleccionaron dieciséis artículos que responden a las preguntas de investigación en los siguientes enfoques: Cognitivo-Lingüístico, Enunciativo-Discursivo y Clínica del Lenguaje (Lingüístico-Discursivo). Resultados:Existen diferentes interpretaciones clínicas para la prevención, criterios diagnósticos, nomenclatura y método de tratamiento. Conclusión: Las diferentes posiciones teóricas definen diferentes modelos clínicos, considerando cómo la oralidad puede afectar la escritura. (AU)

Comunicação social no transtorno do espectro autista: adolescentes no contexto teatral / Social communication in autistic spectrum disorder: teenagers in a theater context / Comunicación social en el trastorno del espectro autista: los adolescentes en el contexto teatral

Introdução: O transtorno do espectro autista (TEA) é caracterizado por prejuízos persistentes na comunicação e interação social e por padrões restritos de interesses e de atividades. As manifestações do quadro são presentes em níveis variáveis entre indivíduos e podem ser evidenciadas à medida que as demandas sociais excedem o limite de suas habilidades. A hipótese é de que a exposição à atividade teatral geraria impactos na comunicação social. Objetivo: Comparar o desempenho em aspectos sociais e de linguagem antes e após realização de atividade teatral em um grupo de adolescentes com TEA. Método: Participaram do estudo12 indivíduos com diagnóstico multidisciplinar de TEA com média de 16,1 anos de idade, todos com comunicação predominantemente verbal, inseridos em atividade pedagógicas e/ou ocupacionais com frequência de participação na atividade teatral de pelo menos 75%. Foram avaliados pré e pós-atividade teatral os aspectos de compreensão verbal, realização de inferência e memória a partir do reconto de uma história e as respostas diante de um texto curto em formato de piada. Esses dados foram relacionados a variáveis de nível de inteligência e de habilidades adaptativas. Resultados: Houve relação entre desempenho em habilidades de linguagem e aspectos cognitivos e de habilidades adaptativas e essas relações mantiveram-se positivas pré e pós-atividade proposta. Conclusão: A hipótese inicial foi parcialmente confirmada e os resultados sugerem tendência de melhora da comunicação social nesse contexto. (AU)

Introduction: Autism spectrum disorder (ASD) is characterized by persistent impairments in communication and social interaction and by restricted patterns of interests and activities. The condition ́smanifestations are present at different levels between individuals and can be evidenced as social demands exceed the limits of their abilities. The hypothesis is that exposure to theatrical activity would generate social communication impacts. Objective: To compare performance in social and language aspects before and after performing a theatrical activity in a group of adolescents with ASD. Method: Twelve individuals with a multidisciplinary diagnosis of ASD with an average age of 16.1 years participated in the study, all with predominantly verbal communication, engaged in educational and/or occupational activities and with at least 75% of frequency in theatrical activities. The aspects of verbal comprehension, inference and memory from the retelling of a story and the answers to a short text in a joke format were evaluated before and after the theatrical activity. These data were related to variables of level of intelligence and adaptive abilities. Results: There was a relationship between performance in language skills and cognitive aspects and adaptive skills and those relationships remained positive before and after the proposed activity. Conclusion: The initial hypothesis was partially confirmed and the results suggest a trend towards improvement in social communication in this context. (AU)

Introducción: El trastorno del espectro autista (TEA) se caracteriza por deficiencias persistentes en la comunicación y la interacción social y por patrones restringidos de intereses y actividades. Las manifestaciones de la condición están presentes en distintos niveles entre individuos y pueden evidenciarse a medida que las demandas sociales superan los límites de sus capacidades. La hipótesis es que la exposición a la actividad teatral generaría impactos en la comunicación social. Objetivo:Comparar el desempeño en aspectos sociales y lingüísticos antes y después de realizar una actividad teatral en un grupo de adolescentes con TEA. Método: Participaron del estudio doce personas con diagnóstico multidisciplinario de TEAcon una edad promedio de 16,1 años, todas con comunicación predominantemente verbal, dedicadas a actividades educativas y / u ocupacionales con una frecuencia de participación en la actividad teatral de al menos 75%. Se evaluaron los aspectos de comprensión verbal, inferencia y memoria a partir del recuento de una historia y las respuestas a un texto breve en formato de broma antes y después de la actividad teatral. Estos datos se relacionaron con variables de nivel de inteligencia y habilidades adaptativas. Resultados: Hubo una relación entre el desempeño en las habilidades del lenguaje y los aspectos cognitivos y las habilidades adaptativas y estas relaciones se mantuvieron positivas antes y después de la actividad propuesta. Conclusión: La hipótesis inicial fue parcialmente confirmada y los resultados sugieren una tendencia hacia la mejora de la comunicación social en este contexto. (AU)

Auditory evoked response to an oddball paradigm in children wearing cochlear implants.

OBJECTIVE: Although children with cochlear implants (CI) achieve remarkable success with their device, considerable variability remains in individual outcomes. Here, we explored whether auditory evoked potentials recorded during an oddball paradigm could provide useful markers of auditory processing in this pediatric population. METHODS: High-density electroencephalography (EEG) was recorded in 75 children listening to standard and odd noise stimuli: 25 had normal hearing (NH) and 50 wore a CI, divided between high language (HL) and low language (LL) abilities. Three metrics were extracted: the first negative and second positive components of the standard waveform (N1-P2 complex) close to the vertex, the mismatch negativity (MMN) around Fz and the late positive component (P3) around Pz of the difference waveform. RESULTS: While children with CIs generally exhibited a well-formed N1-P2 complex, those with language delays typically lacked reliable MMN and P3 components. But many children with CIs with age-appropriate skills showed MMN and P3 responses similar to those of NH children. Moreover, larger and earlier P3 (but not MMN) was linked to better literacy skills. CONCLUSIONS: Auditory evoked responses differentiated children with CIs based on their good or poor skills with language and literacy. SIGNIFICANCE: This short paradigm could eventually serve as a clinical tool for tracking the developmental outcomes of implanted children.

Thematic Analysis of Coping Strategies Used by Parents of Children with Cleft Lip and Palate in El Salvador.

OBJECTIVE: The aim of this study was to describe coping strategies used by parents of children with cleft palate with or without a cleft (CP ± L) during the early development of their children in El Salvador. DESIGN: Qualitative interviews were completed with 16 parents of children born with CP ± L who were 6 months to 6 years old. Parents were questioned about their emotions and coping during eight time periods: prenatal, birth, social interaction before the first surgery, the beginning of surgeries, social interaction after the first surgery, early childhood education (ECE), speech-language therapy, and formal education. Thematic analysis (TA) was used to identify coping strategies as conceptualized by Lazarus and Folkman (1984). RESULTS: Four major themes emerged: (a) experienced emotions related to diagnosis, (b) interpretations related to the birth of a child with a cleft, (c) seeking and experiencing cleft treatment, and (d) social interaction of the children. During prenatal and birth stages, parents used emotion-focused strategies. A few hours to a week after birth, they used problem-focused strategies, which led them in search of treatment. Some parents used avoidance strategies during periods of social interaction before surgery, ECE, and formal education. Socioeconomic challenges impacted access to speech-language therapy. Sociocultural factors, such as discrimination, religion, and folk beliefs, appeared to influence some of the coping strategies used by parents. CONCLUSIONS: Problem-focused strategies appear to be helpful in seeking surgical treatments. The emotion-focused strategy of avoidance seemed to have adverse effects in minimizing opportunities for social interaction prior to surgery and early education.

Adapting prenatal iron supplementation to maternal needs results in optimal child neurodevelopment: a follow-up of the ECLIPSES Study.

BACKGROUND: Prenatal prescription of standard iron supplements to prevent iron deficiency appears not to be appropriate for all women and their children, as some women may be at risk of iron deficiency and others at risk of iron excess early in pregnancy. The present study aimed to assess whether prenatal iron supplementation adapted to the needs of each pregnant woman affects their child's neurodevelopment. METHODS: Follow-up of a community-based RCT involving 503 mother-child pairs. Non-anaemic pregnant women recruited in Tarragona (Spain) early in pregnancy were prescribed a daily iron dose based on their initial haemoglobin levels: Stratum 1 (Hb = 110-130 g/L, 80 or 40 mg/d of iron) and Stratum 2 (Hb > 130 g/L, 40 or 20 mg/d of iron). Women receiving 40 mg/d were considered the control group in each Strata. The child's neurodevelopment was assessed at 40 days of age using the Bayley Scales of Infant Development-III (BSID-III). Adjusted multiple regression models were used. RESULTS: Multiple regression analyses showed no association between the intervention and control group within each Strata on the BSID-III scores on any of the developmental scales in children, including cognitive, language, and motor development: Stratum 1 (ß 1.46, 95%CI -2.15, 5.07; ß 1.30, 95%CI -1.99, 4.59; and ß 2.04, 95%CI -3.88, 7.96, respectively) and Stratum 2 (ß -4.04, 95%CI -7.27, 0.80; ß -0.36, 95%CI -3.47, 2.75; and ß -3.76, 95%CI -9.30, 1.78, respectively). CONCLUSIONS: In non-anaemic women in early pregnancy, no differences were found in the cognitive, language and motor development of children at 40 days of age between the dose of iron tested in each case -adjusted to initial Hb levels- compared to the dose of the control group. Further studies are guaranteed to confirm our findings. TRIAL REGISTRATION: The ECLIPSES study was registered at www.clinicaltrialsregister.eu as EudraCT number 2012-005,480-28.

Longitudinal trajectories of electrophysiological mismatch responses in infant speech discrimination differ across speech features.

Infants rapidly advance in their speech perception, electrophysiologically reflected in the transition from an immature, positive-going to an adult-like, negative-going mismatch response (MMR) to auditory deviancy. Although the MMR is a common tool to study speech perception development, it is not yet completely understood how different speech contrasts affect the MMR's characteristics across development. Thus, a systematic longitudinal investigation of the MMR's maturation depending on speech contrast is necessary. We here longitudinally explored the maturation of the infant MMR to four critical speech contrasts: consonant, vowel, vowel-length, and pitch. MMRs were obtained when infants (n = 58) were 2, 6 and 10 months old. To evaluate the maturational trajectory of MMRs, we applied second-order latent growth curve models. Results showed positive-going MMR amplitudes to all speech contrasts across all assessment points that decreased over time towards an adult-like negativity. Notably, the developmental trajectories of speech contrasts differed, implying that infant speech perception matures with different rates and trajectories throughout the first year, depending on the studied auditory feature. Our results suggest that stimulus-dependent maturational trajectories need to be considered when drawing conclusions about infant speech perception development reflected by the infant MMR.

Effect of cerebrolysin on neurodevelopmental outcome of high risk preterm infants: A randomized controlled trial.

BACKGROUND: A significant proportion of preterm infants experience developmental delay despite receiving a post discharge early interventional care. Cerebrolysin is a peptide mixture which acts similar to endogenous neurotrophic factors through promoting neurogenesis and enhancing neuronal plasticity. OBJECTIVE: To compare the effect of Cerebrolysin plus routine intervention program versus routine intervention program alone on the outcome of preterm infants at high risk for neurodevelopmental delay. METHODS: In a randomized controlled trial, high-risk preterm infants < 32 weeks' gestation who have abnormal neurological assessment at two months corrected post-natal age were randomized at 6 months corrected post natal age to receive either early intervention program or early intervention program plus Cerebrolysin injection of 0.1 mL/kg body weight every week for 3 months as an adjuvant therapy. The primary outcome was the rate of failure of the gross motor assessment at 12 months of corrected age and secondary outcomes included fine motor, language, and personal social development at 12 months corrected post-natal age as assessed by Denver Developmental Screening Test II. RESULTS: Cerebrolysin group had a significant lower number of infants diagnosed with failed gross motor development compared to infants in the routine intervention group [10 (33%) versus 21 (70%), p = 0.009]. Cerebrolysin group had a significant lower number of infants diagnosed with failed fine motor, language and personal social development compared to infants in the routine intervention group. CONCLUSION: Cerebrolysin, as an adjuvant therapy to routine early interventional care, may improve gross motor development of high-risk preterm infants at 12 months corrected post-natal age.

Small-quantity lipid-based nutrient supplements for children age 6-24 months: a systematic review and individual participant data meta-analysis of effects on developmental outcomes and effect modifiers.

BACKGROUND: Small-quantity (SQ) lipid-based nutrient supplements (LNSs) provide many nutrients needed for brain development. OBJECTIVES: We aimed to generate pooled estimates of the effect of SQ-LNSs on developmental outcomes (language, social-emotional, motor, and executive function), and to identify study-level and individual-level modifiers of these effects. METHODS: We conducted a 2-stage meta-analysis of individual participant data from 14 intervention against control group comparisons in 13 randomized trials of SQ-LNSs provided to children age 6-24 mo (total n = 30,024). RESULTS: In 11-13 intervention against control group comparisons (n = 23,588-24,561), SQ-LNSs increased mean language (mean difference: 0.07 SD; 95% CI: 0.04, 0.10 SD), social-emotional (0.08; 0.05, 0.11 SD), and motor scores (0.08; 95% CI: 0.05, 0.11 SD) and reduced the prevalence of children in the lowest decile of these scores by 16% (prevalence ratio: 0.84; 95% CI: 0.76, 0.92), 19% (0.81; 95% CI: 0.74, 0.89), and 16% (0.84; 95% CI: 0.76, 0.92), respectively. SQ-LNSs also increased the prevalence of children walking without support at 12 mo by 9% (1.09; 95% CI: 1.05, 1.14). Effects of SQ-LNSs on language, social-emotional, and motor outcomes were larger among study populations with a higher stunting burden (≥35%) (mean difference: 0.11-0.13 SD; 8-9 comparisons). At the individual level, greater effects of SQ-LNSs were found on language among children who were acutely malnourished (mean difference: 0.31) at baseline; on language (0.12), motor (0.11), and executive function (0.06) among children in households with lower socioeconomic status; and on motor development among later-born children (0.11), children of older mothers (0.10), and children of mothers with lower education (0.11). CONCLUSIONS: Child SQ-LNSs can be expected to result in modest developmental gains, which would be analogous to 1-1.5 IQ points on an IQ test, particularly in populations with a high child stunting burden. Certain groups of children who experience higher-risk environments have greater potential to benefit from SQ-LNSs in developmental outcomes.This trial was registered at www.crd.york.ac.uk/PROSPERO as CRD42020159971.

Benefícios das Intervenções Assistidas por Animais para estudantes com alteração de linguagem verbal / Benefits of Animal Assisted Intervention for students with verbal language disorders / Los Beneficios de las Intervenciones Asistidas por Animales para estudiantes con trastornos del lenguaje verbal

Introdução: As Intervenções Assistidas por Animais- IAA- com a mediação de cães compreendem atividades com fins terapêuticos e/ou educacionais, nas quais o cachorro é o principal mediador. Objetivo: Apresentar e analisar os resultados parciais das atividades desenvolvidas em um Projeto de Pesquisa e de Extensão, realizado no Colégio de Aplicação da Universidade Federal de Santa Catarina- CA/UFSC, evidenciando os benefícios das IAA com a mediação de cães, no processo de desenvolvimento e aprendizagem, sobretudo da linguagem verbal (fala, leitura e escrita) para os estudantes participantes. Método: Seguiu-se a abordagem qualitativa da pesquisa e realizou-se a Análise de Conteúdo¹ dos registros em diário de campo das atividades desenvolvidas. Resultados: São apresentados os resultados de três ações realizadas no projeto durante o primeiro semestre de 2019. A análise dessas atividades demonstrou que foram favorecidas as habilidades relacionadas à linguagem verbal dos estudantes. Conclusão: Considera-se que no decorrer do projeto, os participantes das IAA com a mediação de cães vêm demonstrando melhora nas aprendizagens, bem como aperfeiçoamento nas habilidades de fala, leitura e escrita.

Introduction: The Animal Assisted Intervention with the mediation of dogs comprises activities for therapeutic and / or educational purposes, in which the dog is the main mediator. Objective: To present and analyze the partial results of the activities developed in a Research and Extension Project, carried out at the Colégio de Aplicação da Universidade Federal de Santa Catarina- CA/UFSC, showing the benefits of Animal Assisted Intervention with the mediation of dogs in the process of development and learning, especially of the verbal language (speaking, reading and writing) for participating students. Method: The qualitative research approach was followed and Content Analysis¹ was carried out on the records in the daily field of the activities developed. Results: The results of three actions carried out in the project during the first semester of 2019 are presented. The analysis of these activities showed that the students' verbal language skills were instigated. Conclusion: It is considered that during the project, the participants of Animal Assisted Intervention with the mediation of dogs have been showing improvement in learning, as well as improvement in speaking, reading and writing skills.

Introducción: Las intervenciones asistidas por animales con la mediación de perros comprende actividades con fines terapéuticos y / o educativos, en las que el perro es el principal mediador. Objetivo: Presentar y analizar los resultados parciales de las actividades desarrolladas en un Proyecto de Investigación y Extensión, realizado en el Colégio de Aplicação da Universidade Federal de Santa Catarina- CA/UFSC, mostrando los beneficios de las intervenciones asistidas por animales con la mediación de perros en el proceso de desarrollo y aprendizaje, especialmente del lenguaje verbal (hablar, leer y escribir) para los estudiantes participantes. Método: Se siguió el enfoque de investigación cualitativa y se realizó el Análisis de Contenido Content de los registros en el campo diario de las actividades desarrolladas. Resultados: Se presentan los resultados de tres acciones llevadas a cabo en el proyecto durante el primer semestre de 2019. El análisis de estas actividades mostró que las habilidades del lenguaje verbal de los estudiantes fueron instigadas. Conclusión: Se considera que durante el proyecto, los participantes de las intervenciones asistidas por animales con la mediación de perros han ido mostrando una mejora en el aprendizaje, así como una mejora en las habilidades de expresión oral, lectura y escritura.

A Multi-Sectoral Approach Improves Early Child Development in a Disadvantaged Community in Peru: Role of Community Gardens, Nutrition Workshops and Enhanced Caregiver-Child Interaction: Project "Wawa Illari".

Background: Multi-dimensional monitoring evaluation and learning strategies are needed to address the complex set of factors that affect early child development in marginalized populations, but few studies have explored their effectiveness. Objective: To compare improvement of health and development of children 0-3 years between intervention communities (IC) and control communities (CC) from peripheral settlements of Lima. Sequential interventions included: (1) home and community gardens, (2) conscious nutrition, and (3) parenting workshops following the International Child Development Program (ICDP). Methods: Interventions were delivered by community health promoters (CHPs) using a "step-by-step" learning system. Both IC and CC were monitored before the interventions began, at 8 and 12 months (n = 113 IC and 127 CC children). Data were collected on household characteristics, diet, food security, health indicators (history of diarrhea and respiratory infections, hemoglobin, intestinal parasites, anthropometry), caregiver-child interactions and stress, and achievement of Pan-American Health Organization age-specific developmental milestones. Stepwise multiple logistic regressions were used to determine if the interventions affected food insecurity, as well as motor, social/cognitive and language delays. Results: At baseline, 2.6% were categorized as "suspected developmental delay" and 14.2% were on "alert for development delay." Food insecurity, diarrhea and respiratory infections were lowered following the interventions. Through the "step-by-step" approach, caregivers in IC gained skills in gardening, conscious nutrition and parenting that reduced the risk of food insecurity [Adjusted Risk Ratio = 0.20 (95% CI: 0.08-0.51)] and language delay [0.39 (0.19-0.82)] but not motor or social/cognitive delay. Use of a multiple micronutrient supplement decreased the risk of motor delay [0.12 (0.03-0.56)], but more pets were associated with higher risk of motor [3.24 (1.47-7.14)] and social/cognitive delay [2.72 (1.33-5.55)], and of food insecurity [1.73 (1.13-2.66)]. Conclusion: The combined interventions delivered by CHPs helped to mitigate the impact of adversity on food insecurity and language delay. Additional improvements may have been detected if the interventions had continued for a longer time. Our results indicate that control of infections and pets may be needed to achieve measurable results for motor and social/cognitive development. Continuous monitoring facilitated adjusting implementation strategies and achieving positive developmental outcomes.

Influence of a Functional Nutrients-Enriched Infant Formula on Language Development in Healthy Children at Four Years Old.

Nutrition during early life is essential for brain development and establishes the basis for cognitive and language skills development. It is well established that breastfeeding, compared to formula feeding, has been traditionally associated with increased neurodevelopmental scores up to early adulthood. We analyzed the long-term effects of a new infant formula enriched with bioactive compounds on healthy children's language development at four years old. In a randomized double-blind COGNIS study, 122 children attended the follow-up call at four years. From them, 89 children were fed a standard infant formula (SF, n = 46) or an experimental infant formula enriched with functional nutrients (EF, n = 43) during their first 18 months of life. As a reference group, 33 exclusively breastfed (BF) were included. Language development was assessed using the Oral Language Task of Navarra-Revised (PLON-R). ANCOVA, chi-square test, and logistic regression models were performed. EF children seemed to show higher scores in use of language and oral spontaneous expression than SF children, and both SF and EF groups did not differ from the BF group. Moreover, it seems that SF children were more frequently categorized into "need to improve and delayed" in the use of language than EF children, and might more frequently present "need to improve and delayed" in the PLON-R total score than BF children. Finally, the results suggest that SF children presented a higher risk of suffering language development than BF children. Secondary analysis also showed a slight trend between low socioeconomic status and poorer language skills. The functional compound-enriched infant formula seems to be associated with beneficial long-term effects in the development of child's language at four years old in a similar way to breastfed infants.

[Context and results of early childhood development in 12 to 59 months old children living in Mexico]. / Contexto y resultados del desarrollo infantil temprano en niños y niñas de 12 a 59 meses en México.

OBJECTIVE: To evaluate early childhood development (ECD) and its determinants in 12 to 59 months old children residents of communities <100 000 inhabitants. MATERIALS AND METHODS: The Encuesta Nacional de Salud y Nutrición of communities <100 000 inhabitants (Ensanut 100k) evaluated language level, access to ECD care services and standardized indicators of the eight quality of the development environment. We report indicator prevalence and standardized language scores according to variables of interest. RESULTS: 20.7% of children attended eight wellchild care visits within the first year of life, 13.0% received an ECD assessment, 75.0% receive support for learning, 23.4% have books and 57.7% experiment violent discipline. Improved language levels are associate with socioeconomic capacities, maternal education, preschool attendance, support for learning and household books. Children exposed to more protective factors present a language level 1.5 standard deviations higher than their peers exposed to more risk factors. CONCLUSIONS: There is a need to increase the coverage of ECD care services and to improve early development opportunities within households.

OBJETIVO: Evaluar el desarrollo infantil temprano (DIT) y sus determinantes en niños/as de 12 a 59 meses residentes en localidades de menos de 100 000 habitantes. MATERIAL Y MÉTODOS: . La Encuesta Nacional de Salud y Nutrición en localidades con menos de 100 000 habitantes (Ensanut 100k) evaluó el nivel de lenguaje, acceso a servicios de atención al DIT e indicadores de calidad del contexto de desarrollo. Se estiman prevalencias de indicadores y puntajes estandarizados de lenguaje según variables de interés. RESULTADOS: 20.7% de los niños/as asistió a ocho consultas del niño sano en su primer año, 13.0% recibió evaluación de DIT, 75.0% recibe apoyo al aprendizaje, 23.4% cuenta con libros y 57.7% sufre disciplina violenta. Mejores niveles de lenguaje se asocian con las capacidades económicas, escolaridad materna, asistencia a preescolar, apoyo al aprendizaje y acceso a libros. Los niños/as expuestos a más factores protectores presentan nivel de lenguaje 1.5 DE mayor que en niños/as con más factores de riesgo. CONCLUSIONES: Se requiere aumentar la cobertura de atención al DIT y mejorar las oportunidades de desarrollo en hogares.

Contexto y resultados del desarrollo infantil temprano en niños y niñas de 12 a 59 meses en México / Context and results of early childhood development in 12 to 59 months old children living in Mexico

Resumen: Objetivo: Evaluar el desarrollo infantil temprano (DIT) y sus determinantes en niños/as de 12 a 59 meses residentes en localidades de menos de 100 000 habitantes. Material y métodos: La Encuesta Nacional de Salud y Nutrición en localidades con menos de 100 000 habitantes (Ensanut 100k) evaluó el nivel de lenguaje, acceso a servicios de atención al DIT e indicadores de calidad del contexto de desarrollo. Se estiman prevalencias de indicadores y puntajes estandarizados de lenguaje según variables de interés. Resultados: 20.7% de los niños/as asistió a ocho consultas del niño sano en su primer año, 13.0% recibió evaluación de DIT, 75.0% recibe apoyo al aprendizaje, 23.4% cuenta con libros y 57.7% sufre disciplina violenta. Mejores niveles de lenguaje se asocian con las capacidades económicas, escolaridad materna, asistencia a preescolar, apoyo al aprendizaje y acceso a libros. Los niños/as expuestos a más factores protectores presentan nivel de lenguaje 1.5 DE mayor que en niños/as con más factores de riesgo. Conclusión: Se requiere aumentar la cobertura de atención al DIT y mejorar las oportunidades de desarrollo en hogares.

Abstract: Objective: To evaluate early childhood development (ECD) and its determinants in 12 to 59 months old children residents of communities <100 000 inhabitants. Materials and methods: The Encuesta Nacional de Salud y Nutrición of communities <100 000 inhabitants (Ensanut 100k) evaluated language level, access to ECD care services and standardized indicators of the eight quality of the development environment. We report indicator prevalence and standardized language scores according to variables of interest. Results: 20.7% of children attended eight well-child care visits within the first year of life, 13.0% received an ECD assessment, 75.0% receive support for learning, 23.4% have books and 57.7% experiment violent discipline. Improved language levels are associate with socioeconomic capacities, maternal education, preschool attendance, support for learning and household books. Children exposed to more protective factors present a language level 1.5 standard deviations higher than their peers exposed to more risk factors. Conclusion: There is a need to increase the coverage of ECD care services and to improve early development opportunities within households.

Rhythmic structure facilitates learning from auditory input in newborn infants.

Rhythm and metrical regularities are fundamental properties of music and poetry - and all of those are used in the interaction between infants and their parents. Music and rhythm perception have been shown to support auditory and language skills. Here we compare newborn infants' learning from a song, a nursery rhyme, and normal speech for the first time in the same study. Infants' electrophysiological brain responses revealed that the nursery rhyme condition facilitated learning from auditory input, and thus led to successful detection of deviations. These findings suggest that coincidence of prosodic cue patterns and to-be-learned items is more important than the format of the input. Overall, the present results support the view that rhythm is likely to create a template for future events, which allows auditory system to predict prospective input and thus facilitates language development.

A Multisectoral Food-Assisted Maternal and Child Health and Nutrition Program Targeted to Women and Children in the First 1000 Days Increases Attainment of Language and Motor Milestones among Young Burundian Children.

BACKGROUND: Child development is affected by multiple factors throughout pregnancy and childhood. Multisectoral programs addressing these factors may improve children's development. OBJECTIVE: We evaluated the impact of a food-assisted multisectoral nutrition program (Tubaramure) on children's (4-41.9 mo) motor and language development. Tubaramure was targeted to Burundian women and children in the first 1000 d and provided micronutrient-fortified food rations; nutrition, health, and hygiene behavior change communication; and health system-strengthening activities. METHODS: Program impact was assessed using a cluster-randomized controlled trial with repeated cross-sections: 2010 (baseline, children 4-41.9 mo), 2012 (follow-up during implementation, children 4-23.9 mo), and 2014 (follow-up postimplementation, children 24-41.9 mo). Sixty villages were randomly assigned to 4 groups with varying timing and duration of food rations: pregnancy-24 mo; pregnancy-18 mo; 0-24 mo; and control, no direct Tubaramure benefits. Treatment groups were pooled and compared with control using difference-in-difference estimates. We examined impact pathways by assessing program impacts on intermediary variables and their associations with development outcomes. RESULTS: At first follow-up, Tubaramure positively affected language (0.4 milestones, P < 0.05) but not motor development among children aged 4-23.9 mo. Among the 12-23.9 mo age subgroup, the program positively affected language (0.7 milestones, P < 0.01) and motor (0.6 milestones, P = 0.08) development. At second follow-up, among children aged 24-41.9 mo, Tubaramure marginally affected motor development (0.4 milestones, P = 0.09). In age subgroup analyses, program impacts were limited to children aged 24-29.9 mo [0.4 motor (P = 0.09) and 1.0 language (P < 0.01) milestones]. Pathway analyses revealed significant positive impacts on diet, health, and nutritional indicators of children aged 12-23.9 mo and health and nutritional indicators of children aged 24-29.9 mo, supporting the plausibility of program impacts on child development. CONCLUSIONS: Tubaramure had small positive impacts on children's motor and language development through multiple pathways, demonstrating the role multisectoral nutrition programs can play in improving children's development. This trial was registered at clinicaltrials.gov as NCT01072279.

Effects of increased hemoglobin on child growth, development, and disease: a systematic review and meta-analysis.

In children under 5, a hemoglobin (Hb) cutoff of 11 g/dL is recommended by the World Health Organization to define anemia, yet few studies have examined whether this cut point accurately coincides with negative functional consequences. This systematic review and meta-analysis of iron intervention and observational studies aimed to clarify the consequences of low Hb concentration in children under age 5 years on growth, development, and chronic disease (functional outcomes) across the full range of Hb values. A literature search returned 5049 studies; of these, 56 intervention and 20 observational studies fit the inclusion criteria. Among iron supplementation trials, a metaregression indicated significant associations between intervention effects on Hb and their effects on motor and mental development. For each 1 standard deviation (SD) increase in Hb, motor scores increased by 0.28 SD and mental scores increased by 0.24 SD. Iron supplementation trials among children with lower Hb concentrations at baseline showed stronger associations between their effects on Hb and their effects on mental development (P-interaction = 0.008). Heterogeneity among observational studies precluded calculation of pooled associations between Hb and functional outcomes. Available evidence was not able to establish an inflection point at which decreasing Hb begins to be associated with negative functional outcomes. Future research is needed to examine associations of Hb with growth and development in populations with varying levels of Hb, inflammation, and in different ages and settings.

Sensitivity of expressive linguistic domains to surgery age and audibility of speech in preschoolers with cochlear implants.

OBJECTIVES: To determine whether relative delays among domains exist in the conversational use of vocabulary, syntax, and morphology by children with cochlear implants (CIs) and whether these were differentially affected by age of implantation (AOI) and the audibility of speech. METHODS: Participants in this short-term longitudinal study were 126 children with AOI of 6-38 months and a matched group of 30 children without hearing loss. Language samples of the same children at ages 3.5 and 4.5 were analyzed for the breadth of vocabulary and bound morphemes used, and sentence length. RESULTS: At both test ages, expressive language domains were delayed equally. Higher performance across domains was independently associated with younger AOI and better pre-implant-aided thresholds. No domain was affected differently by very early implantation, but bound morpheme breadth was associated with better CI-aided thresholds. Between 63 and 78% of children with AOI of 6-11 months scored close to hearing age-mates by 4.5, a level achieved by fewer than 25% of those with AOI of 19-24 months or later ages. DISCUSSION: Previous studies indicated greater language delays in the areas of morphology and syntax than those of vocabulary, with the earliest ages of implantation conferring the greatest benefit to those domains. The current design addressed inconsistency across studies in modes of communication used, presence/absence of other disabilities, and differences in language domains chosen as outcome measures. CONCLUSIONS: Linguistic domains benefitted equally from early implantation, regardless of the duration of auditory stimulation. Better pre-CI-aided hearing often compensated for later AOI. Bound morpheme use was greater with better CI-aided thresholds.

Effect of Omega-3 and -6 Supplementation on Language in Preterm Toddlers Exhibiting Autism Spectrum Disorder Symptoms.

Delayed language development may be an early indicator of autism spectrum disorder (ASD). Early intervention is critical for children with ASD, and the present study presents pilot data on a clinical trial of omega-3 and -6 fatty acid supplementation and language development, a secondary trial outcome, in children at risk for ASD. We randomized 31 children to receive an omega-3 and -6 supplement or a placebo for 3 months, and measured their language abilities at baseline and after supplementation. Gesture use, but not word production, increased for children in the treatment group more than children in the placebo group. These results suggest possible effectiveness of omega-3 and -6 supplementation for language development in children at risk for ASD.

Predictors and pathways of language and motor development in four prospective cohorts of young children in Ghana, Malawi, and Burkina Faso.

BACKGROUND: Previous reviews have identified 44 risk factors for poor early child development (ECD) in low- and middle-income countries. Further understanding of their relative influence and pathways is needed to inform the design of interventions targeting ECD. METHODS: We conducted path analyses of factors associated with 18-month language and motor development in four prospective cohorts of children who participated in trials conducted as part of the International Lipid-Based Nutrient Supplements (iLiNS) Project in Ghana (n = 1,023), Malawi (n = 675 and 1,385), and Burkina Faso (n = 1,122). In two cohorts, women were enrolled during pregnancy. In two cohorts, infants were enrolled at 6 or 9 months. In multiple linear regression and structural equation models (SEM), we examined 22 out of 44 factors identified in previous reviews, plus 12 additional factors expected to be associated with ECD. RESULTS: Out of 42 indicators of the 34 factors examined, 6 were associated with 18-month language and/or motor development in 3 or 4 cohorts: child linear and ponderal growth, variety of play materials, activities with caregivers, dietary diversity, and child hemoglobin/iron status. Factors that were not associated with child development were indicators of maternal Hb/iron status, maternal illness and inflammation during pregnancy, maternal perceived stress and depression, exclusive breastfeeding during 6 months postpartum, and child diarrhea, fever, malaria, and acute respiratory infections. Associations between socioeconomic status and language development were consistently mediated to a greater extent by caregiving practices than by maternal or child biomedical conditions, while this pattern for motor development was not consistent across cohorts. CONCLUSIONS: Key elements of interventions to ensure quality ECD are likely to be promotion of caregiver activities with children, a variety of play materials, and a diverse diet, and prevention of faltering in linear and ponderal growth and improvement in child hemoglobin/iron status.