Validating motor delays across the developmental coordination disorder-questionnaire and the Vineland adaptive behavior scales (VABS) in children with autism spectrum disorderASD: A SPARK dataset analysis.

Motor delays in children with autism spectrum disorder (ASD) are being increasingly recognized using a brief screening tool, called the Developmental Coordination Disorder-Questionnaire (DCD-Q). Further validation of these motor delays using a more robust normed, developmental measure is clearly warranted. In this analysis, a nationally representative sample from the SPARK study was used wherein parents completed the DCD-Q and a more widely used developmental/adaptive functioning measure, called the Vineland Adaptive Behavior Scales (VABS); which comprises of various developmental domains including the motor domain (N = 2,644 completed the DCD-Q and VABS). Eighty two percent children with ASD had a motor delay based on their DCD-Q scores whereas 77% children with ASD had a motor delay based on their VABS motor domain scores. Approximately 70% children with ASD had concurrent motor delay on the DCD-Q and the VABS (i.e., positive predictive value of DCD-Q). Furthermore, there was 81.2% accuracy in reporting a risk/no risk of motor delay across both measures. Overall, these statistics align with the recent reports on proportions of children with ASD having motor delays. Parents of ~70% children with ASD are reporting motor delays that are corroborated across two different motor measures. This not only validates the motor delays reported based on the DCD-Q but also indicates the need for concurrent motor screening using both DCD-Q and VABS for better detection of motor delays in children with ASD. Only 10%-32% of the current SPARK sample received any physical or recreational therapies. This mismatch between presence of motor delays and the lack of access to motor services highlights the need for more motor intervention referrals for children with ASD.

Demographic differences in access to health/therapeutic services over first year of the pandemic: a SPARK COVID-19 impact survey analysis.

Introduction: This analysis examined changes in services received and service recovery one-year post-pandemic compared to pre-pandemic levels in children with ASD aged between 19 months and 17 years in various subgroups based on factors such as age, income, race/ethnicity, geographic location, and sex. Methods: An online, parent report survey was completed by the parents of children with ASD in the SPARK study cohort (N = 6,393). Descriptive statistics, chi-square analyses, and Spearman correlations were performed to study associations between various factors and service access, pre-pandemic and one-year, post-pandemic. Results: One year after pandemic, the lag in service recovery in children with ASD was greatest for PT/OT services followed by SLT. ABA services only recovered in half of the subgroups. In contrast, SES fully recovered and MH and MED services superseded pre-pandemic levels. Across majority of the timepoints, younger children received more SLT, PT/OT, and ABA services whereas older children received more SES, MH, and MED services. Higher income families accessed more SES, SLT, and ABA whereas lower income families received more MH services. White families received less SLT compared to non-white families. Hispanic families received more SLT services compared to non-Hispanic families. Compared to rural families, urban families received more ABA services at baseline which also recovered one year after the pandemic. Certain counterintuitive findings may be attributed to home/remote schooling leading to reduced access to related services. Conclusions: Future research and policy changes are needed to address the American healthcare vulnerabilities when serving children with ASD by enhancing the diversity of healthcare formats for continued service access during future pandemics and other similar crises.

Exploring cortical activation and connectivity in infants with and without familial risk for autism during naturalistic social interactions: A preliminary study.

Behavioral signs of Autism Spectrum Disorder (ASD) are typically observable by the second year of life and a reliable diagnosis of ASD is possible by 2 to 3 years of age. Studying infants with familial risk for ASD allows for the investigation of early signs of ASD risk within the first year. Brain abnormalities such as hyper-connectivity within the first year may precede the overt signs of ASD that emerge later in life. In this preliminary study, we use functional near-infrared spectroscopy (fNIRS), an infant-friendly neuroimaging tool that is relatively robust against motion artifacts, to examine functional activation and connectivity during naturalistic social interactions in 9 high-risk (HR; older sibling with ASD) and 6 low-risk (LR; no family history of ASD) infants from 6 to 9 months of age. We obtained two 30-second baseline periods and a 5-minute social interaction period. HR infants showed reduced right and left-hemispheric activation compared to LR infants based on oxy (HbO2) and deoxy (HHb) signal trends. HR infants also had greater functional connectivity than LR infants during the pre- and post-social periods and showed a drop in connectivity during the social period. Our findings are consistent with previous work suggesting early differences in cortical activation associated with familial risk for ASD, and highlight the promise of fNIRS in evaluating potential markers of ASD risk during naturalistic social contexts.

Relation between early motor delay and later communication delay in infants at risk for autism.

BACKGROUND: Motor delays have been reported in retrospective studies of young infants who later develop Autism Spectrum Disorders (ASDs). OBJECTIVE: In this study, we prospectively compared the gross motor development of a cohort at risk for ASDs; infant siblings of children with ASDs (AU sibs) to low risk typically developing (LR) infants. METHODS: 24 AU sibs and 24 LR infants were observed at 3 and 6 months using a standardized motor measure, the Alberta Infant Motor Scale (AIMS). In addition, as part of a larger study, the AU sibs also received a follow-up assessment to determine motor and communication performance at 18 months using the Mullen Scales of Early Learning. RESULTS: Significantly more AU sibs showed motor delays at 3 and 6 months than LR infants. The majority of the AU sibs showed both early motor delays and later communication delays. LIMITATIONS: Small sample size and limited follow-up. CONCLUSIONS: Early motor delays are more common in AU sibs than LR infants. Communication delays later emerged in 67-73% of the AU sibs who had presented with early motor delays. Overall, early motor delays may be predictive of future communication delays in children at risk for autism.

Social and non-social visual attention patterns and associative learning in infants at risk for autism.

BACKGROUND: Social inattention is common in children with autism whereas associative learning capabilities are considered a relative strength. Identifying early precursors of impairment associated with autism could lead to earlier identification of this disorder. The present study compared social and non-social visual attention patterns as well as associative learning in infant siblings of children with autism (AU sibs) and low-risk (LR) infants at 6 months of age. METHODS: Twenty-five AU sibs and 25 LR infants were observed in a novel social-object learning task, within which attention to social and non-social cues was contrasted. Video recorded data were coded for percent duration of gaze to objects or caregiver. Movement rates to activate the toy within the associative learning task were also quantified. RESULTS: Both groups learned the association between moving a switch and activating a cause-effect toy. AU sibs spent less time looking at caregivers and more time looking at the toy or joystick when their caregivers made no attempts to engage their attention. However, response to caregiver-initiated social bids was comparable for both groups. CONCLUSIONS: Infrequent self-initiated socially directed gaze may be an early marker of later social and communication delays.

Toy-oriented changes in early arm movements III: constraints on joint kinematics.

The purpose of this study was to identify invariant features of shoulder and elbow kinematics during prereaching arm movements with and without a toy present. Invariant movement features may reflect the presence of constraints that reduce the complexity of learning to reach and provide a link between early arm movements and reaching. Joint excursion and smoothness were consistently greater at the shoulder than the elbow suggesting strong organismal constraints on prereaching movements. Speed became greater in the shoulder than the elbow only with a toy present during the 4 weeks leading up to reach onset suggesting the introduction of task related constraints. We propose that organismal constraints on joint coordination throughout the prereaching period provide a foundation for the overlay of task related constraints closer to reach onset. We also suggest that the coordinative structures of early arm movements and later reaching may be much more similar than currently thought. This similarity would significantly reduce the elements needing to be actively controlled, and simplify the learning process.

Toy-oriented changes in early arm movements II--joint kinematics.

UNLABELLED: Our recent work suggests that infants begin to change their hand and joint kinematics in the presence of a toy months before the onset of purposeful reaching. Moreover, these 'toy-oriented' changes in hand kinematics cluster into Early, Mid and Late phases. The purpose of the present study was to test hypotheses regarding toy-oriented changes in joint kinematics in the same infants. METHODS: Thirteen infants were observed every other week from 8 weeks up to the first week of reaching around 20 weeks. At each session, a high-speed motion analysis system recorded infants' arm movements with and without a toy present. RESULTS: During the Early phase, infants scaled down their movements. In contrast, during the Mid phase infants scaled up their movements and did not change the relationship between the shoulder and elbow for speed and smoothness-related variables. In addition, infants showed toy-oriented changes such as increase in shoulder flexion and adduction. In the Late phase, infants continued to produce toy-oriented changes in shoulder orientation, and increased shoulder excursion and speed relative to the elbow. Thus, the toy-oriented changes in hand kinematics in the Mid and Late phases [Bhat, A. N., & Galloway, J. C. (2006). Toy-oriented changes in early arm movements of young infants: Hand kinematics. Infant Behavior and Development, 29(3), 358-372] more closely followed changes in shoulder kinematics. Lastly, results are discussed in terms of shoulder-elbow dissociations, speed-amplitude relationships, and the key role of spontaneous movements in the development of reaching.

Toy-oriented changes during early arm movements: hand kinematics.

UNLABELLED: In a recent cross-sectional study, we found that young infants changed their spontaneous arm movements in the presence of a toy, termed 'toy-oriented changes', in systematic ways beginning many weeks before their first consistent reaches [Bhat, A. N., Heathcock, J. H., & Galloway, J. C. (2005). Toy-oriented changes in hand and joint kinematics during the emergence of purposeful reaching. Infant Behavior and Development, 28(4), 445-465]. The purpose of the present study was to test specific hypotheses regarding toy-oriented changes in a longitudinal design. METHODS: Thirteen infants were observed every other week from 8 weeks of age up to the onset of reaching. At each session, hand and joint motions were observed with and without a toy present using a high-speed motion capture system. This paper focuses on the toy-oriented changes in hand variables. RESULTS: As predicted, infants displayed a meaningful pattern of toy-oriented changes, which systematically changed as infants approached the first week of reaching. During the Early phase (8-10 weeks before reaching), infants scaled down their movement length and speed in the presence of a toy. During the Mid phase (4-6 weeks before reaching), infants scaled up movement number and speed, increased movement smoothness, and decreased their hand-toy distance in the presence of a toy. During the Late phase (within 2 weeks of reaching), infants continued to change their hand's position to get closer to the toy and began contacting it. Interestingly, movement number and smoothness displayed similar developmental patterns, where movement length and speed displayed similar patterns. CONCLUSION: Toy-oriented adaptation of arm movements emerges in the first months of life and forms a complex, yet tractable continuum with purposeful reaching. These results provide a foundation to test more specific hypotheses of hand and joint coordination in both typically developing infants and those infants born at risk for coordination impairments.

Cytokine induction of inducible nitric oxide synthase in an oligodendrocyte cell line: role of p38 mitogen-activated protein kinase activation.

The induction of inducible nitric oxide synthase (iNOS) by proinflammatory cytokines was studied in an oligodendrocyte progenitor cell line in relation to mitogen-activated protein kinase (MAPK) activation and cytokine-mediated cytotoxicity. When introduced individually to cultures of CG4 cells, the cytokines, i.e., tumor necrosis factor-alpha (TNF alpha), interleukin-1 (IL-1), and interferon-gamma (IFN gamma), had either minimal (TNF alpha) or no (IL-1 and IFN gamma) detectable stimulatory effect on the production of nitric oxide. However, combinations of these factors, in particular, TNF alpha plus IFN gamma, elicited a strong enhancement of nitric oxide synthesis and, as revealed by western blot and RT-PCR analysis, the expression of iNOS. TNF alpha and IL-1 were able to activate p38 MAPK in a time- and dose-dependent manner and together showed a combinatorial effect. In contrast, IFN gamma neither activated on its own nor enhanced the activation of p38 MAPK in response to TNF alpha and IL-1. However, a specific inhibitor of p38 MAPK, i.e., SB203580, inhibited the induction of iNOS in cytokine combination-treated cells in a dose-dependent manner, thereby suggesting a role for the MAPK cascade in regulating the induction of iNOS gene expression in cytokine-treated cells. Blocking of nitric oxide production by an inhibitor of iNOS, i.e., nitro-L-arginine methyl ester, had a minimal protective effect against cytokine-mediated cytotoxicity that occurred before the elevation of nitric oxide levels, thereby indicating temporal and functional dissociation of nitric oxide production from cell killing.

Mediastinitis due to Mycobacterium fortuitum infection following Fontan operation in a child.

Here we report a case of mediastinitis due to Mycobacterium fortuitum infection in a child after a Fontan operation. To our knowledge this is the first report of atypical mycobacterial mediastinal infection after congenital heart surgery. Atypical mycobacteria can be the cause of "culture negative" sternal and thoracotomy wound infections. A brief review of the literature is included in the discussion.

Breast feeding or spoon feeding after cleft lip repair: a prospective, randomised study.

It has been a tradition for plastic surgeons to withhold breast feeding from babies after cleft lip repair to prevent wound disruption. A prospective, randomised trial of 40 infants showed that early postoperative breast feeding after cleft lip repair is safe, results in more weight gain at 6 weeks after surgery (P < 0.01) and is more economical than spoon feeding.

The expression of myristoylated alanine-rich C-kinase substrate in oligodendrocytes is developmentally regulated.

Myristoylated alanine-rich C-kinase substrate (MARCKS), a major substrate of activated protein kinase C (PKC), is thought to be involved in PKC-mediated signal transduction events. In the present study, we have examined the expression of MARCKS in primary cultures of rat glial cells. Western blot analysis of different glial cell types (i.e., astrocytes, oligodendrocytes and microglia) revealed a relatively high level of MARCKS protein in oligodendrocytes. MARCKS protein and MARCKS mRNA levels in oligodendrocytes increased with time in culture, indicating a developmental regulation in MARCKS gene expression in differentiating oligodendrocytes. Immunocytochemical examination of developing oligodendrocytes indicated a strong labeling of MARCKS distributed both in the cell body and in the lacy network of processes. These findings, in concert with our previous observations on the role of PKC in oligodendrogenesis, strongly implicate a PKC-signaling system in oligodendrocyte development.

Transient ischemia stimulates glial fibrillary acid protein and vimentin gene expression in the gerbil neocortex, striatum and hippocampus.

Astrocytic activation plays a major role in homeostatic maintenance of the central nervous system in response to neuronal damage. To assess the reactivity of astrocytes in transient cerebral ischemia of the gerbil, we studied the levels of glial fibrillary acidic protein (GFAP) and its mRNA. GFAP mRNA increased by 4 h after carotid artery occlusion, reached peak levels by 72 h with a 12-fold increase over control and then started declining as early as 96 h postischemia. An examination of the specific regions of the brain revealed an increase in GFAP mRNA associated with the forebrain, midbrain, hippocampus and striatum. GFAP mRNA in the non-ischemic cerebellum however, remained expressed at constitutively low levels. Immunoblot analysis with anti-GFAP antibodies demonstrated a 2- to 3-fold increase in the protein after 24 and 48 h of reperfusion. Pretreatment with pentobarbital and 1-(5'-oxohexyl)-3-methyl-7-propyl xanthine (HWA 285), the drugs that have been shown to protect against ischemic damage, prevented the increase in GFAP mRNA in the cortex following ischemic injury. Forebrain ischemia also induced vimentin mRNA and protein quantities by 12 h of reperfusion in the cortex. The levels of c-fos and preproenkephalin mRNA increased rapidly within 1 h after ischemic injury, demonstrating a temporal difference in mRNA changes following ischemia. These results indicate that an increase in GFAP and vimentin, the two glial intermediate filament proteins in the area of the ischemic lesion may be associated with a glial response to injury.

Pyridine-2-aldoxime and 6-methylpyridine-2-aldoxime as gravimetric reagents for estimation of palladium(II) and uranium(VI).

Pyridine-2-aldoiumc (I) has been found to be a sensitive reagent for the gravimetric determination of palladium(II). From chloride medium, precipitation is complete at pH 3.0-11.0, and in solution containing 1NHNO(3) to pH6.0. The compositions of the precipitates (dried at 130 degrees ) correspond to PdL(2), and PdL(2). HNO(3) (HL representing the reagent) respectively. Pd(II) can be estimated gravimetncally in presence of acetate, oxalate, tartrate, phosphate, fluoride borate, perchlorate, Cu(II), Cd, Co(II), Fe(II), Ni, Zn, Pb, Bi, Sb(III), Pt(IV), Ir(IV), Ru(III), Rh(III); Os(IV) in quantities more than twice that of Pd(II), and Ag(I), Au(III) and Fe(II) even m traces cause serious interference. The yellow uranium(VI) complex with (I) is precipitated quantitatively over the pH range 3.5-10.5 and, after washing and drying corresponds to the composition (c(6)h(5)n(2)o)(2)uo(2), The uranium(VI) complex with 6-methylpyridine-2-aldoxime (II) is precipitated quantitatively over the pH range 3.0-10.5, and after washing and drying at 120-130 degrees corresponds to UO(2),(C(7),H(7),N(2)O)(2). Both (I) and (II) are suitable for the estimation of 1-50 mg of uranium(VI) in the presence of up to 10-fold quantities ofTh(IV), La(III) and Ce(III) even when present together. Ce(IV) in quantities more than three times that of U must be reduced to Ce(III). Tartrate, citrate, phosphate, Ti(IV) and Zr interfere, but acetate, oxalate, and borate do not.

Spectrophotometric determination of ruthenium(III) and iridium(TV) with 8-hydroxyquinoIine N-oxide.

The spectrophotometric characteristics and the stability constants of the yellow to brown 1:1 and 1:2 complexes of platinum metals with oxine N-oxide (existing as chloro mixed-ligand complexes) have been investigated. Oxine N-oxide can be used as a spectrophotometric reagent for ruthenium(III) and iridium(IV).

Spectrophotometric determination of osmium(IV), iridium(IV) and platinum(iv) and separation and determination of palladium(II) and ruthenium(III) in the presence of other platinum metals, with oximidobenzotetronic acid as reagent.

Oximidobenzotetronic acid is suggested as a reagent for the spectrophotometric determination of osmium(IV), iridium(III), iridium(IV), platinum(IV) and for separation and determination of palladium(II) and ruthenium(III) in the presence of other platinum metals. Iridium(III) and (IV) can be estimated when present together.

Rapid spectrophotometric determination of cobalt after extraction using oximidobenzotetronic acid.

A spectrophotometric method based on the extraction of cobalt with benzene solutions of oximidobenzotetronic acid (OBTA) is proposed for the estimation of 0.2-3.0 ppm of cobalt. The 3:1 OBTA : Co complex containing cobalt(III) has its absorption maximum at 430 nm; its molar absorptivity in benzene is 1.82 x 10(3)L. mole(-1). mm(-1). Since the blue iron(II) complex is not extracted into benzene, iron(II) and cobalt(II) can be separated and determined spectrophotometrically.

Spectrophotometric studies of ruthenium(III)and rhodium(III)-oximidobenzotetronic acid complexes and the simultaneous determination of the two metals.

Ruthenium(III) and rhodium(III) form stable coloured complexes in ethanolic solution with oximidobenzotetronic acid (OBTA). Ruthenium forms a purple-violet Ru(OBTA)(3) complex at pH 1.1-3.5, which is stable over the pH range 1.1-11.3. Rhodium(III) forms a yellowish-brown complex, RhCl(2)(OBTA)(2), at pH 2-8; at higher pH (11.5 and above) the complex is reddish-brown, but has the same Rh:OBTA ratio. A method for the simultaneous determination of these two metals is proposed, and the interference by commonly occurring ions has been investigated.