Attentional differences in audiovisual face perception between full- and preterm very low birthweight toddlers.

AIM: To investigate whether rightward attention to the mouth during audiovisual speech perception may be a behavioural marker for early brain development, we studied very preterm and low birthweight (VLBW) and typically developing (TD) toddlers. METHODS: We tested the distribution of gaze points in Japanese-learning TD and VLBW toddlers when exposed to talking, silent and mouth moving faces at 12, 18 and 24 months (corrected age). Each participant was categorised based upon the area they gazed at most (Eye-Right, Eye-Left, Mouth-Right, Mouth-Left) per stimulus per age. A log-linear model was applied to three-dimensional contingency tables (region, side and group). RESULTS: VLBW toddlers showed fewer gaze points than TD toddlers. At 12 months, more VLBW toddlers than TD toddlers showed left attentional bias toward any one face; however, this difference in attention asymmetry receded somewhat by 24 months. In talking condition, TD toddlers showed right attentional bias from 12 to 24 months, whereas VLBW toddlers showed such bias upon reaching 24 months. Additionally, more TD toddlers than VLBW toddlers attended to the mouth. CONCLUSION: Delays in exhibiting the attentional bias for an audiovisual face or general faces displayed by typically developing children might suggest differential developmental timing for hemispheric specialisation or dominance.

Autistic traits of children born very preterm assessed using Autism Diagnostic Observation Schedule, Second Edition.

Preterm birth has been linked with increased incidence of autism spectrum disorder (ASD). Despite the remarkable difference in the clinical backgrounds between ASD children born preterm and term, cross-sectional studies have found no striking difference in their autistic traits. To highlight autistic traits related with preterm birth, children born very preterm (prospective birth cohort, n = 50) and term (case cohort, n = 16), who were diagnosed as "Autism" by the Autism Diagnostic Observation Schedule (ADOS), 2nd edition, were compared using the calibrated severity scores of ADOS-2 and T-scores of the Social Responsiveness Scale, 2nd edition. No significant difference was found in the calibrated severity scores between ASD children born preterm and term. There was a trend that T-scores were smaller for the preterm cohort, which did not reach a statistical significance. Even when detailed cross-sectional information was obtained using ADOS-2, no difference in autistic traits was observed between children born very preterm and term. Our findings were consistent with a previous study, which assessed the entire prospective cohort of children born very preterm and found no difference in original ADOS scores. Further studies are warranted to delineate how preterm birth affects the autistic traits and their parental perception in a large prospective cohort.

Diagnostic rate of autism spectrum disorder in a high-survival cohort of children born very preterm: A cross-sectional study.

To investigate the diagnostic rate of autism spectrum disorder (ASD) in a high-survival cohort of very preterm children, 77 infants born very preterm (<32 weeks of gestation) were assessed at age 4-6 years old using the Autism Diagnostic Observation Schedule, 2nd edition (ADOS-2) and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Sixteen children (20.8%) were classified as both DSM-5-positive ASD and ADOS-2-identified "autism," which were defined as confirmed ASD in this study. Our result suggests that the prevalence of ASD in very preterm children might be much higher than reported in previous studies when all children were individually evaluated. Further studies in a large sample are required to clarify the true risk of ASD in preterm birth.

Perinatal factors contributing to intellectual impairment in a cohort of Japanese children with very low birth weight.

BACKGROUND: To determine whether prematurity, intrauterine growth restriction (IUGR), or neonatal stress affects intellectual impairment in children with very low birth weight (VLBW). METHODS: This national historical cohort study evaluated children with VLBW cared for in perinatal medical centers throughout Japan. Factors assessed included three latent variables (prematurity, IUGR, and stress during the neonatal period) and eight observed variables during perinatal period. The primary endpoint was intellectual or developmental quotient (IQ/DQ) at age ≥3 years. Structural equation model (SEM) was used to examine factors associated with IQ/DQ. RESULTS: The study included 248 VLBW children, who were of mean age 5.7±2.0 years and mean IQ/DQ of 85.5 at last encounter. SEM showed that stress during the neonatal period (ß=-0.37) contributed more to IQ/DQ than intrauterine malnutrition (ß=0.25) and prematurity (ß=0.15) and that the duration of mechanical ventilation was an important contributor to stress during the neonatal period. CONCLUSIONS: Neonatal stress was more harmful to future intellectual impairment of VLBW neonates, with IUGR contributing more than prematurity. Duration of mechanical ventilation was an important risk factor in neonatal stress. Neonatologists should minimize neonatal stress in VLBW neonates, and obstetricians should monitor fetal growth restriction to prevent intellectual impairment in later life.

Primitive reflexes in very low birth weight infants later diagnosed with autism spectrum disorder.

BACKGROUND: As early screening and diagnosis is very important in treatment and intervention of Autism Spectrum Disorder, we investigated the relationship between primitive reflexes and Autism Spectrum Disorder (ASD). METHODS: Of 88 very low birth weight infants (<1500g) born from April 2010 to March 2012, subjects comprised 38 examined for 18 primitive reflexes between age 38 and 45 wks corrected age and followed-up over 6 yrs. ASD was diagnosed using Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) and Autism Diagnostic Observation Schedule Second Edition (ADOS-2). We compared the number of abnormal primitive reflexes between two groups (11 children with and 19 without ASD) after excluding eight children with cerebral palsy in this case-control study. RESULTS: Twenty cases showed one to four hypoactive reflex(es) and two showed one hyperactive reflex together with hypoactive reflex(es). Ten out of 11 cases with ASD had one to four abnormal reflex(es). The number of abnormal hypoactive primitive reflexes was significantly higher in the ASD group (p=0.002). CONCLUSIONS: The result suggests primitive reflexes can be one of the key elements in very early infancy to identify ASD in low birth weight infants. Abnormal hypoactive primitive reflex of low birth weight infants with ASD may inform future research of the pathogenesis of ASD.

Children's Perceived Competence Scale: reevaluation in a population of Japanese elementary and junior high school students.

BACKGROUND: It is important for children to maintain high self-perceived competence and self-esteem, and there are few measures to evaluate them through elementary to junior high school days in Japan. To evaluate psychometric properties of the Children's Perceived Competence Scale (CPCS). METHODS: Data were collected from 697 elementary school and 956 junior high school students. Some of these students completed measures for construct validity, whereas others repeated the CPCS. RESULTS: The results demonstrated the three-factor structure of the CPCS: cognitive (nine items), social (eight items) and physical (nine items). Factorial invariance was confirmed between elementary and junior high school students, as well as between boys and girls. Construct validity was excellent. Scores on the cognitive, physical and general self-worth domains declined with increasing age. Boys scored significantly higher than girls on physical and general self-worth domains. CONCLUSIONS: The CPCS is a valid and reliable measure of perceived competence in Japanese children aged 6-15 years. The CPCS may be applied to students from elementary through junior high school days as a measure of self-perceived and psychological state in Japan.

Self-perception of children with autism spectrum disorders.

BACKGROUND: We aimed to evaluate self-perceived competence and self-esteem of primary school children with autism spectrum disorder (ASD) in Japan and compare to those of children with other chronic physical diseases and healthy controls. METHODS: Data were collected from 227 children: ASD (N.=91), nephrotic syndrome (NS) (N.=52) and asthma (N.=84), using Children's Perceived Competence Scale (CPCS) in 2012-2014. CPCS measures perceived competence in cognitive, social and physical domains, and a general self-worth domain as self-esteem. RESULTS: Scores in the social domain of the ASD group were lower than those of all other groups after adjusting for school age grades and gender. Scores of the ASD group negatively correlated with psychosomatic symptoms in all domains and IQ in the physical domain. CONCLUSIONS: These findings are the first data set in Japan on self-perceived competence and self-esteem in primary school children with ASD. Those results were comparable to previous researches in adolescents with ASD. Low social domain scores in the ASD group indicate the CPCS may be one of the useful tools to evaluate difficulty in social competence from the children's point of view. Correlations between CPCS scores and psychosomatic symptoms in the ASD group suggest development of psychosomatic symptoms may be addressed early by attention to low scores, especially in general self-worth.

Children's Perceived Competence Scale: Reference values in Japan.

To support children with chronic diseases, reference values to measure developmental changes in self-perception and self-esteem are considered a useful yardstick. To develop reference values to measure self-perceived competence and self-esteem in Japanese children, the Children's Perceived Competence Scale (CPCS) was administered to 768 children of elementary school grade 1 (6 years) to grade 6 (11 years) at four public schools in Japan, from November to December 2012. After excluding 74 with chronic diseases and/or incomplete responses, 694 children were included. CPCS measures children's self-perceived competence in cognitive, social, physical domains, and general self-worth, namely self-esteem. There was a tendency for scores of cognitive and general self-worth to decrease with increasing grade. Scores among grade 5 respondents were significantly lower than those among grade 4 respondents for both social and physical domains. Scores among boys and girls differed significantly, with boys scoring higher for physical domain in grades 3 and 6 and for general self-worth domain in grade 6. The CPCS reference values to measure self-perceived competence and self-esteem in Japanese children were developed in this study. These reference values are useful to inform practitioners supporting children with psychological or psychiatric problems or those with chronic diseases.

Depression in the mother and maternal attachment--results from a follow-up study at 1 year postpartum.

Although evidence exists pointing to the impact of maternal depression in puerperium upon mother-child interaction, longitudinal studies on this perspective are rare. Hence, this study was designed to examine the association between maternity blues and maternal attachment in the puerperium with depression in the mother and attachment after 1 year together with the factors involved. A questionnaire survey consisting of Zung's Self-Rating Depression Scale (ZSDS) and a 'maternal attachment' scale, comprised of subscales on 'core maternal attachment' and 'anxiety regarding children', was conducted on mothers who had participated in a previous puerperium survey. The mean ZSDS score of 42.1 +/- 7.45 after 1 year did not differ significantly from puerperium results. 'Maternity blues' was found to influence the maternal depression after 1 year, which was in turn associated with 'core maternal attachment' and 'anxiety regarding children', supporting the need for early intervention in maternity blues starting in the perinatal period for the mental health of mother and child.