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1.
Codas ; 32(1): e20170097, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31851208

RESUMO

PURPOSE: To verify the access to speech-language pathology (SLP) therapy and continuity of assistance in Primary Health Care (PHC) for victims of motorcycle accidents. METHODS: A quantitative and qualitative study was conducted at a large hospital in the city of Recife, Pernanbuco state, Brazil. Among the 99 victims recruited between June and July 2014, 30 had SLP complaints as a result of the accidents. After hospital discharge, all victims were contacted for investigation of the SLP rehabilitation process. Absolute and relative frequencies were used for the analysis in PHC, and data were displayed in tables for the therapy cases. RESULTS: Among the 30 individuals who reported having alterations of the stomatognathic system, eight were undergoing rehabilitation and 18 reported residing in an area covered by the Family Health Strategy (primary care modality). Seeking and obtaining continuity of treatment (medication and bandaging) in primary care were frequent; in contrast, home visits were less frequent. The main obstacles to access SLP therapy were distance to the service and waiting time to begin treatment. CONCLUSION: This study identified obstacles that hamper access to SLP therapy in PHC, such as the low frequency of home visits, contributing to the fragmentation of continuous and complete care for victims.


Assuntos
Acidentes de Trânsito , Transtornos de Deglutição/reabilitação , Acesso aos Serviços de Saúde/estatística & dados numéricos , Transtornos da Linguagem/reabilitação , Motocicletas , Atenção Primária à Saúde , Adulto , Brasil , Estudos Transversais , Transtornos de Deglutição/epidemiologia , Transtornos de Deglutição/etiologia , Feminino , Humanos , Transtornos da Linguagem/epidemiologia , Transtornos da Linguagem/etiologia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
2.
Int J Pediatr Otorhinolaryngol ; 126: 109602, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31374388

RESUMO

OBJECTIVE: To investigate the role of the period of emergence of the first words and its interactions with other risk factors in predicting the development of speech sound disorder (SSD) among 4- to 5-year-old children. METHODS: After 373 children underwent otolaryngology and speech pathology examinations, their parents answered a questionnaire about potential risk factors for speech impairment. The presence of SSD was identified by a speech pathologist who administered Fanzago's Articulation Test to each child. Multivariate logistic analysis was used to explore the relationships between variables and outcomes. RESULTS: Mean age at first words was 17.8 ±â€¯6.5 months of life; 25.7% of patients suffered from SSD, and 3.7% from stuttering. A family history of language impairment was found in 12.9% of the sample, whereas a family history of reading difficulty was reported in only 5.4% of cases. No differences in terms of mean age (p = 0.3) or gestational age (p = 0.16) were found between children affected by SSD and those who were not. Multivariate logistic analysis revealed that male sex (p < 0.001), a family history of language impairment (p < 0.001) and stuttering (p = 0.001) were significantly associated to SSD. Age at first words did not result a predictor of speech impairment. CONCLUSION: In contrast to male sex (p < 0.001), family history of language impairment (p < 0.001) and stuttering (p = 0.001) which resulted significantly associated to SSD, age at first words does not seem to be a predictor of SSD (p = 0.11); however, it remains a useful indicator of language delay and, when considered in association with other language milestones, can be a reason of concern for parents and caregivers about their children's developmental and speech therapy needs.


Assuntos
Linguagem , Transtorno Fonológico/diagnóstico , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Transtornos da Linguagem/epidemiologia , Masculino , Pais , Fatores Sexuais , Transtorno Fonológico/epidemiologia , Gagueira/epidemiologia , Inquéritos e Questionários
3.
Neurología (Barc., Ed. impr.) ; 34(6): 353-359, jul.-ago. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-185452

RESUMO

Introducción: La neurofibromatosis tipo 1 (NF1) es un síndrome neurocutáneo frecuente que en muchos casos se asocia a dificultades cognitivas específicas que habitualmente no son tenidas en cuenta en el seguimiento médico de estos pacientes. Objetivo: Trazar el perfil cognitivo de pacientes con NF1 detectando trastornos en funciones superiores asociados al mismo. Identificar motivos de consulta de pacientes pediátricos con NF1 en relación con su desempeño escolar. Métodos: Trabajo descriptivo transversal. Se evaluó neuropsicológicamente a 24 pacientes con NF1 con edades comprendidas entre los 5 y los 16 años de edad. Resultados: Los motivos de consulta más frecuentes fueron: problemas atencionales (58,33%), aprendizaje (25%), coordinación motora (25%) y lenguaje (0,8%). Si bien el estudio reveló que el 96% de los pacientes tenía compromiso en al menos una de las áreas evaluadas, solo el 83,34% de los padres las refirieron. El 58,33% presentó trastorno por déficit de atención con hiperactividad (TDAH), el 33,33% trastorno de aprendizaje no verbal (TANV), el 20,83% dificultades en aspectos expresivos del lenguaje, el 8,33% coeficiente intelectual (CI) limítrofe, el 4,16% retraso mental y el 4,16% no mostró dificultades. Conclusiones: Existe alta frecuencia de trastornos en funciones superiores en niños con NF1. Aunque muchos padres detectan dichos trastornos, se ha observado que otros son subestimados. Consideramos conveniente que todos los niños con NF1 cuenten con una evaluación neuropsicológica a fin de poder detectar dificultades existentes en cada caso y así poder elaborar una estrategia de rehabilitación cognitiva precoz y efectiva


Introduction: Neurofibromatosis type 1 (NF1) is a common neurocutaneous syndrome often associated with specific cognitive deficits that are rarely monitored during follow-up of these patients. Objective: The purpose of our study is two-fold. First, we aimed to describe the cognitive profile of patients with NF1 and detect disorders in higher brain functions associated with the disease. Second, we identified the reasons for consultation associated with school performance in these patients. Methods: We conducted a descriptive cross-sectional study of 24 paediatric patients (ages 5 to 16) with NF1 who underwent neuropsychological assessment. Results: The most frequent reasons for consultation were attention deficits (58.33%), learning disorders (25%), poor motor coordination (25%), and language impairment (0.8%). Although 96% of the patients displayed impairments in at least one of the assessed areas, only 83.34% of the parents had reported such impairments. Attention-deficit/hyperactivity disorder was present in 58.33% of the patients, whereas 33.33% had nonverbal learning disabilities, 20.83% had expressive language disorder, 8.33% had borderline intellectual functioning, 4.16% had mental retardation, and only 4.16% showed no cognitive impairment. Conclusion: Higher brain functions are frequently impaired in paediatric patients with NF1. Although many parents report such disorders, they can go undetected in some cases. Neuropsychological assessment is recommended for all paediatric patients with NF1 to detect cognitive impairment and provide early, effective rehabilitation treatment


Assuntos
Humanos , Masculino , Feminino , Criança , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/epidemiologia , Transtornos da Linguagem/diagnóstico , Transtornos de Aprendizagem/diagnóstico , Neurofibromatose 1/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Estudos Transversais , Deficiência Intelectual/diagnóstico , Deficiência Intelectual/epidemiologia , Transtornos da Linguagem/epidemiologia , Transtornos de Aprendizagem/epidemiologia , Testes Neuropsicológicos/estatística & dados numéricos
4.
Salud Publica Mex ; 61(4): 514-523, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31314207

RESUMO

OBJECTIVE: To Identify possible changes in the frequency of psychopathological syndromes in Mexican children population over a 15-year period using the Brief Screening and Diagnostic Questionnaire (CBTD in Spanish). MATERIALS AND METHODS: Information gathered from different studies on the general population, schools and medical general practice are analyzed. Results from the Mexico City study were used as base rates for comparisons. RESULTS: Higher prevalence of externalizing syndromes such as attention deficit and hyperactivity, oppositional and explosive conduct were very evident. Also, anxiety and depressive syndromes showed a notable increase. Prevalence of abnormal language and probable epilepsy were also increased on different age-groups. CONCLUSIONS: Findings are discussed in light of longitudinal reports in the literature as well as on reports in adolescent population in Mexico.


Assuntos
Transtornos de Ansiedade/epidemiologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/epidemiologia , Transtorno Depressivo/epidemiologia , Prioridades em Saúde , Saúde Mental , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Criança , Pré-Escolar , Transtorno da Conduta/epidemiologia , Epilepsia/epidemiologia , Feminino , Inquéritos Epidemiológicos/métodos , Humanos , Transtornos da Linguagem/epidemiologia , Masculino , México/epidemiologia , Prevalência , Distribuição por Sexo
5.
Croat Med J ; 60(2): 141-149, 2019 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-31044585

RESUMO

Perhaps due to different roles they have had in social groups during evolution, men and women differ in their verbal abilities. These differences are also (if not even more) present in children, both in the course of typical and pathological development. Beside the fact that girls have a well-documented advantage in early language development, almost all developmental disorders primarily affecting communication, speech, and language skills are more frequent in boys. The sex-related difference in the prevalence of these disorders is especially pronounced in autism spectrum disorder (1 girl for each 4-5 boys is affected). The aim of this review is to present the sex differences in typical communication and language development and in the prevalence of communication-related neurodevelopmental disorders. Also, a special focus is put on data from the field of neuroscience that might provide insight into the neurobiological mechanisms that can add to the understanding of this phenomenon. We argue that the functional organization of the female brain gives women an inherent advantage in the acquisition of communication and language system over men.


Assuntos
Comunicação , Desenvolvimento da Linguagem , Transtornos da Linguagem/epidemiologia , Caracteres Sexuais , Transtorno do Espectro Autista , Criança , Feminino , Hormônios Esteroides Gonadais/fisiologia , Humanos , Linguagem , Masculino , Prevalência
6.
Ann Hum Biol ; 46(2): 109-119, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31132892

RESUMO

Background: Robinson Crusoe Island is a geographically and socially isolated settlement located over 600 km west of the Port of Valparíso, Chile. An unusually high incidence (30%) of the Chilean equivalent of developmental language disorder (in Spanish, trastorno especifico de lenguaje (TEL)), has been reported in Islander children, with 90% of these affected children found to be direct descendants of a pair of original founder-brothers, therefore strongly suggesting a shared genetic basis. Aim: This study reports a comprehensive examination of 34 genes that have been previously directly implicated in language-related mechanisms. It utilises whole-genome sequencing to investigate potential underlying variants in seven TEL affected and 10 unaffected islanders. The aim was to identify the underlying genetic cause of the TEL phenotype under two inheritance model paradigms; Mendelian monogenic and complex susceptibility. Subjects and methods: A targeted candidate gene approach was used to look for rare, shared variants that may underlie the diagnosis of TEL in a Mendelian genetic model. This study tested whether an overall burden of rare variants is enriched in individuals affected by TEL or with Islanders related to the founder-brother lineage. It further examined if any variants segregate with affection status or with founder-brother-related status and, therefore, may increase risk of developing a language disorder as part of a complex model. Finally, gene-based tests were performed to evaluate relationships between combined variation across candidate genes and TEL affection status. Results: No single pathogenic rare variant segregated with either affection or founder-related status within the 34 candidate genes. Additionally, no evidence was found of an overall increased variant burden in TEL individuals compared to those with TLD. Gene-based analysis found no clear association between the combined effects of variants across the 34 genes and affection status or founder-brother-relatedness. Conclusion: The high prevalence of language disorders found on Robinson Crusoe Island is not caused by either a shared high-impact variant, or an increased burden of variants within candidate genes previously implicated in language disorders. We have comprehensively tested for 'low hanging fruit' in genes implicated in language disorders. Therefore, the underlying cause of TEL on Robinson Crusoe lies outside of these known language disorder genes, or within a complex susceptibility model.


Assuntos
Predisposição Genética para Doença/etiologia , Transtornos da Linguagem/genética , Linhagem , Fenótipo , Chile/epidemiologia , Predisposição Genética para Doença/epidemiologia , Humanos , Ilhas/epidemiologia , Transtornos da Linguagem/epidemiologia , Prevalência
7.
PLoS One ; 14(3): e0213492, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30845265

RESUMO

BACKGROUND: Centile curves and standard scores are common in epidemiological research. However, standardised norms and centile growth curves for language disorder that reflect the entire UK local school population do not exist. METHODS: Scores on six language indices assessing receptive and expressive functioning of children were obtained from the SCALES population survey. Monolingual English speaking participants were aged between five and nine years. Children who attended special schools at study intake, or who were learning English as an additional language were excluded. We constructed language norms using the LMS method of standardisation which allows for skewed measurements. We made use of probability weights that were produced from a two-step logistic model. Distributions of estimated standard scores from an intensively assessed sub-population and from the full population were contrasted to demonstrate the role of weights. RESULTS: Non-overlapping centile curves and standardised scores at each age were obtained for the six language indices. The use of weights was essential at retrieving the target distribution of the scores. An online calculator that estimates standardised scores for the measures was constructed and made freely available. CONCLUSIONS: The findings highlight the usefulness and flexibility of the LMS method at dealing with the standardisation of linguistic and educational measures that are sufficiently continuous. The paper adds to the existing literature by providing population norms for a number of language tests that were calculated from the same group of individuals.


Assuntos
Desenvolvimento da Linguagem , Transtornos da Linguagem , Linguagem , Criança , Pré-Escolar , Inglaterra/epidemiologia , Feminino , Humanos , Transtornos da Linguagem/epidemiologia , Transtornos da Linguagem/fisiopatologia , Transtornos da Linguagem/terapia , Masculino
8.
Minerva Pediatr ; 71(4): 343-348, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26899672

RESUMO

BACKGROUND: Although achondroplasia (ACH) may not be considered a condition that is strictly related to neuropsychiatric problems, many children referred to pediatric neurologists and psychiatrists to undergo motor and linguistic diagnostic-rehab procedures. The purpose of this study was to delineate a characterization of language difficulties in a sample of Italian children with achondroplasia and analyze how an untreated language disorder can develop into a learning disability. METHODS: Seventeen Italian children (average age: 5 years and 8 months) with a clinical diagnosis genetically confirmed of achondroplasia were enrolled. Each child underwent a neuropsychological evaluation depending on the age, which included the following areas: intelligence, language, visual-spatial skills, memory, academic achievements, behavior. RESULTS: Most of ACH patients showed delayed speech development milestones. Cognitive evaluation revealed average abilities. All the ACH children have received a diagnosis of language impairment (DSM-5 "The Diagnostic and Statistical Manual of Mental Disorders 5° edition"): "Speech sound disorder" in the pre-school-age group, "Language disorder" with impairment of both verbal expression and verbal comprehension in the school age children. CONCLUSIONS: Several studies on general population demonstrated that children with developmental speech and language problems are at considerable risk for learning disability. Considering that in our ACH sample the language disorder has been diagnosed in all children, we expect a higher prevalence of learning disabilities in ACH than in general population.


Assuntos
Acondroplasia/psicologia , Cognição/fisiologia , Transtornos da Linguagem/diagnóstico , /diagnóstico , Acondroplasia/fisiopatologia , Criança , Pré-Escolar , Compreensão/fisiologia , Feminino , Humanos , Inteligência/fisiologia , Itália , Transtornos da Linguagem/epidemiologia , Masculino , Testes Neuropsicológicos , Fenótipo
9.
Neurologia ; 34(6): 353-359, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28431841

RESUMO

INTRODUCTION: Neurofibromatosis type 1 (NF1) is a common neurocutaneous syndrome often associated with specific cognitive deficits that are rarely monitored during follow-up of these patients. OBJECTIVE: The purpose of our study is two-fold. First, we aimed to describe the cognitive profile of patients with NF1 and detect disorders in higher brain functions associated with the disease. Second, we identified the reasons for consultation associated with school performance in these patients. METHODS: We conducted a descriptive cross-sectional study of 24 paediatric patients (ages 5 to 16) with NF1 who underwent neuropsychological assessment. RESULTS: The most frequent reasons for consultation were attention deficits (58.33%), learning disorders (25%), poor motor coordination (25%), and language impairment (0.8%). Although 96% of the patients displayed impairments in at least one of the assessed areas, only 83.34% of the parents had reported such impairments. Attention-deficit/hyperactivity disorder was present in 58.33% of the patients, whereas 33.33% had nonverbal learning disabilities, 20.83% had expressive language disorder, 8.33% had borderline intellectual functioning, 4.16% had mental retardation, and only 4.16% showed no cognitive impairment. CONCLUSION: Higher brain functions are frequently impaired in paediatric patients with NF1. Although many parents report such disorders, they can go undetected in some cases. Neuropsychological assessment is recommended for all paediatric patients with NF1 to detect cognitive impairment and provide early, effective rehabilitation treatment.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/epidemiologia , Transtornos da Linguagem/diagnóstico , Neurofibromatose 1/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Criança , Estudos Transversais , Feminino , Humanos , Deficiência Intelectual/diagnóstico , Deficiência Intelectual/epidemiologia , Transtornos da Linguagem/epidemiologia , Masculino , Testes Neuropsicológicos/estatística & dados numéricos
10.
Early Interv Psychiatry ; 13(3): 369-378, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-28857488

RESUMO

AIM: Higher-order language functions are associated with understanding indirect speech acts, lexical-semantic processes, the understanding and production of prosody, discourse production and comprehension. Only a few studies imply that language abnormalities may be present in individuals at ultra-high risk for psychosis (UHR) and first-episode of schizophrenia (FE). The purpose of this study was to test the presence of higher-order language dysfunctions in UHR and FE subjects using a standardized comprehensive test battery. METHODS: Twenty patients experiencing FE schizophrenia, 33 UHR individuals and 20 healthy controls (HC) took part in the study. Higher-order language and extralinguistic abilities were evaluated using the Right Hemisphere Language Battery (RHLB-PL). The battery consisted of tests covering the comprehension of implicit information, lexico-semantic processing, understanding humour, making inappropriate remarks and comments, understanding and explaining metaphors, understanding prosody and appropriateness of behaviour in communication settings. RESULTS: The UHR patients scored lower than HC when comprehending implicit information, discourse and in areas associated with the effectiveness of interpersonal communication; however, they scored higher than the FE participants in explanation of metaphors and processing language information in the context of general knowledge. The FE participants scored lower than healthy controls in comprehension of implicit information, explanation of metaphors, discourse understanding, processing language information in the context of general knowledge and effectiveness of interpersonal communication. CONCLUSIONS: The higher-order language dysfunctions mediated by the right hemisphere appear to be present in subjects at UHR of schizophrenia and those experiencing their FE. The results may play a crucial role in diagnostic processes.


Assuntos
Transtornos da Linguagem/epidemiologia , Transtornos Psicóticos/epidemiologia , Esquizofrenia/epidemiologia , Adolescente , Comorbidade , Feminino , Humanos , Masculino , Polônia/epidemiologia , Sintomas Prodrômicos , Adulto Jovem
11.
Atten Defic Hyperact Disord ; 11(3): 325-332, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30382558

RESUMO

Attention-deficit hyperactivity disorder (ADHD) is frequently associated with language impairment, autism spectrum disorder (ASD) symptoms and higher-order language deficit (HOLD); yet, their complex relationship is poorly understood. HOLD encompasses deficits in using language for reasoning, problem-solving, causal and critical thinking. This study evaluates the roles of HOLD in children with ADHD. We hypothesise that both our subgroups (ADHD-only and ADHD + 'ASD traits') will have HOLD difficulties, though to a differing degree, as children with ADHD are compromised by executive function deficits, and those with additional ASD traits are further impaired by pragmatic language deficits. Data were reviewed from 36 children with ADHD (± 'ASD traits'), who attended the tier 4 statewide specialist clinic for ADHD patients non-responsive to community care. HOLD was assessed by the Test of Problem Solving-3 Elementary (TOPS-3). The age of the sample ranged from 6 to 12 years with a male-to-female ratio of 8:1. The rate of HOLD in our sample was 47.2% (published controls = 16%). Likewise, the rates of Making Inferences (50.0%, p < 0.001), Sequencing (44.4%, p < 0.001), Negative Questions (33.3%, p = 0.278), Problem-Solving (38.9%, p = 0.022), Predicting (27.8%, p = 0.022) and Determining Causes (30.6%, p = 0.022) were all elevated. When stratified, the rates in ADHD-only group and ADHD + 'ASD traits' group were 37.5% and 55.0%, respectively. Children with ADHD + 'ASD traits' had greater 'Sequencing' deficit. Our exploratory study confirms that HOLD is more common in children with ADHD, including deficits in Making Inferences, Sequencing, Problem-Solving, Predicting, Determining Causes and understanding Negative Questions. Our findings provide preliminary support for the potentially important role played by HOLD in neurodevelopmental disorders.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Espectro Autista/epidemiologia , Transtornos da Linguagem/epidemiologia , Estudos de Casos e Controles , Criança , Comorbidade , Feminino , Humanos , Masculino , Estudos Retrospectivos , Austrália Ocidental/epidemiologia
12.
AIDS Care ; 31(1): 61-68, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29950105

RESUMO

Despite the increased recognition of how neighborhood conditions bear on cognitive and academic outcomes, no studies have examined the influences of objective and subjective neighborhood indices on specific areas of cognitive functioning among youth living with perinatal HIV (PHIV). In the United States (US), this is of particular concern as HIV has disproportionately affected African American youth living in economically disadvantaged and racially segregated communities. Thus, based on a longitudinal cohort study of psychosocial and behavioral health outcomes in 340 perinatally HIV-exposed but uninfected (PHEU) and PHIV youth residing in New York City, ages 9-16 years at enrollment, we analyzed data from baseline and multiple follow-up (FU) quantitative interviews with youth and their primary caregivers, from when they were at least 13-years-old (approximately 4-6 years post enrollment). We examined the association between baseline neighborhood indices (2000 US census data and caregiver's perception of neighborhood stressors) and youth receptive language skills (PPVT; Peabody Picture Vocabulary Test) at FU2 and FU3. Census data (percentage of families in neighborhood living below the national poverty rate, median neighborhood household income, and percentage of residents professionally employed) were not independently associated with PPVT scores at both follow-ups. However, in the logistic regression model, the more caregivers perceived their neighborhood as stressful and subjected to violence, the stronger the relationship between census data indicators of low resource neighborhoods and lower PPVT scores for both groups. Findings support "place-based" policies and practices that alleviate caregiver experiences of neighborhood stressors which may contribute to improved cognitive outcomes for youth living with and affected by PHIV.


Assuntos
Cuidadores/psicologia , Infecções por HIV/psicologia , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Desenvolvimento da Linguagem , Transtornos da Linguagem/epidemiologia , Características de Residência , Adolescente , Criança , Cognição/fisiologia , Estudos de Coortes , Feminino , Infecções por HIV/epidemiologia , Humanos , Linguagem , Transtornos da Linguagem/etiologia , Estudos Longitudinais , Masculino , New York/epidemiologia , Cidade de Nova Iorque/epidemiologia , Gravidez , Vocabulário
13.
Dev Med Child Neurol ; 61(5): 523-534, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30548847

RESUMO

AIM: In an attempt to clarify the debate surrounding the diagnostic validity of childhood disintegrative disorder (CDD), we systematically reviewed its characteristics and compared it with autism spectrum disorder (ASD). METHOD: Four databases were searched (PubMed, PsycINFO, Embase, and Web of Science). Included articles had participants with CDD, as defined by symptoms present in the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision and the International Classification of Diseases, 10th Revision. Comparison groups were those with ASD and ASD with regression. Case studies were excluded. RESULTS: Twenty articles, comprising 96 participants with CDD (80 males, 16 females), were included. Most studies were cross-sectional. The prevalence of CDD was 1.1 to 9.2 per 100 000, with a mean age at regression of 3 years 2 months (SD 1y 1mo), with a range of 2 years to 7 years. In addition to core CDD symptoms, most had intellectual impairment, anxiety, challenging behaviours, and regressed in toileting skills. Participants with CDD and ASD shared core diagnostic and extra-diagnostic features. However, participants with CDD seemed to have more severe symptoms and a different symptom profile, including apparently typical development before regression, faster regression, more affective symptoms, and more global developmental deficit. Possible genetic and autoimmune neurobiological mechanisms were identified. INTERPRETATION: There is limited high-quality evidence describing the aetiology and outcomes of CDD. However, given the qualitative and prognostic differences between ASD and CDD, we recommend that future diagnostic criteria should distinguish late-onset regression.


Assuntos
Transtorno do Espectro Autista , Deficiência Intelectual/complicações , Transtornos da Linguagem/complicações , Transtornos do Comportamento Social/complicações , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/fisiopatologia , Criança , Pré-Escolar , Humanos , Deficiência Intelectual/epidemiologia , Transtornos da Linguagem/epidemiologia , Transtornos do Comportamento Social/epidemiologia
14.
Int J Law Psychiatry ; 61: 40-49, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30420110

RESUMO

BACKGROUND: While studies confirm high prevalence of language disorder among justice-involved young people, little is known about the impact of Fetal Alcohol Spectrum Disorder (FASD) on language among this population. It is also not clear how language skills vary according to language diversity in Australian youth justice settings, where a disproportionate number of justice-involved youth are Aboriginal and may not speak Standard Australian English (SAE) as their first language. Language skills are important to understand, as language disorder and language difference can lead to a mismatch between the communication skills of a young person and the communication skills of the justice workforce with whom they are communicating. In the highly verbal environments that are common to justice systems, language disorder and language difference may result in a young person misunderstanding legal information and expectations placed on them and not being adequately understood by the justice workforce. METHODS: This study examined the language skills of 98 young people sentenced to detention in Western Australia (WA), who participated in a cross-sectional study examining the prevalence of FASD. Language skills assessed using standardised and non-standardised tasks were analysed by the three major language groups identified: speakers of SAE, Aboriginal English and English as an additional language. RESULTS: We identified rich diversity of languages, and multilingualism was common. Most young people for whom English was not their first language demonstrated difficulties in SAE competence. Further, nearly one in two young people were identified with language disorder - over half of whom had language disorder associated with FASD. CONCLUSIONS: This study has documented language diversity and the prevalence of language disorder associated with FASD among a representative sample of youth sentenced to detention in WA. Results underscore the need for the justice workforce to consider language difference when working with justice-involved youth, as well as language disorder and FASD. The findings also demonstrate the need for speech pathology to be embedded as core service in youth justice systems, working in collaboration with local cultural and language advisors and accredited interpreters. This can better enable appropriate identification of and response to communication and associated rehabilitation needs of young people navigating youth justice systems.


Assuntos
Compreensão , Transtornos do Espectro Alcoólico Fetal/psicologia , Transtornos da Linguagem/psicologia , Linguagem , Adolescente , Consumo de Bebidas Alcoólicas/efeitos adversos , Estudos Transversais , Feminino , Transtornos do Espectro Alcoólico Fetal/epidemiologia , Humanos , Transtornos da Linguagem/epidemiologia , Testes de Linguagem , Masculino , Exposição Materna/efeitos adversos , Grupo com Ancestrais Oceânicos/psicologia , Índice de Gravidade de Doença , Austrália Ocidental/epidemiologia
15.
J Epidemiol Community Health ; 72(12): 1132-1140, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30242060

RESUMO

BACKGROUND: Identifying children at risk of poor developmental outcomes remains a challenge, but is important for better targeting children who may benefit from additional support. We explored whether data routinely collected in early life predict which children will have language disability, overweight/obesity or behavioural problems in later childhood. METHODS: We used data on 10 262 children from the UK Millennium Cohort Study (MCS) collected at 9 months, 3, and 11 years old. Outcomes assessed at age 11 years were language disability, overweight/obesity and socioemotional behavioural problems. We compared the discriminatory capacity of three models: (1) using data currently routinely collected around the time of birth; (2) Model 1 with additional data routinely collected at 3 years; (3) a statistically selected model developed using a larger set of early year's risk factors for later child health outcomes, available in the MCS-but not all routinely collected. RESULTS: At age 11, 6.7% of children had language disability, 26.9% overweight/obesity and 8.2% socioemotional behavioural problems. Model discrimination for language disability was moderate in all three models (area under the curve receiver-operator characteristic 0.71, 0.74 and 0.76, respectively). For overweight/obesity, it was poor in model 1 (0.66) and moderate for model 2 (0.73) and model 3 (0.73). Socioemotional behavioural problems were also identified with moderate discrimination in all models (0.71; 0.77; 0.79, respectively). CONCLUSION: Language disability, socioemotional behavioural problems and overweight/obesity in UK children aged 11 years are common and can be predicted with moderate discrimination using data routinely collected in the first 3 years of life.


Assuntos
Transtornos do Comportamento Infantil/epidemiologia , Diagnóstico Precoce , Transtornos da Linguagem/epidemiologia , Obesidade Pediátrica/epidemiologia , Criança , Feminino , Humanos , Masculino , Valor Preditivo dos Testes , Fatores de Risco , Reino Unido/epidemiologia
16.
Res Dev Disabil ; 83: 168-178, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30227350

RESUMO

BACKGROUND: Autism spectrumdisorder (ASD) commonly presents with co-occurring medical conditions (CoCs). Little is known about patterns in CoCs in a time of rising ASD prevalence. AIMS: To describe trends in number and type of documented CoCs in 8-year-old children with ASD. METHODS: We used Autism and Developmental Disabilities Monitoring Network (ADDM) data, a multi-source active surveillance system monitoring ASD prevalence among 8-year-old children across the US. Data from surveillance years 2002, 2006, 2008, and 2010 were used to describe trends in count, categories, and individual CoCs. RESULTS: Mean number of CoCs increased from 0.94 CoCs in 2002 to 1.06 CoCs in 2010 (p < 0.001). The percentage of children with ASD with any CoC increased from 44.5% to 56.4% (p < 0.001). CoCs with the greatest increases were in general developmental disability (10.4% to 14.5%), language disorder (18.9% to 23.6%), and motor developmental disability (10.5% to 15.6%). Sex modified the relationship between developmental (P = 0.02) and psychiatric (P < 0.001) CoCs and surveillance year. Race/ethnicity modified the relationship between neurological conditions (P = 0.04) and surveillance year. CONCLUSIONS: The increase in the percentage of children with ASD and CoCs may suggest the ASD phenotype has changed over time or clinicians are more likely to diagnose CoCs.


Assuntos
Transtorno do Espectro Autista , Deficiências do Desenvolvimento/epidemiologia , Transtornos da Linguagem/epidemiologia , Transtornos Mentais/epidemiologia , Transtornos das Habilidades Motoras/epidemiologia , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/psicologia , Criança , Comorbidade , Grupos Étnicos , Feminino , Humanos , Masculino , Vigilância da População , Prevalência , Estados Unidos/epidemiologia
17.
Tijdschr Psychiatr ; 60(9): 606-618, 2018.
Artigo em Holandês | MEDLINE | ID: mdl-30215449

RESUMO

BACKGROUND Klinefelter syndrome (ks) is the most common type of sex chromosome aneuploidy and is associated with psychiatric comorbidities. ks is only diagnosed in less than half of the cases due to the heterogeneous phenotype.
AIM: This study investigates the prevalence of secondary psychiatric diseases and their treatment in ks patients.
METHOD: Relevant articles were identified using the PubMed database. We included articles published in the last ten years, concerning ks patients who were assessed for comorbidities.
RESULTS: A total of 50 articles were included. The most prevalent comorbidities were language disorders and autism spectrum symptoms. Only half the ks population was treated (50.4%) with the primary treatment consisting of hormone therapy. 14% of patients were never treated hormonally.
CONCLUSION: Psychiatric comorbidities were observed in many patients with ks. The early diagnosis of ks in patients is important, given that inadequate treatment of ks patients can lead to reduced social functioning.


Assuntos
Transtorno do Espectro Autista/epidemiologia , Síndrome de Klinefelter/epidemiologia , Síndrome de Klinefelter/psicologia , Transtornos da Linguagem/epidemiologia , Transtorno do Espectro Autista/psicologia , Comorbidade , Humanos , Síndrome de Klinefelter/genética , Transtornos da Linguagem/psicologia
18.
Sch Psychol Q ; 33(3): 356-360, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30010357

RESUMO

Children and youth rely on language skills to navigate environments, many of which are multifaceted and complex. In a society in which successful interactions involve language and prosocial behavior, children who struggle with language or classroom behavior are predisposed to failure. The present perspectives article (a) summarizes the comorbidity of and relations between language skills and behavior problems, (b) provides examples of recent descriptive and experimental studies on these relations, (c) overviews current theoretical frameworks for situating empirical research in this area, and (d) recommends directions for future research. (PsycINFO Database Record


Assuntos
Transtornos do Comportamento Infantil , Transtornos da Linguagem , Comportamento Social , Adolescente , Criança , Transtornos do Comportamento Infantil/epidemiologia , Comorbidade , Humanos , Transtornos da Linguagem/epidemiologia
19.
Pediatrics ; 142(2)2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30026243

RESUMO

CONTEXT: A large number of studies have shown a relationship between language disorders and problem behaviors; however, methodological differences have made it difficult to draw conclusions from this literature. OBJECTIVE: To determine the overall impact of language disorders on problem behaviors in children and adolescents between the ages of birth and 18 years and to investigate the role of informant type, age, and type of problem behavior on this relationship. DATA SOURCES: We searched PubMed, EBSCO, and ProQuest. STUDY SELECTION: Studies were included when a group of children with language disorders was compared with a group of typically developing children by using at least 1 measure of problem behavior. DATA EXTRACTION: Effect sizes were derived from all included measures of problem behaviors from each study. RESULTS: We included 47 articles (63 153 participants). Meta-analysis of these studies revealed a difference in ratings of problem behaviors between children with language disorders and typically developing children of moderate size (g = 0.43; 95% confidence interval 0.34 to 0.53; P < .001). Age was entered as a moderator variable, and results showed that the difference in problem behavior ratings increases with child age (increase in g for each additional year in age = 0.06; 95% confidence interval 0.02 to 0.11; P = .004). LIMITATIONS: There was considerable heterogeneity in the measures of problem behaviors used across studies. CONCLUSIONS: Children with language disorders display greater rates of problem behaviors compared with their typically developing peers, and this difference is more pronounced in older children.


Assuntos
Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/psicologia , Transtornos da Linguagem/epidemiologia , Transtornos da Linguagem/psicologia , Comportamento Problema/psicologia , Criança , Transtornos do Comportamento Infantil/diagnóstico , Desenvolvimento Infantil/fisiologia , Humanos , Transtornos da Linguagem/diagnóstico
20.
Psychiatry Res ; 267: 63-72, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29885556

RESUMO

The purpose of the study was to examine the presence of pragmatic dysfunctions in first episode (FE) subjects and their healthy first degree relatives as a potential endophenotype for schizophrenia. Thirty-four FE patients, 34 parents of the patients (REL) and 32 healthy controls (HC) took part in the study. Pragmatic language functions were evaluated with the Right Hemisphere Language Battery, attention and executive functions were controlled, as well as age and education level. The parents differed from HC but not from their FE offspring with regard to overall level of language and communication and the general knowledge component of language processing. The FE participants differed from HC in comprehension of inferred meaning, emotional prosody, discourse dimensions, overall level of language and communication, language processing with regard to general knowledge and communication competences. The FE participants differed from REL regarding discourse dimensions. Our findings suggest that pragmatic dysfunctions may act as vulnerability markers of schizophrenia; their assessment may help in the diagnosis of early stages of the illness and in understanding its pathophysiology. In future research the adoptive and biological parents of schizophrenia patients should be compared to elucidate which language failures reflect genetic vulnerability and which ones environmental factors.


Assuntos
Transtornos da Linguagem/diagnóstico , Transtornos da Linguagem/psicologia , Pais/psicologia , Esquizofrenia/diagnóstico , Psicologia do Esquizofrênico , Adolescente , Adulto , Compreensão/fisiologia , Emoções/fisiologia , Endofenótipos , Função Executiva/fisiologia , Feminino , Humanos , Transtornos da Linguagem/epidemiologia , Masculino , Pessoa de Meia-Idade , Esquizofrenia/epidemiologia , Adulto Jovem
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