High Maternal Blood Mercury Level Is Associated with Low Verbal IQ in Children.

The objective of the present study was to investigate the relationship of IQ in children with maternal blood mercury concentration during late pregnancy. The present study is a component of the Mothers and Children's Environmental Health (MOCEH) study, a multi-center birth cohort project in Korea that began in 2006. The study cohort consisted of 553 children whose mothers underwent testing for blood mercury during late pregnancy. The children were given the Korean language version of the Wechsler Preschool and Primary Scale of Intelligence, revised edition (WPPSI-R) at 60 months of age. Multivariate linear regression analysis, with adjustment for covariates, was used to assess the relationship between verbal, performance, and total IQ in children and blood mercury concentration of mothers during late pregnancy. The results of multivariate linear regression analysis indicated that a doubling of blood mercury was associated with the decrease in verbal and total IQ by 2.482 (95% confidence interval [CI], 0.749-4.214) and 2.402 (95% CI, 0.526-4.279), respectively, after adjustment. This inverse association remained after further adjustment for blood lead concentration. Fish intake is an effect modifier of child IQ. In conclusion, high maternal blood mercury level is associated with low verbal IQ in children.

Outcomes of hydrocephalus secondary to congenital toxoplasmosis.

OBJECTIVE: Hydrocephalus occurs in children with congenital toxoplasmosis and can lead to severe disability. In these cases, the decision to intervene is often influenced by the expectation of neurological recovery. In this study, clinical responses to neurosurgical intervention in children with hydrocephalus secondary to congenital toxoplasmosis are characterized. METHODS: Sixty-five participants with hydrocephalus due to congenital Toxoplasma gondii infection were evaluated as part of the National Collaborative Chicago-based Congenital Toxoplasmosis Study, and their neuroradiographic findings were reviewed. Clinical outcomes were scored on the basis of cognition and motor skills through the use of IQ scores and Gross Motor Function Classification System (GMFCS) level. Outcomes were then analyzed in relation to approach to management, anatomy of hydrocephalus, and time from diagnosis of hydrocephalus to surgical intervention. RESULTS: There was considerable variation in the outcomes of patients whose hydrocephalus was treated in early life, ranging from normal cognitive and motor function to profound developmental delay and functional limitation. Of the 65 participants included in the study, IQ and GMFCS level were available for 46 (70.8%). IQ and motor score were highly correlated (r = -0.82, p < 0.001). There were people with differing patterns of hydrocephalus or thickness of cortical mantle on initial presentation who had favorable outcomes. Time to neurosurgical intervention data were available for 31 patients who underwent ventriculoperitoneal (VP) shunt placement. Delayed shunt placement beyond 25 days after diagnosis of hydrocephalus was associated with greater cognitive impairment (p = 0.02). Motor impairment also appeared to be associated with shunt placement beyond 25 days but the difference did not achieve statistical significance (p = 0.13). Among those with shunt placement within 25 days after diagnosis (n = 19), the mean GMFCS level was 1.9 ± 1.6 (range 1-5). Five (29.4%) of 17 of these patients were too disabled to participate in formal cognitive testing, after excluding 2 patients with visual difficulties or language barriers that precluded IQ testing. Of the patients who had VP shunt placement 25 or more days after diagnosis (n = 12), the mean GMFCS level was 2.7 ± 1.4 (range 1-4). Of these, 1 could not participate in IQ testing due to severe visual difficulties and 8 (72.7%) of the remaining 11 due to cognitive disability. CONCLUSIONS: VP shunt placement in patients with hydrocephalus caused by congenital toxoplasmosis can contribute to favorable clinical outcomes, even in cases with severe hydrocephalus on neuroimaging. Shunt placement within 25 days of diagnosis was statistically associated with more favorable cognitive outcomes. Motor function appeared to follow the same pattern although it did not achieve statistical significance.

Blood lead concentrations < 10 microg/dL and child intelligence at 6 years of age.

BACKGROUND: Few studies provide data directly relevant to the question of whether blood lead concentrations < 10 microg/dL adversely affect children's cognitive function. OBJECTIVE: We examined the association between blood lead concentrations assessed throughout early childhood and children's IQ at 6 years of age. METHODS: Children were followed from 6 months to 6 years of age, with determination of blood lead concentrations at 6, 12, 18, and 24 months, and 3, 4, 5, and 6 years of age. At 6 years of age, intelligence was assessed in 194 children using the Wechsler Preschool and Primary Scale of Intelligence-Revised. We used general linear and semiparametic models to estimate and test the association between blood lead concentration and IQ. RESULTS: After adjustment for maternal IQ, HOME scale scores, and other potential confounding factors, lifetime average blood lead concentration (mean = 7.2 microg/dL; median = 6.2 microg/dL) was inversely associated with Full-Scale IQ (p = 0.006) and Performance IQ scores (p = 0.002). Compared with children who had lifetime average blood lead concentrations < 5 microg/dL, children with lifetime average concentrations between 5 and 9.9 microg/dL scored 4.9 points lower on Full-Scale IQ (91.3 vs. 86.4, p = 0.03). Nonlinear modeling of the peak blood lead concentration revealed an inverse association (p = 0.003) between peak blood lead levels and Full-Scale IQ down to 2.1 microg/dL, the lowest observed peak blood lead concentration in our study. CONCLUSIONS: Evidence from this cohort indicates that children's intellectual functioning at 6 years of age is impaired by blood lead concentrations well below 10 microg/dL, the Centers for Disease Control and Prevention definition of an elevated blood lead level.

Performance IQ in children is associated with blood cadmium concentration in early pregnancy.

OBJECTIVE: To investigate whether performance IQ in children is associated with maternal blood cadmium concentration in early pregnancy. METHOD: The present study is a component of the Mothers' and Children's Environmental Health (MOCEH) study, a multi-center birth cohort project in Korea that began in 2006. The study cohort consisted of 119 children whose mothers underwent testing of blood cadmium during early pregnancy. All children were evaluated using the Korean version of the Wechsler Preschool and Primary Scale of Intelligence, revised edition (WPPSI-R), at 60 months of age. Multivariate linear regression analysis was performed to analyze the correlation between IQ in children and maternal blood cadmium concentration in early pregnancy, after adjustment for covariates. RESULTS: Maternal blood cadmium concentration during early pregnancy was inversely associated with performance IQ, after adjustment for covariates such as sex, educational levels of both parents, family income, and maternal BMI. Maternal blood cadmium concentration, however, was not associated with cognitive IQ. CONCLUSION: Performance IQ in children is associated with maternal blood cadmium concentration in early pregnancy.

Evidence that cognitive deficit in children is associated not only with iron deficiency, but also with blood lead concentration: a preliminary study.

OBJECTIVE: To investigate whether blood lead concentrations are elevated in iron-deficient children, and to examine the association between iron deficiency and/or elevated blood lead concentration and cognitive deficits in children. METHOD: The present study is a component of the Mothers' and Children's Environmental Health (MOCEH) study, a multi-center birth cohort project in Korea that began in 2006. The study cohort consisted of 194 children who underwent testing of blood lead and serum C-reactive proteins (CRPs) and ferritin concentrations, and the Korean version of the Wechsler Preschool and Primary Scale of Intelligence, revised edition (WPPSI-R), at 60 months of age. In addition, the mothers' blood lead concentrations during pregnancy were included in the analyses. Multivariate linear regression analysis was performed to analyze the correlation between high blood lead and low serum ferritin concentrations, after adjustment for covariates, in children, as well as to analyze the association of verbal IQ with serum ferritin and blood lead concentrations. RESULTS: Lead and ferritin concentrations were inversely and significantly associated in children after adjustment for covariates. Moreover, both concentrations were associated with verbal IQ, after adjustment for covariates, and each was associated with cognitive deficits after adjustment for the other. Sobel test statistics showed that blood lead concentration was a significant partial mediator for the relationship between iron deficiency and verbal IQ. CONCLUSION: Due to the results discussed in the present study, cognitive deficit in children seems to be associated not only with iron deficiency, but also with blood lead concentration.

High Maternal Blood Mercury Level Is Associated with Low Verbal IQ in Children

The objective of the present study was to investigate the relationship of IQ in children with maternal blood mercury concentration during late pregnancy. The present study is a component of the Mothers and Children's Environmental Health (MOCEH) study, a multi-center birth cohort project in Korea that began in 2006. The study cohort consisted of 553 children whose mothers underwent testing for blood mercury during late pregnancy. The children were given the Korean language version of the Wechsler Preschool and Primary Scale of Intelligence, revised edition (WPPSI-R) at 60 months of age. Multivariate linear regression analysis, with adjustment for covariates, was used to assess the relationship between verbal, performance, and total IQ in children and blood mercury concentration of mothers during late pregnancy. The results of multivariate linear regression analysis indicated that a doubling of blood mercury was associated with the decrease in verbal and total IQ by 2.482 (95% confidence interval [CI], 0.749–4.214) and 2.402 (95% CI, 0.526–4.279), respectively, after adjustment. This inverse association remained after further adjustment for blood lead concentration. Fish intake is an effect modifier of child IQ. In conclusion, high maternal blood mercury level is associated with low verbal IQ in children.

Pais, educadores e testes: estão de acordo na avaliação de aptidões de crianças pré-escolares? / Parents, teachers and tests: do they agree in the assessment of preschoolers’ abilities?

O presente estudo pretende contribuir para o esclarecimento de questões relativas ao acordo entre pais e educadores quando avaliam o desenvolvimento infantil e com o grau em que estas avaliações estão relacionadas com aptidões cognitivas das crianças. Cento e setenta e três crianças pré-escolares foram classificadas de modo independente por pais e por educadores em diferentes áreas do desenvolvimento e os resultados na WPPSI-R foram tomados como critério externo. A idade e o género das crianças foram considerados nas análises realizadas. O grau de acordo entre informadores revelou-se baixo a moderado. Em comparação com os educadores, os pais classificam os seus filhos como mais desenvolvidos. Algumas dimensões do desenvolvimento (e.g. aprendizagem) encontram-se mais relacionadas com o desempenho na WPPSI-R do que outras. Os resultados são discutidos quanto às suas implicações para a avaliação psicológica de crianças pré-escolares.

This paper addresses issues related to the agreement between parents and teachers when they assess children's development, and to what extend those assessments are related to children's cognitive abilities. A hundred seventy three preschoolers were independently classified by their parents and teachers regarding different developmental domains. The results on the WPPSI-R test were taken as an external criterion to evaluate the accuracy of the parents' ratings. Children's age and gender were considered in the analysis. Inter-rater agreement is low to moderate. Compared with teachers, parents systematically rate their children as more developed. Some dimensions of development (e.g. learning) are more related to performance on the WPPSIR than others. Results are discussed regarding their implications to the psychological assessment of preschoolers.

Pais, educadores e testes: estão de acordo na avaliação de aptidões de crianças pré-escolares? / Parents, teachers and tests: do they agree in the assessment of preschoolers’ abilities?

O presente estudo pretende contribuir para o esclarecimento de questões relativas ao acordo entre pais e educadores quando avaliam o desenvolvimento infantil e com o grau em que estas avaliações estão relacionadas com aptidões cognitivas das crianças. Cento e setenta e três crianças pré-escolares foram classificadas de modo independente por pais e por educadores em diferentes áreas do desenvolvimento e os resultados na WPPSI-R foram tomados como critério externo. A idade e o género das crianças foram considerados nas análises realizadas. O grau de acordo entre informadores revelou-se baixo a moderado. Em comparação com os educadores, os pais classificam os seus filhos como mais desenvolvidos. Algumas dimensões do desenvolvimento (e.g. aprendizagem) encontram-se mais relacionadas com o desempenho na WPPSI-R do que outras. Os resultados são discutidos quanto às suas implicações para a avaliação psicológica de crianças pré-escolares.(AU)

This paper addresses issues related to the agreement between parents and teachers when they assess children's development, and to what extend those assessments are related to children's cognitive abilities. A hundred seventy three preschoolers were independently classified by their parents and teachers regarding different developmental domains. The results on the WPPSI-R test were taken as an external criterion to evaluate the accuracy of the parents' ratings. Children's age and gender were considered in the analysis. Inter-rater agreement is low to moderate. Compared with teachers, parents systematically rate their children as more developed. Some dimensions of development (e.g. learning) are more related to performance on the WPPSIR than others. Results are discussed regarding their implications to the psychological assessment of preschoolers.(AU)

Confiabilidade do teste WPPSI-R na avaliação do desenvolvimento cognitivo de pré-escolares / Reliability of the WPPSI-R test in the evaluation of cognitive development in preschoolers

O Teste psicométrico WPPSI-R (Wechsler Preschool and Primary Scale of Intelligence - Revised) foi o instrumento de avaliaçäo em uma pesquisa para estudar o desenvolvimento cognitivo, na idade pré-escolar, de uma populaçäo de crianças do Instituto Fernandes Figueira (IFF) nascidas prematuras e de muito baixo peso (MBP), aplicado por quatro psicólogas previamente treinadas. O objetivo foi avlaiar a confiabilidade inter-observador na aplicaçäo do teste. Utilizaram-se dois desenhos: de blocos incompletos equilibrados, para avaliar a concordância na aplicaçäo do teste, e cruzado, para avaliar a concordância na pontuaçäo dos itens. Foram estudadas 12 crianças pré-escolares nascidas no IFF (Peso ao nascer <1.500g). Os coeficientes de correlaçäo intraclasse (CCI) encontrados foram: 0,82 (Escore Total), 0,89 (Escore Verbal) e 0,91 (Escore Executivo), no desenho de blocos incompletos equilibrados, e 0,99, 0,98 e 0,99, respectivamente, no desenho cruzado, indicando uma boa confiabilidade. Estes achados mostram que a aplicaçäo do Teste WPPSI-R no estudo do desenvolvimento cognitivo de prematuros de MBP do IFF foi adequada.