adaptive functioning

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  • 文章类型: Case Reports
    对患有自闭症谱系障碍(ASD)的家族风险婴儿的前瞻性研究已对该疾病的最早体征产生了见解,但代表了病因不明的异质性样本。通过研究与ASD高发率相关的单基因综合征婴儿队列来补充这种方法,为阐明导致ASD的因素提供了机会。
    我们提供了10个月大的1型神经纤维瘤病(NF1)婴儿的前瞻性研究的第一份报告。单基因疾病,ASD或ASD症状高患病率。我们将NF1婴儿的数据与大量有ASD家族风险的婴儿进行了比较,按ASD3岁时的结果分开(n=34),非典型发育(n=44),或典型发展(n=89),和低风险控制(n=75)。根据家长报告和考官观察在10个月评估的领域包括认知和适应功能,感官加工,社会参与,和气质。
    患有NF1的婴儿相对于低风险婴儿在运动功能方面表现出惊人的损害;这种模式见于家族性队列(HR-ASD)的晚期ASD婴儿。NF1和HR-ASD组的婴儿都显示出相对于低风险婴儿的沟通延迟。
    10个月大的NF1婴儿表现出一系列发育困难,在运动和交流领域尤为突出。和HR-ASD婴儿一样,这个年龄段的社交技能没有明显受损。这是NF1早期神经发育的一些初步信息。强大的推论受到样本量的限制,但是这些发现表明了早期比较发展科学的意义,并强调了运动功能是相关动物模型发展的重要领域。这些发现具有临床意义,表明在这种早期诊断的遗传病中早期监测和补救的重要重点。
    Prospective studies of infants at familial risk for autism spectrum disorder (ASD) have yielded insights into the earliest signs of the disorder but represent heterogeneous samples of unclear aetiology. Complementing this approach by studying cohorts of infants with monogenic syndromes associated with high rates of ASD offers the opportunity to elucidate the factors that lead to ASD.
    We present the first report from a prospective study of ten 10-month-old infants with neurofibromatosis type 1 (NF1), a monogenic disorder with high prevalence of ASD or ASD symptomatology. We compared data from infants with NF1 to a large cohort of infants at familial risk for ASD, separated by outcome at age 3 of ASD (n = 34), atypical development (n = 44), or typical development (n = 89), and low-risk controls (n = 75). Domains assessed at 10 months by parent report and examiner observation include cognitive and adaptive function, sensory processing, social engagement, and temperament.
    Infants with NF1 showed striking impairments in motor functioning relative to low-risk infants; this pattern was seen in infants with later ASD from the familial cohort (HR-ASD). Both infants with NF1 and the HR-ASD group showed communication delays relative to low-risk infants.
    Ten-month-old infants with NF1 show a range of developmental difficulties that were particularly striking in motor and communication domains. As with HR-ASD infants, social skills at this age were not notably impaired. This is some of the first information on early neurodevelopment in NF1. Strong inferences are limited by the sample size, but the findings suggest implications for early comparative developmental science and highlight motor functioning as an important domain to inform the development of relevant animal models. The findings have clinical implications in indicating an important focus for early surveillance and remediation in this early diagnosed genetic disorder.
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  • 文章类型: Journal Article
    目的:低出生体重(LBW;低于2500克)是各种神经发育困难的一般危险因素。然而,这些儿童可能仍然更容易受到几年后发生的神经和环境损害。这个前瞻性病例系列报告了患有轻度疾病的儿童,中度,或严重的创伤性脑损伤(TBI)在儿童中期,但谁也出生与出生体重低于2500克。
    方法:参与者为14名轻度、中度,或严重的创伤性脑损伤(TBI),其中5名出生体重低于2500克(LBW),9名正常出生体重(NBW)的儿童。所有参与者都来自一项关于儿童TBI的长期认知和行为影响的更大研究,并在年龄上进行匹配。估计社会经济地位(SES),和TBI的严重程度(NBW儿童实际上具有稍差的整体伤害严重程度)。
    结果:在基线时,两组在WJ-R字母单词识别和计算上表现出相似的分数,伦敦塔号码解决了,和CVLT-C总正确。在CELF-III公式句子(NBW>LBW)和VABS适应性行为复合和社交子域(LBW>NBW)上观察到基线组差异。超过2年,相对于NBW组,LBW组证明在两个WJ-R子测试中都有所下降,CVLT-C总正确,CELF-III制定的句子,和VABS适应行为复合和社会化。
    结论:尽管由于样本量小,在性质上是初步的,研究结果表明,LBW病史会影响儿童TBI后的恢复轨迹。学术和适应性功能以及言语记忆尤其受到影响。
    OBJECTIVE: Low birth weight (LBW; below 2500 grams) is a general risk factor for a variety of neurodevelopmental difficulties. However, these children may remain more vulnerable to neurologic and environmental insults occurring years later. This prospective case series reports on children who sustained a mild, moderate, or severe traumatic brain injury (TBI) in middle childhood but who had also been born with birth weights below 2500 grams.
    METHODS: PARTICIPANTS were 14 children with mild, moderate, or severe traumatic brain injury (TBI), 5 of whom had birth weights under 2500 grams (LBW) and 9 children with normal birth weight (NBW). All participants were drawn from a larger study on the long-term cognitive and behavioral impact of pediatric TBI and were matched on age, estimated socioeconomic status (SES), and severity of TBI (with NBW children actually having a slightly worse overall injury severity).
    RESULTS: At baseline, both groups exhibited similar scores on WJ-R Letter Word Identification and Calculations, Tower of London number solved, and CVLT-C total correct. Baseline group differences were observed on the CELF-III Formulated Sentences (NBW > LBW) and on the VABS Adaptive Behavior Composite and Socialization subdomain (LBW > NBW). Over 2 years, relative to the NBW group, the LBW group evidenced declines on both WJ-R subtests, CVLT-C total correct, CELF-III Formulated Sentences, and VABS Adaptive Behavior Composite and Socialization.
    CONCLUSIONS: Although preliminary in nature due to small sample size, findings suggest a history of LBW influences the recovery trajectory following childhood TBI. Academic and adaptive functioning and verbal memory appeared particularly affected.
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