Scoliosis and Prader- Willi
The Archives of Disease in Childhood reports that children with Prader-Willi Syndrome have a high incidence rate of scoliosis (37.5%) that increases with age. Infants and young children had approximately a 30% rate of scoliosis and adolescents had an 80% rate of scoliosis.
Reference: de Lind van Wijngaarden, Roderick F.A., de Klerk, Luuk W.L., Festen, Dederieke A.M., Hokken-Koelega, Anita C.S. Scoliosis in Prader-Willi syndrome: Prevalence, effects of age, gender, body mass index, lean body mass and genotype Arch Dis Child 2008 0: adc.2007.123836
ADHD and Heart Monitoring
The American Heart Association (AHA) has issued updated recommendations regarding the use of stimulant drugs to treat ADHD. Due to potential for cardiac changes with stimulant use, the AHA recommends that all children with ADHD should have an electrocardiogram before starting the stimulant medications. If a child with ADHD is currently taking stimulant medication, an electrocardiogram should be performed.
Reference: Victoria L. Vetter, Josephine Elia, Christopher Erickson, Stuart Berger, Nathan Blum, Karen Uzark, and Catherine L. Webb Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Stimulant Drugs. A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing Circulation published April 21, 2008, doi:10.1161/CIRCULATIONAHA.107.189473
Exercise and JIA
From the Cochrane Library, a review of the literature was published where the authors concluded that there was no statistically significant evidence to support that exercise improves the quality of life, pain level or functional level in children with juvenile idiopathic arthritis (JIA). The authors also concluded that more research needs to be done on this topic.
Reference: Takken T, van Brussel M, Engelbert RHH, Van der Net J, Kuis W, Helders PJM. Exercise therapy in juvenile idiopathic arthritis. Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD005954. DOI: 10.1002/14651858.CD005954.pub2.
Handwriting and ADHD
Journal of Child Neurology published a review of the literature on handwriting performance and ADHD. The authors suggest that children with ADHD have deficits in handwriting such as illegibility and slower speed of execution. The authors state that larger studies using standardized testing are needed.
Reference: Racine, Marie Brossard, Majnemer, Annette, Shevell, Michael, Snider, Laurie. (2008) Handwriting Performance in Children With Attention Deficit Hyperactivity Disorder (ADHD) J Child Neurol 23: 399-406.
Down Syndrome and Autism – Language Loss
The Journal of Developmental and Behavioral Pediatrics reports that 12 children with Down syndrome and autism exhibited language loss at a mean age of 61.8 (SD=22.9) months old. Children with only autism exhibit language loss at a mean age of 19.7 (SD=5.8) months old. For other skill loss, children with Down syndrome and autism had a mean age of 46.2 (SD=19.1) months and children with autism had a mean age of 19.5 (SD= 5.6) months.
Reference: Castillo, Heidi MD ; Patterson, Bonnie MD ; Hickey, Francis MD; Kinsman, Anne PhD; Howard, Jennifer M. BS; Mitchell, Terry; Molloy, Cynthia A. MD. (2008) Difference in Age at Regression in Children with Autism with and without Down Syndrome. Journal of Developmental & Behavioral Pediatrics. 29(2):89-93.
Risperidone Use in Down’s and Autism
Recent research reported improvements in aggression, disruptiveness, self injury, stereotypy and social withdrawal in children with Down’s Syndrome with autism and severe intellectual disability (mean age 7.8 years old) following the use of Risperidone. Weight gain was a reported side effect.
Reference: Capone, George T. MD Goyal, Parag BA ; Grados, Marco MD, MPH; Smith, Brandon MD; Kammann, Heather BA (2008) Risperidone Use in Children with Down Syndrome, Severe Intellectual Disability, and Comorbid Autistic Spectrum Disorders: A Naturalistic Study. Journal of Developmental & Behavioral Pediatrics. 29(2):106-116
Oral Baclofen and Plantar Flexors in CP
The Journal of Child Neurology has published research on the use of oral baclofen in children with CP for four weeks. This study concluded 9 of the 10 subjects increased their voluntary control over muscles but overall strength (measured by plantar flexion torque) did not change. The researchers hypothosize that the increase in voluntary control as a result of the baclofen may help to bolster strength training.
Reference: van Doornik, Johan, Kukke, Sahana, McGill, Kevin, Rose, Jessica, Sherman-Levine, Sara, Sanger, Terence D. Oral Baclofen Increases Maximal Voluntary Neuromuscular Activation of Ankle Plantar Flexors in Children With Spasticity Due to Cerebral Palsy J Child Neurol 2008 0: 0883073807313046
Medication and Autism
The Journal of Development and Behavioral Pediatrics reports on a population based study in Minnesota reviewing psychostimulant use in autistic subjects ages 0-21 years old. It was determined that 52.4% of the 124 subjects received psycho stimulants with positive responses for 69.4% of 398 episodes. These results suggest that psycho stimulants may improve certain behaviors such as impulsivity, inattention, hyperactivity and dis-inhibition.
Reference: Nickels, Katherine C. MD ; Katusic, Slavica K. MD ; Colligan, Robert C. PhD; Weaver, Amy L. MS; Voigt, Robert G. MD ; Barbaresi, William J. MD. (2008) Stimulant Medication Treatment of Target Behaviors in Children with Autism: A Population-Based Study. Journal of Developmental & Behavioral Pediatrics. 29(2):75-81.
Comparison of intermittent versus continuous PT
A recent study in Developmental Medicine and Child Neurology reports that there was no significant difference in outcomes when comparing intermittent PT for children with CP (1-2x/week x 30 weeks) to continuous PT (4x/week with 6 week break for 30 weeks). Both groups increased scores on the Gross Motor Function Measure.
Reference: Annette Sandahl Christiansen, Christa Lange MSc (2008) Intermittent versus continuous physiotherapy in children with cerebral palsy Developmental Medicine & Child Neurology 50 (4) , 290–293 doi:10.1111/j.1469-8749.2008.02036.x
Autism and Prematurity
Pediatrics published research indicating that extremely low birth weight babies (less than 1500 grams) are at increased risk for autism. The researchers recommend early screening for children in this risk category.
Reference: Limperopoulos, Catherine, Bassan, Haim, Sullivan, Nancy R., Soul, Janet S., Robertson, Richard L., Jr, Moore, Marianne, Ringer, Steven A., Volpe, Joseph J., du Plessis, Adre J. Positive Screening for Autism in Ex-preterm Infants: Prevalence and Risk Factors Pediatrics 2008 121: 758-765
School Aged Children with PMH of Complex Congential Heart Disease
The latest issue of Pediatrics reports that 5 to 10 year old children with a history of complex congenital heart disease are at risk for problems in school. Of the 109 children studied, 53% received remedial services and 15% were in special education classrooms. The children were at a much greater risk for inattentive and hyperactive behaviors.
Reference: Shillingford, Amanda J., Glanzman, Marianne M., Ittenbach, Richard F., Clancy, Robert R., Gaynor, J. William, Wernovsky, Gil Inattention, Hyperactivity, and School Performance in a Population of School-Age Children With Complex Congenital Heart Disease Pediatrics 2008 121: e759-e767