Developmental Medicine & Child Neurology | 2019
DMCN 2019 highlights: medical cannabis, developmental coordination disorder guidelines, cardiovascular disease in cerebral palsy, and more
Abstract
Once again, this year has seen the rise of both our 2-year and 5-year impact factor. However, a more relevant and exciting impact has been our widening reach, strong contributions, and diversity of authorship. We have had multidisciplinary studies and reports from every continent and many international collaborative works. In addition to Spanish and Portuguese translations of abstracts (courtesy of the Academia Latinoamericana de Desarrollo Infantil y Discapacidades), we published invited editorials in those languages as well as in Chinese, Japanese, and Korean. Several commentaries offered perspectives from lived experience (e.g. parents, the dancer Jerron Herman), or policymaking/shaping institutions (e.g. European Parliament and the United Nations High Commissioner for Refugees) as well as from expert clinicians and researchers. Among hot topics in the 2019 volume, mental health in cerebral palsy (CP) was addressed by several studies, highlighting bullying and the emerging influence of social media, and emphasizing the need to identify protective factors for individuals with CP and their families. A clearer picture of cardiovascular risk, disease, and mortality in adults with CP is also emerging thanks to a handful of papers whose conclusions invite readers to apply and evaluate proactive and preventive measures to optimize nutrition, sleep, and physical activity in these individuals. Assessment of visual functioning in disabled children remains a challenging issue but several important papers published in 2019 presented promising tools. The Visual Function Classification System for children with CP is likely to become an indispensable companion to the other classification systems that are being used universally. Classifications and scales were presented or further evaluated for a number of other symptoms and functions, including pain, fatigue, hand function, communication, and to predict eating and drinking difficulties. In the context of the public debate (often ill-informed) about cannabis-derived therapies, one paper clarified the efficacy, safety, and tolerability of cannabidiol in paediatric epilepsy and the clinical challenges associated with its use. Another paper synthesized available studies on the effect of tetrahydrocannabinol on spasticity (mostly in adults with multiple sclerosis) and concluded that there is currently insufficient evidence to support the use of cannabinoids in the treatment of spasticity in children. A review of nusine rsen treatment of spinal muscular atrophy identified gaps in the knowledge of its effectiveness, including in patient groups in which proof of efficacy has been documented. To approach these issues in a systematic, rigorous, and transparent way, we now welcome scoping reviews. The goal is to ‘scope out’ available evidence in emerging clinical areas in order to provide an overview of the current state of research as well as to identify gaps in the evidence to guide future studies. One example was a scoping review of CP research in India. It found a focus on interventions to reduce impairment, while activities, participation, and environmental factors are addressed only minimally. This review also documented that many of the studies are published in journals that are not indexed in worldwide databases of scholarly journals. In the course of this year, we also continued to refine the editorial process for systematic reviews. One major collaborative work followed a systematic review methodology that resulted in clinical practice recommendations on developmental coordination disorder that we anticipate will reshape practice, research, and the evolution of the concept of the condition itself. Finally, I was particularly glad this year to receive the 50-year update on a cohort of individuals with surgically treated spina bifida. The study provided a very long-term perspective through marked evolution in treatment, service, and attitudes towards disability, emphasizing the need for a proactive, lifelong outlook in developmental disability. We look forward to publishing and learning from new studies in Volume 62.