Adam Scheinberg

Oral baclofen in children with cerebral palsy : A double-blind cross-over pilot study

Aim:u2003 To assess the effectiveness of oral baclofen in reducing spasticity and improving function in children with cerebral palsy.

Interventions in Pediatric Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Systematic Review

PURPOSEnA range of interventions have been used for the management of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) in children and adolescents. Currently, debate exists as to the effectiveness of these different management strategies. The objective of this review was to synthesize and critically appraise the literature on interventions for pediatric CFS/ME.nnnMETHODnCINAHL, PsycINFO and Medline databases were searched to retrieve relevant studies of intervention outcomes in children and/or adolescents diagnosed with CFS/ME. Two reviewers independently selected articles and appraised the quality on the basis of predefined criteria.nnnRESULTSnA total of 24 articles based on 21 studies met the inclusion criteria. Methodological design and quality were variable. The majority assessed behavioral interventions (10 multidisciplinary rehabilitation; 9 psychological interventions; 1 exercise intervention; 1 immunological intervention). There was marked heterogeneity in participant and intervention characteristics, and outcome measures used across studies. The strongest evidence was for Cognitive Behavioral Therapy (CBT)-based interventions, with weaker evidence for multidisciplinary rehabilitation. Limited information exists on the maintenance of intervention effects.nnnCONCLUSIONSnEvidence for the effectiveness of interventions for children and adolescents with CFS/ME is still emerging. Methodological inadequacies and inconsistent approaches limit interpretation of findings. There is some evidence that children and adolescents with CFS/ME benefit from particular interventions; however, there remain gaps in the current evidence base.

Paediatric chronic fatigue syndrome: complex presentations and protracted time to diagnosis.

The diagnosis and management of paediatric chronic fatigue syndrome (CFS) remain ongoing challenges for paediatric clinicians, particularly given its unknown aetiology and the little research on effective treatments for this condition. The aim of this study was to describe the presenting features of new patients attending a specialist chronic fatigue clinic at a tertiary‐level Australian childrens hospital.

A retrospective case series of pediatric spinal cord injury and disease in Victoria, Australia.

Study Design. Retrospective case series. Objective. This study aimed to describe the incidence and etiology of pediatric spinal cord disorders (SCD) at The Royal Childrens Hospital (RCH). Summary of Background Data. Spinal cord disorders is rare in children, but those who sustain SCD typically require significant ongoing resources to optimize long-term outcomes. The incidence of pediatric SCD has been reported in Europe, North America, and South America; however, no previous reports are available for Australia. Methods. A retrospective case series of consecutive admissions with SCD was identified using the International Classification of Diseases and Related Health Problems, 10th Edition, Australian Modification, diagnostic codes relating to initial onset of SCD for both traumatic and nontraumatic conditions. Potential cases admitted to RCH between January 1, 2000, and June 30, 2010, were identified and the RCH Trauma Registry was cross-checked to improve accuracy of case attainment. Results. A total of 103 patients were admitted during the study period. Most patients (n = 68, 66%) had a nontraumatic SCD and were male (n = 68, 66%). Of the 68 patients who sustained nontraumatic spinal injuries, the majority (n = 40, 59%) were a result of neoplasm or transverse myelitis (n = 15, 22%) or other diseases of the spinal cord (n = 12, 18%). Thirty-five children were admitted after traumatic injury and more than half of these (n = 19, 54%) were involved in motor vehicle accidents, followed by sporting injuries (n = 8, 23%), falls from height (n = 7, 20%) and assault (n = 1, 3%). The average incidence of traumatic SCD and nontraumatic SCD during the study period was estimated at 3.8 and 6.5 per million children younger than 15 years, respectively. Conclusion. The incidence of pediatric SCD at RCH is lower than reports from Europe and the United States but may be comparable on a population basis. The incidence of nontraumatic pediatric SCD is approximately double that of traumatic SCD. Level of Evidence: 3

Sleep Disturbances in Pediatric Chronic Fatigue Syndrome: A Review of Current Research

OBJECTIVEnChildren and adolescents with chronic fatigue syndrome (CFS) frequently report sleep disturbances. However, little is known about the nature and severity of sleep disturbance and factors associated with sleep problems in pediatric CFS. The purpose of this review was to synthesize and critically appraise existing literature relating to sleep disturbances in pediatric CFS.nnnMETHODSnEmbase, CINAHL, PsychINFO, PubMed. and Medline databases were searched to retrieve all studies that included an assessment of sleep in pediatric CFS. Two reviewers independently assessed eligibility, extracted data, and systematically assessed reporting quality.nnnRESULTSnSix studies were included and these were mostly case-controlled designs. Findings varied across studies; however, most studies found that children and adolescents with CFS had significantly more sleep disturbances when compared to healthy controls. Significant methodological variations and limitations were apparent.nnnCONCLUSIONSnThis review suggests that children and adolescents with CFS experience sleep disturbances. However, results need to be interpreted cautiously given the limited evidence available and its overall low quality. More research is required to elucidate the nature and extent of sleep disturbance in pediatric CFS and should focus on (1) identifying the specific types, causes, and severity of sleep disturbances; (2) the specific consequences of sleep disturbances; and (3) the most effective interventions for sleep problems in this population.

How is paediatric chronic fatigue syndrome/myalgic encephalomyelitis diagnosed and managed by paediatricians? An Australian Paediatric Research Network Study

The diagnosis and management of paediatric chronic fatigue syndrome/myalgic encepnalomyelitis (CFS/ME) represent ongoing challenges for paediatricians. A better understanding of current approaches at a national level is important in informing where research and education could improve treatment outcomes. We aimed to examine current diagnosis and management practices for CFS/ME by Australian paediatricians.

Current status, opportunities, challenges and the paediatrician's role as the National Disability Insurance Scheme rolls out across Australia

Current status, opportunities, challenges and the paediatrician’s role as the National Disability Insurance Scheme rolls out across Australia Tamara May, Mike Forrester, Murray Webber, Jacqueline Roberts, Michelle Spreckley, Adam Scheinberg and Katrina Williams Department of Paediatrics, University of Melbourne, Developmental Disability and Rehabilitation Research, Murdoch Children’s Research Institute, School of Psychology, and Department of Medicine, Deakin University, Neurodevelopment and Disability, Royal Children’s Hospital, Department of Paediatrics, Monash University, Melbourne, Victorian Paediatric Rehabilitation Service, University Hospital Geelong, Barwon Health, Geelong, Victoria, Child and Family Health Team and KidsHealth, Hunter New England Local Health District NSW Government, Newcastle, New South Wales, Autism Centre of Excellence, School of Education and Professional Studies, Griffith University, Brisbane, Queensland, Australia

Brief history and user's guide to the Australian National Disability Insurance Scheme

Brief history and user’s guide to the Australian National Disability Insurance Scheme Tamara May, Jacqueline Roberts, Murray Webber, Michelle Spreckley, Adam Scheinberg, Mike Forrester and Katrina Williams Department of Paediatrics, University of Melbourne, Murdoch Children’s Research Institute, Royal Children’s Hospital Melbourne, Victorian Paediatric Rehabilitation Service, Department of Paediatrics, Monash University, Melbourne, School of Psychology, and Medicine, Deakin University, University Hospital Geelong, Barwon Health, Geelong, Victoria, Autism Centre of Excellence, School of Education and Professional Studies, Griffith University, Brisbane, Queensland and Hunter New England NSW Government Health, Newcastle, New South Wales, Australia

Juvenile Parkinsonism: Juvenile Parkinsonism

We present the case of a 14‐year‐old boy presented with a recent history of progressive neurologic decline and extrapyramidal features. The history and findings with illustrative figures are detailed, and a diagnostic approach to the presentation is considered. The therapeutic options and broader management issues are briefly reviewed.

Therapy service use in children and adolescents with cerebral palsy: An Australian perspective.

The aim of this study was to describe the patterns of therapy service use for a sample of children and adolescents with cerebral palsy over a 1 year period and to identify factors associated with frequency of therapy and parental satisfaction with therapy frequency.