Eva Tideman

Cognitive function in young adults following intrauterine growth restriction with abnormal fetal aortic blood flow

Intrauterine growth restriction (IUGR) is a recognized risk factor for neurological deficits later in life. Abnormal fetal blood flow in the presence of IUGR helps to distinguish fetuses with true growth impairment from those that are small but normally grown. This study aimed to evaluate the influence of IUGR with abnormal fetal blood flow on cognitive function and psychological development in young adults.

Longitudinal follow-up of children born preterm: cognitive development at age 19

In a long-term prospective study, 39 preterm children born before 35 completed weeks of gestation and 23 full-term children were followed up at 4, 9 and 19 years of age. Psychometric evaluation of the cognitive development at 4 years of age showed that the preterms fell within the normal range, although their performance was inferior to that of the full-terms. This difference between the groups was not found at 9 and 19 years of age. Within the preterm group there was no correlation between the test results and birthweight, gestational age, prenatal or perinatal optimality scores. Full-terms had better scholastic performance at the end of compulsory schooling, while there was no difference at 19 years of age. At 19 years of age, about 1/3 of the children in both groups rated themselves as having had attention deficits during their childhood and adolescence. In this group of moderately immature, low-risk children, preterm birth without major physical or mental disabilities poses a developmental risk that seems to have the greatest impact during the preschool years and then gradually attenuates.

Anger, depression and anxiety associated with endothelial function in childhood and adolescence

Objective Psychosocial adversity is a risk factor for cardiovascular disease (CVD) in adults. The authors assessed associations of reactive hyperaemia peripheral arterial tonometry (RH-PAT), a measure of endothelial function predictive of CVD, with self-assessed psychological health among school children. Methods A total of 248 healthy school children (mean (SD) age 14.0 (1.0); 136 girls and 112 boys) underwent RH-PAT testing. They completed the Beck Youth Inventories (BYI) of emotional and social impairment scales, which is used to screen for depression, anxiety, anger and disruptive behaviour. Results No sex differences were observed for the RH-PAT score. Statistically significant differences were observed for the BYI scores; girls had higher scores for depression, anger and anxiety. Among the girls, there were statistically significant associations between lower RH-PAT scores and higher scores for anger (B coefficient=−0.100, p=0.040), depression (−0.108, p=0.009) and anxiety (−0.138, p=0.039) after adjustment for age. Among the boys, disruptive behaviour was associated with higher RH-PAT scores (0.09, p=0.006). Conclusions The girls have higher levels of self-assessed anger; depression and anxiety compared with the boys, and these characteristics are associated with lower RH-PAT scores, indicating attenuated endothelial function. Among the boys, disruptive behaviour was associated with better endothelial function. Although psychological ill-health is associated with impaired endothelial function and CVD among adults, such processes may also be relevant to children. Psychosocial adversity in childhood might be a risk factor for subsequent CVD.

Improving Foster Children's School Achievements: Promising Results from a Swedish pilot study

Eva Tideman, Bo Vinnerljung, Kristin Hintze and Anna Aldenius Isaksson report on the results of a Swedish project aimed at improving foster childrens school achievements. Standardised psychological and pedagogical instruments were used for assessing each individual foster childs potential, her or his educational service needs, and for tailoring the individualised educational and psychological support that was provided for two years. After this period, the 25 children included in the project were re-tested with the same instruments. Post-intervention test results were compared to preintervention scores for assessing outcomes. Results showed significant gains in IQ (as measured by WISC-III), reading and spelling skills, but weaker, non-significant improvements in maths skills.

Longitudinal follow-up of preterm children: the mother-and child relationship at 9 and 19 years of age

In this longitudinal prospective study, two groups of children, preterms and fullterms, were followed up regarding the mother-child relationship at 9 and 19 years of age. Information was obtained from both the children and their mothers. A self-report scale was utilized for the assessment of the conscious attachment model, and percept-genetic tests displaying pictorial mother-child themes were utilized as a method of evaluating the unconscious attachment model. A questionnaire was used to measure the degree of expressed emotion in the mother-child relationship. Percept-genetic tests showed that at 9 years of age, the preterm children and their mothers differed significantly from the full-terms in their reports of the mother-child theme, and that at age 19, the preterms differed significantly from the full-terms in their perceptions of the attachment and separation themes. A greater degree of expressed emotion was found among the preterm mother-child dyads. The results indicate that preterm children may harbour emotional vulnerability regarding attachment and separation as young adults.In this longitudinal prospective study, 2 groups of children, 39 preterms and 23 fullterms, were followed up regarding the mother-child relationship at 9 and 19 years of age. Information was obtained from both the children and their mothers. A self-report scale was utilized for the assessment of the conscious attachment model, and percept-genetic tests displaying pictorial mother-child themes were utilized as a method of evaluating the uncon¬scious attachment model. A questionnaire was used to measure the degree of expressed emotion in the mother-child relationship. Percept-genetic tests show that at 9 years of age, the preterm children and their mothers differed significantly from the full-terms in their reports of the mother-child theme, and that at age 19, the preterms differed significantly from the full-terms in their perceptions of the attachment and separation themes. A greater degree of expressed emotion was found among the preterm mother-child dyads. The results indicate that preterm children may harbor emotional vulnerability regarding attachment and separation as young adults. (Less)

Epilepsy surgery in children with drug-resistant epilepsy, a long-term follow-up

In this follow‐up study, we wanted to present the long‐term outcome (5–21 years) in terms of seizure freedom, seizure reduction, and the cognitive development in the first 47 children who underwent epilepsy surgery at the University Hospital in Lund from 1991 to 2007.

Mild intellectual disability and ADHD; a comparative study of school age children's adaptive abilities

To compare adaptive functioning in children with mild intellectual disability (MID) with that of children with attention‐deficit/hyperactivity disorder (ADHD).

Auditory event-related potentials are related to cognition at preschool age after very preterm birth

Background:Auditory event-related potentials (AERP) are neurophysiological correlates of sound perception and cognitive processes. Our aim was to study in very preterm born children at preschool age if AERP correlate with cognitive outcome.Methods:Seventy children (mean ± SD gestational age 27.4 ± 1.9 wk, birth weight 996 ± 288 g) were investigated at age 4.3–5.3 y with psychological testing (WPPSI-R, four subtests of NEPSY). Electroencephalogram was recorded while they listened to a repeated standard tone, randomly replaced by one of three deviants. Latencies and amplitudes for AERP components and mean amplitudes in successive 50-ms AERP time windows were measured.Results:Better cognitive test results and higher gestational age correlated with shorter P1 latencies and more positive mean amplitudes 150–500 ms after stimulus change onset. Neonatal brain damage was associated with a negative displacement of AERP curves. Neonatal morbidity had an impact on earlier time windows while gestational age and brain damage on both early and later time windows.Conclusion:AERP measures were associated with cognitive outcome. Neonatal morbidity mainly affects early cortical auditory encoding, while immaturity and brain damage additionally influence higher cortical functions of auditory perception and distraction. Perinatal auditory environment might play a role in development of auditory processing.

Paired Reading for foster children: results from a Swedish replication of an English literacy intervention

A UK literacy intervention – Paired Reading – was replicated in seven Swedish local authorities, with 81 foster children aged 8–12 participating in a 16-week trial. Ability was measured pre/post intervention with age-standardised literacy tests and a short version of the WISC-IV. Results confirm and expand findings from the UK, namely that: almost all foster carers and children completed the programme (attrition 2.4%), average improvement in reading age was 11 months, basically the same as in the UK; younger children (aged 8–9) improved significantly on all four administered standardised reading tests, and on the WISC-IV Vocabulary subtest. Older children (aged 10–12) improved significantly on three of five literacy tests and on the WISC-IV Vocabulary subtest. On the short version of WISC-IV, vocabulary improvements over time reduced the proportion of children who could be classified as having ‘weak cognitive skills’ (IQ<85) from 54% to 36%. This finding is in line with results from other studies, indicating that scores from cognitive tests of pre-teen children in out-of-home care should not be regarded as fixed and can be improved by effective interventions.

PS 15-07 STRESSED TEENAGERS REPORT HIGH LEVEL OF PSYCHOSOMATIC PROBLEMS AND HAVE HIGH NUMBER OF CIRCULATING LEUKOCYTES

Objective: In Sweden, a high level of stress among adolescents has been frequently reported in recent decades. However, we know little about whether stress may affect different physiological systems. We aimed to identify psychosocial factors that are associated with stress during adolescence and to study the associations between the levels of adolescents’ self-perceived stress, psychosomatic problems and physiological functions. Design and Method: A total of 177 healthy adolescents (99 females, mean age 13.6 ± 0.5 years) from different districts in Gothenburg participated in the study. We used well-validated questionnaires to examine self-perceived stress (PSS), happiness index, familial factors, peer relations, school satisfaction and psychosomatic problems such as ‘difficulty concentrating’, ‘difficulty sleeping’, ‘suffers from headaches’, ‘suffers from stomach-aches’, ‘feels tense’, ‘poor appetite’ and ‘feels low’. We measured BMI, resting blood pressure and the number of circulating leukocytes. Results: We found that in these adolescents, high level of stress during the last month was associated with low level of happiness index (r = −0.551, p < 0.001), school satisfaction (r = −0.549, p < 0.001), and good relation with parents (r = −0.484, p < 0.001). These three factors accounted for 44% of the variation in stress. Furthermore, we found that high level of stress was associated with high level of psychosomatic problems (r = 0.652, p < 0.001). Adolescents in the highest quartile of stress had high number of leukocytes (6.8 ± 1.8 x109/L) than those in the lowest stress quartile (5.8 ± 1.5 x109/L) and those in the second stress quartile (5.8 ± 1.4 x109/L), both with p < 0.05 (Bonferroni). We did not find any statistically significant difference in BMI or resting blood pressure. Conclusions: Our data suggest that school, parents and feeling happy are the most important determinants for the stress level in 13-year-olds, and adolescents who have high level of stress are likely to report more psychosomatic problems and have high number of leukocytes, indicating an elevated degree of subclinical, most likely, chronic inflammatory state.