Lars Smith

Effect of Supplementing Pregnant and Lactating Mothers With n-3 Very-Long-Chain Fatty Acids on Children's IQ and Body Mass Index at 7 Years of Age

OBJECTIVES. Arachidonic acid (20:4n-6) and docosahexaenoic acid (22:6n-3) are essential for brain growth and cognitive development. We have reported that supplementing pregnant and lactating women with n-3 very-long-chain polyunsaturated fatty acids promotes higher IQ scores at 4 years of age as compared with maternal supplementation with n-6 polyunsaturated fatty acids. In our present study, the children were examined at 7 years of age with the same cognitive tests as at 4 years of age. We also examined the relation between plasma fatty acid pattern and BMI in children, because an association between arachidonic acid and adipose tissue size has been suggested. METHODS. The study was randomized and double-blinded. The mothers took 10 mL of cod liver oil or corn oil from week 18 of pregnancy until 3 months after delivery. Their children were tested with the Kaufman Assessment Battery for Children at 7 years of age, and their height and weight were measured. RESULTS. We did not find any significant differences in scores on the Kaufman Assessment Battery for Children test at 7 years of age between children whose mothers had taken cod liver oil (n = 82) or corn oil (n = 61). We observed, however, that maternal plasma phospholipid concentrations of α-linolenic acid (18:3n-3) and docosahexaenoic acid during pregnancy were correlated to sequential processing at 7 years of age. We observed no correlation between fatty acid status at birth or during the first 3 months of life and BMI at 7 years of age. CONCLUSION. This study suggests that maternal concentration of n-3 very-long-chain polyunsaturated fatty acids during pregnancy might be of importance for later cognitive function, such as sequential processing, although we observed no significant effect of n-3 fatty acid intervention on global IQs. Neonatal fatty acid status had no influence on BMI at 7 years of age.

Improved Cognitive Development Among Preterm Infants Attributable to Early Supplementation of Human Milk With Docosahexaenoic Acid and Arachidonic Acid

OBJECTIVE. The objective of our study was to evaluate the effect of supplementation with docosahexaenoic acid and arachidonic acid for human milk-fed preterm infants. The primary end point was cognitive development at 6 months of age. METHODS. The study was a randomized, double-blind, placebo-controlled study among 141 infants with birth weights of <1500 g. The intervention with 32 mg of docosahexaenoic acid and 31 mg of arachidonic acid per 100 mL of human milk started 1 week after birth and lasted until discharge from the hospital (on average, 9 weeks). Cognitive development was evaluated at 6 months of age by using the Ages and Stages Questionnaire and event-related potentials, a measure of brain correlates related to recognition memory. RESULTS. There was no difference in adverse events or growth between the 2 groups. At the 6-month follow-up evaluation, the intervention group performed better on the problem-solving subscore, compared with the control group (53.4 vs 49.5 points). There was also a nonsignificant higher total score (221 vs 215 points). The event-related potential data revealed that infants in the intervention group had significantly lower responses after the standard image, compared with the control group (8.6 vs 13.2). There was no difference in responses to novel images. CONCLUSIONS. Supplementation with docosahexaenoic acid and arachidonic acid for very preterm infants fed human milk in the early neonatal period was associated with better recognition memory and higher problem-solving scores at 6 months.

A randomized controlled trial of preschool-based joint attention intervention for children with autism

BACKGROUND Deficits in joint attention (JA) and joint engagement (JE) represent a core problem in young children with autism as these affect language and social development. Studies of parent-mediated and specialist-mediated JA-intervention suggest that such intervention may be effective. However, there is little knowledge about the success of the intervention when done in preschools. AIM Assess the effects of a preschool-based JA-intervention. METHODS 61 children (48 males) with autistic disorder (29-60 months) were randomized to either 8 weeks of JA-intervention, in addition to their preschool programs (n = 34), or to preschool programs only (n = 27). The intervention was done by preschool teachers with weekly supervision by trained counselors from Child and Adolescent Mental Health Clinics (CAMHC). Changes in JA and JE were measured by blinded independent testers using Early Social Communication Scale (ESCS) and video taped preschool teacher-child and mother-child play at baseline and post-intervention. CLINICAL TRIALS REGISTRATION Clinicaltrials.gov: NCT00378157. RESULTS Intention-to-treat analysis showed significant difference between the intervention and the control group, with the intervention group yielding more JA initiation during interaction with the preschool teachers. The effect generalized to significantly longer duration of JE with the mothers. CONCLUSIONS This is the first randomized study to show positive and generalized effects of preschool-based JA-intervention.

The Strange Stories test A replication study of children and adolescents with Asperger syndrome

The aim of the present study was to assess the ability of 21 children and adolescents with Asperger syndrome (AS) of normal intelligence to infer mental states in a story context using Happé’s [15] Strange Stories test. The participants in the AS group were compared with an age-matched control group (N=20) of normally developing children and adolescents on a test of social understanding. The test material comprised social communication such as Pretence, Joke, Lie, White Lie, Figure of Speech, Misunderstanding, Persuasion, Irony, Double Bluff and Contrary Emotions, Appearance/Reality and Forgetting. As compared to the controls, the participants in the AS group performed less well on these tasks, and answered fewer correct mental state inferences, but performed well on a physical state control task. This study supports the main finding of earlier studies, showing that even individuals with AS of normal intelligence have problems in using mental state terms context-appropriately when tested on the Strange Stories test.

VISION, COGNITION AND DEVELOPMENTAL CHARACTERISTICS OF GIRLS AND WOMEN WITH RETT SYNDROME

Forty‐two females with Rett syndrome, aged 2.5 to 47 years, were assessed with the Teller Acuity Cards and a new version of the Fagan test for age 2 years and above, and their parents were interviewed about the childrens communication skills. The visual function of the subjects indicated arrested development, and they scored significantly lower on the Fagan test than a normal comparison group. Their visual processing and memory deteriorated somewhat with age, while those of the comparison group showed a slight increase. Both age at onset of Rett syndrome symptomatology and speech measures were inversely correlated with visual processing and memory, indicating that age at recession may have differential consequences for different functions. Among the subjects, persistent looking was associated with low cognitive function. The results have implications for intervention, and demonstrate that the paradigm of preferential looking may be useful in cognitive assessment of females with Rett syndrome.

Effect of early intervention on social interaction between mothers and preterm infants at 12 months of age: a randomized controlled trial.

In a randomized controlled trial at 12-months of age, the effect of the Mother Infant Transaction Program was tested on social interaction between mothers and moderately and late preterm infants with gestational age≥30.0 and <36 weeks. Ninety-three play sessions were videotaped and coded, 46 mothers-infants in the intervention group and 47 mothers-infants in the control group. The intervention mothers scored higher on maternal sensitivity/responsiveness (p=.05). Being a first-time mother was a moderator that enhanced the effects of the intervention. First-time mothers were more sensitive/responsive to their infants cues (p=.01), and the dyads evinced higher level of synchrony (p=.02) as compared with experienced mothers. More positive mood was observed among their infants (p=.04). The findings suggest that the intervention contributes to better mother-infant interactions in moderately and late preterm infants of first-time mothers.

Disembedding performance in children and adolescents with Asperger syndrome or high-functioning autism

The aim of the present study was to assess the findings, reported in earlier studies, that individuals with autism spectrum disorders process visuo-spatial tasks faster than typically developing control persons. The participants in the present study were children and adolescents with Asperger syndrome (AS) or high-functioning autism (HFA) (N = 13), and a matched group of typically developing children and adolescents (N = 13). The results showed that the participants in the clinical group performed marginally less well than those in the control group on both the Block Design Test and the Embedded Figures Test, but the differences were not statistically significant. Thus, earlier findings suggesting that individuals with autism spectrum disorders solve non-social cognitive tasks faster than typically developing control persons were not replicated. The results are discussed with special reference to the hypothesis of weak central coherence.

Productive vocabulary size predicts event-related potential correlates of fast mapping in 20-month-olds

Although it is well documented that children undergo a productive vocabulary spurt late in the second year, it is unclear whether this development is accompanied by equally significant advances in receptive word processing. In the present study, we tested an electrophysiological procedure for assessing receptive word learning in young children, and the impact of productive vocabulary size for performance in this task. We found that 20-month-olds with high productive vocabularies displayed an N400 incongruity effect to violations of trained associations between novel words and pictures, whereas 20-month-olds with low productive vocabularies did not. However, both high and low producers showed an N400 effect for common real words paired with an incongruous object. These findings indicate that there may be substantial differences in receptive fast mapping efficiency between typically developing children who have reached a productive vocabulary spurt and typically developing children who have not yet reached this productive spurt.

The Role of Joint Attention in Later Development Among Preterm Children: Linkages Between Early and Middle Childhood

Joint attention is a hallmark of human cognition. It refers to the capacity to coordinate attention to objects and events with attention to other people. Infants display considerable individual differences in this capacity. This longitudinal study of 13-month-old preterms was conducted to examine the hypothesis that two different types of joint-attention skills assessed in an infant–tester paradigm are related to verbal and nonverbal IQ measures through middle childhood. Data are reported separately for the childrens tendency to initiate such skills and to respond to an experimenters offers to share in such behaviours. The results provide support for the hypothesis that the initiation of joint attention makes a unique contribution to later nonverbal IQ apart from variance associated with biomedical risk status and infant development. The results of this study have implications for the conceptualisation of joint-attention skills, as well as for understanding the relation between joint attention and later cognition.

Attention among very low birth weight infants following early supplementation with docosahexaenoic and arachidonic acid

Aim:  To investigate the effect of supplementation with docosahexaenoic acid (DHA) and arachidonic acid (AA) in early neonatal life on cognitive functions among human milk fed very low birth weight infants (<1500 g) at 20 months chronological age.