Lewis A. Leavitt

Advanced Parental Age and the Risk of Autism Spectrum Disorder

This study evaluated independent effects of maternal and paternal age on risk of autism spectrum disorder. A case-cohort design was implemented using data from 10 US study sites participating in the Centers for Disease Control and Preventions Autism and Developmental Disabilities Monitoring Network. The 1994 birth cohort included 253,347 study-site births with complete parental age information. Cases included 1,251 children aged 8 years with complete parental age information from the same birth cohort and identified as having an autism spectrum disorder based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria. After adjustment for the other parents age, birth order, maternal education, and other covariates, both maternal and paternal age were independently associated with autism (adjusted odds ratio for maternal age ≥35 vs. 25–29 years = 1.3, 95% confidence interval: 1.1, 1.6; adjusted odds ratio for paternal age ≥40 years vs. 25–29 years = 1.4, 95% confidence interval: 1.1, 1.8). Firstborn offspring of 2 older parents were 3 times more likely to develop autism than were third- or later-born offspring of mothers aged 20–34 years and fathers aged <40 years (odds ratio = 3.1, 95% confidence interval: 2.0, 4.7). The increase in autism risk with both maternal and paternal age has potential implications for public health planning and investigations of autism etiology.

Fathers' and mothers' responses to infant smiles and cries*

Forty-eight mother—father pairs watched a 6-minute videotape presentation of an infant during which time their skin conductance and blood pressure (systolic and diastolic) were monitored. Mood scales were also administered. Half of the subjects saw a crying baby, while the other half viewed a smiling infant. The baby was labeled as “normal,” “difficult,” or “premature,” to equal proportions of the sample. All parents completed standard questionnaires concerning their own child. The smiling infant triggered positive emotions and negligible changes in autonomic arousal, whereas a crying infant was perceived as aversive and elicited diastolic blood-pressure and skin-conductance increases. Skin-conductance increases were especially apparent when the infant was described as “premature.” Mothers and fathers did not differ either in their responses to the stimulus baby or in their perception of their own child.

Apnea and sudden unexpected death in infants with achondroplasia

Thirteen infants with achondroplasia and sudden unexpected death or unexplained apnea were discovered through nonsystematic retrospective case collection. Most were initially thought to have died from sudden infant death syndrome. However, historical and pathologic findings suggest that many of these infants had apnea and sudden unexpected death secondary to acute or chronic compression of the lower brainstem or cervical spinal cord. Infants with achondroplasia evidently are at considerably increased risk for such deaths between 1 month and 1 year of age. Appropriate intervention, given these previously unrecognized risks, may include cervical restraint, polysomnographic evaluation, and apnea monitoring.

The Psychological effects of war and violence on children

Contents: L.A. Leavitt, N.A. Fox, Introduction. Part I:Overview. E. Goldson, War Is Not Good for Children. J. Garbarino, K. Kostelny, Childrens Response to War: What Do We Know? D. Cicchetti, S.L. Toth, M. Lynch, The Developmental Sequelae of Child Maltreatment: Implications for War-Related Trauma. Part II:The Middle East Conflict: Its Effect on Children. A. Klingman, A. Sagi, A. Raviv, The Effect of War on Israeli Children. N. Shilo-Cohen, Israeli Children Paint War. C.W. Greenbaum, C. Erlich, Y.H. Toubiana, Settler Children and the Gulf War. S. Masalha, The Effect of Prewar Conditions on the Psychological Reactions of Palestinian Children to the Gulf War. N. Bat-Zion, R. Levy-Shiff, Children in War: Stress and Coping Reactions Under the Threat of Scud Missile Attacks and the Effect of Proximity. R.J. Apfel, B. Simon, On the Value of a Psychoanalytic Perspective in Research on Children in War: Group Interviews of Israeli and Palestinian Children During the Gulf War and 1 Year Later. K. Nader, R.S. Pynoos, The Children of Kuwait After the Gulf Crisis. Part III:International Perspectives on Children and Violence. C. Liddell, J. Kemp, M. Moema, The Young Lions: South African Children and Youth in Political Struggle. E. Cairns, I.J. Toner, Children and Political Violence in Northern Ireland: From Riots to Reconciliation. S. Goldberg, Violence at a Distance: Thinking About the Nuclear Threat. J.E. Richters, P. Martinez, Children as Victims of and Witnesses to Violence in a Washington, D.C. Neighborhood. Part IV:Perspectives on Intervention. S. Marans, D.J. Cohen, Children and Inner-City Violence: Strategies for Intervention. T. Field, Israeli Children in the Gulf War: Problems of Masks and Peer Separation. A. Raviv, The Use of Hotline and Media Interventions in Israel During the Gulf War. C.R. Figley, War-Related Stress and Family-Centered Intervention: American Children and the Gulf War.

Lead-Stimulation Effects on Human Cardiac Orienting and Blink Reflexes.

Innocuous prestimulation can inhibit or facilitate a startle reflex in lower animals, depending on its lead time and on whether it is dircrete or continues throughout the lead interval. Similar effects of lead stimulation on the unconditioned blink reflex were found in human subjects, but human subjects also showed an effect not seen in lower animals. Under conditions of temporal and stimulus uncertainty, the presentation of discrete stimuli at lead times that have no effect in rats produced blink facilitation as well as pronounced cardiac decelerations during the lead interval in man. The article suggests that this effect might be mediated by an attentional process and that it could be dissociated from effects produced by a classical arousal mechanism.

The beginning of conversation: Early patterns of mother-infant vocal responsiveness☆

Abstract Microanalytic techniques were used to characterize the structure of the prespeech communication of 4-month-old infants and their mothers. Two observers continuously recorded the interactive behavior of mothers and their infants during hour-long observations in the homes of 25 families. Loglinear models were used to examine the extent to which the vocal behavior of one person was conditional upon the vocal behavior of the partner. Within the limits of this microanalytic approach, analyses indicated that patterns of mother-infant vocal exchange were structurally similar to patterns of adult conversation. Initial vocal responses were followed by suppression of vocalization, allowing the partner to join the conversation. The comparative effectiveness of vocal behavior as an elicitor of vocalization and as a response to vocalization was shown for mothers and infants relative to the other behaviors observed. Vocalization served as a modulator of visual attentiveness: When the partner was not visually attentive, vocalization elicited visual attention.

The OHRP and SUPPORT - Another view

A group of physicians, bioethicists, and scholars in allied fields agrees with the Office for Human Research Protections about the informed-consent documents in SUPPORT.

Individual measurement of exposure to everyday violence among elementary schoolchildren across various settings

One hundred and thirty-four second- and fourth-grade students from two schools in Israel were measured individually using a Hebrew adaptation of the Violence Exposure Scale—Revised (VEX-R), a self-report scale measuring childrens exposure to everyday violence. Children reported exposure as a function of situation (witness or victim) and setting (home, school, or neighborhood). They also reported on their own distress symptoms. The childrens mothers also completed the VEX-R, indicating how they expected their child would report, and the Child Behavior Checklist. Children reported more exposure to violence at school compared to either the home or neighborhood, and more as witnesses than victims. Most of the violence reported was mild (e.g., pushing, chasing), while severe violence (e.g., shooting, stabbing) was rare in all settings. Children who reported themselves as frequent victims of violence were rated by their mothers as exhibiting more behavior problems than those reporting less victimization. The results support the validity of the VEX-R as a measure of exposure to violence for young children.

Children's Self-Report of Exposure to Violence and Its Relation to Emotional Distress

Over 1,000 second and fourth graders from schools reported to have high or low levels of violence completed a group-administrated questionnaire designed to assess exposure to violence in young children. Exposure was measured for the school environment and for TV. Children also completed a questionnaire assessing symptoms of distress in children. Results showed that students in the high violence schools reported more exposure to violence than children in the low violence schools, boys reported more exposure than girls, and fourth graders reported more exposure than second graders. These results also add to the validity of the instrument used, showing that young children are capable of reporting their experiences accurately. Scores on the exposure to violence questionnaire were correlated with expressions of distress in children: children who reported high levels of exposure to violence also reported high levels of emotional distress.

The Impact of Low-risk Prematurity on Maternal Behaviour and Toddler Outcomes

This short-term longitudinal research project was designed to compare the maternal behaviour of mothers whose toddlers had been born preterm with the maternal behaviour of mothers whose toddlers had been born at term; the outcomes for the toddlers were also assessed. Twenty-one toddlers who had been born preterm with low medical risk (1460-2420 grams) were compared with 21 term toddlers who were matched in terms of social class. The heightened maternal responsiveness that had been observed during the first year with preterm infants had disappeared by 12 months, and by 20 months it was the mothers whose infants had been born at term who were more vocally responsive. During the second year, the mothers of preterm toddlers were characterised by more maternal control behaviour than were the mothers of term toddlers. Assessments of cognitive and language performance at the gestationally corrected ages of 12 and 20 months did not differentiate the toddlers who had been born preterm and term. In terms of play skills, reflected during interaction with their mothers at 12 and 20 months, the preterm toddlers were more actively involved than were the term toddlers. Despite the successful adjustment of these low-risk preterm toddlers, maternal behaviour was affected by the circumstances of preterm birth, even after 20 months.