Susanne W. Duvall

Comparison of Structural Magnetic Resonance Imaging and Development in Toddlers Born Very Low Birth Weight and Full-term

Research suggests that regional structural differences can be associated with the neurodevelopmental impairments faced by children born very low birth weight. However, most studies have used magnetic resonance imaging (MRI) during the neonatal period or during adolescence. The current study used structural MRI to examine relationships between regional volume differences in toddlers (18—22 months adjusted age) born very low birth weight (n = 16) and full-term (n = 10) and neurodevelopmental outcomes, including cognition, language, and early executive functioning. Compared with the full-term group, the very low birth weight group had larger third ventricles and smaller cerebral white matter, thalamus, hippocampus, cerebellum white matter, and anterior cingulate volume. Additionally, a significant interaction was found between language and early executive function scores and cerebral white matter volumes between groups, suggesting that young children born very low birth weight can have different trajectories in the growth and development of overall brain structure.

Early working memory and maternal communication in toddlers born very low birth weight.

Aim: Early working memory is emerging as an important indicator of developmental outcome predicting later cognitive, behavioural and academic competencies. The current study compared early working memory in a sample of toddlers (18–22 months) born very low birth weight (VLBW; n = 40) and full term (n = 51) and the relationship between early working memory, mental developmental index (MDI), and maternal communication in both samples.

Perinatal Medical Variables Predict Executive Function within a Sample of Preschoolers Born Very Low Birth Weight

The goal was to identify perinatal predictors of early executive dysfunction in preschoolers born very low birth weight. Fifty-seven preschoolers completed 3 executive function tasks: Dimensional Change Card Sort-Separated (inhibition, working memory, and cognitive flexibility), Bear Dragon (inhibition and working memory), and Gift Delay Open (inhibition). Relationships between executive function and perinatal medical severity factors (gestational age, days on ventilation, size for gestational age, maternal steroids, and number of surgeries) and chronological age were investigated by multiple linear regression and logistic regression. Different perinatal medical severity factors were predictive of executive function tasks, with gestational age predicting Bear Dragon and Gift Open; and number of surgeries and maternal steroids predicting performance on Dimensional Change Card Sort-Separated. By understanding the relationship between perinatal medical severity factors and preschool executive outcomes, we can identify children at highest risk for future executive dysfunction, thereby focusing targeted early intervention services.

Healthcare transition challenges faced by young adults with autism spectrum disorder

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that impacts communicative interactions, with patterns of repetitive and restricted behaviors, interests, and cognitive rigidity. Recent incidence rate estimates for ASD are 1 in 68, and primarily male (4:1). A major epidemiological issue in ASD is transitioning to independence in adulthood, particularly navigating the healthcare system. This commentary will focus on approaches healthcare providers can use to not overlook and support individuals with ASD.

Screening for dysregulation among toddlers born very low birth weight

Background:Children born very low birth weight (VLBW) are at increased risk for regulatory difficulties. However, identifying toddlers at risk has been impeded by a lack of screening measures appropriate for this population. Methods:We studied the nature of dysregulation in toddlers born VLBW (N = 32) using the Infant-Toddler Social and Emotional Assessment (ITSEA) Dysregulation Domain, a multiscale (including negative emotionality, sleep, eating, and sensory sensitivity) screening assessment of regulatory abilities. Results:As evidence of construct validity for this population, ITSEA scores for toddlers born VLBW showed greater overall dysregulation, as well as sensory sensitivity, compared with an ITSEA manual-based premature/LBW sample. This was seen both by higher overall Dysregulation Domain scores and higher percentages of toddlers exceeding the clinical cutoff levels. Furthermore, compared with age- and gender-matched full-term toddlers, the VLBW toddlers displayed gender-specific dysregulation profiles. Conclusions:The greater overall dysregulation in VLBW toddlers compared with premature/LBW toddlers suggests that early screening for such difficulties among VLBW toddlers is warranted, and this study provides preliminary evidence that the ITSEA Dysregulation Domain may be an appropriate screening measure.

Are we missing a vulnerable population in early intervention

Infants with low birth weight (LBW ⩽ 2,500 g) are at high risk for developmental delays, including cognitive impairments. Retrospective studies have shown that these children often have learning and/or behavioral difficulties at school age. Early evaluation and enrollment in early intervention (EI) programs may reduce the impact of these difficulties; however, many children who would benefit from such programs may not receive EI services. This study provides information on 279 children born LBW and includes information on developmental capability and EI enrollment. Results indicate that children born LBW in EI services had lower overall developmental standard scores than those not in EI. However, it is concerning that almost an equal number of children across all categories of birth weight are not in services.

Occupational performance goals of mothers of adolescents with disabilities and mothers of adolescents with typical development

ABSTRACT This mixed methods study describes the occupational performance goals of mothers of adolescents with disabilities and mothers of typically developing adolescents. A sample of 40 mothers was recruited, 20 mothers of typically developing adolescents and 20 mothers of adolescents with disabilities. Semi-structured interviews guided by the Canadian Occupational Performance Measure were used to gather descriptive data from the mothers. The data were then qualitatively analyzed, compared, and organized into six themes describing the mothers’ occupational performance goals. The six themes were Taking Care of Myself, Making Time for Own Occupations, Life Organization, Quality Time with Others, Sharing the Load, Supporting/Encouraging Adolescent Development. Five of the six themes were shared between both groups. The final theme was only evident in the group of mothers of adolescents with disabilities. The findings highlight the differences and similarities of occupational performance goals between mothers of typically developing adolescents and mothers of adolescents with disabilities. While similarities existed between the two groups, it is important to understand the different life experiences of mothers of adolescents with disabilities to better support them in their daily occupations.