Ulla Ek

Relation between blindness due to retinopathy of prematurity and autistic spectrum disorders: a population-based study.

Children with blindness due to retinopathy of prematurity (ROP) ‐ who are at greatly increased risk of cerebral damage ‐ have been noted to have a high rate of autistic symptoms, but systematic controlled studies have been lacking. A controlled population‐based study was performed; one group was blind due to ROP (N=27) and the other was congenitally blind due to hereditary retinal disease (N=14). Fifteen of the 27 children with ROP had autistic disorder. All these children were mentally retarded and about one‐third of them had cerebral palsy. In the comparison group, two of the 14 children had autistic disorder. It is concluded that there is a strong association between ROP and autistic disorder. The association is most probably mediated by brain damage and is largely independent of the blindness per se.

Academic performance of adolescents with ADHD and other behavioural and learning problems -a population-based longitudinal study.

Aim:  To study academic performance (final grades at the age of 16 years) in individuals with i) attention‐deficit/hyperactivity disorder (ADHD) and ii) other learning and/or behavioural problems.

Visual and perceptual characteristics, ocular motility and strabismus in children with periventricular leukomalacia

The immature visual system is vulnerable to adverse events. Periventricular leukomalacia (PVL), an end-stage lesion after hypoxia-ischemia at gestational age 24–34 weeks affecting the visual radiation, has become a principal cause of visual impairment in children. Cerebral visual dysfunction caused by PVL is characterized by delayed visual maturation, subnormal visual acuity, crowding, visual field defects, and visual perceptual-cognitive problems. Magnetic resonance imaging is the method of choice for diagnosing this brain lesion, which is associated with optic disk abnormalities, strabismus, nystagmus, and deficient visually guided eye movements. Children with PVL may present to the ophthalmologist within a clinical spectrum from severe visual impairment in combination with cerebral palsy to only early-onset esotropia, normal intellectual level and no cerebral palsy. Optimal educational and habilitational strategies need to be developed to meet the needs for this group of children.

Cognitive and behavioural characteristics in blind children with bilateral optic nerve hypoplasia.

AIM To describe cognitive and behavioural characteristics in a group of blind children with bilateral optic nerve hypoplasia (ONH). METHODS Data from records, parents, teachers, and repeated developmental assessments of 13 blind children with ONH born in 1988-1998 were analysed. All children had neuroimaging and/or hormonal evidence of midline malformations. They were all blind and able to communicate with speech. RESULTS Severe mood swings and temper tantrums were common, especially during the first years of life. Later in life, sluggish tempo, low frustration tolerance and a narrow range of interests were common. Autism had been diagnosed in 6/13 children, autistic-like condition (ALC) was found in another three. The behaviour of the remaining four children was not within the autism spectrum. Eight children had cognitive capacities within the normal or near-normal range; five had mental retardation. Autism/ALC was found in all cognitive subgroups. All children exhibited fluent speech and, of these, 12 had started to talk at the expected age, but had clear deficiencies in communicative ability. CONCLUSION These children had a common pattern of behavioural characteristics including autism spectrum disorders independent of intellectual capacities.

Children with blindness due to retinopathy of prematurity: a population‐based study. Perinatal data, neurological and ophthalmological outcome

A population‐based group of 27 children with total blindness due to retinopathy of prematurity (ROP), born in Sweden from 1980 to 1990, was examined. They constituted all but two of the total of 29 children with total blindness due to ROP known to the nationai register of visually impaired children when reviewed from 1980 to 1 January 1995. All children had a gestational age of less than 31 weeks and most had had a complicated perinatal period. The retinal disease was discovered late, most often after it had already progressed to bilateral retinal detachment. Repeated vitreoretinal surgery had been performed in most children, but postoperative visual function did not improve. Three‐quarters of the group had major neurological impairment (mental retardation, cerebral palsy, or epilepsy) at age 4 to 14 years. There was an impression that extensive ophthalmological efforts delayed nenrodevelopmental assessments and examinations as well as adequate habilitation.

Self-esteem in children with attention and/or learning deficits: the importance of gender.

Objective: Our objective was to analyze self‐esteem in children within a spectrum of attention disorders, that is, besides attention deficit hyperactivity disorder (ADHD), also children with subthreshold ADHD and even milder attention deficits and/or learning problems.

Dental caries in adolescents with attention deficit hyperactivity disorder: a population‐based follow‐up study

This study tested the hypothesis that adolescents with attention deficit hyperactivity disorder (ADHD) exhibit a higher prevalence of caries than adolescents in a control group. Thirty-two adolescents with ADHD and a control group of 55 adolescents from a population-based sample, all 17 yr of age, underwent a clinical and radiographic dental examination. The mean ± SD number of decayed surfaces (DS) was 2.0 ± 2.2 in adolescents with ADHD and 0.9 ± 1.4 in adolescents of the control group. Thirty-one per cent of the adolescents in the ADHD group had no new caries lesions (DS = 0) compared with 62% in the control group. Six per cent of the adolescents in the ADHD group were caries free [decayed, missing or filled surfaces (DMFS) = 0] compared with 29% in the control group. Adolescents with ADHD also had a higher percentage of gingival sites that exhibited bleeding on probing compared with the control group: 35 ± 39% vs. 16 ± 24% (mean ± SD), respectively. At 17 yr of age, adolescents with ADHD exhibited a statistically significantly higher prevalence of caries compared with an age-matched control group. Adolescents with ADHD need more support regarding oral hygiene and dietary habits. They should be followed up with shorter intervals between dental examinations to prevent caries progression during adulthood.

Cognitive strengths and deficits in schoolchildren with ADHD

Background: Few studies provide detailed analyses of the various aspects of the entire cognitive profile of children with ADHD.

Large variability in Performance IQ associated with postnatal morbidity, and reduced Verbal IQ among school-aged children born preterm

Aim: To assess cognitive ability in a population‐based group of prematurely born school‐aged children and to relate these findings to postnatal morbidity. Method: The study group consisted of a cohort of 51 children born preterm, 43 (26 boys, 17 girls) of whom were available for psychological evaluation At evaluation, their median age was 10 y (range 8–11 y). They were all born between 1988 and 1991, with gestational age less than 29 wk (median 27, range 24–28). Their median birthweight was 1060 g (range 450–1450). The Wechsler Intelligence Scale for Children (WISC‐III) was used, and the test results were compared with those of a standardized, age‐matched, normative group of children. Results: Thirteen children (30%) performed below average [intelligence quotient (IQ) >80] for Full Scale IQ (FSIQ). Thirty‐six children had a Verbal IQ (VIQ) below the mean value of 100 [84%, 95% confidence interval 73–95%], p > 0.0001. The Performance IQ (PIQ) was within the expected range of a normal population, although a large variability was observed. Discrepancies between VIQ and PIQ of more than 15 IQ units were found in 42% of the children. High postnatal morbidity (days with assisted ventilation, number of blood transfusions) and low birthweight standard deviation scores (SDS) were associated with lower PIQ than VIQ, while low postnatal morbidity and high birthweight were associated with higher PIQ than VIQ.

Borderline intellectual functioning in children and adolescents - insufficiently recognized difficulties

Aim:  To draw attention to groups of children and adolescents with borderline intellectual functioning, especially with respect to their school‐situation.