No abstract

Children with SLI viewed social situations in ways similar to those of TD children but different from those of children with ASD. However, children with SLI concentrated on the speaker's mouth, possibly to compensate for audiovisual processing deficits. Because eyes carry important information, this difference may influence the social development of children with SLI.

SUMMARYObjective: Some patients with Sturge-Weber syndrome (SWS) need epilepsy surgery for adequate seizure control and prevention of psychomotor deterioration. The majority of patients with SWS have leptomeningeal angioma located over the temporal, parietal, and occipital lobes. We applied posterior quadrant disconnection surgery for this type of SWS with intractable seizure. We evaluated the efficacy of this procedure in seizure control and psychomotor development. Methods: Ten patients who were surgically treated using the posterior quadrantectomy (PQT) were enrolled in this study. Surgical outcome was analyzed as seizure-free or not at 2 years after surgery. Psychomotor development was evaluated by the scores of mental developmental index (MDI) and psychomotor developmental index (PDI) in the Bayley Scales of Infant Development II preoperatively, and at 6 and 12 months after the PQT. Results: Eight of 10 patients were seizure-free. Patients without complete elimination of the angiomatous areas had residual seizures. Average MDI and PDI scores before the surgery were 64.8 and 71.6, respectively. Scores of MDI at 6 and 12 months after the PQT in seizure-free patients were 80.5 and 84.5, respectively (p < 0.01). PDI scores at these postoperative intervals were 87.3 and 86.4, respectively (p < 0.05). Patients with residual seizures did not improve in either MDI or PDI. Significance: The PQT achieved good seizure control and improved psychomotor development in patients with SWS. The complete deafferentation of angiomatous areas is required for seizure-free results and psychomotor developmental improvement.

This exploratory study aimed to explore the association between depression and self-harming behaviour in adolescence and the timing of diagnosis for autism spectrum disorder. We analysed data on 11,320 14 year olds, including 396 children with autism spectrum disorder, from the UK Millennium Cohort Study. Exposures were the timing of diagnosis for autism spectrum disorder confirmed by parental report at ages 5, 7, 11 and 14. Outcomes were depression measured by the Short Mood and Feelings Questionnaire (scores ⩾12) and self-report of self-harming behaviour, both assessed at age 14. Data were analysed using multivariable regression analysis. 91% of the autism spectrum disorder group had within-typical-range cognitive ability. After adjusting for child and family confounders, there was a positive linear trend between diagnostic age and depression, with children diagnosed between ages 7 and 11 and children diagnosed after age 11 showing increased symptoms (odds ratio = 2.21 and 3.58, respectively). A similar trend was observed for self-harming behaviour, with children diagnosed after age 11 showing the strongest association (odds ratio = 3.16). These results suggest the importance of earlier diagnosis in preventing secondary mental health problems in this population, particularly among those without cognitive delays. Further studies replicating across a wider intellectual spectrum and clarifying the underlying mechanism are warranted. Lay Abstract Children with autism spectrum disorder are at increased risk of depression and self-harming behaviours. The question of whether timing of diagnosis of autism spectrum disorder is associated with these consequences in adolescence has not yet been studied. This exploratory study aimed to explore the association between depression and self-harming behaviour in adolescence and the parent-reported timing of diagnosis for autism spectrum disorder using a large population-based cohort in the United Kingdom. Most of the children with autism spectrum disorder in our study had within-typical-range cognitive ability. We found a linear association between timing of autism spectrum disorder diagnosis and depression and self-harming behaviour in adolescence; later diagnosis of autism spectrum disorder, particularly diagnosis in adolescence, was associated with the increased risk of self-reported depressive symptoms and self-harming behaviour in adolescence among children with autism spectrum disorder. Our findings, albeit observational, suggest that interventions targeting the earlier diagnosis of autism spectrum disorder and approaches to improve person–environment fit may help prevent secondary mental health problems in this population, particularly among those without cognitive delays and those diagnosed late. Further studies replicating across a wider intellectual spectrum and clarifying the underlying mechanism are warranted.

Background The Coronavirus Disease 2019 (COVID-19) pandemic has changed the lives of children and parents, raising concerns about child maltreatment. Objective We examined the prevalence of abusive parenting behavior during the pandemic of the COVID-19 and its relations with physical, psychological, and social factors and positive parenting behavior. Participants and setting An online survey was performed during the COVID-19 state of emergency in Japan. Participants were 5344 parents of children aged 0–17 years. Methods We conducted an anonymous online survey using multiple platforms, including websites of child-related organizations and social networking services (SNS). Multiple logistic regression analyses were performed to identify factors associated with abusive behavior. Results One-fifth of parents reported abusive behaviors, whereas over 80% of parents reported positive parenting behaviors (e.g., empathizing with a child). Abusive parenting behaviors were associated with longer screen time (6+ hours per day: OR, 1.44; 95%CI, 1.05–1.98), poor maternal mental health (K6 = 13+: OR, 2.23; 95%CI, 1.71–2.89), and the occurrence of domestic violence (OR, 4.54; 95%CI, 3.47–5.95). Positive parenting behaviors, especially showing empathy, were associated with lower risks of abusive behaviors (OR, 0.51: 95%CI, 0.39–0.66). Conclusions Positive parenting behavior is essential to the prevention of child maltreatment during the COVID-19 pandemic.

This study aimed to identify determinants of a late autism spectrum disorder diagnosis, including diagnoses made ‘very late’ (i.e., in adolescence), using the Millennium Cohort Study, a nationally representative population-based cohort in the United Kingdom. Children diagnosed with autism spectrum disorder by age 14 (N = 581) were included and grouped by the parent-reported timing of diagnosis: before school (up to age 5), during primary school (age 5–11) and during secondary school (age 11–14). Predictors of diagnostic timing, at the child, family and school levels, were investigated using multinomial logistic regression. Most (79%) children with autism spectrum disorder were diagnosed after school entry, and 28% were not diagnosed until secondary school. Among those not diagnosed until secondary school, 75% had been identified at age 5 years by a parent and/or teacher as having socio-behavioural difficulties. Being diagnosed after starting school was predicted by living in poverty (adjusted relative risk ratio: primary = 1.90, 95% confidence interval: 1.03–3.53; secondary = 2.15, 1.05–4.42) and/or having no initial parental concerns (primary = 0.32, 0.15–0.70; secondary = 0.19, 0.09–0.43). Having typical-range intelligence also predicted diagnosis during secondary school. The result indicates that those without cognitive delays and poorer children were at risk of ‘very late’ (i.e. adolescent) diagnosis. Strategies to promote earlier identification, targeting age at primary school entry, could help those more likely to be diagnosed late. Lay abstract Despite policy emphasis on early identification, many children with autism spectrum disorder are diagnosed late, with some being diagnosed as late as in adolescence. However, evidence on what determines the timing of autism spectrum disorder diagnosis including children diagnosed in adolescence is lacking. Understanding these determinants, particularly in those diagnosed later than is ideal, can inform the development of effective strategies to improve earlier identification of autism spectrum disorder. This study used a nationally representative population-based cohort in the United Kingdom to explore child, family and school level predictors of timing of autism spectrum disorder diagnosis. In the United Kingdom, 79% of the children with autism spectrum disorder were diagnosed after entering primary school and 28% during secondary school. Among those not diagnosed until secondary school, 75% had shown social difficulties noticed by parents and/or teachers at age 5 years. The results suggest that healthcare providers should be aware that, even for universal systems of care, those living in poverty and having higher intelligence are most likely to miss out on a timely diagnosis. Strategies to promote earlier identification among school-aged children, including targeting primary school entry age (i.e. around age 5) and that encouraging referrals for a formal assessment at the first report of concerns over the child’s social development may benefit those children who would otherwise be diagnosed later.

Background: Bullying victimisation is of global importance due to its long-term negative consequences. We examined the prevalence of victimisation and its inequalities in 15-year-olds across 71 countries. Methods: Data were from the Programme for International Student Assessment (March-August 2018). Students reported frequencies of relational, physical, and verbal victimisation during the last 12 months, which were analysed separately and combined into a total score. Prevalence of frequent victimisation (> a few times a month) was estimated, followed by mean differences in total score by gender, wealth and academic performance quintiles in each country. Meta-analyses were used to examine country differences. Findings: Of 421,437 students included, 113,602 (30¢4%) experienced frequent victimisation, yet this varied by country-from 9¢3% (Korea) to 64¢8% (Philippines). Verbal and relational victimisation were more frequent (21¢4%, 20.9%, respectively) than physical victimisation (15¢2%). On average, boys (vs girls +0¢23SD, 95%CI: 0¢22À0¢24), students from the lowest wealth (vs highest +0¢09SD, 0¢08À0¢10) and with lowest academic performance (vs highest +0¢49SD, 0¢48À0¢50) had higher scores. However, there was substantial between-country heterogeneity in these associations (I 2 =85%À98%). Similar results were observed for subtypes of victimisation-except relational victimisation, where gender inequalities were smaller. Interpretation: Globally, bullying victimisation was high, although the size, predominant subtype and strength of associations with risk factors varied by country. The large cross-country differences observed require further replication and empirical explanation, and suggest the need to and the large scope for reducing bullying victimisation and its inequity in the future.

In VLBW infants, urinary 8-OHdG level correlated with mental development rather than psychomotor development at 18 months' corrected age; urinary 8-OHdG might be a predictive marker of neurodevelopmental outcome in VLBW infants.