SUMMARY Thirteen preterm children, aged 4 to 14 years, with visual impairment due to periventricular leukomalacia (PVL) were evaluated for visual function, intellectual level, cognitive profile and motor function. Their visual impairment was characterized by low acuity, crowding, visual field defects and ocular motility disturbances. Their cognitive profile was uneven, often with considerably higher scores on verbal than on visual‐spatial tasks. Nine children had normal intelligence, three had mild mental retardation and one had severe mental retardation. In all the children, visual impairment was complicated by visual perceptual difficulties, accounting for their greater visual handicap than would be expected from their visual acuities and strabismus alone. Though CT or MRI revealed bilateral PVL in all the children, six had no motor impairment consistent with cerebral palsy, which is an unexpected finding. RÉSUMÉ Troubles visuels chez le prématuré avec leacomalacie péri‐ventriculaire‐caractéristiques visuelles, cognitives el neuropédiatriques reliees àľimagerie cérébrale Une évaluation de la fonction visuelle, du niveau intellectuel, du profit cognitif et de la fonction motrice, a été effectuée chez treize prématurés âgés de 4 à 14 ans et présentant un trouble visuel liéà une leucomalacie périventriculaire (PVL). Le trouble visuel était caractérisé par une baisse de ľacuité, un décrochage du suivi, des défauts du champ visuel et des troubles de la motilité oculaire. Leur profil cognitif était dysharmonieux avec souvent des scores considérablement plus cleves aux taches verbales qu'aux taches visuo‐spatiales. Neuf enfants avaient une intelligence normale, trois un retard mental leger et un, un retard mental sévère. Chez tous les enfants, le trouble visuel était compliqué par des difficultés visuo‐perceptives, rendant compte ďun plus fort handicap visuel qu'on aurait pu attendre de leur acuité visuelle et du strabisme seuls. Bien que le scanner ct ľIRM. montraient une PVL bilatérale chez tous les enfants, six ne présentaient pas de déficit moteur de type IMC, ce qui est une découverte inattcndue. ZUSAMMENFASSUNG Visuelle Störungen bei Frühgeborenen mit perivenrikulärer Leukomalazie ‐ visuelle, kognitive und neuropädiatrisclie Clwrakleristika in. Relation zu CT und MRT Befunden Bei 13 Frühgeborenen mit visuellen Störungen aufgrund einer periventrikulären Leukomalazie (PVL) wurden im Alter von 4 bis 14 Jahren Sehfunktion, Intelligenzgrad, Wahrnehmungsprofil und Motorfunktion untersucht. Ihre visuelle Stöning war charakterisiert durch gcringe Sehschärfe, Crowding, Gesichtsfeldeinschränkungen und Augenmotilitätsstörungen. Ihr Wahnehmungsprofil war unterschiedlich, häufig mit erhcblich höheren Scores bei den verbalen als bei den visucllräumlichen Aufgaben. Neun hatten eine normale Intelligenz, drei warcn leicht retardiert und eins hatte eine schwere geistige Behinderung. Bei allen Kindern war die visuelle Befund durch eine visuelle Perzeptionsstörung kompliziert. die für ihre größere visuelle Behinderung verantwortlic...
Attention deficit hyperactivity disorder (ADHD) is a common developmental disorder. The present study tested the hypotheses that children with ADHD, particularly those exhibiting severe hyperactivity and impulsivity, have a different stress reaction (measured by salivary cortisol) during a dental recall visit and are more dentally anxious than children in a control group. Eighteen children with ADHD and a control group of 71 children, all 13 yr of age, underwent a clinical dental examination and completed the Corah Dental Anxiety Scale (CDAS). Four saliva samples were gathered for analysis of cortisol: one prior to dental examination, one after, and two the following morning. The subgroup ADHD with hyperactivity/impulsivity had statistically significantly lower cortisol levels than the control group 30 min after awakening. When cortisol values were plotted on a timeline, this subgroup always had lower cortisol concentrations than children in the control group. There was a significant correlation between CDAS scores and cortisol concentrations prior to the dental examination in both the ADHD and the control group. Behavioral expressions of anxiety in children with ADHD may be different from those in other children, not only due to the characteristics of their disorder, but also because of lower stress reactivity.
Attention deficit hyperactivity disorder (ADHD) is a common developmental disorder. This study tested the hypothesis that children with ADHD exhibit a higher caries prevalence and poorer oral health behavior than children in a control group. Twenty-one children with ADHD and a control group of 79 children, all aged 13 yr, underwent a clinical dental examination and completed two questionnaires on dietary habits and dental hygiene habits. Differences between the groups regarding decayed, missed, or filled surfaces, decayed surfaces, initial caries lesions, and gingival inflammation were non-significant. Forty-eight percent in the ADHD group brushed their teeth every evening compared with 82% in the control group. The corresponding frequencies for brushing the teeth every morning were 48% and 75%. Children with ADHD were 1.74 times more likely to eat or drink more than five times a day than children in the control group. In conclusion, at age 13, children with ADHD do not exhibit a statistically significantly higher caries prevalence but do have poorer oral health behavior than children in a control group. The intervals between dental examinations of children with ADHD should be shorter than for other children to prevent a higher caries incidence in adolescence because of their oral health behavior.
Attention deficit hyperactivity disorder (ADHD) is a common developmental disorder. The aim of this study was to investigate whether children with ADHD have a higher caries prevalence, a higher degree of dental anxiety, or more dental behavior management problems (BMP) than children of a control group. Twenty-five children with ADHD and a control group of 58 children, all aged 11 yr, were included in the study. The children underwent a clinical dental examination, and bitewing radiographs were taken. The parents completed the Dental Subscale of Children's Fear Survey Schedule (CFSS-DS). Dental records from the subjects were obtained, and data regarding notes on behavior management problems (BMP) of the children when between 3 and 10 yr of age were compiled. Compared with controls, children with ADHD had significantly higher decayed, missing or filled surfaces (DMFS) (2.0 +/- 3.0 vs. 1.0 +/- 1.5) and significantly higher decayed surfaces (DS) (1.7 +/- 3.6 vs. 0.5 +/- 0.9). Differences between the groups regarding CFSS-DS scores were non-significant. In the ADHD group, the prevalence of BMP increased when the children were between 7 and 9 yr of age. In conclusion, children with ADHD exhibited a higher caries prevalence, did not exhibit a higher degree of dental anxiety, and had more BMP than children of a control group.
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.
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