Co-occurrence et gravité du poids neurodéveloppemental (déficience cognitive, paralysie cérébrale, trouble du spectre de l'autisme et épilepsie) à l'âge de 10 ans chez les enfants nés grands prématurés

Aperçu: G.M.

Cette étude vise à déterminer la prévalence des déficiences neurodéveloppementales à l'âge de dix ans chez les enfants nés extrêmement prématurés (moins de 28 semaines d'âge gestationnel) et à offrir un cadre de catégorisation des limitations neurologiques.Une étude de suivi de cohorte prospective multicentrique a recruté 889 enfants de 10 ans nés entre 2002 et 2004. Les chercheurs ont évalué la prévalence de la déficience cognitive, mesurée par quotient intellectuel et les tests de fonction exécutive, la paralysie cérébrale (PC), le "trouble du spectre de l'autisme" (TSA), et l'épilepsie seule et en combinaison. Les trois niveaux de gravité de la déficience étaient les suivants: catégorie I - absence de déficience neurodéveloppementale majeure; capacité cognitive normale de catégorie II avec CP, TSA et / ou épilepsie; et catégorie III - enfants atteints de déficience cognitive.Au total, 214 des 873 enfants (25%) avaient des troubles cognitifs, 93 des 849 enfants (11%) avaient une CP, 61 des 857 enfants (7%) avaient des TSA et 66 des 888 enfants (7%) souffraient d'épilepsie. De plus, 19% de tous les enfants avaient un diagnostic, 10% avaient deux diagnostics et 3% avaient trois diagnostics. La diminution de l'âge gestationnel était associée à l'augmentation du nombre de déficiences (P <0,001). La moitié des enfants atteints de déficience cognitive et un tiers des enfants atteints de PC, de TSA ou d'épilepsie présentaient une seule déficience.

Six cent un (68% [IC 95%, 64,5% -70,7%]) étaient dans la catégorie I, 74 (8% [IC 95%, 6,6% -10,3%]) dans la catégorie II, et 214 (24% [IC à 95% 21,7% -27,4%]) étaient dans la catégorie III.Les trois quarts des enfants avaient un intellect normal à l'âge de dix ans; Près de 70% étaient exempts de déficience neurodéveloppementale. Quarante pour cent des enfants atteints de déficiences ont eu plusieurs diagnostics. 

Pediatr Neurol. 2017 Nov 13. pii: S0887-8994(17)30718-X. doi: 10.1016/j.pediatrneurol.2017.11.002.

Co-occurrence and Severity of Neurodevelopmental Burden (Cognitive Impairment, Cerebral Palsy, Autism Spectrum Disorder, and Epilepsy) at Age 10 Years in Children Born Extremely Preterm

Hirschberger RG¹, Kuban KCK², O'Shea TM³, Joseph RM⁴, Heeren T⁵, Douglass L², Stafstrom CE⁶, Jara H⁷, Frazier JA⁸, Hirtz D⁹, Rollins J³, Paneth N¹⁰; ELGAN Study Investigators.

Collaborators (66)

Ware J¹¹, Coster T¹¹, Hanson B¹¹, Wilson R¹¹, McGhee K¹¹, Lee P¹¹, Asgarian A¹¹, Sadhwani A¹¹, Perrin E¹², Neger E¹², Mattern K¹², Walkowiak J¹², Barron S¹², Shah B¹³, Singh R¹³, Smith A¹³, Klein D¹³, McQuiston S¹³, Venuti L¹⁴, Powers B¹⁴, Foley A¹⁴, Dessureau B¹⁴, Wood M¹⁴, Damon-Minow J¹⁴, Ehrenkranz R¹⁵, Benjamin J¹⁵, Romano E¹⁵, Tsatsanis K¹⁵, Chawarska K¹⁵, Kim S¹⁵, Dieterich S¹⁵, Bearrs K¹⁵, Peters N¹⁶, Brown P¹⁶, Ansusinha E¹⁶, Waldrep E¹⁶, Friedman J¹⁶, Hounshell G¹⁶, Allred D¹⁶, Engelke SC¹⁷, Darden-Saad N¹⁷, Stainback G¹⁷, Warner D¹⁸, Wereszczak J¹⁸, Bernhardt J¹⁸, McKeeman J¹⁸, Meyer E¹⁸, Pastyrnak S¹⁹, Rathbun J¹⁹, Nota S¹⁹, Crumb T¹⁹, Lenski M²⁰, Weiland D²⁰, Lloyd M²⁰, Hunter S²¹, Msall M²¹, Ramoskaite R²¹, Wiggins S²¹, Washington K²¹, Martin R²¹, Prendergast B²¹, Scott M²¹, Klarr J²², Kring B²², DeRidder J²², Vogt K²².

Author information

1

Division of Pediatric Neurology, Department of Pediatrics, Boston Medical Center, Boston, Massachusetts. Electronic address: rachel.hirschberger@childrens.harvard.edu.

2

Division of Pediatric Neurology, Department of Pediatrics, Boston Medical Center, Boston, Massachusetts.

3

University of North Carolina, Chapel Hill, North Carolina.

4

Department of Psychology and Neuroanatomy, Boston University, Boston, Massachusetts.

5

Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts.

6

Division of Pediatric Neurology, Department of Neurology, Johns Hopkins Hospital, Baltimore, Maryland.

7

Department of Radiology, Boston Medical Center, Boston University, Boston, Massachusetts.

8

Departments of Psychiatry and Pediatrics, UMASS Medical School/ University of Massachusetts Memorial Health Care, Worcester, Massachusetts.

9

National Institute of Neurological Disorders and Stroke, Bethesda, Maryland.

10

Department of Epidemiology and Biostatistics and Pediatrics and Human Development, Michigan State University, East Lansing, Michigan.

11

Boston Children's Hospital, Boston, Massachusetts.

12

Tufts Medical Center, Boston, Massachusetts.

13

Baystate Medical Center.

14

University of Massachusetts Medical School, Worcester, Massachusetts.

15

Yale University School of Medicine, New Haven, Connecticut.

16

Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina.

17

University Health Systems of Eastern Carolina, Greenville, North Carolina.

18

North Carolina Children's Hospital, Chapel Hill, North Carolina.

19

Helen DeVos Children's Hospital, Grand Rapids, Michigan.

20

Sparrow Hospital, Lansing, Michigan.

21

University of Chicago Medical Center, Chicago, Illinois.

22

William Beaumont Hospital, Royal Oak, Michigan.

Abstract

BACKGROUND:

This study aims to determine the prevalence of neurodevelopmental impairments at age ten years among children born extremely preterm (less than 28 weeks gestational age) and to offer a framework for categorizing neurological limitations.

METHODS:

A multicenter, prospective cohort follow-up study recruited 889 ten-year-old children born from 2002 to 2004. We assessed prevalence of cognitive impairment, measured by intelligent quotient and tests of executive function, cerebral palsy (CP), autism spectrum disorder (ASD), and epilepsy singly and in combination. The three levels of impairment severity were: category I-no major neurodevelopmental impairment; category II-normal cognitive ability with CP, ASD, and/or epilepsy; and category III-children with cognitive impairment.

RESULTS:

A total 214 of 873 children (25%) had cognitive impairment, 93 of 849 children (11%) had CP, 61 of 857 children (7%) had ASD, and 66 of 888 children (7%) had epilepsy. Further, 19% of all children had one diagnosis, 10% had two diagnoses, and 3% had three diagnoses. Decreasing gestational age was associated with increasing number of impairments (P < 0.001). Half the children with cognitive impairment and one third of children with CP, ASD, or epilepsy had a single impairment. Six hundred one (68% [95% CI, 64.5%-70.7%]) children were in category I, 74 (8% [95% CI, 6.6%-10.3%]) were in category II, and 214 (24% [95% CI 21.7%-27.4%]) were in category III.

CONCLUSIONS:

Three quarters of children had normal intellect at age ten years; nearly 70% were free of neurodevelopmental impairment. Forty percent of children with impairments had multiple diagnoses.

Copyright © 2017 Elsevier Inc. All rights reserved.

PMID:29310907

DOI:10.1016/j.pediatrneurol.2017.11.002

Prévalence et caractéristiques des troubles du spectre de l'autisme chez les enfants avec une paralysie cérébrale

Aperçu: G.M.

L'étude a pour objectif d'évaluer la prévalence des troubles du spectre de l'autisme (TSA) co-occurrents chez les enfants avec une paralysie cérébrale (CP) et décrire leurs caractéristiques.

Parmi les enfants avec CP, 107 avaient un diagnostic associé de TSA - soit 8.7% de la population étudiée. Cette proportion variait selon les centres de 4,0% à 16,7%, mais était indépendante de la prévalence du CP.  

Le sexe masculin, l'épilepsie coexistant, le handicap intellectuel et une meilleure aptitude à la marche étaient associés à la coexistence des TSA.

Dev Med Child Neurol. 2017 Apr 25. doi: 10.1111/dmcn.13436.

Prevalence and characteristics of autism spectrum disorders in children with cerebral palsy

Delobel-Ayoub M^1,2,3, Klapouszczak D^1,2,3, van Bakel MME⁴, Horridge K⁵, Sigurdardottir S⁶, Himmelmann K⁷, Arnaud C^1,2,3.

Author information

1

Inserm UMR 1027, Toulouse, France.

2

Université de Toulouse III, Toulouse, France.

3

CHU Toulouse, Registre des Handicaps de l'Enfant en Haute-Garonne, Toulouse, France.

4

Register for Severely Disabled Children and Perinatal Observatory, Grenoble, France.

5

Paediatric Disability Department, Sunderland Royal Hospital, Sunderland, UK.

6

The State Diagnostic and Counselling Centre, Kopavogur, Iceland.

7

Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Abstract

AIM:

To evaluate the prevalence of co-occurring autism spectrum disorders (ASDs) among children with cerebral palsy (CP), and to describe their characteristics.

METHOD:

The data of 1225 CP cases from four population-based registers (Iceland, Sweden, and two in France) and one population-based surveillance programme (North East England, UK) participating in the Surveillance of Cerebral Palsy in Europe Network (SCPE) were analysed. The ASD diagnoses were systematically recorded using category F84 of the International Classification of Diseases, 10th Revision. The registers provided data on children born between 1995 and 2006, while the cross-sectional survey in the UK concerned children aged 0 to 19 years, registered in 2010.

RESULTS:

Among the children with CP, 107 had an associated diagnosis of ASD - i.e., 8.7% of the study population (95% confidence interval 7.2-10.5). This proportion varied across centres from 4.0% to 16.7% but was independent of CP prevalence. Male sex, co-occurring epilepsy, intellectual disability, and better walking ability were associated with the coexistence of ASD.

INTERPRETATION:

Our findings support the need for a multidisciplinary approach to management of children with CP to adequately identify and address all facets of presentation, including ASD.

© 2017 Mac Keith Press.

PMID: 28439889

DOI: 10.1111/dmcn.13436

Que dit la littérature sur l'utilisation de robots pour les enfants handicapés?

Aperçu: G.M.

Le but de cette étude est d'examiner l'importance et le type de robots utilisés pour la réadaptation et l'éducation des enfants et des jeunes avec de CP et TSA.

La littérature savante a été systématiquement recherchée et analysée. 

15 systèmes robotiques ont été rapporté dans 34 études qui ont fourni un faible niveau de preuve.  

Les résultats portaient principalement sur l'interaction avec des enfants avec TSA et qui avaient une diminution du comportement autistique, et pour la paralysie cérébrale, elles portaient sur le développement cognitif, l'apprentissage et le jeu.

De plus amples recherches sont nécessaires dans ce domaine en utilisant des modèles qui offrent une plus grande validité.

Le faible niveau de preuve plus la nécessité d'un soutien technique spécialisé devraient être considérés comme des facteurs critiques avant de prendre la décision d'acheter des robots pour un traitement pour les enfants avec CP et TSA.

   

Disabil Rehabil Assist Technol. 2017 Apr 25:1-12. doi: 10.1080/17483107.2017.1318308

What does the literature say about using robots on children with disabilities?

Miguel Cruz A^1,2, Ríos Rincón AM^2,3, Rodríguez Dueñas WR¹, Quiroga Torres DA¹, Bohórquez-Heredia AF¹.

Author information

1

a Biomedical Engineering Program, School of Medicine and Health Sciences , Universidad del Rosario , Bogotá , DC , Colombia.

2

b Department of Occupational Therapy, Faculty of Rehabilitation Medicine , University of Alberta , Edmonton , AB , Canada.

3

c Program of Occupational Therapy, School of Medicine and Health Sciences , Universidad del Rosario , Bogotá , DC , Colombia.

Abstract

PURPOSE:

The purpose of this study is to examine the extent and type of robots used for the rehabilitation and education of children and young people with CP and ASD and the associated outcomes.

METHODS:

The scholarly literature was systematically searched and analyzed. Articles were included if they reported the results of robots used or intended to be used for the rehabilitation and education of children and young people with CP and ASD during play and educative and social interaction activities.

RESULTS:

We found 15 robotic systems reported in 34 studies that provided a low level of evidence. The outcomes were mainly for children with ASD interaction and who had a reduction in autistic behaviour, and for CP cognitive development, learning, and play.

CONCLUSION:

More research is needed in this area using designs that provide higher validity. A centred design approach is needed for developing new low-cost robots for this population. Implications for rehabilitation In spite of the potential of robots to promote development in children with ASD and CP, the limited available evidence requires researchers to conduct studies with higher validity. The low level of evidence plus the need for specialized technical support should be considered critical factors before making the decision to purchase robots for use in treatment for children with CP and ASD. A user-entered design approach would increase the chances of success for robots to improve functional, learning, and educative outcomes in children with ASD and CP. We recommend that developers use this approach. The participation of interdisciplinary teams in the design, development, and implementation of new robotic systems is of extra value. We recommend the design and development of low-cost robotic systems to make robots more affordable.

PMID: 28440095

DOI: 10.1080/17483107.2017.1318308