The present paper documents the development of autism/autistic spectrum disorder in a consecutive series of nine high-risk infants followed prospectively from 6 months of age. Evidence is provided for two broadly defined subgroups: the first subgroup (n = 6) showed a decrease in IQ between 12 and 24 or 36 months (from average/near average to severe cognitive impairment), whereas the second subgroup (n = 3) continued to obtain average or near average IQs. Signs of autism emerged and/or were more striking earlier in the first subgroup. In all nine children, early impairment in social-communicative development coexisted with atypical sensory and/or motor behaviors, as did a temperamental profile marked by irritability/distress and dysregulated state. Discussion focuses on issues raised by the pattern of findings.
The Autism Observation Scale for Infants (AOSI) was developed to detect and monitor early signs of autism as they emerge in high-risk infants (all with an older sibling with an autistic spectrum disorder). Here we describe the scale and its development, and provide preliminary data on its reliability. Inter-rater reliability both for total scores and total number of endorsed items is good to excellent at 6, 12 and 18 months; reliability is more modest for individual items, particularly in 6-month-olds. Test-retest reliability of the AOSI at 12 months of age is within acceptable limits. Evidence that the AOSI provides reliable data is the first critical step towards evaluating its efficacy in distinguishing high-risk infants who develop ASD.
The objective of this study was to compare the efficacy of corticotropin (ACTH) versus vigabatrin in treating infantile spasms and to determine which medication has a more favorable long-term outcome in terms of cognitive function, evolution of epilepsy, and incidence of autism. Patients with infantile spasms were included in the study if they were 3 to 16 months old, had hypsarrhythmia, and had no previous treatment with vigabatrin or corticosteroids. Patient evaluation included electroencephalographic and psychometric measures before and after treatment. Patients were stratified based on etiology (idiopathic or symptomatic) and sex and then randomized between the ACTH and vigabatrin treatment groups. Each of the treatment groups received either ACTH or vigabatrin for 2 weeks. At the end of 2 weeks of treatment, patients were considered responders if spasms and hypsarrhythmia resolved. Nonresponders were crossed over and treated with the alternate drug. Nine patients were included in the study. Three patients received ACTH, one of whom was a responder. Six patients received vigabatrin, three of whom were responders. The five nonresponders received both therapies. All patients had some degree of developmental plateau or regression before the initiation of treatment. Four patients with idiopathic infantile spasms showed improved cognitive function following treatment. The remaining five patients remained significantly delayed. Five patients with symptomatic infantile spasms had epilepsy following treatment; three of them were in the autistic spectrum. The small number of infants in this pilot study is insufficient to determine which of the two drugs is more effective. However, the following trends were identified: vigabatrin may be more effective for patients with symptomatic infantile spasms; patients with idiopathic infantile spasms tend to have a better cognitive outcome; and patients with symptomatic infantile spasms tend to develop both epilepsy and autism.
Introduction Public health responses often lack the infrastructure to capture the impact of public health emergencies on pregnant women and infants, with limited mechanisms for linking pregnant women with their infants nationally to monitor long-term effects. In 2019, the Centers for Disease Control and Prevention (CDC), in close collaboration with state, local, and territorial health departments, began a 5-year initiative to establish population-based mother-baby linked longitudinal surveillance, the Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET). Objectives The objective of this report is to describe an expanded surveillance approach that leverages and modernizes existing surveillance systems to address the impact of emerging health threats during pregnancy on pregnant women and their infants. Methods Mother-baby pairs are identified through prospective identification during pregnancy and/or identification of an infant with retrospective linking to maternal information. All data are obtained from existing data sources (e.g., electronic medical records, vital statistics, laboratory reports, and health department investigations and case reporting). Results Variables were selected for inclusion to address key surveillance questions proposed by CDC and health department subject matter experts. General variables include maternal demographics and health history, pregnancy and infant outcomes, maternal and infant laboratory results, and child health outcomes up to the second birthday. Exposure-specific modular variables are included for hepatitis C, syphilis, and Coronavirus Disease 2019 (COVID-19). The system is structured into four relational datasets (maternal, pregnancy outcomes and birth, infant/child follow-up, and laboratory testing). Discussion SET-NET provides a population-based mother-baby linked longitudinal surveillance approach and has already demonstrated rapid adaptation to COVID-19. This innovative approach leverages existing data sources and rapidly collects data and informs clinical guidance and practice. These data can help to reduce exposure risk and adverse outcomes among pregnant women and their infants, direct public health action, and strengthen public health systems.
We examined strategic intervention when learners were actively engaged in group discussion to assess the impact of peer interaction. In addition, memory performance was compared between students who generated or evaluated elaborations when using the elaborative interrogation strategy, as well as between a supported strategy where learners were provided with explanatory elaborations and a self‐study condition. Introductory psychology students (N=263) in groups of 3 to 5 members studied sixty facts about familiar and unfamiliar animals. Overall, the potency of elaborative interrogation was confirmed regardless of whether students studied interactively or independently. The contribution of group members in facilitating knowledge when the group was able to share sophisticated strategic information also was highlighted. Most critically, when background knowledge was sufficient to promote connections between existing and new material, it was the active generation of elaborations that maximized learning. Copyright © 2000 John Wiley & Sons, Ltd.
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