Sleep and its Disorders in Children and Adolescents with a Neurodevelopmental Disorder

Schizophrenia before the age of 18 years is usually divided into two categories. Early-onset schizophrenia (EOS) presents between the ages of 13 and 17 years, whereas very-early-onset schizophrenia (VEOS) presents at or before the age of 12 years. Previous studies have found that neurodevelopmental difficulties in social, motor, and linguistic domains are commonly observed in VEOS/EOS patients. Recent research has also shown a high prevalence of neurodevelopmental disorders (e.g., intellectual disability, communication disorders, autism spectrum disorder, neurodevelopmental motor disorders) in VEOS/EOS patients, indicating genetic overlap between these conditions. These findings lend support to the neurodevelopmental continuum model, which holds that childhood neurodevelopmental disorders and difficulties and psychiatric disorders (e.g., schizophrenia) fall on an etiological and neurodevelopmental continuum, and should not be considered discrete entities. Based on this literature, in this study we focused on the overlap between neurodevelopmental disorders and schizophrenia investigating, in a large sample (N = 230) of VEOS/EOS children and adolescents, the clinical differences, at the onset of psychosis, between VEOS/EOS with neurodevelopmental disorder or neurodevelopmental difficulties and VEOS/EOS with no diagnosed neurodevelopmental disorder or neurodevelopmental difficulties. The findings showed that, in children and adolescents with a neurodevelopmental disorder or neurodevelopmental difficulties, psychosis onset occurred at an earlier age, was associated with more severe functional impairment (e.g., global, social, role), and was characterized by positive symptoms (e.g., grandiose ideas, perceptual abnormalities, disorganized communication) and disorganized symptoms (e.g., odd behavior or appearance, bizarre thinking). Instead, in children and adolescents without a neurodevelopmental disorder or neurodevelopmental difficulties, psychosis onset was mainly characterized by negative symptomatology (e.g., social anhedonia, avolition, expression of emotion, experience of emotions and self, ideational richness). Given these differences, the presence of a neurodevelopmental disorder or neurodevelopmental difficulties should be carefully investigated and integrated early into the assessment and treatment plan for VEOS/EOS patients.

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The Impact of the COVID-19 Pandemic on Multidisciplinary Diagnostic Evaluations for Children and Adolescents With a Neurodevelopmental Disorder.

10.21203/rs.3.rs-670856/v1 ◽

2021 ◽

Author(s):

Eva Cloet ◽

Jansen Anna ◽

Leys Mark

Keyword(s):

Children And Adolescents ◽

Time Management ◽

Developmental Disorders ◽

Neurodevelopmental Disorder ◽

Temporary Increase ◽

Optimal Care ◽

Healthcare Needs ◽

Policy Measures ◽

The Impact ◽

Working Processes

Abstract Introduction Since the end of 2019, measures have been taken to control the spread of COVID-19. The effects of the pandemic-related precautionary measures on children with developmental disorders require specific attention as these children have greater healthcare needs and mental health concerns, and depend on community-based services for support. Prior to the COVID-19 pandemic, adequate access to multidisciplinary diagnostic evaluations for children and adolescents with suspected developmental disorders was already problematic. This article aims to explore the impact of the policy measures in response to the COVID-19 pandemic on the accessibility, changes in working processes and action strategies after the first lockdown period. Methods A rapid response study was done after the first wave of the virus in Belgium. A questionnaire with open-ended questions was sent out to respondents of all centers for ambulatory rehabilitation, autism reference centers and centers for developmental disorders, three types of organizations identified as main providers of diagnostic evaluations for children and adolescents. Qualitative data were thematically analyzed in an iterative process including researcher triangulation.Results The response rate was 0.60. All centers reported an impact of COVID-19-related policy measures on accessibility, working processes, working practices, workload, planning, and time management, as well as on the quality of the diagnostic assessments and the contacts with clients. Suggestions to decrease the impact of the pandemic-related measures on the care trajectories of children with (suspected) developmental disorder include the definition of priority groups, a temporary increase of public financing to expand team capacity, a less rigid application of regulatory restrictions as well as a temporary assignment stop.Conclusion The impact of the COVID-19 pandemic reinforced the problem of accessibility of multidisciplinary diagnostic evaluations for children suspected of a neurodevelopmental disorder. The organization of health services should guarantee optimal care trajectories for all vulnerable children. Accessibility problems can be reduced by providing “bridging care”, helping children and families with needs to overcome “gaps” of care and support during waiting periods. In the long term, an in-depth exploration of mechanisms that strengthen interorganisational collaboration is required to structurally optimize the capacity and accessibility to care for children with suspected neurodevelopmental disorders.

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Fourier Transform Infrared Spectroscopy Based Complementary Diagnosis Tool for Autism Spectrum Disorder in Children and Adolescents

Molecules ◽

10.3390/molecules25092079 ◽

2020 ◽

Vol 25 (9) ◽

pp. 2079

Author(s):

Gulce Ogruc Ildiz ◽

Sevgi Bayari ◽

Ahmet Karadag ◽

Ersin Kaygisiz ◽

Rui Fausto

Keyword(s):

Autism Spectrum Disorder ◽

Fourier Transform ◽

Children And Adolescents ◽

Infrared Spectra ◽

Neurodevelopmental Disorder ◽

Fourier Transform Infrared ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Analytical Models ◽

Societal Implications

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that begins early in life and continues lifelong with strong personal and societal implications. It affects about 1%–2% of the children population in the world. The absence of auxiliary methods that can complement the clinical evaluation of ASD increases the probability of false identification of the disorder, especially in the case of very young children. In this study, analytical models for auxiliary diagnosis of ASD in children and adolescents, based on the analysis of patients’ blood serum ATR-FTIR (Attenuated Total Reflectance-Fourier Transform Infrared) spectra, were developed. The models use chemometrics (either Principal Component Analysis (PCA) or Partial Least Squares Discriminant Analysis (PLS-DA)) methods, with the infrared spectra being the X-predictor variables. The two developed models exhibit excellent classification performance for samples of ASD individuals vs. healthy controls. Interestingly, the simplest, unsupervised PCA-based model results to have a global performance identical to the more demanding, supervised (PLS-DA)-based model. The developed PCA-based model thus appears as the more economical alternative one for use in the clinical environment. Hierarchical clustering analysis performed on the full set of samples was also successful in discriminating the two groups.

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The association between treated psychiatric and neurodevelopmental disorders and out-of-home care among Finnish children born in 1997

European Child & Adolescent Psychiatry ◽

10.1007/s00787-021-01819-1 ◽

2021 ◽

Author(s):

Antti Kääriälä ◽

David Gyllenberg ◽

Reijo Sund ◽

Elina Pekkarinen ◽

Markus Keski-Säntti ◽

...

Keyword(s):

Home Care ◽

Children And Adolescents ◽

Neurodevelopmental Disorders ◽

Service Use ◽

Neurodevelopmental Disorder ◽

Significant Proportion ◽

Psychiatric Services ◽

Out Of Home Care ◽

Oppositional Defiant ◽

Self Harm

AbstractComprehensive overviews of the use of psychiatric services among children and adolescents placed in out-of-home care (OHC) by child welfare authorities are scarce. We examine specialized service use for psychiatric and neurodevelopmental disorders among children and adolescents in a total population involving children in OHC. We used the longitudinal administrative data of a complete Finnish birth cohort 1997 (N = 57,174). We estimated risk ratios (RRs) for a range of diagnosed psychiatric and neurodevelopmental disorders among children in OHC. We also estimated RRs for OHC among those with diagnosed disorders. We used descriptive methods to explore the timing of first entry into OHC relative to the first diagnosis. Among children in OHC, 61.9% were diagnosed with any psychiatric or neurodevelopmental disorder, compared with 18.0% among those never in OHC (RR: 3.7; 95% CI 3.6–3.8). The most common diagnosed disorders among children in OHC were depression and anxiety disorders, neurodevelopmental disorders, and oppositional defiant disorder/conduct disorder (ODD/CD). Among all children with any diagnosis, 18.1% experienced OHC, compared with 2.5% among those without a diagnosis (RR: 7.4; 95% CI 6.9–7.9). Of those diagnosed with self-harm and suicidality, ODD/CD, substance-related disorders, and psychotic and bipolar disorders, 43.5–61.2% experienced OHC. Of the children in OHC receiving psychiatric services, half were diagnosed before first placement in OHC. The majority of children with experience in OHC were diagnosed with psychiatric or neurodevelopmental disorders. They comprised a significant proportion of individuals treated for severe and complex psychiatric disorders and self-harm.

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Gender-Related Clinical Characteristics in Children and Adolescents with ADHD

Journal of Clinical Medicine ◽

10.3390/jcm11020385 ◽

2022 ◽

Vol 11 (2) ◽

pp. 385

Author(s):

Pietro De Rossi ◽

Italo Pretelli ◽

Deny Menghini ◽

Barbara D’Aiello ◽

Silvia Di Vara ◽

...

Keyword(s):

Children And Adolescents ◽

Clinical Characteristics ◽

Neurodevelopmental Disorder ◽

Attention Problems ◽

School Age Children ◽

Functional Impairments ◽

Obsessive Compulsive ◽

Global Functioning ◽

Hyperactivity Disorder ◽

Significant Impairment

Attention Deficit/Hyperactivity Disorder (ADHD) is the most frequently diagnosed neurodevelopmental disorder in school-age children, and it is usually associated with a significant impairment in global functioning. Traditionally, boys with ADHD are more likely to be referred for clinical assessments due to a higher prevalence of externalizing symptoms. However, as regards gender-related differential clinical characteristics between boys and girls with ADHD, further investigation is warranted in light of conflicting results found in currently available literature. In fact, a more precise clinical characterization could help increase appropriate diagnoses and treatment planning. In this context, we carried out a retrospective observational study on 715 children and adolescents diagnosed with ADHD from 2018 to 2020 at our center, in order to describe their gender-related clinical characteristics. Boys displayed higher average IQs, but they were comparable to girls in functional impairments and adaptive skills. Girls displayed higher scores on the Attention Problems subscale of the CBCL 6–18 and on several CPRS-R:L subscales, suggesting higher general ADHD symptom severity. Boys showed higher scores on CBCL 6–18 subscales, such as withdrawn/depressed, internalizing, and obsessive-compulsive problems. In conclusion, girls showed more severe ADHD features and lower IQ in clinically referred settings, while boys showed more internalizing problems and obsessive-compulsive symptoms.

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An update on the cause and treatment of sleep disturbance in children and adolescents with autism spectrum disorder

Yeungnam University Journal of Medicine ◽

10.12701/yujm.2021.01410 ◽

2021 ◽

Vol 38 (4) ◽

pp. 275-281 ◽

Cited By ~ 1

Author(s):

Wan Seok Seo

Keyword(s):

Quality Of Life ◽

Autism Spectrum Disorder ◽

Sleep Disturbance ◽

Children And Adolescents ◽

Sleep Disturbances ◽

Neurodevelopmental Disorder ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Adolescents With Asd

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by abnormalities in social communication/interaction and restrictive, repetitive patterns of behavior. ASD is a relatively common psychiatric disorder, with a prevalence of approximately 1.7% in children. Although many children and adolescents with ASD visit the hospital for medical help for emotional and behavioral problems such as mood instability and self-harming behavior, there are also many visits for sleep disturbances such as insomnia and sleep resistance. Sleep disturbances are likely to increase fatigue and daytime sleepiness, impaired concentration, negatively impact on daytime functioning, and pose challenges in controlling anger and aggressive behavior. Sleep disturbance in children and adolescents with ASD negatively affects the quality of life, nothing to say the quality of life of their families and school members. In this review, sleep disturbances that are common in children and adolescents with ASD and adolescents are presented. The developmental and behavioral impacts of sleep disturbances in ASD were also considered. Finally, non-pharmacological and pharmacological treatments for sleep disturbances in children and adolescents with ASD and adolescents are reviewed.

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Effects of Exercise on Cognitive Performance in Children and Adolescents with ADHD: Potential Mechanisms and Evidence-based Recommendations

Journal of Clinical Medicine ◽

10.3390/jcm8060841 ◽

2019 ◽

Vol 8 (6) ◽

pp. 841 ◽

Cited By ~ 9

Author(s):

Lasse Christiansen ◽

Mikkel M. Beck ◽

Niels Bilenberg ◽

Jacob Wienecke ◽

Arne Astrup ◽

...

Keyword(s):

Children And Adolescents ◽

Cognitive Performance ◽

Cognitive Functions ◽

Large Scale ◽

Low Cost ◽

Neurodevelopmental Disorder ◽

Preliminary Evidence ◽

Population Based ◽

Beneficial Effects ◽

Positive Effects

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder with a complex symptomatology, and core symptoms as well as functional impairment often persist into adulthood. Recent investigations estimate the worldwide prevalence of ADHD in children and adolescents to be ~7%, which is a substantial increase compared to a decade ago. Conventional treatment most often includes pharmacotherapy with central nervous stimulants, but the number of non-responders and adverse effects call for treatment alternatives. Exercise has been suggested as a safe and low-cost adjunctive therapy for ADHD and is reported to be accompanied by positive effects on several aspects of cognitive functions in the general child population. Here we review existing evidence that exercise affects cognitive functions in children with and without ADHD and present likely neurophysiological mechanisms of action. We find well-described associations between physical activity and ADHD, as well as causal evidence in the form of small to moderate beneficial effects following acute aerobic exercise on executive functions in children with ADHD. Despite large heterogeneity, meta-analyses find small positive effects of exercise in population-based control (PBC) children, and our extracted effect sizes from long-term interventions suggest consistent positive effects in children and adolescents with ADHD. Paucity of studies probing the effect of different exercise parameters impedes finite conclusions in this regard. Large-scale clinical trials with appropriately timed exercise are needed. In summary, the existing preliminary evidence suggests that exercise can improve cognitive performance intimately linked to ADHD presentations in children with and without an ADHD diagnosis. Based on the findings from both PBC and ADHD children, we cautiously provide recommendations for parameters of exercise.

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152 Development of Deutetrabenazine as a Potential New Non-Antipsychotic Treatment for Tourette Syndrome in Children and Adolescents

CNS Spectrums ◽

10.1017/s1092852920000681 ◽

2020 ◽

Vol 25 (2) ◽

pp. 297-297

Author(s):

Joseph Jankovic ◽

Barbara Coffey ◽

Daniel O. Claassen ◽

David Stamler ◽

Barry J. Gertz ◽

...

Keyword(s):

Children And Adolescents ◽

Tourette Syndrome ◽

Neurodevelopmental Disorder ◽

The United States ◽

Fixed Dose ◽

Dose Titration ◽

Controlled Study ◽

Antipsychotic Treatment ◽

Open Label

Abstract:Background:Tourette syndrome (TS) is a neurodevelopmental disorder characterized by the hyperkinetic movements of motor and phonic tics manifested in young age. Currently approved treatments in the United States are antipsychotics: haloperidol, pimozide, and aripiprazole, which are associated with serious side effects, including tardive dyskinesia (TD). Deutetrabenazine, a vesicular monoamine transporter type 2 (VMAT2) inhibitor, was approved in 2017 by the US FDA for the treatment of chorea associated with Huntington’s disease and TD. Three ongoing studies (Alternatives for Reducing Tics in TS [ARTISTS]) are evaluating the efficacy, safety, and tolerability of deutetrabenazine in reducing tics in TS in children and adolescents (age 6-16 years).Methods:ARTISTS 1, a phase 2/3, response-driven, dose-titration, placebo-controlled study, randomizes patients (N=116) 1:1 to deutetrabenazine or placebo for 12 weeks. ARTISTS 2, a phase 3, fixed-dose study, randomizes patients (N=150) 1:1:1 to deutetrabenazine high or low dose, or placebo for 8 weeks. The primary efficacy outcome in these pivotal studies is change from baseline to end of treatment in the Total Tic Score (TTS) of the Yale Global Tic Severity Scale (YGTSS). Additional efficacy endpoints and safety/tolerability are also evaluated. ARTISTS is a 56-week, open-label, single-arm, long-term safety/tolerability study in patients who have successfully completed either ARTISTS 1 or ARTISTS 2.Results:Not available yet.Conclusion:TS can have potentially long-term life impact, and there remains unmet medical need for effective and well-tolerated treatments. Three ARTISTS studies will evaluate the efficacy, safety, and tolerability of deutetrabenazine in patients with tics in TS.Funding Acknowledgements:The studies are sponsored by Teva Pharmaceuticals and operationalized by Teva’s development partner, Nuvelution TS Pharma INC.

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Lactobacillus plantarum PS128 and Other Probiotics in Children and Adolescents with Autism Spectrum Disorder: A Real-World Experience

Nutrients ◽

10.3390/nu13062036 ◽

2021 ◽

Vol 13 (6) ◽

pp. 2036

Author(s):

Martina Maria Mensi ◽

Chiara Rogantini ◽

Michele Marchesi ◽

Renato Borgatti ◽

Matteo Chiappedi

Keyword(s):

Autism Spectrum Disorder ◽

Side Effects ◽

Children And Adolescents ◽

Lactobacillus Plantarum ◽

Neurodevelopmental Disorder ◽

Real Life ◽

Specific Effect ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Positive Effects

Autism Spectrum Disorder is a neurodevelopmental disorder. Recent data suggest that probiotics can reduce some symptoms of this disorder and Lactobacillus plantarum PS128 has been reported to be especially useful. We recruited a sample of 131 autistic children and adolescents (M:F = 122:19; age: 86.1 ± 41.1 months) and evaluated their changes after use of probiotics by mean of CGI. We found some significant improvements with very few side effects; these positive effects were more evident in younger children. Patients taking Lactobacillus plantarum PS128 had greater improvements and fewer side effects than those taking other probiotics. Our real-life data are consistent with existing literature showing a specific effect of Lactobacillus plantarum PS128 in Autism Spectrum Disorder.

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Specificities of psychoses in children and adolescents with mental retardation

Medicinski pregled ◽

10.2298/mpns0306251k ◽

2003 ◽

Vol 56 (5-6) ◽

pp. 251-255

Author(s):

Dusan Kolar ◽

Svetomir Bojanin ◽

Mila Kolar

Keyword(s):

Mental Retardation ◽

Children And Adolescents ◽

Social Factors ◽

Psychotic Disorders ◽

Neurodevelopmental Disorder ◽

Mentally Retarded ◽

Differential Diagnostics ◽

Mentally Retarded Children ◽

Clinical Pictures ◽

Developmental Psychiatry

Mental retardation is a heterogeneous neurodevelopmental disorder characterized by arrested or incomplete psychological development. The first part of the study deals with psychological and biological factors: etiology and pathogenesis of mental retardation and comorbid psychiatric disorders Their etiopathogenesis is similar as in other neurodevelopmental disorders and it was analyzed in the part dealing with biological specificities of persons with mental retardation. Numerous bio-psycho-social factors cause increased vulnerability of the mentally retarded to development of mental disorders. Thus, prevalence of these disorders is higher in mentally retarded persons than in general population. This study also deals with specificities regarding diagnosis of psychotic disorders in mentally retarded persons as well as neurobiologic, epidemiologic, clinical and therapeutic characteristics of schizophrenic psychoses, autism and affective disorders in persons with mental retardation. Special emphasis was given to diagnostics of these disorders in mentally retarded children and adolescents, as well as to problems of differential diagnostics. Apart from other things, we have concluded that specific clinical pictures demand subspeciality approach in the frame of developmental psychiatry.

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