ABSTRACT
Abstract Objective: to determine the association between breastfeeding and associated factors with neuropsychomotor development of children living in social vulnerability. Methods: cross-sectional study within a socially vulnerable community. Households with children aged seven to 72 months, and their biological mothers were included. Sociodemographic, anthropometric and breastfeeding variables were collected using questionnaires, and neuropsychomotor development was assessed using the Denver II screening test. Adjusted prevalence ratios were calculated using multivariable models, oriented by directed acyclic graphs. Results: from the 654 households visited, 224 mother-child binomials were included. The mean age of children was 28 (18.7) months, and 143 (63.8%) of them presented suspected delay in neuropsychomotor development. Mothers presented a median of 8 years of formal schooling and 64 (28.6%) had performed exclusive breastfeeding for 6 months. Exclusive breastfeeding was not associated with neuropsychomotor development (PR=0.92; CI95%=0.84-1.00). A significant association was observed only with years of formal maternal education (PR=0.98; CI95%=0.97-0.99). A mediation analysis did not show any clear mediator between maternal education and neuropsychomotor development. Conclusions: children living in social vulnerability presented a high prevalence of suspected delay in neuropsychomotor development. Maternal education was the only variable associated with such condition.
Resumo Objetivos: determinar a associação entre o aleitamento materno e fatores associados ao desenvolvimento neuropsicomotor de crianças em extrema vulnerabilidade social. Métodos: estudo transversal conduzido em uma comunidade em vulnerabilidade social, envolvendo crianças de sete a 72 meses, e suas mães biológicas. Variáveis sociodemográficas, antropométricas e de amamentação foram coletadas por meio de questionários e o desenvolvimento neuropsicomotor foi avaliado por meio do teste de triagem Denver II. Razões de prevalência ajustadas foram calculadas usando modelos multivariáveis, orientados por grafos acíclicos direcionados. Resultados: dos 654 domicílios visitados, foram incluídos 224 binômios mãe-filho, com média de idade de 28,8 (18,7) meses, em que 143 (63,8%) crianças apresentavam suspeita de atraso no desenvolvimento neuropsicomotor e 64 (28,6%) haviam realizado aleitamento materno exclusivo até o sexto mês. Aleitamento materno exclusivo por 6 meses não se associou ao desenvolvimento neuropsicomotor (RP= 0,91; IC95%=0,83-1,00). Houve associação significativa observada apenas com anos de escolaridade materna formal (RP=0,97; IC95%=0,96-0,99). Análise de mediação não mostrou nenhum mediador entre escolaridade materna e desenvolvimento neuropsicomotor. Conclusões: destaca-se a alta prevalência de crianças com suspeita de atraso no desenvolvimento neuropsicomotor. A escolaridade materna foi a única variável associada à esta condição.
Subject(s)
Humans , Infant , Child, Preschool , Child , Breast Feeding , Developmental Disabilities , Educational Status , Social Vulnerability , Anthropometry , Cross-Sectional Studies , Surveys and Questionnaires , Risk Factors , Sociodemographic FactorsABSTRACT
Resumo A pesquisa teve como objetivo estudar o impacto da ausência do brincar precoce no desenvolvimento psíquico do bebê, quando ele se encontra privado de trocas lúdicas na relação bebê-cuidadora, no contexto das creches. A correlação dos resultados dos instrumentos IRDI, MPPE e AP3 no acompanhamento longitudinal de cinco bebês, dos 8 meses de vida aos 4 anos de idade, apontou que a ausência do brincar precoce resulta no empobrecimento do brincar simbólico e entraves no processo de subjetivação da criança.
Abstract This study investigate the absence of early play, that is, the deprivation of playful exchanges with caregivers in the nursery environment, and its impact on the psychic development of infants. Results from a longitudinal study with five infants, from 8 months to 4 years of age, collected by the IRDI, MPPE and AP3 instruments showed that the absence of early play results in the impoverishment of further symbolic play and in obstacles to the child's subjectivation process.
Resumen La investigación tiene como objetivo estudiar el impacto de la ausencia del juego precoz en el desarrollo psíquico en bebés, cuando estos se encuentran privados de intercambios lúdicos en la relación bebé-cuidador/a. En el ámbito de las guarderías, la correlación de los resultados de los instrumentos IRDI, MPPE y AP3 en el acompañamiento longitudinal de cinco bebés de ocho meses a cuatro años indicó que la ausencia del juego precoz provoca empobrecimiento del juego símbolo e impedimentos en el proceso de subjetividad del niños.
Résumé Cette étude s'intéresse à l'absence de jeux précoces, c'est-à-dire à la privation d'échanges ludiques avec les soignants dans l'espace de la crèche, et à son impact dans le développement psychique des nourrissons. Les résultats d'une étude longitudinale auprès de cinq nourrissons, suivis de 8 mois à 4 ans, recueillis à l'aide des instruments IRDI, MPPE et AP3, ont montré que l'absence de jeux précoces entraîne un appauvrissement des jeux symboliques ultérieurs et des obstacles au processus de subjectivation de l'enfant.
Subject(s)
Infant, Newborn , Infant , Child, Preschool , Play and Playthings , Child Care , Child Day Care Centers , Child Development , Psychological Tests , Developmental Disabilities/psychology , Early Intervention, Educational/methodsABSTRACT
Se presenta un niño de 6 años con antecedente de retraso del lenguaje que llevó a sus padres a realizar múltiples consultas. En un primer momento, su cuadro fue interpretado como parte de un retraso global del desarrollo. Posteriormente, el paciente presentó convulsiones y episodios de descompensación metabólica, comenzando desde entonces su seguimiento por los Servicios de neurología, genética y metabolismo. Finalmente, tras varios estudios complementarios, por medio de un exoma trío se arribó al diagnóstico de síndrome de microduplicación del cromosoma 7q11.23, lo que justifica tanto el retraso global de desarrollo del paciente como su clínica neurológica. (AU)
A six-year-old boy presents with a history of language delay that led his parents to make multiple consultations. At first, we interpreted his condition as part of a global developmental delay. Subsequently, the patient presented seizures and episodes of metabolic decompensation, and since then, he had to be followed up by neurology, genetics, and metabolism services. Finally, after several complementary studies, following a trio exome analysis, we diagnosed chromosome 7q11.23 microduplication syndrome, which explains his global developmental delay and neurological symptoms. (AU)
Subject(s)
Humans , Male , Child , Chromosomes, Human, Pair 7/genetics , Developmental Disabilities/genetics , Williams Syndrome/genetics , Chromosome Duplication , Language Development Disorders/genetics , Intellectual Disability/genetics , Developmental Disabilities/diagnosis , Developmental Disabilities/metabolism , Genetic Testing , Williams Syndrome/diagnosis , Williams Syndrome/metabolism , Language Development Disorders/diagnosis , Intellectual Disability/diagnosis , Intellectual Disability/metabolismABSTRACT
Objetivo: Descrever as consequências do herpes tipo 1 no desenvolvimento neuropsicomotor. Metodologia: Trata-se de uma revisão narrativa das consequências da Herpes do tipo 1 no Desenvolvimento Neuropsicomotor. Questão norteadora: "Quais os efeitos da infecção congênita da Herpes tipo 1 no Desenvolvimento Neuropsicomotor observadas entre os anos de 2010 a 2020?". O levantamento dos dados ocorreu: dezembro/2021 a janeiro/2022 nas bases de dados: Scientific Eletronic Library Online, Literatura Latino Americana e do Caribe em Ciências da Saúde e National Library of Medicine. Descritores: "Herpes"; "Desenvolvimento Neuropsicomotor"; "Herpes Congênita" e "Neuropsychomotor Development" com operadores booleanos AND e OR. Critérios de inclusão: artigos originais, texto completo. Exclusão: cartas ao editor, teses, dissertações e revisões de literatura. Resultados: Foram encontrados 21 artigos nas bases de dados pesquisadas, contudo, após a aplicação dos critérios de inclusão, 3 artigos foram considerados elegíveis. Após a análise, pode-se afirmar os impactos do Vírus Herpes pode gerar ao desenvolvimento neuropsicomotor, podendo ocasionar disfagia, disartria, alterações motoras, cognitivas e sociais, bem como outros sinais e sintomas que levarão ao atraso no desenvolvimento. Conclusão: O Herpes Vírus Simples pode ocasionar transtornos cerebrais em crianças, o que acarreta distúrbios para o amadurecimento normal, com consequente atrasos no desenvolvimento neuropsicomotor.
Objective: To describe the consequences of herpes type 1 on neuropsychomotor development. Methodology: This is a narrative review of the consequences of Herpes type 1 on Neuropsychomotor Development. Guiding question: "What are the effects of congenital Herpes type 1 infection on Neuropsychomotor Development observed between the years 2010 to 2020?". Data collection took place: December/2021 to January/2022 in the following databases: Scientific Electronic Library Online, Latin American and Caribbean Literature in Health Sciences and National Library of Medicine. Keywords: "Herpes"; "Neuropsychomotor Development"; "Herpes Congenita" and "Neuropsychomotor Development" with Boolean operators AND and OR. Inclusion criteria: original articles, full text. Exclusion: letters to the editor, theses, dissertations and literature reviews. Results: 21 articles were found in the searched databases, however, after applying the inclusion criteria, 3 articles were considered eligible. After the analysis, it can be said the impacts of the Herpes Virus can generate neuropsychomotor development, which can cause dysphagia, dysarthria, motor, cognitive and social changes, as well as other signs and symptoms that will lead to developmental delay. Conclusion: Herpes Simplex Virus can cause brain disorders in children, which causes disturbances to normal maturation, with consequent delays in neuropsychomotor development.
Objetivo: Describir las consecuencias del herpes tipo 1 en el desarrollo neuropsicomotor. Metodología: Se trata de una revisión narrativa de las consecuencias del Herpes Tipo 1 en el Desarrollo Neuropsicomotor. Pregunta norteadora: "¿Cuáles son los efectos de la infección congénita por Herpes tipo 1 en el desarrollo neuropsicomotor observados entre los años 2010 y 2020?". Los datos se recopilaron entre diciembre de 2021 y enero de 2022 en las siguientes bases de datos: Scientific Eletronic Library Online, Latin American and Caribbean Literature on Health Sciences y National Library of Medicine. Descriptores: "Herpes"; "Desarrollo neuropsicomotor"; "Herpes congénito" y "Desarrollo neuropsicomotor" con operadores booleanos AND y OR. Criterios de inclusión: artículos originales, texto completo. Criterios de exclusión: cartas al director, tesis, disertaciones y revisiones bibliográficas. Resultados: Se encontraron 21 artículos en las bases de datos consultadas, sin embargo, tras aplicar los criterios de inclusión, se consideraron elegibles 3 artículos. Después del análisis, se puede afirmar los impactos que el Herpes Virus puede tener en el desarrollo neuropsicomotor, que puede causar disfagia, disartria, alteraciones motoras, cognitivas y sociales, así como otros signos y síntomas que conducirán a un retraso en el desarrollo. Conclusión: El virus del herpes simple puede causar alteraciones cerebrales en los niños, lo que conduce a trastornos de la maduración normal, con los consiguientes retrasos en el desarrollo neuropsicomotor.
Subject(s)
Psychomotor Performance , Developmental Disabilities , Herpes Simplex/diagnosis , Nervous System Diseases , Brain Diseases , Review Literature as Topic , Databases, Bibliographic , Dysarthria , Failure to ThriveABSTRACT
OBJECTIVE@#To explore the clinical characteristics and genetic etiology of a child with Schaaf-Yang syndrome (SYS).@*METHODS@#Peripheral blood samples of the child and his parents were collected and subjected to whole exome sequencing. Sanger sequencing was used for family constellation verification, and bioinformatic analysis was performed for the candidate variant.@*RESULTS@#The child, a 1-year-and-9-month-old boy, had clinical manifestations of retarded growth, small penis, and unusual facies. Genetic testing revealed that the child has harbored a novel heterozygous variant of c.3078dupG (p.Leu1027Valfs*28) of the MAGEL2 gene. Sanger sequencing showed that neither parent of the child carried the same variant. The c.3078dupG(p.Leu1027Valfs*28) variant of the MAGEL2 gene has not been included in the databases of ESP, 1000 Genomes and ExAC. According to the Standards and Guidelines for the Interpretation of Sequence Variants of the American College of Medical Genetics and Genomics (ACMG), the variant was judged to be pathogenic.@*CONCLUSION@#The c.3078dupG (p.Leu1027Valfs*28) variant of the MAGEL2 gene probably underlay the SYS in this child, which has further expanded the spectrum of the MAGEL2 gene variants.
Subject(s)
Child , Humans , Infant , Male , Exome Sequencing , Genetic Testing , Heterozygote , Mutation , Proteins/genetics , Developmental Disabilities/geneticsABSTRACT
OBJECTIVE@#To assess the value of copy number variation sequencing (CNV-seq) for the diagnosis of children with intellectual disability (ID), developmental delay (DD), and autistic spectrum disorder (ASD).@*METHODS@#Forty patients with ID/DD/ASD referred to Nanshan Maternity and Child Health Care Hospital from September 2018 to January 2022 were enrolled. G-banded karyotyping analysis was carried out for the patients. Genomic DNA was extracted from peripheral blood samples and subjected to CNV-Seq analysis to detect chromosome copy number variations (CNVs) in such patients. ClinVar, DECIPHER, OMIM and other database were searched for data annotation.@*RESULTS@#Among the 40 patients (including 30 males and 10 females), 16, 15 and 6 were diagnosed with ID, DD and ASD, respectively. One patient had combined symptoms of ID and DD, whilst the remaining two had combined ID and ASD. Four patients were found with abnormal karyotypes, including 47,XY,+mar, 46,XY,inv(8)(p11.2q21.2), 46,XX,del(5)(p14) and 46,XX[76]/46,X,dup(X)(p21.1q12). Chromosome polymorphism was also found in two other patients. CNV-seq analysis has detected 32 CNVs in 20 patients (50.0%, 20/40). Pathogenic CNVs were found in 10 patients (25.0%), 15 CNVs of uncertain clinical significance were found in 12 patients (30.0%), and 7 likely benign CNVs were found in 4 patients (10.0%).@*CONCLUSION@#Chromosome CNVs play an important role in the pathogenesis of ID/DD/ASD. CNV-seq can detect chromosomal abnormalities including microdeletions and microduplications, which could provide a powerful tool for revealing the genetic etiology of ID/DD/ASD patients.
Subject(s)
Pregnancy , Child , Male , Humans , Female , DNA Copy Number Variations , Intellectual Disability/genetics , Autism Spectrum Disorder/genetics , Developmental Disabilities/genetics , Abnormal KaryotypeABSTRACT
OBJECTIVE@#To explore the clinical features and genetic etiology of two children with intellectual developmental disorder and microcephaly with pontine and cerebellar hypoplasia (MICPCH).@*METHODS@#Two children with MICPCH who were presented at the Henan Provincial People's Hospital between April 2019 and December 2021 were selected as the study subjects. Clinical data of the two children were collected, along with peripheral venous blood samples of them and their parents, and amniotic fluid sample of the mother of child 1. Whole exome sequencing (WES), array-comparative genomic hybridization (aCGH) and real-time quantitative PCR (qPCR) were carried out for the children, their parents and the fetus. The pathogenicity of candidate variants were evaluated.@*RESULTS@#Child 1 was a 6-year-old girl featuring motor and language delay, whilst child 2 was a 4.5-year-old girl mainly featuring microcephaly and mental retardation. WES revealed that child 2 has harbored a 158.7 kb duplication in Xp11.4 (chrX: 41446160_41604854), which has encompassed exons 4~14 of the CASK gene. The same duplication was not found in either of her parents. aCGH revealed that child 1 has harbored a 29 kb deletion at Xp11.4 (chrX: 41637892_41666665), which encompassed exon 3 of the CASK gene. The same deletion was not found in either of her parents and the fetus. The above results were confirmed by qPCR assay. Above deletion and duplication were not found in the ExAC, 1000 Genomes and gnomAD databases. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), both variants were rated as likely pathogenic (PS2+PM2_Supporting).@*CONCLUSION@#The deletion of exon 3 and duplication of exons 4~14 of the CASK gene probably underlay the pathogenesis of MICPCH in these two children, respectively.
Subject(s)
Humans , Child , Female , Child, Preschool , Microcephaly/genetics , Developmental Disabilities/genetics , Intellectual Disability/complications , Comparative Genomic Hybridization , MutationABSTRACT
OBJECTIVE@#To explore the clinical and genetic characteristics of two children with developmental delay.@*METHODS@#Two children who had presented at the Children's Hospital Affiliated to Shandong University on August 18, 2021 were enrolled as the study subjects. Clinical and laboratory examination, chromosomal karyotyping and high-throughput sequencing were carried out for both children.@*RESULTS@#Both children had a 46,XX karyotype. High-throughput sequencing showed that they have respectively carried a c.489delG (p.Q165Rfs*14) and a c.1157_1158delAT (p.Y386Cfs*22) frameshifting variant of the CTCF gene, both had a de novo origin and were unreported previously.@*CONCLUSION@#The CTCF gene variants probably underlay the development delay in the two children. Above discovery has enriched the mutational spectrum of the CTCF gene and has important implications for revealing the genotype-phenotype correlation for similar patients.
Subject(s)
Child , Humans , Developmental Disabilities/genetics , High-Throughput Nucleotide Sequencing , Intellectual Disability/genetics , Karyotyping , MutationABSTRACT
OBJECTIVE@#To explore the genetic basis for a child featuring global developmental disorder with epilepsy.@*METHODS@#A child who had presented at Guangzhou Women and Children's Medical Center in July 2022 was selected as the study subject. Clinical data was collected. Potential variant was detected by whole exome sequencing (WES). Candidate variant was validated by Sanger sequencing and bioinformatic analysis.@*RESULTS@#The child, a three-year-old ethnic Zhuang Chinese girl, had presented with global developmental disorder and epilepsy, for which rehabilitation therapy was ineffective. Genetic testing revealed that she has harbored a homozygous c.821T>C (p.Leu274Pro) missense variant of the PIGW gene, for which both of her parents and sister were heterozygous carriers. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was classified as variant of uncertain significance.@*CONCLUSION@#The homozygous c.821T>C (p.Leu274Pro) variant of the PIGW gene probably underlay the onset of disease in this child. Above finding has enriched the mutational spectrum of the PIGW gene.
Subject(s)
Child, Preschool , Female , Humans , Computational Biology , Developmental Disabilities , Epilepsy/genetics , Genetic Testing , HomozygoteABSTRACT
OBJECTIVE@#To explore the clinical phenotype and genetic characteristics of a child with Intellectual developmental disorder with behavioral abnormalities and craniofacial malformations without epilepsy (IDDBCS).@*METHODS@#A child who had visited the Lianyungang Maternal and Child Health Care Hospital in April 2021 was selected as the study subject. Clinical data of the child were collected. Genomic DNA was extracted from peripheral blood samples of the child and his parents and subjected to whole exome sequencing (WES). Candidate variants were verified by Sanger sequencing of his family members.@*RESULTS@#The child, a 3-year-and-4-month-old male, had presented with global developmental delay and cranial malformation. Genetic testing revealed that he has harbored a heterozygous c.1703delA (p.K568Sfs9) variant of the PHF21A gene, for which both of his parents were of the wild type. This low-frequency variant may alter the structure and function of the protein product. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), it was classified as a pathogenic variant (PVS1+PS2+PM2_Supporting).@*CONCLUSION@#The heterozygous c.1703delA (p.K568Sfs9) variant of the PHF21A gene probably underlay the IDDBCS in this patient.
Subject(s)
Child , Male , Humans , Infant , Developmental Disabilities/genetics , Craniofacial Abnormalities/genetics , Seizures/genetics , Intellectual Disability/genetics , Problem Behavior , MutationABSTRACT
Objective: To discuss the clinical and genetic features of intellectual developmental disorder with behavioral abnormalities and craniofacial dysmorphism with or without seizures (IDDBCS). Methods: The clinical and genetic records of a patient who was diagnosed with IDDBCS caused by PHF21A gene variation at Children's Hospital Capital Institute of Pediatrics in 2021 were collected retrospectively. Using " PHF21A gene" as the keyword, relevant articles were searched at CNKI, Wanfang Data and PubMed from establishment of databases to February 2023. Clinical and genetic features of IDDBCS were summarized in the combination of this case. Results: An 8 months of age boy showed overgrowth (height, weight and head circumference were all higher than the 97th percentile of children of the same age and sex) and language and motor developmental delay after birth, and gradually showed autism-like symptoms like stereotyped behavior and poor eye contact. At 8 months of age, he began to show epileptic seizures, which were in the form of a series of spastic seizures with no reaction to adrenocorticotropic hormone but a good response to vigabatrin. Physical examination showed special craniofacial appearances including a prominent high forehead, sparse eyebrows, broad nasal bridge, and downturned mouth with a tent-shaped upper lip. The patient also manifested hypotonia. Whole exome sequencing showed a de novo heterogeneous variant, PHF21A (NM_001101802.1): c.54+1G>A, and IDDBCS was diagnosed. A total of 6 articles (all English articles) were collected, involving this case and other 14 patients of IDDBCS caused by PHF21A gene variation. Clinical manifestations were intellectual disability or developmental delay (15 patients), craniofacial anomalies (15 patients), behavioral abnormalities (12 patients), seizures (9 patients), and overgrowth (8 patients). The main pathogenic variations were frameshift variations (8 patients). Conclusions: IDDBCS should be considered when patients show nervous developmental abnormalities, craniofacial anomalies, seizures and overgrowth. PHF21A gene variation detection helps to make a definite diagnosis.
Subject(s)
Male , Humans , Child , Intellectual Disability/genetics , Developmental Disabilities/genetics , Retrospective Studies , Seizures/genetics , Craniofacial Abnormalities/genetics , Histone Deacetylases/geneticsABSTRACT
OBJECTIVE@#To explore the genetic basis for a child with congenital heart disease (CHD) and global developmental delay (GDD).@*METHODS@#A child who was hospitalized at the Department of Cardiac Surgery of Fujian Children's Hospital on April 27, 2022 was selected as the study subject. Clinical data of the child was collected. Umbilical cord blood sample of the child and peripheral blood samples of his parents were collected and subjected to whole exome sequencing (WES). Candidate variant was verified by Sanger sequencing and bioinformatic analysis.@*RESULTS@#The child, a 3-year-and-3-month-old boy, had manifested cardiac abnormalities and developmental delay. WES revealed that he had harbored a nonsense variant of c.457C>T (p.Arg153*) in the NONO gene. Sanger sequencing showed that neither of his parents has carried the same variant. The variant has been recorded by the OMIM, ClinVar and HGMD databases, but not in the normal population databases of 1000 Genomes, dbSNP and gnomAD. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), it was rated as a pathogenic variant.@*CONCLUSION@#The c.457C>T (p.Arg153*) variant of the NONO gene probably underlay the CHD and GDD in this child. Above finding has expanded the phenotypic spectrum of the NONO gene and provided a reference for the clinical diagnosis and genetic counseling for this family.
Subject(s)
Humans , Male , Child, Preschool , Computational Biology , DNA-Binding Proteins , Genetic Counseling , Genomics , Heart Defects, Congenital/genetics , Mutation , Parents , RNA-Binding Proteins , Developmental Disabilities/geneticsABSTRACT
OBJECTIVE@#To explore the genetic etiology of two patients with developmental delay and intellectual disability.@*METHODS@#Two children who were respectively admitted to Henan Provincial People's Hospital on August 29, 2021 and August 5, 2019 were selected as the study subjects. Clinical data were collected, and array comparative genomic hybridization (aCGH) was carried out on the children and their parents for the detection of chromosomal microduplication/microdeletions.@*RESULTS@#Patient 1 was a 2-year-and-10-month female and patient 2 was a 3-year-old female. Both children had featured developmental delay, intellectual disability, and abnormal findings on cranial MRI. aCGH revealed that patient 1 has harbored arr[hg19] 6q14.2q15(84621837_90815662)×1, a 6.19 Mb deletion at 6q14.2q15, which encompassed ZNF292, the pathogenic gene for Autosomal dominant intellectual developmental disorder 64. Patient 2 has harbored arr[hg19] 22q13.31q13.33(46294326_51178264)×1, a 4.88 Mb deletion at 22q13.31q13.33 encompassing the SHANK3 gene, haploinsufficiency of which can lead to Phelan-McDermid syndrome. Both deletions were classified as pathogenic CNVs based on the guidelines of American College of Medical Genetics and Genomics (ACMG) and were not found in their parents.@*CONCLUSION@#The 6q14.2q15 deletion and 22q13-31q13.33 deletion probably underlay the developmental delay and intellectual disability in the two children, respectively. Haploinsufficiency of the ZNF292 gene may account for the key clinical features of the 6q14.2q15 deletion.
Subject(s)
Humans , Child , Female , Child, Preschool , Intellectual Disability/genetics , Comparative Genomic Hybridization , Chromosome Disorders/genetics , Chromosome Deletion , Magnetic Resonance Imaging , Chromosomes, Human, Pair 22 , Developmental Disabilities/genetics , Carrier Proteins/genetics , Nerve Tissue Proteins/geneticsABSTRACT
ABSTRACT The development of the human nervous system makes up a series of fundamental and interdependent events involving birth, growth, and neuronal maturation, in addition to the positive or negative selection of synapses of these neurons that will participate in the composition of neural circuits essential to the activity of the nervous system. In this context, where environment and social relationships seem to be relevant markers for neurodevelopment, advanced neuroimaging techniques and behavioral assessment tools have demonstrated alterations in brain regions and cognitive functions among children developing in low or high socioeconomic status environments. Considering the aspects mentioned, this review aimed to identify the importance of socioeconomic status in children's brain development, seeking to identify what are the impacts of these factors on the morphological and physiological formation of the nervous system, allowing a greater understanding of the importance of environmental factors in neurodevelopmental processes.
RESUMO O desenvolvimento do sistema nervoso humano compõe uma série de eventos fundamentais e interdependentes envolvendo o nascimento, crescimento e maturação neuronal, além da seleção positiva ou negativa de sinapses desses neurônios que participarão da composição de circuitos neurais essenciais à atividade do sistema nervoso. Nesse contexto, em que o ambiente e as relações sociais parecem ser marcadores relevantes para o neurodesenvolvimento, técnicas avançadas de neuroimagem e ferramentas de avaliação comportamental têm demonstrado alterações em regiões cerebrais e funções cognitivas em crianças que se desenvolvem em ambientes de baixo ou alto nível socioeconômico. Considerando os aspectos mencionados, esta revisão teve como objetivo identificar a importância do status socioeconômico no desenvolvimento cerebral infantil, buscando identificar quais são os impactos desses fatores na formação morfológica e fisiológica do sistema nervoso, permitindo maior compreensão da importância dos fatores ambientais nos processos de neurodesenvolvimento.
Subject(s)
Humans , Developmental Disabilities , Child Development , Cognitive DysfunctionABSTRACT
O presente artigo tem como objetivo apresentar a construção metodológica desenvolvida em uma pesquisa de mestrado, na qual sustentamos a escrita de cenas como método de pesquisa da escuta clínica. As cenas do trabalho em questão foram recolhidas ao longo do tempo, no contorno da experiência de um projeto de extensão universitária de atenção à infância e adolescência em situação de vulnerabilidade social, situado em uma comunidade periférica. Apresentamos, neste texto, as interrogações que se elaboraram em torno da escolha pelo trabalho com cenas, e compartilhamos o resgate histórico dessas como um método de escrever a clínica, bem como a retomada de sua análise a partir da tradição psicanalítica. Amparadas nesta teoria e em leituras e contribuições do filósofo francês Jacques Derrida, embasamos a noção de que a cena se constitui como um lugar de produção, ao engendrar a configuração particular de elementos significantes nos processos de subjetivação e de construção social. A cena não é, então, compreendida aqui como uma representação do que acontece na clínica, mas como um modo de produzir a escuta e os seus processos de investigação.(AU)
This article aims to present the methodological construction developed in a master's research, in which the writing of scenes as a method of clinical listening research was endorsed. The scenes from the study in question were collected over time, from the experience gained in a project conducted within a university extension program on care in childhood and adolescence in social vulnerability, in a peripheral community. In this study, we present some questions that were elaborated surrounding the choices of working with scenes; and we share the historical rescue of this work as a method of writing on clinic practices and resuming their analysis from the psychoanalytic tradition. Based on the psychoanalytic theory and on the readings and contributions of the French philosopher Jacques Derrida, we corroborate the notion that the scene is constituted as a place of production, engendering the particular configuration of significant elements in the processes of subjectivation and social construction. Here, the scene is not a representation of clinical practice but one mode of producing listening and its research processes.(AU)
Este artículo tiene como objetivo presentar la construcción metodológica desarrollada en una investigación de maestría, en la que sostenemos la escritura de escenas como método de investigación de la escucha clínica. Las escenas del trabajo en cuestión se recogieron a lo largo del tiempo desde la experiencia en un proyecto de extensión universitario de atención a la niñez y adolescencia en situación de vulnerabilidad social aplicado en una comunidad periférica. En este texto, presentamos los interrogantes que se elaboraron en torno a la elección por el trabajo con escenas y compartimos el rescate histórico de las mismas como un método de escribir la clínica y la reanudación del análisis a partir de la tradición psicoanalítica. Amparadas en el psicoanálisis y en lecturas y contribuciones del filósofo francés Jacques Derrida, nos basaremos en la noción de que la escena se constituye como un lugar de producción, engendrando la configuración particular de elementos significantes en los procesos de subjetivación y de construcción social. La escena no es aquí una representación de lo que pasa en la clínica, sino un modo de producir escucha y sus procesos de investigación.(AU)
Subject(s)
Humans , Female , Child, Preschool , Psychoanalysis , Child , Child Welfare , Equipment and Supplies , Methodology as a Subject , Meals , Social Vulnerability , Parapsychology , Parent-Child Relations , Parents , Paternity , Play and Playthings , Play Therapy , Poverty , Psychological Phenomena , Psychological Theory , Psychology , Psychology, Clinical , Reality Therapy , Scapegoating , Schools , Sibling Relations , Social Class , Social Isolation , Social Justice , Social Responsibility , Social Support , Social Work , Speech , Superego , Unconscious, Psychology , Behavior , Poverty Areas , Solid Waste Use , Child, Abandoned , Child Abuse , Child Advocacy , Child Care , Child Development , Developmental Disabilities , Residence Characteristics , Hygiene , Child Health , Liability, Legal , Adolescent , Parenting , Clinical Clerkship , Comprehensive Health Care , Consciousness , Life , Crime , Crisis Intervention , Affect , Culture , Narration , Diapers, Infant , Research Subjects , Aggression , Human Rights Abuses , Dreams , Education , Ego , Employment , Job Market , Ethics , Child Nutrition , Bullying , Social Marginalization , Child, Foster , Social Privilege , Freedom , Freudian Theory , Economic Status , Respect , Clinical Decision Rules , Social Inclusion , Housing Instability , Low Socioeconomic Status , History , Human Rights , Id , Functional Laterality , Love , Memory , Memory, Short-Term , Morale , NamesABSTRACT
Este artigo pretende conhecer como a rede de cuidados em saúde tem se operacionalizado a partir da percepção de familiares de crianças com demanda de cuidado em saúde mental (SM). Foram realizados dois grupos focais, um com familiares da Atenção Básica (AB) e outro com familiares do Centro de Atenção Psicossocial Infantojuvenil (CAPSij), totalizando 15 participantes. Seguiu-se com a análise lexical do tipo classificação hierárquica descendente, com o auxílio do software R Interface, a fim de análises multidimensionais de textos e questionários (IRaMuTeQ), resultando em cinco classes: A Pílula Mágica; Forças e Fraquezas dos serviços; Procurando por ajuda; Aceitando o diagnóstico da criança e Onde procurei ajuda. Os resultados apontam para dificuldades presentes na AB em identificar e manejar situações de Saúde Mental Infantojuvenil (SMIJ), por meio de uma lógica ainda medicalizante. Ressalta-se que a escola é apresentada como lugar de destaque na produção da demanda por cuidado e a família ainda é pouco convocada à construção das ações. Conclui-se, então, que avanços ainda são necessários para operacionalização de um cuidado pautado nas diretrizes da política de SMIJ.(AU)
This article aims to know how the healthcare network has been operationalized from the perception of family members of children with demand for mental health care (MH). Two focus groups were held, one with family members from Primary Care (PC) and the other with family members from the Child Psychosocial Care Center (CAPSij), totaling 15 participants. A lexical analysis of the descending hierarchical classification type was performed with the help of the software R Interface for multidimensional analyzes of texts and questionnaires (IRAMUTEQ), resulting in five classes: The Magic Pill; Strengths and Weaknesses of services; Looking for help; Accepting the child's diagnosis; and Where did I look for help. The results point to difficulties present in PC in identifying and managing situations of mental health in children and adolescents (MHCA), with a medicalization logic. Note that the school is presented as a prominent place in producing the demand for care, and the family is still not very much involved in the actions. It is, thus, concluded that advances are still needed for operationalization of care guided by MHCA policy guidelines.(AU)
Este artículo tuvo por objetivo conocer cómo opera una red asistencial a partir de la percepción de familiares de niños con demanda de atención en salud mental (SM). Se realizaron dos grupos focales, uno con familiares de Atención Primaria (AP) y otro con familiares del Centro de Atención Psicosocial Infantojuvenil (CAPSij), totalizando 15 participantes. Se realizó análisis léxico del tipo clasificación jerárquica descendente con la ayuda del software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRAMUTEQ), lo que resultó en cinco clases: "La píldora mágica"; "Fortalezas y debilidades de los servicios"; "En busca de ayuda"; "Aceptar el diagnóstico del niño" y "¿Dónde busqué ayuda?". Los resultados apuntan las dificultades presentes en AP para identificar y manejar situaciones de salud mental infantojuvenil (SMIJ) mediante una lógica aún medicalizante. La escuela tiene un lugar destacado en la producción de la demanda de cuidados y la familia aún no está muy involucrada en la construcción de acciones. Se concluye que se necesitan avances para ofertar una atención guiada por lineamientos de la política del SMIJ.(AU)
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adult , Middle Aged , Young Adult , Child , Adolescent , Intersectoral Collaboration , Mental Health Assistance , Health Policy , Anxiety Disorders , Parents , Patient Escort Service , Pediatrics , Play and Playthings , Play Therapy , Prejudice , Professional-Family Relations , Professional-Patient Relations , Proprioception , Psychoanalysis , Psychology , Psychomotor Disorders , Psychotherapy , Psychotic Disorders , Referral and Consultation , Attention Deficit Disorder with Hyperactivity , Self Care , Autistic Disorder , Social Alienation , Social Environment , Social Isolation , Social Support , Socialization , Pathological Conditions, Signs and Symptoms , Therapeutics , Violence , Mainstreaming, Education , Shyness , Neurosciences , Adaptation, Psychological , Patient Acceptance of Health Care , Health Centers , Cognitive Behavioral Therapy , Comorbidity , Child Advocacy , Child Behavior Disorders , Child Care , Child Development , Developmental Disabilities , Child Language , Occupational Therapy , Cognition , Communication Disorders , Neurobehavioral Manifestations , Stereotypic Movement Disorder , Behavioral Disciplines and Activities , Disabled Children , Affect , Crying , Aggression , Dermatitis, Contact , Diagnosis , Dissociative Disorders , Dyslexia , Echolalia , Education , Education of Intellectually Disabled , Education, Special , Emotions , Family Conflict , Speech, Language and Hearing Sciences , Medication Adherence , Apathy , Acceptance and Commitment Therapy , Emotional Adjustment , Literacy , Neurodevelopmental Disorders , Autism Spectrum Disorder , Orientation, Spatial , Applied Behavior Analysis , Cognitive Remediation , Emotion-Focused Therapy , Pediatricians , Data Analysis , Sadness , Psychological Distress , Social Interaction , Health Services Accessibility , Human Rights , Hyperkinesis , Intelligence , Interpersonal Relations , Anger , Language Disorders , Learning , Learning Disabilities , Loneliness , Malpractice , Mental Disorders , Intellectual Disability , Nervous System Diseases , Obsessive-Compulsive DisorderABSTRACT
O objeto de estudo deste trabalho é a atuação de psicólogas(os) no campo da educação básica. Tivemos como objetivo investigar as práticas de atuação e os desafios enfrentados pelas(os) psicólogas(os) que trabalham na educação em Boa Vista (RR), com intuito de conhecer a inserção desses profissionais no sistema educacional. Trata-se de pesquisa qualitativa, orientada pelo referencial teórico-metodológico da Psicologia Escolar Crítica. Realizamos o processo de levantamento dos dados entre os meses de março e abril de 2018, por meio de entrevistas semiestruturadas, audiogravadas e transcritas. Encontramos 21 psicólogas e um psicólogo trabalhando em instituições educacionais e de ensino na cidade; a maioria atuava na educação básica; metade dos entrevistados ingressou por concurso público e a outra metade era contratada e comissionada; poucos(as) foram contratados(as) como psicólogos(as) escolares. Para a análise, selecionamos dez psicólogas(os) com mais tempo no cargo. Quanto às práticas de atuação, identificamos que 60% atuavam na modalidade clínica e 40% na modalidade clínica e institucional. Como desafios, encontramos melhoria das condições de trabalho; estabelecimento de relações hierárquicas e a dificuldade de fazer compreender as especificidades desse campo de trabalho; necessidade na melhoria das condições para formação continuada; atuação da(o) psicóloga(o) escolar enquanto ação institucional. Diante do exposto, compreendemos ser necessária uma mudança de paradigma na atuação das(os) psicólogas(os) que trabalham na educação na região, e a apropriação das discussões da área, principalmente, aquelas apresentadas pela Psicologia Escolar Crítica, vez que esta contribui para uma atuação que leve em conta os determinantes sociais, políticos, culturais e pedagógicos que constituem o processo de escolarização.(AU)
This work has as object of study the role of psychologists in the field of Basic Education. We aimed to investigate practices and challenges faced by psychologists who work in education in Boa Vista/RR, to know the insertion of these professionals in the educational system. This is a qualitative research, guided by the theoretical-methodological framework of Critical School Psychology. The data collection process was carried out between March and April 2018, with semi-structured, audio-recorded, and transcribed interviews. We found 21 female psychologists and one male psychologist working in educational institutions in the municipality; most worked in Basic Education; half of the interviewees had applied to work as government employee and the other half were hired and commissioned; few were hired as school psychologists. To carry out the analysis, we selected ten psychologists with more time in the position. Regarding the practices, we have identified that 60% worked in the clinical modality and 40% in the clinical and institutional modality. As challenges, we find the improvement in working conditions; the establishment of hierarchical relationships and the difficulty of making the specificities of this field of work understood; the need to improve conditions for continuing education; the practice of the school psychologist as institutional action. In view of the above, we understand that a paradigm shift in the performance of psychologists working in education in that region is necessary, and the appropriation of discussions in the area, especially those presented by Critical School Psychology, contributes to an action that considers social, political, cultural, and pedagogical determinants that constitute the schooling process.(AU)
Este trabajo tiene como objeto de estudio la actuación profesional de las(os) psicólogas(os) en la educación básica. Su objetivo es investigar las prácticas y retos que enfrentan las(os) psicólogas(os) que trabajan en la educación en Boa Vista, en Roraima (Brasil), con la intención de conocer la inserción de estos profesionales en el sistema educativo. Esta es una investigación cualitativa que se guía por el marco teórico-metodológico de la Psicología Escolar Crítica. Se recopilaron los datos entre los meses de marzo y abril de 2018, mediante entrevistas semiestructuradas, grabadas en audio y después transcritas. Las 21 psicólogas y un psicólogo trabajan en instituciones educativas de la ciudad; la mayoría trabajaba en la educación básica; la mitad de los entrevistados ingresaron mediante concurso público y la otra mitad era contratada y de puesto comisionado; pocos fueron contratados como psicólogos escolares. Para el análisis, se seleccionaron diez psicólogas(os) con más tiempo en el cargo. Con respecto a las prácticas, el 60% trabajaba en la modalidad clínica; y el 40%, en la modalidad clínica e institucional. Los retos son mejora de las condiciones laborales; establecimiento de relaciones jerárquicas y dificultad para comprender las especificidades de este campo de trabajo; necesidad de mejorar las condiciones para la educación continua; y actuación dela (del) psicóloga(o) escolar como acción institucional. En vista de lo anterior, es necesario el cambio de paradigma en la práctica profesional de las(os) psicólogas(os) que trabajan en la educación de la región y la apropiación de las discusiones del área, especialmente las presentadas por la Psicología Escolar Crítica, que contribuye a una acción que tiene en cuenta los determinantes sociales, políticos, culturales y pedagógicos que constituyen el proceso de escolarización.(AU)
Subject(s)
Humans , Male , Female , Psychology, Educational , Schools , Education, Primary and Secondary , Pathology , Aptitude , Play and Playthings , Play Therapy , Prejudice , Psychology , Psychology, Applied , Psychology, Clinical , Psychomotor Performance , Public Policy , Quality of Life , Remedial Teaching , Attention Deficit Disorder with Hyperactivity , School Health Services , Autistic Disorder , Social Adjustment , Social Change , Social Environment , Social Isolation , Social Values , Socialization , Student Dropouts , Students , Pathological Conditions, Signs and Symptoms , Task Performance and Analysis , Thinking , Underachievement , Behavior , Mainstreaming, Education , Mentors , Adaptation, Psychological , Family , Child Advocacy , Developmental Disabilities , Child Guidance , Child Rearing , Mental Health , Child Health , Mental Competency , Public Sector , Practice Guidelines as Topic , Disabled Persons , Interview , Cognition , Communication , Communication Disorders , Problem-Based Learning , Community Participation , Behavioral Disciplines and Activities , Counseling , Creativity , Growth and Development , Dyslexia , Education of Intellectually Disabled , Education, Special , Educational Measurement , Educational Status , Projects , Ethics, Institutional , Information Technology , Faculty , Resilience, Psychological , Musculoskeletal and Neural Physiological Phenomena , Bullying , Medicalization , Neurodevelopmental Disorders , Academic Failure , School Mental Health Services , Psychosocial Functioning , Social Vulnerability , Health Services Needs and Demand , Holistic Health , Human Development , Human Rights , Individuality , Intelligence , Interpersonal Relations , Learning , Learning Disabilities , Medical History Taking , Memory , Mental Disorders , MotivationABSTRACT
El presente trabajo se ocupa de evaluar posibilidades del método de observación aplicado al análisis de estrategias de resolución de problemas en niños con discapacidad mediante juegos y tareas estructuradas. El marco teórico de referencia de esta contribución está representado por la teoría de la resolución de problemas, que contiene los principales procesos que intervienen en la gestión de los problemas y que nosotros aplicamos al desarrollo cognitivo y metacognitivo atípico. Junto con tres tareas diferentes estructuradas(Torre de Hanoi, Tetris y Bloques de construcción), usamos dos listas de comportamientos para codificar estrategias de resolución de problemas adoptadas por niños y/o adolescentes con desarrollo atípico. La aplicación de este tipo de observación con el uso de listas de comportamientos podría ser útil para crear en relación entre la investigación cualitativa y cuantitativa para mejorar el conocimiento de las estrategias de resolución de problemas y competencias metacognitivas en niños desarrollados atípicos(AU)
This paper is concerned with evaluating the possibilities of the observational method applied to the analysis of problem-solving strategies in children with disabilities through structured tasks. The theoretical framework of reference for this contribution is represented by the theory of problem-solving, containing the main processes involved in problem management,which we apply to atypical cognitive and metacognitive development. Together with three different structured tasks (Tower of Hanoi, Tetris, and Building Blocks), we used two lists of behaviors to code problem-solving strategies adopted by children and/or adolescents with atypical development. The application of this type of observation with the use of lists of behaviors could be useful to create a link between qualitative and quantitative research to improve the knowledge of problem-solving strategies and metacognitive competencies in atypically developed children(AU)
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Problem Solving , Developmental Disabilities/psychology , Observation/methods , Disabled Children , Play Therapy , Child Behavior , Qualitative ResearchABSTRACT
RESUMEN INTRODUCCIÓN: Los aspectos narrativos del lenguaje constituyen una competencia en el desarrollo funcional de la comunicación, la cual predice el desempeño académico de los niños. En este trabajo se estudia la narrativa en niños con trastornos del desarrollo, a fin de hacer diagnósticos precoces y adoptar mejores estrategias terapéuticas. MATERIAL Y MÉTODO: Estudio controlado analítico de corte transversal. Se incluyen sujetos de 9 a 17 años, evaluados con la prueba de teoría de la mente (TOM) de Sally y Anne, quienes luego deben narrar la historia de la prueba. Se evaluó el número total de palabras (TP), la cantidad total de oraciones (TO), el promedio de palabras por oración (PPO), la sintaxis (S) y la capacidad expresar la idea central del relato (ICR). RESULTADOS: Participaron 61 sujetos. El grupo 1 o control con 24, el grupo 2 con 37 sujetos (con diagnóstico de trastorno por déficit de atención (TDA), trastorno de la lectoescritura (TLE), trastorno del espectro autista (TEA) y discapacidad intelectual (DI)). En teoría de la mente respondieron correctamente 18 participantes del grupo 1, 7 participantes con TDA, 4 de los TLE, 5 sujetos con DI y 3 sujetos con TEA. Los sujetos del grupo 2 presentaron distintos grados de dificultades narrativas según el trastorno. A mayor edad utilizaron mayor cantidad de palabras, sin distinción por sexo. CONCLUSIÓN: Es importante estudiar los aspectos narrativos del lenguaje en pediatría puesto que las habilidades requeridas incluyen aspectos estructurales del lenguaje y habilidades cognitivas que es necesario tener en cuenta para definir estrategias terapéuticas más precisas y acordes a las necesidades de este grupo de pacientes.
ABSTRACT INTRODUCTION: Narrative is a competence in the functional development of communication that predicts academic performance in children. We studied narrative in children with developmental disorders in order to develop better therapeutic strategies. METHODS: Cross-sectional analytical controlled study. We included subjects age 9 to 17 years old, evaluated with the Mind Theory Test (TOM) of Sally and Anne in which they have to repeat a story. We evaluated total number of words (TP), total number of sentences (TO), average words per sentence (PPO), syntax (S) and ability to express the central idea of the story (ICR). RESULTS: We included 61 subjects in two groups. Group 1 or control with 24, Group 2 with 37 subjects (with a diagnosis of attention deficit disorder (ADD), literacy disorder (TLE), autistic spectrum disorder (ASD), intellectual disability (ID)). TOM 3 was correctly answered by 18 subjects of Group 1, 7 of ADD, 4 of the TLE, 5 of the ID and 3 participants with TEA. The Group 2 presented different degrees of narrative difficulties. All children said more words when they grew up without distinction by gender. DISCUSSION: Children with developmental disorders present a lower performance in narrative aspects depending of the disorder, which allows to carry out therapeutic strategies according to their needs.
Subject(s)
Writing , Developmental Disabilities , Executive Function , LinguisticsABSTRACT
Introdução: A terapia Cuevas Medek Exercises (CME) é um método fisioterapêutico de manuseio sem comandos verbais, pois não busca reações voluntárias e, sim, acessar a via cortical involuntária. As correções dos movimentos acontecem pelo estímulo sensorial da mão do terapeuta. Objetivo: Avaliar o efeito da CME na displasia do desenvolvimento de quadril (DDQ) de uma paciente com paralisia cerebral (PC). Métodos: A pesquisa é caracterizada como estudo de caso, tendo como participante uma menina de seis anos com PC, tetraparesia e displasia bilateral de quadril. As intervenções começaram após avaliação desenvolvida pelo método CME, radiografia de quadril e classificação nos níveis do Sistema de Classificação da Função Motora Grossa (GMFCS). A criança foi submetida a terapia CME para tratar a DDQ durante 10 meses, totalizando 136 sessões (45 minutos cada), composta de quatro a seis exercícios repetidos, seis vezes em média. Foram registrados o tempo e/ou quantas repetições conseguiu realizar. Resultados: Evoluiu de 55 para 61 pontos no score do CME, melhorou sua idade motora e, na radiografia de quadril, o esquerdo passou de subluxado para quadril de risco. Conclusão: A paciente melhorou idade motora, controle de tronco e bipedestação, autonomia e encaixe do quadril em ambos os lados. (AU)