Growth Velocities Across Distinct Early Life Windows and Child Cognition: Insights from a Contemporary US Cohort.

OBJECTIVE: To evaluate the relative importance of overall and period-specific postnatal growth and their interaction with fetal growth on cognition in a generally well-nourished population. STUDY DESIGN: We included 1052 children from Project Viva, a prospective cohort in Boston, Massachusetts. Using linear spline mixed-effects models, we modeled length/height and body mass index (BMI) trajectories from birth to 7 years and estimated standardized overall (0-7 years) and period-specific growth velocities ie, early infancy (0-4 months), late infancy (4-15 months), toddlerhood (15-37 months), and early childhood (37-84 months). We investigated associations of growth velocities as well as their interactions with birthweight-for-gestational age on mid-childhood (mean age: 7.9 years) IQ, visual memory and learning, and visual motor ability. RESULTS: Greater overall height velocity was associated with modestly higher design memory score, (adjusted ß [95% CI] 0.19 [-0.01,0.38] P = .057])points per SD increase but lower verbal IQ (-0.88 [-1.76,0.00] P = .051). Greater early infancy height velocity was associated with higher visual motor score (1.92 [0.67,3.18]). Greater overall BMI velocity was associated with lower verbal IQ (-0.71 [-1.52,0.11] P = .090). Greater late infancy BMI velocity was associated with lower verbal IQ (-1.21 [-2.07,-0.34]), design memory score (-0.22 [-0.42,-0.03)], but higher picture memory score (0.22 [0.01,0.43]). Greater early infancy height velocity (-1.5 SD vs 1.5 SD) was associated with higher nonverbal IQ (margins [95% CI] 102.6 [98.9106.3] vs 108.2 [104.9111.6]) among small-for-gestational age infants (P-interaction = 0.04). CONCLUSIONS: Among generally well-nourished children, there might not be clear cognitive gains with faster linear growth except for those with lower birthweight-for-gestational age, revealing the potential importance of early infancy compensatory growth.

Teste de Bender: versão de rastreio para a avaliação da maturidade perceptomotora / Bender Test: screening version for evaluation of perceptive-motor maturity / Test de Bender: versión de rastreo para la evaluación de la madurez perceptomotora

Este estudo buscou evidências de validade de conteúdo e critério para a versão de rastreio do Bender - Sistema de Pontuação Gradual. Para isso, 693 crianças, ambos os sexos, com idades entre seis e 10 anos (M = 8,42; DP = 1,38) reproduziram a cópia de três figuras. Os resultados indicaram que a Figura 3 apresentou alto nível de dificuldade, sendo necessário maior nível de maturidade perceptomotora para sua execução. As Figuras 7a e 7b, embora apresentem sobreposição, foram mais fáceis de serem copiadas. Verificou-se que os erros de distorções na reprodução das figuras tendem a diminuir gradualmente conforme aumenta a idade das crianças. Observou-se que as três figuras não apresentam funcionamento diferencial dos itens entre meninas e meninos, além disso também não foram encontradas diferenças de média de desempenho. Esses achados sugerem que a versão de rastreio é uma proposta promissora para ser utilizada na avaliação da maturidade perceptomotora. (AU)

This study sought evidence of content and criteria validity for the screening version of the Bender - Gradual Scoring System. For this, 693 children of both sexes, between 6 and 10 years of age (M = 8.42; SD = 1.38), reproduced three figures. The results indicated that Figure 3 had a greater level of difficulty, with a greater level of perceptive-motor maturity required for its execution. Figures 7a and 7b, although overlapping, were easier to reproduce. It was found that the errors of distortions in the reproduction of figures tended to gradually decrease as the child's age increased. Another point observed was that the three figures did not present differential functioning for the items between girls and boys, nor were any mean performance differences found. These findings suggest that the screening version is a promising proposition for use in the evaluation of perceptive-motor maturity. (AU)

El estudio buscó evidencias de validez de contenido y criterio para la versión de rastreo del Bender - Sistema de Puntuación Gradual. Por esto, participaron 693 niños de ambos sexos con edades entre 6 y 10 años (M= 8,42; DP = 1,38), que reprodujeron la copia de tres figuras. Los resultados indicaron que la Figura 3 presentó alto nivel de dificultad, siendo necesario un mayor nivel de madurez perceptiva para su ejecución. Las Figuras 7a y 7b, aunque presentaban superposición, fueron más fáciles de dibujar. Se verificó que los errores de distorsión en la reproducción de las figuras tienden a disminuir gradualmente según aumenta la edad de los niños. Otro punto observado fue que las tres figuras no presentan funcionamiento diferencial entre las niñas y niños, además tampoco se encontraron diferencias de promedio de rendimiento. Estos hallazgos sugieren que la versión de rastreo es una propuesta oportuna para ser usada en la evaluación de la madurez perceptiva. (AU)

Uncovering neurodevelopmental windows of susceptibility to manganese exposure using dentine microspatial analyses.

BACKGROUND: Associations between manganese (Mn) and neurodevelopment may depend on dose and exposure timing, but most studies cannot measure exposure variability over time well. OBJECTIVE: We apply temporally informative tooth-matrix biomarkers to uncover windows of susceptibility in early life when Mn is associated with visual motor ability in childhood. We also explore effect modification by lead (Pb) and child sex. METHODS: Participants were drawn from the ELEMENT (Early Life Exposures in MExico and NeuroToxicology) longitudinal birth cohort studies. We reconstructed dose and timing of prenatal and early postnatal Mn and Pb exposures for 138 children by analyzing deciduous teeth using laser ablation-inductively coupled plasma-mass spectrometry. Neurodevelopment was assessed between 6 and 16 years of age using the Wide Range Assessment of Visual Motor Abilities (WRAVMA). Mn associations with total WRAVMA scores and subscales were estimated with multivariable generalized additive mixed models. We examined Mn interactions with Pb and child sex in stratified models. RESULTS: Levels of dentine Mn were highest in the second trimester and declined steeply over the prenatal period, with a slower rate of decline after birth. Mn was positively associated with visual spatial and total WRAVMA scores in the second trimester, among children with lower (< median) tooth Pb levels: one standard deviation (SD) increase in ln-transformed dentine Mn at 150 days before birth was associated with a 0.15 [95% CI: 0.04, 0.26] SD increase in total score. This positive association was not observed at high Pb levels. In contrast to the prenatal period, significant negative associations were found in the postnatal period from ~ 6 to 12 months of age, among boys only: one SD increase in ln-transformed dentine Mn was associated with a 0.11 [95% CI: - 0.001, - 0.22] to 0.16 [95% CI: - 0.04, - 0.28] SD decrease in visual spatial score. CONCLUSIONS: Using tooth-matrix biomarkers with fine scale temporal profiles of exposure, we found discrete developmental windows in which Mn was associated with visual-spatial abilities. Our results suggest that Mn associations are driven in large part by exposure timing, with beneficial effects found for prenatal levels and toxic effects found for postnatal levels.

The Bicycle Drawing Test: What Does It Measure in Developmentally Typical Children?

To verify the dimensionality of Bicycle Drawing Test (BDT), we applied the coding system of Greenberg, Rodriguez, and Sesta to bicycle drawings made by 295 boys and 320 girls (6-10 years old) with typical development, and submitted the data to item analysis, exploratory factor analysis, and confirmatory factor analysis. These analyses confirmed only two of the original four dimensions of the BDT: spatial reasoning and visual-motor control. The scores in these two factors were correlated with the Colored Progressive Matrices, the Rey Complex Figure (Copy and Memory) and with the teachers' ratings in mathematics, language, and drawing. The correlations, albeit moderate in magnitude, were consistent with the hypothesized convergent and discriminant validity. After checking for measurement invariance across gender and age, we conducted two analyses of variance, the first of which showed a significant difference between younger children (6-8 years old) and older children (9-10 years old); the analysis of variance by gender did not yield significant differences. These data enhance the usefulness of the BDT as a measure of separate cognitive components, but do not support its use as a measure of mechanical reasoning.

Impaired cognitive functions in adult-onset primary cranial cervical dystonia.

BACKGROUND: Adult-onset primary dystonia is thought to be a purely motor disorder. Nevertheless, several studies provided evidence that sensory and psychiatric disturbances may contribute to the clinical spectrum of of dystonia, whereas evidence supporting cognitive impairment is still limited. METHODS: A set of neuropsychological tests was administered to non depressed, non demented patients with cranial-cervical dystonia and healthy control subjects. The test battery included n-Back Task, Wechsler Memory Scale, Trail Making Test version A and B, and Wisconsin Card Sorting Test. RESULTS: As compared with healthy control subjects of similar age, sex and socio-economic status, patients with cranial-cervical dystonia showed deficit on working memory functions revealed by n-Back task, impairment of mental control and visual reproduction subtests of Wechsler memory scale, deficit on information processing speed and set-shifting capacity revealed by Trail Making Test A and B. CONCLUSION: Patients with cranial-cervical dystonia may have impairment in specific cognitive domains relative to working memory, processing speed, visual motor ability and short term memory. Probably, these deficits are not dependent on the clinical expression of dystonia but might rather reflect the cortical and subcortical changes highlighted by functional and VBM imaging studies in patients with different forms of dystonia.

Habilidad viso-motriz y deficiencia intelectual: estudio de validez para el Bender-SPG / Visual motor ability and intellectual disabilities: validity study of the Bender-SPG / Habilidade viso-motriz e deficiência intelectual: estudo de validade para o Bender-SPG

Este trabajo tuvo por objetivo establecer la evidencia de validez convergente por medio del análisis de la asociación entre el la Prueba Gestáltica Viso-Motriz de Bender-Sistema de Puntuación Gradual (B-SPG), el Dibujo de la Figura Humana-Escala Sisto (DFH) y las Matrices Progresivas Coloridas de Raven (CPM). Participaron en el estudio 397 personas, entre los seis y 24 años de edad, con deficiencia intelectual. Los datos fueron obtenidos en la escuela de los niños y de forma individual. Los resultados indicaron una correlación de magnitud moderada entre los tests, confirmando la evidencia de validez para el B-SPG. Además, al comparar los resultados con los baremos de los tres tests se verificó que el desempeño de los sujetos de esta investigación estuvo muy debajo de lo esperado, una vez que el resultado fue semejante o inferior al de niños de seis años de los baremos que aparecen en los manuales de los tests.

This study aimed to establish evidence of convergent validity through the analysis of the association between the Bender Visual-Motor Gestalt Test -Gradual Scoring System (B-SPG, for its Spanish acronym), the Human Figure Drawing Test - Sisto's Scale (DFH for its Spanish acronym) and the Colorful Raven's Progressive Matrices (CPM).The participants in the study were 397 individuals, aged between 6 and 24 years old, who showed intellectual impairment. Data were gathered on an individual basis at the school these people attended. Results indicated a moderate magnitude correlation between the tests, thus confirming validity evidence for B-SPG. Moreover, when comparing the results with the scales of the three tests it was verified that the performance of the participants in this research was well below expectations, since the scores obtained were similar to or lower than those of children six years old of the scales contained in the testing manuals.

Este trabalho teve como objetivo estabelecer a evidência de validade convergente por meio da análise da associação entre o Teste Gestáltico Visomotor de Bender-Sistema de Pontuação Gradual (B-SPG), o Desenho da Figura Humana-Escala Sisto (DFH) e as Matrizes Progressivas Coloridas de Raven (CPM). Participaram no estudo 397 pessoas, entre seis e vinte e quatro anos de idade, com deficiência intelectual. Os dados foram obtidos na escola das crianças e de forma individual. Os resultados indicaram uma correlação de magnitude moderada entre os testes, confirmando a evidência de validade para o B-SPG. Além disso, ao comparar os resultados com parâmetros dos três testes verificou-se que o desempenho dos sujeitos desta pesquisa esteve muito abaixo do esperado, já que o resultado foi similar ou inferior ao de crianças de seis anos dos parâmetros que aparecem nos manuais dos testes.