Association between parents' concerns about eating and sleeping problems and social-emotional development in Chinese children aged 3 to 6 years.

Background: Parents' parenting beliefs have a major influence on their children's eating and sleeping problems and emotional socialization. However, the relationship between parent's concerns about eating or sleeping problems and social-emotional development is unclear. Methods: We used a convenience sampling method to investigate 997 parents of preschool children aged 3 to 6 in Hangzhou, China, and asked them to complete the "Ages & Stages Questionnaire: Social-Emotional (2nd Edition)" (ASQ: SE-2) and the Survey of Concerns about Children's Eating and Sleeping Problems. To examine the relationship between children's social-emotional development and their parents' concerns about their eating or sleeping problems, binary logistic regression was used. Results: There were 218 children (21.9%) with a suspected social-emotional development delay, and 273 parents (27.4%) were concerned about their children's eating or sleeping problems, which mainly focused on ill-balanced eating, bad eating habits, and difficulty falling asleep. The rate of suspected social-emotional development delay in children with the co-occurrence of eating and sleeping problems (37.8%) was significantly higher than those with only eating problems (29.7%), only sleeping problems (24.4%), and those with no eating or sleeping problems (18.8%) (p < 0.05). A binary logistic regression analysis showed that parents' concerns about the co-occurrence of eating and sleeping problems (OR = 2.52, p = 0.01) and only eating problems (OR = 1.71, p = 0.004) were risk factors for children's social-emotional development. In addition, boys were more likely than girls to have suspected social-emotional development delay (OR = 1.49, p = 0.01). Conclusion: Children whose parents were concerned about only eating or the co-occurrence of eating and sleeping problems were linked to have a higher risk of suspected social-emotional development delay.

Advances in the Diagnosis and Treatment of Autism Spectrum Disorders in Children.

Objective: This study aims to review recent developments in the diagnosis and treatment of Autism Spectrum Disorder (ASD )and provide insights for its clinical management. Methods: The literatures were researched fro the pubmed, Wanfang and CNKI. We searched for research on the etiology, pathogenesis, diagnosis (screening and evaluation), and treatment of Autism spectrum disorder. When selecting papers to be included, priority should be given to randomized clinical trials, systematic evaluations, meta-analyses, clinical practice guidelines, and articles related to general medical readers. Results: ASD is a widely present neurodevelopmental disorder characterized by social and communication difficulties, narrow interests, and repetitive behavior, accompanied by symptoms such as irritability, self-harm, attention deficit hyperactivity disorder (ADHD), and sleep problems. Irritability, self-harm, ADHD, and sleep problems are common accompanying symptoms that contribute to the challenges faced by individuals with ASD. At present, there is no fully effective treatment method for ASD, and key factors affecting the prognosis of ASD include early diagnosis time, early language communication level, intelligence level, disease severity, comorbidities, family participation, appropriate intervention, and social support. Therefore, early individualized long-term comprehensive training and drug therapy, hyperbaric oxygen therapy, and combined family participation can improve the prognosis of pediatric patients. Before selecting treatment plans for children, collecting as much information as possible about various treatment methods and choosing personalized treatment plans based on the child's developmental assessment level is necessary. In addition, the treatment of ASD is also influenced by factors such as family economic status, parental mentality, and social environment. During the training process, it is important to be family-centered, tolerant, and understand children's behavior. Conclusion: It is significant to take effective treatment measures to improve the quality of life and prognosis of children with autism spectrum disorders.

Timing of iron deficiency and recognition memory in infancy.

Objective: To determine the relationship between iron deficiency (or iron-deficient, ID) and neural correlates of recognition memory depending on ID timing (gestation vs. infancy) and infant age at testing (9 vs. 18 months).Study design: Event-related potentials (ERP) were used in a visual recognition memory task (mother vs. stranger face) to compare healthy term infants according to iron status at birth and 9 months. Fetal-neonatal ID was defined as cord serum ferritin < 75 µg/l or zinc protoporphrin/heme ratio > 118 µmol/mol, postnatal ID as ≥ 2 abnormal iron measures at 9 months with normal cord-blood iron status, and iron-sufficient as not ID at birth or 9 months. Recognition of mother faces was measured by negative component (Nc) and late slow wave (LSW). These ERP components reflect attention and memory updating processes, respectively.Results: All groups showed differences in Nc amplitude elicited by mother and stranger faces at 9 months. At 18 months, only postnatal ID and iron-sufficient groups showed condition differences in Nc amplitude. However, the 2 groups were different in the involved brain regions. For LSW, only the 2 ID groups showed condition differences in amplitude at 9 months. At 18 months, condition differences were not observed in any group.Conclusions: This study indicates that the timing of ID in early life (fetal-neonatal vs. postnatal) modulates the impact of ID on recognition memory. Such impact also varies depending on the age of infants at testing (9 vs. 18 months).

A Research on Developmental Characteristics of Children With Language Delay in Zhejiang Province, China.

Study Design: We used Sign-significant relations (S-S) to assess the developmental characteristics of 1- to 4-year-old children with language delays in Zhejiang Province and to provide scientific basis for early clinical detection and comprehensive intervention. Methods: A total of 1,113 children among the ages of 1 and 4 who complained of poor language skills were assessed in language competence using S-S. These children diagnosed with language delays were divided into six groups, with each group having an age difference of 6 months. The developmental characteristics of each group were described and analyzed. Results: (1) Children from the age of 18 to 36 months were most likely to be affected by language problems, while boys were more susceptible than girls in each group. (2) There was no significant difference in the proportion of children with poor communication attitude among the groups. (3) The older the group, the higher the proportion of basic learning ability abnormality. The cutoff age for qualitative leap in the proportion of basic learning abilities was 2 years old. (4) With the increase of age, the proportion of abnormal language comprehension in each group increased gradually. The cutoff age for qualitative leap in the proportion of language comprehension was 1.5 and 2 years old. Conclusion: Language delays usually occur in children around the age of two, and as the children get older, in addition to expression of language abilities, they are more likely to have abnormal language comprehensive abilities and abnormal basic learning abilities. Based on the clinical research, we must take seriously the early screenings for this age group and conduct intervention training as soon as possible.

Vitamin D ameliorates adipose browning in chronic kidney disease cachexia.

Patients with chronic kidney disease (CKD) are often 25(OH)D3 and 1,25(OH)2D3 insufficient. We studied whether vitamin D repletion could correct aberrant adipose tissue and muscle metabolism in a mouse model of CKD-associated cachexia. Intraperitoneal administration of 25(OH)D3 and 1,25(OH)2D3 (75 µg/kg/day and 60 ng/kg/day respectively for 6 weeks) normalized serum concentrations of 25(OH)D3 and 1,25(OH)2D3 in CKD mice. Vitamin D repletion stimulated appetite, normalized weight gain, and improved fat and lean mass content in CKD mice. Vitamin D supplementation attenuated expression of key molecules involved in adipose tissue browning and ameliorated expression of thermogenic genes in adipose tissue and skeletal muscle in CKD mice. Furthermore, repletion of vitamin D improved skeletal muscle fiber size and in vivo muscle function, normalized muscle collagen content and attenuated muscle fat infiltration as well as pathogenetic molecular pathways related to muscle mass regulation in CKD mice. RNAseq analysis was performed on the gastrocnemius muscle. Ingenuity Pathway Analysis revealed that the top 12 differentially expressed genes in CKD were correlated with impaired muscle and neuron regeneration, enhanced muscle thermogenesis and fibrosis. Importantly, vitamin D repletion normalized the expression of those 12 genes in CKD mice. Vitamin D repletion may be an effective therapeutic strategy for adipose tissue browning and muscle wasting in CKD patients.

Iron overload is related to elevated blood glucose levels in obese children and aggravates high glucose-induced endothelial cell dysfunction in vitro.

INTRODUCTION: This study was performed to investigate the role of iron overload in the early stage of hyperglycemia-induced vascular functional impairment. RESEARCH DESIGN AND METHODS: A total of 196 obese children were enrolled, and data regarding ferritin levels, blood glucose levels, intima-media thickness of carotid arteries, liver function and fibrosis index, hemoglobin, blood pressure, blood lipids, and inflammation indicators were collected. Ferritin levels were compared with a control group, which consisted of 148 healthy non-obese children who were age-matched and gender-matched. Endothelial cells were cultured in high glucose medium and supplemented with ferric citrate with or without iron remover (deferoxamine), a reducing agent (N-acetyl-cysteine), or a nuclear factor-κB (NF-κB) inhibitor (BAY 11-7082). Apoptosis, oxidative stress, nitric oxide levels, and endothelin content were evaluated. DNA microarray analysis was performed to analyze the expression of genes in the NF-κB signaling pathway. RESULTS: Obese children have significantly higher ferritin levels compared with the control group. Ferritin level was positively correlated with hemoglobin and was related to metabolic disorders, including impaired glucose tolerance, higher blood pressure, dyslipidemia, and impaired hepatic function. Endothelial cells treated with ferric citrate showed a significantly higher rate of apoptosis, higher levels of oxidative stress, and impaired vasomotor function under high glucose conditions. The above effects were rescued by treatment with an iron remover, reducing agent, or NF-κB inhibitor. Further, detection of phosphorylated-p65 distribution in cells confirmed activation of the NF-κB pathway. DNA microarrays and subsequent gene oncology enrichment analyses revealed the main processes activated in cells. CONCLUSION: Increased ferritin levels are related to impaired glucose tolerance and other metabolic disorders in obese children. At the cellular level, iron overload aggravated the endothelial cell dysfunction caused by high glucose.

Vitamin D repletion ameliorates adipose tissue browning and muscle wasting in infantile nephropathic cystinosis-associated cachexia.

BACKGROUND: Ctns-/- mice, a mouse model of infantile nephropathic cystinosis, exhibit hypermetabolism with adipose tissue browning and profound muscle wasting. Ctns-/- mice are 25(OH)D3 and 1,25(OH)2 D3 insufficient. We investigated whether vitamin D repletion could ameliorate adipose tissue browning and muscle wasting in Ctns-/- mice. METHODS: Twelve-month-old Ctns-/- mice and wild-type controls were treated with 25(OH)D3 and 1,25(OH)2 D3 (75 µg/kg/day and 60 ng/kg/day, respectively) or an ethylene glycol vehicle for 6 weeks. Serum chemistry and parameters of energy homeostasis were measured. We quantitated total fat mass and studied expression of molecules regulating adipose tissue browning, energy metabolism, and inflammation. We measured lean mass content, skeletal muscle fibre size, in vivo muscle function (grip strength and rotarod activity), and expression of molecules regulating muscle metabolism. We also analysed the transcriptome of skeletal muscle in Ctns-/- mice using RNAseq. RESULTS: Supplementation of 25(OH)D3 and 1,25(OH)2 D3 normalized serum concentration of 25(OH)D3 and 1,25(OH)2 D3 in Ctns-/- mice, respectively. Repletion of vitamin D partially or fully normalized food intake, weight gain, gain of fat, and lean mass, improved energy homeostasis, and attenuated perturbations of uncoupling proteins and adenosine triphosphate content in adipose tissue and muscle in Ctns-/- mice. Vitamin D repletion attenuated elevated expression of beige adipose cell biomarkers (UCP-1, CD137, Tmem26, and Tbx1) as well as aberrant expression of molecules implicated in adipose tissue browning (Cox2, Pgf2α, and NF-κB pathway) in inguinal white adipose tissue in Ctns-/- mice. Vitamin D repletion normalized skeletal muscle fibre size and improved in vivo muscle function in Ctns-/- mice. This was accompanied by correcting the increased muscle catabolic signalling (increased protein contents of IL-1ß, IL-6, and TNF-α as well as an increased gene expression of Murf-2, atrogin-1, and myostatin) and promoting the decreased muscle regeneration and myogenesis process (decreased gene expression of Igf1, Pax7, and MyoD) in skeletal muscles of Ctns-/- mice. Muscle RNAseq analysis revealed aberrant gene expression profiles associated with reduced muscle and neuron regeneration, increased energy metabolism, and fibrosis in Ctns-/- mice. Importantly, repletion of 25(OH)D3 and 1,25(OH)2 D3 normalized the top 20 differentially expressed genes in Ctns-/- mice. CONCLUSIONS: We report the novel findings that correction of 25(OH)D3 and 1,25(OH)2 D3 insufficiency reverses cachexia and may improve quality of life by restoring muscle function in an animal model of infantile nephropathic cystinosis. Mechanistically, vitamin D repletion attenuates adipose tissue browning and muscle wasting in Ctns-/- mice via multiple cellular and molecular mechanisms.

[Environmental risk factors for autism spectrum disorders in children].

OBJECTIVE: To investigate the environmental risk factors for autism spectrum disorders (ASD) in children. METHODS: In this case-control study, 81 boys with ASD, 74 boys with global developmental delay (GDD), and 163 healthy boys were enrolled. A self-designed nurturing environment questionnaire was used to record general demographic data, family social-economic status, parents' living habits and environmental exposure, maternal health status during pregnancy, birth situations, and rearing environment after birth. Multivariate logistic regression was used to identify environmental risk factors for ASD and GDD. RESULTS: Multivariate logistic regression analysis showed that six environmental risk factors such as maternal occupational toxicant exposure, diseases during pregnancy and a history of passive smoking, children's birth places, the frequency of outdoor activities in the second year after birth, and the opportunities to communicate with other age-matched children were significantly associated with the incidence of ASD (OR=20.67, 3.559, 2.422, 2.646, 23.820, and 5.081, respectively; P<0.05). Among the above six risk factors, passive smoking during pregnancy, the opportunities to communicate with their peers, and the frequency of outdoor activities in the second year after birth were also significantly associated with the incidence of GDD (P<0.05). CONCLUSIONS: Maternal occupational toxicant exposure, diseases during pregnancy, and low level of children's birth places may be the specific risk factors associated with ASD, and passive smoking during pregnancy, fewer opportunities to communicate with their peers, and fewer outdoor activities in the second year after birth are non-specific risk factors for ASD, indicating that the development of ASD may be influenced by both genes and environmental factors.

Impact of Fetal-Neonatal Iron Deficiency on Recognition Memory at 2 Months of Age.

OBJECTIVE: To assess the effects of fetal-neonatal iron deficiency on recognition memory in early infancy. Perinatal iron deficiency delays or disrupts hippocampal development in animal models and thus may impair related neural functions in human infants, such as recognition memory. STUDY DESIGN: Event-related potentials were used in an auditory recognition memory task to compare 2-month-old Chinese infants with iron sufficiency or deficiency at birth. Fetal-neonatal iron deficiency was defined 2 ways: high zinc protoporphyrin/heme ratio (ZPP/H > 118 µmol/mol) or low serum ferritin (<75 µg/L) in cord blood. Late slow wave was used to measure infant recognition of mother's voice. RESULTS: Event related potentials patterns differed significantly for fetal-neonatal iron deficiency as defined by high cord ZPP/H but not low ferritin. Comparing 35 infants with iron deficiency (ZPP/H > 118 µmol/mol) to 92 with lower ZPP/H (iron-sufficient), only infants with iron sufficiency showed larger late slow wave amplitude for stranger's voice than mother's voice in frontal-central and parietal-occipital locations, indicating the recognition of mother's voice. CONCLUSIONS: Infants with iron sufficiency showed electrophysiological evidence of recognizing their mother's voice, whereas infants with fetal-neonatal iron deficiency did not. Their poorer auditory recognition memory at 2 months of age is consistent with effects of fetal-neonatal iron deficiency on the developing hippocampus.

Low-level prenatal lead exposure alters auditory recognition memory in 2-month-old infants: an event-related potentials (ERPs) study.

This study used event-related potentials (ERPs) to assess effects of low-level prenatal lead exposure on auditory recognition memory in 2-month-old infants. Infants were divided into four groups according to cord-blood lead concentration: (1) <2.00 µ g/dL, (2) 2.00-2.99 µ g/dL, (3) 3.0-3.7 µ g/dL, and (4) ≥3.7 µ g/dL. The first group showed the normally expected differences in P2, P750, and late slow wave (LSW) amplitudes elicited by mothers' and strangers' voices. These differences were not observed for one or more ERP components in the other groups. Thus, there was electrophysiological evidence of poorer auditory recognition memory at 2 months with cord-blood lead ≥2.00 µ g/dL.

No relationship between maternal iron status and postpartum depression in two samples in China.

Maternal iron status is thought to be related to postpartum depressive symptoms. The purpose of the present study was to evaluate the relationship between pre- and postnatal maternal iron status and depressive symptoms in pilot (n = 137) and confirmatory (n = 567) samples of Chinese women. Iron status was evaluated at mid- and late pregnancy and 3 days postpartum. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess maternal postpartum depression 24-48 hours after delivery and 6 weeks later. In the pilot sample, correlations between early- and late-pregnancy maternal Hb and EPDS scores at 6 weeks were r = 0.07 and -0.01, respectively (nonsignificant). In the confirmatory sample, the correlations between maternal iron measures (Hb, MCV, ZPP, ferritin, sTfR, and sTfR Index) in mid- or late pregnancy or 3 days postpartum and EPDS scores shortly after delivery or at 6 weeks were also low (r values < 0.10). EPDS scores in anemic and nonanemic mothers did not differ, regardless of sample or timing of maternal iron status assessment. In addition, women with or without possible PPD were similar in iron status in both samples. Thus, there was no relationship between maternal iron status and postpartum depression in these samples.

High prevalence of vitamin D deficiency among children aged 1 month to 16 years in Hangzhou, China.

BACKGROUND: Recent studies have suggested that vitamin D deficiency in children is widespread. But the vitamin D status of Chinese children is seldom investigated. The objective of the present study was to survey the serum levels of 25-hydroxyvitamin D [25(OH)D] in more than 6,000 children aged 1 month to 16 years in Hangzhou (latitude: 30°N), the capital of Zhejiang Province, southeast China. METHODS: The children aged 1 month to 16 years who came to the child health care department of our hospital, the children's hospital affiliated to Zhejiang university school of medicine, for health examination were taken blood for 25(OH) D measurement. Serum 25(OH) D levels were determined by direct enzyme-linked immunosorbent assay and categorized as < 25, < 50, and < 75 nmol/L. RESULTS: A total of 6,008 children aged 1 month to 16 years participated in this cross-sectional study. All the subjects were divided into subgroups according to their age: 0-1y, 2-5y, 6-11y and 12-16y representing infancy, preschool, school age and adolescence stages respectively. The highest mean level of serum 25(OH)D was found in the 0-1y stage (99 nmol/L) and the lowest one was found in 12-16y stage (52 nmol/L). Accordingly, the prevalence of serum 25(OH)D levels of < 75 nmol/L and < 50 nmol/L were at the lowest among infants (33.6% and 5.4% respectively) and rose to the highest among adolescents (89.6% and 46.4% respectively). The mean levels of serum 25(OH)D and the prevalence of vitamin D deficiency changed according to seasons. In winter and spring, more than 50% of school age children and adolescents had a 25(OH)D level at < 50 nmol/L. If the threshold is changed to < 75 nmol/L, all of the adolescents (100%) had low 25(OH)D levels in winter and 93.7% school age children as well. CONCLUSIONS: The prevalence of vitamin D deficiency and insufficiency among children in Hangzhou Zhejiang province is high, especially among children aged 6-16 years. We suggest that the recommendation for vitamin D supplementation in Chinese children should be extended to adolescence.

Cachexia and protein-energy wasting in children with chronic kidney disease.

Children with chronic kidney disease (CKD) are at risk for "cachexia" or "protein-energy wasting" (PEW). These terms describe a pathophysiologic process resulting in the loss of muscle, with or without loss of fat, and involving maladaptive responses, including anorexia and elevated metabolic rate. PEW has been defined specifically in relation to CKD. We review the diagnostic criteria for cachexia and PEW in CKD and consider the limitations and applicability of these criteria to children with CKD. In addition, we present an overview of the manifestations and mechanisms of cachexia and PEW. A host of pathogenetic factors are considered, including systemic inflammation, endocrine perturbations, and abnormal neuropeptide signaling, as well as poor nutritional intake. Mortality risk, which is 100- to 200-fold higher in patients with end-stage renal disease than in the general population, is strongly correlated with the components of cachexia/PEW. Further research into the causes and consequences of wasting and growth retardation is needed in order to improve the survival and quality of life for children with CKD.

Charting the developmental trajectories of attention and executive function in Chinese school-aged children.

Attention is a complex domain that has reawakened research interest in recent years. There are relatively few studies that have examined age-related changes across different attention subcomponents, such as selection, maintenance, and control, using large samples covering a wide age range. The present study assessed performance in 466 participants in order to identify the ages at which mature performance was reached across differing attention subcomponents. Furthermore, we investigated whether the nature of the attentional demands or task difficulty predicted the age at which stable levels of performance were reached. The results supported the former rather than the latter alternative.

The impact of inflammation on bone mass in children.

Bone is a dynamic tissue. Skeletal bone integrity is maintained through bone modeling and remodeling. The mechanisms underlying this bone mass regulation are complex and interrelated. An imbalance in the regulation of bone remodeling through bone resorption and bone formation results in bone loss. Chronic inflammation influences bone mass regulation. Inflammation-related bone disorders share many common mechanisms of bone loss. These mechanisms are ultimately mediated through the uncoupling of bone remodeling. Cachexia, physical inactivity, pro-inflammatory cytokines, as well as iatrogenic factors related to effects of immunosuppression are some of the common mechanisms. Recently, cytokine signaling through the central nervous system has been investigated for its potential role in bone mass dysregulation in inflammatory conditions. Growing research on the molecular mechanisms involved in inflammation-induced bone loss may lead to more selective therapeutic targeting of these pathological signaling pathways.

Neonatal screening for congenital hypothyroidism and phenylketonuria in China.

BACKGROUND: Neonatal screening is helpful to prevent serious disability and sufferings caused by congenital or inherited disease. This study was to review the status of neonatal screening for congenital hypothyroidism (CH) and phenylketonuria (PKU) in China. METHODS: We analyzed data of neonatal screening for CH and PKU in the past two decades which were obtained from the national network of neonatal screening centers collected by the National Center for Clinical Laboratory. RESULTS: Of 18.8 million newborns screened from 1985 to 2007, 9198 were identified with CH, giving a prevalence of 1/2047. In 19.0 million newborns screened in the same period, 1638 had PKU, with a prevalence of 1/11 572. An increasing number of neonates have been subjected to neonatal screening in China annually during this period. Data from Zhejiang Neonatal Screening Center showed that the recall rate of neonates suspected with CH and PKU was 95.52% in 2007. Confirmatory tests were performed and treatments were initiated in most of the neonates with CH and PKU within a month after birth. CONCLUSIONS: More governmental support at different levels is needed to make neonatal screening more efficient. The screening should be improved with a satisfactory control system including shorter time of report and a higher recall rate.

[A study on the social adjustment and its affective factors in Down syndrome children].

OBJECTIVE: To explore the social adjustment status and affected factors thereof in Down syndrome children. METHODS: The family environment, cognitive development and social adjustment were examined in 36 Down syndrome children aged 52 - 167 months, 30 mental age-matched children aged 20 - 65 months, and 40 chronological age-matched children aged 43 - 144 months with questionnaire of family influential factors, Peabody Picture Vocabulary Test (PPVT) and Infants-Junior Middle School Students' Social-Life Abilities Scale from September 2004 to July 2006. The gender and general family environment were matched among the three groups. The information about the mode of delivery, history of newborn, family structure, income of family, and parents' education could be gathered from the questionnaire (used by parents). PPVT was adopted as research tool of cognitive development. Infants-Junior Middle School Students' Social-Life Abilities Scale was adopted as research tool of social adjustment. RESULTS: There were no differences between the Down syndrome children and mental age-matched group in communication and socialization. The Down syndrome children were better than the mental age-matched group in self-help [(20.0 +/- 4.8) vs (13.3 +/- 4.7), t = 5.72, P = 0.000]; locomotion [(7.5 +/- 1.4) vs (6.4 +/- 1. 6), t = 3.10, P = 0.003]; occupation [(8.2 +/- 2.4) vs (6.2 +/- 2.0), t = 3.68, P = 0.000], and self-direction [(5.9 +/- 2.6) vs (4.6 +/- 2.0), t = 2. 28, P = 0.026]. The chronological age-matched group were much better than the Down syndrome children in all factors of social-life abilities, including self-help [(20.0 +/- 4.8) vs (26.5 +/- 4.9), t = 5.84, P = 0.000]; locomotion [(7.5 +/- 1.4) vs (11.4 +/- 3.3), t = 6.76, P = 0.000]; occupation [(8.2 +/- 2.4) vs (14.4 +/- 3.9), t = 8.55, P = 0.000]; communication [(8.3 +/- 3.6) vs (18.3 +/- 4.8), t = 10.38, P = 0.000]; socialization [(9.6 +/- 2.3) vs (17.1 +/- 4.2), t = 9.76, P = 0.000], and self-direction [(5.9 +/- 2.6) vs (13. 8 +/- 4.6), t = 9.25, P = 0.000]. There was a relationship between the raw score of PPVT and social-life abilities in these children. Even after controlling effect of age, it was still associated with self-help (r = 0.70, P = 0.000), locomotion (r = 0.74, P = 0.000), occupation (r = 0.77, P = 0.000), communication (r = 0.86, P = 0.000), socialization (r = 0.80, P = 0.000), and self-direction (r = 0.76, P = 0.000). Multiple stepwise regression showed that the main factor influencing self-help was family structure. Family structure and mother's education influenced locomotion. Family structure and newborn history influenced occupation, communication, socialization and self-direction. CONCLUSION: Down syndrome children have better social adjustment than the mental age-matched group, yet worse than the chronological age-matched group. Cognition development, family environment and newborn history differently influence the Down syndrome child, which means proper intervention can improve their social adjustment.

Study on the social adaptation of Chinese children with down syndrome.

PURPOSE: To evaluate social adjustment and related factors among Chinese children with Down syndrome (DS). PATIENTS AND METHODS: A structured interview and Peabody Picture Vocabulary Test (PPVT) were conducted with a group of 36 DS children with a mean age of 106.28 months, a group of 30 normally-developing children matched for mental age (MA) and a group of 40 normally-developing children matched for chronological age (CA). Mean scores of social adjustment were compared between the three groups, and partial correlations and stepwise multiple regression models were used to further explore related factors. RESULTS: There was no difference between the DS group and the MA group in terms of communication skills. However, the DS group scored much better than the MA group in self-dependence, locomotion, work skills, socialization and self-management. Children in the CA group achieved significantly higher scores in all aspects of social adjustment than the DS children. Partial correlations indicate a relationship between social adjustment and the PPVT raw score and also between social adjustment and age (significant r ranging between 0.24 and 0.92). A stepwise linear regression analysis showed that family structure was the main predictor of social adjustment. Newborn history was also a predictor of work skills, communication, socialization and self-management. Parental education was found to account for 8% of self-dependence. Maternal education explained 6% of the variation in locomotion. CONCLUSION: Although limited by the small sample size, these results indicate that Chinese DS children have better social adjustment skills when compared to their mental-age-matched normally-developing peers, but that the Chinese DS children showed aspects of adaptive development that differed from Western DS children. Analyses of factors related to social adjustment suggest that effective early intervention may improve social adaptability.