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Background: Germinal Matrix Intraventricular Hemorrhage (GM-IVH) is associated with an increased risk of neurodevelopmental disabilities in preterm born infants. However, studies from childhood to adulthood are lacking. Aim: To investigate cognitive-behavioral functioning and socioeconomic status (SES) in preterm adults with GM-IVH and to identify their early predictors. Methods: Twelve preterm participants with GM-IVH, 18 low-risk preterm and 29 full-term adults were recruited. All participants underwent a cognitive-behavioral assessment and their childhood and current SES were registered. As part of a previous study, GM-IVH preterm participants were neuropsychologically assessed during childhood. Results: Preterm adults born with GM-IVH showed lower values in a composite score of neurocognitive performance (K-W=22.35; p=0.001) and current SES (K-W=10.03; p=0.007) compared to their term peers. No differences between groups were found in childhood SES, internalizing, externalizing and total problems. In the preterm adult group born with GM-IVH, the model that best predicted neurocognitive performance was composed by FIQ (β= 0.82; p<0.001) and attentional scores (β= -0.25; p=0.023) at childhood (R²=0.94; F_(1,10)=71.27; p<0.001). In the same line, both attentional (β= 0.64; p<0.01) and verbal scores (β= 0.53; p<0.03) at childhood were variables included in the model that best predicted current SES in preterm adults with GM-IVH (R²=0.62; F_(1,10)=7.45; p=0.01). Conclusions: Preterm adults born with GM-IVH seem to suffer from more cognitive alterations and lower SES compared to their term peers. Key adult neurocognitive performance and SES predictors are FIQ related domains as well as attentional and verbal variables at childhood.

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Somatosensory modalities, such as proprioception and haptic ability, influence the achievement of developmental milestones in children. To enable adaptive interaction with the environment an individual is believed to generate a mental representation of the body. Little is known about the development of mental hand representations in children and adolescents.

A cross-sectional study was conducted in 90 healthy children and adolescents (48 males, 42 females; age range 5.0-23.0 years). By comparing the relative locations of the judgement of 10 landmarks on the dorsum of an occluded hand, implicit maps of hand size and shape were constructed and compared to the actual hand dimensions calculating the positive or negative overestimation. Additionally, the explicit hand image was measured in a subgroup consisting of 41 right-handed children comparisons of implicit, explicit and actual shape index.

Implicit hand maps featured underestimation of finger length and overestimation of hand width. Hand side and handedness did not influence the overestimation. A significant interaction of handedness with age was found. Implicit hand shape index differed clearly with actual (p<.01) and explicit shape index (p<.01). The shape index was influenced by age.

We found a systematic deviation of the implicit hand representation from the actual hand size in children and adolescents, featuring shortened fingers and broadened hands. Underestimation of implicit finger length demonstrated a significant main effect of age and a significant handedness by age interaction effect. Explicit hand image showed a veridical representation. Our study establishes a point of reference for examining children at risk of somatosensory impairment.

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BACKGROUNDS AND AIMS:

Caregivers play a key role in the management of children with ASD. The objective of this survey was to determine the repercussions of ASD on family life of the main caregiver.

METHODS:

We used a self-administered web-based questionnaire to explore who is the main caregivers and what are the consequences of having a child with autism in daily life. We also include questions from Caregiver Burden Inventory Modified (CBI-M) which is a multi-dimensional questionnaire measuring caregiver burden.

RESULTS:

Six-hundred-seven participants answered the survey. The median age was 47 years for mothers and 52 years for fathers. Fifty-five percent (329/600) had a partner while 10.83% (65/600) lived separated. Seventy-two percent (432/600) had 1 child with ASD, 3%, 2, and 0.50% had 3. Fifty-seven percent (284/600) of the children went to school, 9.67% (5/600) ordinary, 21.83% (131/600) ordinary with Social Life Aid.

Thirty-four percent (204/607) of mothers had to help them to cope with the routines in more than half of the day. Fifty-one percent (307/607) of the mothers commuted their child to medical centres. Furthermore, 56.51% (343/607) of mothers were the caregiver who spends the most time with the child, 24.55% (149/607) had to quit their job completely and 27.51% (167/607) to reduce their work hours. Only 2.47% (15/607) and 5.93% (36/607) of fathers had to do so.

CONCLUSION:

Caregivers of children with autism in France are mainly mothers, suffering from various problems in daily life as well as their relations which need professional supports and interventions.

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Introduction:

ADHD is a chronic childhood-onset psychiatric disorder; Methylphenidate MP is the best-known and most widely used ADHD medications. Controversy exists in MP effect on linear growth

Objective:

Study the effect of ADHD and different MP formulations (short-acting (SAMP) versus long-acting (LAMP) on the linear growth of children with ADHD for 2 years.

Method:

We studied 53(68% males) prepubertal children with ADHD and school failure. Subjects received SAMP (n =14) or LAMP (n = 39) for 2 year. height, weight, HtSDS, BMISDS were studied at diagnosis, followed for two years after treatment.

Result:

At presentation, BMISDS (1.13±1.49). 30% obese (BMISDS ≥ 2), 66% (-2 < BMISDS > +2). Their HtSDS was (0.30±1.14). Only one patient was short (HtSDS < -2). the LAMP group was elder and had higher BMISDS in comparison to SAMP group (table).

After 10 months HtSDS decreased significantly (p < 0.001) in LAMP group. Further drop noticed by 2 years; HtSDS was significantly decreased compared to HtSDS before therapy (p = 0.03). Children on SAMP had no significant change occurred in their HtSDS or BMISDS compared to data before therapy. (Table)

Conclusion:

No significant growth impairment involving height or weight in children with ADHD, but it seems that using LAMP had a significant adverse effect on linear growth, especially during the first year of therapy. However, this was not detected in the SAMP group for the same period of treatment. We did not find a significant effect of LAMP or SAMP on BMISDS.

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Background:Feeding disorders and gastrointestinal symptoms are very common in children with autism spectrum disorder (ASD) affecting their growth and weight.GI and ASD core symptoms may overlap and are often attributable to sensory issues and behavioural manifestations.Studies have shown that inflammatory bowel disease are more prevalent in children with ASD.Clinical case:A 10-year old boy with a background of ASD presented with a year history of unexplained weight loss, chronic abdominal pain, intermittent diarrhea associated with anorexia, nausea and vomiting.On examination, he was extremely thin and pale.Abdominal examination showed right iliac fossa tenderness with no other sign.Growth assessment indicated a weight drop across centiles over a 2 month period.A full blood count showed hypochromic microcytic anemia.TFTs, TTG, Immunoglobulins, B12, folic acid and vitamin D were normal.Stool samples ruled out infectious causes.Dietician review noted challenging eating behaviours, food and texture selectivity.The impression at this stage was of a sensory element to his symptoms.In light of this, feeding strategies and oral nutritional supplements were trialed with no improvement.Due to ongoing chronic abdominal pain, an abdomen ultrasound was done and suggested chronic appendicitis and colitis.Raised fecal calprotectin was highly suggestive of IBD.The patient was referred to Gastroenterology in CHI-Crumlin for query IBD.A colonoscopy confirmed severe Crohn’s disease.He was started on the appropriate treatment and followed up under the GI team.Discussion:The diagnosis of gastrointestinal disorders in patients with ASD can be very complex.It is important to remember the known association between IBD and ASD, in order to prevent a misdiagnosis or mislabeling of IBD as eating disorder.

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Background

Multidisciplinary management of children with Duchenne Muscular Dystrophy (DMD) focuses on anticipatory diagnostic and therapeutic approaches with emphasis on quality of life. Updated recommendations from a large steering committee has been incorporated into a model of care.

Aims

To examine the management of children with DMD attending the neuromuscular clinic in Tallaght Hospital with reference to the established standards of care and with a view to improving the quality of the service.

Methods

Hospital records and systems were reviewed to identify children as of August 2019 with DMD and examine the components of care received in comparison with the standards.

Results

23 boys with DMD attended the service. Age ranged from 4 to 17.5 years with an average of 11.4 years. Some were attending centres abroad also. Full records were available on 10 boys.

Areas of high compliance included: 100% had MDT assessment (Physio and OT), 100% had endocrine system review, 88% of those indicated for respiratory function had assessments, 80% had cardiology review.

Areas of need included: 20% had evidence of dietician review, 30% had documented influenza vaccination, 20% had mental health/psychology review or input, 30% had transition initiated (approx. half who were indicated)

Conclusions

The care and surveillance of children with DMD shows high levels of alignment with many standards of care. A more holistic care approach requires further emphasis on the Mental Health/ psychosocial and transition components. There is also a role for dietetic input to the service or more concrete links to community services.

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Developmental delay (DD) with a prevalence of 15 percent of all children is one of the most frequent disorders in early childhood affecting annually thousands of individuals in Switzerland. Early identification of children with DD is critical to ensure appropriate therapeutic interventions, to support the families and finally to prevent chronic (i.e., life-long) health, educational and social consequences. However, we note that there is a large paucity of information about supply, demand and effectiveness of services for children with DD in Switzerland. In the Canton of Zurich (Switzerland), there is a centrally organized registration of all children with DD in need of early interventions at the Unit of Special Needs Education (USNE).

We have collected and analyzed a comprehensive data set from all children (age 0-4) admitted to the USNE in 2017 (n=2033). The talk presents a description of the cohort as well as the spectrum of the special needs support of children evaluated by the USNE and contrasts the findings to the eventually utilized interventions. Surprisingly, the number of hours used is by far lower than the assigned amount of support. Furthermore, we aim to explain the discrepancy between assigned therapeutic support and utilization rate of health and educational care for children with DD.