Mortality, major neurological handicaps--including mental retardation, cerebral palsy and epilepsy--educational subnormality and height at 14 years of age were studied by birth weight percentiles in a birth cohort of 12 000 children from northern Finland. Infant mortality was significantly higher below the mean -2 SD, 10th and 25th percentiles, than in the median class, from 25th to 75th percentiles, but mortality from one to 14 years only in the lowest weight class. Educational subnormality, including mental retardation +/- some other handicap, was highly significantly more frequent in all the percentile classes lower than the median class but showed no significant tendency to be less frequent in the percentiles over the median. It was also highly significantly more frequent among the preterm than the term infant. The number of children with a major neurological handicap but normal school performance did not vary significantly by birth weight percentiles or by gestational age. Height at 14 years increased significantly by birth weight percentiles. The height of the boys with birth weight mean - and +2 SD was nevertheless within the 25th-75th percentiles for height at 14 years in general, while the height of the girls came close to these percentile limits. The preterm infants were significantly shorter than the term infants at 14 years.
BACKGROUND: The intention of this study was to increase the knowledge concerning the rehabilitation of women with drug problems after the birth of a child and to find out how the children developed. MATERIAL AND METHODS: A follow-up study of 31 women, former drug and alcohol abusers and their children, 19 girls and 12 boys born in 1982-1983. The first survey took place when the children were 2-3 years of age, then when they were 7-9 and at last when they were 15-17. The biological mothers, foster or adoptive mothers, the children and their teachers were interviewed. RESULTS: The women got more support and control during the pregnancy than afterwards. Most of the mothers became single. Women with the shortest drug history, a good social network and a stable partner without drug problems kept the care of their children. By the first survey (1985), seven children had been placed in foster homes, in the second (1992) two further children had been taken away from their mothers, and in the third (1999) only one third of the children were living with their biological mothers. Most of the children did well at school and in their families, had friends and leisure activities despite still living by their mothers or in foster/adoption homes. None of the youngsters had been in conflict with the law or were drug abusers, but every second teenage girl needed psychological support. Children who had been stable by their drug-free biological mothers functioned best. INTERPRETATION: Mothers with drug problems do not get sufficient attention after the delivery and when the children grow up. A supporting family should be brought in contact with mother and child after the delivery. Under special circumstances pregnancy can be a positive turning point for women with drug problems.
The results from achievement and mental ability testing in grades 3, 5, and 6 (ages 10, 12 and 13) of about 150 Swedish urban schoolchildren (boys and girls) were analysed according to the children's physical maturity (defined by late and early peak height velocity ages) and social background (defined by father's occupation). Social background played the main role in performance on both the achievement and most of the mental ability tests. Early maturers were, in general, superior to late maturers on the mental ability tests in grade 5. On verbally loaded tests and interaction between physical maturity and social background was found--early maturers scored higher than late maturers in the "lowest" social group, while a slight trend or no difference between early and late maturers was noticed for the 'upper' social groups.
The added value of the combined use of the Autism Diagnostic Interview-Revised and the Autism Diagnostic Observation Schedule: diagnostic validity in a clinical Swedish sample of toddlers and young preschoolers.
The diagnostic validity of the new research algorithms of the Autism Diagnostic Interview-Revised and the revised algorithms of the Autism Diagnostic Observation Schedule was examined in a clinical sample of children aged 18-47 months. Validity was determined for each instrument separately and their combination against a clinical consensus diagnosis. A total of N = 268 children (n = 171 with autism spectrum disorder) were assessed. The new Autism Diagnostic Interview-Revised algorithms (research cutoff) gave excellent specificities (91%-96%) but low sensitivities (44%-52%). Applying adjusted cutoffs (lower than recommended based on receiver operating characteristics) yielded a better balance between sensitivity (77%-82%) and specificity (60%-62%). Findings for the Autism Diagnostic Observation Schedule were consistent with previous studies showing high sensitivity (94%-100%) and alongside lower specificity (52%-76%) when using the autism spectrum cutoff, but better balanced sensitivity (81%-94%) and specificity (81%-83%) when using the autism cutoff. A combination of both the Autism Diagnostic Interview-Revised (with adjusted cutoff) and the Autism Diagnostic Observation Schedule (autism spectrum cutoff) yielded balanced sensitivity (77%-80%) and specificity (87%-90%). Results favor a combined usage of the Autism Diagnostic Interview-Revised and Autism Diagnostic Observation Schedule in young children with unclear developmental problems, including suspicion of autism spectrum disorder. Evaluated separately, the Autism Diagnostic Observation Schedule (cutoff for autism) provides a better diagnostic accuracy than the Autism Diagnostic Interview-Revised.
To explore the links between neurodevelopmental disorders - attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) - and personality in a population-based, genetically sensitive study of children.
A population-based sample of 1886 twins aged 9 and 12, enriched for childhood mental health problems, was recruited from the Child and Adolescent Twin Study in Sweden (CATSS). Parents were interviewed over the telephone using the Autism-Tics, AD/HD and other Comorbidities (A-TAC) inventory, and in a second step they rated their children according to the Junior Temperament and Character Inventory (JTCI).
ADHD was strongly correlated with novelty seeking, while ASD was correlated positively with harm avoidance and negatively with reward dependence. The strongest associations between personality traits and neurodevelopmental disorders were negative correlations between the character dimensions of self-directedness and cooperativeness and ADHD and ASD alike. Cross-twin cross-trait correlations between ADHD, ASD, and personality dimensions in monozygotic twins were more than double those in dizygotic twins, indicating a strong genetic effect behind the phenotypic covariation between neurodevelopmental disorders and personality.
Neurodevelopmental disorders are linked specifically to particular temperament profiles and generally to hampered development of the self-governing strategies referred to as "character." Poor self-agency and cooperation may be core functional outcomes in the separation of children with handicapping conditions from those with traits only reminiscent of neurodevelopmental disorders. The associations between neurodevelopmental disorders and personality are at least partly due to genetic effects influencing both conditions. As a consequence, personality must be broadly considered in neuropsychiatry, just as neuropsychiatric disorders and their genetic, neurodevelopmental, and cognitive susceptibilities have to be in personality research and clinical treatment.
OBJECTIVE: To study characteristics of attention-deficit/hyperactivity disorder (ADHD) in a representative group of clinically impaired young children in Sweden with the disorder. METHOD: One hundred thirty-one children with ADHD (aged 3-7 years) were examined, and their parents were interviewed. Independent parent questionnaire data (Child Behavior Checklist, ADHD Rating Scale-IV, Conners) were collected. For comparison 131 children without ADHD were matched for age, gender, parents' marital status, child's adoption status, and social class. RESULTS: Children with ADHD had extremely high ADHD symptom levels--on average four to eight times higher than the comparison group. Sociodemographic correlates of ADHD symptoms were more pronounced in parent questionnaire data than in parent interview data, underscoring the importance of diagnostic interview when dealing with clinical issues. Very few of the children with ADHD (6%) appeared "normal" with regard to attention/activity level at clinical examination. CONCLUSIONS: Clinic children with a diagnosis of DSM-IV ADHD have typical and impairing symptoms already before starting school. The variance of ADHD in this age group appears to be accounted for by primary psychosocial factors only to a limited degree. It would seem reasonable to establish supportive and treatment measures for these young children so that the psychosocial and academic problems shown by so many individuals with ADHD later in their development might be reduced.