Early symptoms of autism spectrum disorder (ASD) develop through the second year of life, making a stable ASD diagnosis possible around 24 months of age. However, in general, children with ASD are ...diagnosed later. In this study we explored the use of a short observation list to detect symptoms associated with ASD in children 12–24 months of age attending typical day-care centers. The results indicate that a short observation list used by day-care teachers does not reveal sufficient properties to be independently used in young children in day-care centers. Further studies should explore multiple and repeated measures for early detection of symptoms associated with ASD in typical day-care centers.
CONTEXT Prenatal folic acid supplements reduce the risk of neural tube defects and may have beneficial effects on other aspects of neurodevelopment. OBJECTIVE To examine associations between mothers' ...use of prenatal folic acid supplements and risk of severe language delay in their children at age 3 years. DESIGN, SETTING, AND PATIENTS The prospective observational Norwegian Mother and Child Cohort Study recruited pregnant women between 1999 and December 2008. Data on children born before 2008 whose mothers returned the 3-year follow-up questionnaire by June 16, 2010, were used. Maternal use of folic acid supplements within the interval from 4 weeks before to 8 weeks after conception was the exposure. Relative risks were approximated by estimating odds ratios (ORs) with 95% CIs in a logistic regression analysis. MAIN OUTCOME MEASURE Children's language competency at age 3 years measured by maternal report on a 6-point ordinal language grammar scale. Children with minimal expressive language (only 1-word or unintelligible utterances) were rated as having severe language delay. RESULTS Among 38 954 children, 204 (0.5%) had severe language delay. Children whose mothers took no dietary supplements in the specified exposure interval were the reference group (n = 9052 24.0%, with severe language delay in 81 children 0.9%). Adjusted ORs for 3 patterns of exposure to maternal dietary supplements were (1) other supplements, but no folic acid (n = 2480 6.6%, with severe language delay in 22 children 0.9%; OR, 1.04; 95% CI, 0.62-1.74); (2) folic acid only (n = 7127 18.9%, with severe language delay in 28 children 0.4%; OR, 0.55; 95% CI, 0.35-0.86); and (3) folic acid in combination with other supplements (n = 19 005 50.5%, with severe language delay in 73 children 0.4%; OR, 0.55; 95% CI, 0.39-0.78). CONCLUSION Among this Norwegian cohort of mothers and children, maternal use of folic acid supplements in early pregnancy was associated with a reduced risk of severe language delay in children at age 3 years.
The rapid neurodevelopment that occurs during the first years of life hinges on adequate nutrition throughout fetal life and early childhood. Therefore, adhering to a dietary pattern based on healthy ...foods during pregnancy and the first years of life may be beneficial for future development. The aim of this paper was to investigate the relationship between adherence to a healthy and potentially sustainable Nordic diet during pregnancy and in early childhood and child development. This study is based on the Norwegian Mother, Father and Child Cohort Study (MoBa) and uses data from the Medical Birth Registry of Norway (MBRN). In 83,800 mother-child pairs, maternal pregnancy diet and child diet at 6 months, 18 months and 3 years were scored according to adherence to the New Nordic Diet (NND). NND scores were calculated both as a total score and categorized into low, medium, or high adherence. Child communication and motor development skills were reported by parents at 6 months, 18 months, 3 and 5 years, using short forms of the Ages and Stages Questionnaire and the Child Development Inventory. Associations of NND adherence with child development were estimated with linear and logistic regression in crude and adjusted models. When examining the NND and child developmental scores as percentages of the total scores, we found positive associations between the NND scores (both maternal pregnancy diet and child diet) and higher scoring on child development (adjusted formula omitted s 95% confidence intervals ranging from 0.007 0.004, 0.009 to 0.045 0.040, 0.050). We further found that low and medium adherence to NND were associated with higher odds of later emerging developmental skills compared to high NND adherence at nearly all measured timepoints (odds ratios 95% CI ranging from significant values 1.15 1.03-1.29 to 1.79 1.55, 2.06 in adjusted analyses). Our findings support that adherence to a healthy and potentially sustainable diet early in life is important for child development every step of the way from pregnancy until age 5 years.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Purpose: This article explored the predictive values of three main language delay (LD) trajectories (i.e., persistent, late onset, and transient) across 3-5 years on poor literacy at 8 years. ...Additionally, the effect of gender was assessed, using both gender-neutral and gender-specific thresholds. Method: The data comprised mother-reported questionnaire data for 8,371 children in the Norwegian Mother, Father, and Child Cohort Study. Analyses were conducted using binary logistic regression in SPSS to make predictions about risk. Results: LD reported at preschool age was associated with excess risk of poor literacy at 8 years with odds ratios ranging from 3.19 to 9.75 dependent on trajectory, persistent LD being the strongest predictor. The odds ratio of transient LD was similar to that of late-onset LD. Gender was not found to play an important role in the association between oral language and literacy, as the gender difference disappeared when gender-specific deficit criterion was used. Conclusion: Our study supports the longitudinal association between preschool oral language and school-aged literacy skills and highlights the importance of different LD trajectories across preschool ages in predicting later literacy. Furthermore, practitioners are recommended to consider gender-specific cutoffs in relation to language and literacy measures.
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DOBA, IZUM, KILJ, NUK, ODKLJ, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Early identification of autism spectrum disorder (ASD) is regarded as crucial for swift access to early intervention and, subsequently, better outcomes later in life. However, current instruments ...miss large proportions of children who later go on to be diagnosed with ASD, raising a question of what these instruments measure. The present study utilized data from the Norwegian Mother, Father, and Child Cohort Study and the Autism Birth Cohort study to explore the subsequent developmental and diagnostic characteristics of children raising developmental concern on the six-critical discriminative item criterion of the M-CHAT (DFA6) at 18 months of age (N = 834). The DFA6 identified 28.8% of children diagnosed with ASD (N = 163), but 4.4% with language disorder (N = 188) and 81.3% with intellectual disability (N = 32) without ASD. Scoring in the «at-risk» range was associated with lower IQ, impaired functional language, and greater severity of autism symptoms whether children had ASD or not.
Autism screening questionnaires are sometimes used as a measure of “autism-associated traits” in samples drawn from the general population, even though such tools are primarily developed and designed ...for use in samples of children diagnosed with or being assessed for autism. Here, we explore the psychometric properties of the Social Communication Questionnaire (SCQ) current version reported at age 8 in a large population-based sample. Using data from the Norwegian Mother, Father and Child Cohort study (MoBa), we perform exploratory (N = 21,775) and confirmatory (N = 21,674) factor analyses on items and compare our results with previously suggested factor structure models of the SCQ. Furthermore, we test for measurement invariance across sex and registry-ascertained autism diagnostic status (Ndiagnosed = 636). A 5-factor model provided best fit to the data in both children with and without autism diagnoses, though with some qualitative differences in what the factors represent across these groups. This model performed largely consistently across boys and girls in the general population. Taken together, the SCQ’s measurement properties must be carefully considered when it is used in population-based samples and measurement invariance testing of other autism screening tools used in similar contexts is warranted.
Lay abstract
Using questionnaires in research relies on the expectation that they measure the same things across different groups of individuals. If this is not true, then interpretations of results can be misleading when researchers compare responses across different groups of individuals or use in it a group that differs from that in which the questionnaire was developed. For the questionnaire we investigated, the Social Communication Questionnaire (SCQ), we found that parents of boys and girls responded to questionnaire items in largely the same way but that the SCQ measured traits and behaviors slightly differently depending on whether the children had autism. Based on these results, we concluded that researchers using this questionnaire should carefully consider these differences when deciding how to interpret findings. SCQ scores as a reflection of “autism-associated traits” in samples that are mostly or entirely made up of individuals without an autism diagnosis may be misleading and we encourage a more precise interpretation of scores as a broader indication of social-communicative and behavioral traits.
Purpose: The aims of this study were (a) to examine the relationship between speech intelligibility at the age of 5 years and literacy skills at the age of 8 years, (b) to explore the possible ...mediating or moderating role of broader language skills at 5 years in the relationship of interest, and (c) to assess whether the potential risk factors (child gender; maternal education levels; and family history of speech, language, reading, and writing difficulties) influence the relationship between speech intelligibility and literacy in terms of moderated mediation effects. Method: We used mother-reported questionnaire data on 16,184 children participating in the population-based, prospective Norwegian Mother, Father and Child Cohort Study as well as conducted linear regression analyses using the PROCESS macro in SPSS. In addition, logistic regression was conducted to make predictions about risk. Results: The association between speech intelligibility at 5 years and literacy skills at 8 years was statistically significant (beta = 0.168, p < 0.001). Children with speech problems at 5 years had a risk ratio of 2.38 (95% CI 2.10, 2.70) and an odds ratio of 2.74 (95% CI 2.35, 3.19), as compared to children without such problems. Broader language skills at 5 years partially mediated the relationship between speech intelligibility at 5 years and literacy at 8 years, and the effect of language skills appeared to be moderated by child gender, a family history of language difficulties, a family history of reading difficulties, and maternal education. Conclusions: Severity of speech problems indexed by parent-reported speech intelligibility in preschool predicted school-age literacy problems. Broader language skills are a crucial mediating mechanism through which these problems are linked, and the mediated relationship is amplified by female gender, low maternal education, family history of language difficulties, and family history of reading difficulties. The findings call for increased use of a multiple-risk model when planning early interventions in children with unclear speech.
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Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Purpose: Early language difficulties are associated with later internalizing problems across different ages and for different aspects of language. The mechanisms behind this association are, however, ...less understood. In the current study, we investigated longitudinal associations between language difficulties at 5 years and internalizing problems at 6 years. We also examined emotion regulation, empathy, assertiveness, and social engagement at 6 years as possible pathways for this association. Method: A subsample from the Norwegian Mother, Father and Child Cohort Study (MoBa) was used (N = 928). Structural equation models were developed to test the longitudinal associations and indirect pathways between language and internalizing problems. Results: The results showed high stability for internalizing problems from 5 to 6 years (beta = 0.59, p < 0.001). Furthermore, semantic language difficulties predicted change in internalizing problems (beta = 0.12, p < 0.001). Finally, the path between semantic language and internalizing problems was partially mediated by social engagement and emotion regulation, with the indirect pathways accounting for 55% of the initial association. For girls, there was a significantly stronger correlation (p < 0.05) between semantic language difficulties and internalizing problems at baseline (r = 0.30, p < 0.001) than for boys (r = 0.16, p < 0.001). Otherwise, there were no sex differences. Conclusions: Indirect pathways from language difficulties to internalizing problems were identified through social engagement and emotion regulation. The results may guide targets for intervention in groups of children with language difficulties at risk for developing internalizing problems.
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Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Numerous studies have investigated the prevalence of neurologic and neurodevelopmental disorders individually, but few have examined them collectively, and there is uncertainty as to what extent they ...overlap.
The study has determined the proportions of children aged 0 to 11 years with diagnoses of autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), epilepsy, and cerebral palsy (CP) in Norway. The data were obtained from the Norwegian Patient Register, which is nationwide and contains diagnoses assigned by Norwegian specialist health services (hospitals and outpatient clinics). The Norwegian Patient Register started collecting individual-level data in 2008, and the follow-up period for the study is years 2008 through 2010.
For ASD, ADHD, and epilepsy, the proportions were highest in the oldest children. At age 11 years, the incidence was 0.7% for ASD, 2.9% for ADHD, and 0.9% for epilepsy. The cumulative incidence is likely to be higher because some cases diagnosed before 2008 were probably missed. For CP, the proportions were ~0.3% for age ≥ 5 years. There was considerable overlap between diagnoses. For all disorders, boys had a significantly increased risk. In school-age children (aged 6-11 years) the male/female ratio was 4.3 for ASD, 2.9 for ADHD, 1.2 for epilepsy, and 1.3 for CP.
The findings demonstrate the significant burden of disease associated with neurologic and neurodevelopmental disorders in children and that this burden is disproportionately skewed toward boys.
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