Publications (43) View all
-
Article: Mercury, APOE, and children's neurodevelopment.
[show abstract] [hide abstract]
ABSTRACT: The benefit of the nutritious elements in fish is insufficient for explaining the controversial finding regarding prenatal mercury (Hg) exposure and neurodevelopment; the varying frequency of susceptible genes among these populations may shed light on these observations. However, limited studies have been reported on the association between genetic susceptibility, of prenatal Hg exposure and child development. Apolipoprotein E (APOE, protein; Apoe, gene) is a major protein transporter expressed in the brain. The Apoe epsilon 4 (ɛ4) allele is associated with poor neural repair function and is a risk factor associated with Alzheimer disease. We conducted a prospective cohort study in 2004 and 2005. In this study, 168 subjects were recruited at delivery and followed up at two years of age, and genetic polymorphisms of Apoe were included to assess genetic susceptibility and to determine the relationship between Hg concentrations in cord blood and neurodevelopment. The results showed that adverse effects on neurodevelopment were consistently associated with prenatal Hg exposure in all subtests of Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) among ɛ4 carriers as assessed by both simple linear and multiple linear regression models. After controlling for confounding factors, statistical significance was found in the subtests of cognition tests (β = -8.47, 95% confidence interval (CI) = -16.10 to -0.84), social tests (β = -11.02, 95% CI = -20.85 to -1.19) and the whole test of CDIIT (β = -10.45, 95% CI = -17.36 to -3.54) in a multiple linear regression model. Additionally, the interaction effect between gene polymorphisms of Apoe and Hg levels was significant in the whole test CDIIT and subtests of cognition, language and fine motor tests. In conclusion, Apoe modifies the adverse effects of cord blood Hg on neurodevelopment at the age of two years.NeuroToxicology 04/2013; · 3.10 Impact Factor -
Article: Linkage of ICF-CY codes with environmental factors in studies of developmental outcomes of infants and toddlers with or at risk for motor delays.
[show abstract] [hide abstract]
ABSTRACT: Abstract Purpose: Environmental variables have been explored in studies of the development of young children with motor delays. Linking environmental variables to the International Classification of Functioning, Disability and Health - Children and Youth (ICF-CY), environmental factors (EFs) categories can provide a common language for documenting their contribution to developmental outcomes. This review of studies aimed to (1) link EFs for developmental outcomes in infants with or at risk for motor delays to ICF-CY categories and (2) synthesize the influences of EFs (with ICF-CY linkage) on developmental outcomes. Method: A systematic literature search was performed of multiple databases. After applying selection criteria, environmental variables in 28 articles were linked to ICF-CY categories and underwent qualitative synthesis. Results: Results indicated that physical environmental variables could be linked successfully to ICF-CY EFs categories, but not social environmental variables. Multiple environmental variables were associated with motor and other developmental outcomes. Conclusion: Difficulties in linking social factors to ICF-CY categories indicate that additional EFs codes may need to be considered in the ICF-CY revision processes. The review provides empirical data on relationships between EFs and developmental outcomes in children with or at risk for motor delay. Implications for Rehabilitation Expansion of codes is needed in the ICF-CY for classifying environmental factors in programs for children. The temporary framework of categorizing the social environmental aspect by using ICF-CY as well as three broadly not-linked social categories can be used to promote communication among professionals serving children with special needs. Findings are consistent with theories that environmental facilitators (barriers) can lead to favorable (adverse) motor, cognitive or language outcomes for children of 2 years old or younger with or at risk for motor delay. Environmental factors can serve as significant indicators in early childhood intervention and habilitation programs.Disability and Rehabilitation 04/2013; · 1.50 Impact Factor -
Article: In utero exposure to environmental lead and manganese and neurodevelopment at 2 years of age.
[show abstract] [hide abstract]
ABSTRACT: BACKGROUND AND OBJECTIVE: Manganese, lead, arsenic and mercury are common neurotoxic metals in the environment. Nonetheless, the relationship between prenatal exposure to low doses of neurotoxic metals and neurodevelopment in children is not clear. The objective of this study was to explore the relationship between in utero exposure to environmental neurotoxic metals and neurodevelopment at 2 years of age. METHODS: The population of this study came from the Taiwan Birth Panel Study. We included 230 pairs of non-smoking mothers without any occupational exposure and their singleton full-term children. The information about exposure during pregnancy was obtained using a structured questionnaire, and the manganese, lead, arsenic and mercury levels in umbilical cord blood samples were analyzed using inductively coupled plasma mass spectrometry. We used the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) to evaluate the developmental status of each child at 2 years of age, and we examined the association of in utero exposure to environmental metals and neurodevelopment using linear regression models. RESULTS: The median concentrations of manganese, lead, arsenic and mercury in the cord blood samples in this study were 47.90µg/L (range, 17.88-106.85µg/L), 11.41µg/L (range 0.16-43.22µg/L), 4.05µg/L (range, 1.50-12.88µg/L) and 12.17µg/L (range, 1.53-64.87µg/L), respectively. After adjusting for maternal age, infant gender, environmental tobacco smoke during pregnancy and after delivery, Home Observation for Measurement of the Environment Inventory results, and arsenic and mercury levels in cord blood, we found that manganese and lead levels above the 75th percentile had a significant adverse association with the overall (β=-7.03, SE=2.65, P=0.0085), cognitive (β=-8.19, SE=3.17, P=0.0105), and language quotients (β=-6.81, SE=2.73, P=0.0133) of the CDIIT. CONCLUSIONS: In utero exposure to environmental manganese and lead may have an adverse association with neurodevelopment at 2 years of age, and there is an interaction effect between the manganese and lead levels in the cord blood that could aggravate the effect.Environmental Research 04/2013; · 3.40 Impact Factor -
Article: Psychometric properties of the Child and Adolescent Scale of Participation - Traditional Chinese version.
[show abstract] [hide abstract]
ABSTRACT: The Child and Adolescent Scale of Participation (CASP) was translated into traditional Chinese and has been included as part of the new Disability Evaluation System (DES) in Taiwan since July 2012 for school-aged children with special needs. The aim of this study was to examine the psychometric properties of the traditional Chinese version of the CASP (CASP-C). Participants were 231 parents/caregivers of children aged 6-18 years recruited from 31 hospitals who qualified for the DES in Taiwan. The majority of the children had intellectual disabilities (67%), followed by physical disabilities and autistic spectrum disorders. The CASP was translated into traditional Chinese according to the cross-cultural adaptation process. Content and known group validity, internal consistency, and internal scale structure were examined using a t-test, Cronbach's α, factor analysis, and Rasch analysis. The CASP-C items were mapped onto all nine chapters of the International Classification of Functioning - Children and Youth version. Children with less severe intellectual disabilities had significantly higher CASP-C scores than children with more severe disabilities. Internal consistency was acceptable on the subdomains and total CASP-C (Cronbach's α=0.88-0.97). Factor analysis yielded a two-factor CASP-C structure contributing 64.1% explained variance. Rasch analysis also indicated a unidimensional construct. The results in psychometric analyses are in agreement with those of other studies, and support that the CASP-C has acceptable psychometric properties for use in the DES in Taiwan. However, further study with a larger and more diverse sample is required to increase the generalizability of the results.Die CASP-Skala (Teilnahme von Kindern und Jugendlichen) wird seit Juli 2012 in der traditionellen Chinesisch-Übersetzung im neuen Disability Evaluation System (DES) in Taiwan bei schulpflichtigen Kindern mit besonderem Förderbedarf angewandt. Ziel der vorliegenden Studie war die Untersuchung der psychometrischen Eigenschaften der CASP-Version in traditionellem Chinesisch (CASP-C). An der Studie nahmen 231 Eltern/Betreuer von Kindern im Alter von 6-18 Jahren teil, die aus 31 Krankenhäusern, die sich für das DES in Taiwan qualifiziert hatten, rekrutiert wurden. Die Mehrheit der Kinder wies eine geistige Behinderung (67 %) auf, gefolgt von einer körperlichen Behinderung und Autismusspektrum-Störungen. Die CASP-Skala wurde im Einklang mit dem kulturübergreifenden Anpassungsprozess in traditionelles Chinesisch übersetzt. Inhalt und bekannte Gruppenvalidität, interne Konsistenz und interne Skalenstruktur wurden unter Zuhilfenahme eines t-Tests sowie von Cronbach α, der Faktor-Analyse und der Rasch-Analyse untersucht. Die Items der CASP-C-Skala wurden auf alle neun Kapitel der Internationalen Klassifikation der Funktionsfähigkeit, Behinderung und Gesundheit bei Kindern und Jugendlichen übertragen. Kinder mit einer geistigen Behinderung geringeren Schweregrads wiesen signifikant höhere CASP-Scores auf als Kinder mit schwereren Behinderungen. Eine interne Konsistenz war bei den Teilbereichen und der CASP-C insgesamt (Cronbach α=0,88-0,97) akzepabel. Die Faktoranalyse ergab eine zweifaktorielle CASP-C-Struktur, die die Varianz von 64,1 % erklärte. Die Rasch-Analyse wies auch auf ein unidimensionales Konstrukt hin. Die Ergebnisse der psychometrischen Analysen stimmen überein mit den Ergebnissen anderer Studien und belegen die Tatsache, dass die CASP-C-Skala akzeptable psychometrische Eigenschaften zur Anwendung im DES in Taiwan hatte. Allerdings ist die Durchführung einer weiteren Studie mit einer größeren, facettenreicheren Stichprobe erforderlich, um die Generalisierbarkeit der Ergebnisse zu steigern.La Escala de Participación Infantil y Adolescente (CASP, por sus siglas en inglés) fue traducida al chino tradicional y ha sido incorporada en Taiwán desde julio de 2012 como parte del nuevo Sistema de Evaluación de las Discapacidades (DES, por sus siglas en inglés) para niños en edad escolar con necesidades especiales. El objetivo de este estudio fue examinar las propiedades psicométricas de la versión en chino tradicional de CASP (CASP-C). En el estudio participaron 231 padres/cuidadores de niños y adolescentes de 6-18 años de edad procedentes de 31 hospitales de Taiwán que participan en el sistema DES. La mayoría de los niños padecían discapacidades intelectuales (67%), seguidos por los niños con discapacidades físicas y con trastornos del espectro autista. CASP fue traducido al chino tradicional de acuerdo con el proceso de adaptación intercultural. El contenido, así como la validez de grupo, la consistencia interna y la estructura interna de la escala se examinaron mediante un t-test, el α de Cronbach, un análisis factorial y un análisis de Rasch. Los ítems de CASP-C se distribuyeron entre los nueve apartados de la Clasificación Internacional del Funcionamiento (versión para la infancia y la adolescencia). Los niños con discapacidades intelectuales menos severas mostraron puntuaciones de CASP-C significativamente mayores que las de aquellos niños con discapacidades más graves. La consistencia interna fue aceptable tanto en los subdominios como en CASP-C en general (α de Cronbach=0,88-0,97). El análisis factorial tuvo como resultado una estructura de CASP-C de dos factores, que contribuyó al 64,1% de la varianza explicada. Además, el análisis de Rasch mostró un constructo unidimensional. Los resultados de los análisis psicométricos concuerdan con los de otros estudios, y confirman que CASP-C posee propiedades psicométricas aceptables para su uso en DES en Taiwán. Sin embargo, se precisan futuros estudios con una muestra más diversa y de mayor tamaño, de modo que se obtengan resultados más generalizables.L' échelle de participation des enfants et des adolescents (CASP) a été traduite en chinois traditionnel et a ensuite été incluse dans le cadre du nouveau système d'évaluation des personnes handicapées (DES) à Taiwan depuis juillet 2012 pour enfants d'âge scolaire ayant des besoins particuliers. Cette étude avait pour objet d'examiner les propriétés psychométriques de la version en chinois traditionnel de la CASP (CASP-C). Les participants étaient 231 parents d'enfants âgés de 6 à 18 ans recrutés dans 31 hôpitaux qui s'étaient qualifiés pour le DES à Taiwan. La plupart des enfants souffraient une déficience intellectuelle (67 %), suivie par des handicaps physiques et des troubles du spectre autistique. La CAPS a été traduite en chinois traditionnel selon le processus d'adaptation interculturelle. Le contenu et la validité connue du groupe , la cohérence interne et la structure interne de l'échelle ont été examinés à l'aide d'un test t, de l'α de Cronbach, d'analyse factorielle et d'analyse de Rasch. Les articles CASP-C ont été cartographiés sur l'ensemble des neuf chapitres de la Classification internationale du fonctionnement - version enfants et jeunes. Les enfants présentant une déficience intellectuelle moins sévère ont obtenu des scores CASP-C considérablement plus élevés que les enfants ayant des déficiences plus graves. La cohérence interne était acceptable sur les sous-domaines et l'échelle CASP-C totale (α de Cronbach = 0,88 à 0,97). L'analyse factorielle a produit une structure CASP-C à deux facteurs, contribuant à une explication de la variance de 64,1 %. L'analyse de Rasch révèle également une construction unidimensionnelle. Les résultats des analyses psychométriques sont en accord avec ceux d'autres études, et confirme que la CASP-C offre des propriétés psychométriques acceptables pour une utilisation dans le système DES à Taiwan. Toutefois, une étude plus approfondie auprès d'un échantillon plus large et plus diversifié sera nécessaire pour accroître la possibilité de généraliser les résultats.International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation 01/2013; · 0.36 Impact Factor -
Article: Individualized Behavioral Assessments and Maternal Ratings of Mastery Motivation in Mental Age-Matched Toddlers With and Without Motor Delay.
[show abstract] [hide abstract]
ABSTRACT: Background Mastery motivation is a precursor of later developmental outcomes. Evidence about whether toddlers with motor delay have lower mastery motivation is inconclusive.Objective To examine differences between mental age matched toddlers with and without motor delay on various mastery motivation indicators.DesignA mental age and gender matched case-control study. METHODS:/b>Twenty-two children with motor delay, aged 23 - 47 months, and 22 children developing typically, aged 15 - 29 months were recruited. Persistence and mastery pleasure were measured with behavioral tasks that were moderately challenging for each child and with maternal ratings using the Dimensions of Mastery Questionnaire (DMQ). The DMQ was rated by the mother based on her perception of her child's motivation. Two types of structured tasks (a puzzle and a cause-effect toy selected to be moderately challenging for each individual child) were administered in a laboratory setting and recorded on videos. Paired t tests or Wilcoxon signed rank tests were used to examine group differences in persistence and mastery pleasure (α=.007; two tailed). RESULTS: /b>Children with motor delay were rated lower on DMQ persistence than the typically developing group, but they did not show significantly lower persistence on the structured tasks. There were no significant differences in mastery pleasure between the two groups on either measure.LimitationsLarge within sample variability on the tasks and small sample size makes subgroup analysis (e.g., different severities) difficult. CONCLUSIONS:/b>Toddlers with motor delays did not show lower persistence and pleasure when given tasks that were moderately challenging; however, mothers tended to view their delayed toddlers as having lower motivation. Clinicians and parents should provide appropriately challenging tasks to increase children's success and motivation.Physical Therapy 09/2012; · 3.11 Impact Factor
