[Show abstract][Hide abstract] ABSTRACT: In young children, visual attention, analysis or memory is only rarely evaluated. Moreover, tools to test for such higher-order visual capacities in children are limited. In an attempt to develop and refine such tools, we selected nine tests to assess visuo-attentional abilities before formal reading education (grade 1). The battery consisted of gaze fixation, visual field, visual extinction, binocular visual pursuit, visual memory, "A" cancellation, Teddy bears cancellation, embedded figures, and matching tasks. This battery was used in the general population (n=110) to calculate cut-off scores identifying the lower 5% of the general population to obtain a screening measure for neurovisual disabilities in children. To evaluate our battery's sensitivity and specificity to neurovisual disorders over ophthalmological diseases, a neurovisual group (n=9) and an ophthalmologic group (n=13) also completed the tests. Overall, all but three tests of the battery could be used to discriminate between neurovisual and ophthalmologic children. The ophthalmologic children failed the visual field extent examination and the cancellation tasks, consistent with deleterious effects of ophthalmologic disease on visual perception as well as higher-order vision. Using the cut-off scores, the battery identified only 2 out of 13 ophthalmologic patients, but 5 out of 9 neurovisual patients. In the general population, these cut-off scores identified seven children. These children were previously undiagnosed with any disability (i.e., no diagnosis of ophthalmological, neurological, or psychiatric disease) and thus did not receive any rehabilitation. This preliminary study highlights the necessity for a neurovisual disorder screening tool for young children.
Research in developmental disabilities 09/2010; 31(5):1102-8. · 4.41 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Temporal processing deficit could be associated with a specific difficulty in learning to read. In 1951, Stambak provided preliminary evidence that children with dyslexia performed less well than good readers in reproduction of 21 rhythmic patterns. Stambak's task was administered to 1,028 French children aged 5-6 years. The score distribution (from 0 to 21) was quasi-normal, with some children failing completely and other performing perfectly. In second grade, reading was assessed in 695 of these children. Kindergarten variables explained 26% of the variance of the reading score at second grade. The Stambak score was strongly and linearly related to reading performance in second grade, after partialling out performance on other tasks (oral repetition, attention, and visuo-spatial tasks) and socio-cultural level. Findings are discussed in relation to perceptual, cerebellar, intermodal, and attention-related theories of developmental dyslexia. It is concluded that simple rhythm reproduction tasks in kindergarten are predictive of later reading performance.
Archives of Clinical Neuropsychology 08/2009; 24(6):555-63. · 2.00 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Self-reported stressful life events and infections have been associated with relapses in multiple sclerosis. Also, anxiety has been reported to influence other diseases of unpredictable course. To study relation of self-reported stressful life events, levels of anxiety, and episodes of infection, with relapses of the disease in women with multiple sclerosis.
This is a one-year prospective study. Thirty seven women with multiple sclerosis were regularly seen every four weeks, for one year. They were keeping diaries of events they considered stressful. These events were ranked according to the Holmes and Rahe Social Readjustment Rating Scale. Their anxiety levels were assessed with the Hamilton rating scale for anxiety. Relapses and episodes of infection were verified at additional visits. Results were studied using a survival analysis model adapted for several recurrent events.
A total of 291 stressful events, 37 episodes of infection, and 48 relapses, were registered. High level of anxiety were stongly related to the number and the severity of reported stressful events during the preceding period and with the advent of a relapse in the following period (Hamilton score greater than 18 is associated with 4.2 times the rate of relapsing and three or more reported stressful events with 5.7 times the rate of relapsing).
Anxiety and self-reported stressful events may in fact be two measures of the same underlying emotional factor, which plays an important role on the course of the disease, in addition to episodes of infection.
[Show abstract][Hide abstract] ABSTRACT: Few epidemiological studies have investigated the long-term outcome of primary glomerulonephritis (GN) and its determinants in the decade since angiotensin-converting enzyme inhibitors entered widespread use.
To study several traditional and less traditional risk factors for kidney disease progression in a cohort of patients with primary GN.
Retrospective cohort study.
We included 536 patients with primary GN first diagnosed between 1994 and 2001: 283 IgA nephropathy (IgA), 129 membranous nephropathy (MN), and 124 focal and segmental glomerulosclerosis (FSGS). Adjusted hazard ratios (HR) or dialysis or preemptive transplantation for end-stage renal disease (ESRD) according to various characteristics were estimated with Cox proportional-hazard models.
At diagnosis, mean patient age was 43 +/- 17 years, 74% were men, and the mean estimated glomerular filtration rate (eGFR) was 69 +/- 31 mL/mn/1.73m(2). After a mean follow-up of 7-years, 104 patients had started ESRD treatment and 14 had died before reaching ESRD. The 7-year renal survival rate was 69% for FSGS, 88% for MN, and 82% for IgAN (p < 0.01). In patients with FSGS, younger age was associated with a higher risk of ESRD. Baseline proteinuria, diabetes, and haemoglobin (Hb) concentration were strongly associated with shorter time to ESRD independent of baseline eGFR, but gender, hypertension and smoking were not. Adjusted HRs for ESRD were 2.6 [95% confidence interval, 1.2-5.8] for diabetes and 2.4 [1.3-4.5] for the lowest and 1.9 [1.0-3.6] for the intermediate Hb tertiles versus the highest.
In patients with primary GN, renal survival is clearly lower for FSGS than for IgAN and MN. Independent predictors for progression were baseline diabetes and anaemia, as well as proteinuria, for all GN types, and younger age, for FSGS.
QJM: monthly journal of the Association of Physicians 03/2008; 101(3):215-24. · 2.46 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Surgical treatment appears to improve the cognitive prognosis in children undergoing surgery for temporal lobe epilepsy (TLE). The beneficial effects of surgery on memory functions, particularly on material-specific memory, are more difficult to assess because of potentially interacting factors such as age range, intellectual level, left-handedness, type of surgery and seizure outcome. This study investigated memory functions in 20 right-handed children who had left or right-temporal lobe surgery - including hippocampectomy - and became seizure-free. The neuropsychological evaluation included tests measuring verbally and visually mediated episodic memory, everyday memory as well as attention/working memory and language/semantic memory. We also assessed the relationships between age of seizure onset, general cognitive ability and memory functions. Children with TLE showed poor memory efficiency before surgery that tended to improve about 1 year after surgery. We found a material-specific memory effect, especially after surgery-9 (out of 12) children with left TLE had worse verbal memory results while 5 (out of 8) with right TLE had worse visual memory results. Post-operatively, most children had poor everyday memory performance on the Rivermead Behavioural Memory Test. No significant relationship was observed between episodic memory scores and age of epilepsy onset but children with early onset remained with lower Performance IQ values, Rey's figure copy scores and naming performances after surgery. Surgery significantly improved all the attention/working memory scores, some verbal episodic memory tasks and naming test performances. A different pattern of episodic and semantic memory limitations related to left or right TLE was observed.
[Show abstract][Hide abstract] ABSTRACT: To evaluate the long term impact of teacher's report of behavior difficulties in children aged 3.5 years.
Teachers assessed behavior and attention difficulties in 2054 children by questionnaire; reading performance, and behavior and attention difficulties were re-assessed in 695 of these children at second grade (7-8 years).
Reading delay was not significantly associated with behavior and attention assessment at 3.5 years. Children with behavior problems according to the teacher were most often different at 3.5 years and at 7-8 years.
Reading delay at second grade was not related to teacher's report of behavior problems at 3.5 years of age in this french longitudinal school study. These observations are discussed in relation to DSM-IV criteria of disruptive behavior and attention deficit in children.
Archives de Pédiatrie 04/2007; 14(3):227-33. · 0.41 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Early detection of specific language impairment and dyslexia in children is an important public health problem. Longitudinal studies are needed for the distinction of real impairments from simple transitory delays.
Teachers filled a 29-item questionnaire on language and behavior for 695 children aged 3.5 years. Four years later (at second grade of primary school) the same children were evaluated for reading and writing. Statistical analysis focused on the relationships between teacher's early observations and reading delay 4 years later. Associated factors were age, sex, educational level and bilinguism of the parents, and area of the school.
The delay in written language acquisition (8.5% of the children) was significantly associated with low educational level (but not bilinguism) of the parents and to the area of the school. In univariate analysis, most of the teacher's early negative assessments were significantly related to reading/writing delay, with the exception of some behavioral problems. However, when the effect of associated factors was taken into account only a few items, mainly concerning language expression, remained significantly associated with later reading/writing delay.
These data show a major role of associated factors (educational level of the parents, area of the school) in reading delay, and help to select specific teacher's observations for an early prediction of this delay.
Revue d Épidémiologie et de Santé Publique 10/2006; 54(4):327-39. · 0.66 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Several tools have been proposed for screening for specific language impairment and behavioral problems in pre-school children. These disorders are risk factors for later poor school achievement and social life. However, presence of real disorders must be differentiated from environmental factors, such as low educational level of the parents or bilingual family.
A 29-item teachers'questionnaire was used for screening for language and behavioral disorders in 2059 nursery-school children aged 3.5 years from 200 nursery-schools of different areas in France.
According to the teachers, difficulties were clearly more frequent in boys than girls, in children from low educational level families, and in children with not-french-speaking parents.
The gender of the child and the characteristics of the family play a very important role in the teachers'assessment of a young pre-school child's language and behavior. Longitudinal studies would be required to differentiate the presence of specific disorders, requiring individual intervention, from simple delays due to environmental factors.
Revue d Épidémiologie et de Santé Publique 01/2006; 53(6):645-57. · 0.66 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Position du problèmePlusieurs outils ont été proposés pour le repérage précoce, dès l’école maternelle, des troubles spécifiques du langage chez l’enfant. Ces troubles peuvent être un facteur de risque de désinsertion scolaire et sociale. Une des difficultés dans l’interprétation des résultats obtenus par ces outils est de différencier la présence d’un « trouble » du rôle de facteurs environnementaux, comme le niveau socioculturel ou le bilinguisme.MéthodesLe questionnaire « Langage et comportement » comporte 29 questions adressées aux enseignants de la petite section de l’école maternelle qui permettraient de repérer les enfants âgés de 3 ans et demi présentant des difficultés de langage et de comportement et nécessitant des examens plus approfondis. Les résultats ont été recueillis dans 200 écoles auprès de 2 059 enfants de milieux divers.RésultatsLes enseignants signalent beaucoup plus souvent des difficultés chez les garçons que chez les filles, quand le niveau socioculturel de la famille est bas et quand au moins un des deux parents n’est pas francophone. L’analyse par item montre que l’effet du niveau socioculturel concerne l’ensemble des domaines ; l’effet du sexe porte sur le comportement, la motricité manuelle fine et l’expression du langage ; le bilinguisme a un effet défavorable seulement sur les questions relatives au langage.ConclusionLe rôle du sexe de l’enfant et des caractéristiques de la famille lorsqu’on examine les appréciations par les enseignants du langage et du comportement des élèves de petite section de maternelle est très important. Seules des études longitudinales permettraient de différencier la présence d’un trouble, nécessitant une intervention individuelle spécifique auprès de l’enfant, des simples retards dus à des facteurs environnementaux.Background
Several tools have been proposed for screening for specific language impairment and behavioral problems in pre-school children. These disorders are risk factors for later poor school achievement and social life. However, presence of real disorders must be differentiated from environmental factors, such as low educational level of the parents or bilinguism.MethodsA 29-item teachers’questionnaire was used for screening for language and behavioral disorders in 2059 nursery-school children aged 3.5 years from 200 nursery-schools of different areas in France.ResultsAccording to the teachers, difficulties were clearly more frequent in boys than girls, in children from low educational level families, and in children with not-french-speaking parents.Conclusion
The gender of the child and the characteristics of the family play a very important role in the teachers’assessment of a young pre-school child's language and behavior. Longitudinal studies would be required to differentiate the presence of specific disorders, requiring individual intervention, from simple delays due to environmental factors.
Revue d'Épidémiologie et de Santé Publique. 12/2005; 53(6):645-657.