Relationships between variance in electroencephalography relative power and developmental status in infants with typical development and at risk for developmental disability: An observational study [version 2; referees: 2 approved]

Background: Electroencephalography (EEG) is a non-invasive tool that has the potential to identify and quantify atypical brain development. We introduce a new measure here, variance of relative power of resting-state EEG. We sought to assess whether variance of relative power of resting-state EEG could predict i) classification of infants as typical development (TD) or at risk (AR) for developmental disability, and ii) Bayley developmental scores at the same visit or future visits. Methods: A total of 22 infants with TD participated, aged between 38 and 203 days. In addition, 11 infants broadly at risk participated (6 high-risk pre-term, 4 low-risk pre-term, 1 high-risk full-term), aged between 40 and 225 days of age (adjusted for prematurity). We used EEG to measure resting-state brain function across months. We calculated variance of relative power as the standard deviation of the relative power across each of the 32 EEG electrodes. The Bayley Scales of Infant Development (3rd edition) was used to measure developmental level. Infants were measured 1-6 times each, with 1 month between measurements. Results: Our main findings were: i) variance of relative power of resting state EEG can predict classification of infants as TD or AR, and ii) variance of relative power of resting state EEG can predict Bayley developmental scores at the same visit (Bayley raw fine motor, Bayley raw cognitive, Bayley total raw score, Bayley motor composite score) and at a future visit (Bayley raw fine motor). Conclusions: This was a preliminary, exploratory, small study. Our results support variance of relative power of resting state EEG as an area of interest for future study as a biomarker of neurodevelopmental status and as a potential outcome measure for early intervention

Recommendations for Enhancing Psychosocial Support of NICU Parents through Staff Education and Support

Providing psychosocial support to parents whose infants are hospitalized in the neonatal intensive care unit (NICU) can improve parents’ functioning as well as their relationships with their babies. Yet, few NICUs offer staff education that teaches optimal methods of communication with parents in distress. Limited staff education in how to best provide psychosocial support to families is one factor that may render those who work in the NICU at risk for burnout, compassion fatigue and secondary traumatic stress syndrome. Staff who develop burnout may have further reduced ability to provide effective support to parents and babies. Recommendations for providing NICU staff with education and support are discussed. The goal is to deliver care that exemplifies the belief that providing psychosocial care and support to the family is equal in importance to providing medical care and developmental support to the baby

How Many Days are Necessary to Represent Typical Daily Leg Movement Behavior for Infants at Risk of Developmental Disabilities?

Background: Movement characteristics can differentiate between infants at risk and infants with typical development. However, it is unknown how many days are needed to accurately represent typical daily behavior for infants at risk of developmental disabilities when using wearable sensors. To consider the balance between participant burden and the amount of data collected and optimizing the efficiency of data collection, our study determined (1) how many days were necessary to represent typical movement behavior for infants at risk of developmental disabilities and (2) whether movement behavior was different on weekend days and weekdays. Methods: We used Opal wearable sensors to collect at least 5 days of 11 infants’ leg movement data. The standard (average of 5 days) was compared with four methods (average of the first 1/2/3/4 days) using the Bland–Altman plots and the Spearman correlation coefficient. We also compared the data from the average of 2 weekend days to the average of the first 2 weekdays for 8 infants. Results: The Spearman correlation coefficient comparing the average of the first 2 days of data and the standards were all above 0.7. The absolute differences between them were all below 10% of the standards. The Bland–Altman plots showed more than 90% of the data points comparing the average of 2 days and the standards fell into the limit of agreement for each variable. The absolute difference between weekend days and weekdays for the leg movement rate, duration, average acceleration, and peak acceleration was 15.2%, 1.7%, 6.8% and 6.3% of the corresponding standard, respectively. Conclusion: Our results suggest 2 days is the optimal amount of data to represent typical daily leg movement behavior of infants at risk of developmental disabilities while minimizing participant burden. Further, leg movement behavior did not differ distinctly across weekend days and weekdays. These results provide supportive evidence for an efficient amount of data collections when using wearable sensors to evaluate movement behavior in infants at risk of developmental disabilities

Electroencephalography power and coherence changes with age and motor skill development across the first half year of life.

Existing research in infants has correlated electroencephalography (EEG) measures of power and coherence to cognitive development and to locomotor experience, but only in infants older than 5 months of age. Our goal was to explore the relationship between EEG measures of power and coherence and motor skill development in younger infants who are developing reaching skill. Twenty-one infants with typical development between 38 and 203 days of age participated. Longitudinal EEG recording sessions were recorded in monthly increments, with 3-5 sessions acquired for 19 participants and 1 session for 2 participants, resulting in 71 sessions in total. EEG variables of interest were relative power in the 6-9 Hz range and coherence between selected electrode pairs. We describe the development of the peak in relative power in the 6-9 Hz frequency band of EEG; it is not present around 1 month of age and starts to appear across the following months. Coherence generally increased in the bilateral frontal-parietal networks, while the interhemispheric connectivity in motor cortices generally decreased. The results of this relatively small pilot study provide a foundational description of neural function changes observed as motor skills are changing across the first half year of life. This is a first step in understanding experience-dependent plasticity of the infant brain and has the potential to aid in the early detection of atypical brain development

The Interprofessional/Family-Centered-Care Observation Rubric (I-FOR): Results of a Multicenter Study of a New Measure of Educational Outcomes

Introduction The ability to provide family-centered care (FCC) and the ability to work in interprofessional care teams (IPC) are essential educational outcomes in graduate training programs. Lack of standardized measures leave programs to rely on idiosyncratic methods to monitor outcomes. We developed a faculty observation tool as part of an effort to create a national quality improvement database. We present evidence for the feasibility and validity of the faculty observation tool. Methods Trainees and faculty at four independent training programs participated. Nineteen maternal and child health disciplines were represented. Faculty supervisors rated trainees using the new measure (I-FOR), and trainees completed related subscales of a previously developed self-report measure, the core competency measure (CCM). Faculty provided qualitative feedback regarding the I-FOR in a separate questionnaire. Results Faculty (n = 78) completed the I-FOR on 86 trainees (86/92 = 93%) and reported satisfaction with completing the measures. The I-FOR demonstrated good internal consistency (Cronbach's alpha > 0.930) and test-retest reliability (IPC r = 0.862, FCC r = 0.823, p < 0.001). Greater than 95% of participants reported that the I-FOR accurately addressed the relevant skills for each practice domain. The I-FOR showed no correlation with the CCM. Significant improvements over time in the I-FOR ratings were demonstrated in three out of four programs. Discussion The I-FOR demonstrated good internal consistency and test-retest reliability. Faculty responses provide evidence for the feasibility and validity of the instrument. Self-report and faculty-observation measures both increased with training but were not correlated with each other

Changes in mean alpha coherence across fine motor scores from the Bayley test.

<p>(A) Changing trends of mean alpha coherence for each electrode pair. In each subplot, blue crosses denote magnitudes of mean alpha coherence for all sessions, and dashed lines are the least-squares fitted lines. (B) Electrode pairs with significance in likelihood ratio tests. Electrode pairs with significance are connected with blue lines.</p

Changes in mean alpha coherence across different reaching skill scores.

<p>(A) Changing trends of mean alpha coherence for each electrode pair. In each subplot, bars present mean magnitudes of mean alpha coherence for sessions of the same reaching skill score, with corresponding standard deviation added on top. (B) Electrode pairs with significance in likelihood ratio tests. Electrode pairs with significance are connected with blue lines.</p

Correlation of alpha band power with chronological age in days.

<p>Each cross represents magnitude of alpha band power from one session. Dashed line shows the least-squares fitted line along maturation. The r and p values denote correlation test results.</p

infant EEG data

see PLOS One publication "Electroencephalography power and coherence changes with age and motor skill development across the first half year of life" by Xiao, Shida-Tokeshi, Vanderbilt, Smith