Speech Delay In Toddlers: Are They Only "Late Talkers"?

Speech delay is prevalent in toddlers. Although some children with speech delay are able to catch up with their peers with time, the delay might be part of a broader condition such as global developmental delay, which requires specific diagnostic work-up. The current study aimed to present the demographic features, developmental profiles of the first 100 preschool-aged children who were seen at Hacettepe University Ihsan Dogramaci Children's Hospital-Developmental Pediatrics Unit with parental concern of speech delay. Moreover, risk factors associated with speech delay, possible diagnosis and intervention strategies are documented. Thirty-one of 100 children were diagnosed with autism spectrum disorder (ASD) and global developmental delay (GDD). The current study presented that 4 out of 5 toddlers exceeded the recommended TV watching time. Moreover, almost one third of children had a poor linguistic home environment. Three parents whose children were diagnosed with ASD or GDD, refused to be reported as 'autism spectrum disorder' or 'intellectual disability' with the anxiety of labeling their child. As a result, these children were unable to receive special education paid for by the government. This study presented 31 of 100 children needed further diagnostic work up and early intervention. Therefore, pediatricians should not underestimate speech delay. On the other hand, due to the fact that, the regulations to receive special education and therapy often create anxiety for the parents, we think that this system needs to be updated and special education support should be determined by the special needs of each child.WoSScopu

Poor Appetite in School Children: Is It a False Perception of Parents?

Aim: Poor appetite is a common symptom in childhood that can either be organic or nonorganic. Prolonged poor appetite may affect children's growth negatively. However picking at food or refusing to eat stresses parents out. In this study, we aimed to investigate the relationship between parental perception of the child's body measurements and appetite in school children who were admitted to the outpatient clinic with the complaint of sustained poor appetite. Materials and Methods: A total of 105 school children (6-15 years old) with the complaint of poor appetite who were investigated several times previously with no organic reason were included in the study. The study was conducted with a questionnaire that was filled out by parents recording demographics. Anthropometric measurements including body weight and height were measured by the same researcher. Body mass index was calculated and BMI for-age was determined. Patients with normal BMI percentile values and patients with low BMI percentile values were compared. Results: 105 children (M/F: 51/54) with a mean age of 8.2 +/- 1.9 years were studied. Mean body weight and height of children were 23.8 +/- 5.7 kg and 124.1 +/- 11.6 cm, respectively. Mean BMI of children was 15.2 +/- 1.5. According to BMI percentiles 65.7% (n=69) of children were normal weight, 30.5% (n=32) were underweight, and 3.8% (n=4) were overweight. When compared in terms of BMI percentiles no difference was found between the groups. Conclusion: Perception of the parents of their children's growth is influenced by many factors and usually does not reflect the facts. In our study, we found that the majority of the children with poor appetite were in normal weight range according to BMI percentile. Nevertheless, nearly one third of the children were underweight, a fact that should not be ignored

Vaccination Practices in Pediatric Dialysis Patients Across Europe. A European Pediatric Dialysis Working Group and European Society for Pediatric Nephrology Dialysis Working Group Study

Background: Data on the immunization practices in pediatric chronic kidney disease (CKD) patients are scarce. The purpose of this study was to evaluate current vaccination practices for children on dialysis across European pediatric nephrology centers. Methods: A total of 18 tertiary pediatric nephrology centers from 12 European countries were included in the study. The data on universal national immunization programs and immunization practices for children with chronic disease or risk were recorded from European Center for Disease Prevention and Control and the World Health Organization. The immunization practices and center protocols for monitoring antibody titers after vaccination in dialysis patients were obtained through a questionnaire. Results: All centers included in the study recommended immunization against hepatitis B virus (HBV), diphtheria, tetanus, pertussis, Hemophilus influenzae type b (Hib), poliomyelitis, measles, mumps, rubella (MMR), and streptococcus pneumonia in dialysis patients. In 16 centers, dialysis patients were vaccinated against influenza virus annually. HBV protective antibody titers were measured in 17 centers (during dialysis period in 14 centers, during pre-renal transplantation preparations in 14 centers or in both times in 11 centers). Hepatitis A virus (HAV) was reported to be followed in 13 centers, in 8 centers during dialysis period, and in 11 centers during pre-RTx preparations. MMR and varicella-zoster virus (VZV) protective antibody titers were measured during the dialysis period or before renal transplantation (RTx) in 12 and 15 centers, respectively, and in 6 centers both titers were checked both times. Conclusion: There are variations in vaccination practice across Europe. Children with CKD, those undergoing dialysis, and transplant candidates should receive age-appropriate vaccinations before RTx as well as before the transition to adult nephrology clinics and antibody levels should be monitored to evaluate the immunization status before and after RTx. (C) 2017 S. Karger AG, Basel