Memory performances and personality traits in mothers of children with obstructive sleep apnea syndrome

Background: Chronic diseases in pediatric age have been identified as stressful risk factors for parents. Studies on caregivers have documented the impact of chronic parenting stress on emotion and cognition.Aim: To investigate the differences between a group of mothers of children affected by obstructive sleep apnea syndrome (OSAS) for at least 4 years and a group of mothers of typically developing children (TDC) in relation to parental stress, self-esteem, locus of control, and memory performances.Methods: A group of 86 mothers (mean age 35.6 +/- 4.9, ranged between 32 and 41 years) of children with OSAS diagnosis, and a group of 52 mothers of TDC (mean age 35.9 +/- 4.2, ranged between 32 and 41 years) participated in the study. All participants were administered stress level, global self-esteem, internal/external locus of control scales, and memory assessment.Results: Mothers of OSAS children, compared to mothers of TDC, had a significantly higher level of stress, lower self-esteem, more external locus of control and poorer memory performance.Conclusions: The child respiratory disease, with its sudden and unpredictable features, appeared as a significant source of stress for the mother. Such stress condition may have an impact on mothers' personality traits (self-esteem, locus of control) and on their memory performances. The data have suggested a need for psychological support programs for mothers to better manage stress associated with children's respiratory disease

VISUOMOTOR INTEGRATION SKILLS IN CHILDREN AFFECTED BY OBSTRUCTIVE SLEEP APNEA SYNDROME: A CASE-CONTROL STUDY

Introduction: Sleep related breathing disorders (SRBD) consist of frequent and repetitive episodes of pharyngeal obstruction during sleep, with consequent intermittent hypoxia, sleep architecture fragmentation, daytime sleepiness and/or behavioural problems and executive impairment in children. When untreated, SRBD and obstructive sleep apnea syndrome (OSA) mainly, may impact school performance, cognition, metabolism, and cardiovascular function. Aim of the present study is assessing the visuomotor integration skills in children affected by OSA. Materials and methods: 57 subjects affected by mild-to severe OSA, PSG diagnosed according to international diagnostic criteria, (31 males and 26 females) (mean age 10.8; SD \ub1 2.49) and 83 healthy children (45 males and 38 females) (mean age 9.95; SD \ub1 1.87; p = 0.725). All subjects underwent assessment of motor coordination skills with Movement-ABC tests and visual-motor integration ability with Visual Motor Integration (VMI) test. Results: The subjects with OSA show a worse average performances in all items of Movement ABC (p <0.001) respect of controls. Specifically, children with OSAS show significantly higher values of total points (p <0.001), manual dexterity (p <0.001), ball skills (p <0.001) and balance (p <0.001). Accordingly, the average centile in OSA children at the MABC-test is significantly reduced compared with controls (p <0.001). (Table 1) On the other hand, the VMI test evaluation among children with OSAS shows worst result in total Visuo-Motor Integration (p <0.001), and in Motor Coordination sub-item (p <0.001) than controls. (Table 1). Conclusion: Our results also support for children and adolescents the hypothesis that executive functioning deficits might be linked primarily to the degree of severity nocturnal hypoxemia rather than daytime sleepiness, although several other studies are needed

THE QUALITY OF LIFE IN CHILDREN WITH CEREBRAL PALSY

Background: Cerebral palsy (CP) is the most common pediatric disability causing long-term functional limitations. CP remarkably influences the life of those affected and their families. For this reason it is important and necessary to direct attention not only type of the CP, but also the impact the disorder has on the child, parents, siblings and the entire family as a whole. The aim of this study was to assess the impact of CP on the child’s quality of life, considering parents’ perceptions about their child's illness, in order to underline the impact the illness has not only on the child but also his/her family. Methods: The study included both parents of the 36 subjects enrolled (19 males and 17 females), with established CP diagnosis. The effect of CP on the families was assessed using the Impact of Childhood Illness Scale. This questionnaire assesses the quality of life in children with epilepsy and other chronic pathologies and in their families. All questions refer to effect to the illness family. The scale comprises 30 questions divided into four sections: impact of illness and its treatment ; impact on development and child s adjustment; impact on parents and impact on the family. Descriptive analyses were used for data analysis and it is also calculated the rank correlation coefficient Spearman’s rho. Results and conclusion: The mothers’ group presents little higher average scores than the group of fathers in two four subscales or in the basement “Impact on the child” and “Family impact on the organization”. This could be due to the fact that mothers are concerned most of the child's caregiver, living most of all the difficulties that entails; mothers show greater concerns than fathers. In subscale “Impact on parents” the average score of the answers of the group of mothers coincide with that of the fathers; the experience and the experience of his son's illness is analogous for both parents. No significant differences were found from the correlational analysis between the individual items of the subscales and the different forms of CP. In families of children with CP, strategies for optimizing caregiver physical and psychological health include supports for behavioral management and daily functional activities as well as stress management and self-efficacy techniques

The relationship between maternal reflexive functions and joint attention in neurotypical children

Joint Attention (JA) can be defined as the coordination of attentional orienting between two persons towards a common object. It develops in typically developing children between 6 and 18 months of age across two phases: Initiating Joint Attention (IJA) and Responding to Joint Attention (RJA). For instance, a parent can initiate JA by pointing to an object and the child can respond by moving her eye gaze towards the parent’s pointing. JA represents one of the first precursors of the Theory of Mind (ToM) implying the person’s ability to think and reason about own and another person's mental states, inferring thoughts, beliefs, intentions and desires. Less is clear, instead, on the relationship between the development of JA abilities in children and the mentalizing abilities of mothers. In the present study, we aimed at investigating the relationships between the infant’s (age range: 15 and 20 months) behaviours relating to IJA and the maternal Reflexive Functions (RF). The results showed a significant correlation between these two skills, thus suggesting that the reflective capacity of mothers can play an important role in development of milestones of the child’s social cognition

Neuropsychological profile, emotional/behavioral problems, and parental stress in children with neurodevelopmental disorders

Background: The aim of our study was to trace a specific neuropsychological profile, to investigate emotional-behavioral problems and parental stress in children with Autism Spectrum Disorder Level 1/High functioning (ASD-HF), Specific Learning Disorders (SLD) and Attention Deficit/Hyperactivity Disorder (ADHD) disorders and to highlight similarities and differences among the three groups. Methods: We retrospectively collected the data from a total of 62 subjects with ASD-HF (n = 19) ADHD (n = 21), SLD (n = 22) and 20 typical development. All the participants underwent neuropsychological standardized test for the evaluation of cognitive profile (Wechsler Intelligence Scale for Children Fourth Edition-WISC-IV), behavioral and emotional problems (Child Behavior CheckList CBCL), and parental stress (Parental Stress Index Short Form-PSI-SF). The scores of the ASD-HF, ADHD, and SLD groups were compared using non-parametric statistic methods (Kruskall-Wallis H test and U Mann-Whitney for post-hoc analysis). Results: The ASD-HF group were significantly higher in all areas of the WISC-IV than the other two clinical groups. The SLD group performed significantly lower than ASD-HF in Working Memory Index. The SLD group showed lower scores on the somatic problems subscale than the other two groups. In the Difficult Child subscale of the PSI-SF, parents of ADHD children scored lower than the mothers of SLD subjects and higher than the fathers of SLD subjects. In all three groups there are specific deficiencies compared to the control group in the cognitive profile, behavioral and emotional problems, and parental stress. Conclusions: Our comparative analysis highlighted similarities and differences in three groups of children with different neurodevelopmental disorders, helping to better define cognitive, behavioral, and emotional characteristics of these children and parental stress of their parents

Visual\u2013spatial training efficacy in children affected by migraine without aura: A multicenter study

Routinely in the clinical practice, children affected by migraine without aura (MwA) tend to exhibit severe and persistent difficulties within cognitive processes such as attention, memory, and visual\u2013motor integration (VMI) skills. The aim of this study was to assess the visual\u2013spatial and visual\u2013motor abilities among a sample of children with MwA and the effects of a specific computerized training. The study population was composed of 84 patients affected by MwA (39 girls and 45 boys; mean age: 8.91\ub12.46 years), and they were randomly divided into two groups (group A and group B) comparable for age (P=0.581), gender (P=0.826), socioeconomic status (SES), migraine frequency (P=0.415), and intensity (P=0.323). At baseline (T0), the two groups were comparable for movement assessment battery for children (M-ABC) and VMI performances. After 6 months of treatment (T1), group A showed lower scores in the dexterity item of M-ABC test (P<0.001) and higher scores in M-ABC global performance centile (P<0.001) and total (P<0.001), visual (P=0.017), and motor (P<0.001) tasks of VMI test than group B. Moreover, at T1, group A showed higher scores in total (P<0.001) and motor (P<0.001) tasks of VMI test and in M-ABC global performance centile (P<0.001) and lower scores in the dexterity item of M-ABC test (P<0.001) than at T0. Group B showed, at T1, performances comparable to T0 for all evaluations. As reported by recent studies about alteration MwA among children in motor abilities, our study confirmed these difficulties and the efficacy of a specific software training, suggesting a new rehabilitative proposal in childhood

Sleep Macrostructure and NREM Sleep Instability Analysis in Pediatric Developmental Coordination Disorder

Developmental Coordination Disorder (DCD) is considered to be abnormal motor skills learning, identified by clumsiness, slowness, and/or motor inaccuracy impairing the daily-life activities in all ages of life, in the absence of sensory, cognitive, or neurological deficits impairment. The present research focuses on studying DCD sleep structure and Cyclic Alternating Pattern (CAP) parameters with a full overnight polysomnography and to study the putative correlations between sleep architecture and CAP parameters with motor coordination skills. The study was a cross-sectional design involving 42 children (26M/16F; mean age 10.12 ± 1.98) selected as a DCD group compared with 79 children (49M/30F; mean age 9.94 ± 2.84) identified as typical (no-DCD) for motor ability and sleep macrostructural parameters according to the MABC-2 and polysomnographic (PSG) evaluations. The two groups (DCD and non-DCD) were similar for age (p = 0.715) and gender (p = 0.854). More significant differences in sleep architecture and CAP parameters were found between two groups and significant correlations were identified between sleep parameters and motor coordination skills in the study population. In conclusion, our data show relevant abnormalities in sleep structure of DCD children and suggest a role for rapid components of A phases on motor coordination development

Executive dysfunction in children affected by obstructive sleep apnea syndrome: an observational study

Introduction: The role of sleep in cognitive processes can be considered clear and well established. Different reports have disclosed the association between sleep and cognition in adults and in children, as well as the impact of disturbed sleep on various aspects of neuropsychological functioning and behavior in children and adolescents. Behavioral and cognitive dysfunctions can also be considered as related to alterations in the executive functions (EF) system. In particular, the EF concept refers to self-regulatory cognitive processes that are associated with monitoring and controlling both thought and goal directed behaviors. The aim of the present study is to assess the impact of the obstructive sleep apnea syndrome (OSAS) on EF in a large sample of school aged children. Materials and methods: The study population comprised 79 children (51 males and 28 females) aged 7–12 years (mean 9.14 ± 2.36 years) with OSAS and 92 healthy children (63 males and 29 females, mean age 9.08 ± 2.44 years). To identify the severity of OSAS, an overnight respiratory evaluation was performed. All subjects filled out the Italian version of the Modified Card Sorting Test to screen EFs. Moreover, to check the degree of subjective perceived daytime sleepiness, all subjects were administered the Pediatric Daytime Sleepiness Scale (PDSS). Results: No significant differences between the two study groups were found for age (P = 0.871), gender (P = 0.704), z-score of body mass index (P = 0.656), total intelligence quotient (P = 0.358), and PDSS scores (P = 0.232). The OSAS children showed a significantly higher rate of total errors (P , 0.001), perseverative errors (P , 0.001), nonperseverative errors (P , 0.001), percentage of total errors (P , 0.001), percentage of perseverative errors (P , 0.001), and percentage of nonperseverative errors (P , 0.001). On the other hand, OSAS children showed a significant reduction in the number of completed categories (P = 0.036), total correct sorts (P = 0.001), and categorizing efficiency (P , 0.001). The Pearson’s correlation analysis revealed a significant positive relationship between all error parameters and apnea-hypopnea index, oxygen desaturation index, and percentage of mean desaturation of O2 with a specular negative relationship between the error parameters and the mean oxygen saturation values, such as a significant negative relationship between apnea-hypopnea index, oxygen desaturation index, percent of mean desaturation of O2, and the number of completed categories. Conclusion: Our study identified differences in the executive functioning of children affected by OSAS and is the first to identify a correlation between alteration in respiratory nocturnal parameters and EF that has not yet been reported in developmental age. These findings can be considered as the strength and novelty of the present report in a large pediatric population

Adhd-like symptoms in children affected by obstructive sleep apnea syndrome: A case-control study

Introduction: ADHD is characterized by inattention, hyperactivity, impulsivity, or a combination of these symptoms. Sleep disorders may be considered as a not secondary underlying cause of ADHD and growing evidence evidenced that obstructive sleep apnea syndrome (OSA) symptoms may overlap ADHD's ones. Aim of the present study is verifying the presence of ADHD-like symptoms in other frequent condition such as sleep-related breathing disorders in pediatric age. Materials and methods: 34 children (19 males and 15 females) aged 6-10 years (mean age 9.706 \ub1 3.434) with polysomnographic diagnosis of OSA, according to ICSD-3 criteria, were recruited. Control group was composed by 89 typical developing children (47 males, 42 females) (mean age 9,528 \ub1 3,351). The Conners' Rating Scale- Revised (CRS-R) test was administered to mothers to assess their children's behavior. Results: The two groups are comparable for age (p = 0.794) and sex distribution (p = 0.918). Subjects affected by OSA present higher scores in pathological range in all scales of CRS-R than controls (Table 1). Conclusions: Scientific and clinical evidences tend to stress the similarities between ADHD and OSA effects/comorbidities in pediatric age, suggesting sleep screening as mandatory before starting stimulant drugs treatment

Visuomotor competencies and primary monosymptomatic nocturnal enuresis in prepubertal aged children.

Background: Primary monosymptomatic nocturnal enuresis (PMNE) is a common problem in the developmental ages; it is the involuntary loss of urine during the night in children older than 5 years of age. Several clinical observations have suggested an association between bedwetting and developmental delays in motricity, language development, learning disability, physical growth, and skeletal maturation. The aim of the present study is to evaluate the prevalence of fine motor coordination and visuomotor integration abnormalities in prepubertal children with PMNE. Methods: The study population included 31 children (16 males, 15 females; mean age 8.14 years ± 1.36 years), and the control group comprised 61 typical developing children (32 males, 29 females; mean age 8.03 years ± 1.44 years). The whole population underwent a clinical evaluation to assess total intelligence quotient level, visuomotor integration (VMI) skills, and motor coordination performance (using the Movement Assessment Battery for Children, or M-ABC). Results: No significant differences between the two study groups were found for age (P = 0.725), gender (P = 0.886), z-body mass index (P = 0.149), or intellectual abilities (total intelligence quotient) (P = 0.163). The PMNE group showed a higher prevalence of borderline performance on M-ABC evaluation and in pathologic performance on VMI Total Task compared to controls (P , 0.001). No significant differences between the two study groups were found for pathologic performances on the M-ABC (P = 0.07), VMI Visual Task (P = 0.793), and VMI Motor Task (P = 0.213). Conclusion: Our findings pinpointed that PMNE should not be considered as a voiding disorder alone and, consequently, the children affected should be referred to specific rehabilitative programs that aim to improve motor coordination and visuomotor integration