Failure to thrive in the first postnatal year An inner city community survey

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Individual differences in cognitive planning on the Tower of Hanoi task: neuropsychological maturity or measurement error?

The Tower of Hanoi (ToH) task was given to 238 children aged from 7 to 15 years, and 20 adults. Individual variation within an age band was substantial. ToH score did not correlate significantly with Verbal IQ, nor with ability to inhibit a prepotent response. We readministered the ToH to 45 children after 30 to 40 days. The test-retest correlation of .5 is low in relation to accepted psychometric standards, though at least as high as reliability of the related Tower of London (ToL) in adults. The reasons for low reliability remain unclear: task novelty did not seem to be involved, as children did not improve on retest. We conclude that it is not safe to use this test to index integrity or maturation of underlying neurological systems in children. We compared our results with three published studies using the ToL with children, and found similar levels of performance on problems involving the same number of moves. Another study using automated ToL obtained much poorer scores, suggesting that computerised presentation may impair children's performance

Social cognition and conduct problems: a developmental approach

Objective To estimate associations between trajectories of conduct problems and social-cognitive competences through childhood into early adolescence. Method A prospective population-based cohort, the Avon Longitudinal Study of Parents and Children (ALSPAC) recruited in the prenatal period (13,988 children alive at 12 months) formed the basis for the current study. Socio-emotional and pragmatic language competences were examined in relation to conduct problem development in a group of 6,047 children with no known autistic-spectrum disorders. Specifically, conduct problem trajectories (low, childhood-limited, adolescent-onset, and early-onset persistent) identified using maternal prospective reports (Strengths and Difficulties Questionnaire: ages 4 through 13 years) were contrasted. Demographic confounders, child verbal IQ and other psychopathologies were controlled. Results In contrast to individuals with low conduct problem levels, all conduct problem groups presented with difficulties in both social-cognitive domains. Deficits among those with early-onset persistent conduct problems were particularly apparent: 40.6% of boys and 24.3% of girls with persistent conduct problems met impairment criteria for one or other social-cognitive domain. Associations remained robust after controlling for demographic confounders (maternal age at birth, low SES, maternal education), child verbal IQ, and internalizing and inattention symptoms. For boys, results indicated that overlaps with overactivity symptoms may contribute problems with pragmatic language; this was not the case for girls or for socio-emotional difficulties. Conclusions Findings have far-reaching implications for children with conduct problems, particularly those with early onset and persistent difficulties. Traditional parent training interventions are likely to be bolstered by strategies that help to develop the social competences of these children

Evidence from Turner's syndrome of an imprinted X-linked locus affecting cognitive function

Turner's syndrome is a sporadic disorder of human females in which all or part of one X chromosome is deleted(1). Intelligence is usually normal(2) but social adjustment problems are common(3). Here we report a study of 80 females with Turner's syndrome and a single X chromosome, in 55 of which the X was maternally derived (45,X-m) and in 25 it was of paternal origin (45,X-p). Members of the 45,XP group were significantly better adjusted, with superior verbal and higher-order executive function skills, which mediate social interactions(4). Our observations suggest that there is a genetic locus for social cognition, which is imprinted(5) and is not expressed from the maternally derived X chromosome. Neuropsychological and molecular investigations of eight females with partial deletions of the short arm of the X chromosome(6) indicate that the putative imprinted locus escapes inactivation(7), and probably lies on Xq or close to the centromere on Xp. If expressed only from the X chromosome of paternal origin, the existence of this locus could explain why 46,XY males (whose single X chromosome is maternal) are more vulnerable to developmental disorders of language and social cognition, such as autism, than are 46,XX females(8)

Eating habits and attitudes of mothers of children with non-organic failure to thrive.

The eating habits and attitudes concerning body shape and weight among 26 mothers of children with non-organic failure to thrive (the index group) were studied using the eating disorder examination. They were compared with equivalent data on 26 individually matched women who participated in a large community survey. The index mothers' views of their child's weight and shape were also studied. The principal findings were, firstly, that when compared with the comparison group, mothers of children with non-organic failure to thrive had higher levels of dietary restraint. Secondly, despite their child's low weight, 50% of the index mothers were restricting their child's intake of 'sweet' foods, and a further 30% were restricting foods they considered 'fattening' or 'unhealthy'. These results raise the question of whether maternal eating habits and attitudes have a causal role in the genesis of non-organic failure to thrive. They suggest that careful inquiry about the mothers' eating habits and attitudes is needed when assessing children with non-organic failure to thrive

Recognising failure to thrive in early childhood.

The maximum weight centile achieved by a child between 4 and 8 weeks of age was found to be a better predictor of the centile at 12 months than the birth weight centile. Children whose weight deviated two or more major centiles below this maximum weight centile for a month or more showed significant anthropometric differences during the second year of life from those who showed no such deviation. It is suggested that this leads to a logical and practical definition of failure to thrive