Neonatal encephalopathy: Case definition & guidelines for data collection, analysis, and presentation of maternal immunisation safety data.

To improve comparability of vaccine safety data, the acute neonatal encephalopathy working group has developed a case definition and guidelines neonatal encephalopathy applicable in study settings with different availability of resources, in healthcare settings that differ by availability of and access to health care, and in different geographic regions

Neurologic findings in children with ear malformations

Cephalic neural crest cells contribute to the formation of the external and middle ears, the supporting cells of the statoacoustic ganglion, other cranial nerve components, and the face. The anlage of otic sensory structures receive inductive stimuli from adjacent rhombencephalic tissue. The complex series of interactions that guide organogenesis of the outer, middle, and inner ear structures may explain why neurologic dysfunction is likely to be associated with malformations of the ear. We reviewed the records of 100 patients with complex ear anomalies with or without hearing loss. Mean age was 4.2 years (range 1 day–27 years). Malformations, either bilateral (70) or unilateral (30), involved the external ear (94), middle ear (16), and/or inner ear (12). Eighty-five patients had neurologic dysfunction. Cranial nerve dysfunction was found in 56 patients and involved nerves VIII (39 auditory and/or vestibular), VII (22), II (11), VI (8), V (4), III (3), X (3), XII (1), and IX (1). Sixty-four patients had evidence of central nervous system dysfunction such as mental deficiency/developmental delay (44), non-paretic gait disorders (17), hypotonia (16), microcephaly (13), seizures (8), motor deficits (8), autistic features (7), and radiographically confirmed intracranial abnormalities (5). Eleven of 19 children with hypoactive vestibules had delayed motor development or poor balance. Seventy-four patients had anomalies in other organ systems: 56 craniofacial, 28 osseous, 19 cardiac, 16 genito-urinary, 14 ocular, 11 gastrointestinal, and 7 cutaneous. Sixty-one patients had syndromic conditions, 32 of them branchial arch syndromes. The level of cognitive competence was not related to severity of craniofacial ear, or cranial nerve abnormality Children with ear malformation ederve neurologic and peddiatric evaluations in addition toan otologic work-up

Evidence-based support for autistic people across the lifespan: Maximizing potential, minimizing barriers, and optimizing the person-environment fit

Autism is both a medical condition that can give rise to disability and an example of human neurological variation (‘neurodiversity’) that contributes to identity, with cognitive assets and challenges. We refer to this as the dual nature of autism. Enhancing adaptation and wellbeing is the ultimate goal for intervention/support. Evidence-based support for autistic people across the lifespan is emerging. Support should be collaborative between autistic individuals, their families, and service providers, taking a shared decision-making approach. To maximize the individual’s potential, comprehensive early intervention and parent-mediated intervention, ideally taking a naturalistic approach, may help support the early development of adaptive, cognitive and language skills. Targeted intervention of social skills and aspects of cognition may help but challenges remain for behavioural flexibility and generalisation to different contexts. To minimize barriers for an individual’s development and adaptation, augmentative and alternative communication may potentially reduce communication difficulties. Alleviating co-occurring health challenges by timely medical, pharmacological or psychological interventions is essential. Finally, optimizing the person-environment fit by creating autism-friendly contexts through reasonable adjustments is critical. This involves supporting families, reducing stigma, enhancing peer understanding of autism, and promoting true inclusion in education, community and work environments, alongside strong advocacy

Evidence-based support for autistic people across the lifespan: Maximizing potential, minimizing barriers, and optimizing the person-environment fit

Autism is both a medical condition that can give rise to disability and an example of human neurological variation (‘neurodiversity’) that contributes to identity, with cognitive assets and challenges. We refer to this as the dual nature of autism. Enhancing adaptation and wellbeing is the ultimate goal for intervention/support. Evidence-based support for autistic people across the lifespan is emerging. Support should be collaborative between autistic individuals, their families, and service providers, taking a shared decision-making approach. To maximize the individual’s potential, comprehensive early intervention and parent-mediated intervention, ideally taking a naturalistic approach, may help support the early development of adaptive, cognitive and language skills. Targeted intervention of social skills and aspects of cognition may help but challenges remain for behavioural flexibility and generalisation to different contexts. To minimize barriers for an individual’s development and adaptation, augmentative and alternative communication may potentially reduce communication difficulties. Alleviating co-occurring health challenges by timely medical, pharmacological or psychological interventions is essential. Finally, optimizing the person-environment fit by creating autism-friendly contexts through reasonable adjustments is critical. This involves supporting families, reducing stigma, enhancing peer understanding of autism, and promoting true inclusion in education, community and work environments, alongside strong advocacy