Babies under 1 year with atypical development. Perspectives for preventive individuation and treatment

A baby's first year of life is a time of immense development and cerebral plasticity. Following today's research and clinical observation, the period of the first year of life provides a new challenge inasmuch it is presently clear that it is possible to identify developmental anomalies in this window of time. Effecting early screening procedures could prove very useful, especially where we find genetic vulnerabilities in brothers and sisters of autistic subjects. Interventions of this kind, already practiced by some Public Health systems, can mean taking early action and primary protective measures with significant impacts not only on the subjects (babies and family members) concerned, but also on the public purse. It is, therefore, essential to provide for specific professionalized procedures for psychologists, pediatricians and neuropsychologists to be introduced through personnel highly specialized in interventions during the first year of life

DEVELOPMENTAL INTERVENTIONS FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS: A LITERATURE REVIEW

Developmental approaches characterized interventions based on the typical sequences of the child's development, paying particular attention to the linguistic, motor and socio-emotional aspects, within a relational perspective. The purpose of this paper was to identify developmental interventions for children with Autism Spectrum Disorders (ASD) aged between 0 and 12 years old. A literature review was carried out searching on MEDLINE, PsycINFO, and PsycARTICLES and manually on key journals and reference lists of key articles [...] This review highlights the need for improved research on intervention programs and the important service needs for families and children with Autism Spectrum Disorders

Assessment of a long-term developmental relationship-based approach in children with autism spectrum disorder

90 Italian children (72 boys, 18 girls) with a diagnosis of infantile autism (age range = 2.5–16.5 yr.) were assessed with a non-verbal intelligence test (Leiter–R). The test was repeated 3 times in four years. The measures used were IQ and Fluid Reasoning (FR), as evaluation of inductive and deductive reasoning, and the Autism Diagnostic Observation Schedule (ADOS), indicative of the severity of autistic symptoms at the beginning and at the end of therapy. The increase in the average IQ and FR scores at retests demonstrates the eff ectiveness of a treatment that emphasizes the centrality of the relationship-based approach. Moreover, the FR score at intake was predictive of a signifi cant decrease of ADOS scores after four years of treatment, and of the increase in IQ observed in later evaluations. The data support the hypothesis that a relationship-based intervention allows cognitive improvement regardless of the autism severity expressed in the ADOS score

Couple satisfaction and parenting stress in parents of children with ASD

Introduction Literature on parents’ adjustment in families with autism spectrum disorder (ASD) children highlights on one hand that raising a child with ASD represent a higher stressful experience comparing to families of children with other disabilities and families of children with typical development. On the other hand, a recent systematic review on relationship satisfaction of these parents stressed the very lower levels of couple satisfaction in parents raising a child with ASD. Give that, the aim of this study is to investigate the association between relationship satisfaction and parental stress in a sample of parents of ASD children. Method 70 parents were recruited (34 = M and 36 = F) to sign the following self-reports: Parenting stress index-short-form (PSI-SF), to assess stress relative to parental role, and dyadic adjustment scale (DAS), to assess couple satisfaction. Results The analysis showed no differences between mothers and fathers respect to investigated variables. Negative correlations between almost all subscales of the PSI-SF and the subscales of DAS emerged. Moreover, from the regression analysis performed, it can be concluded that the values of the total score of the DAS predicts the PSI-SF total score. Conclusions In accordance with and building on the achievements of previous studies, these data illustrate a positive influence of couple adjustment on parental stress in parents of ASD children, supporting the hypothesis that relationship satisfaction emerge as a protective variables in the process of parental adaptation. Disclosure of interest The authors have not supplied their declaration of competing interest

Equity in coronavirus disease 2019 vaccine development and deployment

The coronavirus disease 2019 pandemic exposed weaknesses in multiple domains and widened gender-based inequalities across the world. It also stimulated extraordinary scientific achievement by bringing vaccines to the public in less than a year. In this article, we discuss the implications of current vaccination guidance for pregnant and lactating women, if their exclusion from the first wave of vaccine trials was justified, and if a change in the current vaccine development pathway is necessary. Pregnant and lactating women were not included in the initial severe acute respiratory syndrome coronavirus 2 vaccine trials. Therefore, perhaps unsurprisingly, the first vaccine regulatory approvals have been accompanied by inconsistent advice from public health, governmental, and professional authorities around the world. Denying vaccination to women who, although pregnant or breastfeeding, are fully capable of autonomous decision making is a throwback to a paternalistic era. Conversely, lack of evidence generated in a timely manner, upon which to make an informed decision, shifts responsibility from research sponsors and regulators and places the burden of decision making upon the woman and her healthcare advisor. The World Health Organization, the Task Force on Research Specific to Pregnant Women and Lactating Women, and others have highlighted the long-standing disadvantage experienced by women in relation to the development of vaccines and medicines. It is uncertain whether there was sufficient justification for excluding pregnant and lactating women from the initial severe acute respiratory syndrome coronavirus 2 vaccine trials. In future, we recommend that regulators mandate plans that describe the development pathway for new vaccines and medicines that address the needs of women who are pregnant or lactating. These should incorporate, at the outset, a careful consideration of the balance of the risks of exclusion from or inclusion in initial studies, patient and public perspectives, details of ?developmental and reproductive toxicity? studies, and approaches to collect data systematically from participants who are unknowingly pregnant at the time of exposure. This requires careful consideration of any previous knowledge about the mode of action of the vaccine and the likelihood of toxicity or teratogenicity. We also support the view that the default position should be a ?presumption of inclusion,? with exclusion of women who are pregnant or lactating only if justified on specific, not generic, grounds. Finally, we recommend closer coordination across countries with the aim of issuing consistent public health advice

Early mortality in myeloma patients treated with first-generation novel agents thalidomide, lenalidomide, bortezomib at diagnosis: A pooled analysis

Early toxic death (≤60 days of diagnosis) in elderly multiple myeloma (MM) patients is attributable to active disease, age and co-morbidities. Rate of early toxic deaths is 10% with conventional chemotherapy mainly due to infection and renal failure. Novel agents have improved MM outcome at the expense of newer toxicity. Methods: We analyzed 1146 individual patient data to assess toxic deaths during induction treatment with firstgeneration novel agents thalidomide, lenalidomide, bortezomib. Results: During first-line therapy, 119/1146 patients (10%) died for any cause, and 47/1146 (4%) due to toxicity, including 12/1146 (1%) early deaths. The 24-month cumulative incidence was 4.1% without any difference between bortezomib (18/503 patients, 4%) and lenalidomide (29/643patients, 5%; p=0.31). Toxic deaths occurred in 34/1039 (3%) patients<80 years and 13/107 (12%) patients ≥80 years. Causes were cardiac events (28%), infections (26%) and vascular complications (15%). In a multivariate analysis, older age and unfavorable ISS stage increased the risk of death. Conclusion: First-generation novel agents significantly reduced toxic deaths compared to conventional chemotherapy. One third of deaths during first-line therapy were due to cumulative drug-related toxicities, thus supportive approaches and prevention strategies should be optimized. The higher mortality rate for toxicity in octogenarians confirms the need for a careful frailty assessmen