Идентификација и управување со детскиот развој- практични параметри

The main characteristics of children are phenomena of growth and development. Child development could be defined as a complex unfolding of a series of skills and adaptations, with very predictable stages, that occur in multiple dimensions at approximately the same time and in approximately the same order.There are several types of developmental delays in children. These delays can affect child’s physical, cognitive, communication, social, emotional, or behavioural skills. Developmental delays are common in childhood, occurring in 10%-15% of preschool children in different forms. Global developmental delays are less common, occurring in 1%-3% of preschool children. The article gives some practice parameters for identification and management of child development based on the newest published articles included in the PubMed database.Главна карактеристика на децата е феноменот на раст и развој. Детскиот развој може да се дефинира како комплекс од серија вештини и адаптации, со предвидливи стадиуми, кои се јавуваат во разни димензии на приближно слично време и со приближно ист редослед. Постојат неколку вида застој во развојот кај децата. Може да го зафатат физичкиот, когнитивниот, комуникативниот, социјалниот, емоционалниот развој или поведението. Застојот во развој е чест во детството и се јавува кај 10-15% претшколски деца во разни форми. Глобалниот застој на развојот е поредок и се јавува кај 1-3% од претшколските деца. Овој напис дава некои практични насоки за идентификација и постапки за справување со детскиот развој базирани на најнови публикации соржани во базата ПубМед

ADHD as a Specific Cause for Learning Disability

In the spectrum of possible causes for discrepancy between the capacity to learn and the level of school achievement, Attention Deficit Hyperactivity Disorder (ADHD) has an important place. The aim of this chapter is to present obtained own results for a group of 200 pupils, mean age 10.5 ± 2.35 years, and both genders, diagnosed as ADHD following DSM-5 criteria. As psychometric tests, Kohs Block Design Test, Achenbach CBCL, ACTeRS, Stroop Color Word Task (SCWT), and Wisconsin Card Sorting Test (WCST) are used. Additionally, Q-EEG recording using Mitsar 19-channel Q-EEG 201 system was performed. Obtained results confirmed the diagnosis of ADHD as well as the presence of serious difficulties in executive system functioning through ERP’s component extracted from Q-EEG analysis. In the chapter, results for Q-EEG will be discussed more extensively including subtypes. As a used nonpharmacological therapeutic approach, very positive outcome of neurofeedback treatment of these children is accentuated

AUTISM -GENETICS, ELECTROPHYSIOLOGY AND CLINICAL SYNDROMES

Abstract Autism is a severe and the most heritable developmental disorder, whose pathogenesis is still largely unknown. The rising incidence of autism in the last decade has increased the scientific interest and research. More than a thousand papers concerned with information about the etiology of this "static disorder of the immature brain" can be found on Pub Med. The aim of this paper is to give a review of published genetic chromosomal anomalies associated with autistic spectrum disorders, as well as to discuss common syndromes associated with autistic traits. In addition, some of our own findings in genetics, as well as in quantitative electroencephalography and neurofeedback training in autistic children, will be presented and discussed. Generally, the subsequent analyses indicate that the causes of autism include fewer common singlegene mutations and chromosomal abnormalities, as well as multiple interacting genes of weak effect. Genome-wide linkage analysis has identified several susceptibility loci and positional and functional candidate genes which appear to represent possible risks of the autistic spectrum. Electrophysiological findings showed high delta/theta activity in frontal-central regions, while in 25% high beta activity was detected as a result of anxiety. Neurofeedback is a promising therapy for symptom mitigation

Some Peripheral Biofeedback Modules in the Treatment of Chronic Diseases in Children

Biofeedback therapy is a non-drug treatment in which patients learn to control bodily processes that are normally involuntary, such as muscle tension, blood pressure, or heart rate. In this paper we present results obtained with Electro Dermal Response (EDR) and Heart Rate Variability (HRV) applied as adjuvant therapy in chronic pediatric patients. The methodology can be used in scholar settings for stress reducing in pupils and teachers.The evaluated group comprises children and adolescents with: a) cystic fibrosis (N = 40 mean age = 17.5 years ± 23.18 SD); b) bronchial asthma (N = 35, mean age = 11.5 years ± 18.84 SD); c) epilepsy (N = 45, mean age = 13.5 years ± 15.34 SD); and d) diabetes mellitus (N = 30, mean age = 12.5 years ± 12.3 SD).Study showed that peripheral biofeedback is very helpful tool for chronic disorders in children. Both (EDR and HRV) methods confirmed changes on the stress level very significantly. This therapy is non-invasive, easy for application, children accept it with interest and it is cost-effective

Применета неуронаука: Зошто и како функционира биoфидбек методологијата?

Science cannot achieve its purpose without some practical applications. The aim of this article is to inform our colleagues about some practical uses of the methodology named biofeedback in the general population. It is important for the staff, especially for those employed in the public health service, because this method is not useful only for treating some disorders, but also for obtaining some health attitudes, performances and mental relaxation in the general population.Науката без да има практична апликација не ја постигнува својата намена. Овој напис има за цел да ги информира колегите за некои практични примени на методологијата наречена биофидбек во општата популација. Ова е особено важно за кадарот во јавното здравство, затоа што методологијата е полезна не само за третман на некои растројства, туку и за стекнување здрави навики, успешност во работата и ментална релаксација кај општата популација

Analiza frekvencijskog spektra EEG-a kao pokazatelj mentalne pobude u bolesnika s anoreksijom

Aim: Anorexia is characterized by weight loss leading to a body weight of at least 15% below the normal. The aim of this study was to analyze the spectrum weighted frequency- fb (brain rate) as an indicator of general mental arousal in anorectics and to compare the results with healthy preadolescents of the same age and gender. Methods: The diagnosis was made according to two statistic manuals (DMS-IV-R and ICD-10), medical history, neuropsychological assessment, biochemical analysis and quantitative electroencephalography. Results from spectra power for four conditions (eyes closed, eyes open, visual continuous performance test – VCPT and auditory continuous performance test – ACPT) were exported to brain rate software. Results and Discussion: Using factorial ANOVA we found that there is a strong statistical significance between results of brain rate for control group of healthy subjects vs. observed anorectic group (p<0.001). The post hoc Bonferroni test (summary of significant difference of groups) showed that only the fb values for central region are statistically significant. The post hoc analysis regarding condition found a significant difference in fb values for EC vs. EO and EC vs. ACPT for posterior region and for EC vs. VCPT for frontal region (all p<0.05). Conclusions: Brain rate – fb is a good indicator for general mental activity but, further investigations are needed in order to add fb as an indicator of mental arousal in assessment of mental diseases in childhood.Cilj: Anoreksiju karakterizira gubitak tjelesne težine koji dovodi do tjelesne težine od najmanje 15 % ispod normalne za dati uzrast. Cilj ovog rada bio je analizirati spektar usrednjenih frekvencija kao pokazatelj opće mentalne pobude u anoreksičnih preadolescenata, te usporediti rezultate sa zdravom populacijom iste dobi i istog spola. Metode: Dijagnoza je postavljena suglasno s dvama statističkim priručnicima (DMS-IV-R i ICD-10), medicinskom poviješću, neuropsihološkom procjenom, biokemijskom analizom i QEEG-om. Rezultati spektralne snage za četiri uvjeta (zatvorene oči, otvorene oči i ERP za vizualne i auditivne podražaje) obrađeni su u programu za procjenu aktivnosti mozga. Rezultati i diskusija: Računajući faktorsku ANOVU otkrili smo da postoji jaka statistička značajnost između rezultata aktivnosti mozga u kontrolne skupine zdravih ispitanika u odnosu na skupinu anoreksičnih preadolescenata (p < 0.001). Post-hoc analizom utvrđeno je kako su samo fb vrijednosti u centralnim odvodima QEEG-a statistički značajne (p = 0.005). Post-hoc analiza koja se odnosi na opisano stanje pokazuje značajnu razliku u vrijednosti fb za zatvorene oči vs. otvorene oči, zatvorene oči vs. ACPT u stražnjim odvodima i za zatvorene oči vs. VCPT za frontalne regije (svi p < 0,05). Zaključak: fb dobar je pokazatelj opće mentalne aktivnosti – pobude, ali potrebna su daljnja istraživanja kako bi parametar QEEG postao dijelom rutinske analize u procjeni duševnih bolesti u djetinjstvu

Analiza frekvencijskog spektra EEG-a kao pokazatelj mentalne pobude u bolesnika s anoreksijom

Aim: Anorexia is characterized by weight loss leading to a body weight of at least 15% below the normal. The aim of this study was to analyze the spectrum weighted frequency- fb (brain rate) as an indicator of general mental arousal in anorectics and to compare the results with healthy preadolescents of the same age and gender. Methods: The diagnosis was made according to two statistic manuals (DMS-IV-R and ICD-10), medical history, neuropsychological assessment, biochemical analysis and quantitative electroencephalography. Results from spectra power for four conditions (eyes closed, eyes open, visual continuous performance test – VCPT and auditory continuous performance test – ACPT) were exported to brain rate software. Results and Discussion: Using factorial ANOVA we found that there is a strong statistical significance between results of brain rate for control group of healthy subjects vs. observed anorectic group (p<0.001). The post hoc Bonferroni test (summary of significant difference of groups) showed that only the fb values for central region are statistically significant. The post hoc analysis regarding condition found a significant difference in fb values for EC vs. EO and EC vs. ACPT for posterior region and for EC vs. VCPT for frontal region (all p<0.05). Conclusions: Brain rate – fb is a good indicator for general mental activity but, further investigations are needed in order to add fb as an indicator of mental arousal in assessment of mental diseases in childhood.Cilj: Anoreksiju karakterizira gubitak tjelesne težine koji dovodi do tjelesne težine od najmanje 15 % ispod normalne za dati uzrast. Cilj ovog rada bio je analizirati spektar usrednjenih frekvencija kao pokazatelj opće mentalne pobude u anoreksičnih preadolescenata, te usporediti rezultate sa zdravom populacijom iste dobi i istog spola. Metode: Dijagnoza je postavljena suglasno s dvama statističkim priručnicima (DMS-IV-R i ICD-10), medicinskom poviješću, neuropsihološkom procjenom, biokemijskom analizom i QEEG-om. Rezultati spektralne snage za četiri uvjeta (zatvorene oči, otvorene oči i ERP za vizualne i auditivne podražaje) obrađeni su u programu za procjenu aktivnosti mozga. Rezultati i diskusija: Računajući faktorsku ANOVU otkrili smo da postoji jaka statistička značajnost između rezultata aktivnosti mozga u kontrolne skupine zdravih ispitanika u odnosu na skupinu anoreksičnih preadolescenata (p < 0.001). Post-hoc analizom utvrđeno je kako su samo fb vrijednosti u centralnim odvodima QEEG-a statistički značajne (p = 0.005). Post-hoc analiza koja se odnosi na opisano stanje pokazuje značajnu razliku u vrijednosti fb za zatvorene oči vs. otvorene oči, zatvorene oči vs. ACPT u stražnjim odvodima i za zatvorene oči vs. VCPT za frontalne regije (svi p < 0,05). Zaključak: fb dobar je pokazatelj opće mentalne aktivnosti – pobude, ali potrebna su daljnja istraživanja kako bi parametar QEEG postao dijelom rutinske analize u procjeni duševnih bolesti u djetinjstvu

How alchohol damages brain development in children

The world over, people drink in order to socialize, celebrate, and relax, despite the negative health effects of alcohol. Three periods of dynamic brain changes are evidenced to be particularly sensitive to the harmful effects of alcohol: gestation (from conception to birth), later adolescence (15-19 years), and older adulthood (over 65 years). This article is concentrated only on the negative effects of alcohol in children who have been exposed to alcohol before birth, known as foetal alcohol syndrome (FAS). This is a review based on published data in PubMed over the last two decades and is an analysis of more than 150 published papers. Alcohol use during pregnancy can cause miscarriage, stillbirth, and a range of lifelong physical, be�havioural, and intellectual disabilities. The effects of ethanol are expressed on a set of molecules involved in neuroinflammation, myelination, neurotransmission, and neuron function. Modern neuroimaging techniques are able to specify some fine structural changes in the affected areas of the brain: volume reductions in the frontal lobe, including the middle frontal gyri in the prefrontal cortex, hippocampal structure, interhemispheric connectivity, abnormalities in glial cells, white matter deficits etc. Corpus callosum myelination is affected, resulting in a lack of the inter-hemispheric connectivity. This is known to facilitate autism, stroke, schizophrenia, as well as dementia, disrupts cognitive performance, and may lead to neurobehavioral deficits. It was pointed out that many symptoms and neuroimaging characteristics are similar in ADHD and FAS, thus the anamnesis for prenatal alcohol and nicotine exposure must be taken very seriously in order to better understand and interpret clinical symptoms

An overview of pediatric approaches to child with developmental delay especialy if there is suspicion of ASD in first few years of life

To be a pediatrician means that one encounters many serious childhood health problems and one finds many ways to help families cope with these problems. Symptoms in children can be discrete, and the responsibility of the pediatrician to distinguish normal development from pathological. We are facing a new era in the developmental assessment of children. A cluster of neurodevelopmental disorders includes ASD (autism spectrum disorder) and ADHD (attention deficit hyperactivity disorder). Parents often do not recognize the problem on time. Generally, their first concern is speech delay, leading to the suspicion of hearing problems. Therefore, it is very important to obtain objective anamnestic infor�mation and for the child to undergo a careful physical examination, a neurophysiological assessment, and metabolic and genetic testing. The etiology usually is multifactorial: genetic, epigenetic, and non-genetic factors act in combination through various paths. Most children seem to have typical neurodevelopment during first their year. It was found that approximately one-third of children with ASD lose some skills during the preschool period, usually speech related, but sometimes also non-verbal communication, social or play skills. In conclusion we must say that it is very important to recognize the early signs of ASD and any kind of other developmental delay and to start with early intervention. Clinical pediatricians tend to correlate clinical manifestations and biological underpinnings related to neurodevelopmental disorder, especially ASD. Therefore, better treatment possibilities are needed