Time filter

Source Type

Munasinghe S.A.,State Child Development Center | Oliff C.,State Child Development Center | Finn J.,University of Western Australia | Wray J.A.,State Child Development Center
Journal of Autism and Developmental Disorders

To examine the effects of a digestive enzyme supplement in improving expressive language, behaviour and other symptoms in children with Autism Spectrum Disorder. Randomized, double-blind placebo-controlled trial using crossover design over 6 months for 43 children, aged 3-8 years. Outcome measurement tools included monthly Global Behaviour Rating Scales, Additional Rating Scales of other symptoms by parents and therapists, and monthly completion of the Rescorla Language Development Survey. Compared with placebo, treatment with enzyme was not associated with clinically significant improvement in behaviour, food variety, gastrointestinal symptoms, sleep quality, engagement with therapist, or the Language Development Survey Vocabulary or Sentence Complexity Scores. A small statistically significant improvement on enzyme therapy was seen for the food variety scores. No clinically significant effect improvement of autism symptoms with enzyme use was shown with this trial, however, possible effects on improvement in food variety warrants further detailed investigation. © 2010 Springer Science+Business Media, LLC. Source

Shah P.,King Edward Memorial Hospital | Anvekar A.,King Edward Memorial Hospital | McMichael J.,State Child Development Center | Rao S.,King Edward Memorial Hospital | Rao S.,University of Western Australia
Archives of Disease in Childhood: Fetal and Neonatal Edition

Background: Infants who have an Apgar score of zero at 10 min of age are known to have poor long-term prognosis. Expert committee guidelines suggest that it is reasonable to cease resuscitation efforts if the asphyxiated infant does not demonstrate a heart beat by 10 min of life. These guidelines are based on data from the era when therapeutic hypothermia was not the standard of care for hypoxic ischaemic encephalopathy (HIE). Hence, we aimed to review our unit data from the era of therapeutic hypothermia to evaluate the outcomes of infants who had an Apgar score of zero at 10 min and had survived to reach the neonatal intensive care unit. Methods: Retrospective chart review. Study period: 2007-2013. Results: 13 infants (gestational age.35 weeks) with Apgar scores of zero at 10 min were admitted to the neonatal intensive care unit. All were born outside the tertiary perinatal centre. Of them, eight died before discharge. The type and duration of follow-up varied. Of the five survivors, three had normal cognitive scores (100, 100 and 110) on Bayley III assessment at 2 years of age and one had normal Griffiths score (general quotient (GQ) 103) at 1 year. Only one infant developed severe spastic quadriplegia. Conclusions: 4 out of 13 (30.7%) infants with 10 min Apgar scores of zero who survived to reach the neonatal intensive care unit had normal scores on formal developmental assessments. Information from large databases (preferably population based) is necessary to review recommendations regarding stopping delivery room resuscitation in term infants. Source

Reynolds V.,Princess Margaret Hospital | Buckland A.,Princess Margaret Hospital | Bailey J.,Princess Margaret Hospital | Lipscombe J.,Princess Margaret Hospital | And 6 more authors.
Journal of Voice

Objectives/Hypothesis: Instrumental measures of voice allow practitioners to assess the severity of voice disorders and objectively measure treatment outcomes. Instrumental measures should be calculated on both sustained vowel and connected speech samples to ensure ecological validity. However, there is a lack of appropriate, validated acoustic measurements for use in the pediatric population. The Acoustic Voice Quality Index (AVQI) is a multivariate acoustic measure of dysphonia that has been found to be reliable, valid, and have diagnostic accuracy and response to change in an adult population. This study aimed to evaluate the AVQI in a pediatric population. Study Design: This study was a prospective observational study of a sample of dysphonic and normophonic children. Methods: Sixty-seven preterm participants (born at less than 25 weeks gestation) aged between 6 and 15 years were recruited. Participants were excluded because of either inability to comply with task requirements or other speech-related factors that affected acoustic measurement. Forty normophonic term-born participants aged between 5 and 15 years were also recruited. AVQI analysis was conducted on a prolonged vowel sample and a sample of continuous speech. Results: The AVQI was found to have diagnostic accuracy and specificity in this population of children with and without dysphonia. It was moderately correlated with ratings of severity on the GRBAS (overall grade of hoarseness (G), roughness (R), breathiness (B), aesthenicity (A), and strain (S)), a subjective rating scale. The threshold for pathology of this sample of 3.46 showed strong sensitivity, specificity, and accuracy, with good-to-excellent likelihood ratios. Conclusions: This study found that the AVQI has diagnostic accuracy in a pediatric population, suggesting that it is an appropriate assessment tool to determine the presence and severity of pediatric voice disorders. © 2012 The Voice Foundation. Source

French N.,Neonatal Clinical Care Unit | French N.,State Child Development Center | French N.,Center for Neonatal Research and Education | Kelly R.,State Child Development Center | And 6 more authors.

Background and Objectives: Voice abnormality is a frequent finding in school age children born at <25 weeks' gestation in Western Australia. The objective of this study was to determine the frequency of voice abnormality, voice-related quality of life, and demographic and intubation factors in this population. Methods: Survivors <25 weeks' gestational age in Western Australia born from 1996 to 2004 were included. Voice assessments (auditory perceptual assessment scale and Pediatric Voice Handicap Index) were carried out by speech pathologists. Intubation history was obtained by retrospective chart review. Results: Of 251 NICU admissions, 154 (61%) survived. Exclusions were based on severe disability (11) or distant residence (13). Of 70 assessed, 67 completed assessments, 4 (6%) were in the normal range and 39 (58%) showed moderate-severe hoarseness. Simultaneous modeling of demographic and intubation characteristics showed an increased odds of moderate-severe voice disorder for children who had more than 5 intubations (odds ratio 6.96, 95% confidence interval 2.07-23.40, P = .002) and for girls relative to boys (odds ratio 3.46, 95% confidence interval 1.12-10.62, P = .030). Tube size and duration of intubation were not significant in the multivariable model. Median scores of parent-reported voice quality of life on the Pediatric Voice Handicap Index were markedly different for preterm (22) and term (3) groups, P < .001. Conclusions: Voice disorders in this population were much more frequent than expected. Further studies are required to assess voice across a broader range of gestational ages, and to investigate voiceprotective strategies in infants requiring multiple episodes of intubation. Copyright © 2013 by the American Academy of Pediatrics. Source

Unwin L.M.,University of Western Australia | Maybery M.T.,University of Western Australia | Wray J.A.,State Child Development Center | Whitehouse A.J.O.,University of Western Australia
Frontiers in Human Neuroscience

Autism spectrum disorders (ASD) are currently diagnosed in the presence of impairments in social interaction and communication, and a restricted range of activities and interests. However, there is considerable variability in the behaviors of different individuals with an ASD diagnosis. The heterogeneity spans the entire range of IQ and language abilities, as well as other behavioral, communicative, and social functions. While any psychiatric condition is likely to incorporate a degree of heterogeneity, the variability in the nature and severity of behaviors observed in ASD is thought to exceed that of other disorders. The current paper aims to provide a model for future research into ASD subgroups. In doing so, we examined whether two proposed risk factors - low birth weight (LBW), and in uteri exposure to selective serotonin reuptake inhibitors (SSRI) - are associated with greater behavioral homogeneity. Using data from the Western Australian Autism Biological Registry, this study found that LBW and maternal SSRI use during pregnancy were associated with greater sleep disturbances and a greater number of gastrointestinal complaints in children with ASD, respectively. The findings from this "proof of principle" paper provide support for this "bottom-up" approach as a feasible method for creating homogenous groups. © 2013 Unwin, Maybery, Wray and Whitehouse. Source

Discover hidden collaborations