intellectual disability and other delays, formerly called mental retardation

Aptos psychologist: a cerebral palsy love story between father and son

[youtube]http://www.youtube.com/watch?v=flRvsO8m_KI[/youtube]

Cerebral palsy is overcome by this family’s commitment.

Autism Speaks is a US wide + organization

Go to www.autismspeaks.org for listings of resources all across the U.S. re autism. Autism Speaks

Aptos psychologist: How well does the ADOS assess for autism in toddlers?

The Aptos Psychologist says: The Autism Diagnostic Observation Schedule (ADOS) is a tool wherein an adult observes a child’s behavior in a structured setting. The ADOS does not include observations of the child with other children in real life settings.

Children often act very differently with adults than they do with same age peers. That there is no inclusion of real life ratings how the child does with other same age peers is a weakness of the ADOS. Further, in the original ADOS there was no examination of the 3rd category (repetitive behaviors) required for diagnosis of 299.0 Autistic Disorder.

Does the Model T module for under 3 children distinguish with “sensitivity” and “specificity” 299.00 Autistic Disorder from Pervasive Developmental Disorder, Not Otherwise Specified (PDD-NOS)? It seems that the ADOS will distinguish “autistic spectrum disorders” (PDD-NOS, Autistic Disorder, Asperger’s Disorder) but does not distinguish between the ASD disorders.

Diagnosing autism in toddlers: The new ADOS Toddler Module enters the field
Written by Nestor Lopez-Duran PhD on Wednesday, May 20.2009
The Autism Diagnostic Observation Schedule (The ADOS) is a diagnostic instrument that was created by the University of Michigan Professor Dr. Kathy Lord.

During the last 2 decades, the ADOS has become the most accepted diagnostic tool for autism spectrum disorders. The ADOS has 4 different overlapping â€˜versionsâ€™ (or modules) that were designed to be used with individuals of various ages and abilities â€“ including non-verbal individuals.

“However, the original ADOS is not very useful in the diagnosis of children under the age of 3. For these children, the ADOS is not specific enough. That is, it incorrectly identifies ASD in many children who actually have a non-ASD developmental delays.

“But why do we need an autism diagnostic instrument for children under 3?
There are actually a number of valid and important reasons in support of the early diagnosis of autism. When conducting evaluations of children with autism I hear parents describe how they knew that â€™something was wrongâ€™ since their child was very young. This phenomena is not just a clinical anecdote, as it has supported by research studies (see for example Chawarska et al. 2007 DOI:10.1111/j.1469-7610.2006.0185.x) suggesting that in some children, clear symptoms of autism can be identified very early. In addition, a number of studies have shown that early intervention is extremely important in the treatment of autism, thus early identification would help families obtain the interventions they need.

“Given the need to have a diagnostic instrument that can be used with children under 3, Dr. Lord and her team at the University of Michigan have been working on a new ADOS module that would reliably identify autism in these young children. The results of these efforts have now been presented in an article to be published in the Journal of Autism and Developmental Disorders. In the article, the authors described in detail the process that led to the development of the ADOS new toddler module (ADOS-Module T). However, I will limit this post to a description of the validation procedures.

In order to test this new module, the authors used the ADOS-Module T in 360 clinical evaluations with children under age 3 conducted at the University of Michigan Autism and Communication Disorders Clinic, and at the University of California-San Diego Autism Center of Excellence. These children included those who eventually would receive a diagnosis of non-ASD developmental delays, ASDs, or no diagnosis at all (typically developing). The ASD children had their clinical diagnoses of ASD based on a â€œbest estimateâ€ procedure conducted by specialists, and based partly on a modified version of the ADI-R. The non-ASD developmental disorder group as well as the typically developing group were also evaluated for ASDs with the ADI and they did not meet standards for ASDs.

So in essence, the ADOS-Module T was employed on 3 groups of children: Children with ASD, children with a non-ASD disorder, and typically developing children. The clinicians administering and scoring the ADOS-Module T were unaware of the eventual diagnoses of these children. This allows the researchers to examine the specificity and sensitivity of the new ADOS module in the correct identification of autism spectrum disorders.What is sensitivity and specificity? Sensitivity refers to how accurate the instrument is in the identification of autism when autism exist. For example, when a test has 80% sensitivity, this means that 80% of the time when a condition is present the test will â€˜catch itâ€™. Specificity however, refers to how well the test differentiates the target condition from other conditions. So for example, a test may have very high sensitivity in that every time the target condition (in this case autism) is present, the test gives you a â€˜positiveâ€™ result. But the same test my have very low specificity, in that it also gives you a positive result when a different condition is present, so that it incorrectly identifies the target condition as present when itâ€™s not there!

How did the new ADOS Module T perform?

1.The sensitivity of the ADOS Toddler module was 91%. That is, the test was able to correctly identify 91% of the cases of ASD (based on a cut off score of 12).
2.The specificity of the ADOS-Module T when tested against non-ASD disorders was also 91%. This means that only in 9% of the cases, the test suggested a diagnosis when the child had been previously identified as not having an ASD.
3.The specificity of the ADOS-Module T when tested against typically developing cases was 94%. That is, only in 6% of the cases, the test suggested a diagnosis in children who were actually typically developing kids.
These are actually excellent numbers and indicate that the ADOS Toddler Module has excellent sensitivity and specificity. However, the authors also described some general concerns and limitations.

The ADOS, although it is the most reliable and valid diagnostic instrument available, it is still only a clinical tool that must be used in the context of a comprehensive clinical evaluation and it is subservient to clinical judgment. Specifically, a diagnosis of autism is provided only when the person meets the DSM-IV diagnostic criteria. Therefore, clinicians must use their judgments in interpreting and applying the results from the ADOS. There will be cases when the ADOS suggests a diagnosis but the clinician will not provide the diagnosis because the child doesnâ€™t meet full diagnostic criteria based on the DSM-IV.

So you may ask, what is the point? Why do we have the ADOS if all a clinician has to do is go down the list of the DSM-IV criteria and add up the check marks? The ADOS provides for a reliable and valid tool to assess for the specific symptoms included in the DSM-IV criteria and it helps the clinician interpret the childâ€™s clinical presentation as it applies to the DSM-IV criteria. The ADOS standardizes this process so that diagnoses are less dependent upon other factors, such as biases in parental reporting of symptoms, or the skills or training of the clinician in properly indentifying such symptoms. Therefore, the ADOS greatly improves the validity and accuracy of our â€˜clinical judgmentâ€™.

On a personal note and disclaimer. Dr. Luyster (lead author of the study), Dr. Richler, and Dr. Oti were all my classmates in graduate school and I congratulate them for their wonderful work. In addition Dr. Lord, creator of the ADOS and founder of the University of Michigan Autism and Communication Disorders Clinic, will be my collague this Fall when I join the University of Michigan faculty.

The Reference: Luyster, R., Gotham, K., Guthrie, W., Coffing, M., Petrak, R., Pierce, K., Bishop, S., Esler, A., Hus, V., Oti, R., Richler, J., Risi, S., & Lord, C. (2009). The Autism Diagnostic Observation Scheduleâ€”Toddler Module: A New Module of a Standardized Diagnostic Measure for Autism Spectrum Disorders Journal of Autism and Developmental Disorders DOI: 10.1007/s10803-009-0746-z

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4 Responses to â€œ Diagnosing autism in toddlers: The new ADOS Toddler Module enters the field â€
#1 Brandon Says:
May 20th, 2009 at 1:43 pm
Very interesting. Mr. Lopez I hope you enjoy coming to the U of M. I am in the Adult Autism Social Group up there, so I know some of the researchers. I find the ADOS-T very interesting I will be sure to ask Katie Gotham more about it.

#2 Nestor Lopez-Duran PhD Says:
May 20th, 2009 at 4:11 pm
Thank you Brandon for your comment. Iâ€™m sure I will enjoy Michigan. I went to graduate school there and coming back to join the faculty feels like coming back home. Cheers, Nestor.

#3 JulieL Says:
May 22nd, 2009 at 9:29 pm
I listed to a recent podcast with Professor Margot Prior. She noted that there is recent research in the US and UK stating that children can be, as she stated â€œpicked up as at riskâ€ for autism, at the age 12-24 months old. She was clear to state that this was not to say these would be always accurate, but it would be say a marker for close observation for that child. Do you know of anything regarding the research she speaks of? This new research article you present here seems to be adding to that body of agreement.

Thanks

#4 Pregnancy Questions Says:
June 16th, 2009 at 11:45 pm
Do you plan to keep this site updated? I sure hope soâ€¦itâ€™s great.

Aptos psychologist: Identify autistic children at 12 months & offer interventons combining ABA and relationship building

written by Cameorn S. Jackson, Ph.D., J.D., Licensed Psychologist
DrCameronJackson@gmail.com

There are two strands of therapy for young autistic children — the prickly rigor of Applied Behavioral Analysis (ABA) and the softer therapies such as FloorTime and P.L.A.Y. which focus on relationship building. ABA does a great job of jump starting language when there is none. However, ABA can be abrasive and often the parent is largely left out of the loop with the focus on the therapist-child relationship. As a psychologist I have always favored relationship building and having spontaneous fun with a child. Spontaneous, creative interactions between parent-child are so vital and important.

Now for interventions for young autistic children, researchers have combined the two approaches. Successfully!

The method — known as the Early Start Denver Model — can be used with children as young as 12 months. This is REAL progress in the therapy world for autistic children.

See the article below.

Study Finds Early Intervention For Toddlers With Autism Highly Effective
30 Nov 2009 “A novel early intervention program for very young children with autism – some as young as 18 months – is effective for improving IQ, language ability, and social interaction, a comprehensive new study has found.

“This is the first controlled study of an intensive early intervention that is appropriate for children with autism who are less than 2Â½ years of age. Given that the American Academy of Pediatrics recommends that all 18- and 24-month-old children be screened for autism, it is crucial that we can offer parents effective therapies for children in this age range,” said Geraldine Dawson, Ph.D., chief science officer of Autism Speaks and the study’s lead author. “By starting as soon as the toddler is diagnosed, we hope to maximize the positive impact of the intervention.”

“The study, published online in the journal Pediatrics, examined an intervention called the Early Start Denver Model, which combines applied behavioral analysis (ABA) teaching methods with developmental ‘relationship-based’ approaches. This approach was novel because it blended the rigor of ABA with play-based routines that focused on building a relationship with the child.

While the youngest children in the study were 18 months old, the intervention is designed to be appropriate for children with autism as young as 12 months of age. Although previous studies have found that early intervention can be helpful for preschool-aged children, interventions for children who are toddlers are just now being tested. Autism is a lifelong neurodevelopmental disorder characterized by repetitive behaviors and impairment in verbal communication and social interaction. It is reported to affect one in 100 children in the United States.

“Infant brains are quite malleable so with this therapy we’re trying to capitalize on the potential of learning that an infant brain has in order to limit autism’s deleterious effects, to help children lead better lives,” said Sally Rogers, a professor of psychiatry and behavioral sciences, a study co-author and a researcher at the UC Davis MIND Institute in Sacramento, Calif. Rogers and Dawson developed the intervention.

“The five-year study took place at the University of Washington (UW) in Seattle and was led by Dawson, then a professor of psychology and director of the university’s Autism Center, in partnership with Rogers. It involved therapy for 48 diverse, 18- to 30-month-old children with autism and no other health problems. Milani Smith, who oversees the UW Autism Center’s clinical programs, provided day-to-day oversight.

The children were separated into two groups, one that received 20 hours a week of the intervention – two two-hour sessions five days a week – from UW specialists. They also received five hours a week of parent-delivered therapy. Children in the second group were referred to community-based programs for therapy. Both groups’ progress was monitored by UW researchers. At the beginning of the study there was no substantial difference in functioning between the two groups.
At the conclusion of the study, the IQs of the children in the intervention group had improved by an average of approximately 18 points, compared to a little more than four points in the comparison group. The intervention group also had a nearly 18-point improvement in receptive language (listening and understanding) compared to approximately 10 points in the comparison group. Seven of the children in the intervention group had enough improvement in overall skills to warrant a change in diagnosis from autism to the milder condition known as ‘pervasive developmental disorder not otherwise specified,’ or PDD-NOS. Only one child in the community-based intervention group had an improved diagnosis.

“We believe that the ESDM group made much more progress because it involved carefully structured teaching and a relationship-based approach to learning with many, many learning opportunities embedded in the play,” Rogers said.

“Parental involvement and use of these strategies at home during routine and daily activities are likely important ingredients of the success of the outcomes and their child’s progress. The study strongly affirms the positive outcomes of early intervention and the need for the earliest possible start,” Dawson said.

In this study, the intervention was provided in a toddler’s natural environment (their home) and delivered by trained therapists and parents who received instruction and training as part of the model.

“Parents and therapists both carried out the intervention toward individualized goals for each child, and worked collaboratively to improve how the children were responding socially, playing with toys, and communicating,” said Milani Smith, associate director of the UW Autism Center and a study co-author. “Parents are taught strategies for capturing their children’s attention and promoting communication. By using these strategies throughout the day, the children were offered many opportunities to learn to interact with others.”

Other study authors include Jeffrey Munson, Jamie Winter, Jessica Greenson, and Jennifer Varley, all of UW Autism Center or the department of psychiatry and behavioral sciences, and Amy Donaldson of the department of speech and hearing science, Portland State University, Portland, Ore.

The study was funded by a grant from the National Institute of Mental Health (NIMH). NIMH has also funded a multi-site trial of the Early Start Denver Model which is currently being conducted at the University of Washington, the UC Davis MIND Institute and the University of Michigan.

Source: Jane E. Rubinstein
Autism Speaks

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Aptos psychologist: Treatment for autistic children in Santa Cruz County?

written by Psychologist Dr. Cameron Smith Jackson 831 688-6002
www.FreedomOK.net/wordpress

This is written to assist parents with a child age 3 to 4 year old with autistic spectrum issues:

#1: First, get an accurate assessment of the child’s profile. Children with autism and related disorders typically have substantial difficulties in 3 different areas: Social, Communication and Repetitive, stereotyped Movements.

#2: The child’s profile should guide treatment. The areas that the child is weakest in are the ones to focus treatment.

For children with most difficulty in Socialization work on a) improving eye contact.

Once there is good eye contact, work on: b) getting & improving “joint attention” (child looks at you and at the toy between you and the child). Make sure that the child is looking at you. Then you look and point at the toy or object for joint attention. Make it a fun game. Reinforce by saying, “Good __ …” whatever action you are teaching. (Good putting ON the chair…Good putting UNDER the chair …)

For children with most difficultly in Routinized Movements assist the child with activities that help the child become better coordinated and have more control over their body.

For example, horseback riding (Monterey Bay Horsemanship & Therapeutic Center (831 761-1142) helps some autistic children enormously.

Swimming can greatly assist to gain better control and relax. The Simkins Family Swim Center in Santa Cruz can help. And the water is warm! (www.scparks.com/simkins_home.html 831 545-7946).

For children with Communication difficulties Speech services from therapists trained to work with autistic children is crucial.

A normal 3+ child looks forward to their fourth birthday. Most autistic children may “get it” that they get gifts and others are simply not interested in other children sharing their special day.

Some children have only a handful of words by age 2. For severe delays in language development some behavioral techniques can “jump-start” speech. The Bay School in Santa Cruz and ABRITE use behavioral techniques. These techniques are particularly useful for children with out of control behavior issues.

Softer techniques that encourage fun, spontaneous interactions include FloorTime by Dr. Greenspan and P.L.A.Y. offered by Easter Seals in Santa Cruz. I like these approaches as they put the tools for change in the hands of parents. Encouraging fun interactions more than likely will enhance overall family life.

Some other Santa Cruz County resources for children with autistic spectrum issues include: Special Olympics (831 429-4258) Special Parent Information Network (SPIN) and Shared Adventures www.shared.adventures

What kind of a program works best? What your child can tolerate and enjoy. Every child is different. Sufficient to encourage your child to want to be “in your world”.

Hope this is helpful! Use the Reply box for your questions and comments.
DrCameronJackson@gmail.com www.FreedomOK.net/wordpress

$200 price tag to sample vocalizations for autism too high

$200 price tag for an autism screen that samples the child’s vocalizations to assess for autistic spectrum disorder. Is such a tool necessary? Differences in vocalization is just part of the problem, probably not the central problem.

Children with autism spectrum symptoms have non-verbal problems — not following a point, not looking at mommy’s face, not establishing joint attention with their caregivers. Vocalization is just part of the problem.

The real issue is what can be done early on to assess and correct the problems with attachment and non-verbal communication.

See the article below:

“LENA Foundation has increased the accuracy of the LENA Autism Screen (LAS) to 91 percent for children 24 to 48 months. LAS – the first automatic and totally objective autism screen is now as accurate or more accurate than other autism screens currently available to parents and clinicians.

“We’re thrilled with this leap in accuracy, especially on the eve of the launch of LAS for parents of young children who want to screen their child for autism spectrum disorders (ASD),” said Terrance (Terry) D. Paul, president of the foundation. “LAS is truly revolutionary because the analysis is based on the child’s vocalizations in the natural home environment. It will allow parents to quickly and inexpensively screen children as young as 24 months, enabling earlier interventions while reducing the anxiety of ‘not knowing.'”

The LAS, scheduled for release in mid-September, will also include an automatic screen for language delays; the LAS is priced at $200. LAS is expected to be warmly embraced by parents and clinicians in the United States, where 1 in 150 children has ASD and more than 5 percent of children have language delay. Despite the “autism epidemic” and the fact that the American Academy of Pediatrics (AAP) recommends that pediatricians screen children twice for autism by the age of two, the average age of diagnosis is 5.7 years. This diagnostic lapse adds up considerably in financial and societal costs. The estimated cost of treating a person with ASD over a lifetime ranges from $3.5 to $5 million; however, with early detection, such as that enabled by the LAS, it is estimated that costs can be reined in by up to two thirds, reducing that range to $1.2 to $1.7 million. Of course, the improvement in the quality of life enabled through earlier intervention for both autism and language delay is unquantifiable.

The new technique, which generated a significant boost in accuracy compared to the previously announced phone model, incorporates a data-driven cluster approach that utilizes k-means clustering to partition the acoustic feature space of child vocalizations. It has been known for many years that children with ASD have aberrations of voice and prosody. These differences between the vocalizations of typically developing children and children with ASD, though extremely difficult to identify with the human ear, can be identified statistically using advanced computer technology. The new technique was developed based on naturalistic full-day recordings from children diagnosed with ASD and children without ASD.

“Child vocalization decomposition could be done using either a phone model or clusters derived directly from child vocalizations,” explained Dongxin Xu, Ph.D., manager of software and language engineering at the foundation. “The performances of the two methods are similar when applied individually. When combined together, the performance is significantly improved. This suggests that the two approaches capture different discriminant information for autism detection.”

The LENA System comprises advanced processing software and specially designed children’s clothing fitted with a lightweight LENA Digital Language Processor (DLP), a small, unobtrusive digital recorder. Designed for use in the natural home environment, the DLP can save up to 16 hours of high-quality audio, capturing all of a child’s vocalizations as well as adult speech and other sounds.

About LENA Foundation

Established in 2009, the LENA Foundation develops advanced technology for the early screening, diagnosis, research, and treatment of language delays and disorders in children and adults. Philanthropists Terry and Judi Paul formed the not-for-profit organization through a multimillion-dollar gift and the donation of assets from Infoture Inc. Over a five-year period, Infoture created the LENA (Language ENvironment Analysis) System, the world’s first automatic language collection and analysis tool and the foundation’s principal product. The foundation employs a team of scientists and engineers skilled in computerized speech and speaker recognition, microelectronics, statistical research, and children’s language acquisition and development; they are passionately devoted to helping the foundation enhance language development worldwide.

Source: LENA Foundation

Parents need to say to infants what they mean and mean what they say.

Topic: Why infants don’t sleep as they used to when left with babysitters & what to do about it. written by Dr. Cameron Jackson, licensed psychologist PSY14762 cameronjacks@gmail.com

I take care of a grandchild 2 mornings a week. He is 3 months old. This last week he did not sleep much as he used to do. His mother said that happened also this past week when left with the babysitter that comes the other 3 mornings.

I think the 3 month old knows mommy is gone and he is staying awake until she gets back. The child is vigilant concerning the loss of the most important object in his young life — mommy’s presence and mommy’s milk.

What might reduce this infant’s vigilance and mild anxiety? Knowing that she will return soon and that she will do what she says. Can this be taught to an infant? Certainly worth trying.

This infant and all infants need to hear a simple explanation ahead of time: Tomorrow, Mommy goes to work. Mommy comes back in 5 hours. While Mommy is gone, Grand-ma takes care of you. This is a picture of grand-ma. When gone you have a picture of me. I will do what I say. I come back soon.”

Parents need to say what they mean to infants and clearly and simply say what goes on. And then do it. The KISS principal.

Puppets are a wonderful way to teach the stories that infants need to hear. Use a simple, repetitive song to sing the story. It is not too young — in fact it is never too young — to tell infants ahead of time important things that affect their lives. Say clearly and simply, “tomorrow ma-ma goes and grand-ma comes….I come back soon….and fun things will happen while grand-ma cares for you…

Parents need to mean what they say and say what they mean in simple, clear terms talking to their infants. Tell them the important things that are happening in their young lives. And sing it as a simple song.

For example, Old MacDonald Had a Farm can be changed to “Mommy & Daddy have a House… eeeiiii eeeiiii eeeeiiii ooooo. And in that House there lives a boy…. eeeiiii….eeeiiii….eeeeiiiii…oooo. And Grand-ma comes to care for (name of child)….eeeiii…eeeiiii…eeeiiii ooooo. And Grand-ma brings fun things to do…. eeeiiii….eeeiii…eeiiii oooo.

Long before a child can look at a book he or she can hear stories sung in simple rhymes telling them the important events in their lives.

Here is an example: The child’s father wants a BOB stroller so he and mom can jog with their child. Ahead of time, They could improvise Yankee Doodle: The real tune goes like this: “Yankee Doodle went to town Riding on a pony; He stuck a feather in his hat and called it macaroni. Yankee Doodle fa, so, la, Yankee Doodle dandy, Yankee Doodle fa, so, la, Buttermilk and brandy.”

Instead, sing the tune to different words:
“Yankee (baby L) goes to town, A riding in his Bob-Bob. Dad sticks a flower in (name of baby) hat and calls it macaroni…..” And then Dad in fact puts a flower, or feather or whatever in Baby’s hat and off they go on their jog to town.

Done repetitively the child will connect the song with the coming ride in the stroller ahead of time. Knowing what is coming down the line can reduce anxiety about the future. This is a wonderful, easy way to teach language to infants. Use simple, repetitive rhymes sung to simple tunes. Sing the words slowly and clearly sometimes and sometimes quickly. Children need to hear the words clearly and distinctly and see the words illustrated by actions.

For just a few dollars you can get a used nursery rhyme book full of the old classics. Get the old rhymes and improvise. Teach your children your stories about the important events in your lifes. At Logos in Santa Cruz, for $4.00 I got Stories and Rhymes for Every Bedtime. It is full of all the classics.

Here is one I’m going to do next week using puppets to illustrate:

Ding Dong Bell
” Ding Dong bell, Pussy’s in the well. Who put her in? Little Tommy Green. Who pulled her out? Little Tommy Trout. What a naughty boy was that, to try and drown poor pussy cat. Who never did him any harm, and killed the mice in his Father’s barn.”

I have some small bells that I will ring. Ding, dong Bell (ring the bells). Ba-ba (bottle’s) in the Well (glass container to warm the milk) Who put it in? Ma-ma put it in. Who takes it out? Grand-ma takes it out (when nice and warm). Who gets it NOW? (name of child) gets in NOW!

This is one way that young infants hear stories ahead of events using language and song to talk about important events about to happen. Getting a warm bottle is a very important event in the life of a 3 month old. The old stories and rhymes are still useful today.

Let me know your favorite rhymes and stories that might be improvised in new ways with young infants.

written by Cameron S. Jackson, Ph.D., J.D. licensed psychologist DrCameronJackson@gmail.com

831 688-6002

Lots of stimulation helps premature babies develop to full potential. Weight not time matters. www.freedomOK.net/wordpress

1051320760_341724cffc1 Weight Determines The Future Cognitive Development Of Children Born Very Premature
Article Date: 03 Jul 2009

What the following suggests is that EARLY and CONTINUAL stimulation of the central nervous system THROUGH THE FULL DEVELOPMENTAL PERIOD UP TO AGE 16 will maximize cognitive IQ development. So, hold that preme! Sing to that preme! Rock that preme! Weight not length of time in the tummy makes the dfference between babies. Wow! See below:

Researchers of the Department of Neuroscience and Health Sciences of the University of AlmerÃa and Hospital TorrecÃ¡rdenas are carrying out an assessment of the physical neuropsychological characteristics of children born before 32 weeks’ gestation or whose weight is lower than 1500 grams -very premature-. The main aim of this project, coordinated by M Dolores RoldÃ¡n Tapia, from the UAL, is to accurately define the origin of brain damage, so as to stimulate the affected area early thus causing the adequate cognitive and motric development of the individual.

The commonest differences between premature babies and those born after a nine-month pregnancy are mainly related to visoperceptive skills, memory and movement which eventually translate into learning and spatial orientation difficulties. That is why these difficulties that these children have in their cognitive performance and the development of perceptual and executive functions are being studied.

A population sample of 35 very premature children is being taken for this project, together with the same number of healthy children, all of them born between 2000 and 2001, with their parents’ authorisation. Special attention has been paid to the fact that both the children and their parents have similar educational and social levels, as the stimulation they get in the early stages of their lives has a decisive influence in their later development.

The results obtained so far reveal that the decisive variable for the existence of a reversible or irreversible brain damage is the baby’s weight at birth, rather than the time of gestation. According to experts, an early stimulation of the individual’s central nerve system, from birth until his complete cognitive development at 16 years of age, in foetuses whose weight at birth is over 1,500 gr. or who are very premature, will eventually get ideal cognitive levels. However, this stimulation must be continued throughout the whole development of babies whose weight is lower than 1,500 gr. so that they can get a proper brain maturity.

As a complement to this project, Alemeria-based researchers are developing an epidemiological study so as to set the percentage of very premature children who have brain damage against the total number of children born under the same characteristics between 2000 and 2001. This study is funded by FundaciÃ³n para la InvestigaciÃ³n Biosanitaria de AndalucÃa Oriental-Alejandro Otero (FIBAO, Alejandro Otero foundation for bio-health research in eastern Andalusia). Moreover, in collaboration with the University of Granada, experts are developing another line of research whose aim is to determine the existing relationship between visoperceptive skill deficit and the level of reasoning in very premature children.

In the near future, the team of researchers of the University of Almeria will be expanding their research and including new variables that may make a determining brain difference in very premature babies, like for example, the brain difference between babies born in natural multiple births and those with artificial techniques, or the interaction between pre-maturity and bad nutrition.

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