Recall in Infancy: A Neurodevelopmental Account

ABSTRACT— Relations between developments in neural structures and changes in memory in infancy are a relatively recent focus of research. Greater knowledge about brain development, as well as methodological advances such as combined use of behavioral and electrophysiological techniques, have led to the generation and testing of specific hypotheses regarding sources of age-related change. Theory and data converge to suggest that the early-stage processes of encoding and consolidation are a significant source of age-related variability in memory early in life. Additional research is needed to determine how these processes change and interact with myriad other determinants of recall.     

新生儿重症监护室（NICU）中放弃治疗的决策

随着现代主义哲学与伦理学,尤其是生命价值理论对"放弃治疗"的支持,以及相关科学标准和程序法则的建立,对于新生儿重症监护室中的一部分病情危重且又预后不良的新生儿来说,理应作出放弃治疗的决策。但在实施的过程中,存在许多困难,医生有客观告知的义务,但最后的决策权仍在患儿父母。从NICU中放弃治疗的对象、依据、医院面临的困境、决策的实施以及解决实施过程中矛盾冲突的对策方面加以讨论。     

新生儿重症监护室(NICU)中放弃治疗的决策

随着现代主义哲学与伦理学,尤其是生命价值理论对"放弃治疗"的支持,以及相关科学标准和程序法则的建立,对于新生儿重症监护室中的一部分病情危重且又预后不良的新生儿来说,理应作出放弃治疗的决策.但在实施的过程中,存在许多困难,医生有客观告知的义务,但最后的决策权仍在患儿父母.从NICU中放弃治疗的对象、依据、医院面临的困境、决策的实施以及解决实施过程中矛盾冲突的对策方面加以讨论.     

Schizophrenia: A Neurodevelopmental Perspective

Diverse lines of research suggest that schizophrenia is a genetically influenced neurodevelopmental disorder. Family, twin, and adoption studies suggest that most cases of schizophrenia involve a genetic diathesis that is necessary but not sufficient for development of the disorder. Histological, neuroimaging, and neuropsychological findings converge in providing evidence for medial-temporal and frontal lobe dysfunction that likely predates the onset of psychosis. Behavioral phenomenology and neurobiology suggest that dopamine plays a crucial moderating role between these structural abnormalities and functional impairment. Recently, investigators have used animal models and clinical syndromes to integrate these findings into neurodevelopmental models of schizophrenia that hold great potential for yielding etiological insight.     

Neurodevelopmental influences in the genesis and epigenesis of schizophrenia: An overview

The classical view of schizophrenia as a dementing disorder has recently been challenged by several findings pointing to a prenatal/perinatal origin of at least some of the brain abnormalities seen in these patients. This article reviews evidence from a number of different fields, including postmortem neuropathology, in vivo neuroimaging, developmental neuropsychology, and obstetric epidemiology in assessing the viability of a neurodevelopmental perspective of schizophrenia. Although the case for viewing schizophrenia as a neurodevelopmental condition is still circumstantial, and several gaps in this model remain, evidence from these diverse lines of inquiry converge to indicate at least a partial role of disturbances of brain development in the disorder's genesis and epigenesis.     

Neurodevelopmental Disorders Across the Lifespan: A Neuroconstructivist Approach.

Objectives. To investigate neuropsychological and neurobehavioral outcome in children with arterial ischemic stroke (AIS).

Background. Childhood stroke can have consequences on motor, cognitive, and behavioral development. We present a cross-sectional study of neuropsychological and neurobehavioral outcome at least one year poststroke in a uniquely homogeneous sample of children who had experienced AIS.

Method. Forty-nine children with AIS aged 6 to 18 years were recruited from a specialist clinic. Neuropsychological measures of intelligence, reading comprehension, attention, and executive function were administered. A triangulation of data collection included questionnaires completed by the children, their parents, and teachers, rating behavior, executive functions, and emotions.

Key Findings. Focal neuropsychological vulnerabilities in attention (response inhibition and dual attention) and executive function were found, beyond general intellectual functioning, irrespective of hemispheric side of stroke. Difficulties with emotional and behavioral regulation were also found. Consistent with an “early plasticity” hypothesis, earlier age of stroke was associated with better performance on measures of executive function.

Conclusions. A significant proportion of children poststroke are at long-term risk of difficulties with emotional regulation, executive function, and attention. Data also suggest that executive functions are represented in widespread networks in the developing brain and are vulnerable to unilateral injury.     

Neurodevelopmental influences in the genesis and epigenesis of schizophrenia: An overview

The classical view of schizophrenia as a dementing disorder has recently been challenged by several findings pointing to a prenatal/perinatal origin of at least some of the brain abnormalities seen in these patients. This article reviews evidence from a number of different fields, including postmortem neuropathology, in vivo neuroimaging, developmental neuropsychology, and obstetric epidemiology in assessing the viability of a neurodevelopmental perspective of schizophrenia. Although the case for viewing schizophrenia as a neurodevelopmental condition is still circumstantial, and several gaps in this model remain, evidence from these diverse lines of inquiry converge to indicate at least a partial role of disturbances of brain development in the disorder's genesis and epigenesis.     

Screening for Medical and Neurodevelopmental Disorders for the Professional Counselor

This article reviews several assessment factors useful identifying the presence of a possible medical illness or neurodevelopmental disorder contributing to a client's adjustment problems. Use of behavioral observations, record reviews, brief neuro-behavioral screening tests, and the taking of a history are outlined that can assist in raising the index of suspicion for organic influence. Also addressed are issues pertaining to referral for medical and specialty assessments, including neuropsychological evaluation.     

Infant illness severity and family adjustment in the aftermath of NICU hospitalization

Up to 15% of parents have an infant who will spend time in a neonatal intensive care unit (NICU). After discharge, parents may care for a medically fragile infant and worry about their development. The current study examined how infant illness severity is associated with family adjustment. Participants included parents with infants who had been discharged from the NICU 6 months to 3 years prior to study participation (N = 199). Via a Qualtrics online survey, parents reported their infants’ medical history, parenting stress, family burden, couple functioning, and access to resources. Multivariable regression analyses revealed that more severe infant medical issues during hospitalization (e.g., longer length of stay and more medical devices) were associated with greater family burden, but not stress or couple functioning. Infant health issues following hospitalization (i.e., medical diagnosis and more medical specialists) were associated with greater stress, poorer couple functioning, and greater family burden. Less time for parents was associated with increased stress and poorer couple functioning. Surprisingly, parents of infants who were rehospitalized reported less stress and better couple functioning, but greater family burden. Family-focused interventions that incorporate psychoeducation about provider−patient communication, partner support, and self-care may be effective to prevent negative psychosocial sequelae among families.     

Neurodevelopmental assessment of the young child: the state of the art

A wide variety of tests are available to assess the central nervous system (CNS) function of the toddler and preschool-aged child. These tests vary as to function; qualities and abilities tapped; facility with which they can be learned, administered, and scored; availability of test materials and manuals or training videos; and strength of standardization and validation data. Some were developed to screen development of large numbers of children. Others were developed to evaluate a child for diagnosis of disability or delineation of a child's strengths and weaknesses. Some broadly screen or assess multiple aspects of development, while some focus on specific abilities. A limitation of all these tests is that they tap only a small portion of a child's abilities at a given point in time. Administration of a variety of different tests provides a more complete evaluation of a child's abilities. Tests that can follow a child's development over time tap into the continuum of human development. The ability to measure various aspects of CNS functional development is a first step in addressing our greatest challenge, how to promote and support a child's development.     

Repetitive Behavior in Neurodevelopmental Disorders: Clinical and Translational Findings

Repetitive behavior refers to a highly heterogeneous set of responses associated with a wide range of conditions, including normative development. Treatment studies for aberrant repetitive behavior are limited although one promising approach involves conceptualizing such behavior as a generalized inflexibility or lack of variability in responding. Relatively little is known about the neurobiological mechanisms that mediate the development and expression of repetitive behavior, information critical to the design of effective pharmacotherapies, early interventions, and prevention strategies. We will review clinical findings in repetitive behavior as well as findings from animal models highlighting environmental factors and the role of cortical-basal ganglia circuitry in mediating the development and expression of these behaviors. Findings from animal models have included identification of a specific neural pathway important in mediating repetitive behavior. Moreover, pharmacological studies that support the importance of this pathway have led to the identification of novel potential therapeutic targets. Expanding the evidence base for environmental enrichment-derived interventions and focusing on generalized variability in responding will aid in addressing the broader problem of rigidity or inflexibility.