First 1,000 days: enough for mothers but not for children? Long-term outcomes of an early intervention on maternal depressed mood and child cognitive development: follow-up of a randomised controlled trial / M. TOMLINSON in Journal of Child Psychology and Psychiatry, 63-3 (March 2022)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 63-3 (March 2022) . - p.261-272 Titre : First 1,000 days: enough for mothers but not for children? Long-term outcomes of an early intervention on maternal depressed mood and child cognitive development: follow-up of a randomised controlled trial Type de document : Texte imprimé et/ou numérique Auteurs : M. TOMLINSON, Auteur ; S. SKEEN, Auteur ; G. J. MELENDEZ-TORRES, Auteur ; X. HUNT, Auteur ; C. DESMOND, Auteur ; B. MORGAN, Auteur ; L. MURRAY, Auteur ; Peter J. COOPER, Auteur ; S. D. RATHOD, Auteur ; M. MARLOW, Auteur ; P. FEARON, Auteur Article en page(s) : p.261-272 Langues : Anglais (eng) Mots-clés : Infants  adolescence  cognitive development  home visiting intervention  low- and middle-income countries  parenting Index. décimale : PER Périodiques Résumé : BACKGROUND: Child cognitive development is often compromised in contexts of poverty and adversity, and these deficits tend to endure and affect the child across the life course. In the conditions of poverty and violence that characterise many low- and middle-income countries (LMIC), the capacity of parents to provide the kind of care that promotes good child development may be severely compromised, especially where caregivers suffer from depression. One avenue of early intervention focuses on the quality of the early mother-infant relationship. The aim of this study was to examine the long-term impact of an early intervention to improve the mother-infant relationship quality on child cognitive outcomes at 13?years of age. We also estimated the current costs to replicate the intervention. METHOD: We re-recruited 333 children from an early childhood maternal-infant attachment intervention, 'Thula Sana', when the children were 13?years old, to assess whether there were impacts of the intervention on child cognitive outcomes, and maternal mood. We used the Kaufman Assessment Battery to assess the child cognitive development and the Patient Health Questionnaire (PHQ-9) and the Self-Reporting Questionnaire (SRQ-20) to assess maternal mental health. RESULTS: Effect estimates indicated a pattern of null findings for the impact of the intervention on child cognitive development. However, the intervention had an effect on caregiver psychological distress (PHQ-9, ES?=?-0.17 [CI: -1.95, 0.05] and SRQ-20, ES?=?-0.30 [CI: -2.41, -0.19]), but not anxiety. The annual cost per mother-child pair to replicate the Thula Sana intervention in 2019 was estimated at ZAR13,365 ($780). CONCLUSION: In a socio-economically deprived peri-urban settlement in South Africa, a home visiting intervention, delivered by community workers to mothers in pregnancy and the first six postpartum months, had no overall effect on child cognitive development at 13?years of age. However, those caregivers who were part of the original intervention showed lasting improvements in depressed mood. Despite the fact that there was no intervention effect on long-term child outcomes, the improvements in maternal mood are important. En ligne : http://dx.doi.org/10.1111/jcpp.13482 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=457 [article] First 1,000 days: enough for mothers but not for children? Long-term outcomes of an early intervention on maternal depressed mood and child cognitive development: follow-up of a randomised controlled trial [Texte imprimé et/ou numérique] / M. TOMLINSON, Auteur ; S. SKEEN, Auteur ; G. J. MELENDEZ-TORRES, Auteur ; X. HUNT, Auteur ; C. DESMOND, Auteur ; B. MORGAN, Auteur ; L. MURRAY, Auteur ; Peter J. COOPER, Auteur ; S. D. RATHOD, Auteur ; M. MARLOW, Auteur ; P. FEARON, Auteur . - p.261-272. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 63-3 (March 2022) . - p.261-272 Mots-clés : Infants  adolescence  cognitive development  home visiting intervention  low- and middle-income countries  parenting Index. décimale : PER Périodiques Résumé : BACKGROUND: Child cognitive development is often compromised in contexts of poverty and adversity, and these deficits tend to endure and affect the child across the life course. In the conditions of poverty and violence that characterise many low- and middle-income countries (LMIC), the capacity of parents to provide the kind of care that promotes good child development may be severely compromised, especially where caregivers suffer from depression. One avenue of early intervention focuses on the quality of the early mother-infant relationship. The aim of this study was to examine the long-term impact of an early intervention to improve the mother-infant relationship quality on child cognitive outcomes at 13?years of age. We also estimated the current costs to replicate the intervention. METHOD: We re-recruited 333 children from an early childhood maternal-infant attachment intervention, 'Thula Sana', when the children were 13?years old, to assess whether there were impacts of the intervention on child cognitive outcomes, and maternal mood. We used the Kaufman Assessment Battery to assess the child cognitive development and the Patient Health Questionnaire (PHQ-9) and the Self-Reporting Questionnaire (SRQ-20) to assess maternal mental health. RESULTS: Effect estimates indicated a pattern of null findings for the impact of the intervention on child cognitive development. However, the intervention had an effect on caregiver psychological distress (PHQ-9, ES?=?-0.17 [CI: -1.95, 0.05] and SRQ-20, ES?=?-0.30 [CI: -2.41, -0.19]), but not anxiety. The annual cost per mother-child pair to replicate the Thula Sana intervention in 2019 was estimated at ZAR13,365 ($780). CONCLUSION: In a socio-economically deprived peri-urban settlement in South Africa, a home visiting intervention, delivered by community workers to mothers in pregnancy and the first six postpartum months, had no overall effect on child cognitive development at 13?years of age. However, those caregivers who were part of the original intervention showed lasting improvements in depressed mood. Despite the fact that there was no intervention effect on long-term child outcomes, the improvements in maternal mood are important. En ligne : http://dx.doi.org/10.1111/jcpp.13482 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=457

Mavoglurant in adolescents with fragile X syndrome: analysis of Clinical Global Impression-Improvement source data from a double-blind therapeutic study followed by an open-label, long-term extension study / Donald B. Jr BAILEY in Journal of Neurodevelopmental Disorders, 8-1 (December 2016)  

Public ISBD [article]  inJournal of Neurodevelopmental Disorders > 8-1 (December 2016) . - p.1 Titre : Mavoglurant in adolescents with fragile X syndrome: analysis of Clinical Global Impression-Improvement source data from a double-blind therapeutic study followed by an open-label, long-term extension study Type de document : Texte imprimé et/ou numérique Auteurs : Donald B. Jr BAILEY, Auteur ; Elizabeth BERRY-KRAVIS, Auteur ; Anne C. WHEELER, Auteur ; M. RASPA, Auteur ; F. MERRIEN, Auteur ; J. RICART, Auteur ; B. KOUMARAS, Auteur ; G. ROSENKRANZ, Auteur ; M. TOMLINSON, Auteur ; F. VON RAISON, Auteur ; G. APOSTOL, Auteur Article en page(s) : p.1 Langues : Anglais (eng) Mots-clés : Afq056  Cgi-i  Clinical Global Impression-Improvement  Fragile X syndrome  Mavoglurant Index. décimale : PER Périodiques Résumé : BACKGROUND: A phase II randomized, placebo-controlled, double-blind study and subsequent open-label extension study evaluated the efficacy, safety, and tolerability of mavoglurant (AFQ056), a selective metabotropic glutamate receptor subtype-5 antagonist, in treating behavioral symptoms in adolescent patients with fragile X syndrome (FXS). A novel method was applied to analyze changes in symptom domains in patients with FXS using the narratives associated with the clinician-rated Clinical Global Impression-Improvement (CGI-I) scale. METHODS: In the core study, patients were randomized to receive mavoglurant (25, 50, or 100 mg BID) or placebo over 12 weeks. In the extension, patients received 100 mg BID mavoglurant (or the highest tolerated dose) for up to 32 months. Global improvement, as a measure of treatment response, was assessed using the CGI-I scale. Investigators assigning CGI-I scores of 1 (very much improved), 2 (much improved), 6 (much worse), or 7 (very much worse) were provided a standard narrative template to collect further information about the changes observed in patients. Investigator feedback was coded and clustered into categories of improvement or worsening to identify potential areas of improvement with mavoglurant. Treatment effect in each category was characterized using the Cochran-Mantel-Haenszel test. RESULTS: A total of 134 and 103 patients had reached 2 weeks or more of core and extension study treatment, respectively, by the pre-assigned cutoff date for investigator feedback. In the core study, 34 CGI-I scores of 1 or 2 were reported in 28 patients; one patient scored 6. Analysis of the CGI-I narratives did not indicate greater treatment response in patients receiving mavoglurant compared with placebo in any specific improvement domain. There were 54 CGI-I scores of 1 or 2 in 47 patients in the extension study. The most frequently reported categories of improvement were behavior and mood (79.3 and 76.6 % in core and extension studies, respectively), engagement (75.9 and 78.7 %), and communication (69.0 and 61.7 %). CONCLUSIONS: A method was established to capture and categorize FXS symptoms using CGI-I narratives. Although this method did not show benefit of drug over placebo, narratives from investigators were mostly based on parental report and thus do not represent a completely objective alternative assessment. TRIAL REGISTRATION: The studies described are registered at ClinicalTrials.gov with clinical trial identifier numbers NCT01357239 and NCT01433354. En ligne : http://dx.doi.org/10.1186/s11689-015-9134-5 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=348 [article] Mavoglurant in adolescents with fragile X syndrome: analysis of Clinical Global Impression-Improvement source data from a double-blind therapeutic study followed by an open-label, long-term extension study [Texte imprimé et/ou numérique] / Donald B. Jr BAILEY, Auteur ; Elizabeth BERRY-KRAVIS, Auteur ; Anne C. WHEELER, Auteur ; M. RASPA, Auteur ; F. MERRIEN, Auteur ; J. RICART, Auteur ; B. KOUMARAS, Auteur ; G. ROSENKRANZ, Auteur ; M. TOMLINSON, Auteur ; F. VON RAISON, Auteur ; G. APOSTOL, Auteur . - p.1. Langues : Anglais (eng) in Journal of Neurodevelopmental Disorders > 8-1 (December 2016) . - p.1 Mots-clés : Afq056  Cgi-i  Clinical Global Impression-Improvement  Fragile X syndrome  Mavoglurant Index. décimale : PER Périodiques Résumé : BACKGROUND: A phase II randomized, placebo-controlled, double-blind study and subsequent open-label extension study evaluated the efficacy, safety, and tolerability of mavoglurant (AFQ056), a selective metabotropic glutamate receptor subtype-5 antagonist, in treating behavioral symptoms in adolescent patients with fragile X syndrome (FXS). A novel method was applied to analyze changes in symptom domains in patients with FXS using the narratives associated with the clinician-rated Clinical Global Impression-Improvement (CGI-I) scale. METHODS: In the core study, patients were randomized to receive mavoglurant (25, 50, or 100 mg BID) or placebo over 12 weeks. In the extension, patients received 100 mg BID mavoglurant (or the highest tolerated dose) for up to 32 months. Global improvement, as a measure of treatment response, was assessed using the CGI-I scale. Investigators assigning CGI-I scores of 1 (very much improved), 2 (much improved), 6 (much worse), or 7 (very much worse) were provided a standard narrative template to collect further information about the changes observed in patients. Investigator feedback was coded and clustered into categories of improvement or worsening to identify potential areas of improvement with mavoglurant. Treatment effect in each category was characterized using the Cochran-Mantel-Haenszel test. RESULTS: A total of 134 and 103 patients had reached 2 weeks or more of core and extension study treatment, respectively, by the pre-assigned cutoff date for investigator feedback. In the core study, 34 CGI-I scores of 1 or 2 were reported in 28 patients; one patient scored 6. Analysis of the CGI-I narratives did not indicate greater treatment response in patients receiving mavoglurant compared with placebo in any specific improvement domain. There were 54 CGI-I scores of 1 or 2 in 47 patients in the extension study. The most frequently reported categories of improvement were behavior and mood (79.3 and 76.6 % in core and extension studies, respectively), engagement (75.9 and 78.7 %), and communication (69.0 and 61.7 %). CONCLUSIONS: A method was established to capture and categorize FXS symptoms using CGI-I narratives. Although this method did not show benefit of drug over placebo, narratives from investigators were mostly based on parental report and thus do not represent a completely objective alternative assessment. TRIAL REGISTRATION: The studies described are registered at ClinicalTrials.gov with clinical trial identifier numbers NCT01357239 and NCT01433354. En ligne : http://dx.doi.org/10.1186/s11689-015-9134-5 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=348

A review of screening tools for the identification of autism spectrum disorders and developmental delay in infants and young children: recommendations for use in low- and middle-income countries / M. MARLOW in Autism Research, 12-2 (February 2019)  

Public ISBD [article]  inAutism Research > 12-2 (February 2019) . - p.176-199 Titre : A review of screening tools for the identification of autism spectrum disorders and developmental delay in infants and young children: recommendations for use in low- and middle-income countries Type de document : Texte imprimé et/ou numérique Auteurs : M. MARLOW, Auteur ; C. SERVILI, Auteur ; M. TOMLINSON, Auteur Article en page(s) : p.176-199 Langues : Anglais (eng) Mots-clés : autism spectrum disorders  developmental disability  developmental monitoring  low- and middle-income countries  screening tools Index. décimale : PER Périodiques Résumé : Without intervention, developmental delay (DD) and autism spectrum disorders (ASDs) severely restrict children from reaching their developmental potential. Monitoring child development through the use of screening tools can help identify children who need further assessment or intervention. Screening has been widely encouraged to identify children with ASD or DD, and a large variety of screening instruments are suggested in the literature. There is a lack of consensus around which screening tools are most effective, especially where tools are used in cultures other than those in which they were created. We conducted a review of the literature for screening tools for DD and autism to make recommendations for tool selection and use in low- and middle-income countries (LMIC). We included 99 screening tools in the review and created profiles for each tool to evaluate their properties and determine which tools could be effectively used in various LMIC. Our review identified a substantial number (35 for DD and 6 for ASD) of screening tools from LMIC. We identified 10 tools which show promise for use across settings; these tools are brief, low-cost and can be implemented by paraprofessionals or lay community health workers. Routine screening is an important first step toward addressing the need for services in LMIC, but high-quality tools take time to be conceptualized, developed, piloted, and validated, before implementation can happen. A focus on improving the scientific rigor of early detection approaches and on enhancing the reach to underserved populations should be prioritized. Autism Res 2019, 12: 176-199 (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Screening tools are short questionnaires or brief assessments used to identify children at risk of a developmental disability such as autism. Many screening tools exist, but there is uncertainty about which tools work best in non-Western cultures or low-resource settings. We reviewed over 90 screening tools to identify which tools can be easily used in these settings. Selecting tools that are affordable and easy to use will make it easier to identify and support children with developmental difficulties. En ligne : http://dx.doi.org/10.1002/aur.2033 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=383 [article] A review of screening tools for the identification of autism spectrum disorders and developmental delay in infants and young children: recommendations for use in low- and middle-income countries [Texte imprimé et/ou numérique] / M. MARLOW, Auteur ; C. SERVILI, Auteur ; M. TOMLINSON, Auteur . - p.176-199. Langues : Anglais (eng) in Autism Research > 12-2 (February 2019) . - p.176-199 Mots-clés : autism spectrum disorders  developmental disability  developmental monitoring  low- and middle-income countries  screening tools Index. décimale : PER Périodiques Résumé : Without intervention, developmental delay (DD) and autism spectrum disorders (ASDs) severely restrict children from reaching their developmental potential. Monitoring child development through the use of screening tools can help identify children who need further assessment or intervention. Screening has been widely encouraged to identify children with ASD or DD, and a large variety of screening instruments are suggested in the literature. There is a lack of consensus around which screening tools are most effective, especially where tools are used in cultures other than those in which they were created. We conducted a review of the literature for screening tools for DD and autism to make recommendations for tool selection and use in low- and middle-income countries (LMIC). We included 99 screening tools in the review and created profiles for each tool to evaluate their properties and determine which tools could be effectively used in various LMIC. Our review identified a substantial number (35 for DD and 6 for ASD) of screening tools from LMIC. We identified 10 tools which show promise for use across settings; these tools are brief, low-cost and can be implemented by paraprofessionals or lay community health workers. Routine screening is an important first step toward addressing the need for services in LMIC, but high-quality tools take time to be conceptualized, developed, piloted, and validated, before implementation can happen. A focus on improving the scientific rigor of early detection approaches and on enhancing the reach to underserved populations should be prioritized. Autism Res 2019, 12: 176-199 (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Screening tools are short questionnaires or brief assessments used to identify children at risk of a developmental disability such as autism. Many screening tools exist, but there is uncertainty about which tools work best in non-Western cultures or low-resource settings. We reviewed over 90 screening tools to identify which tools can be easily used in these settings. Selecting tools that are affordable and easy to use will make it easier to identify and support children with developmental difficulties. En ligne : http://dx.doi.org/10.1002/aur.2033 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=383

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