1. Gaudet I, Paquette N, Bernard C, Doussau A, Harvey J, Beaulieu-Genest L, Pinchefsky E, Trudeau N, Poirier N, Simard MN, Gallagher A. Neurodevelopmental Outcome of Children with Congenital Heart Disease: A Cohort Study from Infancy to Preschool Age. The Journal of pediatrics. 2021; 239: 126-35.e5.

OBJECTIVE: To characterize the neuropsychological outcome of children with congenital heart disease (CHD) at age 5 years; the stability of cognitive and language abilities across childhood; and to identify early neurodevelopmental markers of neuropsychological outcomes in these children. STUDY DESIGN: Five-year-old children (n = 55) with complex CHD were assessed using standardized and comprehensive neuropsychological measures. Stability of language and cognitive performance was assessed by comparing standardized scores between ages 1, 2, and 5 years old. Association between 5-year-old skills and scores obtained in early childhood was studied to identify potential early markers of preschool performance. Receiver operating characteristic curves were used to evaluate the classification accuracy of Bayley Scales of Infant Development, Third Edition scales in identifying later impairments. RESULTS: At age 5 years, our cohort obtained scores significantly below the norms on most developmental domains, with 35% to 65% of participants showing impaired short-term/working memory, attention, and preacademic skills. Developmental patterns measured between ages 1 and 5 years were different for cognitive and language domains, with a decline with age for cognitive functioning and stable results for expressive language. The Bayley Scales of Infant Development, Third Edition language scores at age 2 years provided a good predictive value in identifying children with impaired language at age 5 years. CONCLUSIONS: In our cohort, we found a high prevalence of impairments affecting higher-order cognitive domains. Although language difficulties can be detected as early as 2 years of age, other neuropsychological impairments, such as attention and pre-academic skills, only appear later during development, which reinforces the need for long-term monitoring and systematic assessment before school entry.

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2. Krijnen LJG, Verhoeven M, van Baar AL. Assessing social-emotional development in infants and toddlers using parent-reports: Comparing the ASQ-SE-NL to the Social-Emotional Scale of the Bayley-III-NL. Early human development. 2021; 161: 105439.

BACKGROUND: The Ages and Stages Questionnaire Social-Emotional (ASQ-SE) is a parent-report screening instrument designed to assess children’s social-emotional development and detect those at risk for delay or problems. Psychometric properties of this questionnaire have been studied before, but the ASQ-SE has never been compared to the Social-Emotional Scale of the Bayley-III (Bayley-III-SE). AIM: To compare the Dutch ASQ-SE (ASQ-SE-NL) to the Dutch Bayley-III-SE (Bayley-III-NL-SE; criterion measure). METHOD: A Dutch community sample of mothers with children aged 3-41 months (n = 1014) filled out both questionnaires. Cut-off scores for the ASQ-SE-NL were determined using: 1) >1 SD above the mean and 2) ROC curves. For the Bayley-III-NL, Dutch norm scores were used. RESULTS: Specificity (70.8% and 88.5%) and screen-out accuracy (0.65 and 0.77) of the ASQ-SE-NL were good. Sensitivity was only sufficient (70.6%) when using ROC curves and only for the ASQ-SE-NL ≥18 months age versions. Screen-in accuracy was insufficient (<0.49). Positive predictive value was 34.7% and 32.7%, and negative predictive value was 87.5% and 92.3%. False positive cases on the ASQ-SE-NL scored significantly lower on the Bayley-III-NL-SE than true negative cases. CONCLUSION: Using the Bayley-III-NL-SE as the criterion, the ASQ-SE-NL performed well in identifying children not at risk for delay or problems. The ASQ-SE-NL sufficiently detected children at risk for delay or problems in the ≥18 months ASQ-SE-NL age versions when cut-off scores were determined by ROC curves. The ASQ-SE-NL can be used in a monitoring routine, but early rescreening is advised after a positive test result, given the number of false positive results.

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3. Shiohama T, Ortug A, Warren JLA, Valli B, Levman J, Faja SK, Tsujimura K, Maunakea AK, Takahashi E. Small Nucleus Accumbens and Large Cerebral Ventricles in Infants and Toddlers Prior to Receiving Diagnoses of Autism Spectrum Disorder. Cerebral cortex (New York, NY : 1991). 2022; 32(6): 1200-11.

Early interventions for autism spectrum disorder (ASD) are increasingly available, while only 42-50% of ASD children are diagnosed before 3 years old (YO). To identify neuroimaging biomarkers for early ASD diagnosis, we evaluated surface- and voxel-based brain morphometry in participants under 3YO who were later diagnosed with ASD. Magnetic resonance imaging data were retrospectively obtained from patients later diagnosed with ASD at Boston Children’s Hospital. The ASD participants with comorbidities such as congenital disorder, epilepsy, and global developmental delay/intellectual disability were excluded from statistical analyses. Eighty-five structural brain magnetic resonance imaging images were collected from 81 participants under 3YO and compared with 45 images from 45 gender- and age-matched nonautistic controls (non-ASD). Using an Infant FreeSurfer pipeline, 236 regionally distributed measurements were extracted from each scan. By t-tests and linear mixed models, the smaller nucleus accumbens and larger bilateral lateral, third, and fourth ventricles were identified in the ASD group. Vertex-wise t-statistical maps showed decreased thickness in the caudal anterior cingulate cortex and increased thickness in the right medial orbitofrontal cortex in ASD. The smaller bilateral accumbens nuclei and larger cerebral ventricles were independent of age, gender, or gestational age at birth, suggesting that there are MRI-based biomarkers in prospective ASD patients before they receive the diagnosis and that the volume of the nucleus accumbens and cerebral ventricles can be key MRI-based early biomarkers to predict the emergence of ASD.

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4. Zhao Z, Xing J, Zhang X, Qu X, Hu X, Lu J. Random and Short-Term Excessive Eye Movement in Children with Autism During Face-to-Face Conversation. Journal of autism and developmental disorders. 2021.

This study investigated the oculomotor performance in children with autism spectrum disorder (ASD) during a face-to-face conversation. A head mounted eye tracker recorded the eye movements in 20 children with ASD and 23 children with typical development (TD). Group comparisons were conducted on the randomness and the quantity of eye movement. The amount of time needed to reveal group difference was also examined. Results showed that the randomness of eye movement was significantly higher at all examined time durations, and the amount of eye movement was significantly greater within 3 s in the ASD group. These findings demonstrated an atypical pattern of oculomotor dynamics in children ASD, which might facilitate the objective identification of ASD during daily social interaction.

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