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Background Child development is influenced by the psychosocial environment. As part of developmental surveillance, identifying psychosocial risk factors that could hinder optimal development is therefore important. However, whether parents consider this type of question pertinent and acceptable remains unknown. Objectives To examine parental perception regarding the acceptability of asking questions about psychosocial background as part of a standardized developmental surveillance questionnaire. Design/Methods Using an online questionnaire and a snowball sampling approach, we surveyed parents living with at least one child Results Of 1651 participants, 97% were mothers and 93% declared having a post-secondary degree. Median age was 34 years old (interquartile range 31-38). An overwhelming majority found acceptable the questions about concerns regarding their child development (99%) and family history of developmental problems (95%). Psychosocial indicators were considered acceptable in the following proportions: substance abuse (84%), food insecurity (77%), past maternal history of depression (74%), and education level (65%). Higher rates of acceptability correlated with higher educational levels. Main themes that emerged regarding unacceptability were as follows: questions being offensive or intrusive, questions not relevant to child development, improper physical environment to ask such questions and lack of relationship with the health care professional in charge. Conclusion As part of developmental surveillance, questions on psychosocial risk factors can be disturbing to parents and must be addressed in a trusting environment and with a sensitive manner.

Purpose: This retrospective study aims to describe the gross motor development of children aged 4 to 24 months with congenital heart disease (CHD) enrolled in a systematic developmental follow-up program and to describe the frequency of physical therapy sessions they received between 4 and 8 months of age. Methods: Twenty-nine infants with CHD underwent motor evaluations using the AIMS at 4 months, and the Bayley-III at 12 and 24 months. Results: Based on AIMS, 79% of 4-month-old infants had a gross motor delay and required physical therapy. Among these, 56.5% received one to two physical therapy sessions, and 43.5% received three to six sessions. Infants who benefited from regular interventions tended to show a better improvement in motor scores from 12 to 24 months. Conclusion: This study highlights the importance of early motor screening in infants with CHD and suggests a potential benefit of early physical therapy in at-risk children. Abbreviations: CHD: Congenital heart disease; AIMS: Alberta Infant Motor Scales; Bayley-III: Bayley Scales of Infant and Toddler Development, Third edition; Bayley-III/GM: Gross Motor section of the Bayley Scales of Infant and Toddler Development, Third edition.

Objective Prenatal exposure to stress and fever are factors lowering seizure threshold in animal models. The fever effect on seizure threshold is well documented in human infants, however the associations between maternal perinatal stress and infants’ susceptibility to seizures is unknown. This is the first study in humans to investigate longitudinally, whether in humans, the effect of maternal perinatal emotional symptoms such as stress, anxiety and depression that may trigger a biological stress response on age at first seizure occurrence. Method The study sample is a subgroup drawn from a longitudinal follow up cohort (3D cohort study: Design, Develop, Discover, N = 2366 mother-infant dyads). Twenty-nine otherwise healthy infants who had a febrile seizure (FS) episode before the last follow-up visit (around 24 months of age) were studied. Mothers completed questionnaires regarding their emotional health at each pregnancy trimester and at three months postpartum. The link between maternal emotional symptoms and infant age at first FS was assessed through correlations and multiple regressions. Results We found that maternal anxiety symptoms during the second trimester of pregnancy are linked to the age at first FS (r(23) = −0.459, p = 0.021) and explain 21.1% of its variance. Postnatal maternal depression symptoms at 3 months postpartum were also associated with the age at first FS (r(23) = −0.587, p = 0.002) and explained an additional 17.6% of variance. Together, the variables explained 38.7% of the variance in age at first FS. Maternal perceived stress symptoms at 3 months postpartum were also linked to the age at first FS (r(23) = −0.418, p = 0.038), however, stress did not significantly contribute to the variance of age at first FS.. Significance Our results suggest a link between increased perinatal maternal emotional symptoms and the age at first FS. An earlier age at first FS may be the manifestation of a lower seizure threshold. Early first seizure occurrence is a risk factor for compromised neurological and cognitive development. Further studies should address the mechanisms by which perinatal maternal emotional symptoms may have an impact on seizure threshold in humans.

Objective To compare children's cognitive, motor, and language development at 2 years of age after assisted reproductive technologies (ARTs) relative to natural conception. Methods The 3D-Study (2010-2012) is a prospective cohort study, which sought to improve the understanding among perinatal events, obstetric outcomes, and child development. A total of 2,366 pregnant women were recruited, of whom 278 conceived with ART: ovarian stimulation, intrauterine sperm insemination, in vitro fertilization, intracytoplasmic sperm injection, or in vitro maturation. Natural conception was defined as the unassisted establishment of pregnancy. Cognitive, motor, and language neurodevelopmental outcomes were compared between ART and natural conception groups at 24 months using the Bayley Scales of Infant and Toddler Development, 3rd edition, and the MacArthur-Bates Communicative Development Inventories. Adjusted linear regression models evaluated the effect of ART on neurodevelopmental outcomes using natural conception as a reference. Results A total of 175 children in the ART group (62.9%) and 1,345 children in the natural conception group (64.4%) underwent neurodevelopmental assessment at 24 months postpartum. After adjusting for relevant confounders, children born after ART showed no difference in Bayley scales' cognitive scores (B1 [standard error]=-1.60 [0.9], 95% confidence interval [CI] -3.36 to 0.16), composite motor scores (B1 [standard error]=-1.33 [1.0], 95% CI -3.29 to 0.63), or MacArthur-Bates language scores (B1 [standard error]=-0.28 [2.1], 95% CI -4.39 to 3.83). No difference was observed when independent ART techniques were compared nor when comparing in vivo (ovarian stimulation or intrauterine insemination) or in vitro (in vitro fertilization, intracytoplasmic sperm injection, or in vitro maturation) techniques (P>.05). Conclusion Children born after ART had similar cognitive, motor, and language development as children born after natural conception at 2 years of age. These findings may be useful in the clinical counseling of patients undergoing ART.

Atypical head circumference (HC) growth has been associated with neurodevelopmental disorders. However, whether it is associated with specific aspects of development in early childhood in the general population is unknown. The objective of this study was to assess the predictive value of HC growth as an early biomarker of behavioral traits. We examined longitudinal associations between HC growth from 0 to 12 months and temperament, cognitive, and motor development at 24 months. A subsample of healthy children (N = 756) was drawn from the 3D (Design, Develop, Discover) cohort study. Early HC growth was modeled with latent growth curve analysis. Greater postnatal HC growth predicted lower temperamental effortful control and lower surgency/extraversion in boys. HC growth did not predict cognitive or fine motor scores, but did predict greater gross motor skills in boys. No significant effect of HC growth was found in girls. This study is the first to demonstrate an association between postnatal HC growth and specific aspects of child development in a healthy population. Results suggest HC growth overshadows brain mechanisms involved in behavioral traits in early infancy. Whether links are maintained throughout development and the mechanisms involved correspond to traits found in atypical populations remains to be studied.

BACKGROUND Infants with childhood-onset epilepsies, including epileptic encephalopathies, are at high risk of developmental challenges such as motor and language delays. There has been a growing focus on developmental screening instruments due to the association between delayed development and long-term adverse outcomes, including negative impacts on health-related quality of life, school achievement and social participation. Therefore, children with developmental delays should be referred as early as possible to rehabilitation services such as occupational, physical, or speech therapy. Developmental screening using standardized tools is recommended in order to identify the high-risk children that require additional developmental assessments. The Ages and Stages Questionnaires (ASQ), a parent-completed developmental screening tool, is one of the more cited and recommended developmental screening tools. However, its utility in children with early-onset epilepsy has yet to be validated. OBJECTIVES This study aimed to determine the validity of the ASQ for identifying children with new-onset epilepsy who require further professional developmental rehabilitation. DESIGN/METHODS Fifty infants (25 males) with seizure onset under 3 years of age were prospectively recruited. Parents completed the ASQ-3 before the first clinic appointment. The ASQ-3 evaluates 5 domains of development. An ASQ score below 2 standard deviations (SD) on any one of the domains was considered abnormal. Once completed, all infants were evaluated by a multidisciplinary team including neurologists, occupational therapists, and physical therapists to determine if they should be referred for further rehabilitation interventions. Accuracy of the ASQ was calculated in terms of sensibility, specificity, positive predictive value (PPV) and negative predictive value (NPV). RESULTS Mean age at the initial evaluation was 13.1 months (SD=8.22). Among the 50 infants, 36 (72%) received a score CONCLUSION The ASQ, a well-known parent-completed developmental screening tool, when abnormal shows adequate validity for the identification of children with early-onset epilepsy who require developmental assessments and interventions by rehabilitation professionals. Our results also provide further evidence that development delay is the rule rather than the exception in infants with new onset epilepsy.

Objective To describe when and by whom concern is first expressed for children referred to rehabilitation because of neuromotor problems. Study Design and Setting We conducted a survey of parents of 92 children (aged 0-6 years) who were on the waiting list for physical or occupational therapy services at rehabilitation centers in Montreal, Quebec. We compared age of child at initial concern with who first expressed concern for children who were considered at risk due to their perinatal history of prematurity and those who were not born prematurely but were later diagnosed as having neuromotor problems. Intervention Parents were interviewed regarding their child’s medical history and utilization of health care services. Results Parents were concerned later than physicians were regarding their child’s development (mean difference, 8.2 months; 95% confidence interval [CI], 3.7-12.6 months). There was no significant difference in time of recognition of problems between the premature (10.2 months) and full-term (11.9 months) groups. Even after controlling for risk group, parental concern occurred later than physician concern (β coefficient, 7.3; 95% CI, 2.5-12.2). The child’s age at the time of initial concern was associated with the child’s age at referral to rehabilitation (β coefficient, 0.04; 95% CI, 0.01-0.06). Conclusions Early recognition is important if a child is to benefit from early rehabilitation. It may be important to improve primary care screening of children for neuromotor problems and to increase parental awareness regarding normal motor development of their children. Prompt, simultaneous referral to medical evaluation and rehabilitation resources may decrease delays in rehabilitation.