| 1. |
- Ek, Ulla, 1948-, et al.
(författare)
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Teenage outcomes after speech and language impairment at preschool age
- 2012
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Ingår i: Neuropsychiatric Disease and Treatment. - 1176-6328 .- 1178-2021. ; 8, s. 221-227
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Ten years ago, we published developmental data on a representative group of children (n = 25) with moderate or severe speech and language impairment, who were attending special preschools for children. The aim of this study was to perform a follow-up of these children as teenagers. Methods: Parents of 23 teenagers participated in a clinical interview that requested information on the child's current academic achievement, type of school, previous clinical assessments, and developmental diagnoses. Fifteen children participated in a speech and language evaluation, and 13 participated in a psychological evaluation. Results: Seven of the 23 teenagers had a mild intellectual disability, and another three had borderline intellectual functioning. Nine had symptoms of disorders on the autism spectrum; five of these had an autism spectrum disorder, and four had clear autistic traits. Six met criteria for attention-deficit hyperactivity disorder (ADHD)/subthreshold ADHD. Thirteen of 15 teenagers had a moderate or severe language impairment, and 13 of 15 had a moderate or severe reading impairment. Overlapping disorders were frequent. None of the individuals who underwent the clinical evaluation were free from developmental problems. Conclusion: A large number of children with speech and language impairment at preschool age had persistent language problems and/or met the criteria for developmental diagnoses other than speech and language impairment at their follow-up as teenagers. Language impairment in young children is a marker for several developmental disorders, particularly intellectual disability and autism spectrum disorder.
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| 2. |
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| 3. |
- Blomqvist, My, et al.
(författare)
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Cognitive ability and dental fear and anxiety
- 2013
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Ingår i: European Journal of Oral Sciences. - : Wiley. - 0909-8836 .- 1600-0722. ; 121:2, s. 117-120
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Tidskriftsartikel (refereegranskat)abstract
- Dental fear and anxiety (DFA), as well as dental behavior management problems, are common in children and adolescents. Several psychological factors in the child, and parental DFA, have been studied and found to correlate to the child's DFA. The aim of this study was to investigate the relationship between cognitive ability and DFA in a population-based group of children with identified behavior and learning problems. In conjunction with a dental examination at 11yr of age, 70 children were assessed with regard to DFA using the Children's Fear Survey Schedule Dental Subscale (CFSS-DS), and their cognitive ability was assessed using the Wechsler Intelligence Scale for Children. In addition, parental DFA was measured using the Corah Dental Anxiety Scale. The results revealed that DFA was significantly correlated to verbal intelligence quotient (IQ) but not to any other cognitive index. A significant correlation was found between parental DFA and child DFA. The results indicate that the child's verbal capacity may be one factor of importance in explaining dental fear in children.
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| 4. |
- Blomqvist, My, et al.
(författare)
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Dental caries in adolescents with attention deficit hyperactivity disorder: a population-based follow-up study.
- 2011
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Ingår i: European Journal of Oral Sciences. - : Wiley. - 1600-0722 .- 0909-8836. ; 119:5, s. 381-385
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Tidskriftsartikel (refereegranskat)abstract
- This study tested the hypothesis that adolescents with attention deficit hyperactivity disorder (ADHD) exhibit a higher prevalence of caries than adolescents in a control group. Thirty-two adolescents with ADHD and a control group of 55 adolescents from a population-based sample, all 17yr of age, underwent a clinical and radiographic dental examination. The mean±SD number of decayed surfaces (DS) was 2.0±2.2 in adolescents with ADHD and 0.9±1.4 in adolescents of the control group. Thirty-one per cent of the adolescents in the ADHD group had no new caries lesions (DS=0) compared with 62% in the control group. Six per cent of the adolescents in the ADHD group were caries free [decayed, missing or filled surfaces (DMFS)=0] compared with 29% in the control group. Adolescents with ADHD also had a higher percentage of gingival sites that exhibited bleeding on probing compared with the control group: 35±39% vs. 16±24% (mean±SD), respectively. At 17yr of age, adolescents with ADHD exhibited a statistically significantly higher prevalence of caries compared with an age-matched control group. Adolescents with ADHD need more support regarding oral hygiene and dietary habits. They should be followed up with shorter intervals between dental examinations to prevent caries progression during adulthood.
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| 5. |
- de Verdier, Kim, et al.
(författare)
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Blindness and Autism : Parents’ Perspectives on Diagnostic Challenges, Support Needs and Support Provision
- 2020
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Ingår i: Journal of autism and developmental disorders. - : Springer Science and Business Media LLC. - 0162-3257 .- 1573-3432. ; 50:6, s. 1921-1930
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Tidskriftsartikel (refereegranskat)abstract
- Autism spectrum disorder (ASD), with or without intellectual disability (ID), is common in children with congenital blindness. This complex combination of disabilities often involves many challenges for the family. This study explored parents’ experiences of having a child with blindness and ASD (with or without ID), their support needs and experiences of the support provided. Interviews with eight parents, representing six families, were performed. The parents emphasized that assessment and diagnostic procedures must be performed by professionals with expertise in blind children’s development, and ASD. The support was often perceived as fragmented and did not correspond to the families’ needs. The results suggest that national guidelines should be produced, to ensure a more coordinated and tailored support to these families.
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| 6. |
- de Verdier, Kim, et al.
(författare)
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Challenges and Successful Pedagogical Strategies : Experiences from Six Swedish Students with Blindness and Autism in Different School Settings
- 2018
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Ingår i: Journal of autism and developmental disorders. - : Springer Science and Business Media LLC. - 0162-3257 .- 1573-3432. ; 48:2, s. 520-532
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Tidskriftsartikel (refereegranskat)abstract
- The prevalence of autism in children with blindness is much higher than in the general population. There are many challenges regarding the school situation for children with this complex dual disability. This study explored challenges and successful strategies in school for a sample of six Swedish children with blindness and autism, with and without intellectual disability, through qualitative interviews with students, teachers and parents. All students displayed executive functioning deficits, and the teaching situation entailed several challenges. Our research points to the importance of adopting evidence-based practices for ASD, but adapted according to the students lack of vision. For this to be possible, close collaboration between teachers, parents and specialists in the field of visual impairment and autism is necessary.
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| 7. |
- de Verdier, Kim, et al.
(författare)
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Children with blindness – major causes, developmental outcomes and implications for habilitation and educational support : a two‐decade, Swedish population‐based study
- 2018
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Ingår i: Acta Ophthalmologica Scandinavica. - : Wiley. - 1395-3907 .- 1600-0420 .- 1755-375X .- 1755-3768. ; 96:3, s. 295-300
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Tidskriftsartikel (refereegranskat)abstract
- PurposeThe aim was to describe the population of children with congenital or early infancy blindness in Sweden, with regard to causes of blindness and prevalence of neurodevelopmental impairments.MethodsMedical, psychological and pedagogical records of Swedish children with congenital or early infancy blindness (total blindness or light perception at the most) born in 1988–2008 were analysed regarding year of birth, gender, cause of blindness, gestational age, associated neurological disorders/syndromes, associated neurodevelopmental impairments, cognitive level and type of school placement.ResultsA total of 150 individuals, 80 girls and 70 boys, were identified, corresponding to a prevalence of 7/100 000. Five causes of blindness dominated, constituting 76% of all represented aetiologies: retinopathy of prematurity (ROP), optic nerve hypoplasia (ONH), Leber congenital amaurosis (LCA), optic nerve atrophy (ONA) and microphthalmia/anophthalmia. Nearly three of four children in the study population had at least one additional disability besides blindness; the most common being intellectual disability (ID) and autism spectrum disorder (ASD). More than half of the population had more than one additional disability. Autism spectrum disorder (ASD) was most common in children with ONH, ROP, LCA and microphthalmia/anophthalmia.ConclusionIn children born within the last decades, isolated blindness is uncommon and the rate of multidisabilities is high. Autism spectrum disorder (ASD) seems to be more strongly associated with specific aetiological subgroups. Further development of the support to families and schools should be based on knowledge about the considerable heterogeneity of the population of children with blindness, and the common occurrence of coexisting neurodevelopmental disorders, especially ID and ASD.
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| 8. |
- Ek, Ulla, et al.
(författare)
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An audit of teenagers who had not succeeded in elementary school : a retrospective case review
- 2012
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Ingår i: Clinical Audit. - : Dovepress. - 1179-2760. ; 4, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim was to perform a retrospective case review of pupils who had not succeeded in elementary school, in order to analyze barriers at individual and system levels. Methods: Forty-five pupils, aged 16–20 years, who had not qualified for senior high school, were consecutively assessed within the school health unit to determine their cognitive function, school history, measures taken, previous assessments, and diagnoses given. Results: School health records revealed early problems with learning, reading, mathematics, and attention, but very few students had received an appropriate diagnosis. Our review and assessment when all the data had been compiled demonstrated that the vast majority (96%) of participants had clear developmental problems. Attention problems or full attention deficit/hyperactivity disorder dominated. About half of the students reported extensive truancy. Mean intelligence quotient in the study group was 83.9, about 1 standard deviation below the mean. Fluid intelligence was significantly superior to crystallized intelligence. Conclusion: Screening and identification are needed throughout the school years of children who present symptoms that could interfere with their academic achievement. Intervention needs to be based on skilled assessment, with consideration given to each individual's broad panorama of cognitive deficits and assets, as well as concomitant social adversities that may underlie their school failure. Since there can be a significant negative impact of limited educational opportunities on future socioeconomic outcomes, the question of who is at risk is important both for affected individuals and more generally for public health. Limitations: The study group was small and may not have been fully representative. In spite of limited confidence about generalizing from the results, the findings call for reflection.
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| 9. |
- Ek, Ulla, 1948-
(författare)
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Children with visual disorders : cognitive development, developmental disorders and consequences for treatment and counselling
- 2000
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The causes of visual impairment and blindness has changed over the years, in Sweden and in other industrialised countries, giving rise to a new population of visually impaired children. Damages to the posterior visual pathway and the brain are now common causes of visual impairment. In contrast, purely ocular diseases or conditions are increasingly rare. In this thesis this changed panorama was explored and cognitive and behavioural outcome in children with ocular vs. cerebral visual impairment was examined in various studies. More cognitive deficits and developmental disorders, such as autism, attention deficit hyperactivity disorders and complex visual perceptual and visual cognitive disorders were found in children with cerebral visual impairment or combinations of ocular and cerebral causes of visual impairment. Children born preterm, now form a considerable part of the population of visually impaired children and are at risk for such disorders. In contrast, children born at term with visual impairment due to causes in the anterior parts of the visual system have an entirely different developmental outcome. Psychological assessment methods, early intervention, counselling of parents and teachers and the education of visually impaired children in mainstream classes should be adapted to correspond with this changing population of visually impaired children.
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| 10. |
- Ek, Ulla, et al.
(författare)
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Cognitive strengths and deficits in schoolchildren with ADHD.
- 2007
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Ingår i: Acta Paediatrica (Oslo, Norway : 1992). - : Wiley. - 0803-5253 .- 1651-2227. ; 96:5, s. 756-761
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Few studies provide detailed analyses of the various aspects of the entire cognitive profile of children with ADHD. MATERIAL AND METHODS: Cognitive test data were analysed for 10- to 11-year-old children with (1) ADHD, (2) subthreshold ADHD and (3) milder attention and/or learning problems, and compared with normative data. RESULTS: Thirty-two had ADHD and 10 met the criteria for subthreshold ADHD, prevalence rates of 5.4% and 1.6%, respectively. On a group level, children with ADHD/subthreshold ADHD, and those with milder attention and/or learning problems had almost identical cognitive profiles for the 13 subtests comprising the WISC III, with particularly low results on the arithmetic, coding, information and digit span subtests (ACID profile). When analyzed individually, a complete or incomplete ACID profile (three of four subtests) was equally common in children with ADHD/subthreshold ADHD and in children with milder problems, found in about 1/5. The relative strengths of both groups were in areas demanding logical thinking, reasoning and common sense. CONCLUSION: The specific ACID profile is as common in children with ADHD as in those with minor attention and/or learning problems. The cognitive weaknesses reflected in the ACID profile might play a role as an underlying factor in various developmental disorders.
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| 11. |
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| 12. |
- Ek, Ulla, et al.
(författare)
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General versus executive cognitive ability in pupils with ADHD and with milder attention problems
- 2013
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Ingår i: Neuropsychiatric Disease and Treatment. - 1176-6328 .- 1178-2021. ; 9, s. 163-168
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to analyze two main types of cognitive domains in school children with different types and severities of attention-related problems. The cognitive domains examined were general cognitive ability and executive abilities. Methods: Three different clinical samples of pupils with school problems were analyzed to assess their cognitive Wechsler Intelligence Scale for Children profiles. In particular, the general cognitive ability index and the executive markers (ie, verbal memory index and processing speed index) were of interest. Of the total sample (n = 198), two main groups were contrasted; one met the full criteria for attention deficit hyperactivity disorder (ADHD)/subthreshold ADHD, and one was comprised of those with milder attention problems, insufficient to meet the criteria for ADHD/subthreshold ADHD. Results: It could be demonstrated that both groups had a significantly higher score on the general cognitive ability index than on measures of working memory and processing speed. This difference was more pronounced for boys. Conclusion: These types of cognitive differences need to be considered in children with different kinds of learning, behavior, and attention problems; this is also true for children presenting with an average general intelligence quotient and with milder attention problems. Current educational expectations are demanding for children with mild difficulties, and such cognitive information will add to the understanding of the child's learning problems, hopefully leading to a better adapted education than that conventionally available.
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| 13. |
- Ek, Ulla, 1948-
(författare)
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Psykologiska bedömningar
- 2012
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Ingår i: Barn med funktionsnedsättning. - Lund : Studentlitteratur AB. - 9789144071879 ; , s. 319-325
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 14. |
- Ek, Ulla, et al.
(författare)
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Relation between blindness due to retinopathy of prematurity and autistic spectrum disorders: a population-based study.
- 1998
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Ingår i: Developmental Medicine and Child Neurology. - 0012-1622. ; 40:5, s. 297-301
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Tidskriftsartikel (refereegranskat)abstract
- Children with blindness due to retinopathy of prematurity (ROP)--who are at greatly increased risk of cerebral damage--have been noted to have a high rate of autistic symptoms, but systematic controlled studies have been lacking. A controlled population-based study was performed; one group was blind due to ROP (N=27) and the other was congenitally blind due to hereditary retinal disease (N=14). Fifteen of the 27 children with ROP had autistic disorder. All these children were mentally retarded and about one-third of them had cerebral palsy. In the comparison group, two of the 14 children had autistic disorder. It is concluded that there is a strong association between ROP and autistic disorder. The association is most probably mediated by brain damage and is largely independent of the blindness per se.
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| 15. |
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| 16. |
- Ek, Ulla, 1948-
(författare)
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Specialpedagogik – en framtidsvy
- 2012
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Ingår i: Barn med funktionshinder. - Lund : Studentlitteratur AB. - 9789144071879 ; , s. 327-333
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 17. |
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| 18. |
- Fahnehjelm, Kristina, et al.
(författare)
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Optic nerve hypoplasia in children and adolescents; prevalence, ocular characteristics and behavioural problems
- 2014
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Ingår i: Acta Ophthalmologica. - : Wiley. - 1755-375X .- 1755-3768. ; 92:6, s. 563-570
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To report prevalence, ocular characteristics and coexisting behavioural problems in children and adolescents with optic nerve hypoplasia (ONH), which is a common cause of visual impairment in children in western countries, often associated with neurological or endocrinological problems and where autism has been reported in severe cases with blindness. Methods: This is a population-based cross-sectional study of patients <20 years of age who had been diagnosed with ONH and lived in the county of Stockholm in December 2009. Ophthalmological assessments including fundus photographs with optic disc analyses were made. A questionnaire was used to screen for behaviour and development. Results: The prevalence of ONH in all living children <18 years of age in Stockholm was 17.3/100 000 with a prevalence of visual impairment (<0.3) of 3.9/100 000. In total, 66 patients, median age 9.3 years (0.6-19.4), 36 with bilateral and 30 with unilateral ONH, were included in the current study; 53 were re-examined clinically, group A, and 13 agreed to retrospective analyses of existing medical records, group B. Analyses of the optic discs were made in fundus photographs from 53 patients comparing a semi-automated (Retinal Size Tool) and a manual method (Zeki). There was a strong curvilinear correlation (rS = -0.91 p < 0.0001 for both eyes). Behavioural problems were more common (p < 0.05) in bilateral ONH. Conclusion: Opticnerve hypoplasia is a common ocular malformation with a prevalence of 17.3/100 000 children and adolescents <18 years of age in Stockholm. Unilateral ONH seems as common as bilateral.
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| 19. |
- Fernell, Elisabeth, 1948, et al.
(författare)
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Borderline intellectual functioning in children and adolescents - insufficiently recognized difficulties
- 2010
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Ingår i: Acta Paediatrica (Oslo, Norway : 1992). - : Wiley. - 1651-2227 .- 0803-5253. ; 99:5, s. 748-753
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To draw attention to groups of children and adolescents with borderline intellectual functioning, especially with respect to their school-situation. Methods: In one study, population-based, children with borderline intellectual functioning at age 10 years were followed until they finished compulsory school when their final certificates could be analysed. In a second study parents of 20 individuals in the upper secondary school for pupils with mild mental retardation were interviewed according to the Vineland adaptive scales and school health records were reviewed. In a third study pupils attending an individual programme in upper secondary school were assessed and we report one representative case. Results: (1) Pupils with borderline intellectual functioning, assessed in grade 4, received significantly lower grades when finishing the compulsory school. (2) In the group of pupils in the upper secondary school for the mildly mentally retarded, compiled data indicated that a considerable number did not fulfil the combined IQ and adaptive criteria for mild mental retardation. (3) The subtle nature of borderline intellectual functioning may delay appropriate measures at school, which our case illustrates. Conclusion: Borderline intellectual functioning seldom attracts attention. Our studies indicate that school and also society at large must be prepared to adapt educational and working conditions for the large minority of individuals with borderline intellectual functioning.
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| 20. |
- Jacobson, Lena, et al.
(författare)
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Children with blindness due to retinopathy of prematurity: a population-based study. Perinatal data, neurological and ophthalmological outcome.
- 1998
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Ingår i: Developmental Medicine and Child Neurology. - : Wiley. - 0012-1622 .- 1469-8749. ; 40:3, s. 155-159
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Tidskriftsartikel (refereegranskat)abstract
- A population-based group of 27 children with total blindness due to retinopathy of prematurity (ROP), born in Sweden from 1980 to 1990, was examined. They constituted all but two of the total of 29 children with total blindness due to ROP known to the national register of visually impaired children when reviewed from 1980 to 1 January 1995. All children had a gestational age of less than 31 weeks and most had had a complicated perinatal period. The retinal disease was discovered late, most often after it had already progressed to bilateral retinal detachment. Repeated vitreoretinal surgery had been performed in most children, but postoperative visual function did not improve. Three-quarters of the group had major neurological impairment (mental retardation, cerebral palsy, or epilepsy) at age 4 to 14 years. There was an impression that extensive ophthalmological efforts delayed neurodevelopmental assessments and examinations as well as adequate habilitation.
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| 21. |
- Wikström, Tove, et al.
(författare)
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Microbial and human transcriptome in vaginal fluid at midgestation: Association with spontaneous preterm delivery.
- 2022
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Ingår i: Clinical and translational medicine. - : Wiley. - 2001-1326. ; 12:9
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Tidskriftsartikel (refereegranskat)abstract
- Intrauterine infection and inflammation caused by microbial transfer from the vagina are believed to be important factors causing spontaneous preterm delivery (PTD). Multiple studies have examined the relationship between the cervicovaginal microbiome and spontaneous PTD with divergent results. Most studies have applied a DNA-based assessment, providing information on the microbial composition but not transcriptional activity. A transcriptomic approach was applied to investigate differences in the active vaginal microbiome and human transcriptome at midgestation between women delivering spontaneously preterm versus those delivering at term.Vaginal swabs were collected in women with a singleton pregnancy at 18 + 0 to 20 + 6 gestational weeks. For each case of spontaneous PTD (delivery<37 + 0weeks) two term controls were randomized (39 + 0 to 40 + 6weeks). Vaginal specimens were subject to sequencing of both human and microbial RNA. Microbial reads were taxonomically classified using Kraken2 and RefSeq as a reference. Statistical analyses were performed using DESeq2. GSEA and HUMAnN3 were used for pathway analyses.We found 17 human genes to be differentially expressed (false discovery rate, FDR<0.05) in the preterm group (n =48) compared to the term group (n =96). Gene expression of kallikrein-2 (KLK2), KLK3 and four isoforms of metallothioneins 1 (MT1s) was higher in the preterm group (FDR<0.05). We found 11 individual bacterial species to be differentially expressed (FDR<0.05), most with a low occurrence. No statistically significant differences in bacterial load, diversity or microbial community state types were found between the groups.In our mainly white population, primarily bacterial species of low occurrence were differentially expressed at midgestation in women who delivered preterm versus at term. However, the expression of specific human transcripts including KLK2, KLK3 and several isoforms of MT1s was higher in preterm cases. This is of interest, because these genes may be involved in critical inflammatory pathways associated with spontaneous PTD.
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