Table of Content

10 December 2022, Volume 30 Issue 12

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Professional Forum

Evaluation and intervention of hot- and cool-executive function in children with attention deficit hyperactivity disorder

YANG Bin-rang, CHEN Qiao-ru

2022, 30(12):  1277-1281.  DOI: 10.11852/zgetbjzz2022-1315

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Executive function impairment emerges as a primary cognitive deficit in children with attention deficit hyperactivity disorder (ADHD), involving prefrontal cortex and multi-level brain network dysfunction. Executive function has been functionally classified into cool and hot. Cool-executive function impairment mainly manifests in response inhibition, working memory and cognitive flexibility, while hot-executive function impairment usually involves delayed gratification, reward/punishment-related decision-making, self-regulation and emotion regulation. A variety of traditional paradigms have been used when assessing executive function in ADHD children, some of which are reliably modified and culturally adapted. Based on the literature, clinical practice should not focus exclusively on cool executive function. Children′s impairment in hot executive function (with emotional and social components) should also be noted as significant indicators when evaluating the state of children′s condition. Additionally, dynamic follow-up and intervention should be required to achieve the best results in the long term.

Original Articles

Analysis of correlation between resting-state functional magnetic resonance imaging regional homogeneity signals and attention cognition in school-age children

ZHANG Ling-yun, REN Yan-hong, WANG Xiao-wen, SHI Cong-cong, YANG Shuo

2022, 30(12):  1282-1286.  DOI: 10.11852/zgetbjzz2021-0167

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Objective To investigate the correlation of spontaneous brain activity and continuous operation task (CPT) performance with regional homogeneity (ReHo) of the resting-state functional magnetic resonance imaging, and to explore the neural basis of children′s attention function. Methods From May 2018 to October 2019, 33 children were recruited from the physical examination department of Henan Children′s Hospital, whose blood oxygenation level dependent (BOLD) signal and task behavioral performance(reaction time, RT) were acquired.ReHo is calculated by BOLD signal, which reflects the synchronization of neuron activation in brain regions.Pearson correlation analysis between the ReHo values and the RT was performed in a voxel-wise manner to get the significant ReHo-RT correlation map. Results Significant negative ReHo-RT correlations were observed in right middle temporal gyrus (BA20, r=-0.84), right medial prefrontal lobe (BA32, r=-0.83), right inferior parietal lobule (BA19, r=-0.78), left precuneus (BA7, r=-0.84) and right lingual gyrus (BA17, r=-0.82).Significant positive ReHo-RT correlations were observed in bilateral middle frontal gyrus (BA11, r=0.87), left precentral gyrus (BA6, r=0.84), left thalamus (r=0.72), left posterior cerebellar lobe (r=0.72). Conclusions There is a significant correlation between the spontaneous activity of bilateral middle frontal gyrus and default network, left anterior central gyrus, left posterior cerebellar lobe, left thalamus and right lingual gyrus and the reaction time of children′s performance in CPT task, suggesting that the middle frontal gyrus plays an important role in the maintenance of attention function, and the appropriate activity level of default network is more conducive to the completion of executive function.The cortical-cerebellar-thalamus-cortical circuit may be the underlying neural basis for school-age children′s attention and executive function.

Effect of aerobic exercise on the amplitude of low-frequency fluctuation of executive function in children with attention deficit hyperactivity disorder

GE Ya-wen, DING Jie-jun, JIANG Kai-hua

2022, 30(12):  1287-1290.  DOI: 10.11852/zgetbjzz2021-1438

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Objective To explore the amplitude of low-frequency fluctuation(ALFF) characteristics of the improvement of executive function in children with attention deficit hyperactivity disorder(ADHD) by aerobic exercise,in order to provide evidence for exploring mechanism of aerobic exercise improving executive function. Methods From March 2019 to December 2020,17 children diagnosed with ADHD in Changzhou Children′s Hospital were enrolled in this study to participated in rope jumping aerobic exercise training for 8 weeks. Functional magnetic resonance imaging(fMRI) and executive function were examined before and after training. The ALFF index was used in fMRI,and the flanker task was used in executive function test. Paired t-test was used to compare ALFF and response time of executive function before and after training,and correlation analysis was conducted between ALFF value changes and the difference of response time of executive function. Results After aerobic exercise training,the brain regions which the ALFF value of ADHD children significantly increased included medial superior frontal gyrus,left superior frontal gyrus,left middle frontal gyrus,and right anterior cerebellar lobe(P<0.05). The response time of the flanker task decreased significantly after training(t=-4.75,P=0.001). The changes of ALFF values of medial superior frontal gyrus(r=-0.53,P=0.02),left superior frontal gyrus(r=-0.58, P=0.01) and left middle frontal gyrus(r=-0.51, P=0.02) before and after aerobic exercise were negatively correlated with the difference of response time of executive function. Conclusion Aerobic exercise can improve the executive function of ADHD children,and the brain mechanism is mainly related to the enhancement of spontaneous activity in the prefrontal lobe and cerebellum.

Efficacy of methylphenidate hydrochloride prolonged-release tablets and atomoxetine on symptoms and executive function in children with attention deficit hyperactivity disorder

LI Yan, WEN Zhu, DENG Si-yu, JIANG Wen-qing, FAN Juan, DU Ya-song

2022, 30(12):  1291-1296.  DOI: 10.11852/zgetbjzz2022-0284

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Objective To compare the improvement of symptoms and executive function of children with attention deficit hyperactivity disorder (ADHD) treated with methylphenidate hydrochloride (MPH) prolonged-release tablets and atomoxetine (ATX), in order to provide more reference for clinical intervention. Methods From 2017 to 2019,children with ADHD who had not been medicated in the Pediatric and Juvenile Outpatient Clinic of the Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine were selected into the study, then 64 ADHD Children were divided into MPH group and ATX group according to medication treatment strategy. Changes in symptom scores and executive function indicators were assessed at baseline, at the end of 4, 8, and 24 weeks of medication. Swanson, Nolan, and Pelham Rating Scale-Ⅳ (SNAP-Ⅳ) and Conners Parents Symptom Questionnaire (PSQ) were used to evaluate symptoms. Executive function was evaluated by Stroop color-word test, Wisconsin card classification test and Digital Span test. Results Symptom scores and several core indicators of executive function improved significantly in both groups of ADHD children at the end of the 24th weekend (P<0.05). There were no significant differences in SNAP-Ⅳ scale scores, PSQ scores, Stroop test, as well as the scores of WCST and Digital Span between the two groups at baseline, at the end of 4th week, 8th week and 24th week (P>0.05). Conclusion Both MPH and ATX can continuously improve behavioral symptoms and executive function performance of ADHD children.

Validity and reliability of the Chinese version of the Sluggish Cognitive Temp Scale

WEN Zhu, LI Yan, LIN Yu-xiong, SUN Zhi-xin, JIANG Wen-qing

2022, 30(12):  1297-1303.  DOI: 10.11852/zgetbjzz2022-0168

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Objective To revise the Chinese version of the sluggish cognitive tempo(SCT) Scale, and to test its reliability and validity,in order to provide a valid tool for assessing SCT. Methods Totally 1 735 students from two ordinary primary schools in Shanghai were randomly selected from April to December 2020, whose parents completed the questionnaire, including SCT scale, Attention Deficit Hyperactivity Disorder Diagnostic Scale-Parent Version(ADHDDS-P), Achenbach Child Behaviour Checklist (CBCL). Partly 266 students randomly selected from school samples in grades one to five were assessed with SCT scale to analyze the test-retest reliability 1 month later. And 106 patients diagnosed with the DSM-5 criteria of ADHD disorder from Shanghai Mental Health Center were tested by SCT and ADHDDS-P. Results The Cronbach′s α coefficient of the SCT scale was 0.920, and the test-retest coefficient was 0.85 (P<0.01). The consistency between the items and the total score ranged from 0.469 to 0.784(P<0.01). Exploratory factor analysis showed that SCT had 3 factors (KMO=0.946, P＜0.001), named daydreaming, tardiness and cognitive decline. Confirmatory factor analysis tested proved the three-factor model basically fit (χ²/df=7.739, RMSEA=0.084). The SCT total scores were positively correlated with ADHDDS-P total scores (r=0.753, P＜0.05), and the SCT scores were higher in children with ADHD(boys: t=13.77, girls: t=7.81, P＜0.001). Conclusions SCT scale is basically appropriate for Chinese because of its good validity and reliability. The three-factor model fits well proved by exploratory and confirmatory factor analysis, so it could be used to assess sluggish cognitive tempo symptoms for children.

Preliminary development and reliability and validity test of Physical Activity Afterschool Questionnaire for preschooler

WANG Xiao-juan, XU Meng-xue, ZHANG Meng-nan, REN Xia, JIANG Yuan-yuan, ZHANG Xue-jiao, YANG Lin, WU Jian-xin, ZHANG Ting, ZHU Zong-han, GUANHong-yan

2022, 30(12):  1304-1308.  DOI: 10.11852/zgetbjzz2022-0233

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Objective To develop a Physical Activity Afterschool Questionnaire for Preschooler (P-PAQ), and to examine its reliability and validity, so as to provide a reliable and effective measurement tool for assessing Chinese preschooler′s physical activity after school. Methods P-PAQ was developed after reviewing the literature and consulting physical activity experts, also integrating with the characteristic of Chinese preschooler′s physical activity after school. The frequency and duration of children′s physical activity after school with various intensities in the past week (including 5 school days and 2 weekend days) was investigated. Recruitment of children aged 3 to 6 years was conducted utilizing a convenience sampling method in three kindergartens from Beijing, Shenyang and Xi′an from November to December 2020. Totally 225 children′s primary caregivers filled in P-PAQ twice with two-day interval to explore the test-retest reliability. Additional 229 children wore accelerometers (ActiGraph GT9X) for one week, then their primary caregivers filled in P-PAQ. Results The intra-group correlation coefficient(ICC) of test-retest on school days and weekends for the light physical activity, moderate-to-vigorous physical activity, and total physical activity time ranged from 0.636 to 0.844 (P<0.01). Spearman correlation coefficient between time spent on moderate-to-vigorous activity on schooldays and weekends was 0.153 and 0.151, respectively (P<0.05). Bland-Altman plots showed that P-PAQ and accelerometer had great consistency in measuring preschooler′s physical activity after school. Conclusion P-PAQ has good reliability and validity, which can be used to investigate physical activity behavior of preschool children, and to guide caregivers to improve children′s physical activity level after school in community and family settings.

Correlation of parenting style with emotional and behavioral problems of preschool firstborn children during transition to siblinghood

ZHANG Qin, LIU Qin, SHENG Lu-lu, WU Wen-yi, ZHOU Yuan-ke, XI Xuan

2022, 30(12):  1309-1314.  DOI: 10.11852/zgetbjzz2021-1580

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Objective To investigate the association of different parenting styles with emotional and behavioral problems of preschool firstborn children during transition to siblinghood(TTS), so as to provide reference for improving children′s emotional and behavioral problems. Methods A total of 882 preschool firstborn children(398 boys and 484 girls) in TTS with an average age of (3.58 ± 1.25) years old, were recruited from March to December 2019 in two tertiary facilities by a purposive sampling method. A self-designed questionnaire and parental version of Child Behavior Checklist(CBCL) were used to investigate the parenting style and emotional and behavioral problems. Multiple linear regression method was used to analyze the correlation of parenting style with emotional and behavioral problems of preschool firstborn children in TTS. Results The scores of internalization problems, externalization problems and total problems in 882 preschool firstborn children were 6.0(3.0,10.0),8.0(3.0,13.0)and 22.0(10.0,37.0), respectively. The results of multiple regression analysis showed that the firstborn children with maternal autocratic parenting style, paternal autocratic parenting style and uninvolved parenting style had higher levels of internalization problems(β=0.08, 0.12, 0.12), externalizing problems(β=0.08, 0.16, 0.14) and total problems(β=0.08, 0.16, 0.14). The older firstborn children had lower scores of externalizing problems(β=-0.11) and total problems(β=-0.11), and those with harmonious family atmosphere had lower scores of internalization problems(β=-0.24), externalizing problems(β=-0.21) and total problems(β=-0.23), while those with difficult-to-raise temperament and slow-to-develop temperament had higher levels of internalization problems(β=0.16, 0.20), externalizing problems(β=0.16, 0.13) and total problems(β=0.17, 0.16)(P<0.05). Conclusion Maternal autocratic parenting style, paternal autocratic parenting style and permissive parenting style are associated with higher levels of emotional and behavioral problems of preschool firstborn children in TTS.

Written vocabulary size and errors of children with dyslexia in grade three to five

GUO Xu-ning, PU Ying-qi, MA Jing-wen, PAN Ning, FAN Xiao-xuan, XU Xiao-yu, JIN Yu-ying, GUO Yang-feng, LI Xiu-hong

2022, 30(12):  1315-1321.  DOI: 10.11852/zgetbjzz2021-1899

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Objective To investigate the written vocabulary size and the characteristics of written errors of children with developmental dyslexia (DD) in grade three to five, so as to provide reference for the targeted literacy teaching and the improvement of DD children′s Chinese character writing skills. Methods Totally 839 students of grade three to five in Nansha, Guangzhou were selected as the research subjects. Children with DD were screened out by using the Dyslexia Checklist for Chinese Children. The standard literacy test was used to test children′s written vocabulary size and the types of written errors. Data were analyzed by t test, χ² test, univariate and multivariate regression. Results Children with DD had lower written vocabulary size (β=-250.55,95%CI:-318.17 - -182.94), higher abnormal written vocabulary size rate (OR=3.08,95%CI:1.68 - 5.66). DD children were more likely to make mistakes in Chinese character transcription (β=0.44,95%CI:0.05 - 0.84) and Chinese character output (β=5.79,95%CI:3.13 - 8.46) tasks. DD children′s grouping word component error rate(β=0.28,95%CI:0.06 - 0.50)and phrase forming error rate (β=5.48, 95%CI:2.89 - 8.07) were higher than those of normal children. Stratified Logistic regression analysis showed that DD children in grade three and grade four were more likely to make mistakes in output tasks, which reflected in making phrase forming error (β=5.85, 95%CI: 1.75 - 9.95) in grade three and grouping word component error(β=0.56, 95%CI: 0.19 - 0.93), phrase forming error(β=8.05, 95%CI: 3.34 - 12.76) in grade four. Conclusions Children with DD in grade three to five have obvious literacy defects, and are more prone to transcription error and grouping word component error, phrase forming error. DD children in grade three are prone to phrase forming error. DD children in grade four are prone to grouping word component error and phrase forming error.

Association between parenting styles and children′s sleep problems

LIN Tong, SUN Xiao-ning, LI Wen, WANG Zi-jing, WANG Guang-hai, JIANG Fan

2022, 30(12):  1322-1326.  DOI: 10.11852/zgetbjzz2021-1383

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Objective To investigate the association between parenting styles and children′s sleep problems,in order to provide reference for sleep intervention based on parenting style. Methods From December 2019 and January 2020,children from 6 kindergartens and 2 primary schools of three cities were recruited through convenient cluster sampling. Children′s parents were asked to complete a self-designed questionnaire on socio-demographic characteristics,parenting styles and Children′s Sleep Habits Questionnaire(CSHQ) through online system. Covariance analysis and binary Logistic regression analysis were used to analyze the association between parenting styles and children′s sleep problems. Results Totally 3 861 children aged (5.57±2.28) years were finally enrolled into the study,including 2 007 boys(52.0%) and1 854 girls(48.0%). The proportion of permissive,moderate and authoritative parenting was 4.6%,86.6% and 8.8%,respectively. After controlling socioeconomic status,children with permissive parenting scored higher on total scale(F=44.77,P<0.001) and eight subscales of CSHQ. Compared with moderate parenting,permissive parenting was a risk factor for children′s sleep problems(OR=3.62,95%CI:1.88 - 6.96),especially for sleep resistance(OR=3.80,95%CI:2.51 - 5.75). Conclusions Parenting style is associated with children′s sleep problems,of which permissive parenting is a risk factor for sleep problems. Thus,more sleep health education and behavioral intervention on parenting styles are needed.

Multi-center study on the chopsticks using skills in preshool children

WEI Zhuang, LIU Chun-yang, SHEN Rui-yun, YANG Chen-lu, QIAN Yue, HUANG Hong-mei

2022, 30(12):  1327-1331.  DOI: 10.11852/zgetbjzz2022-1003

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Objective To observe common patterns of chopsticks using skill, and to analyze their efficiency and developmental trends with age. Methods From March 2014 to March 2017, a sample survey of 7 kindergartens in 5 urban areas in the north and west of China was carried out by photographing. The physical characteristics of the interaction between fingers and chopsticks were analyzed, children′s chopsticks using action modes were classified, and the use efficiency of different action modes were evaluated, then the developmental characteristics of children′s chopsticks using modes at different ages were compared. Results Totally 291 children participated in this study. Finally 11 action modes have been coded, which were classified into "four fingers prehension", "three fingers prehension", "palm prehension" and "other types" modes concerning Yokubo′s classification. Children hold chopsticks in the middle (63.57%), upper middle (17.18%) and lower middle (15.81%) part. Among the movement tasks, the "three fingers prehension" was most efficient. The efficiency rates of "palm prehension" [(78.7 ± 54.6) s, 77.4%] and "other types" [(62.5±42.5) s, 60.0%] modes were significantly lower than those of "four fingers prehension" [(54.6±40.3) s, 97.3%] and "three fingers prehension " [(53.8±31.1) s, 96.6%] (P<0.05). The proportion of children using the "palm prehension" movement mode decreased with age (32.6% at the age of 3 and 12.8% at the age of 5), while the use of the "three fingers prehension" movement mode increased with age (41.3% at the age of 3 and 59.6% at the age of 5). Conclusion The movement mode of chopsticks using in early childhood is still immature and diverse, and tends to developfrom low-efficiency mode to high-efficiency mode with age.

Review

Intervention progress in attention deficit hyperactivity disorder in preschool children

ZHU Pei-ying, WANG Yu

2022, 30(12):  1332-1335.  DOI: 10.11852/zgetbjzz2021-0610

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Attention-deficit hyperactivity disorder(ADHD) is a common neurodevelopmental disorder in childhood,with inattention,hyperactivity and impulsivity as the main symptoms,and it is mainly manifested as hyperactivity in preschool period. ADHD has a seriously negative impact on children′s academic performance,interpersonal communication,physical and mental development and other aspects,and can continue to adolescence or adulthood. Early intervention can reduce the core symptoms of ADHD and reduce the incidence of comorbidities. Current interventions for preschool ADHD include behavioral therapy,physical therapy and drug therapy. Drug treatment can significantly improve the core symptoms of ADHD,but it can not improve the social interaction and executive functions of preschool children,and the side reactions of drugs can cause problems such as drug addiction and poor compliance. Behavior therapy can not only improve children′s social function and emotional problems,reduce the pressure of parenting,but also have no problems such as drug side reactions,which has become a current research hotspot. This article reviews the intervention progress in ADHD in preschool children.

Research progress in the application of bacterial lysates in children with respiratory allergic diseases

LI Yu, KAN Xuan

2022, 30(12):  1336-1340.  DOI: 10.11852/zgetbjzz2021-1206

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The incidence of respiratory allergic diseases in children is increasing year by year, which has become an important disease burden and medical challenge. Bacterial lysates have long been used as an immunomodulator in recurrent respiratory tract infections in children, but have not been studied in depth in allergic diseases. This paper aims to review the progress in the application of bacterial lysates in childhood respiratory allergic disease, so as to provide scientific basis for the application of bacterial lysates in the treatment of allergic rhinitis (AR) and bronchial asthma in children.

Application of resting-state functional magnetic resonance imaging in evaluating emotional disorders among obstructive sleep apnea children

JIN Ling-lin, CHEN Jie

2022, 30(12):  1341-1344.  DOI: 10.11852/zgetbjzz2022-0030

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Obstructive sleep apnea (OSA) is common in children, which is characterized bypathophysiological alterations of intermittent hypoxia (IH)and sleep fragmentation(SF). OSA may result in emotional disorders in children, while its neurobiological mechanisms remain unknown. Recent studies have shown that inflammatory response and oxidative stress play important roles in emotional disorders of OSA children. Resting-state functional magnetic resonance imaging (rs-fMRI) is an ideal imaging tool for the detection of brain injuries in OSA children. This article reviews the neurobiological researches concerning cerebral injuries in OSA and relevant clinical trials on rs-fMRI, aiming to find the target brain areas and mechanisms which may provide a new outlook on the early diagnosis and treatment of emotional disorders in OSA children.

Research progress of exosomes in autism spectrum disorder

ZHU Yu-xuan, TIAN Ya-ning, PAN Jue, QIN Yan-nan

2022, 30(12):  1345-1349.  DOI: 10.11852/zgetbjzz2021-1269

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Autism spectrum disorder(ASD) is a typical form of pervasive developmental disorder characterized by social interaction and communication disorders,attention deficits,narrow interests,and repetitive/stereotypical behavior patterns. In recent decades,the prevalence rate of autism has been on the rise all over the world and there is a lack of specific treatments. Therefore,it is very urgent to search for sensitive and specific biomarkers and specific treatments. Exosomes are nanoscale vesicles that can be released by most cell types in the central nervous system. Bioactive macromolecules such as RNA,proteins and lipids in exosomes participate in the material exchange and information exchange of various nerve cells, and play an important role in the regulation of nerve development, differentiation,regeneration and synaptic regulation. With the development of molecular biology and the improvement of diagnostic technology,exosomes have gradually become the focus of ASD research due to their advantages of convenient collection,stable structure,easy degradation of macromolecules in exosomes and the ability to pass the blood-brain barrier. It has been reported that exosomes are related to the occurrence and development of ASD,and may be an important source of diagnostic markers for ASD and a new drug treatment carrier. This article reviews the research progress of exosomes in ASD,in order to provide reference for early diagnosis,clinical treatment and prognosis judgment of ASD.

Research progress of neural network basis on social brain in autism spectrum disorder

YU Han, QU Hang, ZHAO Yi, PAN Yu, WANG Wei

2022, 30(12):  1350-1353.  DOI: 10.11852/zgetbjzz2021-1270

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Autism spectrum disorder(ASD) is a heterogeneous neurodevelopmental disorder characterized by impairments in social communication and restricted and repetitive behaviors and interests,with symptom onset during the first few years of life. Over the past two decades,neuroimaging has revealed numerous findings of atypical activity and abnormal connectivity of "social brain" networks,including analysis of faces and gaze by the fusiform face area(FFA),emotional processing in the amygdala,mentalizing in the default mode network(DMN) and imitation and understanding of others′ actions by the regions associated with the mirror neuron system(MNS),yet no consensus view on crucial developmental causes of social communications deficits has emerged. Aside from methodological challenges and studies on the connectivity of individual brain networks,the deeper problem concerns the strong heterogeneity of ASD. This inconsistent finding may be due to changes in diagnostic criteria and the atypical neurodevelopment trajectories of autism at preschool period. Therefore,cohort studies on subtypes of autism and of longitudinal cohort with a large sample are warranted.

Research progress in school refusal of children

ZHOU Ya-nan, YANG Chun, WU Dan-dan

2022, 30(12):  1354-1357.  DOI: 10.11852/zgetbjzz2021-0872

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School refusal(SR) is a common psychological behavioral problem in children,which can be manifested by children′s reluctance to go to school,lack of interest in learning and school,or even completely refusing to go to school. More and more studies have shown that most children with school refusal are accompanied by anxiety,depression and other emotional problems,which may have a wide and negative impact on their academic performance,family,interpersonal relationship and other aspects. This review combs the definition,assessment,etiology,treatment and prognosis of school refusal in children,which is helpful for clinicians to further explore the etiology of school refusal in children,and timely assess and intervene to help them improve clinical outcomes and return to school as soon as possible.

Meta Analysis

Systematic review of assessment tools of anxiety for children with autism spectrum disorder

LYU Ping-ping, CUI Nai-xue, HAN Jing, HU Meng-zhu, YUE Lei, SHAN Ru-jie

2022, 30(12):  1358-1363.  DOI: 10.11852/zgetbjzz2022-0271

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Objective To systematically evaluate the anxiety assessment tools for children with autism spectrum disorder(ASD) at home and abroad, in order to provide evidence for practice and research in this field. Methods Eleven electronic databases were searched. Studies on the development of anxiety assessment tools and/or the testing of psychometric properties for children with ASD were included and evaluated according to the COSMIN standards. Results A total of 31 articles in English language that appraised 16 anxiety assessment tools for ASD children were yielded and included in the systematic review. Among the 16 tools, ten were developed for typically developed children, five were specifically adapted for children with ASD, and one was developed to measure the anxiety of both typically developed children and ASD children. The Anxiety Scale for Children with Autism Spectrum Disorder (ASC-ASD) demonstrated the best psychometric properties. Conclusions Among the tools in English, ASC-ASD is the most recommended anxiety assessment tool for children with ASD. To our best knowledge, the Chinese version of ASC-ASD is still not found, which can be prioritized for translation and validation.

Current status and trends of adverse childhood experiences in brain function during 2012 to 2022

LUO Mei-qi, YUE Yu-chuan, WU Dong-mei

2022, 30(12):  1364-1370.  DOI: 10.11852/zgetbjzz2022-0282

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Objective To conduct a knowledge graph visualization analysis through CiteSpace, to analyze the international literature related to adverse childhood experiences(ACEs) in the field of brain function by metrics, keyword co-occurrence and cluster analysis, and to determine relevant research hotspots and trends, with a view to providing guidance for futher related research. Methods The Web of Science core dataset and PubMed database from 2012 to 2022 were searched for literature related to ACEs in the field of functional brain science in the database. CiteSpace was used to visualize and analyze the number of publications, countries, authors, institutions, and co-cited literature, and to conduct co-occurrence analysis, cluster analysis and emergent word analysis on keywords in the literature. Results Only 678 articles were published overall in the last 10 years, with the highest number of articles and centrality in the U.S. Poletti S was the top author and formed some collaborative relationships with relevant researchers. The institution with the highest number of publications was the University of Pittsburgh. Keywords with the highest frequency were post-traumatic stress disorder and abusive brain injury. Conclusion ACEs has not been sufficiently studied in the field of brain function, and the main focus has been on exploring the association of ACEs, with key brain regions such as the amygdala, hippocampus and prefrontal cortex through functional MRI and the altered physiological structure of the brain in offspring as a result of parents′ ACEs.

Clinical Research

Attention cognitive event-related potentials and behaviors of school-age obese children

NI Man-man, WANG Chao-qun, WANG Ying-ying, DONG Xuan, DONG Yu, YIN Zhi-ping, SHEN Hui-juan

2022, 30(12):  1371-1375.  DOI: 10.11852/zgetbjzz2022-0628

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Objective To explore the relationship between childhood obesity and attention cognitive control through event-related potentials and behavioral monitoring using the cued target/non-target (Go/Nogo) task mode, in order to provide reference for early detection of attention problems in obese children. Methods A total of 38 obese children were selected from the obesity clinic of Changzhou Children′s Hospital from August 2019 to August 2021, and 41 normal children were selected from a primary school in Changzhou during the same period. A continuous performance test (CPT) was used to conduct electroencephalogram (EEG) tests, ERP and behavioral data were recorded and compared. Results At the behavioral level, compared with the normal group, the correct hits of obese children were significantly reduced [37(35, 39) vs. 39(38, 40), Z=-3.459, P=0.001)], and the reaction time was prolonged [(502.21±95.29) ms vs. (454.45±95.24) ms, t=2.210, P=0.030], and the variability of reaction time was higher [(147.74±50.15) ms vs. (105.89±44.87) ms, t=3.330, P=0.001]. There was no significant difference in the number of false reports between the two groups (P > 0.05). At the cognitive level, there was no significant difference in N2 amplitude and latency between the obesity group and normal group under Go and Nogo conditions. The P3 Nogo/Go effect of obese children was significantly weaker than that of the normal group, and the Nogo-P3 amplitude of obese children was significantly lower than that of the control group [(16.47±8.46) μV vs. (21.58±7.91) μV, t=-2.771, P=0.007]. Conclusions Obese individuals have cognitive impairment of continuous attention, which is manifested in the decrease of hit number and the increase of response variation at the behavioral level. The conflict monitoring ability of obese children is equivalent to that of normal children, but their active inhibition ability is impaired, with the decrease of Nogo-P3 amplitude as a sensitive index of impairment.

Study on the neglect status of urban migrant children aged 6 to 11 in three prefectures(cities) of Yunnan Province

HAN Fang, JIAO Feng, YANG Wen, YANG Yong-zhi, DENG rui

2022, 30(12):  1376-1379.  DOI: 10.11852/zgetbjzz2021-1395

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Objective To understand the current situation and main causes of neglect of urban migrant children in three regions of Yunnan Province, so as to provide scientific basis for reducing neglect and formulating intervention measures effectively. Methods According to the economic and educational level and other factors, multi-stage stratified cluster sampling was adopted to select three areas of Kunming, Dali Prefecture and Lincang City were selected as the survey points from September to December 2020. A related survey was conducted among 1 193 students by using the Constant Modulus Table of Neglect Evaluation of Urban Children and Adolescents in China. Results The total neglect rate of urban migrant children aged 6 to 11 in three regions of Yunnan Province was 40.7%(486/1 193), of which the neglect rate of urban migrant children was 40.80%(393/963), the neglect rate of non-urban migrant children was 40.4%(93/230). The neglect rates of urban migrant boys at all levels were significantly higher than those of girls, of which the difference in safety level was statistically significant(χ²=4.417, P<0.05). Except for medical treatment, the neglect rate of Han nationality was higher than that of ethnic minorities(χ²= 6.963, P<0.05), of which the differences in physical neglect and emotional neglect were significant(χ²= 6.963, 6.850, P<0.05). Compared with rural children in Yunnan Province, left-behind children in rural China, and corresponding indicators of children in China, the neglect degree of urban migrant children in Yunnan Province was significantly lower(6- to 8- year-old children t=20.281, 19.153, 13.616, P<0.05; 9- to 11-year-old children t=7.075, 13.101, 8.047, P<0.05). Conclusions Child neglect is less severe than what it was a decade ago, and the effects of relevant policies for migrant children are gradually emerging. The mode of family education has changed. The "involvement of parents in education" has gradually replaced "children working in cities with their parents" by "parents studying in cities with their children". However, the social integration and adaptation of young migrant children should be paid continuous attention. The gender gap in child neglect rates is smaller at the ethnic education level, and school and family education should be tailored to the local context and focus on parent-child participation.

Effects of family function and stress feeling on the mental health of adolescents

LIN Hong, HUANG Qian-kun, TONG Sheng-li

2022, 30(12):  1380-1384.  DOI: 10.11852/zgetbjzz2021-1701

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Objective To understand the mental health status of adolescents in Yichang City, and to analyze the impact of family function and stress feeling on them. Method Using stratified cluster random sampling, 4 674 students from 5 middle schools in Yichang City were investigated by middle school students′ Mental Health Scale (MSSMHS), family care index and stress perception scale (PSS) in September 2021. Results The detection rate of adolescents′ psychological problems in Yichang City was 24.22% (1 132/4 674). Except for mental imbalance, the scores of other factors and total scores of girls in MSSMHS were significantly higher than those of boys (P<0.01). The total scores and scores of all factors of high school students were significantly higher than those of junior high school students (P<0.01) .Non-only children had significantly higher learning pressure and mood swing factor scores than only children (t=2.13, 2.21, P<0.05). The total scores and the scores of various factors of single-parent families and non-parent-supported students were also significantly higher than those of non-single-parent families and parent-supported students (P<0.01). Pearson analysis showed that MSSMHS total score and each factor score were negatively correlated with family care index (r ranged from -0.51 to -0.37, P<0.01), but positively correlated with stress perception (r ranged from 0.41 to 0.52, P<0.01). Multiple stepwise regression analysis showed that grade, single-parent family, family care index score, and stress score effected the mental health of adolescents (β=0.112,-0.400,-0.385, 0.400, P<0.01). Conclusions There are certain problems in the mental health of adolescents in Yichang City, which are affected by family function and environment, stress feelings, gender and grade.It is suggested that schools,families and students should cooperate together,take targeted intervention to improve adolescents′ mental health.

Relationship among alexithymia, parental rearing style and psychological symptoms in adolescent migraine patients

LIU Ming, WU Yan-min

2022, 30(12):  1385-1389.  DOI: 10.11852/zgetbjzz2021-1612

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Objective To analyze the characteristics of alexithymia in adolescent migraine patients, and to explore its correlation with parental rearing style, anxiety and depression. Methods A total of 110 adolescent migraine patients diagnosed in Shijiazhuang People′s Hospital from October 2017 to February 2019 were selected as the study subjects. The general information questionnaire, Toronto Alexithymia Rating Scale (TAS-20), Egma Minnen av Barndoms Uppfostran (EMBU), Visual Analog Scale (VAS), Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale(HAMD) were used for questionnaire survey and evaluation. Results 1)The detection rate of alexithymia in adolescent migraine patients was 47.3%, and the total score of alexithymia in adolescent migraine patients was (49.33 ± 17.02). The prevalence rates of anxiety and depression symptoms were 68.1% and 47.3%, respectively. 2)The score of emotional warmth factor of parents in alexithymia group was significantly lower than that in non-alexithymia group(t=1.350,4.064), while the scores of excessive parental interference(t=1.069,2.621), refusal to deny(t=3.611,2.020) and excessive protection(t=3.578,2.621) of parents in alexithymia group were significantly higher P<0.05). The scores of perception on pain, anxiety and depression in alexithymia group were significantly higher than those in non-alexithymia group(t=3.640,3.801,5.318, P<0.05). The total score of alexithymia and sub-dimensions scores were negatively correlated with parental emotional warmth (r＝-0.607 to -0.207, P<0.05). The total score of alexithymia and sub-dimensions scores were significantly positively related to parents′ excessive interference, refusal to deny, pain, anxiety and depression (r=0.456 - 0.963, P<0.05). 3) Alexithymia could affect the association of parental rearing style with pain, anxiety and depression symptoms of adolescent migraine as an intermediary variable. Conclusions Adolescent migraine patients have a certain degree of alexithymia. Parental rearing style has an impact on alexithymia, and can affect the emotional state and pain perception of patients through the mediation of alexithymia.

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Difference in fecal intestinal flora instructure and short chain fatty acids between children with autism spectrum disorder and healthy children

ZHANG Yu, LU Hong-yan, TANG Wei, HAO Xiao-bo

2022, 30(12):  1390-1394.  DOI: 10.11852/zgetbjzz2021-1015

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Objective To investigate the difference in fecal intestinal flora instructure and short chain fatty acids between children with autism spectrum disorder (ASD) and healthy children, so as to provide new clues for the prevention and treatment of ASD from the perspective of intestinal flora. Methods A total of 25 ASD childrendiagnosed in the Department of Pediatrics, Afficiated Hospital of Jiangsu University were enrolled in the ASD group from January to November 2019. Meanwhile 24 healthy children with typical growth and development who took physical examination were selected as control group. Their feces samples were collected. 16SrRNA sequencing was used to analyze the structure of the intestinal microflora, and gas chromatography was used to detect the content of short-chain fatty acids in feces. Results Compared with the control group, ASD children had a significant decrease in the abundance (Chao index and Ace index) and diversity (Shannon index) of intestinal flora (t=2.917, 2.890, 3.353, P＜0.05), an increase in the abundance of Firmicutes and Proteus and a decrease in the abundance of Bacterioidetes at the phylum level(t=3.180, 5.761, 5.970, P＜0.05). At the genus level, ASD children had a significant decrease in the abundance of Bacterioides, Bifidobacterium, Blautia and Streptococcus, a significant increase in the abundance of Clostridium and Sutterella (Z=2.440, 3.100, 3.620, 3.500, 4.200, 4.054, P＜0.05). Compared with the control group, the levels of acetic acid, propionic acid and total short chain fatty acids in ASD group were significantly increased, while the butyric acid was significantly decreased(t=3.040, 3.220, 2.560, 4.100, P<0.05). Spearman correlation analysis showed Bifidobacterium was negatively correlated with propionic acid and total short chain fatty acids(r=－0.422,－0.412, P＜0.05). Conclusions There are significant changes in the structure of intestinal flora and the content of short chain fatty acids in feces of ASD children. The increase of the content of propionic acid and the total short chain fatty acids caused by the decrease of Bifidobacterium may be related to ASD.

Case study on motor intervention and its effect in children with attention deficit hyperactivity disorder and dysgraphia

JIANG Wen, SONG Yi-ling, REN Yuan-chun, JI Ning

2022, 30(12):  1395-1399.  DOI: 10.11852/zgetbjzz2022-0236

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Objective To explore the effect of motor intervention on children with attention deficit hyperactivity disorder (ADHD) and dysgraphia, in order to provide reference for the development of non-drug intervention approaches for children with ADHD and dysgraphia. Methods A 6.9-year-old boy with ADHD and dysgraphia was selected as the study subject for an 8-week online motor intervention. Before and after the intervention, the subject′s fine motor ability was assessed by Movement Assessment Battery for Children (MABC-2) and Grooved Pegboard Task (GPT). Development Test of Visual Perception-3 (DTVP-3) and Tseng Handwriting Problem Checklist (THPC) were used to evaluate the subject′s visual perception and writing ability, respectively. Results Before the intervention, the fine hand movements of MABC-2 in children were significantly backward. The nailing time of GPT for preferred and non-preferred hand was 40 seconds and 41 seconds, respectively. Visual perception and visual motor integration ability in DTVP-3 were at the backward level. The subject scored 51 points in THPC. After the intervention, the hand fine motor of MABC-2 increased by 48%, reaching the average level. Hand nailing speeds of preferred and non-preferred hand in GPT increased by 22.5% and 19.5% respectively. Visual perception and optokinetic integration in DTVP-3 reached the average level, and THPC score increased by 59.9%. Conclusion A personalized intervention program characterized by promoting fine movement, visual perception and visual motor integration, can effectively improve the fine motor development and visual perception development of ADHD children with dysgraphia, effectively reduce writing errors, improve writing speed and neatness, and contribute to the development of writing ability.

Status quo and related factors of emotional problems in children with bronchial asthma

ZHANG Yang, WANG Hui-yuan, GENG Yan, JIN Qiao-yan, HAO Juan-juan, HOU Wei

2022, 30(12):  1400-1403.  DOI: 10.11852/zgetbjzz2021-1514

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Objective To analyze the emotional problems of children with asthma and the related factors, so as to provide basis for clinical comprehensive treatment and intervention of children with asthma. Methods A total of 70 asthmatic children aged 8 to 16 years who visited the Pediatric Asthma Clinic of the Second Affiliated Hospital of Xi′an Jiaotong University from May to December 2017 were selected into this study. All participants were asked to fill out general condition questionnaire, Asthma Control Questionnaire(ACQ), the Screen for Child Anxiety Related Emotional Disorders(SCARED) and Depression Self-Rating Scale for children(DSRS). Results There were 24(34.3%) cases and 26(37.1%) cases of positive screening for anxiety and depression in children with asthma. The scores of anxiety and depressive disorders in the only child group were higher than those in the non-only birth group(t=2.986, 3.125), those in the disharmony family relationship group were higher than those in the harmony family relationship group(t=3.636, 5.309), and those in the asthma poor-controlled group were higher than those in the asthma well-controlled group(t=2.743, 2.086), and the differences were significant(P＜0.05). The score of depressive disorder in the asthma non-standard management group was significantly higher than that in the asthma standard management group(t=2.336, P＜0.05). The results of multivariate regression analysis showed that whether the only child or not and the degree of asthma control were the main factors affecting anxiety disorder in children with asthma(β=0.289, -0.423, P＜0.05). Whether the only child or not, family relationship and the degree of asthma control were the main factors affecting depressive disorder in children with asthma(β=0.282, -0.283, -0.266, P＜0.05). Conclusions Children with asthma are more likely to have negative emotions such as anxiety and depression than healthy children of the same age. Family members and medical staff should pay more attention to children′s emotional problems and improve their quality of life.

Effects of different bathing methods on physiological parameters and stress of first-time bathed newborns

HUANG Yu-ting, TANG Qin, Hawa Abdillah, HU Ben, JIANG Yi-yao, ZHOU Le-shan

2022, 30(12):  1404-1408.  DOI: 10.11852/zgetbjzz2021-1572

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Objective To compare the effects of swaddled bathing and traditional tub bathing on first-time bathing of newborns, in order to explore a more suitable way of individualized newborn bathing. Methods A total of 60 newborns admitted to the Obstetrics Department of the Third Xiangya Hospital of Central South University from May to July 2021, were enrolled in this study and were randomly assigned by computer to swaddled bathing group(n=30) and traditional tub bathing group(n=30). The Neonatal Stress Scale(NSS) was used to assess stress levels, and physiological parameters were measured, including body temperature, respiratory rate, heart rate and oxygen saturation before bathing, immediately after, and 10 minutes after bathing. The bathing time and crying time during bathing between the two groups were recorded and compared. Results For immediately after bathing, and 10 minutes after bathing, the body temperature(t=2.21,5.11) and oxygen saturation(t=4.59,5.00) of newborns in swaddled bathing group were higher than those in traditional tub bathing group(P<0.05), while the heart rate(t=-3.17,-6.20), respiratory rate(t=-7.92,-5.67) and the NSS score(t=-5.91,-3.42) of newborns in swaddled bathing group were significantly lower than those in traditional tub bathing(P<0.05). The crying time of newborns in traditional tub bathing group was significantly longer than that in swaddled group(t=-7.06, P<0.05). Conclusions The swaddled bathing does better in maintaining the stability of the physiological parameters of full-term newborns, and can also reduce bathing pressure.Therefore, swaddled bathing can be used in first-time bathing of full-term newborns,which is beneficial to their early healthy development.

Prognosis of neonates with mild hyperthyrotropinemia

LIANG Li-yu, ZHU Hui

2022, 30(12):  1409-1413.  DOI: 10.11852/zgetbjzz2021-1717

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Objective To analyze the effect of thyroid hormone on the prognosis of newborns with mild hyperthyrotropinemia, so as to provide theoretical basis for clinical treatment of mild neonatal hyperthyrotropinemia. Methods Clinical data of newborns with mild hyperthyrotropinemia admitted to the Neonatal Intensive Care Unit in Fujian Provincial Hospital were retrospectively analyzed. According to treatment or not, newborns were divided into treatment group and control group. The rate of permanent hypothyroidism, Gesell Developmental Schedules(GDS) score, body length, body weight and normal thyroid function in different stages were compared between the treatment group and control groups. Results A total of 470 infants with mild hyperthyrotropinemia were enrolled in the study, including 182 cases in treatment group and 288 cases in control group. The gestational age, birth weight, body length and head circumference of newborns in the treatment group were significantly lower than those in control group(Z=-6.600,-6.140,-5.444,-6.537, P＜0.05).The prevalence rates of neonatal infection, neonatal respiratory distress syndrome, bronchopulmonary dysplasia and critical condition in the control group were significantly higher than those in the control group(χ²=8.755, 34.285, 19.044, 29.235, P＜0.05). Finally, 148 pairs of cases were matched successfully by propensity score matching (PSM). There was no significant difference in baseline data between the two groups (P>0.05). After PSM, neither the treatment group nor the control group had cases developing permanent hypothyroidism, and there were no significant differences in the score of GDS and body weight between the two groups (P>0.05). The number of cases whose thyroid function returned to normal within 1 month and 3 months in the treatment group was significantly less than that in the control group(χ²=21.765,8.601, P＜0.05). Conclusions Thyroid hormone supplementation in newborns with mild hyperthyrotropinemia can prolong the duration of thyroid function level returning to normal range within three months. Therefore, it is not recommended to supplement mild hyperthyrotropinemia infants with thyroid hormoneation.