Kaplan Bonnie J, Hilbert Paula, Tsatsko Ekaterina
Faculty of Medicine, University of Calgary, The Child Development Centre, 3820 - 24 Avenue NW, Calgary, AB, T3B 2X9, Canada.
, 59 Dogwood Trail, Ocala, FL, 34472, USA.
J Med Case Rep. 2015 Oct 29;9:240. doi: 10.1186/s13256-015-0735-0.
In clinical studies of adults and children, broad-spectrum micronutrients (minerals and vitamins) have proven beneficial for improving mood regulation and attention. We report here pilot work whose primary objective was to evaluate the feasibility of studying micronutrient treatment in school-aged children with emotional and behavioral problems. Issues examined included feasibility of participant recruitment from a culturally diverse population, probability of sample retention for a 12-week trial, acceptability of the outcome measures, supplement adherence, as well as trends in treatment benefit.
The families of two boys (ages 5 and 6) and one girl (age 14) were invited to participate in a 12-week pilot trial of micronutrients carried out during the summer months. All children were enrolled in the private school at which future research was being considered. During the previous school year, all three had been extremely difficult to educate due to their inability to pay attention and learn, as well as their behavior problems. Although the two younger children had not been formally diagnosed, parents and teachers provided reports of hyperactivity and inability to focus on education in the classroom. The oldest child was often aggressive, and had been diagnosed with bipolar disorder, attention deficit hyperactivity disorder, and oppositional defiant disorder. All three children were Hispanic and spoke both Spanish and English. For 12 weeks, after signing consent forms, the children's parents provided weekly ratings on the parent-report Child Mania Rating Scale; the children consumed the micronutrient formula daily and provided a daily rating of how they felt. The parent ratings revealed significantly improved behavior, p = .002. Children's ratings approached the ideal level of 7, indicating "happy" self-reports. Parent interviews confirmed the weekly scores. Several feasibility questions were answered: all three children completed the 12-week trial, all scores were completed by parents and children, adherence to the protocol was excellent, and no adverse reactions emerged.
Family physicians and pediatricians are often confronted with the challenge of improving the lives of families whose children experience school crises due to emotional and behavioral dysregulation. Three children, who participated in pilot work to determine the feasibility of further investigations, experienced impressive changes that clearly warrant both research and clinical exploration.
在针对成人和儿童的临床研究中,广谱微量营养素(矿物质和维生素)已被证明有助于改善情绪调节和注意力。我们在此报告一项初步研究,其主要目的是评估对有情绪和行为问题的学龄儿童进行微量营养素治疗研究的可行性。所考察的问题包括从文化多元群体中招募参与者的可行性、为期12周试验的样本保留概率、结果测量的可接受性、补充剂依从性以及治疗益处的趋势。
邀请了两名男孩(5岁和6岁)和一名女孩(14岁)的家庭参加在夏季进行的为期12周的微量营养素初步试验。所有儿童都就读于一所正在考虑开展未来研究的私立学校。在上一学年,这三名儿童由于注意力不集中、学习困难以及行为问题,极难接受教育。尽管两名年幼的儿童未得到正式诊断,但家长和教师报告了他们的多动情况以及在课堂上无法专注于学习。年龄最大的孩子经常具有攻击性,已被诊断患有双相情感障碍、注意力缺陷多动障碍和对立违抗障碍。这三名儿童均为西班牙裔,会说西班牙语和英语。在签署同意书后的12周内,孩子们的家长每周根据家长报告的儿童躁狂评定量表进行评分;孩子们每天服用微量营养素配方,并对自己的感受进行每日评分。家长评分显示行为有显著改善,p = 0.002。孩子们的评分接近理想水平7,表明自我报告为“开心”。家长访谈证实了每周的评分。回答了几个可行性问题:所有三名儿童都完成了为期12周的试验,所有评分均由家长和孩子完成,对方案的依从性极佳,且未出现不良反应。
家庭医生和儿科医生常常面临改善那些因孩子情绪和行为失调而经历学业危机的家庭生活的挑战。三名参与初步研究以确定进一步调查可行性的儿童经历了令人印象深刻的变化,这显然值得进行研究和临床探索。