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1-5 岁性染色体三体(47,XXX、47,XXY、47,XYY)儿童的行为特征。

The behavioral profile of children aged 1-5 years with sex chromosome trisomy (47,XXX, 47,XXY, 47,XYY).

机构信息

Clinical Neurodevelopmental Sciences, Leiden University, Leiden, The Netherlands.

Leiden Institute for Brain and Cognition, Leiden, The Netherlands.

出版信息

Am J Med Genet C Semin Med Genet. 2020 Jun;184(2):444-455. doi: 10.1002/ajmg.c.31788. Epub 2020 May 20.

Abstract

Children with SCT have an increased risk of suboptimal neurodevelopment. Previous studies have shown an elevated risk for neurobehavioral problems in individuals with SCT. However, not much is known about neurobehavioral problems in very young children; knowledge that could help with early identification of children at risk for suboptimal development, and that could help establish targets for early intervention. This study addressed the question of what the behavioral profile of children with SCT aged 1-5 years looks like. In total, 182 children aged 1-5 years participated in this study (N =87, N = 95). Recruitment and assessment took place in the Netherlands and the United States. The SCT group was recruited through prospective follow-up (50%), information seeking parents (31%), and clinical referral (18%). Behavioral profiles were assessed with the child behavior checklist and the ages-and-stages social-emotional questionnaire. Levels of parent-rated problem behavior were higher in children with SCT. Difficulties with overall social-emotional functioning were already present in 1-year-olds, and elevated scores were persistent across the full age range. Affective and pervasive developmental behaviors were seen in late toddlerhood and prominent at preschool age. Anxiety, attention deficit, and oppositional defiant behaviors were seen in preschool-aged children. Within this cross-sectional study, the developmental trajectory of affective, pervasive developmental, and oppositional defiant behaviors seemed to be different for SCT children than nonclinical controls. Collectively, these results demonstrate the importance of behavioral screening for behavioral problems in routine clinical care for children with SCT from a young age. Social-emotional problems may require special attention, as these problems seem most prominent, showing increased risk across the full age range, and with these problems occurring regardless of the timing of diagnosis, and across all three SCT karyotypes.

摘要

患有 SCT 的儿童神经发育不良的风险增加。先前的研究表明,SCT 个体存在神经行为问题的风险增加。然而,对于非常年幼的儿童的神经行为问题知之甚少;这些知识有助于早期识别神经发育不良风险的儿童,并有助于确定早期干预的目标。本研究旨在探讨 1-5 岁 SCT 儿童的行为特征是什么样的。共有 182 名 1-5 岁的儿童参与了这项研究(N=87,N=95)。招募和评估分别在荷兰和美国进行。SCT 组通过前瞻性随访(50%)、寻求信息的家长(31%)和临床转介(18%)招募。行为特征使用儿童行为检查表和年龄与阶段社会情感问卷进行评估。SCT 儿童的父母报告的问题行为水平更高。1 岁时就已经存在整体社会情感功能障碍,并且在整个年龄范围内评分持续升高。在幼儿期就可以看到情感和普遍发育行为,并且在学龄前更为突出。在学龄前儿童中可以看到焦虑、注意力缺陷和对立违抗性行为。在这项横断面研究中,SCT 儿童的情感、普遍发育和对立违抗性行为的发展轨迹似乎与非临床对照组不同。总的来说,这些结果表明,在儿童 SCT 的常规临床护理中,从幼年开始进行行为筛查以发现行为问题非常重要。社会情感问题可能需要特别关注,因为这些问题最为突出,在整个年龄范围内风险增加,并且无论诊断时间如何,以及所有三种 SCT 核型都会出现这些问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7e3/7384033/7b7e9e8c944e/AJMG-184-444-g001.jpg

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