Mental health and developmental outcomes for children born after ART: a comparative prospective study on child gender and treatment type. Developmental course of attention deficit hyperactivity disorder and its predictors. Psychoeducational treatment for school-aged children with bipolar disorder. The Groningen assisted reproductive technologies cohort study: developmental status and behavior at 2 years. Preliminary data suggesting the efficacy of attention training for school-aged children with ADHD Acute hyperglycemia alters mood state and impairs cognitive performance in people with type 2 diabetes. Does Cognitive Training Prevent Cognitive Decline? Transitions on and off AFDC: implications for parenting and children's cognitive development. Increased time to pregnancy is associated with less optimal neurological condition in 4-year-old singletons, in vitro fertilization itself is not. The Power of Personality: The Comparative Validity of Personality Traits, Socioeconomic Status, and Cognitive Ability for Predicting Important Life Outcomes Development of children born after ovarian superovulation induced by long-acting gonadotropin-releasing hormone agonist and menotropins, and by in vitro fertilization.
STUDY QUESTION Do children born after assisted reproductive techniques ( ART ; IVF/ICSI )  display more mental health issues or social and cognitive developmental problems at 7 - 8 years than naturally conceived ( NC ) controls , and does child gender play a role ? SUMMARY ANSWER ART children do not differ with regard to mental health or social and cognitive developmental problems when compared with controls , but some gender-specific differences do exist . WHAT IS KNOWN ALREADY Systematic review s have not found any evidence of delays in neurocognitive or sensorimotor development in ART children . However findings on the effect of the type of ART treatment ( IVF versus ICSI ) on the offspring 's physical and mental development have not been uniform . Knowledge of the role of child gender in ART research is scarce . STUDY DESIGN , SIZE , DURATION This prospect i ve follow-up study compares mental health and social and cognitive developmental problems between 7 - 8-year-old ART and NC children , controlling for the father 's age , length of the parents ' partnership , mother 's parity , child 's gestational age , and the need of neonatal intensive care unit ( NICU ) . Further , within the ART group , we analysed whether the treatment type ( IVF versus ICSI ) and the child 's gender are associated with the mental health and developmental outcomes . PARTICIPANTS / MATERIAL S , SETTING , METHODS In this study , 255 singleton ART children ( IVF and ICSI ) were compared with 278 NC children on parent-reported internalizing and externalizing symptoms , and social ( social skills and peer relations ) and cognitive development ( executive functioning , perception , memory , and language ) . Within the ART group , 164 IVF and 76 ICSI children were compared on the same outcomes . Statistics included analyses of covariates ( ANCOVA ) with group main effects , group and gender interaction effects , and Bonferroni post hoc tests . MAIN RESULTS AND THE ROLE OF CHANCE ART and NC children did not differ generally in terms of their internalizing and externalizing symptoms or in the number of social and cognitive developmental problems ( Group main effects , P > 0.05 ) , but gender-specific group differences existed . The ART boys showed lower levels of cognitive problems than the NC boys , whereas ART girls showed higher levels of cognitive problems than the NC girls ( Group × Gender-interaction effects with Bonferroni post hoc tests on mother-reports , P < 0.01 ) . Further , unlike in the NC group , where boys showed more externalizing symptoms and social and cognitive developmental problems than girls ( Group × Gender-interaction effects with Bonferroni post hoc tests for both parents ' reports , P < 0.05 ) , gender differences were not found in the ART group . Within the ART group , IVF and ICSI children did not differ in terms of mental health or developmental outcomes , and no significant gender differences emerged . LIMITATIONS , REASONS FOR CAUTION The information on children 's mental health and development was based on parental reports only . The dropout rate between the child 's first year and the school age assessment s was very high for fathers ( 57.4 % ) and substantial for mothers ( 30.1 % ) , and the participating group was biased for older age of both parents and for better education of the fathers . WIDER IMPLICATION S OF THE FINDINGS The findings indicate the importance of considering child gender in learning about multiple developmental outcomes among children born after ART . STUDY FUNDING /COMPETING INTERESTS This study was supported by the Academy of Finl and ( # 11232276 ) , the Emil Aaltonen Foundation , The Family Federation of Finl and , Helsinki University Central Hospital Research Funds , and the National Graduate School of Psychology . None of authors has any competing interests to declare OBJECTIVE To outline the key features of the developmental progression of ADHD and to consider the most prominent influences on its developmental course and outcomes . METHODS This is a selective review focusing primarily on prospect i ve follow-up studies . Relevant publications were selected by search ing the MEDLINE and PubMed data bases using keywords : ADHD , development , preschool , adolescent , adult , follow up , outcome , long-term , predictors , and treatment . Reference lists of the result ing articles were then review ed for additional publications . RESULTS Presentation of ADHD and associated impairments evolve across development , as do outcome predictors . In early development , in addition to genetics , some forms of prenatal adversity increase the risk for ADHD . In preschool years , symptom severity , cognitive function , and family factors become significant predictors of school age outcomes . These continue to predict long-term outcomes in school aged children , and comorbidity emerges as another significant long-term outcome predictor at this stage . CONCLUSIONS Presentation of ADHD and risk factors for later adversity evolve across development , which calls for developmentally-informed clinical practice Bipolar disorder ( BPD ) has received increasing attention from public and professional sources . Although pharmacologic treatments are considered the sine qua non in the treatment of youth with BPD , psychosocial interventions are critical to assist the child and family cope with symptoms that carry with them significant morbidity and mortality . Treatments developed to date are few in number ; all are psychoeducationally based , using cognitive-behavioral and family systems interventions within a biopsychosocial framework . This paper review s possible mediators of outcome , including caregiver concordance , children 's social skills , hopelessness , and family stress . The author has developed two family-based psychoeducational interventions for the treatment of youth with BPD : multifamily psychoeducation groups ( MFPG ) and individual family psychoeducation ( IFP ) . These treatments are both described and the results from a previously published r and omized clinical trial ( RCT ) of MFPG are summarized . Then , new findings from an RCT of IFP are presented , along with preliminary pilot data from an exp and ed version of IFP . The paper concludes with recommendations for future research OBJECTIVE To evaluate whether children 's  cognitive and psychomotor development and behavior at 2 years are affected by ovarian hyperstimulation and the IVF laboratory procedures or subfertility . DESIGN Prospect i ve longitudinal cohort study . SETTING University Medical Center Groningen , the Netherl and s. PATIENT(S ) Singletons born after controlled ovarian hyperstimulation (COH)-IVF ( n=66 ) and modified natural cycle-IVF ( n=56 ) , singletons born to subfertile couples who conceived naturally ( subfertile-naturally conceived , n=87 ) , and a reference group of 101 2-year-old singletons born to fertile couples . INTERVENTION(S ) None . MAIN OUTCOME MEASURE(S ) Bayley Scales of Infant Development and Achenbach Child Behavior Checklist . RESULT ( S ) Mental and psychomotor development and behavioral outcome in COH-IVF , modified natural cycle-IVF , and subfertile-natural cycle groups was not different . Developmental outcome and behavior of the subfertile groups were largely similar to those of the fertile reference group . Nevertheless , the subfertile groups scored higher on the scale of anxious-depressed behavior than the reference group . CONCLUSION ( S ) This present relatively small study found no differences in cognitive and psychomotor development and behavior at 2 years in children born after COH-IVF or modified natural cycle-IVF or naturally conceived children of subfertile parents . Replication of the study is needed before firm conclusions can be drawn . Furthermore , long-term follow-up is needed to confirm these findings in older children A pilot r and omized clinical trial was conducted to examine the initial efficacy of Pay Attention ! , an intervention training sustained , selective , alternating , and divided attention , in children diagnosed with Attention-Deficit/Hyperactivity Disorder ( ADHD ) . After a diagnostic and baseline evaluation , school-aged children with ADHD were r and omized to receive 16 bi-weekly sessions of Pay Attention ! ( n=54 ) or to a waitlist control group ( n=51 ) . Participants completed an outcome evaluation approximately 12 weeks after their baseline evaluation . Results showed significant treatment effects for parent and clinician ratings of ADHD symptoms , child self-report of ability to focus , and parent ratings of executive functioning . Child performance on neuropsychological tests showed significant treatment-related improvement on strategic planning efficiency , but no treatment effects were observed on other neuropsychological outcomes . Treatment effects were also not observed for teacher ratings of ADHD . These data add to a growing body of literature supporting effects of cognitive training on attention and behavior , however , additional research is warranted OBJECTIVE To examine the effects of acute hyperglycemia on cognitive function and mood in people with type 2 diabetes . RESEARCH DESIGN AND METHODS Twenty subjects with type 2 diabetes , median age 61.5 years ( range 53.1 - 72.0 ) , known duration of diabetes 5.9 years ( range 2.8 - 11.2 ) , BMI 29.8 kg/m2 ( range 22.0 - 34.6 ) , and HbA1c 7.5 % ( range 6.7 - 8.4 ) were studied . Treatment modalities varied from antidiabetic medications to insulin . A hyperinsulinemic glucose clamp was used to maintain arterialized blood glucose at either 4.5 ( euglycemia ) or 16.5 mmol/l ( hyperglycemia ) on two occasions in a r and omized and counterbalanced fashion . Tests of information processing , immediate and delayed memory , working memory , and attention were administered , along with a mood question naire , during each experimental condition . RESULTS Speed of information processing , working memory , and some aspects of attention were impaired during acute hyperglycemia . Subjects were significantly more dysphoric during hyperglycemia , with reduced energetic arousal and increased sadness and anxiety . CONCLUSIONS During acute hyperglycemia , cognitive function was impaired and mood state deteriorated in a group of people with type 2 diabetes . These findings are of practical importance because intermittent or chronic hyperglycemia is common in people with type 2 diabetes and may interfere with many daily activities through adverse effects on cognitive function and mood Fear of losing one 's cognitive ability to Alzheimer disease and related dementias ( ADRD ) and ultimately declining to a state considered by many to be worse than death ( 1 ) is driving a growing brain-training industry . Cognitive training programs , marketed to otherwise healthy adults and persons with a recent diagnosis of mild cognitive impairment ( MCI ) , make bold cl aims for reversing brain aging . Such cl aims include the ability to boost cognitive reserve in midlife ( with cognitive reserve referring to both the mismatch between clinical symptoms of dementia and pathologic brain lesion load at death and the repeatedly demonstrated association between educational achievement and dementia risk ) . However , few studies have evaluated the effect of cognitive training programs on cognitive decline or the onset of dementia , which is the outcome of interest for most people who buy these programs . This review systematic ally evaluates the existing literature on the effectiveness of cognitive training in preventing cognitive decline and ADRD . It is part of a larger systematic review commissioned by the National Institute on Aging to address a range of potential interventions to slow cognitive decline and prevent or delay dementia . Methods We developed and followed a st and ard protocol that was posted on the Agency for Healthcare Research and Quality ( AHRQ ) Web site ( www.effectivehealthcare.ahrq.gov ) . Full details of the methods , including literature search es , findings , and evidence tables , are available in the final report ( 2 ) . Data Sources and Search es We search ed Ovid MEDLINE , PsycINFO , EMBASE , and the Cochrane Central Register of Controlled Trials for relevant literature published between January 2009 and July 2017 ( see Part A of the Supplement , for search es ) and h and - search ed reference lists of selected articles . We identified studies published before 2009 by review ing studies included and excluded from the 2010 AHRQ review on preventing Alzheimer disease and cognitive decline ( 3 ) . Supplement . Cognitive Training Supplement Study Selection Two investigators independently review ed titles and abstract s of search results and screened the full text of potentially eligible references . We included r and omized trials of cognitive training interventions enrolling adults with either normal cognition or MCI if the studies followed participants for at least 6 months , provided cognitive performance or incident dementia outcomes , and were published in English . We excluded studies that enrolled only persons diagnosed with dementia . The final health outcome of interest was incident ADRD . Intermediate health outcomes of interest included performance on cognitive testing , biomarker protein levels , brain matter volume , and brain cell activity level . No restrictions were placed on sample size or comparator type . Data Extraction and Quality Assessment One review er extracted study , population , intervention , comparator , and setting characteristics as well as the funding source from all eligible studies . Risk of bias was assessed independently from full texts by 2 investigators using an instrument based on AHRQ guidance ( 4 ) . Risk of bias was individually review ed overall and for each outcome and time point , and was summarized as low , medium , or high on the basis of a summary of bias risk across risk-of-bias domains and confidence that results were credible given the study 's limitations . Outcomes and adverse events were extracted from studies with low to medium risk of bias . A second review er checked the quality of all data . Data Synthesis and Analysis Only studies with low or medium risk of bias were summarized , because we judged findings from studies with high risk of bias to lack validity , have little meaning , or be easily misinterpreted . Because studies used a highly varied set of outcome measures , neuropsychological tests were categorized by the following specific cognitive domains to facilitate analysis : executive function , attention , and processing speed ; memory ; language ; and visuospatial abilities ( Supplement Table A1 ) . The domains of executive function , attention , and processing speed were grouped together because cognitive tests frequently measure all 3 of these related domains . Because studies analyzed and reported cognitive test results in many different ways , making it difficult or impossible to determine effect size or to assess whether between-group differences in scores or subscores were clinical ly meaningful ( Supplement Table A2 ) , we analyzed and reported cognitive test results by direction of effect and statistical significance . When we identified at least 2 studies or 1 large study ( > 500 participants ) for a treatment comparison , 2 review ers grade d strength of evidence for each outcome on the basis of study limitations , directness , consistency , and precision ; otherwise , strength of evidence was grade d as insufficient . Assessment s were confirmed by consensus . Role of the Funding Source The National Institute on Aging of the National Institutes of Health requested this report from the AHRQ Evidence -based Practice Center Program . The funding agencies provided comments on draft reports but had no role in data collection , analysis , interpretation , or manuscript development . Results We identified 35 publications of 34 unique r and omized controlled trials of cognitive training interventions , 11 of which had medium or low risk of bias ( 516 ) . Only 1 trial was industry funded ( 8) , whereas in 3 cases , trial funding was not reported ( 9 , 15 , 16 ) . ( See the Supplement Figure and Supplement Tables C1 to C4 for the literature flow diagram , evidence tables , and risk-of-bias assessment s. ) The Table summarizes the overall strength-of- evidence findings . For cognitively normal adults , moderate-strength evidence suggests that cognitive training in a particular domain improves performance in that domain compared with inactive or attention control population s. These results are driven largely by the results from the ACTIVE ( Advanced Cognitive Training for Independent and Vital Elderly ) trial . Low-strength evidence suggests that for persons with MCI , cognitive training in a particular domain does not improve performance in that domain compared with controls . The MCI trials have more limitations and are less precise than the studies conducted with cognitively normal participants . Evidence is insufficient for incident MCI or ADRD outcomes . Table . Summary of Conclusions and Strength of Evidence for Cognitive Training in Adults With Normal Cognition or MCI * Studies in Cognitively Normal Population s Six trials with low to medium risk of bias tested training interventions in cognitively normal older adults ( 510 ) . Sample sizes for the selected studies ranged from 40 to 2832 participants . Interventions lasted from 2 weeks to 6 months ; follow-up ranged from 6 months to 2 years . Three of the 6 trials used only computer-based interventions ( 68 ) , 2 used a combination of computer and noncomputer ( paper- and -pencil ) interventions ( 5 , 9 ) , and 1 used group-based competition to increase divergent thinking ( 10 ) . Three of the computer-based interventions were design ed to increase performance on a specific cognitive domain ( such as processing speed ) ( 5 , 6 , 9 ) , 1 used computers for cognitive stimulation more generally ( 7 ) , and 1 used a computer program design ed to train several cognitive domains ( 8) . Comparators included both inactive ( 5 , 7 , 8 , 10 ) and attention controls ( 6 , 9 ) . No studies reported adverse effects . The largest trial of cognitive training , ACTIVE , r and omly assigned 2832 older adults ( mean age , 74 years ) without clinical ly significant cognitive impairment to 1 of 3 training groups or a no-contact control group ( 5 ) . In each training group , a different cognitive domain was targeted : memory , reasoning , or processing speed . Participants in the intervention groups received 10 trainings of 60 to 70 minutes over 6 weeks . Cognitive testing outcomes included measuring changes in domain-specific test performance . Patient-centered cognitive outcomes included measuring changes in everyday problem solving ( such as the ability to identify information on medication bottles ) , everyday speed ( such as the time required to find food items on a grocery shelf ) , driving , and degree of dependency in completing activities of daily living and instrumental activities of daily living . Incident MCI or ADRD was not a prespecified outcome . Although 5- and 10-year outcomes from the ACTIVE trial have been published ( 17 , 18 ) , only the results from the 2-year study had a medium risk of bias ( 5 ) . At 2 years , ACTIVE participants showed improvement in the cognitive domains in which they were trained ( for example , those who received memory training improved on memory-related tasks compared with control participants ) , but no statistically significant differences were found among groups with regard to other cognitive outcomes ( for example , persons who received training in memory did not do better than control participants on reasoning tasks ) . Intervention and control groups did not differ in other patient-centered cognitive outcomes at 2-year follow-up . Modeled on the visual process and speed training group of the ACTIVE trial , IHAMS ( the Iowa Healthy and Active Minds Study ) ( n= 681 ) ( 6 ) r and omly assigned adults by age group ( 50 to 64 years vs. 65 years ) to visual processing speed training at the study center , visual processing speed training on the participant 's home computer , or computerized crossword puzzles ( attention control group ) . Two-hour training sessions were held once a week for 5 weeks . Participants assigned to the intervention at the training center also received a booster training at 11 months . One year after training , both intervention groups showed statistically significant improvement in the primary outcome of the Useful Field of View test compared with the attention control group . The IHAMS participants also were administered 8 secondary cognitive tests on which they had not been The goal of current national and state legislation on welfare reform is to decrease the number of people who are dependent on public assistance  , most of whom are mothers and their young children . Mothers ' patterns of welfare receipt in the 3 years following the birth of a child were examined vis-à-vis their associations with maternal emotional distress ( General Health Question naire ) , provision of learning experiences ( Home Observation of the Measurement of the Environment ) , parenting behavior , and the child 's cognitive test score ( Stanford-Binet ) in the third year of life . The data set was the Infant Health and Development Program , an eight-site r and omized clinical trial design ed to test the efficacy of educational and family support services in reducing developmental delays in low-birthweight , preterm infants ( N = 833 ) . Strong negative associations were found between receiving welfare and parenting behavior and child outcomes at age 3 years . Outcomes varied depending on when the mother received public assistance  ( earlier or later in her child 's first 3 years ) and family poverty status on leaving welfare . The parenting behavior of mothers who had left welfare by their child 's third birthday was more likely to be authoritarian if she had left public assistance without also leaving poverty . Implication s of these findings for the well-being of children in low-income families are discussed STUDY QUESTION Does ovarian hyperstimulation , the in vitro procedures required for in vitro fertilization (IVF)/ intracytoplasmic sperm injection or the combination of both , affect the  neurological outcome  of 4-year-old singletons ? SUMMARY ANSWER Ovarian hyperstimulation , the in vitro procedure and the combination of both , were not associated with the worse neurological outcome in 4-year-old singletons . WHAT IS KNOWN ALREADY Assisted reproduction techniques ( ARTs ) are not associated with neurological dysfunction during the first post-natal years ; however , effects on the long-term neurological outcome are still inconclusive . An increased time to pregnancy ( TTP , a proxy for the severity of subfertility ) has been associated with a less optimal neurological condition at age 2 . The present study focuses on the neurodevelopmental outcome of 4-year-old ART-offspring . STUDY DESIGN , SIZE , DURATION Longitudinal , prospect i ve follow-up study . PARTICIPANTS , SETTING , METHODS Four-year-old singletons born to subfertile parents ( subfertile group , n = 195 ) , including singletons born after controlled ovarian hyperstimulation IVF ( COH-IVF , n = 63 ) , modified natural cycle IVF ( MNC-IVF , n = 53 ) and natural conception ( Sub-NC , n = 79 ) . Data on underlying cause of subfertility and TTP were present . In addition , we assessed newly recruited 4-year-old singletons born to fertile parents after natural conception ( reference group , n = 98 ) . Neurological development was evaluated with the neurological examination according to Hempel , result ing in a neurological optimality score ( NOS ) , a fluency score and the occurrence of the clinical ly relevant form of minor neurological dysfunction ( complex MND ) . The primary outcome was the fluency score , as fluency of movements is easily reduced by subtle brain dysfunction . Data were analysed with univariable and multivariable regression analyses , in which special attention was paid to sex differences in the neurological outcome . MAIN RESULTS AND THE ROLE OF CHANCE The fluency score , NOS and the prevalence of complex MND were similar in COH-IVF , MNC-IVF and Sub-NC children . The neurological condition of children born to subfertile parents was similar to that of children of fertile parents and was independent of the underlying cause of subfertility . No statistically significant associations were found between TTP and the fluency score and NOS . However , a positive correlation was found between TTP and the prevalence of complex MND ( TTP in years , adjusted odds ratio [ OR ] [ 95 % confidence interval , CI ] : 1.207 [ 1.038 to 1.404 ] , P = 0.014 ) ; a correlation which could be attributed to girls , in whom an evident positive correlation was present ( adjusted OR [ 95 % CI ] : 1.542 [ 1.161 to 2.047 ] , P = 0.003 ) . A similar association was absent in boys . LIMITATIONS , REASONS FOR CAUTION The prospect i ve design of our study and small post-natal attrition rate ( 9.3 % ) reduced potential selection bias based on the child 's development or health . The assessors were blind to the mode of conception , except for the group of children born to fertile parents , which was newly recruited . The study lacks sufficient power to conclude firmly that increased TTP is associated with a higher prevalence of complex MND . WIDER IMPLICATION S OF THE FINDINGS Our study suggests that the severity of subfertility , rather than its simple presence or components of IVF treatment , affects the neurological outcome . Moreover , girls may be neurologically more vulnerable for the effect of severity of subfertility . The finding that the severity of subfertility may be the decisive factor rather than the presence of a history of subfertility per se corroborates previous reports . Our results can not be generalized to multiples , as we studied singletons only . STUDY FUNDING /COMPETING INTERESTS The study was financially supported by the University Medical Center Groningen , grant number : 754510 , the Junior Scientific Masterclass , the Postgraduate School Behavioural and Cognitive Neurosciences and the Cornelia Foundation , Groningen , The Netherl and s. The authors have no conflicts of interest to declare The ability of personality traits to predict important life outcomes has traditionally been question ed because of the putative small effects of personality . In this article , we compare the predictive validity of personality traits with that of socioeconomic status ( SES ) and cognitive ability to test the relative contribution of personality traits to predictions of three critical outcomes : mortality , divorce , and occupational attainment . Only evidence from prospect i ve longitudinal studies was considered . In addition , an attempt was made to limit the review to studies that controlled for important background factors . Results showed that the magnitude of the effects of personality traits on mortality , divorce , and occupational attainment was indistinguishable from the effects of SES and cognitive ability on these outcomes . These results demonstrate the influence of personality traits on important life outcomes , highlight the need to more routinely incorporate measures of personality into quality of life surveys , and encourage further research about the developmental origins of personality traits and the processes by which these traits influence diverse life outcomes The use of a gonodotropin-releasing hormone ( Gn-RH ) agonist in an in vitro fertilization ( IVF ) program raises the question of any influence on the physical , neurologic , and mental development of the children . We compared the development of children born after long-acting Gn-RH agonist treatment with that of children born after spontaneous pregnancies . Children from singleton pregnancies and > or = 28 months of age were examined by a pediatric neurologist and a psychologist who did not know to which group the children belonged . The General Cognitive Index test was used . Each group included 30 children . Five children cooperated only partly . Physical and neurologic findings were normal in all children , except that one in the group born after in vitro fertilization had diffuse hypotonia , attention-deficit hyperactivity disorder , and hyperactivity . The General Cognitive Index for the 26 children in the study group and the 29 children in the control group who fully cooperated were 102 + /- 13.3 and 106 + /- 13.5 , respectively ( p = 0.37 ) . The verbal perception , motor , and memory indexes were not significantly different . We conclude that the long-acting Gn-RH agonist had no clinical ly identifiable influence on the development of these children
SUMMARY ANSWER The available high- quality evidence indicates that specific treatments may give rise to different effects on cognitive development , with certain treatments , including ICSI , associated with cognitive impairment .
STUDY QUESTION Does  fertility treatment  influence cognitive ability in school aged children , and does the impact vary with the type of treatment ?
WHAT IS KNOWN ALREADY Previous review s of the literature concerning cognitive outcomes among children conceived with medical assistance have concluded that study findings are generally ' reassuring ' , but limited attention has been paid to the quality of this research .
In addition , no review has separately assessed the range of treatment modalities available , which vary in invasiveness , and thus , potentially , in their effects on developmental outcomes .