The edition · Paediatrics
Autism occurrence held flat across 12 birth cohorts when every child was screened
A population-wide screening study of more than 62,000 South Korean seven-year-olds found no rise in incidence or prevalence across children born 1998 to 2010. Plus a negative NICU fortification trial, and a quarter of people with seizures in endemic regions have neurocysticercosis.
The edition in brief
Today's paediatrics desk leads with a study that does something almost no autism prevalence estimate does: it screened everyone. Twelve consecutive South Korean birth cohorts, children born 1998 to 2010 and assessed at age seven, were screened population-wide rather than counted through services. Across the whole period, seven-year cumulative incidence ranged from 1.9% to 3.2% and prevalence from 2.0% to 3.4%, with no significant trend in either direction. Girls were over-represented among children found in mainstream education who had never been diagnosed. A double-blind randomised trial in very preterm infants tested whether analysing each mother's milk and fortifying to target improves growth and brain development. It did not. Weight, length and head circumference z scores, body composition and brain MRI indices were no different, and base milk protein was in fact slightly higher in the control group - nutrient intakes met or exceeded recommendations in both arms. A Bayesian meta-analysis of 77 studies estimates that 25.2% (95% credible interval 19.5% to 32.2%) of people presenting with epileptic seizures in endemic regions have neurocysticercosis, with the proportion falling since 2008 and heterogeneity high. Five-year follow-up of 63 adolescents treated for PTSD by nurses without prior psychotherapy training shows maintained symptom reduction, with the early advantage of prolonged exposure over supportive counselling no longer significant at 60 months.
When every child is screened, autism occurrence has not risen
Tell parents the rise in autism figures largely reflects better detection, and actively lower your threshold for assessing girls who appear to be coping.
Analysing each mother's milk and fortifying to target did not improve growth or brain MRI
Do not adopt point-of-care human milk analysis for targeted fortification; check instead that your standard protocol is hitting recommended intakes.
A quarter of people presenting with seizures in endemic regions have neurocysticercosis
In endemic settings, image a child with a first afebrile seizure rather than waiting, because roughly a quarter of seizure presentations are neurocysticercosis.
Ask the parents of a well-behaved girl how she is when she gets home
When a school describes a girl as quiet and coping but her parents describe difficulty at home, take the discrepancy seriously and assess.
Nurses without psychotherapy training treated adolescent PTSD, and it held for five years
Where specialist child psychotherapy is unavailable, a nine-session protocol delivered by trained and supervised nurses is a defensible service model with five-year durability.
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