Researchers at Columbia University and the New York State Psychiatric Institute have been analyzing data on US kids under the age of nineteen with bipolar disorder and have found there's been a huge increase. The question now is: Is the surge real, or are many children being misdiagnosed?

A 40-fold increase between 1994 and 2003 ... that's a jump from 20,000 to 800,000 kids ... just happens to coincide with the use of antipsychotic drugs in children. Considering that some doctors don't even believe in bipolar disorder in kids, these numbers are worrying.

Dr. Thomas Insel, director of the National Institute of Mental Health, which partially funded the research, said the study "waves a flag saying we've got to do much, much better in finding ways to validate psychiatric diagnoses in children. This is an area that really needs hard science."

Yeah ... I'd say our kids deserve some hard science.

The University of Oregon has developed a questionnaire for parents meant to help pediatricians catch developmental delays in young children that seems to be working.

In a year-long study, the 15 minutes it took parents to answer the questions resulted in a 224% increase in referrals of one- and two-year-olds with mild delays, and this with only a 54% return rate.

A doctor in Eugene says:

"We had intuitions that physicians had difficulty identifying children with mild developmental delays, especially in the fine motor, problem-solving and personal-social domains. Physicians focus mostly on milestones involving communication and gross motor skills. The data shows that when physicians suspect a delay, those children are almost always eligible for early intervention services, but, at the same time, we have our limited powers of observation."

He adds that it's much harder for doctors to identify delays in 12-month-olds than in 24-month-olds, which is a problem in that early intervention is the best medicine for improving long-term outcomes, and it's the mild delays that respond best to getting started sooner, rather than later.

The university is now experimenting with putting the questionnaire online in hopes of streamlining the process and getting more pediatricians to use the information.

Parents can find it here.

Not that we're all going to be willing or able to use the technology, but a Washington University pediatrician at the St. Louis Children's Hospital is reporting that an MRI scan on babies born prematurely may predict the child's future development.

Starting with MRIs done on babies born at 30 weeks or less, doctors followed infants from birth to the age of two, grading abnormalities they'd noted on the MRI and predicting the risk of "cognitive delays, psychomotor delays, cerebral palsy, or hearing or visual impairments that may be visible by age 2."

With an increase of 13% in the rate of premature births in the US in the ten years following 1992, and data showing that 50% of premies suffer some neurodevelopmental challenges, the information could be very helpful.

Once again, early intervention might make a big difference in the quality of a child's life.

And sticking with the early intervention theme, a recently published study indicates that autism can be diagnosed at close to one year of age in approximately half of all children who will be found to be autistic.

Through repeated observation and the use of standardized tests of development, researchers identified, for the first time, disruptions in social, communication and play development that were indicative of ASD in 14-month olds. Multiple signs indicating these developmental disruptions appear simultaneously in children with the disorder.

Some of the signs the researchers looked at were: communication skills, inability to recognize opportunities to share experience, unusual uses of toys, very limited use of sounds, words and gestures.

And in another study on autism, this one funded by the National Institutes of Health, it has been suggested that one-year-olds who don't respond to their names are more likely to be diagnosed with an autism spectrum disorder than those who do.

Calling this "one of the most consistently documented behaviors in infancy that distinguishes children later diagnosed with autism from those with typical development or developmental delays," a doctor at the University of California, Davis, took part in the study of infants with a autistic sibling, therefore considered at risk of autism, calling names of babies from 6-months-old to 12-months.

The six-month-olds were all pretty much clueless, but by 12-months 100% of the control group babies, not at-risk children, passed the name test while 86% of the at-risk kids responded. By the age of two, three-fourths of those who had not reacted to their names were diagnosed with developmental problems.

"Since this task is easy to administer and score and takes few resources, it could be incorporated into well-child pediatric visits at 12 months of age," they conclude. "If a child fails to orient to name, particularly reliably over time, this child has a high likelihood of some type of developmental abnormality and should be referred for more frequent screening, comprehensive assessment and, if indicated, preventive early intervention."

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