ADHD – INFANTS
APGAR Scores – ADHD In Infants
The Journal of Pediatrics discussed a study of ADHD and early signs in infants regarding the early detection of ADHD. According to the study, babies born with low scores on the APGAR test of newborn vitality, are at higher risk to develop attention deficit hyperactivity disorder than infants with near-perfect scores. ADHD signs in infants might be detectable with the APGAR test which would allow for early treatment or behavior modification, and mitigate the symptoms of the illness.
Attention Deficit Disorder in Children
ADHD is a neuro-developmental condition that affects about 5% of children who are born prematurely. Both ADHD and ADD or attention deficit disorder are terms which have become increasingly popular among laypersons, the media, and even some professionals. They are now interchangeable.
How the Test Scoring Came About
The APGAR procedure was developed in 1952 and is used around the world. This is a 10-point scale that measures respiration, reflexes, skin color, pulse, and heart rate in the first minutes of life and may be repeated later if the score is and remains low. A study of 980,902 babies born in Denmark from 1988 to 2001 found that newborns with APGAR scores between 1 and 4 had a 75% higher risk of developing ADHD than babies with scores of 9 to 10. The risk of ADHD was 63% higher with scores of 5 to 6. ADHD cases totaled 8,234 and 82% were boys. Why aren’t nearly all infants tested for ADHD?
The Results of The Study and Test
APGAR scores were inversely associated with risk of ADHD (hazard ratio .92; 95% confidence interval [CI]: .88-.96, P trend < .001). Compared with children with APGAR scores of 9 or 10 at 5 minutes, the risk for ADHD was 75% higher in children with APGAR scores of 1 to 4 (hazard ratio 1.75; 95% CI: 1.15-2.11) and 63% higher for those with AGAR scores of 5 to 6 (95% CI: 1.25-2.11). Low APGAR scores and ADHD may share common causes or a low APGAR score reflects at least one causal pathway leading to ADHD.
APGAR TABLE:
| Sign | 0 Points | 1 Point | 2 Points | |
A |
Activity (Muscle Tone) | Absent | Arms and Legs Flexed | Active Movement |
P |
Pulse | Absent | Below 100 bpm | Above 100 bpm |
G |
Grimace (Reflex Irritability) | No Response | Grimace | Sneeze, cough, pulls away |
A |
Appearance (Skin Color) | Blue-gray, pale all over | Normal, except for extremities | Normal over entire body |
R |
Respiration | Absent | Slow, irregular | Good, crying |
A low score on the one-minute test may show that the neonate requires medical attention but is not necessarily an indication that there will be long term problems, particularly if there is an improvement by the stage of the 5 minute test. If the APGAR score remains below 3 at later times such as 10, 15, or 30 minutes, there is a risk
that the child will suffer longer term neurological damage. There is also a small but significant increase of the risk of cerebral palsy.
A score of 10 is uncommon due to the prevalence of transient cyanosis, and is not substantially different from a score of 9. Transient cyanosis is common, particularly in babies born at high altitude. A study comparing babies born in Peru near sea level with babies born at very high altitude (4340 m) found a significant difference in the first but not the second APGAR score. Oxygen saturation also was lower at high altitude.
Several studies have linked low APGAR scores with neurological diseases such as epilepsy, cerebral palsy, mental retardation; and might signal ADHD and early signs in Infants, researchers said.
NEXT PAGE – ADHD TREATMENT