@article {8501, title = {Early diagnosis and Early Start Denver Model intervention in autism spectrum disorders delivered in an Italian Public Health System service.}, journal = {Neuropsychiatr Dis Treat}, volume = {12}, year = {2016}, month = {2016}, pages = {1379-84}, abstract = {

BACKGROUND: Early diagnosis combined with an early intervention program, such as the Early Start Denver Model (ESDM), can positively influence the early natural history of autism spectrum disorders. This study evaluated the effectiveness of an early ESDM-inspired intervention, in a small group of toddlers, delivered at low intensity by the Italian Public Health System.

METHODS: Twenty-one toddlers at risk for autism spectrum disorders, aged 20-36 months, received 3 hours/wk of one-to-one ESDM-inspired intervention by trained therapists, combined with parents{\textquoteright} and teachers{\textquoteright} active engagement in ecological implementation of treatment. The mean duration of treatment was 15 months. Cognitive and communication skills, as well as severity of autism symptoms, were assessed by using standardized measures at pre-intervention (Time 0 [T0]; mean age =27 months) and post-intervention (Time 1 [T1]; mean age =42 months).

RESULTS: Children made statistically significant improvements in the language and cognitive domains, as demonstrated by a series of nonparametric Wilcoxon tests for paired data. Regarding severity of autism symptoms, younger age at diagnosis was positively associated with greater improvement at post-assessment.

CONCLUSION: Our results are consistent with the literature that underlines the importance of early diagnosis and early intervention, since prompt diagnosis can reduce the severity of autism symptoms and improve cognitive and language skills in younger children. Particularly in toddlers, it seems that an intervention model based on the ESDM principles, involving the active engagement of parents and nursery school teachers, may be effective even when the individual treatment is delivered at low intensity. Furthermore, our study supports the adaptation and the positive impact of the ESDM entirely sustained by the Italian Public Health System.

}, issn = {1176-6328}, doi = {10.2147/NDT.S106850}, author = {Devescovi, Raffaella and Monasta, Lorenzo and Mancini, Alice and Bin, Maura and Vellante, Valerio and Carrozzi, Marco and Colombi, Costanza} } @article {3548, title = {Piccolipi{\`u}, a multicenter birth cohort in Italy: protocol of the study.}, journal = {BMC Pediatr}, volume = {14}, year = {2014}, month = {2014}, pages = {36}, abstract = {

BACKGROUND: The fetal and infant life are periods of rapid development, characterized by high susceptibility to exposures. Birth cohorts provide unique opportunities to study early-life exposures in association with child development and health, as well as, with longer follow-up, the early life origin of adult diseases. Piccolipi{\`u} is an Italian birth cohort recently set up to investigate the effects of environmental exposures, parental conditions and social factors acting during pre-natal and early post-natal life on infant and child health and development. We describe here its main characteristics.

METHODS/DESIGN: Piccolipi{\`u} is a prospective cohort of expected 3000 newborns, who will be recruiting in six maternity units of five Italian cities (Florence, Rome, Trieste, Turin and Viareggio) since October 2011. Mothers are contacted during pregnancy or at delivery and are offered to participate in the study. Upon acceptance, their newborns are recruited at birth and followed up until at least 18 years of age. At recruitment, the mothers donate a blood sample and complete a baseline questionnaire. Umbilical cord blood, pieces of umbilical cord and heel blood spots are also collected. Postnatal follow-up currently occurs at 6, 12, and 24 months of age using on-line or postal self administered questionnaire; further questionnaires and medical examinations are envisaged. Questionnaires collect information on several factors, including mother{\textquoteright}s and/or child{\textquoteright}s environmental exposures, anthropometric measures, reproductive factors, diet, supplements, medical history, cognitive development, mental health and socioeconomic factors. Health promotion materials are also offered to parents.

DISCUSSION: Piccolipi{\`u} will broaden our understanding of the contribution of early-life factors to infant and child health and development. Several hypotheses on the developmental origins of health can be tested or piloted using the data collected from the Piccolipi{\`u} cohort. By pooling these data with those collected by other existing birth cohorts it will be possible to validate previous findings and to study rare exposures and outcomes.

}, keywords = {Adolescent, Child, Child Development, Child Welfare, Child, Preschool, Cohort Studies, Environmental Exposure, Humans, Infant, Infant, Newborn, Italy, Prospective Studies, Socioeconomic Factors}, issn = {1471-2431}, doi = {10.1186/1471-2431-14-36}, author = {Farchi, Sara and Forastiere, Francesco and Vecchi Brumatti, Liza and Alviti, Sabrina and Arnofi, Antonio and Bernardini, Tommaso and Bin, Maura and Brescianini, Sonia and Colelli, Valentina and Cotichini, Rodolfo and Culasso, Martina and De Bartolo, Paolo and Felice, Laura and Fiano, Valentina and Fioritto, Alessandra and Frizzi, Alfio and Gagliardi, Luigi and Giorgi, Giulia and Grasso, Chiara and La Rosa, Francesca and Loganes, Claudia and Lorusso, Paola and Martini, Valentina and Merletti, Franco and Medda, Emanuela and Montelatici, Veronica and Mugelli, Isabella and Narduzzi, Silvia and Nistic{\`o}, Lorenza and Penna, Luana and Piscianz, Elisa and Piscicelli, Carlo and Poggesi, Giulia and Porta, Daniela and Ranieli, Antonella and Rapisardi, Gherardo and Rasulo, Assunta and Richiardi, Lorenzo and Rusconi, Franca and Serino, Laura and Stazi, Maria Antonietta and Toccaceli, Virgilia and Todros, Tullia and Tognin, Veronica and Trevisan, Morena and Valencic, Erica and Volpi, Patrizia and Ziroli, Valentina and Ronfani, Luca and Di Lallo, Domenico} }