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Classification is a tool for communication so that when clinicians, policy-makers, or researchers refer to some features they talk about the same thing. The classification of neurodevelopmental problems in children and adolescents is crucial to better understand their prevalence and the intervention or treatment that should be provided. However, such classification might be challenging, especially when development aspects have to be taken into account. This chapter aims to provide a better understanding of the classification of neurodevelopmental disabilities. Thus, we provide an overview of the different classification systems that are the most commonly used, such as the well-known Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD). Moreover, we address opportunities and challenges inherent to the classification of neurodevelopmental disorders and the implications for clinical practice and research areas., (Copyright © 2020 Elsevier B.V. All rights reserved.)

The purpose of a pediatric neuropsychologic assessment is to evaluate cognitive, behavioral, sensory-motor, perceptual, and socioaffective functioning. A standardized, validated set of tools, questionnaires, and qualitative methods is applied to this end. The neuropsychologist integrates the results of the formal assessment, the case history, and third-party observations to interpret the individual findings across disciplines and draw conclusions about brain-behavior relationships. Various indications for neuropsychologic assessment include the identification of neurodevelopmental difficulties and the characterization of the impact of medical conditions or a pharmaceutical treatment. Prior to the evaluation, as much information as possible must be gathered about the child for efficient and accurate planning. In the context of pediatric neuropsychologic assessments, special challenges requiring more flexibility as regards the duration of the assessment, the use of different age-specific tools, or particular sensitivity when interacting with the child may arise. Neuropsychologic assessment is a cornerstone in the process of diagnosing neurodevelopmental disabilities in children and is frequently a component of a multidisciplinary evaluation. From it can be derived recommendations for the different contexts of a child's life (e.g., family, care team, school)., (Copyright © 2020 Elsevier B.V. All rights reserved.)

This longitudinal study aims to describe the trajectory of language development in children with CHD aged 12-24 months assessed through an early monitoring and individualized intervention program. We also sought to determine whether early language performances, at 12 months of age, predict 24-month language abilities. We conducted developmental assessments of 49 children with CHD using the Bayley Scales of Infant and Toddler Developmental, third edition (Bayley-III) at 12 and 24 months, and the MacArthur-Bates Communicative Development Inventories (MBCDI) at 12, 18 and 24 months. Compared to normative populations, CHD patients showed significantly lower mean scores in both receptive and expressive language scales of the Bayley-III and the MBCDI at 12 months, whereas at 18 and 24 months only expressive language scores were reduced. No differences were found in the cognitive scale. Communicative gestures at 12 months were significantly predictive of language skills at 24 months of age. Our findings indicate specific vulnerability of language outcome, especially in expressive skills, rather than a global cognitive impairment in our patients with CHD. We recommend using communicative gestures as an early marker of language development to improve our ability to detect language delays in this population., (Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Purpose: Seizures are common in critically ill neonates. Both seizures and antiepileptic treatments may lead to short term complications and worsen the outcomes. Predicting the risks of seizure reoccurrence could enable individual treatment regimens and better outcomes. We aimed to identify EEG signatures of seizure reoccurrence by investigating periictal electrographic features and spectral power characteristics in hypothermic neonates with hypoxic-ischemic encephalopathy (HIE) with or without reoccurrence of seizures on rewarming., Methods: We recruited five consecutive HIE neonates, submitted to continuous EEG monitoring, with high seizure burden (>20% per hour) while undergoing therapeutic hypothermia. Two of them had reoccurrence of seizures on rewarming. We performed quantitative analysis of fifteen artifact-free consecutive seizures to appreciate spectral power changes between the interictal, preictal and ictal periods, separately for each patient. Visual analysis allowed description of electrographic features associated with ictal events., Results: Every patient demonstrated a significant increase in overall spectral power from the interictal to preictal and ictal periods (p<0.01). Alpha power increase was more pronounced in the two patients with reoccurrence of seizures on rewarming and significant when comparing both interictal-to-preictal and interictal-to-ictal periods. This alpha activity increase could be also appreciated using visual analysis and distinguished neonates with and without seizure reoccurrence., Conclusion: This distinct alpha activity preceding ictal onset could represent a biomarker of propensity for seizure reoccurrence in neonates. Future studies should be performed to confirm whether quantitative periictal characteristics and electrographic features allow predicting the risks of seizure reoccurrence in HIE neonates and other critically ill patients., (Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.)

As part of a presurgical investigation for a resection of a tumor located in the left temporal brain region, we evaluated pre- and postsurgical language lateralization in a right-handed boy with refractory epilepsy. In this study, we compared functional near infrared spectroscopy (fNIRS) results obtained while the participant performed expressive and receptive language tasks with those obtained using functional magnetic resonance imaging (fMRI). This case study illustrates the potential for NIRS to contribute favorably to the localization of language functions in children with epilepsy and cognitive or behavioral problems and its potential advantages over fMRI in presurgical assessment. Moreover, it suggests that fNIRS is sensitive in localizing an atypical language network or potential brain reorganization related to epilepsy in young patients.

Epilepsy surgery is now widely accepted as an effective therapeutic option for carefully selected children with medically refractory epilepsy. The surgical procedure may cause cognitive deficits or exacerbate existing impairments, but it may also improve cognitive abilities by the restoration of functions located in adjacent or contralateral areas that had been secondarily affected by the epilepsy or the underlying pathology. Compared to adults, better cognitive outcome has been reported in children, a finding probably due to the developing state of the brain, which possesses considerable structural and functional plasticity. More extensive and effective surgery such as hemispherectomy is more commonly used in the pediatric population, and this must also influence surgical outcome. However, studies related to cognitive outcome of epilepsy surgery in children are limited, and controversial results are often reported. In this chapter, we provide a current overview of the literature on cognitive outcomes in children who undergo different types of epilepsy surgery, including focal resections as well as corpus callosotomy and hemispherectomy. Early surgical intervention appears to be a rational option for the treatment of childhood epilepsy since many cognitive deficits are linked to the epileptic process and may disappear when seizures are controlled., (Copyright © 2013 Elsevier B.V. All rights reserved.)

This article describes the development of a best practice statement on postoperative pain management. It examines why this area was considered a priority, the development process, the content of the statement and the recommendations emerging from it.