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9/25/2018  |   12:00 PM - 12:30 PM   |  Diamond II Ballroom

An Emerging Picture: Behavioral Presentation of Children with Congenital Cytomegalovirus and the Impact of Hearing Loss

BACKGROUND. Children born with congenital cytomegalovirus (CMV) are at risk for developing sequelae including microcephaly, seizures, sensorineural hearing loss (SNHL), motor and visual defects, and symptoms indicating involvement of the reticuloendothelial system (i.e., anemia, hyperbilirubinemia, and hepatosplenomegaly). Despite extensive medical literature documenting physical involvement, behavioral and psychiatric research associated with congenital CMV infection in children who are asymptomatic and symptomatic at birth remains limited. It remains unclear how children with congenital CMV, with and without hearing loss, will present behaviorally and if they are at risk for clinically concerning behaviors. METHODS. The current study examined behavioral and audiological data previously collected from participants involved in The Houston Longitudinal CMV Study through Baylor College of Medicine, using the Behavior Assessment System for Children (BASC-2). RESULTS. Children with symptomatic congenital CMV were significantly more likely to have parent rated scores in the at-risk and clinically significant (i.e., clinically concerning) range on the BASC-2 than the normative group in the domains of Activities of Daily Living (ADLs; p=0.042) and Functional Communication (p=0.001). Additionally, a large percentage of the symptomatic children (29%) had scores in the significant range on the Hyperactivity, Withdrawal, Attention Problems, and Leadership scales. Asymptomatic children had significantly more scores rated in the clinically concerning range on the Attention Problems (p=0.004), Adaptability (p<0.000), Social Skills (p=0.024), and ADLs (p=0.005) scales than children in the normative group on the BASC-2. No significant differences were found in the frequency of the Attention Problems or Social Skills clinically concerning scores among asymptomatic children between those with and without hearing loss. CONCLUSIONS. Children with congenital CMV are at risk of behavioral problems, regardless of symptom presentation at birth and audiological status. Results of the current study supports the medical necessity of universal CMV screening at birth.

  • Obtain a working knowledge of previous behavioral and psychiatric research of children and adolescents with congenital CMV
  • Identify clinically concerning behaviors children with congenital CMV may be at risk of presenting as indicated in the current study
  • Understand the characteristics of hearing loss among children with congenital CMV in the current study and its impact on behavior

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Garry Wright (Primary Presenter,Author), garry.wright@gallaudet.edu;
Garry Wright is a doctoral student in clinical psychology at Gallaudet University. He completed practicum training at Gallaudet University's Counseling and Psychological Services and Children's National Medical Center in Washington, D.C., and Kennedy Krieger Institute in Baltimore, Maryland. Mr. Wright holds a master's degree in counseling psychology from the University of Kentucky where he completed an internship at the Kentucky School for the Deaf. He is currently completing his doctoral internship at Nationwide Children's Hospital in Columbus, Ohio. His clinical and research interests include investigating neurocognitive and behavioral outcomes in children with congenital cytomegalovirus (CMV), psychological assessment of individuals with hearing and/or vision loss, and working with children with intellectual and developmental disabilities and their families. Mr. Wright is fluent in American Sign Language (ASL).

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Donna Morere (Author,Co-Author), donna.morere@gallaudet.edu;
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Regina Nuzzo (Author,Co-Author), regina.nuzzo@gallaudet.edu;
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Jerry Miller (Co-Author), jamiller@texaschildrens.org;
Dr. Miller is an epidemiologist with expertise in infectious disease epidemiology, cancer and biostatistics. He has been active in public health and epidemiology research areas including stomach cancer, hepatitis epidemiology, public health emergency preparedness, and outcomes of congenital cytomegalovirus infection. His earlier research showed that the stomach bacterium Helicobacter pylori was directly mutagenic, supporting its classification as a causative agent for stomach cancer. He and colleagues have examined the effectiveness of prevention and control programs for hepatitis and breast cancer in underserved populations. He has also researched the knowledge and training needs of health workers in bioterrorism-related outbreaks. Dr. Miller has contributed to the BBC and ABC news on health matters, taught statistics and global health to nursing students and has authored or co-authored over 10 publications in health and epidemiology. He lives with his wife in Houston, Texas where he enjoys the science of cooking.

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Gail Demmler-Harrison (Author,Co-Author), gdemmler@bcm.edu;
Professor of Pediatrics at Baylor College of Medicine with over 30 years experience in the research and clinical management of infants with congenital CMV infection; PI of the HOuston Longitudinal Congenital CMV Followup Study; co author or author of numerous publicaitons, chapters and presenter at national and international meetings

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