Cynthia A. Riccio - Pediatric Neurotoxicology: Academic and Psychosocial Outcomes
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This book focuses on children and the impact of neurotoxins on the developing brain to guide the practice of psychologists working with children in clinical and school settings. Each chapter covers a distinct neurotoxin or group of neurotoxins, with particular emphasis on the impact of the neurotoxin exposure on the developing brain and long-term cognitive and psychosocial outcomes. This is more complex than studying neurotoxins with adults because of the rapid development occurring in the childs brain. Further, children are more susceptible than adults to the effects of neurotoxins due to their developmental status. Many of the effects discussed in this volume occur in utero, thus setting the stage for an altered developmental trajectory.
Cynthia A. Riccio: author's other books
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Cynthia A. Riccio
Ellen M. Chiocca
Ashley Wazana
Amritpal Singh Saroya
Christopher E. Fundakowski
Victoria Hall Moran
James L. McClelland
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Springer International Publishing Switzerland 2016
Cynthia A. Riccio and Jeremy R. Sullivan (eds.) Pediatric Neurotoxicology Specialty Topics in Pediatric Neuropsychology 10.1007/978-3-319-32358-9_11. Neurotoxins and Neurodevelopment
Cynthia A. Riccio 1
(1)
Department of Educational Psychology and Institute of Neuroscience, Texas A&M University, 4225 TAMU, College Station, TX 77843-4225, USA
(2)
Department of Educational Psychology, Texas A&M University, 4225 TAMU, College Station, TX 77843-4225, USA
(3)
Department of Educational Psychology, University of Texas at San Antonio, 501 W. Cesar E. Chavez Blvd., San Antonio, TX 78207, USA
Cynthia A. Riccio (Corresponding author)
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Morgan B. Drake
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Jeremy R. Sullivan
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Keywords
Neurotoxins Neurodevelopment Prevention Identification InterventionDevelopmental perspectives for understanding how neurological factors relate to overall functioning and behavior across the life span are imperative. The leading cause of neonatal mortality is birth defects (McKenzie et al., ). Therefore, those who work with children, expectant mothers, or families should be knowledgeable about neurotoxins and their effects on child development in order to enhance prevention efforts, improve diagnosis, and formulate and implement research-based interventions. In each of the ensuing chapters the research specific to a class of neurotoxins is summarized, with a focus on the potential effects on neurocognitive and neurobehavioral domains.
What Are Neurotoxins?
Neurotoxins are harmful substances that damage or destroy neural tissue (Costa, Aschner, Vitalone, Syversen, & Porat-Soldin, ).
Exposure to neurotoxins may be in the form of direct interaction, as in the case of a child who chews on a toy that has been finished with lead paint or was inadvertently contaminated with pesticides. Some research indicates that the majority of exposure to neurotoxic chemicals such as lead occurs postnatally, while most of the exposure to mercury and PCBs occur prenatally. It is important to note, however, that exposure has been found to occur across the life span and can have detrimental consequences to neurodevelopment and associated behaviors (Winneke, ).
Environmental toxins are not the only teratogens that can have an impact on neurodevelopmental functioning. From the time of conception, the developing fetal brain is exposed to the chemical and electrical environment of the mother. Studies consistently indicate that substance use and consumption of certain medications by pregnant women place their unborn children at risk. Effects on an unborn child are indirect and occur through maternal contact or ingestion of the toxin, including prescribed medications. Medications may be prescribed to address concerns with the maintenance of the pregnancy (e.g., diethylstilbestrol [DES], thalidomide) or to address the medical status of the mother (e.g., seizure control, diabetes). A wide range of medications have been identified as disturbing the normal developmental process in utero (Pillard et al., ). As detailed in these chapters, children who have been exposed to various recreational drugs by their mothers demonstrate increased risk for poor academic and social-emotional outcomes.
Mechanisms of Impact on the Developing Child
Any disruption in the extended process of central nervous system development can affect structures or functions of the nervous system, with associated negative consequences for later developing functions and behaviors (Gilbert et al., ). Even for in utero exposure, timing is important.
In Utero Exposure
Effects on the fetus are likely associated with neuronal rapid cell proliferation, synaptic pruning, suppression, and neuronal cell death (i.e., apoptosis) as a result of exposure (Gilbert et al., ).
Childhood and Beyond
In addition to in utero exposure to neurotoxins, children and adults potentially are exposed to neurotoxins in the environment across the life span. Synaptic development, myelination, and pruning occur throughout the life span, but are especially prevalent in childhood and adolescence (Rice & Barone, ). While there is minimal understanding of the long term effects of exposure, there is research to suggest impact on children, as well as adults.
Impact and Diagnostic Considerations
It is well established that various mechanisms can affect neural development negatively, and, as a result, alter the developmental trajectory of specific abilities, processes, and functions. Development of the brain and central nervous system starts in utero and continues through adolescence or early adulthood (Archer, Kostrzewa, Beninger, & Palomo, ).
As already noted, different manifestations of neurodevelopmental problems are dependent on the time in development when exposure occurs (Archer et al., ). This importance of timing applies regardless of the neurotoxin.
The effects of neurotoxin exposure can be diffuse and affect all areas of function as well as global neurocognitive and neurobehavioral outcomes. Alternatively, the effects may be more focal and affect only specific functional systems and outcomes. For example, exposure to toxic chemicals and environmental agents has been linked to decreased intelligence, psychomotor and language deficits, inattention, aggression, and hyperactivity (Henn et al., ).
Moderating Factors
Maturation theory posits that functional asymmetry of the cerebral hemispheres develops with age, beginning at conception, and is influenced by environmental events and stimulation (Boles, Barth, & Merrill, ). As such, overall functioning is not only the result of the integrity of brain function, but that brain function is influenced by (and influences) environmental/social contexts. Hence, the context in which the individual functions is of importance.
Genetic Contribution
Genetic contributions may serve as a predisposition or diathesis that can be altered or modified for better or worse by environmental stimulation or exposure (Asbury, Wachs, & Plomin, ). Similar to the interactions seen between neurotoxins and environmental factors, genes can shape the likelihood and expression of neural damage.
Stimulation
While neuropsychology embraces the idea that the integrity of the neurological system determines behavior, there is evidence that environmental factors, including failure to stimulate particular areas of the brain, will impact functioning (Zillmer et al., ).
Additionally, environmental factors can increase or diminish the scope of the damages caused by neurotoxin exposure (Cory-Slechta, ). Overall, whether neurotoxin exposure occurs or not, stress and environmental factors play a large role in the development of a variety of cognitive and behavioral disorders. Thus, two different children exposed to the same neurotoxin may experience divergent outcomes based on the interactions among these genetic and environmental factors.
Considerations for Prevention and Intervention
When introduced prenatally, exposure may be time limited, yet these substances can have both indirect and direct effects on children across their lifetime. At the same time, there is continued risk across the life span of exposure. Research findings have led to some changes in environmental policy as well as health care. For example, many pesticides are no longer considered acceptable and modifications to air exchange systems are being made. With increased knowledge of the effects of drugs on the developing fetus, there is considerable caution exercised with regard to the use of medications of any type by pregnant women (Bercovici, ), as well as decreased exposure to environmental toxins of the mother.
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