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Sabbadin C, Marin L, Manso J, Mozzato C, Camozzi V, Andrisani A, Sacchetti C, Mian C, Scaroni C, Guazzarotti L, Ceccato F. Transition from pediatrics to adult health care in girls with turner syndrome. Expert Rev Endocrinol Metab 2024; 19:229-240. [PMID: 38664997 DOI: 10.1080/17446651.2024.2347265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 04/22/2024] [Indexed: 05/12/2024]
Abstract
INTRODUCTION Turner Syndrome is a rare condition secondary to a complete or partial loss of one X chromosome, leading to a wide spectrum of clinical manifestations. Short stature, gonadal dysgenesis, cardiovascular malformations, and dysmorphic features characterize its common clinical picture. AREAS COVERED The main endocrine challenges in adolescent girls with Turner Syndrome are puberty induction (closely intertwined with growth) and fertility preservation. We discuss the most important clinical aspects that should be faced when planning an appropriate and seamless transition for girls with Turner Syndrome. EXPERT OPINION Adolescence is a complex time for girls and boys: the passage to young adulthood is characterized by changes in the social, emotional, and educational environment. Adolescence is the ideal time to encourage the development of independent self-care behaviors and to make the growing girl aware of her health, thus promoting healthy lifestyle behaviors. During adulthood, diet and exercise are of utmost importance to manage some of the common complications that can emerge with aging. All clinicians involved in the multidisciplinary team must consider that transition is more than hormone replacement therapy: transition in a modern Healthcare Provider is a proactive process, shared between pediatric and adult endocrinologists.
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Affiliation(s)
- Chiara Sabbadin
- Endocrine Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
- Endocrine Unit, University-Hospital of Padova, Padova, Italy
| | - Loris Marin
- Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Jacopo Manso
- Endocrine Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
- Endocrine Unit, University-Hospital of Padova, Padova, Italy
- Pediatric Endocrinology and Adolescence Unit, Department of Women's and Children's Health, University-Hospital of Padova, Padova, Italy
| | - Chiara Mozzato
- Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Valentina Camozzi
- Endocrine Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
- Endocrine Unit, University-Hospital of Padova, Padova, Italy
| | - Alessandra Andrisani
- Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Cinzia Sacchetti
- Associazione Famiglie di Soggetti con Deficit dell'Ormone della Crescita e altre Patologie Rare (AFADOC), Vicenza, Italy
| | - Caterina Mian
- Endocrine Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
- Endocrine Unit, University-Hospital of Padova, Padova, Italy
| | - Carla Scaroni
- Endocrine Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
- Endocrine Unit, University-Hospital of Padova, Padova, Italy
| | - Laura Guazzarotti
- Pediatric Endocrinology and Adolescence Unit, Department of Women's and Children's Health, University-Hospital of Padova, Padova, Italy
| | - Filippo Ceccato
- Endocrine Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
- Endocrine Unit, University-Hospital of Padova, Padova, Italy
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Eye Movement Patterns and Approximate Number Sense Task Performance in Williams Syndrome and Down Syndrome: A Developmental Perspective. J Autism Dev Disord 2019; 49:4030-4038. [PMID: 31270701 PMCID: PMC6751143 DOI: 10.1007/s10803-019-04110-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
It has been reported that approximate number sense (ANS) task performance is impaired in individuals with Williams syndrome (WS) and Down syndrome (DS). Research with infants has suggested this impairment is caused by sticky fixation in WS and sustained attention deficits for those with DS. This study examined looking patterns of older children and adults with WS (n = 24) and DS (n = 23) during an ANS task compared to typically developing controls matched for chronological age and those matched for mental age. Results showed that, although there were no group differences, looking patterns changed with chronological age for both the WS and DS groups. Looking behaviour related to ANS performance only in the WS group. Implications for interventions are discussed.
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Hutaff-Lee C, Bennett E, Howell S, Tartaglia N. Clinical developmental, neuropsychological, and social-emotional features of Turner syndrome. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2019; 181:126-134. [PMID: 30767374 DOI: 10.1002/ajmg.c.31687] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 12/11/2022]
Abstract
Individuals with Turner syndrome (TS) are at risk for a constellation of neurocognitive and psychosocial differences, although there is significant individual variability in these features. TS is associated with an increased risk for difficulties with visual-spatial reasoning, visual-spatial memory, attention, executive functioning, motor, and math skills. Additionally, increased rates of social difficulties, anxiety, and depression are observed. There can be significant interplay between all of these factors contributing to the behavioral phenotype. Neuropsychological features and previous research are reviewed. Clinical considerations and recommendations for evaluation and treatment of psychological and behavioral difficulties are provided, including consideration of medical features in TS, as well as therapies, educational supports, and medication treatment. Future research is needed to evaluate effectiveness of different treatments for neuropsychological and psychosocial features of TS, including modification and validation of existing evidence-based treatments and new approaches to care.
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Affiliation(s)
- Christa Hutaff-Lee
- Division of Neurology, Children's Hospital Colorado, Aurora, Colorado, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado.,Department of Pediatrics, eXtraOrdinary Kids Turner Syndrome Clinic, Children's Hospital Colorado, Aurora, Colorado
| | - Elizabeth Bennett
- Department of Pediatrics, eXtraOrdinary Kids Turner Syndrome Clinic, Children's Hospital Colorado, Aurora, Colorado.,Division of Developmental Pediatrics, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - Susan Howell
- Department of Pediatrics, eXtraOrdinary Kids Turner Syndrome Clinic, Children's Hospital Colorado, Aurora, Colorado.,Division of Developmental Pediatrics, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - Nicole Tartaglia
- Department of Pediatrics, eXtraOrdinary Kids Turner Syndrome Clinic, Children's Hospital Colorado, Aurora, Colorado.,Division of Developmental Pediatrics, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
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Abstract
Math skills are necessary for success in the childhood educational and future adult work environment. This article reviews the changing terminology for specific learning disabilities (SLD) in math and describes the emerging genetics and neuroimaging studies that relate to individuals with math disability (MD). It is important to maintain a developmental perspective on MD, as presentation changes with age, instruction, and the different models (educational and medical) of identification. Intervention requires a systematic approach to screening and remediation that has evolved with more evidence-based literature. Newer directions in behavioral, educational and novel interventions are described.
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Affiliation(s)
- Neelkamal Soares
- Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA
| | - Teresa Evans
- Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA
| | - Dilip R Patel
- Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA
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Mazzocco MMM, Chan JYC, Bock AM. Early Executive Function and Mathematics Relations: Correlation Does Not Ensure Concordance. ADVANCES IN CHILD DEVELOPMENT AND BEHAVIOR 2017; 53:289-307. [PMID: 28844247 DOI: 10.1016/bs.acdb.2017.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
In this chapter, we address one potentially overlooked component of the relation between executive function (EF) skills and early mathematics, a relation for which there is widespread empirical support. Evidence for this relation has, thus far, been largely correlational. Here we emphasize that because positive correlations do not guarantee concordance among all members of a sample or population, a small but meaningful number of children may either fare well in mathematics despite poor EF skills, or may have strong EF skills despite weak mathematics skills. We propose that attention to different profiles of discordance for EF and mathematics may help identify individualized learning needs for students at risk for mathematics difficulties and disabilities.
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Affiliation(s)
- Michèle M M Mazzocco
- Institute of Child Development, University of Minnesota, Minneapolis, MN, United States.
| | - Jenny Yun-Chen Chan
- Institute of Child Development, University of Minnesota, Minneapolis, MN, United States
| | - Allison M Bock
- Center for Early Education and Development, University of Minnesota, Minneapolis, MN, United States
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Brankaer C, Ghesquière P, De Wel A, Swillen A, De Smedt B. Numerical magnitude processing impairments in genetic syndromes: a cross-syndrome comparison of Turner and 22q11.2 deletion syndromes. Dev Sci 2016; 20. [PMID: 27748007 DOI: 10.1111/desc.12458] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 04/26/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Carmen Brankaer
- Parenting and Special Education Research Unit; Faculty of Psychology and Educational Sciences; University of Leuven; Belgium
| | - Pol Ghesquière
- Parenting and Special Education Research Unit; Faculty of Psychology and Educational Sciences; University of Leuven; Belgium
| | - Anke De Wel
- Center for Developmental Disorders; University Hospital Gasthuisberg; University of Leuven; Belgium
| | - Ann Swillen
- Center for Human Genetics; Faculty of Medicine; University of Leuven; Belgium
| | - Bert De Smedt
- Parenting and Special Education Research Unit; Faculty of Psychology and Educational Sciences; University of Leuven; Belgium
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Dennis M, Spiegler BJ, Simic N, Sinopoli KJ, Wilkinson A, Yeates KO, Taylor HG, Bigler ED, Fletcher JM. Functional plasticity in childhood brain disorders: when, what, how, and whom to assess. Neuropsychol Rev 2014; 24:389-408. [PMID: 24821533 PMCID: PMC4231018 DOI: 10.1007/s11065-014-9261-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Accepted: 04/17/2014] [Indexed: 12/29/2022]
Abstract
At every point in the lifespan, the brain balances malleable processes representing neural plasticity that promote change with homeostatic processes that promote stability. Whether a child develops typically or with brain injury, his or her neural and behavioral outcome is constructed through transactions between plastic and homeostatic processes and the environment. In clinical research with children in whom the developing brain has been malformed or injured, behavioral outcomes provide an index of the result of plasticity, homeostasis, and environmental transactions. When should we assess outcome in relation to age at brain insult, time since brain insult, and age of the child at testing? What should we measure? Functions involving reacting to the past and predicting the future, as well as social-affective skills, are important. How should we assess outcome? Information from performance variability, direct measures and informants, overt and covert measures, and laboratory and ecological measures should be considered. In whom are we assessing outcome? Assessment should be cognizant of individual differences in gene, socio-economic status (SES), parenting, nutrition, and interpersonal supports, which are moderators that interact with other factors influencing functional outcome.
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Affiliation(s)
- Maureen Dennis
- Department of Psychology, Program in Neurosciences and Mental Health, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada,
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Crocker N, Riley EP, Mattson SN. Visual-spatial abilities relate to mathematics achievement in children with heavy prenatal alcohol exposure. Neuropsychology 2014; 29:108-16. [PMID: 25000323 DOI: 10.1037/neu0000094] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE The current study examined the relationship between mathematics and attention, working memory, and visual memory in children with heavy prenatal alcohol exposure and controls. METHOD Subjects were 56 children (29 AE, 27 CON) who were administered measures of global mathematics achievement (WRAT-3 Arithmetic & WISC-III Written Arithmetic), attention, (WISC-III Digit Span forward and Spatial Span forward), working memory (WISC-III Digit Span backward and Spatial Span backward), and visual memory (CANTAB Spatial Recognition Memory and Pattern Recognition Memory). The contribution of cognitive domains to mathematics achievement was analyzed using linear regression techniques. Attention, working memory, and visual memory data were entered together on Step 1 followed by group on Step 2, and the interaction terms on Step 3. RESULTS Model 1 accounted for a significant amount of variance in both mathematics achievement measures; however, model fit improved with the addition of group on Step 2. Significant predictors of mathematics achievement were Spatial Span forward and backward and Spatial Recognition Memory. CONCLUSIONS These findings suggest that deficits in spatial processing may be related to math impairments seen in FASD. In addition, prenatal alcohol exposure was associated with deficits in mathematics achievement, above and beyond the contribution of general cognitive abilities.
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Affiliation(s)
- Nicole Crocker
- Center for Behavioral Teratology, Department of Psychology, San Diego State University
| | - Edward P Riley
- Center for Behavioral Teratology, Department of Psychology, San Diego State University
| | - Sarah N Mattson
- Center for Behavioral Teratology, Department of Psychology, San Diego State University
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Abstract
This article presents a critical review of the term and concept of nonverbal learning disability (NLD). After a brief historical introduction, the article focuses on the apparent rarity of NLD; the hypothesis of the frequent co-occurrence of emotional disorder, depression, and suicide in NLD; the white matter hypothesis as an explanation of the origin of NLD; and the question of NLD as part of a variety of other disorders. It is argued that NLD presents a broad hypothesis, but that there is little evidence to support its use in clinical practice.
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Affiliation(s)
- Otfried Spreen
- Department of Psychology, University of Victoria, Victoria , B.C., Canada.
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De Smedt B, Swillen A, Verschaffel L, Ghesquière P. Mathematical learning disabilities in children with 22q11.2 deletion syndrome: a review. ACTA ACUST UNITED AC 2009; 15:4-10. [PMID: 19213009 DOI: 10.1002/ddrr.44] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Mathematical learning disabilities (MLD) occur frequently in children with specific genetic disorders, like Turner syndrome, fragile X syndrome and neurofibromatosis. This review focuses on MLD in children with chromosome 22q11.2 deletion syndrome (22q11DS). This syndrome is the most common known microdeletion syndrome with a prevalence of at least 1:4000 to 1:6000 live births. Although the clinical presentation of 22q11DS is quite variable, its major characteristics include velopharyngeal abnormalities, congenital cardiac anomalies, mild facial dysmorphism and learning difficulties. Children with 22q11DS show considerable difficulties in mathematics, despite relatively normal reading performance. While fact retrieval seems to be preserved, impairments in procedural calculation and word problem solving are particularly prominent. Children with 22q11DS also have substantial difficulties in understanding and representing numerical quantities, possibly related to poor visuospatial attention, which all might stem from their underlying abnormalities in the inferior parietal cortex. This review ends with a discussion on how research on genetic disorders might aid our understanding of MLD in general.
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Affiliation(s)
- Bert De Smedt
- Centre for Parenting, Child Welfare and Disabilities, Katholieke Universiteit Leuven, Leuven, Belgium.
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