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Rosenblum S, Sharfi K, Elimelech OC, Regev S, Grinblat N. Predicting emotional consequences of disorganization among adults with neurodevelopmental disorders: a structural equation model. Disabil Rehabil 2024:1-11. [PMID: 39119890 DOI: 10.1080/09638288.2024.2385733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 07/21/2024] [Accepted: 07/24/2024] [Indexed: 08/10/2024]
Abstract
PURPOSE Previous studies exhibited differences in sensory processing, motor coordination, metacognitive executive functions (EF-MI), and sleep quality among adults with neurodevelopmental disorders (NDD). This study aims to find relationships between those abilities and organization-in-time, focusing on emotional responses after decreased organization abilities. MATERIALS AND METHODS This is a secondary data analysis of a larger sample from three previous studies conducted in one laboratory. Data were collected from 290 adults; 149 with NDD and 141 sex- and age- (20-50 years) matched controls completed the Adolescent/Adult Sensory Profile, Adult Developmental Coordination Disorder, Adults Behavioral Rating Inventory of Executive Functions, Mini Sleep, and Time Organization and Participation questionnaires. Structural equation model (SEM) analysed relationships and variable prediction. RESULTS Significant between-group differences were found for all variables; SEM indicated similar paths in both groups. Sensory processing affected EF-MI and sleep quality and significantly correlated with motor coordination, affecting EF-MI; EF-MI affected organization-in-time. Sleep quality significantly affected organization-in-time, affecting emotional responses. CONCLUSIONS Sensory, motor, EF, and sleep differences were associated with decreased organization-in-time abilities of adults with NDD, adversely affecting their emotional well-being. Early detection of such differences and targeted interventions may improve daily functioning and life quality and prevent negative emotional implications.
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Affiliation(s)
- Sara Rosenblum
- The Laboratory of Complex Human Activity and Participation (CHAP), Department of Occupational Therapy, University of Haifa, Haifa, Israel
| | - Kineret Sharfi
- Department of Occupational Therapy, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ortal Cohen Elimelech
- The Laboratory of Complex Human Activity and Participation (CHAP), Department of Occupational Therapy, University of Haifa, Haifa, Israel
| | - Sivan Regev
- Department of Occupational Therapy, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Department of Health Policy and Management, Israel Implementation Science and Policy Engagement Centre (IS-PEC), Guilford Glazer Faculty of Business and Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Nufar Grinblat
- The Laboratory of Complex Human Activity and Participation (CHAP), Department of Occupational Therapy, University of Haifa, Haifa, Israel
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Casalini C, Pecini C. Telerehabilitation of Developmental Dyslexia: Critical Considerations on Intervention Methods and Their Effectiveness. Brain Sci 2024; 14:793. [PMID: 39199485 PMCID: PMC11352316 DOI: 10.3390/brainsci14080793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 07/26/2024] [Accepted: 07/26/2024] [Indexed: 09/01/2024] Open
Abstract
Paper-based or IT tools can be used in telerehabilitation mode to improve the skills of children with developmental dyslexia (DD), seeking to increase reading speed and reduce errors. Telerehabilitation is the provision of remote treatments in which the patient works autonomously in a familiar environment under the remote monitoring, through telecommunication means, of an expert operator. Through telerehabilitation, children with DD can receive treatments outside the specialist clinic, at home or school, via internet connections, and through advanced technological platforms. These procedures allow adequate communication with the family, intensity of treatment, self-adaptivity of exercises, and child engagement; these factors are crucial for a high intervention efficacy. Recent studies have supported the effectiveness of the telerehabilitation of reading in children with DD, with some studies reporting no differences in efficacy between remote and in-person methods. Nevertheless, many points remain to be clarified about the procedures and methods required by telerehabilitation, the variables linked to its effectiveness (e.g., the impact of the intensity of the training and the neuropsychological profile of the child), and the comparative validity of different tele-treatment paths. These aspects are discussed in the present paper.
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Affiliation(s)
- Claudia Casalini
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Pisa, Italy;
| | - Chiara Pecini
- Department of Education, Languages, Intercultures, Literatures and Psychology, University of Florence, 50121 Firenze, Italy
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Chu JTW, Wilson H, Cai CZ, McCormack JC, Newcombe D, Bullen C. Technologies for Supporting Individuals and Caregivers Living With Fetal Alcohol Spectrum Disorder: Scoping Review. JMIR Ment Health 2024; 11:e51074. [PMID: 38994826 PMCID: PMC11259581 DOI: 10.2196/51074] [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: 07/20/2023] [Revised: 04/14/2024] [Accepted: 04/15/2024] [Indexed: 07/13/2024] Open
Abstract
Background Fetal alcohol spectrum disorder (FASD) is a common developmental disability that requires lifelong and ongoing support but is often difficult to find due to the lack of trained professionals, funding, and support available. Technology could provide cost-effective, accessible, and effective support to those living with FASD and their caregivers. Objective In this review, we aimed to explore the use of technology available for supporting people living with FASD and their caregivers. Methods We conducted a scoping review to identify studies that included technology for people with FASD or their caregivers; focused on FASD; used an empirical study design; were published since 2005; and used technology for assessment, diagnosis, monitoring, or support for people with FASD. We searched MEDLINE, Web of Science, Scopus, Embase, APA PsycINFO, ACM Digital Library, JMIR Publications journals, the Cochrane Library, EBSCOhost, IEEE, study references, and gray literature to find studies. Searches were conducted in November 2022 and updated in January 2024. Two reviewers (CZC and HW) independently completed study selection and data extraction. Results In total, 17 studies exploring technology available for people with FASD showed that technology could be effective at teaching skills, supporting caregivers, and helping people with FASD develop skills. Conclusions Technology could provide support for people affected by FASD; however, currently there is limited technology available, and the potential benefits are largely unexplored.
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Affiliation(s)
- Joanna Ting Wai Chu
- National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand
- Centre for Arts and Social Transformation, Faculty of Education and Social Work, The University of Auckland, Auckland, New Zealand
- Centres for Addiction Research, Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- Social and Community Health, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Holly Wilson
- National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand
- Social and Community Health, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Cynthia Zhiyin Cai
- National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand
- Social and Community Health, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Jessica C McCormack
- National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand
- Sensory Neuroscience Lab, Food Science, University of Otago, Dunedin, New Zealand
| | - David Newcombe
- Centres for Addiction Research, Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- Social and Community Health, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Chris Bullen
- National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand
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Bellato A, Hall CL, Groom MJ, Simonoff E, Thapar A, Hollis C, Cortese S. Practitioner Review: Clinical utility of the QbTest for the assessment and diagnosis of attention-deficit/hyperactivity disorder - a systematic review and meta-analysis. J Child Psychol Psychiatry 2024; 65:845-861. [PMID: 37800347 DOI: 10.1111/jcpp.13901] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Several computerised cognitive tests (e.g. continuous performance test) have been developed to support the clinical assessment of attention-deficit/hyperactivity disorder (ADHD). Here, we appraised the evidence-base underpinning the use of one of these tests - the QbTest - in clinical practice, by conducting a systematic review and meta-analysis investigating its accuracy and clinical utility. METHODS Based on a preregistered protocol (CRD42022377671), we searched PubMed, Medline, Ovid Embase, APA PsycINFO and Web of Science on 15th August 2022, with no language/type of document restrictions. We included studies reporting accuracy measures (e.g. sensitivity, specificity, or Area under the Receiver Operating Characteristics Curve, AUC) for QbTest in discriminating between people with and without DSM/ICD ADHD diagnosis. Risk of bias was assessed with the Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS-2). A generic inverse variance meta-analysis was conducted on AUC scores. Pooled sensitivity and specificity were calculated using a random-effects bivariate model in R. RESULTS We included 15 studies (2,058 participants; 48.6% with ADHD). QbTest Total scores showed acceptable, rather than good, sensitivity (0.78 [95% confidence interval: 0.69; 0.85]) and specificity (0.70 [0.57; 0.81]), while subscales showed low-to-moderate sensitivity (ranging from 0.48 [0.35; 0.61] to 0.65 [0.52; 0.75]) and moderate-to-good specificity (from 0.65 [0.48; 0.78] to 0.83 [0.60; 0.94]). Pooled AUC scores suggested moderate-to-acceptable discriminative ability (Q-Total: 0.72 [0.57; 0.87]; Q-Activity: 0.67 [0.58; 0.77); Q-Inattention: 0.66 [0.59; 0.72]; Q-Impulsivity: 0.59 [0.53; 0.64]). CONCLUSIONS When used on their own, QbTest scores available to clinicians are not sufficiently accurate in discriminating between ADHD and non-ADHD clinical cases. Therefore, the QbTest should not be used as stand-alone screening or diagnostic tool, or as a triage system for accepting individuals on the waiting-list for clinical services. However, when used as an adjunct to support a full clinical assessment, QbTest can produce efficiencies in the assessment pathway and reduce the time to diagnosis.
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Affiliation(s)
- Alessio Bellato
- School of Psychology, University of Nottingham, Nottingham, Malaysia
- Mind & Neurodevelopment (MiND) Research Cluster, University of Nottingham, Nottingham, Malaysia
| | - Charlotte L Hall
- NIHR MindTech MedTech Co-operative, Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Institute of Mental Health, University of Nottingham, Nottingham, UK
- Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Madeleine J Groom
- NIHR MindTech MedTech Co-operative, Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Institute of Mental Health, University of Nottingham, Nottingham, UK
- Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Emily Simonoff
- Department of Child and Adolescent Psychiatry, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Anita Thapar
- Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Cardiff University School of Medicine, Cardiff, UK
| | - Chris Hollis
- NIHR MindTech MedTech Co-operative, Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Institute of Mental Health, University of Nottingham, Nottingham, UK
- Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Samuele Cortese
- Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- Solent NHS Trust, Southampton, UK
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK
- Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, NY, USA
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Toma MV, Turcu CE, Turcu CO, Vlad S, Tiliute DE, Pascu P. Extended Reality-Based Mobile App Solutions for the Therapy of Children With Autism Spectrum Disorders: Systematic Literature Review. JMIR Serious Games 2024; 12:e49906. [PMID: 38373032 PMCID: PMC10913001 DOI: 10.2196/49906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/30/2023] [Accepted: 12/21/2023] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND The increasing prevalence of autism spectrum disorder (ASD) has driven research interest on the therapy of individuals with autism, especially children, as early diagnosis and appropriate treatment can lead to improvement in the condition. With the widespread availability of virtual reality, augmented reality (AR), and mixed reality technologies to the public and the increasing popularity of mobile devices, the interest in the use of applications and technologies to provide support for the therapy of children with autism is growing. OBJECTIVE This study aims to describe the literature on the potential of virtual reality, AR, and mixed reality technologies in the context of therapy for children with ASD. We propose to investigate and analyze the temporal distribution of relevant papers, identify the target audience for studies related to extended reality apps in ASD therapy, examine the technologies used in the development of these apps, assess the skills targeted for improvement in primary studies, explore the purposes of the proposed solutions, and summarize the results obtained from their application. METHODS For the systematic literature review, 6 research questions were defined in the first phase, after which 5 international databases (Web of Science, Scopus, ScienceDirect, IEEE Xplore Digital Library, and ACM Digital Library) were searched using specific search strings. Results were centralized, filtered, and processed applying eligibility criteria and using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The results were refined using a technical and IT-oriented approach. The quality criteria assessed whether the research addressed ASDs, focused on children's therapy, involved targeted technologies, deployed solutions on mobile devices, and produced results relevant to our study. RESULTS In the first step, 179 publications were identified in Zotero reference manager software (Corporation for Digital Scholarship). After excluding articles that did not meet the eligibility or quality assessment criteria, 28 publications were finalized. The analysis revealed an increase in publications related to apps for children with autism starting in 2015 and peaking in 2019. Most studies (22/28, 79%) focused on mobile AR solutions for Android devices, which were developed using the Unity 3D platform and the Vuforia engine. Although 68% (19/28) of these apps were tested with children, 32% (9/28) were tested exclusively by developers. More than half (15/28, 54%) of the studies used interviews as an evaluation method, yielding mostly favorable although preliminary results, indicating the need for more extensive testing. CONCLUSIONS The findings reported in the studies highlight the fact that these technologies are appropriate for the therapy of children with ASD. Several studies showed a distinct trend toward the use of AR technology as an educational tool for people with ASD. This trend entails multidisciplinary cooperation and an integrated research approach, with an emphasis on comprehensive empirical evaluations and technology ethics.
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Affiliation(s)
- Marian-Vladut Toma
- Faculty of Economics, Administration and Business, "Stefan cel Mare" University of Suceava, Suceava, Romania
| | - Cristina Elena Turcu
- Faculty of Electrical Engineering and Computer Science, University of Suceava, Suceava, Romania
| | - Corneliu Octavian Turcu
- Faculty of Electrical Engineering and Computer Science, University of Suceava, Suceava, Romania
| | - Sorin Vlad
- Faculty of Economics, Administration and Business, "Stefan cel Mare" University of Suceava, Suceava, Romania
| | - Doru Eugen Tiliute
- Faculty of Economics, Administration and Business, "Stefan cel Mare" University of Suceava, Suceava, Romania
| | - Paul Pascu
- Faculty of Economics, Administration and Business, "Stefan cel Mare" University of Suceava, Suceava, Romania
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Vonthron F, Yuen A, Pellerin H, Cohen D, Grossard C. A Serious Game to Train Rhythmic Abilities in Children With Dyslexia: Feasibility and Usability Study. JMIR Serious Games 2024; 12:e42733. [PMID: 37830510 PMCID: PMC10811594 DOI: 10.2196/42733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/26/2023] [Accepted: 10/09/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Rhythm perception and production are related to phonological awareness and reading performance, and rhythmic deficits have been reported in dyslexia. In addition, rhythm-based interventions can improve cognitive function, and there is consistent evidence suggesting that they are an efficient tool for training reading skills in dyslexia. OBJECTIVE This paper describes a rhythmic training protocol for children with dyslexia provided through a serious game (SG) called Mila-Learn and the methodology used to test its usability. METHODS We computed Mila-Learn, an SG that makes training remotely accessible and consistently reproducible and follows an educative agenda using Unity (Unity Technologies). The SG's development was informed by 2 studies conducted during the French COVID-19 lockdowns. Study 1 was a feasibility study evaluating the autonomous use of Mila-Learn with 2500 children with reading deficits. Data were analyzed from a subsample of 525 children who spontaneously played at least 15 (median 42) games. Study 2, following the same real-life setting as study 1, evaluated the usability of an enhanced version of Mila-Learn over 6 months in a sample of 3337 children. The analysis was carried out in 98 children with available diagnoses. RESULTS Benefiting from study 1 feedback, we improved Mila-Learn to enhance motivation and learning by adding specific features, including customization, storylines, humor, and increasing difficulty. Linear mixed models showed that performance improved over time. The scores were better for older children (P<.001), children with attention-deficit/hyperactivity disorder (P<.001), and children with dyslexia (P<.001). Performance improved significantly faster in children with attention-deficit/hyperactivity disorder (β=.06; t3754=3.91; P<.001) and slower in children with dyslexia (β=-.06; t3816=-5.08; P<.001). CONCLUSIONS Given these encouraging results, future work will focus on the clinical evaluation of Mila-Learn through a large double-blind randomized controlled trial comparing Mila-Learn and a placebo game.
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Affiliation(s)
| | | | - Hugues Pellerin
- Service de Psychiatrie de l'Enfant et de l'Adolescent, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - David Cohen
- Service de Psychiatrie de l'Enfant et de l'Adolescent, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
- Institut des Systèmes Intelligents et Robotiques (ISIR, CNRS UMR7222), Sorbonne Université, Paris, France
| | - Charline Grossard
- Service de Psychiatrie de l'Enfant et de l'Adolescent, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
- Institut des Systèmes Intelligents et Robotiques (ISIR, CNRS UMR7222), Sorbonne Université, Paris, France
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7
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Montoya-Rodríguez MM, de Souza Franco V, Tomás Llerena C, Molina Cobos FJ, Pizzarossa S, García AC, Martínez-Valderrey V. Virtual reality and augmented reality as strategies for teaching social skills to individuals with intellectual disability: A systematic review. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023; 27:1062-1084. [PMID: 35420906 DOI: 10.1177/17446295221089147] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Virtual reality (VR) and augmented reality (AR) programs have proliferated significantly in recent years and they are finding their way into different educational and therapeutic purposes. This systematic review aims at analyzing the virtual reality and augmented reality programs designed to promote the development of social skills in individuals with intellectual disability. Searches were carried out in the Scopus, Science Direct, Springer and Web of Science databases in the period from 2005 to 2020. A total of six articles met the inclusion criteria. A descriptive data analysis was performed. The results show that the clinical profile of the individuals who participated in the interventions is diverse. It can be concluded that there is some scientific evidence that points to the usefulness of VR and AR in the development of intervention programs to improve the social skills of individuals diagnosed with developmental deficits. However, it is necessary to acknowledge methodological limitations such as the lack of control groups, follow-up measures and of generalization of the results.
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Gustafsson U, Hansen M. QbTest for Monitoring Medication Treatment Response in ADHD: A Systematic Review. Clin Pract Epidemiol Ment Health 2023; 19:e17450179276630. [PMID: 38164455 PMCID: PMC10758132 DOI: 10.2174/0117450179276630231030093814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/27/2023] [Accepted: 10/10/2023] [Indexed: 01/03/2024]
Abstract
Introduction Attention deficit hyperactivity disorder (ADHD) is considered one of the most common neurodevelopmental disorders in childhood and adolescence. Pharmacological treatment plays an important part in the therapy of the disorder and verifying the effectiveness of ADHD medication is essential throughout the course of treatment. QbTest is a computerized test, for which intended use is to provide healthcare professionals with objective measurements of hyperactivity, impulsivity, and inattention to aid in the clinical assessment of ADHD and the evaluation of treatment interventions. Methods A systematic review of relevant articles was conducted for which QbTest was used for monitoring medication treatment response in ADHD. Literature published between 2004 and 2023 was appraised. Results A total of 15 studies were included in the review. Thirteen articles involved subjects diagnosed with ADHD and two studies that were related to the disorder, which evaluated QbTest in medication treatment response. Changes in QbTest data such as Q-scores, effect size, or improvement/deterioration of QbTest variables were evaluated. A clinically relevant decrease in QbTest Q-scores was found in the majority of the studies when treated with any type of ADHD medication in therapeutic doses, both in comparison to placebo and when compared from baseline to endpoint treatment. Conclusion QbTest can distinguish pharmacological treatment effects within hours of pharmacological titration and can be used for monitoring of long-term treatment of ADHD. A need for optimization and individualization of medication treatment response could be addressed with access to objective measures in ADHD management.
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Affiliation(s)
- Urban Gustafsson
- Qbtech AB, Medical Department, Cardellgatan 1, 11436 Stockholm, Sweden
| | - Mikkel Hansen
- Qbtech AB, Medical Department, Cardellgatan 1, 11436 Stockholm, Sweden
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Bertacchini F, Demarco F, Scuro C, Pantano P, Bilotta E. A social robot connected with chatGPT to improve cognitive functioning in ASD subjects. Front Psychol 2023; 14:1232177. [PMID: 37868599 PMCID: PMC10585023 DOI: 10.3389/fpsyg.2023.1232177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/11/2023] [Indexed: 10/24/2023] Open
Abstract
Neurodevelopmental Disorders (NDDs) represent a significant healthcare and economic burden for families and society. Technology, including AI and digital technologies, offers potential solutions for the assessment, monitoring, and treatment of NDDs. However, further research is needed to determine the effectiveness, feasibility, and acceptability of these technologies in NDDs, and to address the challenges associated with their implementation. In this work, we present the application of social robotics using a Pepper robot connected to the OpenAI system (Chat-GPT) for real-time dialogue initiation with the robot. After describing the general architecture of the system, we present two possible simulated interaction scenarios of a subject with Autism Spectrum Disorder in two different situations. Limitations and future implementations are also provided to provide an overview of the potential developments of interconnected systems that could greatly contribute to technological advancements for Neurodevelopmental Disorders (NDD).
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Affiliation(s)
- Francesca Bertacchini
- Department of Mechanical, Energy and Management Engineering, University of Calabria, Rende, Italy
- Laboratory of Cognitive Psychology and Mathematical Modelling, University of Calabria, Rende, Italy
| | - Francesco Demarco
- Laboratory of Cognitive Psychology and Mathematical Modelling, University of Calabria, Rende, Italy
- Department of Physics, University of Calabria, Rende, Italy
| | - Carmelo Scuro
- Laboratory of Cognitive Psychology and Mathematical Modelling, University of Calabria, Rende, Italy
- Department of Physics, University of Calabria, Rende, Italy
| | - Pietro Pantano
- Laboratory of Cognitive Psychology and Mathematical Modelling, University of Calabria, Rende, Italy
- Department of Physics, University of Calabria, Rende, Italy
| | - Eleonora Bilotta
- Laboratory of Cognitive Psychology and Mathematical Modelling, University of Calabria, Rende, Italy
- Department of Physics, University of Calabria, Rende, Italy
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10
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Stevanovic D, Nasic S, Doric A, Wentz E, Knez R. The Structure and Diagnostic Accuracy of the QbTest in Pediatric ADHD: A Retrospective Clinical Study. J Atten Disord 2023; 27:1296-1305. [PMID: 37199293 DOI: 10.1177/10870547231174035] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
OBJECTIVE The QbTest that combines a continuous performance task (CPT) with a motion-tracking system may help identify attention deficit hyperactivity disorder (ADHD). This study examined the structure and diagnostic ability of the QbTest in children and adolescents. METHOD Retrospective data from 1,274 children and adolescents were analyzed. The study assessed data on a principal component analysis (PCA), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). RESULTS The QbActivity component included the variables micro-events, distance, area, and time active; the QbImpulsivity included normalized commissions and commissions (anticipatory errors were added in a version for 6-12-year-olds only); and the QbInattention included omissions, reaction time, and reaction time variation. Sensitivity ranged between 22% and 50%, specificity 79% and 96%, PPVs 40% and 95%, and NPVs 24% and 66%. CONCLUSION The structure of the QbTest with three cardinal parameters and nine/ten CPT and motion analysis variables was supported. The diagnostic accuracy was found to be poor to moderate. Given that this is a retrospective study, the interpretation of diagnostic accuracy should be considered within this context.
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Affiliation(s)
- Dejan Stevanovic
- Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia
- University of Gothenburg, Sweden
| | - Salmir Nasic
- University of Gothenburg, Sweden
- Skaraborgs Hospital, Skövde, Sweden
| | - Ana Doric
- University of Rijeka, Croatia
- IntechOpen Limited, Rijeka, Croatia
| | | | - Rajna Knez
- University of Gothenburg, Sweden
- Skaraborgs Hospital, Skövde, Sweden
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11
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Liu X, Zhao W, Qi Q, Luo X. A Survey on Autism Care, Diagnosis, and Intervention Based on Mobile Apps Focusing on Usability and Software Design. SENSORS (BASEL, SWITZERLAND) 2023; 23:6260. [PMID: 37514555 PMCID: PMC10384173 DOI: 10.3390/s23146260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/27/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023]
Abstract
This article presents a systematic review on autism care, diagnosis, and intervention based on mobile apps running on smartphones and tablets. Here, the term "intervention" means a carefully planned set of activities with the objective of improving autism symptoms. We guide our review on related studies using five research questions. First, who benefits the most from these mobile apps? Second, what are the primary purposes of these mobile apps? Third, what mechanisms have been incorporated in these mobiles apps to improve usability? Fourth, what guidelines have been used in the design and implementation of these mobile apps? Fifth, what theories and frameworks have been used as the foundation for these mobile apps to ensure the intervention effectiveness? As can be seen from these research questions, we focus on the usability and software development of the mobile apps. Informed by the findings of these research questions, we propose a taxonomy for the mobile apps and their users. The mobile apps can be categorized into autism support apps, educational apps, teacher training apps, parental support apps, and data collection apps. The individuals with autism spectrum disorder (ASD) are the primary users of the first two categories of apps. Teachers of children with ASD are the primary users of the teacher training apps. Parents are the primary users of the parental support apps, while individuals with ASD are usually the primary users of the data collection apps and clinicians and autism researchers are the beneficiaries. Gamification, virtual reality, and autism-specific mechanisms have been used to improve the usability of the apps. User-centered design is the most popular approach for mobile app development. Augmentative and alternative communication, video modeling, and various behavior change practices have been used as the theoretical foundation for intervention efficacy.
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Affiliation(s)
- Xiongyi Liu
- Department of Curriculum and Foundations, Cleveland State University, Cleveland, OH 44115, USA
| | - Wenbing Zhao
- Department of Electrical and Computer Engineering, Cleveland State University, Cleveland, OH 44115, USA
| | - Quan Qi
- College of Information Science and Technology, Shihezi University, Shihezi 832003, China
| | - Xiong Luo
- School of Computer and Communication Engineering, University of Science and Technology Beijing, Beijing 100083, China
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12
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Gidziela A, Ahmadzadeh YI, Michelini G, Allegrini AG, Agnew-Blais J, Lau LY, Duret M, Procopio F, Daly E, Ronald A, Rimfeld K, Malanchini M. A meta-analysis of genetic effects associated with neurodevelopmental disorders and co-occurring conditions. Nat Hum Behav 2023; 7:642-656. [PMID: 36806400 PMCID: PMC10129867 DOI: 10.1038/s41562-023-01530-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 01/16/2023] [Indexed: 02/22/2023]
Abstract
A systematic understanding of the aetiology of neurodevelopmental disorders (NDDs) and their co-occurrence with other conditions during childhood and adolescence remains incomplete. In the current meta-analysis, we synthesized the literature on (1) the contribution of genetic and environmental factors to NDDs, (2) the genetic and environmental overlap between different NDDs, and (3) the co-occurrence between NDDs and disruptive, impulse control and conduct disorders (DICCs). Searches were conducted across three platforms: Web of Science, Ovid Medline and Ovid Embase. Studies were included only if 75% or more of the sample consisted of children and/or adolescents and the studies had measured the aetiology of NDDs and DICCs using single-generation family designs or genomic methods. Studies that had selected participants on the basis of unrelated diagnoses or injuries were excluded. We performed multilevel, random-effects meta-analyses on 296 independent studies, including over four million (partly overlapping) individuals. We further explored developmental trajectories and the moderating roles of gender, measurement, geography and ancestry. We found all NDDs to be substantially heritable (family-based heritability, 0.66 (s.e. = 0.03); SNP heritability, 0.19 (s.e. = 0.03)). Meta-analytic genetic correlations between NDDs were moderate (grand family-based genetic correlation, 0.36 (s.e. = 0.12); grand SNP-based genetic correlation, 0.39 (s.e. = 0.19)) but differed substantially between pairs of disorders. The genetic overlap between NDDs and DICCs was strong (grand family-based genetic correlation, 0.62 (s.e. = 0.20)). While our work provides evidence to inform and potentially guide clinical and educational diagnostic procedures and practice, it also highlights the imbalance in the research effort that has characterized developmental genetics research.
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Affiliation(s)
- Agnieszka Gidziela
- School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK.
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK.
| | - Yasmin I Ahmadzadeh
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Giorgia Michelini
- School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
- UCLA Semel Institute for Neuroscience, Division of Child and Adolescent Psychiatry, University of California, Los Angeles, Los Angeles, CA, USA
| | - Andrea G Allegrini
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Jessica Agnew-Blais
- School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Lok Yan Lau
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Megan Duret
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Francesca Procopio
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Emily Daly
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Angelica Ronald
- Department of Psychological Sciences, Birkbeck University of London, London, UK
| | - Kaili Rimfeld
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
- Department of Psychology, Royal Holloway University of London, Egham, UK
| | - Margherita Malanchini
- School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK.
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK.
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13
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Ren X, Wu Q, Cui N, Zhao J, Bi HY. Effectiveness of digital game-based trainings in children with neurodevelopmental disorders: A meta-analysis. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 133:104418. [PMID: 36603312 DOI: 10.1016/j.ridd.2022.104418] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/14/2022] [Accepted: 12/30/2022] [Indexed: 06/17/2023]
Abstract
Digital game-based training programs have recently been used to train the cognitive abilities of children with neurodevelopmental disorders (NDDs). However, the effects of training remain controversial. The present meta-analysis explored the effectiveness of digital game-based training in children with NDDs and examined the possible moderators of its effects. Twenty-nine studies with cognitive outcomes in 1535 children were included in the present meta-analysis. The results showed that digital game-based training could significantly enhance the core cognitive abilities of children with each type of NDDs and that training could be used remotely. Meanwhile, task content and game features of digital game-based interventions separately make unique and significant contributions to the training effects, suggesting that the combination of training content and game features could efficiently improve children's cognition. Although the present study revealed that the training benefits could be maintained over a period of time, more studies are needed to explore the retention effects of digital game-based training. The present study provides a comprehensive understanding of the training effects of digital game-based interventions and new insights for future cognitive training design and application.
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Affiliation(s)
- Xiaoyu Ren
- CAS Key Laboratory of Behavioral Science, Center for Brain Science and Learning Difficulties, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
| | - Qianbing Wu
- Beijing Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing 100037, China
| | - Nan Cui
- Beijing Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing 100037, China
| | - Jing Zhao
- Beijing Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing 100037, China.
| | - Hong-Yan Bi
- CAS Key Laboratory of Behavioral Science, Center for Brain Science and Learning Difficulties, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China.
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14
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Previously Marzena Szkodo MOR, Micai M, Caruso A, Fulceri F, Fazio M, Scattoni ML. Technologies to support the diagnosis and/or treatment of neurodevelopmental disorders: A systematic review. Neurosci Biobehav Rev 2023; 145:105021. [PMID: 36581169 DOI: 10.1016/j.neubiorev.2022.105021] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/13/2022] [Accepted: 12/23/2022] [Indexed: 12/27/2022]
Abstract
In recent years, there has been a great interest in utilizing technology in mental health research. The rapid technological development has encouraged researchers to apply technology as a part of a diagnostic process or treatment of Neurodevelopmental Disorders (NDDs). With the large number of studies being published comes an urgent need to inform clinicians and researchers about the latest advances in this field. Here, we methodically explore and summarize findings from studies published between August 2019 and February 2022. A search strategy led to the identification of 4108 records from PubMed and APA PsycInfo databases. 221 quantitative studies were included, covering a wide range of technologies used for diagnosis and/or treatment of NDDs, with the biggest focus on Autism Spectrum Disorder (ASD). The most popular technologies included machine learning, functional magnetic resonance imaging, electroencephalogram, magnetic resonance imaging, and neurofeedback. The results of the review indicate that technology-based diagnosis and intervention for NDD population is promising. However, given a high risk of bias of many studies, more high-quality research is needed.
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Affiliation(s)
| | - Martina Micai
- Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Angela Caruso
- Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Francesca Fulceri
- Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Maria Fazio
- Department of Mathematics, Computer Science, Physics and Earth Sciences (MIFT), University of Messina, Viale F. Stagno d'Alcontres, 31, 98166 Messina, Italy.
| | - Maria Luisa Scattoni
- Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
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15
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Merlo G, Chifari A, Chiazzese G, Denaro P, Firrera N, Savio NL, Patti S, Palmegiano L, Taibi D, Seta L. The BEHAVE application as a tool to monitor inclusive interventions for subjects with neurodevelopmental disorders. Front Psychol 2023; 13:943370. [PMID: 36743629 PMCID: PMC9889555 DOI: 10.3389/fpsyg.2022.943370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 12/28/2022] [Indexed: 01/20/2023] Open
Abstract
In the last few years, many educational and therapeutic interventions for young people with neurodevelopmental disorders are based on systematic monitoring of the outcomes. These interventions are typically conducted using single-case experimental designs, (SCEDs) a set of methods aimed at testing the effect of an intervention on a single subject or a small number of subjects. In SCEDs, an effective process of decision-making needs accurate, precise, and reliable data but also that caregivers and health professionals can gather information with minimal effort. The use of Information Communication Technologies in SCEDs can support the process of data collection and analysis, facilitating the collection of accurate and reliable data, providing reports accessible also by non-experts, and promoting interactions and sharing among clinicians, educators, and caregivers. The present paper introduces the BEHAVE application, a web-based highly customizable application, designed to implement SCEDs, supporting both data collection and automatic analysis of the datasets. Moreover, the paper will describe two case studies of kindergarten children with neurodevelopmental disorders, highlighting how the BEHAVE application supported the entire process, from data collection in multiple contexts to decision-making based on the analysis provided by the system. In particular, the paper describes the case studies of Carlo and Dario, two children with severe language and communication impairments, and the inclusive education interventions carried out to maximize their participation in a typical home and school setting increasing their mand repertoire. Results revealed an increase in the mand repertoire in both children who become able to generalize the outcomes to multiple life contexts. The active participation of the caregivers played a crucial role in the ability of children to use the learned skills in settings different from the ones they were learned in.
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Affiliation(s)
- Gianluca Merlo
- Istituto per le Tecnologie Didattiche, Consiglio Nazionale delle Ricerche, Palermo, Italy,*Correspondence: Gianluca Merlo,
| | - Antonella Chifari
- Istituto per le Tecnologie Didattiche, Consiglio Nazionale delle Ricerche, Palermo, Italy
| | - Giuseppe Chiazzese
- Istituto per le Tecnologie Didattiche, Consiglio Nazionale delle Ricerche, Palermo, Italy
| | - Paola Denaro
- Istituto per le Tecnologie Didattiche, Consiglio Nazionale delle Ricerche, Palermo, Italy
| | | | | | | | | | - Davide Taibi
- Istituto per le Tecnologie Didattiche, Consiglio Nazionale delle Ricerche, Palermo, Italy
| | - Luciano Seta
- Istituto per le Tecnologie Didattiche, Consiglio Nazionale delle Ricerche, Palermo, Italy
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16
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Charline G, Bettencourt C, Kellems R, Chetouani M, Cohen D. Building the design ICT inventory (DICTI): A Delphi study. COMPUTERS IN HUMAN BEHAVIOR REPORTS 2023. [DOI: 10.1016/j.chbr.2022.100261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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17
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Eguia KF, Capio CM. Teletherapy for children with developmental disorders during the COVID-19 pandemic in the Philippines: A mixed-methods evaluation from the perspectives of parents and therapists. Child Care Health Dev 2022; 48:963-969. [PMID: 35023228 DOI: 10.1111/cch.12965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 12/17/2021] [Accepted: 01/08/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES As a response to the lockdown associated with COVID-19 in the Philippines, therapy services for children with developmental disorders shifted to telehealth (i.e., teletherapy). This study evaluated the delivery of teletherapy from the perspectives of parents and therapists. METHODS Participants consisted of parents (n = 47) and therapists (n = 102) of children with developmental disorders who were receiving teletherapy during the lockdown. A mixed-methods triangulation design-convergence model was adopted; participants were invited to respond to an online survey with closed- and open-ended questions. Quantitative data were analysed using descriptive and non-parametric inferential tests, while qualitative data were examined using thematic analysis. RESULTS Overall satisfaction with teletherapy was positive, with parents reporting significantly higher satisfaction compared with therapists. Satisfaction was positively associated with the frequency of teletherapy sessions for parents and with their years of experience for therapists. The top enabling factors were family participation and effective communication. The main challenges were time constraints and difficulty with instruction and monitoring associated with the two-dimensional nature of teletherapy. The benefits included parents' empowerment and enhanced understanding of their children's needs. DISCUSSION Delivery of teletherapy was enabled by a heightened focus on family-centred care. The evaluation findings suggest that the general satisfaction with teletherapy and the benefits associated with family-centred care would potentially promote teletherapy as a service delivery mode to continue beyond the pandemic.
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Affiliation(s)
| | - Catherine M Capio
- Centre for Educational and Developmental Sciences, Education University of Hong Kong, Tai Po, Hong Kong.,Health Science Department, Ateneo de Manila University, Quezon City, Philippines
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18
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Sujar A, Bayona S, Delgado-Gómez D, Miguélez-Fernández C, Ardoy-Cuadros J, Peñuelas-Calvo I, Baca-García E, Blasco-Fontecilla H. Attention Deficit Hyperactivity Disorder Assessment Based on Patient Behavior Exhibited in a Car Video Game: A Pilot Study. Brain Sci 2022; 12:877. [PMID: 35884684 PMCID: PMC9313446 DOI: 10.3390/brainsci12070877] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 06/29/2022] [Accepted: 06/30/2022] [Indexed: 11/16/2022] Open
Abstract
Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) include excessive activity, difficulty sustaining attention, and inability to act in a reflective manner. Early diagnosis and treatment of ADHD is key but may be influenced by the observation and communication skills of caregivers, and the experience of the medical professional. Attempts to obtain additional measures to support the medical diagnosis, such as reaction time when performing a task, can be found in the literature. We propose an information recording system that allows to study in detail the behavior shown by children already diagnosed with ADHD during a car driving video game. We continuously record the participants' activity throughout the task and calculate the error committed. Studying the trajectory graphs, some children showed uniform patterns, others lost attention from one point onwards, and others alternated attention/inattention intervals. Results show a dependence between the age of the children and their performance. Moreover, by analyzing the positions by age over time using clustering, we show that it is possible to classify children according to their performance. Future studies will examine whether this detailed information about each child's performance pattern can be used to fine-tune treatment.
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Affiliation(s)
- Aaron Sujar
- Department of Computer Engineering, Universidad Rey Juan Carlos, 28933 Madrid, Spain; (A.S.); (S.B.)
- Department of Psychiatry, Puerta de Hierro University Hospital, Health Research Institute Puerta de Hierro-Segovia de Arana (IDIPHISA), 28222 Majadahonda, Spain;
| | - Sofia Bayona
- Department of Computer Engineering, Universidad Rey Juan Carlos, 28933 Madrid, Spain; (A.S.); (S.B.)
- Center for Computational Simulation, Universidad Politécnica de Madrid, 28040 Boadilla del Monte, Spain
| | | | | | - Juan Ardoy-Cuadros
- Department of Psychology, Faculty of Health Sciences, University Rey Juan Carlos, Avda. Atenas s/n, 28922 Alcorcón, Spain;
| | - Inmaculada Peñuelas-Calvo
- Department of Child and Adolescent Psychiatry, University Hospital 12 de Octubre, 28041 Madrid, Spain;
| | - Enrique Baca-García
- Department of Psychiatry, IIS-Jimenez Diaz Foundation, 28040 Madrid, Spain;
- CIBERSAM (Centro de Investigación en Salud Mental), Carlos III Institute of Health, 28029 Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Hilario Blasco-Fontecilla
- Department of Psychiatry, Puerta de Hierro University Hospital, Health Research Institute Puerta de Hierro-Segovia de Arana (IDIPHISA), 28222 Majadahonda, Spain;
- CIBERSAM (Centro de Investigación en Salud Mental), Carlos III Institute of Health, 28029 Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- ITA Mental Health, 28043 Madrid, Spain
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19
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Abstract
Immunity could be viewed as the common factor in neurodevelopmental disorders and cancer. The immune and nervous systems coevolve as the embryo develops. Immunity can release cytokines that activate MAPK signaling in neural cells. In specific embryonic brain cell types, dysregulated signaling that results from germline or embryonic mutations can promote changes in chromatin organization and gene accessibility, and thus expression levels of essential genes in neurodevelopment. In cancer, dysregulated signaling can emerge from sporadic somatic mutations during human life. Neurodevelopmental disorders and cancer share similarities. In neurodevelopmental disorders, immunity, and cancer, there appears an almost invariable involvement of small GTPases (e.g., Ras, RhoA, and Rac) and their pathways. TLRs, IL-1, GIT1, and FGFR signaling pathways, all can be dysregulated in neurodevelopmental disorders and cancer. Although there are signaling similarities, decisive differentiating factors are timing windows, and cell type specific perturbation levels, pointing to chromatin reorganization. Finally, we discuss drug discovery.
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Affiliation(s)
- Ruth Nussinov
- Computational Structural Biology Section, Frederick National Laboratory for Cancer Research in the Cancer Innovation Laboratory, National Cancer Institute, Frederick, MD 21702, USA
- Department of Human Molecular Genetics and Biochemistry, Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- Corresponding author
| | - Chung-Jung Tsai
- Computational Structural Biology Section, Frederick National Laboratory for Cancer Research in the Cancer Innovation Laboratory, National Cancer Institute, Frederick, MD 21702, USA
| | - Hyunbum Jang
- Computational Structural Biology Section, Frederick National Laboratory for Cancer Research in the Cancer Innovation Laboratory, National Cancer Institute, Frederick, MD 21702, USA
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20
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Farroni T, Valori I, Carnevali L. Multimedia Interventions for Neurodiversity: Leveraging Insights from Developmental Cognitive Neuroscience to Build an Innovative Practice. Brain Sci 2022; 12:brainsci12020147. [PMID: 35203911 PMCID: PMC8870117 DOI: 10.3390/brainsci12020147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/18/2022] [Accepted: 01/20/2022] [Indexed: 12/10/2022] Open
Abstract
Multimedia technologies and virtual reality offer unique possibilities to manipulate sensory, motor, interpersonal, and cognitive processes contributing to atypical developmental trajectories, thus holding an explosive potential to design innovative and engaging interventions. However, there has been little progress in developing interventions that go beyond the patient’s diagnosis or the fascination of technology and rather spring from a deep understanding of the specific neuropsychological processes to be nurtured in individuals. This perspective paper outlines how recent insights from developmental cognitive neuroscience can be leveraged to promote children’s multidimensional development and highlight future directions and challenges for innovating both research and clinical practice. Finally, we focus on some practical examples of multimedia and virtual reality activities we have designed to stimulate bodily-self experiences, which are crucial for building up a coherent sense of self and lay the foundation for interacting with the external world. Atypical bodily self is an early marker of heterogeneous neurodevelopmental conditions (such as autism spectrum disorders) and seems to be under-targeted in research and clinical approaches.
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Affiliation(s)
- Teresa Farroni
- Department of Developmental Psychology and Socialisation, University of Padova, 35131 Padova, Italy; (I.V.); (L.C.)
- Padova Neuroscience Center (PNC), University of Padova, 35129 Padova, Italy
- Correspondence:
| | - Irene Valori
- Department of Developmental Psychology and Socialisation, University of Padova, 35131 Padova, Italy; (I.V.); (L.C.)
| | - Laura Carnevali
- Department of Developmental Psychology and Socialisation, University of Padova, 35131 Padova, Italy; (I.V.); (L.C.)
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21
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Nussinov R, Tsai CJ, Jang H. How can same-gene mutations promote both cancer and developmental disorders? SCIENCE ADVANCES 2022; 8:eabm2059. [PMID: 35030014 PMCID: PMC8759737 DOI: 10.1126/sciadv.abm2059] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/22/2021] [Indexed: 05/05/2023]
Abstract
The question of how same-gene mutations can drive both cancer and neurodevelopmental disorders has been puzzling. It has also been puzzling why those with neurodevelopmental disorders have a high risk of cancer. Ras, MEK, PI3K, PTEN, and SHP2 are among the oncogenic proteins that can harbor mutations that encode diseases other than cancer. Understanding why some of their mutations can promote cancer, whereas others promote neurodevelopmental diseases, and why even the same mutations may promote both phenotypes, has important clinical ramifications. Here, we review the literature and address these tantalizing questions. We propose that cell type–specific expression of the mutant protein, and of other proteins in the respective pathway, timing of activation (during embryonic development or sporadic emergence), and the absolute number of molecules that the mutations activate, alone or in combination, are pivotal in determining the pathological phenotypes—cancer and (or) developmental disorders.
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Affiliation(s)
- Ruth Nussinov
- Computational Structural Biology Section, Frederick National Laboratory for Cancer Research in the Laboratory of Cancer Immunometabolism, National Cancer Institute, Frederick, MD 21702, USA
- Department of Human Molecular Genetics and Biochemistry, Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Chung-Jung Tsai
- Computational Structural Biology Section, Frederick National Laboratory for Cancer Research in the Laboratory of Cancer Immunometabolism, National Cancer Institute, Frederick, MD 21702, USA
| | - Hyunbum Jang
- Computational Structural Biology Section, Frederick National Laboratory for Cancer Research in the Laboratory of Cancer Immunometabolism, National Cancer Institute, Frederick, MD 21702, USA
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22
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Schmidt NB, Vereenooghe L. Targeting hostile attributions in inclusive schools through online cognitive bias modification: A randomised experiment. Behav Res Ther 2021; 146:103949. [PMID: 34583306 DOI: 10.1016/j.brat.2021.103949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 05/11/2021] [Accepted: 08/25/2021] [Indexed: 11/18/2022]
Abstract
The tendency to make hostile attributions in ambiguous social situations has been associated with aggression and may be targeted through cognitive bias modification for interpretations (CBM-I). Despite their high prevalence of aggression and internalising problems, children and young people with neurodevelopmental disorders (NDD) or special educational needs (SEN) are markedly absent from CBM-I studies. This pilot study investigates whether online CBM-I can reduce hostile attributions and reactive aggression in inclusive school pupils. In Study 1, 71 pupils (mean age = 12.2, SD = 1.5; 25.4% presented with NDD or SEN) were randomly allocated to complete three sessions of either CBM-I (n = 37) or active control training (n = 34). CBM-I involved interpreting ambiguous scenarios or faces in a non-hostile manner, whereas the control training involved attention and memory exercises without resolving ambiguity. Between-group comparison showed CBM-I to reduce both hostile attributions and reactive aggression. In Study 2, follow-up focus groups with 23 pupils demonstrated the acceptability of training content and delivery. Together, these findings show online CBM-I to be acceptable and effective at reducing both hostile attributions and reactive aggression in an inclusive setting. The possibility of intervention effects on behavioural outcomes and potential confounding variables require further investigation.
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Affiliation(s)
- Nora B Schmidt
- Faculty of Psychology and Sports Science, Bielefeld University, Germany.
| | - Leen Vereenooghe
- Faculty of Psychology and Sports Science, Bielefeld University, Germany
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23
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Pi HJ, Kallapiran K, Munivenkatappa S, Kandasamy P, Kirubakaran R, Russell P, Eapen V. Meta-Analysis of RCTs of Technology-Assisted Parent-Mediated Interventions for Children with ASD. J Autism Dev Disord 2021; 52:3325-3343. [PMID: 34318434 DOI: 10.1007/s10803-021-05206-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2021] [Indexed: 12/27/2022]
Abstract
Technology-assisted parent-mediated interventions improve accessibility and are acceptable but not proven to be effective. We conducted a systematic search of 6 databases. We included and analysed results from studies on social and communication outcomes. Sixteen Randomised-Controlled-Trials (RCTs) with 748 participants were included. Most studies were rated as of good quality. Meta-analysis suggested that interventions were probably effective in improving emotion recognition. No significant differences were found in social communication, social functioning or language outcomes. At present, isolated tech interventions do not fulfil criteria for promising or established evidence-based interventions for ASD. Future research needs to focus on improving the effectiveness of technology-assisted parent-mediated interventions for ASD. Prospero Registration Number: CRD42020162825.
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Affiliation(s)
- Hong Ji Pi
- Darling Downs Health Service, The Toowoomba Hospital, Toowoomba, QLD, Australia
| | - Kannan Kallapiran
- Gold Coast Health Service, Gold Coast, QLD, Australia. .,Southport Health Precinct, 16-30 High Street, Gold Coast, QLD, 4215, Australia.
| | | | | | - Richard Kirubakaran
- Prof BV Moses Center for Evidence-Informed Health Care and Health Policy, Vellore, India
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24
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Stasolla F. Virtual Reality and Wearable Technologies to Support Adaptive Responding of Children and Adolescents With Neurodevelopmental Disorders: A Critical Comment and New Perspectives. Front Psychol 2021; 12:720626. [PMID: 34322073 PMCID: PMC8311117 DOI: 10.3389/fpsyg.2021.720626] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 06/18/2021] [Indexed: 12/16/2022] Open
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25
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Technology-Based Assessments and Treatments of Anxiety in Autistic Individuals: Systematic Review and Narrative Synthesis. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00275-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AbstractThis systematic review (Prospero Registration Number: CRD42019142910) aimed to narratively synthesise technology-aided assessments and treatments of anxiety in individuals with autism spectrum disorder (ASD) for the first time. Sixteen studies were identified: 5 assessment studies and 11 treatment studies. Assessment studies targeted state anxiety using ecological momentary assessment, wearables, or computerised tasks. Treatment studies targeted specific fears/phobias using electronic screen media or transdiagnostic anxiety using telemedicine. Broadly, results indicated technology-aided assessments and treatments may be feasible and effective at targeting anxiety in ASD, except treatments involving social scripts or peer modelling. Assessment results further indicated that state anxiety in ASD has a distinct psychophysiological signature and is evoked by idiosyncratic triggers. However, larger scale studies with representative samples are needed.
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Adamou M, Jones SL, Fullen T, Galab N, Abbott K, Yasmeen S. Remote assessment in adults with Autism or ADHD: A service user satisfaction survey. PLoS One 2021; 16:e0249237. [PMID: 33765076 PMCID: PMC7993762 DOI: 10.1371/journal.pone.0249237] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/13/2021] [Indexed: 01/15/2023] Open
Abstract
Advances in digital health have enabled clinicians to move away from a reliance on face to face consultation methods towards making use of modern video and web-based conferencing technology. In the context of the COVID-19 pandemic, remote telecommunication methods have become much more common place in mental health settings. The current study sought to investigate whether remote telecommunication methods are preferable to face to face consultations for adults referred to an Autism and ADHD Service during the COVID-19 pandemic. Also, whether there are any differences in preferred consultation methods between adults who were referred for an assessment of Autism as opposed to ADHD. 117 service users who undertook assessment by the ADHD and Autism Service at South West Yorkshire NHS Partnership Foundation Trust from April to September 2020 completed an adapted version of the Telehealth Usability Questionnaire (TUQ). Results demonstrated that service users found remote telecommunication to be useful, effective, reliable and satisfactory. Despite this, almost half of service users stated a general preference for face to face consultations. There was no difference in the choice of methods of contact between Autism and ADHD pathways. Remote telecommunication methods were found to be an acceptable medium of contact for adults who undertook an assessment of Autism and ADHD at an NHS Service during the COVID-19 pandemic.
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Affiliation(s)
- Marios Adamou
- University of Huddersfield, Huddersfield, United Kingdom
| | - Sarah L. Jones
- South West Yorkshire Partnership NHS Foundation Trust, Wakefield, United Kingdom
| | - Tim Fullen
- South West Yorkshire Partnership NHS Foundation Trust, Wakefield, United Kingdom
| | - Nazmeen Galab
- South West Yorkshire Partnership NHS Foundation Trust, Wakefield, United Kingdom
| | - Karl Abbott
- South West Yorkshire Partnership NHS Foundation Trust, Wakefield, United Kingdom
| | - Salma Yasmeen
- South West Yorkshire Partnership NHS Foundation Trust, Wakefield, United Kingdom
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27
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Jiménez-Muñoz L, Peñuelas-Calvo I, Calvo-Rivera P, Díaz-Oliván I, Moreno M, Baca-García E, Porras-Segovia A. Video Games for the Treatment of Autism Spectrum Disorder: A Systematic Review. J Autism Dev Disord 2021; 52:169-188. [PMID: 33651285 DOI: 10.1007/s10803-021-04934-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2021] [Indexed: 12/28/2022]
Abstract
Video games are a promising area of intervention for children diagnosed with Autism Spectrum Disorders (ASD). However, reviews on this topic are scarce. This review on studies exploring video games for the treatment of ASD followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and its protocol was registered in PROSPERO. PubMed, PsycInfo, Embase, WebOfScience and clinicaltrials.gov databases were searched. Twenty-four articles were included in the review. Video game-based interventions were effective for alleviating ASD symptoms, albeit with small effect sizes. High rates of acceptability and adherence to treatment were obtained. Conclusion: Video games are a promising area for improving the treatment of children with ASD. Exploring commercial video games is one of the lines for future research.
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Affiliation(s)
- Laura Jiménez-Muñoz
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.,Departamento de Psiquiatria, Universidad Autónoma de Madrid, Madrid, Spain
| | - Inmaculada Peñuelas-Calvo
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain. .,Departamento de Psiquiatría Infantojuvenil, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain. .,Facultad de Psicología, Universidad Complutense de Madrid, Madrid, Spain.
| | - Pilar Calvo-Rivera
- Departamento de Psiquiatría Infantojuvenil, Hospital Reina Sofía de Córdoba, Córdoba, Spain
| | - Isaac Díaz-Oliván
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.,Departamento de Psiquiatria, Universidad Autónoma de Madrid, Madrid, Spain
| | - Manon Moreno
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.,Departamento de Psiquiatria, Universidad Autónoma de Madrid, Madrid, Spain
| | - Enrique Baca-García
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.,Departamento de Psiquiatria, Universidad Autónoma de Madrid, Madrid, Spain.,Departamento de Psiquiatría Infantojuvenil, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.,Departamento de Psiquiatría, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.,Hospital Universitario de Valdemoro, Madrid, Spain.,Departamento de Psiquiatría, Hospital Universitario Central de Villalba, Madrid, Spain.,CIBERSAM, Madrid, Spain.,Université de Nîmes, Nîmes, France.,Departamento de Psiquiatría, Universidad Católica del Maule, Talca, Chile
| | - Alejandro Porras-Segovia
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.,Hospital Universitario Rey Juan Carlos, Móstoles, Spain
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28
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Chen B, Liang RQ, Chen RY, Xu FY. The effect of virtual reality training on the daily participation of patients: A meta-analysis. Complement Ther Med 2021; 58:102676. [PMID: 33561530 DOI: 10.1016/j.ctim.2021.102676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 01/10/2021] [Accepted: 01/29/2021] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Virtual reality (VR) training are regarded as promising new tools for rehabilitation, but the effect on patients' daily participation is controversial. This study aimed to evaluate the effect of virtual reality (VR) training on different types of patients' daily participation through a meta-analysis. METHODS The PubMed, Cochrane central register of controlled trials, Embase, and web science databases were searched for studies published through September 2020. Thirty-five randomized controlled trials of virtual reality (VR) training compared with conventional treatment, Other electronic rehabilitation systems, usual care for various types of patients were included. All of the studies were available in English. Standardized mean differences (SMD), 95 % confidence intervals (CI), publication bias, and heterogeneity were calculated. RESULTS The Virtual reality (VR) training group is better than the control group in daily participation improvement on all types of patients. There was a small, significant effect(p<0.001; SMD = 0.25[95 %CI,0.14 to 0.36], I2 = 0.00 %). Observing only the type of Stroke, the VR training group is still better than the control group in improving patients' daily participation (p<0.001, SMD = 0.24[95 %CI, 0.11 to 0.37], I2 = 0.00 %). Using the cumulative Meta-analysis method to observe the included literature according to the timeline, Using the cumulative Meta-analysis method to observe the included literature according to the timeline, and it has only achieved positive results since 2015 (Nam-YoNg Lee 2015, p = 0.048, SMD = 0.22[95 %CI,0.00 to 0.44]). The heterogeneity of the studies was not detected, but there is obvious publication bias. CONCLUSIONS Because of controversy over obvious publication bias, we need to be cautious about the conclusion that VR is better than the control group in promoting the patient's daily participation.
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Affiliation(s)
- Bo Chen
- Department of Rehabilitation, The Affiliated Hospital of Southwest Medical University, Sichuan, Luzhou, 646000, China.
| | - Rui-Qi Liang
- The Affiliated Hospital of Southwest Medical University, Sichuan, Luzhou, 646000, China
| | - Ru-Yan Chen
- Department of Rehabilitation, The Affiliated Hospital of Southwest Medical University, Sichuan, Luzhou, 646000, China
| | - Fang-Yuan Xu
- Department of Rehabilitation, The Affiliated Hospital of Southwest Medical University, Sichuan, Luzhou, 646000, China.
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29
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Romero-Ayuso D, Toledano-González A, Rodríguez-Martínez MDC, Arroyo-Castillo P, Triviño-Juárez JM, González P, Ariza-Vega P, Del Pino González A, Segura-Fragoso A. Effectiveness of Virtual Reality-Based Interventions for Children and Adolescents with ADHD: A Systematic Review and Meta-Analysis. CHILDREN-BASEL 2021; 8:children8020070. [PMID: 33494272 PMCID: PMC7909839 DOI: 10.3390/children8020070] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 01/17/2021] [Accepted: 01/18/2021] [Indexed: 12/13/2022]
Abstract
This review aims to evaluate the effectiveness of virtual reality-based interventions (VR-based interventions) on cognitive deficits in children with attention deficit hyperactivity disorder (ADHD). A systematic review and meta-analysis were performed according to the PRISMA statement and the Cochrane Handbook guidelines for conducting meta-analyses. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used to assess the quality of the evidence. Clinical trials published up to 29 October 2020, were included. The meta-analysis included four studies, with a population of 125 participants with ADHD. The magnitude of the effect was large for omissions (SMD = −1.38; p = 0.009), correct hits (SMD = −1.50; p = 0.004), and perceptual sensitivity (SMD = −1.07; p = 0.01); and moderate for commissions (SMD = −0.62; p = 0.002) and reaction time (SMD = −0.67; p = 0.03). The use of VR-based interventions for cognitive rehabilitation in children with ADHD is limited. The results showed that VR-based interventions are more effective in improving sustained attention. Improvements were observed in attentional vigilance measures, increasing the number of correct responses and decreasing the number of errors of omission. No improvements were observed in impulsivity responses.
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Affiliation(s)
- Dulce Romero-Ayuso
- Department of Physical Therapy, Occupational Therapy Division, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (P.A.-C.); (P.A.-V.)
- Correspondence:
| | - Abel Toledano-González
- Faculty of Health Sciences, University of Castilla-La Mancha, Talavera la de Reina, 45600 Toledo, Spain; (A.T.-G.); (A.S.-F.)
| | | | - Palma Arroyo-Castillo
- Department of Physical Therapy, Occupational Therapy Division, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (P.A.-C.); (P.A.-V.)
| | | | - Pascual González
- LoUISE Research Group, Computing Systems Department, University of Castilla-La Mancha, 02071 Albacete, Spain;
| | - Patrocinio Ariza-Vega
- Department of Physical Therapy, Occupational Therapy Division, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (P.A.-C.); (P.A.-V.)
| | - Antonio Del Pino González
- Department of Educational Orientation, IES Máximo Laguna, Consejería de Educación, Junta de Castilla-La Mancha, Santa Cruz de Mudela, 13730 Ciudad Real, Spain;
| | - Antonio Segura-Fragoso
- Faculty of Health Sciences, University of Castilla-La Mancha, Talavera la de Reina, 45600 Toledo, Spain; (A.T.-G.); (A.S.-F.)
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30
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Valentine AZ, Hall SS, Young E, Brown BJ, Groom MJ, Hollis C, Hall CL. Implementation of Telehealth Services to Assess, Monitor, and Treat Neurodevelopmental Disorders: Systematic Review. J Med Internet Res 2021; 23:e22619. [PMID: 33326409 PMCID: PMC7819544 DOI: 10.2196/22619] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 09/29/2020] [Accepted: 10/26/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND In response to COVID-19, there has been increasing momentum in telehealth development and delivery. To assess the anticipated exponential growth in telehealth, it is important to accurately capture how telehealth has been used in specific mental health fields prior to the pandemic. OBJECTIVE This systematic review aimed to highlight how telehealth has been used with clinical samples in the neurodevelopmental field, including patients with neurodevelopmental disorders (NDDs), their families, and health care professionals. To identify which technologies show the greatest potential for implementation into health services, we evaluated technologies for effectiveness, economic impact, and readiness for clinical adoption. METHODS A systematic search of literature was undertaken in April 2018 and updated until December 2019, by using the Medline, Web of Science, Scopus, CINAHL Plus, EMBASE, and PsycInfo databases. Extracted data included the type of technology, how the technology was used (ie, assessment, treatment, and monitoring), participant characteristics, reported outcomes and authors' views on clinical effectiveness, user impact (ie, feasibility and acceptability), economic impact, and readiness for clinic adoption. A quality review of the research was performed in accordance with the Oxford Centre for Evidence-Based Medicine Levels of Evidence. RESULTS A total of 42 studies met the inclusion criteria. These studies included participants and family members with autism spectrum disorders (21/42, 50%), attention deficit hyperactivity disorders (8/42, 19%), attention deficit hyperactivity or autism spectrum disorders (3/42, 7%), communication disorders (7/42, 17%), and tic disorders (2/42, 5%). The focus of most studies (33/42, 79%) was on treatment, rather than assessment (4/42, 10%) or monitoring (5/42, 12%). Telehealth services demonstrated promise for being clinically effective, predominantly in relation to diagnosing and monitoring NDDs. In terms of NDD treatment, telehealth services were usually equivalent to control groups. There was some evidence of positive user and economic impacts, including increased service delivery efficiency (eg, increased treatment availability and decreased waiting times). However, these factors were not widely recorded across the studies. Telehealth was demonstrated to be cost-effective in the few studies that considered cost-effectiveness. Study quality varied, as many studies had small sample sizes and inadequate control groups. Of the 42 studies, only 11 (26%) were randomized controlled trials, 12 (29%) were case studies or case series, 6 (14%) were qualitative studies, and 5 (12%) were noncomparative trials. CONCLUSIONS Telehealth has the potential to increase treatment availability, decrease diagnosis waiting times, and aid in NDD monitoring. Further research with more robust and adequately powered study designs that consider cost-effectiveness and increased efficiency is needed. This systematic review highlights the extent of telehealth technology use prior to the COVID-19 pandemic and the movement for investing in remote access to treatments. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42018091156; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42018091156.
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Affiliation(s)
- Althea Z Valentine
- Institute of Mental Health, School of Medicine, Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Sophie S Hall
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Centre for Medicine, Leicester, United Kingdom
| | - Emma Young
- Nottinghamshire Healthcare National Health Service Foundation Trust, Library and Knowledge Services, Duncan Macmillan House Staff Library, Nottingham, United Kingdom
| | - Beverley J Brown
- Institute of Mental Health, School of Medicine, Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Madeleine J Groom
- Institute of Mental Health, School of Medicine, Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Chris Hollis
- Institute of Mental Health, School of Medicine, Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, United Kingdom
- National Institute for Health Research MindTech MedTech Co-operative, Institute of Mental Health, School of Medicine, Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, United Kingdom
- Department of Child and Adolescent Psychiatry, Queen's Medical Centre, Nottingham, United Kingdom
| | - Charlotte L Hall
- Institute of Mental Health, School of Medicine, Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, United Kingdom
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