The problem of dyslexia in teenage

The prevalence of dyslexia and AD/HD in a sample of forensic psychiatric rapists

The prevalence of dyslexia and attention deficit/hyperactivity disorder (AD/HD) (DSM-IV) is markedly increased among those who are sentenced for criminal offences. The aim of the study was to identify developmental disabilities, dyslexia and AD/HD among severely disturbed men in forensic psychiatric care, and to study the co-occurrence of such disabilities, with the objective to discuss the importance of the diagnoses in forensic psychiatry. The participants were 10 males who had committed rape on adult women, and included two murder-rapists, one of which had murdered more than one victim (i.e. a serial murderer). All had been assigned to special long-term forensic psychiatric care, based predominantly on a psychodynamic ground. In order to be identified as having dyslexia, a participant's performance on at least three out of four tests of academic skills had to be markedly below the expected level (more than two stanine steps), given the participant's non-verbal intellectual capacity and considering the length of his education. AD/HD was investigated by studying the participants' forensic psychiatric files and by a clinical interview. Seven of the 10 participants met the DSM-IV criteria for dyslexia, and six of them met the DSM-IV criteria for AD/HD. Four participants had AD/HD and dyslexia, three had AD/HD but no dyslexia, and two had dyslexia but no AD/HD. Only one participant had neither dyslexia nor AD/HD. The participants with dyslexia performed well in tests assessing non-verbal reasoning, visuo-spatial capacity and visual memory. Although the generalization of the results from 10 rapists is severely limited, the results indicate the importance of assessing dyslexia as well as AD/HD in people who are admitted for forensic psychiatric assessment. The lack of correct diagnoses may negatively influence the choice of appropriate forensic psychiatric care. Early assessment of those disorders might have a positive influence on the psychological development and socialization process in people with dyslexia and/or AD/HD.

Dyslexia and psychosocial factors. A follow-up study of young Norwegian adults with a history of dyslexia in childhood

The present study is a follow-up of two different groups of young adults with a history of dyslexia problems in childhood. Group A was drawn from a larger longitudinal study where students were diagnosed with dyslexia at age 10. Group B was recruited at a child psychiatric clinic and also had dyslexic problems. Measures of educational level, life satisfaction and psychosocial factors were applied. The assessment was carried out by means of tests, questionnaires and personal interviews. The results showed lower levels of educational attainment in group B as well as lower satisfaction with health, friends and education compared to group A and a normative group. Both dyslexic groups showed more psychiatric problems than those in the normative sample.

Attention deficit disorder with developmental coordination disorders

AIMS

To analyse the contribution of certain social, familial, prenatal, perinatal, and developmental background factors in the pathogenesis of deficits in attention, motor control, and perception (DAMP).

METHODS

A population based case-control study was carried out with 113 children aged 6 years, 62 diagnosed with DAMP and 51 controls without DAMP. The children's health and medical records were studied and their history with regard to background factors was taken at an interview with the mother using a standardised schedule. Familial factors, possible non-optimal factors during pregnancy (including smoking), developmental factors (including early language development), and medical and psychosocial data were scored in accordance with the reduced optimality method.

RESULTS

Low socioeconomic class was common in the group with DAMP. Familial language disorder and familial motor clumsiness were found at higher rates in the DAMP group. Neuropathogenic risk factors in utero were also more common in the children with DAMP. Maternal smoking during pregnancy appeared to be an important risk factor. Language problems were present in two thirds of the children with DAMP. Sleep problems and gastrointestinal disorders, but not atopy or otitis media, were significantly more common in the DAMP group.

CONCLUSIONS

Prenatal familial and neuropathogenic risk factors contribute to the development of DAMP. Primary prevention, such as improved maternal health care and early detection or treatment, or both, of associated language problems appear to be essential.

Mental and somatic health and social adjustment in ordinary school children during childhood and adolescence related to central nervous functions as expressed by a complex reaction time

A cohort of ordinary Swedish children were followed up from school entry through childhood and adolescence and checked retrospectively from birth to the age of 6 years regarding psychiatric and physical health and contact with the social welfare authorities. The children were allocated to different risk groups at age 7 on the basis of their psycho-physical development expressed as complex reaction time (CRT). It was previously shown that many of the slow CRT children have problems in psychomotor and language development at school, and that many leave compulsory school with poor achievements in Swedish and gymnastics as continuing signs of their developmental delay. This study shows that slow CRT children have an increased prevalence of child psychiatric problems. At an early age there were symptoms of aggression, hyperactivity and withdrawal in conjunction with developmental delay. During adolescence, depression, maladjustment and psycho-somatic disorders were prominent features, often in association with developmental delay, dyslexia and poor motoric skill. These children could have a disadvantage at school and in society and they felt themselves "handicapped" and were stressed by feelings of limited future possibilities. In adolescence, many of them were in need of help, especially financial aid from the social welfare services. The findings stress that a slow cognitive processing ability seen as a slow CRT must be considered a handicap of importance and a risk-factor in the society of today, with primary or secondary psychic and social manifestations often in a multifactorial setting of biological co-morbidity and family problems. In contrast, an advanced CNS development with a fast CRT may be seen as a protective factor.

School achievement and school adaptation in children in relation to CNS development as assessed by a complex reaction time measured on school entry--a follow-up

Schoolchildren aged seven years underwent a complex reaction time (CRT) measurement and were followed up regarding language achievements and performance in gymnastics during the nine years of compulsory school. An analysis was made of the correlation between school results and CRT findings. In grade 3, there were large differences in psychomotor development between children with fast and slow CRT in both sexes. Only minor differences in school achievement were seen between girls in different CRT groups. Among the boys, however, many with a slow CRT were considered handicapped in language development, with dyslexia as the most important problem in addition to poor motoricity. They left compulsory school with poor results in Swedish, their native language, and gymnastics, and with a certificate that may reduce their changes of future studies and employment. The boys in general were inferior to the girls. The slow CRT boys, who were mainly considered to be developmentally delayed, also carried a risk of social maladjustment. It would appear to be important that psychophysical maturity receives attention at school, in addition to emotional and social factors. The school health services have an important responsibility in this respect.

School readiness and CNS maturity: relation to psychophysical and psychosocial development and to early school achievement

In randomly selected schools 113 girls and 102 boys were subjected to a School Readiness (SR) test and to a Complex Reaction Time (CRT) measurement at the age of 7. Their psychophysical development, social adjustment and school achievement were assessed by teachers and by means of self-ratings during the first 3 school years. The developmental outcome of the children seemed principally related to CNS-maturity as measured by CRT, and not to the SR test scores. A CNS-dysfunction, indicated by slow CRT, seemed to be an essential handicap during the early school years, impairing particularly the boys' language and motor development and their school achievement and causing feelings of inferiority. This handicap, which is mainly a developmental delay, should thus be taken into consideration when assessing school maturity. Early detection of this handicap might enable us to take preventive measures with regard to these children.

Patients in child and adolescent psychiatric care: psychopathology and background factors

All 142 consecutive patients born between January 1, 1947 and February 28, 1949 who were cared for at the Department of Child and Adolescent Psychiatry at General Hospital in Uppsala are described. The patients' symptoms, family situation, early development, CNS dysfunction and social situation are presented. The negative factors were numerous: 78% of patients had some form of family affliction, 60% had minimal brain dysfunction (MBD) factors which, while not associated with a clinical diagnosis of MBD, included hyperactivity, motor handicap, reading and writing difficulties, poor fine muscle activity and pathological EEG, and 58% had negative factors in their home environment. The majority were judged as having been subjected to negative parental attitudes. When psychotic symptoms were present, there was a high prevalence of psychotic illness in the family. A negative social situation in the home environment was most common for maladjusted patients. The presence of MBD factors was associated with disturbances in the child's early development. Nevertheless, many background factors continually affected one another and contributed to the mental disorder.

Ten-year follow-up of adolescent dyslexics

A follow-up study of 26 dyslexics with an age range from 20 to 28 years revealed that reading and writing problems were essentially unchanged from the time of diagnosis 7-10 years earlier. The intellectual capacity of all subjects was normal. One of the ten who finished high school had started university studies. Sixteen (62%) had completed only the obligatory nine years of schooling. Fourteen (54%) were in practical occupations such as a cook, storeman, and truck driver. Our results suggest that with late diagnosis and no remedial treatment, dyslexia remains. The subjects report that their handicap has interfered with their choice of occupation.

Specific reading retardation, hyperactive child syndrome, and juvenile delinquency

The purpose of the study was to ascertain the extent to which a specific reading retardation leads to criminal development in adolescent and to what factors such development is due in these cases. For this purpose, 224 adolescents with a specific reading retardation were investigated. A relatively large number of these (12.1%) were prone to criminality between the ages of 15 and 20 years, whereas the severity of the specific reading retardation did not seem to contribute to this propensity. Symptoms of hyperactivity, on the other hand, seemed to contribute to criminal behaviour.