Specific learning disability

Abuse and Neglect of Children With Specific Learning Disorders in Türkiye: A Case-Control Study

BACKGROUND

Although it is often stated that children with special needs are at risk of being abused and neglected, research conducted on the abuse of children with specific learning disorders (SLDs) is limited.

METHODS

This case-control study aims to compare exposure to neglect and abuse among children diagnosed with SLDs (case group) and children with typical development (control group). The study included children aged 6 to 12 years who were referred to the Child and Adolescent Psychiatry Outpatient Clinic and Pediatric Clinic of a hospital in Türkiye. The data collection process included 196 participants and lasted for 7 months in 2020.

RESULTS

Based on the analysis of the data collected with the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Turkish Version (K-SADS-PL-T) and the Abuse Assessment Questionnaire, we determined that children with SLDs were physically and emotionally abused more than the children of the control group. In addition, they witnessed violence between their parents more than the control group. Physical abuse, emotional abuse and witnessing family violence were identified as significant predictors for SLD.

CONCLUSIONS

The presence of SLDs is a significant risk factor for children to be exposed to abuse even in the absence of ADHD as a comorbidity.

Which factors accompany maternal acceptance-rejection in children with specific learning disabilities?

BACKGROUND

Children with specific learning disabilities (SLDs) and their parents experience many problems that may influence their interactions. The study aimed to evaluate the maternal acceptance/rejection status of children with SLDs and their associations with sociodemographic characteristics, and problem behaviors.

METHODS

The Parental Acceptance-Rejection/Control Questionnaire (PARQ/C) and Strengths and Difficulties Questionnaire (SDQ) were applied to the mothers with children aged 7-17 years with a diagnosis of SLD.

RESULTS

Among 266 children enrolled, the mean age was 10.2 years, and 61.7% were male, the mean score was 30.4 for warmth/affection, 25.8 for hostility/aggression, 22.9 for indifference/neglect, 16.3 for undifferentiated rejection, 95.4 for the total PARQ, and 40.8 for the control scales. Generalized linear models revealed that maternal depression, poor family income, parental smoking, and presence of dysgraphia, and poor total difficulties and prosocial scores of SDQ subscales were associated with the maternal acceptance-rejection. There was an interaction between the maternal control subscale and the school success of the child.

CONCLUSION

Mothers of children with SLDs had high maternal rejection scores which were associated with unfavorable characteristics of child and family. Early detection and giving appropriate support of these cases could improve the mother's relationship with her SLD child.

Specific Learning Disorders (SLD) and Behavior Impairment: Comorbidity or Specific Profile?

INTRODUCTION

Specific Learning Disorder (SLD) is a neurodevelopmental disorder characterized by difficulties in perceiving and processing verbal and non-verbal information. It is usually accompanied by impaired academic skills leading to school dropout and emotional disturbances, resulting in significant distress and behavioral problems.

METHODS

A cognitive, academic, and emotional-behavioral assessment was performed at T0 and T1 in children and adolescents with SLD. Participants received psychotherapy and speech therapy treatment from T0 to T1.

RESULTS

In SLD, the most compromised cognitive functions were working memory and writing skills. An impact on academic abilities was found. Children and adolescents with SLD experience greater anxiety and depression levels compared to their control peers.

CONCLUSIONS

SLD may adversely influence psychological well-being. To counteract such a consequence, more specific cognitive and academic skill-oriented strategies should be taken into consideration.

Prevalence, nature, and severity of the psychiatric comorbidities and their impact on quality of life in adolescents with Juvenile myoclonic epilepsy

INTRODUCTION

Adults with Juvenile myoclonic epilepsy (JME) are at increased risk for psychiatric comorbidities, personality traits, and abnormality in executive function. But studies on adolescents and their impact on quality of life are scarce in the literature.

MATERIALS AND METHODS

This cross-sectional study was performed between August 2019 and October 2022 to compare the prevalence of psychiatric comorbidities in adolescents with JME and age and gender-matched healthy controls. After completing DSM-5 Structured Clinical Interview (SCID-5) initially in all patients, we measured the severity of individual psychiatric problems like anxiety, depression, and somatic symptoms by using an appropriate psychometric scale. We also measured both groups' intelligence quotient (IQ), executive function, and quality of life.

RESULTS

One hundred patients with JME (14.3 ± 2.5 years, 48 boys) and 100 controls were enrolled. Psychiatric disorders were observed in 46% of JME and 6% of controls (p < 0.01). Psychiatric comorbidities noted in the patients with JME were: somatic symptom and related disorders(n = 14), anxiety (n = 13), adjustment disorders (n = 12), depression (n = 11), oppositional defiant disorder (n = 6), conduct disorder (n = 5), anorexia nervosa (n = 3), narcissistic (n = 3), histrionic (n = 1), substance-related disorder (n = 1), borderline (n = 2) and antisocial personality disorder (n = 2). The prevalence of depressive disorders, anxiety disorders, adjustment disorders, somatic symptoms, related disorders, and any personality disorder was significantly more in the JME group (p < 0.01 for all). Female gender, higher Epilepsy Stigma Scale score, and lower Epilepsy Outcome Expectancy Scale were significantly associated with depressive disorders (p = 0.04, 0.03, 0.03 respectively). Similarly, for anxiety, only female gender and lower Epilepsy Outcome Expectancy Scale were significant associated factors (p = 0.03, 0.02 respectively).

CONCLUSIONS

Psychiatric disorders like anxiety, depression, and personality disorders are more frequent in adolescents with JME than in controls.

Attention-Deficit Hyperactivity Disorder and Learning Disabilities Modify Recovery and Sport Behavior Following Sport-Related Concussion

Limited evidence exists concerning how a diagnosis of attention-deficit hyperactivity disorder and/or learning disabilities (ADHD/LD) modifies recovery and behavior following sport-related concussion (SRC). To understand how ADHD/LD modifies the post-SRC experience, we conducted a retrospective cohort study of concussed young athletes through phone interviews with patients and guardians. Outcomes included time until symptom resolution (SR) and return-to-learn (RTL), plus subjective changes in post-SRC activity and sports behavior. Multivariate Cox and logistic regression was performed, adjusting for biopsychosocial characteristics. The ADHD/LD diagnosis was independently associated with worse outcomes, including lower likelihood to achieve SR (hazard ratio [HR] = 0.62, 95% confidence interval [CI] = [0.41-0.94]; P = .02) and RTL (HR = 0.55, 95% CI = [0.36-0.83]; P < .01) at any time following injury, and increased odds of changing sport behavior after concussion (odds ratio [OR] = 3.26, 95% CI = [1.26-8.42], P = .02), often to a safer style of play (62.5% vs 39.6%; P = .02) or retiring from the sport (37.5% vs 18.5%; P = .02). These results provide further evidence of the unique needs for athletes with ADHD/LD following SRC.

Where Exactly Is the Therapist in Virtual Reality and Game-Based Rehabilitation Applications? A Randomized Controlled Trial in Children with Specific Learning Disability

Objective: Children with specific learning disability (SLD) experience problems in visual perception that influence academical skills and activities of daily living. Virtual reality and game-based rehabilitation applications are becoming increasingly popular in rehabilitation, including visual perception rehabilitation. However, the usage of commercially available and easily accessible games as intervention tools raises the question whether rehabilitation conducted with these games is really rehabilitation, or just casual gameplay. Therefore, we aimed to investigate the effects of a nonactively supervised (game-based intervention program [GIP]) and an actively supervised (therapist guided game-based intervention program [TGGIP]) on the visual perception skills of children with SLD. Materials and Methods: This study was designed as a single-blind randomized, controlled trial of a TGGIP on visual perception skills in children with SLD compared with the self-oriented, nonsupervised program (GIP). A total of 138 children with SLD participated in the study and were randomly divided into two groups (TGGIP and GIP). Children's visual perception skills were assessed with Motor-Free Visual Perception Test-3. Results: Both groups showed significant improvements in visual perception after the intervention programs (P < 0.05). However, the TGGIP (a supervised and structured intervention program) was significantly more effective in improving the visual perception skills compared with the GIP (a standard, nonsupervised, and unstructured intervention program) (P < 0.05). Conclusion: We think that the TGGIP methodology that we designed acts as a facilitator for therapists in using trademarked, commercially available, and easily accessible games for structured and supervised virtual reality and game-based rehabilitation applications.

Strengths and difficulties in children with specific learning disabilities

BACKGROUND

The study aims to investigate the social, emotional, and behavioral challenges in children with a specific learning disability (SLD) and to identify the factors that accompany these problems by screening with the Strengths and Difficulties Questionnaire (SDQ).

METHODS

The descriptive study was conducted on 278 children with SLD. Strengths and difficulties in children were evaluated by the SDQ applied to their mothers. The percentage of cases above the cut-off limits of the SDQ was calculated. Chi-square test and multiple logistic regression analysis were used for analysis.

RESULTS

The mean (SD) total SDQ score was 15.8 (6.5). The percentage of scores of abnormal total difficulties in SLD was 47.8%. Multivariate analysis revealed that cases exposed to antenatal smoking had higher odds ratio of abnormal emotional symptoms and abnormal total difficulties; cases with poor familial income and the presence of a history of antenatal smoking exposure showed considerably higher odds ratio of conduct problems; cases with younger age at the diagnosis of SLD, dyscalculia, extreme duration of preschool screen time (≥4 h), and history of hospitalization had significantly higher odds ratio for hyperactivity-inattention problems; and cases having shorter breastfeeding duration had higher odds ratio of peer problems compared to counterparts.

CONCLUSION

Children with SLD have a high score on the SDQ. Practitioners could especially give guidance and support to families with financial problems and those having a child with an early age at diagnosis, exposure to antenatal smoking, short breastfeeding period, early age of the first screen use, and long screen exposure duration during the preschool period.

Factor structure of the new Scandinavian WISC-V version: Support for a five-factor model

The fifth version of Wechsler Intelligence Scale for Children is designed to measure five distinct aspects of intelligence, incorporating a new fluid reasoning index to the four indexes of the previous fourth version. Several factor analyses, however, have failed to support the fifth factor. The Scandinavian version is the only national version not showing clear superiority for the five-factor solution in the Manual. In the present study, we analyze WISC-V protocols from a clinical sample of 237 children tested with the new Scandinavian version. We perform six confirmatory factor analyses (CFA) testing three hierarchical-, two bifactor-, and one correlated candidate factor models. The study shows that the three-factor model does not fit the data, and that all four- and five-factor models showed good fit. The four-factor bifactor model was somewhat better than the five-bifactor and hierarchical models, but the correlated five-factor model was the superior model. Finding support for five-factors in a clinical sample representative of those most probable to be tested with the test, strengthen the claim that also the Scandinavian version measure a distinct fluid factor as intended by the test owners, and thus that clinicians may use the index scores as their main level of analysis. Review of previous CFAs show that the choice of statistical methods for CFA, bifactor or hierarchical/correlated, influence whether second order factor models are better than g-factor models.

[Developmental disorders of academic skills in children: the efficacy and safety of Tenoten for children in the multicenter double-blind placebo-controlled randomized study]

OBJECTIVE

To evaluate the efficacy and safety of tenoten for children in the treatment of specific developmental disorders of academic skills in children of 1-3 grades.

MATERIAL AND METHODS

Two hundred and forty children, aged 7-9 years, (Total set, Safety population) with verified specific reading disorder (F81.0), specific spelling disorder (F81.1), specific disorder of arithmetical skills (F81.2), mixed disorder of scholastic skills (F81.3; F81.2+F81.0, or F81.2+F81.1, or F81.2+F81.0+F81.1), diagnosed with the use of logopedic or psychological testing (15-35 scores in Fotekova T.A. and Akhutina T.V. reading and writing tests; 5-15 scores in arithmetical subscale of the Wechsler Intelligence Scale for Children) were enrolled in the study. CT was conducted in 10 clinical centers in Russian Federation in 2015- 2019. Patients were randomized into two groups. The first one (n=122) received tenoten for children in a dose of 1 tablet 3 times a day, the second one (n=118) was administered placebo in the same dosage regimen. The clinical data on 237 children (121 of the tenoten group and 116 of the placebo group) were used for Intention-to-treat efficacy analysis. Data on 220 children (115 of the tenoten group and 105 of the placebo group) were included in Per-protocol analysis. The duration of study was 12 weeks. The mean total academic skills (reading, spelling, and counting) score in groups after 12 weeks of treatment was set as the primary efficacy endpoint.

RESULTS

The mean total academic skills score increased by 18.55±15.87 points. The significant total difference between the median changes in the total score in the tenoten and placebo groups was 5 points. There was a trend towards positive changes in reading and spelling mean scores in tests that didn't reach statistical significance due to lack of normal distribution of points in samples. There were 73 adverse events (AEs) in 42 patients of the tenoten group and 95 AEs in 31 children of the placebo group. No serious or severe AEs were registered in the tenoten group. No AEs definitely related to the study treatment were registered. No negative drug interactions were observed in the tenoten group.

CONCLUSIONS

Tenoten for children is an effective and safe treatment for specific developmental disorders of academic skills in primary school children. Tenoten for children is well tolerated. The treatment is characterized by a high level of adherence of children and their parents to therapy.

Timing is key to providing modified assessments for students with specific learning difficulties

INTRODUCTION

Medical students who are diagnosed with a specific learning difficulty (SpLD) will typically receive a reasonable adjustment within examinations in the form of modified assessment provision (MAP). This study investigated whether the timing of SpLD diagnosis and subsequent implementation of MAP has an impact on performance in applied medical knowledge multiple choice question (MCQ) assessments.

METHOD

The MCQ performance of 108 students diagnosed with SpLD who received a MAP was monitored and compared with 1960 students who received an unmodified assessment, over 5 years of a medical program. Students who received a SpLD diagnosis in the latter years of the program were identified as not receiving a MAP in assessments prior to diagnosis.

RESULTS

Differences were found between declaration and diagnosis, with 44.4% of students who declared and 48.1% who did not declare subsequently receiving a diagnosis. Students with SpLD who receive a MAP increase their applied medical knowledge assessment performance, although there is a delay of up to a year for this impact to reach significance.

CONCLUSION

Early diagnosis of SpLD is necessary to ensure the intended benefit is received from MAP.

Does the Efferent Auditory System Have a Role in Children with Specific Learning Disabilities?

Objective

This study aimed to compare the baseline transient otoacoustic emission (t-OAE) amplitudes and medial olivo-cochlear (MOC) efferent activity in children with specific learning disability (SLD) and children with normal development.

Methods

The study was conducted in two groups. The patient group included 30 children aged 6 to 10 years and diagnosed with SLD, and the control group included 30 children in the same age range without SLD. The patient group included eight males and 22 females, and the control group included 14 females and 16 males. t-OAE and contralateral suppression test were performed in both groups.

Results

In the first t-OAE measurements, a statistically significant difference was observed between the patient and the control group at frequencies of 1400, 2000, 2800, and 4000 Hz, but no such difference was observed at 1000 Hz frequency. In the control group, significantly better emission amplitudes were observed. No differences were found at any frequency between the patient and the control groups after suppression. When the subjects in the two groups were compared among themselves, there was a statistically significant difference between the before and after suppression scores in the patient group except at 4000 Hz. Likewise, an important difference was also observed in all frequencies in the control group.

Conclusion

This study shows that suppression effects of t-OAE on children diagnosed with SLD and children with no SDL are not significantly different.