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Caprì T, Dovigo L, Semino M, Lotan M, Mohammadhasani N, Zamarra G, Fabio RA. Use of a low-tech tool in the improvement of social interaction of patients with Rett Syndrome: an observational study. Front Public Health 2024; 12:1353099. [PMID: 38645452 PMCID: PMC11027742 DOI: 10.3389/fpubh.2024.1353099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 03/22/2024] [Indexed: 04/23/2024] Open
Abstract
Introduction The main aim of the present study was to examine whether the use of a low-tech tool, called click4all, inserted into cognitive and motor training can increase social interaction of patients with Rett Syndrome (RTT) with classmates in a school setting. Methods Twenty-seven participants with RTT were randomly assigned to two groups: the experimental group received treatment with click4all, and the control group received traditional treatment without click4all. Parameters were measured before treatment (T1), 6 months after treatment (T2), 6 months after the second treatment phase (T3) and at the end of the third treatment phase (T4). Results The results demonstrated an increase in levels of social interaction among classmates and patients with RTT in the experimental group, over time, compared to the control group, 95% CI [5.20-15.30]. Classmates also showed a higher level of knowledge related to participants of the experimental group, and this increased over time, 95% CI [24.98-63.52]. The level of knowledge related to the control group was stable over time and lower than the experimental group. Discussion This study demonstrated that the use of a low-tech tool can increase social interactions of patients with RTT in a school setting. This is important, as patients with RTT are often restricted in an isolation condition.
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Affiliation(s)
- Tindara Caprì
- Department of Life and Health Sciences, and Health Professions, Link Campus University, Rome, Italy
| | - Lucia Dovigo
- Airett Innovation and Research Center, Verona, Italy
| | | | - Meir Lotan
- Department of Physical Therapy, Ariel University, Ariel, Israel
| | - Nasrin Mohammadhasani
- Department of Educational Technology, Faculty of Educational Sciences and Psychology, Kharazmi University, Tehran, Iran
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Dovigo L, Caprì T, Iannizzotto G, Nucita A, Semino M, Giannatiempo S, Zocca L, Fabio RA. Social and Cognitive Interactions Through an Interactive School Service for RTT Patients at the COVID-19 Time. Front Psychol 2021; 12:676238. [PMID: 34248774 PMCID: PMC8265204 DOI: 10.3389/fpsyg.2021.676238] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 05/27/2021] [Indexed: 11/30/2022] Open
Abstract
Background: The closure of all educational institutions and most rehabilitation centres represents a precautionary measure to face the COVID-19 pandemic, but the isolation and social distancing may be particularly challenging for children with special needs and disabilities (SEND), such as Rett Syndrome (RTT). The main aim of this study was to promote cognitive and social interactions among children with RTT through an interactive school program. Methods: The Interactive School palimpsest was composed of moments in which a teacher spoke directly to children with RTT and expected a response through eye gaze, and moments in which storeys-cartoon were presented while tracking the eye gaze of children. We investigated behavioural, social and cognitive parameters. Results: Children participated in both social and cognitive tasks with the spontaneous reduction of stereotypies and with increase in attention. They recalled more significant indexes when music or a song was presented together with a cartoon or a cognitive task. Conclusions: This study provides initial insights in promoting cognitive and social interactions and in the support needs of families with a child with RTT during the COVID-19 pandemic.
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Affiliation(s)
- Lucia Dovigo
- Airett Innovation and Research Center, Verona, Italy
| | - Tindara Caprì
- Airett Innovation and Research Center, Verona, Italy
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Giancarlo Iannizzotto
- Airett Innovation and Research Center, Verona, Italy
- Department of Cognitive Sciences, Psychological, Educational and Cultural Studies, University of Messina, Messina, Italy
| | - Andrea Nucita
- Airett Innovation and Research Center, Verona, Italy
- Department of Cognitive Sciences, Psychological, Educational and Cultural Studies, University of Messina, Messina, Italy
| | - Martina Semino
- Airett Innovation and Research Center, Verona, Italy
- Tice Learning Center, Piacenza, Italy
| | - Samantha Giannatiempo
- Airett Innovation and Research Center, Verona, Italy
- Tice Learning Center, Piacenza, Italy
| | - Lia Zocca
- Airett Innovation and Research Center, Verona, Italy
| | - Rosa Angela Fabio
- Airett Innovation and Research Center, Verona, Italy
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Dovigo L, Caprì T, Iannizzotto G, Nucita A, Semino M, Giannatiempo S, Zocca L, Fabio RA. Social and Cognitive Interactions Through an Interactive School Service for RTT Patients at the COVID-19 Time. Front Psychol 2021; 12:676238. [PMID: 34248774 PMCID: PMC8265204 DOI: 10.3389/fpsyg.2021.676238 10.3389/fpsyg.2021.676238] [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] [Indexed: 11/05/2022] Open
Abstract
Background: The closure of all educational institutions and most rehabilitation centres represents a precautionary measure to face the COVID-19 pandemic, but the isolation and social distancing may be particularly challenging for children with special needs and disabilities (SEND), such as Rett Syndrome (RTT). The main aim of this study was to promote cognitive and social interactions among children with RTT through an interactive school program. Methods: The Interactive School palimpsest was composed of moments in which a teacher spoke directly to children with RTT and expected a response through eye gaze, and moments in which storeys-cartoon were presented while tracking the eye gaze of children. We investigated behavioural, social and cognitive parameters. Results: Children participated in both social and cognitive tasks with the spontaneous reduction of stereotypies and with increase in attention. They recalled more significant indexes when music or a song was presented together with a cartoon or a cognitive task. Conclusions: This study provides initial insights in promoting cognitive and social interactions and in the support needs of families with a child with RTT during the COVID-19 pandemic.
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Affiliation(s)
- Lucia Dovigo
- Airett Innovation and Research Center, Verona, Italy
| | - Tindara Caprì
- Airett Innovation and Research Center, Verona, Italy,Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy,*Correspondence: Tindara Caprì
| | - Giancarlo Iannizzotto
- Airett Innovation and Research Center, Verona, Italy,Department of Cognitive Sciences, Psychological, Educational and Cultural Studies, University of Messina, Messina, Italy
| | - Andrea Nucita
- Airett Innovation and Research Center, Verona, Italy,Department of Cognitive Sciences, Psychological, Educational and Cultural Studies, University of Messina, Messina, Italy
| | - Martina Semino
- Airett Innovation and Research Center, Verona, Italy,Tice Learning Center, Piacenza, Italy
| | - Samantha Giannatiempo
- Airett Innovation and Research Center, Verona, Italy,Tice Learning Center, Piacenza, Italy
| | - Lia Zocca
- Airett Innovation and Research Center, Verona, Italy
| | - Rosa Angela Fabio
- Airett Innovation and Research Center, Verona, Italy,Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Fabio RA, Pergolizzi G, Nucita A, Iannizzotto G, Caprì T. The role of a virtual avatar in attention and memory tasks in Rett syndrome. BMC Neurol 2021; 21:223. [PMID: 34126956 PMCID: PMC8201674 DOI: 10.1186/s12883-021-02212-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/26/2021] [Indexed: 11/10/2022] Open
Abstract
Background Since subjects with Rett syndrome (RTT) focus their attention mainly on the faces of people with whom they interact, in this study the role of a human-like smart interactive agent (an avatar) in enhancing cognitive processes is examined. More in depth, this study aimed to understand if, and to what extent, the use of an avatar can improve attention and memory abilities in subjects with RTT. Method Thirty-six subjects with RTT participated in the study. All participants performed over-selectivity and memory tasks, for a total of six trials. These trials were randomly presented in two different conditions: with and without virtual avatar. Results The results indicated that the participants improved their attention and memory abilities when they performed the tasks with the avatar. There were no improvements when they performed the tasks without the avatar. Discussion The results were discussed considering the relationship between motivation, attention and memory in RTT. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-021-02212-w.
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Affiliation(s)
- Rosa Angela Fabio
- Department of Experimental and Clinical Medicine, University of Messina, Via Bivona, 98122, Messina, Italy.
| | - Giorgia Pergolizzi
- Department of Experimental and Clinical Medicine, University of Messina, Via Bivona, 98122, Messina, Italy
| | - Andrea Nucita
- Department of Cognitive Sciences, Psychological, Educational and Cultural Studies, University of Messina, Via Concezione, 6, 98122, Messina, Italy
| | - Giancarlo Iannizzotto
- Department of Cognitive Sciences, Psychological, Educational and Cultural Studies, University of Messina, Via Concezione, 6, 98122, Messina, Italy
| | - Tindara Caprì
- Department of Experimental and Clinical Medicine, University of Messina, Via Bivona, 98122, Messina, Italy
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Fabio RA, Giannatiempo S, Semino M, Caprì T. Longitudinal cognitive rehabilitation applied with eye-tracker for patients with Rett Syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 111:103891. [PMID: 33581477 DOI: 10.1016/j.ridd.2021.103891] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 01/27/2021] [Accepted: 02/02/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND longitudinal effects of cognitive rehabilitation in Rett Syndrome (RTT) have been poorly investigated and the mechanisms do not appear to have been described in detail. AIMS the aim of this study was to examine the effects of cognitive rehabilitation with eye-tracker technology on attention, choice behaviours and language over a 2-year period in patients with RTT. METHODS AND PROCEDURES 28 participants with RTT, ranging from age 4-22 years old (M = 13.85 years, SD = 5.89), received 30 min of cognitive rehabilitation with eye-tracker for 3 days a week over a 1-month for 2 years. They then underwent cognitive assessment to evaluate attention, choice, language and global functioning in four specific times: before cognitive rehabilitation (T1), after six months of cognitive rehabilitation (T2), six months after the second cognitive rehabilitation phase (T3) and at the end of the third cognitive rehabilitation phase (T4). OUTCOME AND RESULTS patients with RTT show long-term improvements in seconds of attention and number of choice behaviours, with barely any improvement in global functioning. No improvement in language was found. CONCLUSIONS AND IMPLICATIONS this is the first study aimed at examining longitudinal effects of cognitive rehabilitation in patients with RTT, demonstrating a linear improvement across time in attention and choice.
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Affiliation(s)
- Rosa Angela Fabio
- Department of Clinical and Experimental Medicine, University of Messina, Via Bivona, 98100, Messina, Italy
| | - Samantha Giannatiempo
- Centro AIRETT Ricerca e Innovazione (CARI), Research and Innovation Airett Center, Verona, Italy
| | - Martina Semino
- Centro AIRETT Ricerca e Innovazione (CARI), Research and Innovation Airett Center, Verona, Italy
| | - Tindara Caprì
- Department of Clinical and Experimental Medicine, University of Messina, Via Bivona, 98100, Messina, Italy.
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Romano A, Caprì T, Semino M, Bizzego I, Di Rosa G, Fabio RA. Gross Motor, Physical Activity and Musculoskeletal Disorder Evaluation Tools for Rett Syndrome: A Systematic Review. Dev Neurorehabil 2020; 23:485-501. [PMID: 31668104 DOI: 10.1080/17518423.2019.1680761] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In recent years, much attention has been paid to motor impairment of persons with Rett Syndrome (RTT), with increasing literature aimed to describe gross motor functioning and musculoskeletal disorders of the RTT population. The aim of this systematic review is to describe clinical evaluation tools used in the last decade to assess motor functioning and musculoskeletal abnormalities of patients with RTT. Thirty-four studies were reviewed and 20 tools were presented. Results showed that only two tools were used to measure functional change after rehabilitative or therapeutic interventions. This review underlies the lack of adequate evaluation tools to assess musculoskeletal abnormalities and deformities in RTT population. The absence of these assessments could be due to a statistical difficulty as it is challenging to build an evaluation tool that can score the entities of the abnormalities related to the amount of disability they cause.
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Affiliation(s)
- Alberto Romano
- Movement Analysis and Robotics Laboratory (MARLab) , Rome, Italy
| | - Tindara Caprì
- Department of Clinical and Experimental Medicine, University of Messina , Via Bivona, Messina, Italy
| | - Martina Semino
- Centro AIRETT Ricerca e Innovazione (CARI), Research and Innovation Airett Center , Verona, Italy
| | - Ilaria Bizzego
- Centro AIRETT Ricerca e Innovazione (CARI), Research and Innovation Airett Center , Verona, Italy
| | - Gabriella Di Rosa
- Division of Child Neurology and Psychiatry, G. Martino Hospital, University of Messina , Messina, Italy
| | - Rosa Angela Fabio
- Department of Clinical and Experimental Medicine, University of Messina , Via Bivona, Messina, Italy
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Effects of Combined Transcranial Direct Current Stimulation with Cognitive Training in Girls with Rett Syndrome. Brain Sci 2020; 10:brainsci10050276. [PMID: 32370253 PMCID: PMC7287589 DOI: 10.3390/brainsci10050276] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/18/2020] [Accepted: 04/22/2020] [Indexed: 01/04/2023] Open
Abstract
Background: Transcranial Direct Current Stimulation (tDCS) combined with traditional rehabilitative techniques has not been widely applied to Rett Syndrome (RTT). The aim of this study was to examine the effects of combined cognitive traditional training with tDCS applied to attention and language measures in subjects with RTT. Methods: 31 subjects with RTT were randomly allocated into two groups: non-sham tDCS (n = 18) and sham tDCS (n = 13). The former received the integrated intervention non-sham tDCS plus cognitive empowerment during the treatment phase. The latter received sham stimulation plus cognitive empowerment. All participants underwent neurological and cognitive assessment to evaluate attention and language measures: before integrated treatment (pre-test phase), at the conclusion of the treatment (post-test phase), and at 1 month after the conclusion of the treatment (follow-up phase). Results: the results indicated longer attention time in the non-sham tDCS group compared to the sham tDCS group with a stable trend also in the follow-up phase; an increase of the number of vowel/phoneme sounds in the non-sham tDCS group; and an improvement in the neurophysiological parameters in the non-sham tDCS group. Conclusions: This study supports the use of tDCS as a promising and alternative approach in the RTT rehabilitation field.
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Lecciso F, Colombo B. Beyond the Cortico-Centric Models of Cognition: The Role of Subcortical Functioning in Neurodevelopmental Disorders. Front Psychol 2020; 10:2809. [PMID: 31920851 PMCID: PMC6927277 DOI: 10.3389/fpsyg.2019.02809] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 11/28/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Flavia Lecciso
- Lab of Applied Psychology and Intervention, Department of History, Society and Human Studies, Università del Salento, Lecce, Italy
| | - Barbara Colombo
- Neuroscience Lab, Champlain College, Burlington, VT, United States
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Stasolla F, Caffò AO, Perilli V, Albano V. Experimental Examination and Social Validation of a Microswitch Intervention to Improve Choice-Making and Activity Engagement for Six Girls with Rett Syndrome. Dev Neurorehabil 2019; 22:527-541. [PMID: 31169045 DOI: 10.1080/17518423.2019.1624655] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: The use of assistive technology, specifically microswitches, with children with RTT has been shown to effectively moderate the impact of their disability on their quality of life- by facilitating access to meaningful leisure and other activities. Objectives: This study aimed to evaluate the effectiveness of a microswitch intervention on increased choice making, engagement in a targeted sorting activity, and indices of happiness, and decreased stereotypic behaviors for six girls with Rett syndrome. Targeted dependent variables were also assessed at six months post-intervention. Following the intervention study, 90 external raters completed a social validation procedure. Method: An ABABAB experimental sequence was implemented for each participant with a cross-over effect. A social validation assessment involving 90 external raters was carried out. Results: Data emphasized an improved performance for each participants involved (i.e., adaptive responses). Five participants showed a capacity of independent choice. One participant seemed to be closely linked to the position of the container. Social raters favorably endorsed the use of the program since they positively evaluated the use of the technology on all the dimensions investigated. Conclusion: A microswitch intervention may improve choice making and activity engagement for children with Rett syndrome. Further research is needed on the development of more sophisticated forms of individualized technological options to improve opportunities for enhanced engagement and choice-making for individuals with RTT.
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Affiliation(s)
| | | | | | - Vincenza Albano
- Department of Educational Sciences, Psychology, Communication, University of Bari , Italy
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