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Maggio R, Turriziani L, Campestre C, Di Cara M, Tripodi E, Impallomeni C, Quartarone A, Passantino C, Cucinotta F. An individual-supported program to enhance placement in a sheltered work environment of autistic individuals mostly with intellectual disability: a prospective observational case series in an Italian community service. Front Psychiatry 2023; 14:1225236. [PMID: 38025472 PMCID: PMC10651717 DOI: 10.3389/fpsyt.2023.1225236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 09/22/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Autism spectrum disorder is a lifelong neurodevelopmental disorder. The profile of functioning in autistic people is very heterogeneous, and it is necessary to take into account individual characteristics to better support integration in the workplace. However, unemployment rates are higher for autistic people than for other types of disabilities. We present a prospective case series to explore the feasibility and efficacy of an individual-supported program to enhance placement in a sheltered work environment delivered by an Italian community day care center. Methods Autistic subjects, aged from 12 to 31 years, participated in an individual-supported program regarding employment in sheltered art workshops, integrated into the regular activity of a semi-residential center three times a week for 1 year. Their feasibility retention rate and time worked per session were registered; moreover, working methods efficacy and self-organization improvement were tracked by the Likert-based rating system. Secondary outcome measures span functional levels, challenge behaviors, and sensory problems. Results All the individuals presented a good adaptation to the environment, with a significant increase in time worked per session. After 1 year, the intervention allowed an increase in tasks completed in an assigned complex job and an improvement in self-organization within the work schedule in a group of subjects consisting mainly of severe-to-moderate levels of autism severity (86.6%). Finally, we observed a significant increase in independent functioning areas of the TEACCH transitional assessment profile. Challenge behaviors and sensory problems were also recorded. Conclusion This case series supports the idea that individual-supported programs for placement in sheltered job environments delivered by community day care centers could be feasible and effective for ASD with higher levels of severity and co-occurring intellectual disability. Further targeted studies based on community models and accessible methods need to be planned to define the effectiveness of the intervention and promote improved practice at the community level with a better social impact.
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Affiliation(s)
- Roberta Maggio
- Center for Autism “Dopo di noi”, Barcellona Pozzo di Gotto, Messina, Italy
| | - Laura Turriziani
- Center for Autism “Dopo di noi”, Barcellona Pozzo di Gotto, Messina, Italy
- Unit of Child Neurology and Psychiatry, Department of Human Pathology of the Adult and Developmental Age, “Gaetano Barresi” University of Messina, Messina, Italy
| | - Caterina Campestre
- Center for Autism “Dopo di noi”, Barcellona Pozzo di Gotto, Messina, Italy
| | | | | | | | | | - Claudio Passantino
- Center for Autism “Dopo di noi”, Barcellona Pozzo di Gotto, Messina, Italy
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Cappadona I, Ielo A, La Fauci M, Tresoldi M, Settimo C, De Cola MC, Muratore R, De Domenico C, Di Cara M, Corallo F, Tripodi E, Impallomeni C, Quartarone A, Cucinotta F. Feasibility and Effectiveness of Speech Intervention Implemented with a Virtual Reality System in Children with Developmental Language Disorders: A Pilot Randomized Control Trial. Children (Basel) 2023; 10:1336. [PMID: 37628335 PMCID: PMC10453720 DOI: 10.3390/children10081336] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 07/24/2023] [Accepted: 07/31/2023] [Indexed: 08/27/2023]
Abstract
Language disorders are characterized by impairments in verbal expression/understanding, including difficulties with one or more language components. The Virtual Reality Rehabilitation System (VRRS) is a bioelectromedical device equipped with exercise sections aimed at improving cognitive and language deficits. It also increases patient motivation and engagement. The aim of our study was to test the feasibility and efficacy of VRRS intervention to improve speech therapy treatment for children with speech disorders. Thirty-two patients were enrolled in this study and randomly assigned to the experimental (EG) or control group (CG). The CG underwent conventional speech therapy, while EG underwent VRRS-implemented speech therapy. Both groups were evaluated before (T0) and after (T1) the intervention using the Language Assessment Test. The results showed improvements in both groups. However, the EG group showed greater improvement in various areas, including comprehension of total words, repetition, naming of body parts, naming of everyday objects, total naming, morphosyntactic accuracy, sentence construction, average length of utterance, and spontaneous word production. This study demonstrated that VRRS can be a valuable tool for implementing effective speech rehabilitation. Further studies are needed, as the use of VRRS is still in its early stages, requiring larger samples sizes and long-term follow-up.
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Affiliation(s)
| | | | | | - Maria Tresoldi
- IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy; (I.C.); (A.I.); (M.L.F.); (C.S.); (M.C.D.C.); (R.M.); (C.D.D.); (M.D.C.); (F.C.); (E.T.); (C.I.); (A.Q.); (F.C.)
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Settimo C, De Cola MC, Pironti E, Muratore R, Giambò FM, Alito A, Tresoldi M, La Fauci M, De Domenico C, Tripodi E, Impallomeni C, Quartarone A, Cucinotta F. Virtual Reality Technology to Enhance Conventional Rehabilitation Program: Results of a Single-Blind, Randomized, Controlled Pilot Study in Patients with Global Developmental Delay. J Clin Med 2023; 12:4962. [PMID: 37568364 PMCID: PMC10419390 DOI: 10.3390/jcm12154962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/24/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
Global developmental delay (GDD) is a complex disorder that requires multimodal treatment involving different developmental skills. The objective of this single-blind, randomized, controlled pilot study is to evaluate the feasibility and effectiveness of conventional rehabilitation programs integrated with the BTs-Nirvana virtual reality system. Patients with GDD aged 12 to 66 months were enrolled and treated for a 48-session cycle. Patients were randomized into two groups, (1) conventional treatment and (2) conventional treatment supplemented with the use of BTs-Nirvana, in a 1:1 ratio. Before and after treatments, areas of global development were tested with the Griffiths-III Mental Developmental Scale and the clinical indicator of global improvement were measured with the Clinical Global Impressions-Improvement (CGI-I). Feasibility was confirmed by the high retention rate. The experimental group presented a significantly improvement in General Quotient (GQ) after treatment (GQ, p = 0.02), and the effect of the two treatments was significantly different in both the GQ (t =2.44; p = 0.02) and the Foundations of Learning subscale (t =3.66; p < 0.01). The overall improvement was also confirmed by the CGI-I (p = 0.03). According to these preliminary data, virtual reality can be considered a useful complementary tool to boost the effectiveness of conventional therapy in children with GDD.
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Affiliation(s)
- Carmela Settimo
- IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy; (M.C.D.C.); (R.M.); (F.M.G.); (M.T.); (M.L.F.); (C.D.D.); (E.T.); (C.I.); (A.Q.); (F.C.)
| | - Maria Cristina De Cola
- IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy; (M.C.D.C.); (R.M.); (F.M.G.); (M.T.); (M.L.F.); (C.D.D.); (E.T.); (C.I.); (A.Q.); (F.C.)
| | - Erica Pironti
- Woman-Child Department, Unit of Child Neurology and Psychiatry, Policlinico Riuniti Foggia, 71122 Foggia, Italy;
| | - Rosalia Muratore
- IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy; (M.C.D.C.); (R.M.); (F.M.G.); (M.T.); (M.L.F.); (C.D.D.); (E.T.); (C.I.); (A.Q.); (F.C.)
| | - Fabio Mauro Giambò
- IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy; (M.C.D.C.); (R.M.); (F.M.G.); (M.T.); (M.L.F.); (C.D.D.); (E.T.); (C.I.); (A.Q.); (F.C.)
| | - Angelo Alito
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, 98122 Messina, Italy;
| | - Maria Tresoldi
- IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy; (M.C.D.C.); (R.M.); (F.M.G.); (M.T.); (M.L.F.); (C.D.D.); (E.T.); (C.I.); (A.Q.); (F.C.)
| | - Margherita La Fauci
- IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy; (M.C.D.C.); (R.M.); (F.M.G.); (M.T.); (M.L.F.); (C.D.D.); (E.T.); (C.I.); (A.Q.); (F.C.)
| | - Carmela De Domenico
- IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy; (M.C.D.C.); (R.M.); (F.M.G.); (M.T.); (M.L.F.); (C.D.D.); (E.T.); (C.I.); (A.Q.); (F.C.)
| | - Emanuela Tripodi
- IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy; (M.C.D.C.); (R.M.); (F.M.G.); (M.T.); (M.L.F.); (C.D.D.); (E.T.); (C.I.); (A.Q.); (F.C.)
| | - Caterina Impallomeni
- IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy; (M.C.D.C.); (R.M.); (F.M.G.); (M.T.); (M.L.F.); (C.D.D.); (E.T.); (C.I.); (A.Q.); (F.C.)
| | - Angelo Quartarone
- IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy; (M.C.D.C.); (R.M.); (F.M.G.); (M.T.); (M.L.F.); (C.D.D.); (E.T.); (C.I.); (A.Q.); (F.C.)
| | - Francesca Cucinotta
- IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy; (M.C.D.C.); (R.M.); (F.M.G.); (M.T.); (M.L.F.); (C.D.D.); (E.T.); (C.I.); (A.Q.); (F.C.)
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Guilmatre A, Dubourg C, Mosca AL, Legallic S, Goldenberg A, Drouin-Garraud V, Layet V, Rosier A, Briault S, Bonnet-Brilhault F, Laumonnier F, Odent S, Le Vacon G, Joly-Helas G, David V, Bendavid C, Pinoit JM, Henry C, Impallomeni C, Germano E, Tortorella G, Di Rosa G, Barthelemy C, Andres C, Faivre L, Frébourg T, Saugier Veber P, Campion D. Recurrent rearrangements in synaptic and neurodevelopmental genes and shared biologic pathways in schizophrenia, autism, and mental retardation. ACTA ACUST UNITED AC 2009; 66:947-56. [PMID: 19736351 DOI: 10.1001/archgenpsychiatry.2009.80] [Citation(s) in RCA: 320] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
CONTEXT Results of comparative genomic hybridization studies have suggested that rare copy number variations (CNVs) at numerous loci are involved in the cause of mental retardation, autism spectrum disorders, and schizophrenia. OBJECTIVES To provide an estimate of the collective frequency of a set of recurrent or overlapping CNVs in 3 different groups of cases compared with healthy control subjects and to assess whether each CNV is present in more than 1 clinical category. DESIGN Case-control study. SETTING Academic research. PARTICIPANTS We investigated 28 candidate loci previously identified by comparative genomic hybridization studies for gene dosage alteration in 247 cases with mental retardation, in 260 cases with autism spectrum disorders, in 236 cases with schizophrenia or schizoaffective disorder, and in 236 controls. MAIN OUTCOME MEASURES Collective and individual frequencies of the analyzed CNVs in cases compared with controls. RESULTS Recurrent or overlapping CNVs were found in cases at 39.3% of the selected loci. The collective frequency of CNVs at these loci is significantly increased in cases with autism, in cases with schizophrenia, and in cases with mental retardation compared with controls (P < .001, P = .01, and P = .001, respectively, Fisher exact test). Individual significance (P = .02 without correction for multiple testing) was reached for the association between autism and a 350-kilobase deletion located at 22q11 and spanning the PRODH and DGCR6 genes. CONCLUSIONS Weakly to moderately recurrent CNVs (transmitted or occurring de novo) seem to be causative or contributory factors for these diseases. Most of these CNVs (which contain genes involved in neurotransmission or in synapse formation and maintenance) are present in the 3 pathologic conditions (schizophrenia, autism, and mental retardation), supporting the existence of shared biologic pathways in these neurodevelopmental disorders.
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Affiliation(s)
- Audrey Guilmatre
- Institut National de la Santé et de la Recherche Médicale, Unité 614, Institut Hospitalo-Universitaire de Recherche Biomédicale, 76000 Rouen, France
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Gagliano A, Germanò E, Pustorino G, Impallomeni C, D'Arrigo C, Calamoneri F, Spina E. Risperidone treatment of children with autistic disorder: effectiveness, tolerability, and pharmacokinetic implications. J Child Adolesc Psychopharmacol 2004; 14:39-47. [PMID: 15142390 DOI: 10.1089/104454604773840472] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Recent evidence indicates that atypical antipsychotics represent a promising option for the treatment of autistic disorder. In particular, risperidone appears to be effective in treating aggressiveness, hyperactivity, irritability, stereotypies, social withdrawal, and lack of interests. OBJECTIVE The aim of the present study was to evaluate the effectiveness and tolerability of risperidone in children with autistic disorder and to examine the correlation between plasma levels of risperidone and its active metabolite 9-hydroxyrisperidone (9-OH-risperidone) and the clinical response. METHODS The effect of treatment with risperidone (0.75-2 mg/day; mean +/- SD dose = 1.26 +/- 0.42 mg/day) was studied for 24 weeks in 20 children (14 boys, 6 girls) ages 3 to 10 years (mean age 6.0 +/- 2.4 years), diagnosed with autistic disorder. Fourteen items selected from the Children's Psychiatric Rating Scale (CPRS-14) and Clinical Global Impression (CGI) were used for behavioral evaluation. Patients were classified as responders if they showed a 25% or greater decrease on CPRS-14 total score at final evaluation compared with baseline and a final CGI rating of 1 or 2. Patients were rated for extrapyramidal side effects on the Abnormal Involuntary Movement Scale (AIMS). Other side effects, including the expected side effects of atypical antipsychotics drugs, were assessed by a checklist. Blood samples for determination of risperidone and its active metabolite 9-OH-risperidone were obtained after 12 weeks, and serum prolactin levels were measured on admission and at weeks 12 and 24. RESULTS The psychopathological state, as assessed by CPRS, improved significantly over the duration of treatment. The mean CPRS-14 scores decreased significantly from 63.7 +/- 10.0 at baseline to 52.9 +/- 14.3 at week 12 (p < 0.01). At the end of 12 weeks of treatment, 8 patients were considered responders, and 10 patients reached a minimal improvement. No further improvement was observed in the following 12 weeks. In all children, serum prolactin levels increased significantly (p < 0.001) from 166 +/- 88 UI/mL at baseline to 504 +/- 207 UI/mL at week 12 of risperidone treatment. Weight gain and increased appetite were the most common unwanted effects. A mean increase of 3.7 +/- 1.7 kg in body weight was observed at final evaluation as compared with baseline. There was no significant correlation between percent improvement in total CPRS score and the plasma level of risperidone's active fractions (the sum of the risperidone and 9-OH-risperidone plasma concentration). CONCLUSIONS This study provides further evidence of the beneficial effects of risperidone in children diagnosed with autistic disorder. However, the potential advantages of risperidone should be weighed against the risk of unwanted effects, such as an increase in serum prolactin levels and weight gain. No relation was observed between total plasma risperidone and 9-OH-risperidone concentrations and clinical response.
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Marchetti PG, Bartolozzi P, Binazzi R, Vaccari V, Girolami M, Impallomeni C, Morici F, Bevoni R. Preoperative reduction of spondylolisthesis. Chir Organi Mov 2002; 87:203-15. [PMID: 12847789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
The treatment of SL, especially in some cases, is mostly surgical. This lesion can be considered an extremely localised kyphosis (only two vertebrae) or a localized (sub-)luxation: at most hearetically pre-operative reduction should represent the first stage of the treatment, also because reduction makes further surgery easier and enables us to obtain the best results. After a glance at the various surgical techniques that have been used in the past, we describe our method of preoperative reduction in case of severe SL, an improvement of Scaglietti's original technique. According to the parameters taken into consideration, spondylolisthesis (SL) of the 4th and, above all, the 5th lumber vertebrae can be considered, especially in severe cases, as kyphosis or displacement (or even dislocation in the case of ptosis). In SL-kyphosis the antero posterior axes of the contiguous vertebral bodies are no longer parallel but tend to over-impose one to the other anteriorly forming an open posterior angle of varying degrees. It is an extremely short kyphosis (only two vertebrae) but from all points of view, even therapeutic, it reflects the characteristics of all types of vertebral kyphosis. SL-subluxation or SL-luxation (ptosis) is characterized by the respectively partial or total loss of normal alignment between the vertebrae involved. This can be explained by the fact that nearly all those who have dealt with the problem of treating SL, especially of L5, always ask themselves beforehand if it is possible and/or opportune to eliminate or improve the condition before surgery. In other words the question of reduction (pre or intraoperative, partial or total) of more or less severe L5 SL is always considered by all authors, even if their conclusions are often in disagreement.
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Affiliation(s)
- P G Marchetti
- Clinica Ortopedica dell'Università-Istituto Ortopedico Rizzoli, Bologna
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Abstract
From May 1993 to January 1997, a total of 130 humeral fractures and nonunions were treated using an "elastic" unreamed nail. The elastic nail consists of a cylindrical proximal component tapered for the application of the impactor-extractor, distally containing the proximal ends of four or five secondary nails preloaded to diverge and held together by a retaining system. The surgical approach is through the olecranic fossa apex. Once introduced, the proximal end of the nail locks automatically by diverging the secondary nails in the proximal humeral epiphysis. Distally, the elastic nail is locked with a crossbolt. The elastic nail enables stable fixation of fractures or nonunions and allows early rehabilitation.
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Affiliation(s)
- P G Marchetti
- Department of Orthopedics, Bologna University, Istituto Ortopedico Rizzoli, Italy
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