Academic skills in children with cerebral palsy and specific learning disorders

AIM

To investigate the prevalence and clinical manifestations of reading, writing, and mathematics disorders in children with cerebral palsy (CP). We explored how the clinical profile of these children differed from those with specific learning disorders (SLDs), taking into account several factors, particularly IQ scores, neuropsychological aspects, and the presence of a visual impairment.

METHOD

A prospective cross-sectional study was conducted in 42 children with CP (mean age 9 years 8 months; SD = 2 years 2 months) and 60 children with SLDs (mean age 10 years; SD = 1 year 7 months). Clinical characteristics, neuromotor and cognitive profiles, neuropsychological aspects (speech performance, academic skills, visual attention, phonological awareness, working memory), and signs of visual impairment (visual acuity, contrast sensitivity, visual field, oculomotor functions) were assessed. A machine learning approach consisting of a random forest algorithm, where the outcome was the diagnosis and the covariates were the clinical variables collected in the sample, was used for the analyses.

RESULTS

About 59% of the children with CP had reading, writing, or mathematics disorders. Children with CP with learning disorders had a low performance IQ, normal phonological awareness, and working memory difficulties, whereas children with SLDs had normal performance IQ, impaired phonological awareness, and mild working memory difficulties. There were no differences in verbal IQ between the two groups.

INTERPRETATION

Learning disorders are frequently associated with CP, with different clinical characteristics, compared with SLDs. Assessment of academic skills is mandatory in these children, even if the IQ is normal. At school age, specific interventions to promote academic skills in children with CP could be a major rehabilitative goal.

WHAT THIS PAPER ADDS

Reading, writing, and mathematics disorders in cerebral palsy have specific clinical characteristics. Their underlying mechanisms differ from those described in specific learning disorders. Working memory impairment can be considered a hallmark of learning disorders in children with cerebral palsy.

Response to Intervention and Specific Learning Disability Identification: Evidence From Tennessee

Response to intervention (RTI) is a method for providing academic support to students and for identifying specific learning disabilities (SLDs). Using interrupted time series and hazard models, we examined if statewide RTI adoption in the U.S. state of Tennessee was associated with changes in rates of SLD and first-time SLD identification in elementary schools, and if these associations varied across student groups. Response to intervention was associated with an initial decline in the percentage of students with SLD in the state that continued over time, with larger decreases for students who were Black or economically disadvantaged. Response to intervention was associated with a 61% average decrease in the odds of first-time SLD identification by third grade (about a 0.006 change in the predicted probability), with greater declines for students who were Black or economically disadvantaged. We discuss these results in the context of disproportionality in special education and the need for research examining whether declines in SLD were due to improved academic outcomes, as opposed to delays in identification.

Executive functions in children with specific learning disorders: Shedding light on a complex profile through teleassessment

Executive Functions (EFs) are high-order cognitive processes relevant to learning and adaptation and frequently impaired in children with specific learning disorders (SLDs). This study aimed to investigate EFs in children with SLD and explore the role of specific EF-related subprocesses, such as stimuli processing and processing speed. Fifty-seven SLD and 114 typically developing (TD) children, matched for gender and age, completed four tasks measuring response inhibition, interference control, shifting, and updating on a web-based teleassessment platform. The results show that SLD children performed lower in all EF tasks than TD children, regardless of stimulus type and condition. Mediation analyses suggested that differences between the SLD and TD groups are mediated by EF-related subprocesses, offering an interpretative model of EF deficits in children with SLD.

B - 07 Rorschach Differences between Reading and Mathematic Impairment in Specific Learning Disorders (SLDs)

OBJECTIVE

To identify differences based on perceptions of the Rorschach test between individuals who were diagnosed with Specific Learning Disorder of Reading (LDR) and Mathematics (LDM) impairment.

METHOD

Participants were selected from a deidentified database from a large Southeastern university. The group assignment of the diagnoses were made according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994). Participants were divided into those with diagnosed LDR (n = 38, 50% white, Mage = 28, SD = 9.82, education Med = 14.02, SD = 2.05) and LDM (n = 41, 61% white, Mage = 29, SD = 11.98, education Med = 13.59, SD = 1.40). The groups were compared on demographic variables (age, education level, race, gender, and handedness) but there were no significant across the variables. Analysis of Variance (ANOVA) compared the means to test the difference between groups on the Rorschach variables.

RESULTS

Individuals with diagnosed LDR had significantly higher levels of Form-Color Ratio (FC, F(1,79) = 5.664, p = 0.02; (M = 2.4471, SD = 2.13). No other Rorschach variables were found to be significant in individuals diagnosed with LDR or LDM.

CONCLUSIONS

Overall the differences between the groups were minimal suggesting that the Rorschach variables were not important. The increase in FC may suggest individuals with LDR have increased difficulties in emotional regulation, processing speed, and executive functioning. Individuals with LDR may therefore struggle with aspects of daily living. Given the lack of differences, the Rorschach may not be the most useful assessment in understanding underlying workings of individuals with LDR or LDM. Additional projective assessments or future developments of individualized assessments would be useful in treating the learning disorder community.

The role of suprathreshold auditory processing abilities in children with specific learning disorder

OBJECTIVE

To assess the suprathreshold auditory processing and speech recognition abilities in noise in children with specific learning disorder (SLD).

METHODS

A group of twenty-five children diagnosed with SLD and a control group of twenty-five neuro-typical children were included in the study. All the participants were between 6-11 years old. To evaluate suprathreshold auditory processing abilities, the participants were given the Temporal Fine Structure (TFS) Sensitivity Test and the Temporal Envelope (TE) Sensitivity Test, as well as the Consonant Identification Test, was administered to evaluate speech recognition ability in noise. In addition, the Wechsler Intelligence Scale for Children - Fourth Edition (WISC-IV) intelligence test was applied to children with SLD, and the relationship between WISC-IV intelligence test scores in different skills and suprathreshold auditory processing and speech recognition abilities in noise was investigated.

RESULTS

Significant differences were found between children diagnosed with SLD and neuro-typical children in terms of suprathreshold auditory processing tasks and speech recognition in noise. Additionally, no correlation was found between suprathreshold auditory processing tasks, speech recognition in noise, and intelligence tests.

CONCLUSION

Suprathreshold auditory processing and speech recognition abilities in noise were found to be affected in children with SLD. A holistic evaluation including a multidisciplinary approach that includes suprathreshold auditory processing abilities is required for children diagnosed with SLD.

Specific Learning Disorders: Variation Analysis of 15 Candidate Genes in 9 Multiplex Families

Background and Objectives: Specific Learning Disorder (SLD) is a complex neurobiological disorder characterized by a persistent difficult in reading (dyslexia), written expression (dysgraphia), and mathematics (dyscalculia). The hereditary and genetic component is one of the underlying causes of SLD, but the relationship between genes and the environment should be considered. Several genetic studies were performed in different populations to identify causative genes. Materials and Methods: Here, we show the analysis of 9 multiplex families with at least 2 individuals diagnosed with SLD per family, with a total of 37 persons, 21 of whom are young subjects with SLD, by means of Next-Generation Sequencing (NGS) to identify possible causative mutations in a panel of 15 candidate genes: CCPG1, CYP19A1, DCDC2, DGKI, DIP2A, DYM, GCFC2, KIAA0319, MC5R, MRPL19, NEDD4L, PCNT, PRMT2, ROBO1, and S100B. Results: We detected, in eight families out nine, SNP variants in the DGKI, DIP2A, KIAA0319, and PCNT genes, even if in silico analysis did not show any causative effect on this behavioral condition. In all cases, the mutation was transmitted by one of the two parents, thus excluding the case of de novo mutation. Moreover, the parent carrying the allelic variant transmitted to the children, in six out of seven families, reports language difficulties. Conclusions: Although the present results cannot be considered conclusive due to the limited sample size, the identification of genetic variants in the above genes can provide input for further research on the same, as well as on other genes/mutations, to better understand the genetic basis of this disorder, and from this perspective, to better understand also the neuropsychological and social aspects connected to this disorder, which affects an increasing number of young people.

Mediating role of self-concept on character strengths and well-being among adolescents with specific learning disorder in India

BACKGROUND

Adolescents with Specific Learning Disorder (SLD) are at higher risk of academic underachievement, stigmatization, and mental health issues. However, the complete elimination of disorder-related deficits and external challenges is an impracticable solution for enhancing their well-being.

AIM

The study adopts a strength-based approach to understand the role of an innate factor, i.e., self-concept, in the association between character strengths and well-being of adolescents with SLD.

METHODS

A correlational research design following a mediation analysis was adopted to examine the association between the study variables on a sample of 115 adolescents with SLD from India.

RESULTS

Self-concept functioned as a partial mediator between the life-satisfaction construct of well-being and six character strengths: Appreciation of beauty and excellence, Perseverance, Judgment, Leadership, Perspective, and Zest. Gender differences were identified with regard to the study variables.

CONCLUSIONS AND IMPLICATIONS

Self-concept of adolescents with SLD could partly contribute to enhanced character strengths awareness to protect well-being. Further, the crucial role of internal factors like self-concept and character strengths in improving the well-being of this population was highlighted. Thereby encouraging future research on SLD to adopt approaches that focus on innate strengths rather than deficits and external sources of well-being.

The hope theory and specific learning disorders and/or attention deficit disorders (SLD/ADHD): Developmental perspectives

Research on disabilities has generally used a deficit-oriented approach. However, the recent appreciation of the personal strengths and positive traits of the disabled has raised awareness of them as empowering and activating factors. According to the hope theory, the ability to embrace future perspectives, set meaningful goals, and plan specific paths to reach these goals predict well-being and adjustment. We review the research on the role of hope in the lives of individuals with SLD/ADHD from a developmental perspective. We investigate hope as a resource in predicting these people's ability to deal with personal risks through developmental stages and contextual conditions. We conclude by proposing future research and intervention directions.

Giftedness and Neurodevelopmental Disorders in Children and Adolescents: A Systematic Review

OBJECTIVE

Throughout the years, several myths have arisen suggesting that children diagnosed with neurodevelopmental disorders possess unusually high abilities in specific domains, depending on the disorder. On the other hand, special skills and talents in children with neurodevelopmental disorders are most commonly overshadowed by their difficulties and overlooked. The purpose of this systematic review is to examine the association between giftedness and neurodevelopmental disorders.

METHODS

The related articles published in PubMed, Google Scholar, PsycINFO, and Embase up to December 31, 2020, as well as their reference lists, were reviewed systematically.

RESULTS

A total of 6069 studies were scanned, and 32 of them (9904 subjects) were deemed eligible for this systematic review. Studies have supported associations between autism spectrum disorders and music ability. Contradictory results have been published regarding associations between giftedness, attention-deficit/hyperactivity disorder, and specific learning disorders. Diagnostic methods seemed to modify associations between giftedness and neurodevelopmental disorders.

CONCLUSION

The dearth of the available evidence is prominent. More research is needed to investigate the field of dual exceptionality. Longitudinal studies are needed, addressing methodological challenges pertaining to variability in the definition of giftedness.

Specific learning disorders in young adults: Investigating pragmatic abilities and their relationship with theory of mind, executive functions and quality of life

BACKGROUND

Specific Learning Disorders (SLD) are lifelong conditions often associated with language difficulties, executive dysfunctions, and psychological problems. Previous research has shown that communicative-pragmatic ability may be impaired in SLD. However, the role of other cognitive abilities in explaining pragmatic difficulties has still not been fully investigated. The relationship between pragmatics and quality of life is not yet clear, as well.

AIMS

Firstly, the study assessed pragmatic comprehension abilities in adults with SLD. Secondly, we examined the relationship between pragmatics, theory of mind, executive functions and quality of life.

METHOD AND PROCEDURES

We enrolled 26 adults with SLD and 30 adults without SLD. Standardized tests assessing pragmatic comprehension, theory of mind and executive functions were used. The quality of life was investigated with a self-reported questionnaire.

OUTCOMES AND RESULTS

Pragmatic comprehension abilities were compromised in young adults with SLD. In this clinical population we also found a link between pragmatic comprehension and visual theory of mind. Finally, independently from the presence of SLD, pragmatics abilities were in relationship with quality of life.

CONCLUSIONS AND IMPLICATIONS

Overall, these data highlight the importance of including pragmatic abilities both in the clinical evaluation, as well as in psychological intervention for adults with SLD.

Sleep Disturbances in Children with Attentional Deficit Hyperactivity Disorder and Specific Learning Disorders

Sleep disturbances may be a significant source of distress for children with neurodevelopmental disorders, and consequently also for their families. Crucially, sleep disturbances might be influenced by comorbidity. Attention deficit hyperactivity disorder (ADHD) and specific learning disorder (SLD) often co-occur, and consequently, investigating sleep disturbances in children with comorbidity of ADHD and SLD is essential. Our study aimed at detecting sleep difficulties in a group of 74 children with ADHD, 78 children with SLD, and 76 children with ADHD and SLD by using the Sleep Disturbances Scale for Children. The results showed that sleep difficulties emerge more clearly in children with comorbid ADHD and SLD compared to children with only ADHD or SLD. These sleep difficulties were not due to differences in ages and behavioral/emotional problems. In conclusion, evaluating sleep disturbances is important when assessing and managing children with ADHD, SLD, and particularly with the two comorbid conditions, to better understand their difficulties and develop tailored interventions.

Children's vocabulary and friendships: A comparative study between children with and without Specific Learning Disorder and Attention Deficit Hyperactivity Disorder

Language skills are important in the formation and maintenance of friendships. Children with specific learning disorder (SLD) or attention-deficit/hyperactivity disorder (ADHD) experience difficulties with their relationships and have language-related problems. This study aims to examine how expressive and receptive vocabulary may relate to friendships of children with and without SLD or ADHD. Participants were 64 children with SLD, 64 children with ADHD, and 64 typically developing (TD) children, aged 8-12 years (M_age  = 9.77 years, SD = 1.22), attending Grades 3 to 6 in inclusive primary schools of Attica, Greece. The Greek versions of the Peabody Picture Vocabulary Test and the expressive vocabulary subscale of the WISC-III were administered along with the sociometric nominations of friends and the self-reports of best friendship duration. Results showed that children with SLD and ADHD reported best friendships of shorter duration and had significantly poorer receptive and expressive vocabulary. Children with ADHD had significantly fewer close and best friends than children with SLD, who in turn had significantly fewer close and best friends than the TD children. Children's vocabulary in all three groups was positively correlated with the duration of their best friendships and was found to moderately predict children's close friendships.

Self-efficacy and psychological well-being in a sample of Italian university students with and without Specific Learning Disorder

BACKGROUND

Despite an internationally recognized significant increase of students with a diagnosed Specific Learning Disorder (SLD) entering higher education, psychological features of university students with SLD still remain to be explored.

AIMS

The study aims to investigate the perceived academic self-efficacy and to identify predictors of psychological well-being in a sample of university students with SLD, compared to a control group of students without SLD.

METHODS AND PROCEDURE

60 Italian undergraduate students with SLD and 283 students without SLD were included in this study.

OUTCOMES AND RESULTS

Results indicated that university students with SLD, compared to students without SLD but with comparable academic achievement, did not report significantly lower levels of academic self-efficacy. Furthermore, a multiple regression analysis indicated that self-esteem and perceived social support by significant others did significantly predict the value of psychological well-being in students with SLD.

CONCLUSIONS AND IMPLICATIONS

The findings suggest that undergraduate students with SLD may represent a particular category of young adults who have beaten the odds, who have persisted in effort even if they struggled and then who have succeeded.

Cognitive correlates of dyslexia, dyscalculia and comorbid dyslexia/dyscalculia: Effects of numerical magnitude processing and phonological processing

Specific learning disorders (i.e., dyscalculia and dyslexia) are common, as is their comorbidity. It has been suggested that the core cognitive deficit in dyscalculia is an impairment in numerical magnitude processing; similarly, in dyslexia, phonological processing deficits are considered to be the main cognitive deficit. Cognitive theories on comorbid dyslexia/dyscalculia have suggested a number of hypotheses about which cognitive deficits underlie the comorbidity. However, few studies have thus far directly compared the abovementioned cognitive correlates of dyscalculia and dyslexia. In this study, we assessed symbolic and non-symbolic numerical magnitude and three subcomponents of phonological processing (phonological awareness, lexical access and verbal short-term memory). In addition, we investigated children's domain-general spatial and verbal skills. The effect of these cognitive correlates on dyscalculia, dyslexia and their comorbidity was explored. We did not find differences between children with and without dyscalculia on numerical magnitude processing. On the other hand, children with dyscalculia had significantly lower spatial skills compared to children without dyscalculia. Children with dyslexia performed significantly lower on all subcomponents of phonological processing. Finally, we found an additive effect for comorbid dyslexia/dyscalculia: impairments in children with co-occurring dyslexia and dyscalculia were similar to the sum of the impairments in the isolated dyslexia and isolated dyscalculia groups. The strongest unique predictor of isolated dyscalculia and comorbid dyslexia/dyscalculia was spatial skills, the strongest unique predictor of isolated dyslexia was phonological awareness. As only a limited number of cognitive variables were assessed in this study and the sample sizes were very small, we should be cautious when interpreting these results.

[Intelligence structure and clinical features of school-age children with attention deficit hyperactivity disorder and specific learning disorder]

OBJECTIVE

To study the intelligence structure and clinical features of children with attention deficit hyperactivity disorder (ADHD) and specific learning disorder (SLD).

METHODS

A retrospective analysis was performed on 88 school-age children with ADHD. According to the presence or absence of SLD, they were divided into two groups: simple ADHD group with 45 children and ADHD+SLD group with 43 children. Intelligence structure and clinical features were compared between the two groups.

RESULTS

Compared with the simple ADHD group, the ADHD+SLD group had significantly lower verbal intelligence quotient (VIQ), performance intelligence quotient (PIQ), and full intelligence quotient (FIQ) (P<0.05), significantly lower scores of VIQ factors (including information, similarities, arithmetic, and recitation) (P<0.05), and significantly lower scores of PIQ factors (including picture completion, picture arrangement, block design, and object assembly) (P<0.05). The development of SLD was negatively correlated with FIQ, VIQ, and PIQ. It was also negatively correlated with the scores of intelligence structure factors (including information, similarities, arithmetic, recitation, picture completion, picture arrangement, block design, and object assembly) (P<0.05).

CONCLUSIONS

Children with ADHD and SLD have poorer FIQ, VIQ, and PIQ than those with ADHD alone, which mainly manifests as the weak abilities of most intelligence structure factors. It is necessary to pay attention to the management and intervention of SLD in school-age children with ADHD.

The discrepancy between verbal and visuoperceptual IQ in children with a specific learning disorder: An analysis of 1624 cases

Children with a specific learning disorder (SLD) are often characterized by marked intellectual strengths and weaknesses. In the last few years, research has focused on a common discrepancy between low working memory and processing speed on the one hand, and high verbal and visuoperceptual intelligence on the other. SLD profiles featuring a specific discrepancy between verbal and visuoperceptual abilities have been only marginally considered, however, and their systematic comparison vis-à-vis typically-developing (TD) populations has yet to be conducted. The present study examined a dataset of 1624 WISC-IV profiles of children with a diagnosis of SLD. It emerged that the proportion of children with a Verbal Comprehension Index (VCI) at least 1.5 SD (22 standardized points) lower than their scores on the Perceptual Reasoning Index (PRI) was larger than the proportion of SLD children with the opposite discrepant profile; it was also larger than the same proportion found among TD children. Comparing the two discrepant profiles revealed that the children also differed by type of learning difficulty, gender, and performance in the WISC-IV Symbol search task. Further examination suggested that children who were discrepant and also distinctly poor in visuoperceptual intelligence were particularly slow in general processing.