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.

Telerehabilitation Pathways in Specific Learning Disorders: Improving Reading and Writing

Telerehabilitation has proved to be a useful tool for neurodevelopmental disorders in allowing timely and intensive intervention and preventing relapses; it is also widely used for specific learning disabilities (SLD), showing significant effects on reading abilities, but variables linked to its effectiveness have not been studied yet. The present study was aimed at testing the effectiveness of telerehabilitation on reading and writing in SLD children, comparing different treatment pathways, and considering the impact of training intensity and executive functions. Seventy-three children were enrolled (telerehabilitation group: 48 children, waiting list group: 25 children). The results showed significant improvements in reading fluency, text dictation, and executive functions in the training group. Children attending a combined training including reading tasks and rapid automatized naming processes improved in word reading fluency and text dictation. The number of training sessions and the change in executive functions significantly correlated with changes in reading accuracy. Here we show a new contribution to telerehabilitation research in SLD: telerehabilitation significantly enhanced learning abilities and executive functions. Training based on the learning task and the underlying processes significantly increased not only reading speed, according to previous studies, but also writing accuracy. The findings’ implications in clinical research and practice are discussed.

Hikikomori: debating a XXI century phenomenon from a clinical point of view

The term hikikomori describes a specific form of social withdrawal that can be observed in children, adolescents, and young adults. Epidemiological research studies have shown that this condition is comorbid with a psychopathological disorder only in 50% of all cases. Many young people in a state of withdrawal do not show symptoms ascribable to already known diagnostic parameters. The authors, psychologist, and psychiatrist at the UFSMIA (Functional Mental Health Unit for Children and Adolescents) in Arezzo, illustrate the current debate on the hikikomori phenomenon from a number of viewpoints: psychiatric, sociological, anthropological, and psychological. On the basis of a clinical case discussed at length in this paper, the authors define their viewpoints and the strategies initiated at the Mental Health Unit in the presence of a patient displaying a state of acute social withdrawal. The multiple actions taken by the UFSMIA are combined according to the concept of modularity. Clinical experiences collected allow the definition of therapeutic protocols useful for the treatment of hikikomori adolescents. The overall objective is to promote the autonomy of the adolescent, as well as the reinforcement of his/her identity and personal resources, as well as the non-traumatic re-entry into the social context.

Psychiatric illness in mental retardation: an update on pharmacotherapy

According to the DSM-IV, all types of psychiatric disorders can be observed in mentally retarded subjects, with prevalence estimated to be three or four times higher than in the general population. Clinical features, longitudinal course and triggering factors are influenced by the characteristics of the intellectual disability. The aim of this paper is to discuss the specificity of the psychopharmacological therapy in mental retardation (sensitivity to specific psychotropic drugs, incidence of side effects, predictive criteria for evaluating risk factors, etc.) and to propose an update in the pharmacotherapy in the most important psychiatric disorders (mood disorders, psychotic disorders, behavioral disorders, anxiety disorders, attention deficit disorders with or without hyperactivity.