Differential neuropsychological profiles in children and adolescents with motor disability in an inclusive educational setting

The aim of this study was to determine the potential cognitive impairment associated with motor disability in a group of children attending regular schools and to analyze whether there were different cognitive profiles according to the type of motor disability they presented. The study had 87 participants, 31 healthy and 56 with three types of motor disability: Neuromuscular Diseases (NMD Group), Cerebral Palsy-Hemiparesis (CP- HPx Group) and Cerebral Palsy-Diplegia (CP-DP). Ages ranged from 6 to 18 years and they had medium and medium-high socioeconomic and cultural levels. All participants attended regular state-funded and independent schools in an inclusive modality. The neuropsychological assessment included the following cognitive domains: processing speed, working memory, verbal and visual episodic memory, language, visuo-perception and constructive praxis and executive functioning. A second analysis was performed with the groups with CP: one based on the severity of gross motor impairment (GMFCS-E&R scale) and the other based on the levels of manual dexterity (MACS scale). ANCOVAs were performed controlling for age and processing speed in the three analyses. The group with CP-HPx was shown to be the most cognitively impaired of the three groups, with significant deficits in visuo-perception, verbal working memory, and visuo-spatial memory. Subjects with greater gross motor dysfunction (GMFCS-E&R) did not show the greatest cognitive impairment, while those with worse manual dexterity (MACS) exhibited greater cognitive impairment. Children and adolescents with motor disabilities, a priori cognitively normal, present different levels of cognitive impairment. This should be considered when planning educational adaptations for this infant-juvenile population.

The promotion of mature theory of mind skills in educational settings: a mini-review

After formal school entry, theory of mind development encounters a blooming period of growth intertwined with social and academic achievements and challenges. Within this framework, in last years researchers have proposed training programs to foster mature ToM skills, but also, to test causal pathways for the role that ToM development may have in broader cognitive and social outcomes. In the current mini-review we examine which training programs have been developed so far to enhance three key aspects of mature ToM skills: second-order false belief reasoning, the ability to put one's own ToM knowledge into use, and the mentalization of thoughts and emotions. We also illustrate effects of these activities on intra- and inter- personal competence. In its conclusion the paper provides considerations of both first achievements of research in this area and gaps to be addressed in future works.

A strategy for school reopening in the Philippines: Lessons from other countries

The Philippine government has not announced a strategy for a safe return to in-person instruction. A gradual approach, beginning in low-risk areas, at 50% capacity for every classroom, with students divided into two groups and alternating between in-person and online instruction every 2 weeks, is proposed. A safe return to in-person instruction in schools for millions of students in the Philippines is consistent with the concept of equity in education.

Regional Differences in School-Based Physical Therapy: Examination of Therapist and Student Characteristics, Service Delivery, Activities, Interventions, and Outcomes

AimsThe aim of this study was to examine regional differences in school-based physical therapy practice focusing on the attributes of the school-based physical therapists and students; service delivery approaches, activities, and interventions; and student outcomes. Recognition of regional practices may decrease unnecessary variations, and assist with therapist clinical decision making and efforts to implement evidence-informed practice.MethodsA secondary data analysis of the PT COUNTS data was performed to compare physical therapist and student attributes; service delivery, activities, and interventions; and student outcomes across the Northeast, Southeast, Central, and Northwest regions of the United States.ResultsDifferences in the physical therapist and student characteristics, service delivery, activities, and interventions existed across the regions. There were no regional differences in outcomes when controlling for student functional level.ConclusionRegional differences in school-based practices may be expected and indicative of the influence of contextual factors including state and local policies and procedures that shape school-based service delivery and the characteristics of the therapists and students. Regional differences in practices may not have been of sufficient clinical magnitude to alter outcomes. Physical therapists can use the findings to reflect upon their individual decision making and practices.

COVID-19 impact on learners: challenges and responses

The effects of coronavirus disease 2019 pandemic among the learners are shown in the rising cases of mental health issues. Young people are forced to stay at home and limit their physical and social interaction with peers. This paper contributes to address the well-being of the young learners.

Educational Setting and SARS-CoV-2 Transmission Among Children With Multisystem Inflammatory Syndrome: A French National Surveillance System

Background: Multisystem inflammatory syndrome in children (MIS-C) is the most severe form associated with SARS-CoV-2 infection in children. To reduce the spread of SARS-CoV-2 at the population level, educational setting closure have been implemented in many countries. However, the direct benefit of school closure on the MIS-C burden remains to be explored. We aimed to assess the role of educational settings in SARS-CoV-2 transmission among children with MIS-C. Methods: We conducted a French national prospective surveillance of MIS-C, coordinated by Public Health France, from April 2020 to March 2021. During this period, we included all children with MIS-C fulfilling the WHO definition who were reported to Public Health France. For each child, we traced the source of SARS-CoV-2 transmission. The main outcome was the proportion of children with MIS-C, with educational setting-related SARS-CoV-2 infection, during the period of school opening. Results: We included 142 children fulfilling WHO criteria for MIS-C: 104 (70%) cases occurred during school opening periods. In total, 62/104 children (60%, 95%CI [50; 69]) had been contaminated by a household contact and 5/104 in educational settings (5%, 95%CI [2; 11]). Among children with MIS-C occurring during school closure periods, the proportion of household transmission remained similar (66%, 25/38). Conclusion: Children with MIS-C were mainly infected by SARS-CoV-2 within their family environment, and the educational setting played a marginal role in this transmission. This suggests that mitigating school attendance may not reduce substantially the burden of MIS-C.

The Psychometric Properties of the Structured Preschool Participation Observation (SPO)

AIMS

To evaluate the validity and reliability of the Structured Preschool Participation Observation (SPO), based on the COnsensus-based-Standards for the selection of health Measurement INstruments. The SPO development was based on biopsychosocial and ecological models to evaluate children's participation in play, learning and social occupational areas.

METHODS

Following the establishment of content validity, construct validity using factor analysis and reliability were examined among 250 preschool children with typical development (TD). The known-groups procedure was used, comparing 88 children with developmental disabilities (DD), who attended special educational settings with the TD children.

RESULTS

Three factors accounted for 68% of the variance. High internal consistency (alpha>.812) was found, as well as a significant moderate-to-high inter-rater reliability in most areas. Children with TD scored significantly higher than children with DD with small to large effect sizes.

CONCLUSIONS

The SPO appears to be a suitable measure for assessing children's participation in preschool activities through structured observation. Further studies are needed to further establish its psychometric properties, along with using additional scales of enjoyment and/or involvement and self-care activities. The SPO may assist in generating intervention goals for children with limitations in participation and may complement information gathered from parents.

Development of student goals in school-based practice: physical therapists' experiences and perceptions

Purpose: Development of individualized student goals is integral to special education. Although United States federal legislation and state, local, and professional guidelines outline preferred goal development processes, actual practice does not always reflect ideal practice. The purposes of this research were to understand how physical therapists develop student goals and to identify facilitators and barriers to development of participation-based goals.Methods: Twenty school-based physical therapists participated in one of five semi-structured focus groups. Two researchers conducted thematic analysis of transcriptions of audio recordings to identify qualitative themes; a third researcher reviewed the analysis.Results: Five themes emerged related to therapists' recommendations for goal development: (1) Understand the student: The foundation for individualized goal development, (2) Teaming: The critical component to integrate varied perceptions and establish a common vision, (3) Relevant focus of goal: Addressing what is meaningful for a student's day, (4) Best practices: Embracing professional advances, and (5) Develop and write the goal: The art and science of writing goals. The first four themes also reflected facilitators and barriers to development of participation-based goals.Conclusions: Therapists' comments reflected striving to follow ideal practice recommendations despite identified challenges. This research helps educational teams understand and reflect on goal development processes.Implications for rehabilitationAlthough writing goals is a foundational task in school-based practice, meaningful goal development is a complex process.School-based physical therapists recommend working closely with students, parents, teachers, and other members of the educational team to establish good communication, trust, and a shared philosophy of collaboration and responsibility for student goalsA thorough understanding of the student serves as the foundation for developing individualized student goals.Educational teams are encouraged to understand professional, federal, state, and local guidelines and embrace professional advances in goal development practices.

An ongoing struggle: a mixed-method systematic review of interventions, barriers and facilitators to achieving optimal self-care by children and young people with type 1 diabetes in educational settings

BACKGROUND

Type 1 diabetes occurs more frequently in younger children who are often pre-school age and enter the education system with diabetes-related support needs that evolve over time. It is important that children are supported to optimally manage their diet, exercise, blood glucose monitoring and insulin regime at school. Young people self-manage at college/university.

METHOD

Theory-informed mixed-method systematic review to determine intervention effectiveness and synthesise child/parent/professional views of barriers and facilitators to achieving optimal diabetes self-care and management for children and young people age 3-25 years in educational settings.

RESULTS

Eleven intervention and 55 views studies were included. Meta-analysis was not possible. Study foci broadly matched school diabetes guidance. Intervention studies were limited to specific contexts with mostly high risk of bias. Views studies were mostly moderate quality with common transferrable findings.Health plans, and school nurse support (various types) were effective. Telemedicine in school was effective for individual case management. Most educational interventions to increase knowledge and confidence of children or school staff had significant short-term effects but longer follow-up is required. Children, parents and staff said they struggled with many common structural, organisational, educational and attitudinal school barriers. Aspects of school guidance had not been generally implemented (e.g. individual health plans). Children recognized and appreciated school staff who were trained and confident in supporting diabetes management.Research with college/university students was lacking. Campus-based college/university student support significantly improved knowledge, attitudes and diabetes self-care. Self-management was easier for students who juggled diabetes-management with student lifestyle, such as adopting strategies to manage alcohol consumption.

CONCLUSION

This novel mixed-method systematic review is the first to integrate intervention effectiveness with views of children/parents/professionals mapped against school diabetes guidelines. Diabetes management could be generally improved by fully implementing and auditing guideline impact. Evidence is limited by quality and there are gaps in knowledge of what works. Telemedicine between healthcare providers and schools, and school nurse support for children is effective in specific contexts, but not all education systems employ onsite nurses. More innovative and sustainable solutions and robust evaluations are required. Comprehensive lifestyle approaches for college/university students warrant further development and evaluation.