How to support peer resistance in adolescents with mild-to-borderline intellectual disability? Intervention development and feasibility

BACKGROUND

Adolescents with mild-to-borderline intellectual disability face peer resistance challenges, risking harmful or dangerous situations.

METHOD

We designed a peer resistance group intervention at school for adolescents with mild-to-borderline intellectual disability, tested its feasibility (N = 4, Mage  = 14.1, MIQ  = 78.8), adapted it, and tested it again (N = 6, Mage  = 15.0, MIQ  = 72.8).

RESULTS

Study 1 demonstrated feasibility in recruitment, resources, and potential benefits on the distal outcome risk taking. However, attendance, obtained knowledge, and potential benefits on peer resistance, peer problems, and prosocial behaviour were suboptimal. Consequently, study 2 contained more learning by doing and individual lessons, resulting in higher attendance and greater personalization. While potential benefits on improved peer resistance measures were not observed, risk taking improved.

CONCLUSIONS

Despite finding no potential benefits on peer resistance, running a peer resistance intervention for adolescents with mild-to-borderline intellectual disability at school is considered feasible.

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.

Go Team Go! Interprofessional Practice for Pediatric Feeding in the Schools

PURPOSE

The purpose of this clinical focus article is to discuss processes and procedures for building school-based programs to address the feeding and swallowing needs of students in the public-school setting. Interprofessional practice (IPP) team member roles and responsibilities, screening, eligibility, considerations for developing Individualized Education Programs that address the needs of students with pediatric feeding disorder (PFD) and dysphagia, as well as billing documentation requirements, are discussed. Additionally, coordination across the continuum of service delivery for students with PFD and dysphagia is investigated. Guidance on documentation, processes, and procedures that comply with the Individuals with Disabilities Education Act mandates will be provided.

CONCLUSIONS

This clinical focus article will demonstrate that students with PFD and dysphagia continue to present to public schools and require skilled services and supports in order to meet their individualized needs. School-based speech-language pathologists have a legal requirement to provide these supports when deemed educationally relevant. Schools must employ processes and procedures that result in the timely and effective evaluation and identification of students with PFD and dysphagia. An IPP approach to the management of PFD and dysphagia is critical to ensure optimal outcomes for students found eligible for services.

Predicting adult-age mental health with childhood reading and math disability: do resilience and coping styles matter?

We studied the associations between childhood-identified learning disabilities and adult-age mental health and whether adult-age reading and math skills, coping styles, or resilience influenced the associations. The participants were 159 Finnish adults (60.4% males). Of them, 48 (30%) had a reading disability (RD), 22 (14%) had a math disability (MD), 21 (13%) had RD + MD identified in childhood, and 68 (43%) were population-based controls, matched based on gender, age, and place of residence. At ages 20-40 (Mage = 29), they reported their mental health, coping styles, and resilience, and their reading and math skills were assessed. The hierarchical regression analyses, predicting mental health with RD, MD, and their interaction while controlling for gender and age, indicated that childhood MD predicted the occurrence of more mental health problems in adulthood, but this was not observed in the case of RD. The RDxMD positive interaction effect reflected better mental health in both the RD and the RD + MD groups than in the MD group. Controlling for adult-age reading and math skills had no effect on the association between MD and mental health outcomes while controlling for resilience and coping styles diminished the impact of MD. Strong resilience without the use of an emotion-oriented coping may thus alleviate the association between MD and mental health. As childhood MD can have long-term associations with mental health problems, these issues need to be addressed in school, at work, and in healthcare. Based on our findings, strengthening effective coping and resilience may be one avenue of support.

Parent-Reported Health-Related Quality of Life Outcomes and Impact on Family of Congenital Diaphragmatic Hernia Survivors After Repair: A Cross-Sectional Comparison to Healthy Controls

BACKGROUND

Congenital diaphragmatic hernia (CDH) survivors often experience long-term CDH-associated morbidities, including musculoskeletal, gastrointestinal and respiratory issues. This study evaluates parent-reported health-related quality of life (HRQOL) and family impact of the disease.

METHODS

Electronic medical records (EMR) were reviewed and phone surveys performed with parents of CDH survivors who underwent repair at our institution from 2010 to 2019. They completed the following Pediatric Quality of Life Inventory™ (PedsQL™) questionnaires: Generic Core Scales 4.0 (parent-proxy report) and Family Impact (FI) Module 2.0. Age-matched and gender-matched healthy controls from an existing database were used for comparison. Subgroup analysis of CDH patients alone was also performed. Appropriate statistical analysis was used with p < 0.05 significance. Data are reported as median (range). Ethical approval was obtained.

RESULTS

Of 76 CDH survivors, 45 parents (59 %) consented for study participation. Patients and controls were aged 6 (3-12) years; 51 % were male. In Core Scales, there were significant differences between the groups in the overall scores (p = 0.003) and the psychosocial health sub-scores (p = 0.004), but no difference in the physical health domain scores. In the Family Impact Module, there were no significant differences between the groups in overall scores, in parent HRQOL and in family functioning sub-scores. However, CDH patients with learning disabilities had significantly worse Family Impact Module overall scores compared to CDH patients without learning disabilities (p = 0.04).

CONCLUSION

The overall HRQOL in children with CDH survivors is worse compared to controls, but impact on family appears similar. We highlight the need for long-term follow-up of CDH patients, especially those with learning disabilities. Healthcare providers should formulate tailored care plans to address patient and caregiver needs.

TYPE OF STUDY

Prospective Study.

LEVEL OF EVIDENCE

Level III.

Do learning disabilities in reading, spelling and numeracy have common underlying factors? Evidence from Arabic-speaking children sample

We examined the role of phonemic awareness [PA], rapid naming [RAN], and verbal short-term memory [VSTM], phonological verbal fluency (PVF) along with literacy related skills (letter naming and orthographic knowledge) in reading, spelling, and numeracy performances. The study was carried out on a sample that consists of 245 native Arabic children of grade 1 and 2. The results showed a significant effect of Group on PA, RAN, VSTM, PVF, and letter naming and orthographic knowledge. There is also a comorbidity effect on PA and orthographic knowledge. The regression analysis indicated that PA and orthographic knowledge are the strongest predictors of the three academic outcomes, whereas VSTM, PVF and RAN displayed less predictive relationships with reading, spelling and numeracy. The results suggest that there are a number of underpinning factors that are linked to PA and orthographic knowledge, which are also accounted for a comorbidity condition between literacy and numeracy.

Atopic dermatitis, cognitive function and psychiatric comorbidities across early childhood and adolescence in a population-based UK birth cohort

BACKGROUND

Atopic dermatitis (AD) may affect cognitive function, but studies are limited and inconsistent. The effect of AD severity on cognition remains underexplored and few previous studies have examined clinically validated or repeated measures of cognition throughout childhood.

OBJECTIVES

To evaluate the relationship of AD activity and severity with validated measures of general cognition in a longitudinal birth cohort.

METHODS

We conducted cross-sectional analyses using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a UK cohort of 14 975 individuals followed prospectively since their birth in 1991-92. AD was assessed 11 times between the age of 6 and 166 months. Mothers were asked if their child had an 'itchy, dry skin rash in the joints and creases', and AD status was time-updated accordingly as 'never', 'maybe', 'inactive', 'active/mild' or 'active/moderate-severe'. General cognition [i.e. intelligence quotient (IQ)] was measured at 18, 49, 103 and 186 months of age using the Griffiths Mental Development Scales (GMDS), Wechsler Preschool and Primary Scale of Intelligence (WPPSI), Wechsler Intelligence Scale for Children (WISC) and Wechsler Abbreviated Scale of Intelligence (WASI), respectively. Multivariable linear regression was used to compare IQ with respect to nearest time-updated AD status. Secondary analyses were stratified by the presence or absence of psychiatric or learning disorders. An exploratory longitudinal analysis of IQ across all four outcome assessments was conducted using generalized estimating equations.

RESULTS

No significant associations between AD status and full-scale IQ scores on the GMDS, WPPSI, WISC and WASI were observed after adjustment for sociodemographic factors, atopic comorbidities and sleep characteristics. However, at 8 years of age, WISC Performance IQ was slightly, although statistically significantly, lower among children with active/moderate-severe AD [β coefficient -2.16, 95% confidence interval (CI) -4.12 to -0.19] and Verbal IQ was slightly, but statistically significantly, higher among those with inactive AD (β coefficient 1.31, 95% CI 0.28-2.34) compared with those without AD. Analyses stratified by psychiatric or learning disorders, and exploratory longitudinal analyses of cognition revealed similar findings.

CONCLUSIONS

We did not find any clinically meaningful associations between AD activity and severity and general cognitive function during early childhood and adolescence. Future studies should incorporate objective measures of AD severity and investigate outcomes beyond IQ.

Neurocognitive mechanisms of co-occurring math difficulties in dyslexia: Differences in executive function and visuospatial processing

Children with dyslexia frequently also struggle with math. However, studies of reading disability (RD) rarely assess math skill, and the neurocognitive mechanisms underlying co-occurring reading and math disability (RD+MD) are not clear. The current study aimed to identify behavioral and neurocognitive factors associated with co-occurring MD among 86 children with RD. Within this sample, 43% had co-occurring RD+MD and 22% demonstrated a possible vulnerability in math, while 35% had no math difficulties (RD-Only). We investigated whether RD-Only and RD+MD students differed behaviorally in their phonological awareness, reading skills, or executive functions, as well as in the brain mechanisms underlying word reading and visuospatial working memory using functional magnetic resonance imaging (fMRI). The RD+MD group did not differ from RD-Only on behavioral or brain measures of phonological awareness related to speech or print. However, the RD+MD group demonstrated significantly worse working memory and processing speed performance than the RD-Only group. The RD+MD group also exhibited reduced brain activations for visuospatial working memory relative to RD-Only. Exploratory brain-behavior correlations along a broad spectrum of math ability revealed that stronger math skills were associated with greater activation in bilateral visual cortex. These converging neuro-behavioral findings suggest that poor executive functions in general, including differences in visuospatial working memory, are specifically associated with co-occurring MD in the context of RD. RESEARCH HIGHLIGHTS: Children with reading disabilities (RD) frequently have a co-occurring math disability (MD), but the mechanisms behind this high comorbidity are not well understood. We examined differences in phonological awareness, reading skills, and executive function between children with RD only versus co-occurring RD+MD using behavioral and fMRI measures. Children with RD only versus RD+MD did not differ in their phonological processing, either behaviorally or in the brain. RD+MD was associated with additional behavioral difficulties in working memory, and reduced visual cortex activation during a visuospatial working memory task.

Evolution of neuropsychological and behavioral profile in a cohort of pediatric patients with Becker muscular dystrophy in a longitudinal study

It has long been reported that neuropsychological deficits may be present in dystrophinopathies, specifically non-progressive cognitive impairment and a global deficit in executive functions; this neurocognitive profile has been less explored in patients with Becker than Duchenne muscular dystrophy (BMD/DMD). We conducted a longitudinal study to explore the evolution of neuropsychological and behavioural profile in a cohort of paediatric BMD. Seventeen patients with BMD without intellectual disability were assessed using a full battery of tests, including intellectual, adaptive and executive functioning, language and behavioral features. Tests were performed at baseline and after 12 months. The results showed adequate cognitive and adaptive profile with falls in Working Memory, as well as lower scores in executive functions. An improvement was observed in Processing Speed. Behavioral questionnaires confirmed a negative trend, while in normal ranges. We found a statistically significant difference between T0 and T1 in some items exploring executive functions. No statistically significant difference was observed stratifying patients by mutation site or IQ level. In conclusion, our study suggests that BMD patients have a stable neurocognitive profile, while a deflection in the executive functions may be observed. We recommend a careful monitoring to intercept learning disabilities and promptly start a multimodal rehabilitation.

Variation in access to specialist services for neurosurgical procedures in adults with epilepsy in England, a cohort study

PURPOSE

To understand if primary consultation at tertiary epilepsy centres (TEC) in England impacts access to neurosurgical procedures (resective surgery, vagus nerve stimulator [VNS], deep brain stimulator [DBS]).

METHODS

Adults with epilepsy, and with a first neurology outpatient visit (index) between 01/01/2013 and 31/12/2015, were followed using English Hospital Episode Statistics from index date to 31/12/2019. Analyses were stratified by geographic location, learning disability record, and whether the index or follow-up visits were at a TEC.

RESULTS

84,093 people were included, with mean 5.5 years of follow-up. 12.4% of the cohort had learning disability (range 10.1%-17.4% across regions). TEC consultations varied by National Health Service regions and Clinical Commissioning Groups. 37.5% of people (11.2%-75.0% across regions) had their index visit at a TEC; and, of those not initially seen at a TEC, 10.6% (6.5%-17.7%) subsequently attended a tertiary centre. During follow-up, 11.1% people (9.5%-13.2%) visited a neurosurgery department, and 2.3% of those (0.9%-5.0%) then underwent a neurosurgical procedure, mainly VNS implantation. Median time from index date to first visit at a neurosurgery centre was 7 months (range 6-8 months across regions) and 40 months to procedure (36.5-49 months, 37.0 months in people with index visit at a TEC and 49.0 months otherwise). People with learning disability were less likely to have resective surgery (<0.5% versus 1.0% in those without) and more likely to undergo VNS implantation (5.8% versus 0.8%).

CONCLUSION

Although clinically recommended for suitable individuals, neurosurgical procedures in epilepsy remain uncommon even after consultation at a TEC. Geographical variation in access to TECs was present.

Which factors accompany maternal acceptance-rejection in children with specific learning disabilities?

BACKGROUND

Children with specific learning disabilities (SLDs) and their parents experience many problems that may influence their interactions. The study aimed to evaluate the maternal acceptance/rejection status of children with SLDs and their associations with sociodemographic characteristics, and problem behaviors.

METHODS

The Parental Acceptance-Rejection/Control Questionnaire (PARQ/C) and Strengths and Difficulties Questionnaire (SDQ) were applied to the mothers with children aged 7-17 years with a diagnosis of SLD.

RESULTS

Among 266 children enrolled, the mean age was 10.2 years, and 61.7% were male, the mean score was 30.4 for warmth/affection, 25.8 for hostility/aggression, 22.9 for indifference/neglect, 16.3 for undifferentiated rejection, 95.4 for the total PARQ, and 40.8 for the control scales. Generalized linear models revealed that maternal depression, poor family income, parental smoking, and presence of dysgraphia, and poor total difficulties and prosocial scores of SDQ subscales were associated with the maternal acceptance-rejection. There was an interaction between the maternal control subscale and the school success of the child.

CONCLUSION

Mothers of children with SLDs had high maternal rejection scores which were associated with unfavorable characteristics of child and family. Early detection and giving appropriate support of these cases could improve the mother's relationship with her SLD child.

Evaluation of a virtual practice placement: A model to increase student capacity

AIM

To describe the development and evaluation of a novel virtual practice placement.

BACKGROUND

Health systems around the world face the challenge of recruiting and retaining sufficient nursing staff to provide high quality care. The need to train more nurses makes it hard to provide sufficient and varied high quality student placements to all students. This paper reports the result of one approach to the provision of a novel virtual placement for pre-registration student nurses.

DESIGN

Online virtual placement evaluated by a questionnaire conducted after the placement.

METHODS

A total of 195 students attended the virtual practice placement between 10th October 2022 and the 10th March 2023. The survey consisted of eight questions, of which one invited a qualitative response.

RESULTS

A total of 188 students completed the questionnaire and provided feedback. Of these 84 were adult nursing students, 67 child, 36 mental health and one learning disability student. The virtual placement required considerable resources to run, however was deemed as valuable by most students. When asked to rate the overall experience out of 5, the median scores were consistently high: adult (Mdn=5), child (Mdn=4), learning disability (Mdn=5) and mental health (Mdn=5) and mean values consistently high across fields: adult (M=4.73), child (M=5), learning disability (M=5) and mental health (M=4.67). Qualitatively, there were four main themes that emerged from the questionnaire responses: increased understanding of community healthcare and holistic approaches to care; developing interpersonal skills; a positive impact on their future career opportunities and the value of realistic case studies.

CONCLUSIONS

Virtual placements are a viable addition to traditional placements. However, they require careful planning and considerable resources including experienced and dedicated facilitators. Principles for the delivery of virtual placements were produced to replicate and share best practice.

The impact of morphological density on reading comprehension in Arabic: A comparison between typically developing and children with reading disabilities

This study examined the influence of morphological density on reading comprehension in Arabic and whether this influence differs between typical and children with reading disabilities. Morphological density in Arabic is a text feature that refers to using bound morphemes, creating dense words with more morphemes. The participants were 182 fifth-graders, both typical and children with reading disabilities. Children were assessed in reading comprehension by reading texts with low- or high-morphological density. Findings revealed that overall morphological density impacted reading comprehension performance. That is, scores were found to be higher while reading low-density text than high-density text. Moreover, an interaction of morphological density condition by reading proficiency showed no density text effect among typical developing readers. However, a difference was obtained in the children with reading disabilities whereas low-morphological density text score was higher than the score of high-morphological density text. The study highlights the importance of morphological awareness in reading comprehension in Arabic, extending that morphological density plays an important role in this process. The results are discussed in light of the lexical quality hypothesis and simple view of reading model. The findings imply the need of explicit morphological instruction for dense morphological forms.

'Why are we stuck in hospital?' Barriers to people with learning disabilities/autistic people leaving 'long-stay' hospital: a mixed methods study

Background

Transforming care so that people with learning disabilities and/or autistic people can receive support at home rather than in hospital settings is a key priority, but progress has been slow. Despite significant national debate, little previous research has engaged directly with people in hospital, their families or front-line staff to understand the issues from their perspectives.

Objectives

This research seeks to better understand the experiences of people with learning disabilities and/or autistic people in long-stay hospital settings, their families and front-line staff - using this knowledge to create practice guides and training materials to support new understandings and ways of working.

Design

Following a structured review of the literature, we sought to work with up to 10 people with learning disabilities and/or autistic people in three case-study sites (2021-22), supplementing this with interviews with family members and commissioners; interviews/focus groups with hospital staff, social workers, advocates and care providers; information from case files; and observations of multidisciplinary meetings.

Setting

Three 'long-stay' hospital settings in England.

Participants

Twenty-seven people in hospital, together with families, health and social care staff and commissioners.

Results

• People in hospital report widespread frustration, feel that hospital environments are not conducive to getting/staying well, and face multiple barriers to leaving hospital. Without someone to fight for them, people struggle to overcome the inertia built into our current systems and processes. • Front-line staff are equally frustrated and describe a complex and seemingly dysfunctional system which they find almost impossible to navigate. • Hospital staff from different professional backgrounds do not have a shared sense of how many people really need to be in hospital or how many people could be cared for in different settings - suggesting that different definitions, world views and professional judgements might be at play. • Hospital staff are frustrated about what they see as the difficulty of discharging people into community services, while community services are equally frustrated about what they see as a risk-averse approach which they feel can lack an up-to-date knowledge of what is possible to achieve in the community. • Despite over a decade of policy attempts to resolve these issues, very significant barriers remain.

Limitations

This research explored the experiences of a small number of people, but has done so in significant depth. The research was undertaken in secure settings, during COVID and in a difficult external policy and practice context, and so has had to be very flexible and empathetic in order to build relationships and make the research possible. Future research could helpfully consider the needs of people from black and minority ethnic communities, the extent to which the experiences of people on forensic pathways are similar to/different from other people's experiences (including perspectives from the criminal justice system), and what happens to people in the long term after they leave hospital.

Conclusions

Working to make the voices of people with learning disabilities and/or autistic people (as well as the staff who support them) centre stage is complex and sensitive. However, this lived experience/practice knowledge is a crucial resource if we are going to develop better policy and practice solutions in the longer term.

Study registration

This study is registered at www.researchregistry.com (researchregistry6124).

Funding

This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR130298) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 3. See the NIHR Funding and Awards website for further award information.

Simulator Driving Abilities, Executive Functions, and Adaptive Behavior Among Adolescents With Complex Attention Deficit Hyperactivity Disorder

OBJECTIVE

To examines the driving skills, executive functions, and adaptive behavior of adolescents diagnosed with Attention-deficit/hyperactivity disorder (ADHD) combined with emotional difficulties and/or learning disabilities (complex ADHD), compared to adolescents without ADHD.

METHOD

A cross-sectional study including 30 adolescents with complex ADHD and 33 adolescents without ADHD aged 15 to 18 years. Driving skills on a simulator, executive functions, and adaptive behavior were evaluated.

RESULTS

Adolescents without ADHD demonstrated significantly higher total scores on the driving simulator, indicating better driving performance compared to adolescents with complex ADHD. In the complex ADHD group, after controlling for different Conners Comprehensive Behavior Rating Scale-Self Report scales, driving simulator scores were partially correlated with executive functions.

CONCLUSION

These findings emphasize the unique needs of adolescents with complex ADHD. Given the significance of driving in today's society, it is crucial to consider the development of intervention programs to support this population's driving skills.

Executive functions underlie word reading and reading fluency in Chinese children with attention deficit/hyperactivity disorder, reading disabilities, and comorbid attention deficit/hyperactivity disorder and reading disabilities

The current study examined the executive function (EF) deficits and their roles in reading in one hundred and four Cantonese-speaking children with typical development, reading disabilities (RD), ADHD, and comorbid ADHD and RD (ADHD + RD). Children's EF and reading skills were measured. Analysis of variance results showed that all children with disorders manifested deficits in verbal and visuospatial short-term and working memory and behavioral inhibition. Moreover, children with ADHD and ADHD + RD also exhibited deficits in inhibition (IC and BI) and cognitive flexibility. These findings demonstrated that the EF deficits in Chinese children with RD, ADHD, and ADHD + RD are similar to those in their counterparts using alphabetic languages. However, children with ADHD + RD displayed more severe deficits in visuospatial working memory compared to children with RD and ADHD, which was inconsistent with that observed in children using alphabetic languages. Regression analysis results showed that verbal short-term memory was a significant predictor for both word reading and reading fluency in children with RD and ADHD + RD. Moreover, behavioral inhibition significantly predicted reading fluency in children with ADHD. These findings also agreed with previous studies. Collectively, the results of the current study showed that the EF deficits and their roles in reading found in Chinese children with RD, ADHD, and ADHD + RD are mainly consistent with children using alphabetic languages. However, more studies are still needed to confirm these findings, especially comparing the severity of working memory among these three disorders.

Differentially expressed long non-coding RNAs and mRNAs of cadmium exposure on learning disability of offspring rats

BACKGROUND

Cadmium (Cd) exposure has been found to have detrimental effects on the development of the central nervous system and cognitive ability in children. However, there is ongoing debate regarding the impact of maternal Cd exposure on the cognitive ability of offspring. In this study, we aimed to investigate the mechanisms underlying the influence of maternal Cd exposure on the cognitive ability of offspring rats.

METHODS

Here, we constructed a model of cadmium poisoning in first-generation rats through gavage. The cognitive and memory abilities of its offspring were evaluated by water maze experiment. Then, we used the gene chip to find out the key genes, and we performed qRT-PCR detection of these genes. Subsequently, enrichment analysis was employed to identify pathways. Finally, we constructed a co-expression network consisting of LncRNAs and mRNAs to elucidate the biological functions and regulatory mechanisms of LncRNAs.

RESULTS

The results of the water maze trial demonstrated that the offspring of rats exposed to cadmium in the first generation had reduced cognitive and memory abilities. Through an analysis of gene expression in the hippocampus of the cadmium-treated rats' offspring and the control group, we identified a correlation between the islet secretion pathway and the cognitive impairment observed in the offspring. Utilizing various algorithms, we identified Cpa1 and Prss1 as potential key genes associated with the cognitive impairment caused by cadmium. The results of qRT-PCR demonstrated a decrease in the expression levels of these genes in the hippocampus of the cadmium-treated rats' offspring. In addition, in the co-expression network, we observed that Cpa1 was co-expressed with 11 LncRNAs, while Prss1 was associated with 4 unexplored LncRNAs. Furthermore, we conducted an analysis to examine the relationship between Cpa1, Prss1-related transcription factors, and LncRNAs.

CONCLUSION

Overall, this study provides novel insights into the molecular effects of first generation Cd exposure on the cognitive ability of offspring. The target genes and signaling pathways investigated in this study could serve as potential targets for improving neurodevelopment and cognitive ability in children.

Will you read how I will read? Naturalistic fMRI predictors of emergent reading

Despite reading being an essential and almost universal skill in the developed world, reading proficiency varies substantially from person to person. To study why, the fMRI field is beginning to turn from single-word or nonword reading tasks to naturalistic stimuli like connected text and listening to stories. To study reading development in children just beginning to read, listening to stories is an appropriate paradigm because speech perception and phonological processing are important for, and are predictors of, reading proficiency. Our study examined the relationship between behavioral reading-related skills and the neural response to listening to stories in the fMRI environment. Functional MRI were gathered in a 3T TIM-Trio scanner. During the fMRI scan, children aged approximately 7 years listened to professionally narrated common short stories and answered comprehension questions following the narration. Analyses of the data used inter-subject correlation (ISC), and representational similarity analysis (RSA). Our primary finding is that ISC reveals areas of increased synchrony in both high- and low-performing emergent readers previously implicated in reading ability/disability. Of particular interest are that several previously identified brain regions (medial temporal gyrus (MTG), inferior frontal gyrus (IFG), inferior temporal gyrus (ITG)) were found to "synchronize" across higher reading ability participants, while lower reading ability participants had idiosyncratic activation patterns in these regions. Additionally, two regions (superior frontal gyrus (SFG) and another portion of ITG) were recruited by all participants, but their specific timecourse of activation depended on reading performance. These analyses support the idea that different brain regions involved in reading follow different developmental trajectories that correlate with reading proficiency on a spectrum rather than the usual dichotomy of poor readers versus strong readers.

Learning semantic categories of L2 verbs: The case of cutting and breaking verbs

To attain native-like proficiency in second-language word usage, learners have to discover intricate semantic categories in the target language. We investigated the factors influencing the development of two aspects of second-language learners' semantic categories: the category center and category boundary of word meanings. In the experiment, second-language learners of Japanese, whose first language is Mandarin, were asked to produce the best verb for 28 videos depicting various cutting and breaking events. Descriptive analyses were conducted to compare the verb patterns used by second-language learners with those of native speakers. The second-language learners' verb use pattern suggested their struggle in delineating the semantic ranges of breaking verbs in a native-like manner. Model analyses further revealed that different factors contribute to learning two different aspects of word meanings. The learning category center of word meaning depended on the similarity between the lexical domains in the first and second languages. On the contrary, the success of learning the semantic boundaries of verbs required a large input frequency and smaller semantic coverage, and smaller category ambiguity. The results suggest that constructing a semantic domain in the second language should be evaluated from at least two different aspects of semantic representation.

Modified Approaches to Treating Anxiety for Children With Visual-Spatial Problems: A Strengths-Based Perspective

Anxiety disorders are common and impairing1 and affect as many as 30% of youth with2 and without3 neurodevelopmental disorders. Nonverbal learning disability (NVLD) is an understudied neurodevelopmental disorder with an estimated prevalence of 3% in North American children and adolescents.4 Although definitions of NVLD vary, all include a core deficit of difficulty with visual-spatial processing. Importantly, anxiety is also a common psychiatric comorbidity for youth with NVLD, affecting roughly one-third of these youth.4,5 In youth with neurodevelopmental disorders, treatment is often sought or received for comorbid conditions (eg, anxiety, attention-deficit/hyperactivity disorder) or associated impairments, rather than for the symptoms or core deficits of the neurodevelopmental disorder itself.6 Considerable work has examined the adaptation of anxiety disorder treatments for children with attention-deficit/hyperactivity disorder7 and autism.8 Comparatively little work has explored treatment approaches for children with NVLD. Given the overlap of anxiety symptoms and visual-spatial problems in NVLD,9,10 herein we consider how these cognitive problems might interfere with patients' abilities to engage with common treatment approaches.

Academic Achievement and Satisfaction Among University Students With Specific Learning Disabilities: The Roles of Soft Skills and Study-Related Factors

Understanding the individual qualities sustaining students with and without specific learning disabilities (SLDs) is key to supporting their academic achievement and well-being. In this study, we investigated the differences between students with and without SLDs in terms of intraindividual factors (soft skills and study-related factors), academic and nonacademic outcomes (achievement, academic and life satisfaction), and the relationships between such intraindividual factors and the three outcomes. A total of 318 students (79 males; Mage = 22.7; SD = 3.56; age range = 19-45 years; 147 with SLDs) completed self-reported questionnaires and a measure of fluid intelligence. The results showed that students with SLDs reported higher creativity but lower academic self-efficacy, study resilience, and academic achievement, with small-to-medium effect sizes. In both groups, achievement significantly positively related to academic self-efficacy and negatively to creativity. Life satisfaction was positively related to study resilience; and academic satisfaction was related to critical thinking, curiosity, and academic self-efficacy. Nurturing such intraindividual factors can benefit students with and without SLDs.

Phonological awareness and rapid automatized naming as predictors of early literacy skills among children with mild to borderline intellectual functioning

The aim was to investigate the predicting role of phonological awareness (PA) and rapid automatized naming (RAN) on early literacy skills (e.g., word reading [WR] and spelling [SP]) among children with mild to borderline intellectual functioning. A total of 68 children in inclusive schools in grades 1 and 2, from 12 primary schools from Makka, classified as having intellectual disabilities (ID) of unspecified origin were chosen to participate in this study. Measures of PA and RAN were correlated with measures of WR and SP in children with mild to borderline intellectual functioning. This study advanced knowledge about the predictors (PA and RAN) of early literacy skills (WR and SP) among children with mild to borderline intellectual functioning.

Mathlete: an adaptive assistive technology tool for children with dyscalculia

PURPOSE

The use of technology in teaching and learning process for children is gaining importance. Children with specific learning disabilities have shown positive results with assistive technology tools. Dyscalculia is a specific learning disability in which an individual faces problem in mathematical skills. Around 3-7% of the world population is affected with it. The aim of the current research study is to determine the effectiveness of an assistive technology tool, Mathlete on children with dyscalculia's early numeracy skills. Such assistive technology tools can serve as a boon for these children.

METHOD

A total of 40 children with dyscalculia (Mage = 6.8 years) were a part of the study. The group of 40 children were randomly divided into two groups: experiment group using mathlete for improving their learning (30 children) and a control group using only traditional teaching for learning (10 children). The children were screened for dyscalculia using the screening module of mathlete.

RESULTS

The two groups showed no significant difference in terms of their socio-economic status, gender and parents education level. Children in the experiment group showed improvement from pre-test to post-test after using mathlete. Also, there was significant difference in learning of both the groups, children in experiment group could understand the concepts better than the ones in control group.

CONCLUSION

Mathlete helped improve the mathematical learning of children with dyscalculia from pre-test to post-test.

Psychometric analysis of the Group Climate Inventory-Revised in adults with mild intellectual disability or borderline intellectual functioning in a secure residential facility

BACKGROUND

In secure residential facilities, group climate perceptions of clients with mild intellectual disability or borderline intellectual functioning are systematically assessed for quality improvement. A valid and reliable measure may ensure that this process is consistent. The Group Climate Inventory-Revised (GCI-R) is a new measure to assess group climate perceptions.

METHOD

Confirmatory factor analysis was conducted in 148 adult clients (79% male) with mild intellectual disability or borderline intellectual functioning in a secure facility to examine internal structure validity and internal consistency reliability of the GCI-R.

RESULTS

The results indicate support for the five-factor structure of the GCI-R ('Support', 'Growth', 'Repression', 'Peer interactions', and 'Physical environment'). The internal consistency reliability of its scales ranged from acceptable to good (α: .72-.87; ω: .76-.86).

CONCLUSION

The GCI-R demonstrates evidence of psychometric adequacy when applied to adult clients with mild intellectual disability or borderline intellectual functioning in secure residential facilities.

Children and young adults with profound and multiple learning disabilities: Evidence of intelligible subvocal language

INTRODUCTION

Literature to date describes people with Profound and Multiple Learning Disabilities (PMLD) as pre-linguistic. In contrast, this study explores the existence and use of meaningful sub vocal (SV) language by twenty PMLD participants.

METHOD

The SV utterances of 20 PMLD participants were recorded and amplified. Recordings were investigated for evidence of language content and structure, listener intelligibility, and acoustic and phonetic features relative to normal speech and whisper.

RESULTS

Language content and structure was identified. Listener intelligibility was demonstrated. Acoustic and phonetic features relative to normal speech and whisper were evident.

CONCLUSION

Twenty PMLD participants produced meaningful SV language intelligible to listeners. This study requires further robust research to fully confirm its findings but highlights implications for clinical practice and for understanding of PMLD communication competencies. This paper is accompanied by audio samples and transcriptions of recorded utterances to demonstrate the SV language produced by the participants. The quality of the samples varies due to the difficulties in recording SV utterances and the difficulties for participants in articulating clearly. This is not normal speech, but it is normal language. The listener may need to replay samples where the quality of the recording is poor.

Technology-assisted reading fluency interventions for students with reading difficulties: evidence from a meta-analytic approach of single case design studies

PURPOSE

The purpose of this article was to provide a quantitative review of technology-assisted reading fluency interventions for students with disabilities and select moderator variables that may modify the effects of the interventions.

MATERIALS AND METHODS

All reviewed 13 studies employed a single-case research design, targeting technology-assisted reading fluency interventions for students with learning disabilities (LDs) or learning difficulties. Studies were descriptively analysed and evaluated for methodological quality. Additionally, to examine the level and trend of reading fluency outcomes, Tau-U was calculated across the studies by measuring the impact of various moderator variables on the intervention effects.

RESULTS AND CONCLUSIONS

Overall, studies showed a moderate to strong effect on reading fluency and there was a significant difference in moderator variables such as student status, type of technology, and features of technology. While the current study found positive outcomes from technology-based fluency interventions for struggling readers suggesting the effectiveness of using technology for the improvement of reading fluency, educators should consider using a rubric when utilising tablets because of the limited instructional components. Possible explanations about intervention effects, moderator effects, and study qualities along with limitations and future research were discussed. Implications for rehabilitationThis article examined a quantitative review of technology-assisted reading fluency interventions for students with disabilities and those considered at-risk. From this examination, we suggest the following implications:More research is needed to explore the effectiveness of technology-assisted reading fluency interventions. Some studies exist exploring the effect of overall reading interventions, but more specific analyses are needed related specifically to fluency and technology-assisted fluency interventions.Due to continuous advancements in technology, more research is also needed related to the integration of tablets and applications (or apps) on reading fluency.The use of technology to teach fluency has a general positive outcome for at-risk students. However, these types of interventions are more effective if they also provide vocabulary support.

Effectiveness of perceptual-motor exercises and physical activity on the cognitive, motor, and academic skills of children with learning disorders: A systematic review

BACKGROUND

Children with specific learning disorders (SLD) may have issues in cognitive, motor, and academic skills, affecting their mental health and level of participation in academic and nonacademic activities at school and in everyday life. Research shows that perceptual-motor (PM) exercises and physical activities can improve the cognitive and motor skills of typically developing children. To use PM exercises as an intervention in clinical practice for children with learning disorders, or to use it in future research, it seems necessary to discuss and summarize the existing documents in this group of children.

OBJECTIVES

We aimed to appraise the extent, and the quality of studies about PM interventions for enhancing cognitive, motor, and academic skills in children with learning disorders.

METHODS

The search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles published between January 2000 and June 2022 were searched in the following scientific databases: PubMed, Medline, Scopus, Web of Science, Cochrane library, Science direct, and Google Scholar. The study eligibility criteria were previously established according to the PICOS model. The Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the studies, and the Cochrane Collaboration tool (ROB2) was used to assess the risk of bias.

RESULTS

The initial search yielded 2160 studies among which 10 studies were systematically reviewed. The total number of participants was 483 children (intervention: 251; control: 232). Findings showed significant improvements in cognitive skills (n = 7/8) such as working memory, attention, and information processing speed. In addition, studies showed that PM and physical activity interventions could increase academic performance (n = 4/5) and motor skills (n = 5/5) in children with LD. Results regarding the mental health effects of PM exercises (n = 1/3) are few in number and contradicting.

DISCUSSION

PM exercises may positively affect cognitive, motor, and academic skills in children with SLD; However, due to the small number of studies, fair methodological quality, and high risk of bias, caution should be taken when interpreting the results.

Route sequence knowledge supports the formation of cognitive maps

In this study, we examined the extent to which knowledge about the sequence of places encountered during route learning supports the formation of a metric cognitive map. In a between subjects design, participants learned a route until they could navigate it independently without error whilst also learning information about either the identity of places along the route (Recognition Learning condition) or the sequence of places along the route (Sequence Learning condition). In a follow-up Reconstruction of Order Task, we confirmed that participants in the Sequence Learning condition had more accurate route sequence knowledge than those in the Recognition Learning condition, despite requiring the same overall number of trials to learn the route. Participants then completed a Pointing Task to assess the quality of their cognitive map of the environment. Both groups performed above chance level, showing incidental encoding of metric information, but the Sequence Learning group produced significantly lower pointing errors than the Recognition Learning group. Further, we found that route distance between pairs of places was a strong predictor of pointing error in both groups, whilst Euclidean distance between places was a significant, but weak, predictor only for the Sequence Learning condition. The results of this study demonstrate that discrete route sequence knowledge directly supports the formation of metric cognitive maps. We consider how the results are best explained by interactions between striatal route representations and hippocampal metric representations, centered around the sequence of places acting as a scaffold for the encoding of metric information.

H - 62 Current State of the Practice of Clinical Neuropsychology in Bolivia

OBJECTIVE

The present study aimed to determine the current state of the practice of clinical neuropsychology in Bolivia.

METHOD

This is a descriptive and cross-sectional study. The sample consisted of 72 professionals working in the field of neuropsychology in Bolivia. The information was collected through an online questionnaire that included 70 questions about the participants' professional training, professional practice, research, teaching, and perceived barriers to the profession's development, among other factors.

RESULTS

Approximately 76% of participants reported receiving postgraduate neuropsychology training. Their training was rated as very good (34.8%) and good (23.9%). Conversely, their clinical supervision was rated very good (24.3%) and good (33.3%). The participants indicated that their professional practice is conducted mainly in private settings (72.2%). Also, they mentioned that the most assessed disorders were learning disabilities (93.5%), intellectual disabilities (90%), and ADHD (87.5%). Similarly, the more frequent conditions rehabilitated were learning disabilities (23.6%), ADHD (20%), and depression (20.85%). Only 41.5% of the participants reported conducting research. A smaller proportion of professionals (31.5%) taught neuropsychology courses.

CONCLUSIONS

Neuropsychology is a relatively new field of work in Bolivia. For this reason, the participants considered that to enhance the quality of this specialty in Bolivia, new graduate programs in neuropsychology must be developed, more standardized tests validated, and more job positions created, especially in public institutions. Additionally, a professional organization that regulates the standards of this field needs to be established.

Autosomal recessive otospondylo-mega-epiphyseal dysplasia: comprehensive clinical review of a pediatric cohort

Autosomal recessive otospondylo-mega-epiphyseal dysplasia (OSMEDB) is characterized by short stature with short limbs, dysmorphic facial features, and hearing loss, which is caused by biallelic, loss-of-function, variants in the COL11A2 gene. Geno-phenotypic data from the medical records of eight affected individuals from five unrelated families was abstracted, recorded in an Excel spreadsheet and analyzed using simple frequency analysis. Either short femora or short extremities with or without other ultrasonographic abnormalities were demonstrated in five patients antenatally. The mean height was -2.29 SDS. Pectus deformity, including either chest asymmetry or pectus excavatum, was present in five patients. Bilateral hearing loss was verified in all patients. Severe speech delay and learning disabilities were present in two patients whose deafness was realized after the age of 12 months. Four novel loss-of-function variants in COL11A2 were found in this cohort. We present novel geno-phenotypic findings in a pediatric cohort with OSMEDB. The age of manifestation of short stature was variable, ranging from birth to middle childhood, and the severity of short stature varied even within the same family. Hearing loss may not be evident in the neonatal period and manifest later in OSMEDB. Intermittent hearing tests should be performed for early intervention of neurolinguistic delay and learning disabilities.

Training arithmetical skills when finger counting and working memory cannot be used: A single case study in a child with cerebral palsy

Children with cerebral palsy (CP) are at greater risk of mathematical learning disabilities due to associated motor and cognitive limitations. However, there is currently little evidence on how to support the development of arithmetic skills within such a specific profile. The aim of this single-case study was to assess the effectiveness of a neuropsychological rehabilitation of arithmetic skills in NG, a 9-year-old boy with CP who experienced math learning disability and cumulated motor and short-term memory impairments. This issue was explored combining multiple-baseline and changing-criterion designs. The intervention consisted of training NG to solve complex additions applying calculation procedures with a tailor-made computation tool. Based on NG's strengths, in accordance with evidence-based practice in psychology, the intervention was the result of a co-construction process involving N, his NG's parents and professionals (therapist and researchers). Results were analyzed by combining graph visual inspections with non-parametric statistics for single-case designs (NAP-scores). Analyses showed a specific improvement in NG's ability to solve complex additions, which maintained for up to 3 weeks after intervention. The training effect did not generalize to his ability to perform mental additions, and to process the symbolic magnitude.

Education and age trajectories of chronic conditions: Are tests of the cumulative advantage and disadvantage hypothesis biased by underreporting?

OBJECTIVE

This study examined the impact of underreporting on tests of the cumulative advantage and disadvantage hypothesis (CAD), which predicts age-related increases in health disparities between individuals with higher and lower education.

METHODS

Using the English Longitudinal Study of Ageing (ELSA), we identified underreporting by comparing self-reported hypertension and diabetes with biomedically measured hypertension (systolic blood pressure≥140 mm Hg and/or diastolic blood pressure≥90 mm Hg) and diabetes (fasting glucose level≥7 mmol/l and/or HbA1c≥6.5%). In a sample of 11,859 respondents aged 50 to 85 (54% women, 97% White), we assessed the associations between underreporting and the main analytic constructs in tests of the CAD (education, age, sex, and cohort).

RESULTS

The results showed that self-reported measures underestimated the prevalence of hypertension and diabetes. Underreporting showed weak to moderate associations with the main constructs in tests of the CAD, being more pronounced in individuals with lower education, in older age, in more recent cohorts, and among men. When correcting for underreporting using biomedical measures, the overall prevalence of hypertension and diabetes increased substantially, but education differences in age trajectories of both conditions remained similar.

CONCLUSIONS

Underreporting affected conclusions about the prevalence of hypertension and diabetes, but it did not affect conclusions about the CAD hypothesis for either condition.

Is it feasible to implement a community-based participatory group programme to address issues of access to healthcare for people with disabilities in Luuka district Uganda? A study protocol for a mixed-methods pilot study

INTRODUCTION

On average, people with disabilities face many difficulties in accessing healthcare and experience worse health outcomes. Yet, evidence on how to overcome these barriers is lacking. Participatory approaches are gaining prominence as they can generate low-cost, appropriate and scalable solutions. This study protocol is for the pilot testing of the co-created Participatory Learning and Action for Disability (PLA-D) groups to assess feasibility.

METHODS AND ANALYSIS

We will pilot test PLA-D in five groups in Luuka district, Uganda during 2023. Each group will include approximately 20 members (people with disabilities, family members, carers) who will meet every 2-3 weeks over a 9-11 month period. The groups, guided by a trained facilitator, will identify issues about health and healthcare access and plan and implement locally generated solutions (eg, raising awareness of rights, advocacy and lobbying, establishing health savings and financing schemes). We will collect diverse sources of data to assess feasibility: (1) in-depth interviews and focus group discussions with group participants, non-participants and group facilitators; (2) monitoring of group activities; (3) direct observation of groups and (4) quantitative survey of group participants at baseline and endline. Data analyses will be undertaken to assess feasibility in terms of: acceptability, demand, implementation and practicality. We will develop and refine evaluation tools in preparation for a future trial.

ETHICS AND DISSEMINATION

Ethical approval for the study has been received by the London School of Hygiene & Tropical Medicine and the Uganda Virus Research Institute ethics committees. Informed consent will be obtained from all study participants, making adaptations for people with disabilities as necessary. We will reach different groups for our dissemination activities, including (1) people with disabilities (eg, community meetings); (2) policy and programme stakeholders in Uganda and international (eg, individual meetings, evidence briefs) and (3) academics (journal articles, conference/seminar presentations).

Associations between Executive Functions and Sensorimotor Performance in Children at Risk for Learning Disabilities

Executive functions (EF) and sensorimotor skills play a critical role in children's goal-directed behavior and school readiness. The aim of the current study is to provide new insights into the relationship between executive functions and sensorimotor development by considering the risks associated with learning difficulties. Therefore, we investigate the predictive role of EF and sensorimotor skills in the development of learning difficulties during preschool years. Ninety-five preschool children (5-7 years old) were tested, comparing the performance of children that are at risk of learning difficulties (n = 55) to the performance of typically developing children (n = 40). Participants completed a battery for the assessment of sensorimotor skills (i.e., Southern California Sensory Integration Test: postural imitation, body midline crossing, bilateral motor coordination, and standing balance with eyes open) and executive functions (i.e., inhibition, cognitive flexibility, and verbal working memory). Our results show that children at risk for learning difficulties exhibited more impairments on sensorimotor and EF measures (inhibition and verbal working memory) when compared with TD children. We ran three separate binary logistic regression analyses to assess the relative influence of EF and sensorimotor functions on predicting risk for learning difficulties. Our findings demonstrated that verbal working memory as EF function (odd ratio (OR) = 0.91, 95% CI 0.78-0.91, P = 0.05) and standing balance skills as a sensorimotor skill (odd ratio (OR) = 0.86, 95% CI 0.81-0.98, P = 0.01) were the strongest predictors of risk for learning difficulties. The findings point to the importance of supporting children's executive function development and promoting sensorimotor development, as both fundamentally influence school readiness.

Working memory training in children with neurodevelopmental disorders and intellectual disabilities, the role of coaching: A double-blind randomised controlled trial

BACKGROUND

Working memory training (WMT) can offer therapeutic benefits to patients with neurodevelopmental disorders (NDD) and mild to borderline intellectual disability (MBID). However, consistent evidence for treatment benefits of WMT over placebo training is missing. So far, participants in double-blind research designs did receive non-specific coaching, whereas active coaching based on individual training results might increase the efficacy of WMT. Furthermore, the intensity and duration of WMT is often too stressful for these children. This study therefore investigated whether a less intensive but more prolonged WMT, with active personalised coaching and feedback, would reduce behavioural symptoms and improve neurocognitive functioning and academic achievements in children with NDD and MBID.

METHOD

A double-blind randomised controlled trial in children (aged 10;0-13;11) with MBID (60 < IQ < 85) and ADHD and/or ASD evaluated the effects of a less intensive but prolonged version of the original Cogmed WMT (30 min a day, 4 days a week, 8 weeks in total). Eighteen participants received active, personalised coaching and feedback, based on their actual individual performance during training. Twenty-two received general non-personalised coaching for the same amount of time. Executive functioning, academic achievements and several behavioural measurements were administered, before and after training, with a 6-months follow-up.

RESULTS

We observed a significant effect of time on both primary and secondary outcome measures, indicating that all children improved in working memory performance and other neurocognitive and academic outcomes. The interaction between time and group was not significant.

DISCUSSION

This study was unable to document superior effects of active personalised coaching and feedback compared with general non-personalised coaching and no feedback in an adaptive WMT in children with MBID and NDD. The objectively documented changes over time suggest that for these vulnerable children, a regular, structured and structural contact with a coach and adapted exercises is enough to develop therapy fidelity, boost motivation and improve neurodevelopmental task performance. Further research is needed to examine which possible subgroups within this heterogenic group of children profit more from WMT compared with other subgroups.

Copy Skills and Writing Abilities in Children With and Without Specific Learning Disabilities

Copying a text quickly and accurately is important both in school and in daily life. However, this skill has never been systematically studied, either in children with typical development (TD) or in children with specific learning disabilities (SLD). The aim of this research was to study the features of a copy task and its relationship with other writing tasks. For this purpose, 674 children with TD and 65 children with SLD from Grades 6 through 8 in Italy were tested with a copy task and other writing assessment tasks, measuring three aspects of writing: handwriting speed, spelling, and expressive writing. Children with SLD performed worse on the copy task, both in terms of speed and accuracy, than children with TD. Copy speed was predicted by grade level and by all three major writing skills for children with TD but only by handwriting speed and spelling for children with SLD. Copy accuracy was predicted by gender and the three major writing skills for children with TD but only by spelling for children with SLD. These results suggest that children with SLD also have difficulty copying a text and benefit less than children with TD from their other writing skills.

Do early life factors explain the educational differences in early labour market exit? A register-based cohort study

BACKGROUND

Socioeconomic inequalities in labour market participation are well established. However, we do not fully know what causes these inequalities. The present study aims to examine to what extent factors in childhood and late adolescence can explain educational differences in early labour market exit among older workers.

METHODS

All men born in 1951-1953 who underwent conscription examination for the Swedish military in 1969-1973 (n = 145 551) were followed from 50 to 64 years of age regarding early labour market exit (disability pension, long-term sickness absence, long-term unemployment and early old-age retirement with and without income). Early life factors, such as cognitive ability, stress resilience, and parental socioeconomic position, were included. Cox proportional-hazards regressions were used to estimate the association between the level of education and each early labour market exit pathway, including adjustment for early life factors.

RESULTS

The lowest educated men had a higher risk of exit through disability pension (HR: 2.72), long-term sickness absence (HR: 2.29), long-term unemployment (HR: 1.45), and early old-age retirement with (HR: 1.29) and without income (HR: 1.55) compared to the highest educated men. Factors from early life explained a large part of the educational differences in disability pension, long-term sickness absence and long-term unemployment but not for early old-age retirement. Important explanatory factors were cognitive ability and stress resilience, whilst cardiorespiratory fitness had negligible impact.

CONCLUSIONS

The association between education and early exit due to disability pension, long-term sickness absence and long-term unemployment was to a large part explained by factors from early life. However, this was not seen for early old-age retirement. These results indicate the importance of taking a life-course perspective when examining labour market participation in later working life.

Cognitive Accessibility of Indoor Navigation Apps

Advances in smartphone technology have made it possible to develop mobile apps that assist people with cognitive or learning disabilities in navigating indoor spaces more easily and independently. This paper reviews the state of the art in smartphone-based indoor navigation for this population and describes a usability trial that was conducted with four individuals in a German city hall. The trial was based on simulated tasks that required the use of the indoor navigation app XXX, during which data about different use cases were gathered. A guided interview was conducted to gather further feedback about the accessibility and the perceived usefulness of the app. The paper highlights the potential of smartphone-based indoor navigation apps for enhancing the independence and quality of life of individuals with cognitive or learning disabilities. The usability trial provided insights into the effectiveness and usability of these apps in real-world settings.

Effects of a developmental dyslexia remediation protocol based on the training of audio-phonological cognitive processes in dyslexic children with high intellectual potential: study protocol for a multiple-baseline single-case experimental design

BACKGROUND

The significant prevalence of children with high intellectual potential (HIP) in the school-age population and the high rate of comorbidity with learning disabilities such as dyslexia has increased the demand for speech and language therapy and made it more complex. However, the management of dyslexic patients with high intellectual potential (HIP-DD) is poorly referenced in the literature. A large majority of studies on HIP-DD children focus on the screening and diagnosis of developmental dyslexia, but only a few address remediation. Developmental dyslexia is a severe and persistent disorder that affects the acquisition of reading and implies the impairment of several underlying cognitive processes. These include deficits in Categorical Perception, Rapid Automatized Naming, and phonological awareness, particularly phonemic awareness. Some authors claim that HIP-DD children's underlying deficits mainly concern rapid automatized naming and phonological awareness. Thus, the purpose of this study is to present a remediation protocol for developmental dyslexia in HIP-DD children. This protocol proposes to compare the effects on reading skills of an intensive intervention targeting categorical perception, rapid automatized naming, and phonemic analysis versus standard speech therapy remediation in HIP-DD children.

METHODS

A multiple-baseline single-case experimental design (A1BCA2) will be proposed to 4 French HIP-DD patients for a period of 30 weeks. Intervention phases B and C correspond to categorical perception training and rapid automatized naming training. During phases B and C, each training session will be associated with phonemic analysis training and a reading and writing task. At inclusion, a speech and language, psychological, and neuropsychological assessment will be performed to define the four patients' profiles. Patients will be assigned to the different baseline lengths using a simple computerized randomization procedure. The duration of the phases will be counterbalanced. The study will be double blinded. A weekly measurement of phonological and reading skills will be performed for the full duration of the study.

DISCUSSION

The purpose of this protocol is to observe the evolution of reading skills with each type of intervention. From this observation, hypotheses concerning the remediation of developmental dyslexia in HIP-DD children can be tested. The strengths and limitations of the study are discussed.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT04028310 . Registered on July 18, 2019. Version identifier is no. ID RCB 2019-A01453-54, 19-HPNCL-02, 07/18/2019.

Arabic digit processing in adults with mathematical learning disability

The processing of Arabic digits is a core difficulty of children suffering from mathematical learning disability (MLD). Dominant accounts assume a semantic impairment affecting either the magnitude representation per se or its access from numerical symbols. But recent data have raised the hypothesis that the impaired processing of Arabic digits may be explained by a selective deficit of digit visual recognition (i.e., recognising a symbol as one of the digits, no matter its identity or numerical meaning). This study aims at testing whether the difficulty to process Arabic digits remains prevalent in adults with MLD and whether it is effectively associated with a digit visual recognition deficit. To do so, we compared 19 adults with MLD to 19 matched controls in an Arabic digit comparison task that required to identify the largest of two digits, and in an Arabic digit lexical decision task that required to decide whether a visual stimulus is a digit or not. The results showed that MLD participants took more time than control participants to perform the comparison task. In contrast, their performance in the digit lexical decision task was within the range of the control participants. Overall, this finding indicates that adults with MLD continue to experience difficulties to process the magnitude of Arabic digits efficiently, and this cannot be explained by a visual recognition deficit for Arabic digits. We conclude that their difficulties are best explained by an impaired representation of number magnitude or by an impaired access to this representation.

Human rights as the key driver for development of Learning Disability services in Qatar

Growing international consensus in recognising rights of individuals with disability to enabling environments has spurred on provision of services for support for these individuals. The provision of this support has however been variable across the globe, often depending upon the economic development and social stigma associated with disability within individual countries. Individuals with Mental health learning disability have experienced even more stigma and limitations to access care. Qatar, a young and economically prosperous country, has adopted this rights-based approach to developing services for individuals with learning disability. This has led to the development of a specialist mental health learning disability services which is taking its initial steps within the country. This specialist service places the individual and their family at the centre of developing and delivering care and aims at reducing stigma and improving access to specialist evidence-based care.

Changes in COVID-19-related mortality across key demographic and clinical subgroups in England from 2020 to 2022: a retrospective cohort study using the OpenSAFELY platform

BACKGROUND

COVID-19 has been shown to differently affect various demographic and clinical population subgroups. We aimed to describe trends in absolute and relative COVID-19-related mortality risks across clinical and demographic population subgroups during successive SARS-CoV-2 pandemic waves.

METHODS

We did a retrospective cohort study in England using the OpenSAFELY platform with the approval of National Health Service England, covering the first five SARS-CoV-2 pandemic waves (wave one [wild-type] from March 23 to May 30, 2020; wave two [alpha (B.1.1.7)] from Sept 7, 2020, to April 24, 2021; wave three [delta (B.1.617.2)] from May 28 to Dec 14, 2021; wave four [omicron (B.1.1.529)] from Dec 15, 2021, to April 29, 2022; and wave five [omicron] from June 24 to Aug 3, 2022). In each wave, we included people aged 18-110 years who were registered with a general practice on the first day of the wave and who had at least 3 months of continuous general practice registration up to this date. We estimated crude and sex-standardised and age-standardised wave-specific COVID-19-related death rates and relative risks of COVID-19-related death in population subgroups.

FINDINGS

18 895 870 adults were included in wave one, 19 014 720 in wave two, 18 932 050 in wave three, 19 097 970 in wave four, and 19 226 475 in wave five. Crude COVID-19-related death rates per 1000 person-years decreased from 4·48 deaths (95% CI 4·41-4·55) in wave one to 2·69 (2·66-2·72) in wave two, 0·64 (0·63-0·66) in wave three, 1·01 (0·99-1·03) in wave four, and 0·67 (0·64-0·71) in wave five. In wave one, the standardised COVID-19-related death rates were highest in people aged 80 years or older, people with chronic kidney disease stage 5 or 4, people receiving dialysis, people with dementia or learning disability, and people who had received a kidney transplant (ranging from 19·85 deaths per 1000 person-years to 44·41 deaths per 1000 person-years, compared with from 0·05 deaths per 1000 person-years to 15·93 deaths per 1000 person-years in other subgroups). In wave two compared with wave one, in a largely unvaccinated population, the decrease in COVID-19-related mortality was evenly distributed across population subgroups. In wave three compared with wave one, larger decreases in COVID-19-related death rates were seen in groups prioritised for primary SARS-CoV-2 vaccination, including people aged 80 years or older and people with neurological disease, learning disability, or severe mental illness (90-91% decrease). Conversely, smaller decreases in COVID-19-related death rates were observed in younger age groups, people who had received organ transplants, and people with chronic kidney disease, haematological malignancies, or immunosuppressive conditions (0-25% decrease). In wave four compared with wave one, the decrease in COVID-19-related death rates was smaller in groups with lower vaccination coverage (including younger age groups) and conditions associated with impaired vaccine response, including people who had received organ transplants and people with immunosuppressive conditions (26-61% decrease).

INTERPRETATION

There was a substantial decrease in absolute COVID-19-related death rates over time in the overall population, but demographic and clinical relative risk profiles persisted and worsened for people with lower vaccination coverage or impaired immune response. Our findings provide an evidence base to inform UK public health policy for protecting these vulnerable population subgroups.

FUNDING

UK Research and Innovation, Wellcome Trust, UK Medical Research Council, National Institute for Health and Care Research, and Health Data Research UK.

Low discriminative power of WISC cognitive profile in developmental dyscalculia

BACKGROUND

The role of domain-general cognitive abilities in the etiology of Developmental Dyscalculia (DD) is a hotly debated issue.

AIMS

In the present study, we tested whether WISC-IV cognitive profiles can be useful to single out DD.

METHODS AND PROCEDURES

Using a stringent 2-SD cutoff in a standardized numeracy battery, we identified children with DD (N = 43) within a clinical sample referred for assessment of learning disability and compared them in terms of WISC cognitive indexes to the remaining children without DD (N = 100) employing cross-validated logistic regression.

OUTCOMES AND RESULTS

Both groups showed higher Verbal Comprehension and Perceptual Reasoning than Working Memory and Processing Speed, and DD scores were generally lower. Predictive accuracy of WISC indexes in identifying DD individuals was low (AUC = 0.67) and it dropped to chance level in discriminating DD from selected controls (N = 43) with average math performance but matched on global IQ. The inclusion of a visuospatial memory score as an additional predictor did not improve classification accuracy.

CONCLUSIONS AND IMPLICATIONS

These results demonstrate that cognitive profiles do not reliably discriminate DD from non-DD children, thereby weakening the appeal of domain-general accounts.

Adapting a virtual manipulative-based instructional sequence to target maintenance

The ability to maintain mathematical skills learned is critical for students to successfully engage in advanced mathematics and promote independence in daily living skills. The purpose of this study was to evaluate the effectiveness of a graduated manipulative sequence consisting of virtual, representational, abstract, and an extended abstract phase (VRAEa) to teach various types of mathematical problems to three students with autism and mild intellectual disability using a multiple probe across behavior single case design. This study extended previous research on the virtual, representational, abstract sequence (VRA) to address deficiency in maintenance results through incorporating the extended abstract phase. The results indicate the intervention was effective, however, maintenance was variable. Implications for practice and ideas for future research to support the learning needs of students with developmental disabilities are discussed.

Psychometric properties of measures designed to assess common mental health problems and wellbeing in adults with intellectual disabilities: a systematic review

BACKGROUND

Multiple measures of mental health problems and mental wellbeing for adults with intellectual disabilities are available, but investigations into their reliability and validity are still in the early stages. The aim of this systematic review was to provide an update to previous evaluations of measures of common mental health problems and wellbeing in adults with mild to moderate intellectual disabilities (ID).

METHODS

A systematic search was performed across three databases (MEDLINE, PsycINFO and SCOPUS). The literature search was limited to the years from 2009 to 2021 and to the original English versions. Ten papers evaluating nine measures were reviewed, and the psychometric properties of these measures were discussed using the Characteristics of Assessment Instructions for Psychiatric Disorders in Persons with Intellectual Developmental Disorders as a framework.

RESULTS

Four measures had at least one rating of 'good' across both dimensions of reliability and at least one dimension of validity and were deemed to have promising psychometric properties: the Clinical Outcomes in Routine Evaluation-Learning Disabilities, Impact of Events Scale-Intellectual Disabilities, Lancaster and Northgate Trauma Scales and Self-Assessment and Intervention (self-report section). Additionally, these measures were developed through consultations with mental health professionals and/or people with IDs and thus were deemed to have good content validity.

CONCLUSIONS

This review informs measurement choice for researchers and clinicians while highlighting a need for continued research efforts into the quality of measures available for people with IDs. The results were limited by incomplete psychometric evaluations of measures available. A paucity of psychometrically robust measures of mental wellbeing was observed.