Phoniatric evaluation: relationships between a set of tests and academic difficulties

Abstract Introduction: Learning disability has a significant relevance and can generate negative social impacts on the future of an individual if not corrected in time. Phoniatrics is an area of otorhinolaryngology responsible for evaluating, diagnosing, and referring these cases for therapy and/or complementing the multidisciplinary diagnosis. Objective: To evaluate in school-aged children the association between the application of a set of tests used in the phoniatric assessment and complaints of academic difficulties. To identify which tests would show the main association with academic performance when applied individually. Methods: Blind, cross-sectional study, subdivided into 4 stages. In the 1st stage, 66 children in the third year of elementary school were submitted to the set of tests of skills applied by the phoniatrician; in the 2nd stage, the physician asked the educators about complaints of academic difficulties regarding the students; in the 3rd stage the students' Portuguese language school grade was obtained and in the 4th stage an analysis was made between the data. Results: The educator identified complaints of academic difficulties in 27.2% of the 66 students. There was a statistically significant association between academic difficulties and the following tests of skills: dictation of words and pseudowords, dictation of words, dictation of pseudowords, rhyming, phonemic synthesis, and in the reading test; fluency, intonation and comprehension of the text and morals were analyzed in the reading test. In the multivariate logistic regression analysis, the tests selected to comprise the final model, showing greater association with the academic difficulty complaint were: dictation of words, intonation in reading and comprehension of the morals of the story. Conclusion: The tests identified as the most relevant in identifying academic difficulties were dictation of words, intonation in reading and comprehension of the morals of the story. However, the other tests that were part of the phoniatric consultation allowed the observation of the individual and their functioning abilities, leading to a better assessment of the case, regarding aspects not directly related to the pedagogical one.

Escrita em alunos com dificuldades de aprendizagem: Efeito Mateus / Writing in students with learning difficulties: Matthew effect

O estudo investigou a linguagem escrita de crianças do 2º e 4º anos com e sem sinais de transtorno específico de aprendizagem. Objetivou comparar as escritas entre dois os grupos de alunos, de modo a verificar se a diferença entre eles seria menor nas séries iniciais e tenderia a aumentar nas séries finais, como previsto teoricamente com base no efeito Mateus. Participaram do estudo 51 professores e 1085 alunos, sendo 49 indicados com sinais compatíveis com o transtorno específico de aprendizagem. O instrumento utilizado para analisar a escrita dos alunos foi o Teste de Desempenho Escolar (TDE-II). A partir das análises realizadas, observou-se que o total de palavras certas no ditado do TDE-II foi maior no 4º ano do que no 2º ano para a amostra total, como esperado, e que a diferença entre os alunos com e sem queixas de dificuldades foi maior no 4º ano do que no 2º ano. Análise de post-hoc revelou que não houve diferença estatisticamente significativa entre os alunos com queixas do 2º ano e do 4º ano, ou seja, a diferença entre eles foi tão pequena que não se mostrou significativa. Tal resultado corrobora o efeito Mateus, sugerindo que crianças com dificuldades ao início da escolarização tendem a apresentar menores ganhos e se distanciar cada vez mais dos colegas com habilidades mais desenvolvidas. Logo, estratégias e intervenções precisam ser desenvolvidas para facilitar o desenvolvimento da linguagem escrita das crianças e promover avanços logo ao início da escolarização.

The study investigated writing of 2nd and 4th grade children with and without signs of the specific learning disorder, and aimed to compare the difference in writing between these two groups of students, to analyze whether the difference between them would be smaller in the early grades and would tend to increase in the final grades, as theoretically predicted by Matthew effect. 51 teachers and 1085 students participated in this study, among which 49 had signs compatible with the specific learning disorder. The instrument used to analyze the students writing was the School Performance Test (TDE-II). It was observed that, in general, the total number of correct words in the TDE-II dictation was greater in the 4th grade, compared to the 2nd grade, as expected, and the difference between students with and without complaints of difficulties was greater among the students in 4th grade than among 2nd grade students. Post-hoc tests showed that there was no statistically significant difference between 2nd grade students with complaints and 4th grade students of with complaints, that is, the difference between them was so small that it was not significant. This result corroborates the "Matthew effect": children with difficulties at the beginning of schooling tend to present lower gains and, increasingly, distance themselves from colleagues with more developed skills. Thus, strategies and interventions must be designed to facilitate children's literacy and promote advances at beginning of schooling.

Características fonológicas en población escolar con dislexia: Un modelo de ecuaciones estructurales / Phonological features in a school population with dyslexia: A structural equation model

Resumen Introducción: El trastorno específico del aprendizaje es una entidad nosológica del neurodesarrollo, las manifestaciones clínicas se hacen evidentes en la etapa escolar y son persistentes en el transcurso de la vida. La dislexia (DS) se caracteriza por una afectación en la comprensión y fluidez del proceso lector, asociada a déficits neurocognitivos. Objetivo: Analizar. la relación existente entre fluidez fonológica, repetición, denominación y comprensión verbal en niños con diagnóstico de DS. Método: Se empleó una muestra de N=114 personas con diagnóstico de DS escolarizados, en edades entre 7 y 16 años y un. muestreo no probabilístico. Construimos un modelo de ecuaciones estructurales (MEE) en el software RCran 4.0.4, para analizar la relación entre las variables latentes (fluidez fonológica, fluidez semántica, repetición de pseudopalabras, repetición de frases, denominación y comprensión verbal), a través de los resultados de pruebas psicométricas estandarizadas; Test de Fluencia Verbal, Test de Boston, Evaluación Neuropsicológica Infantil y Escala Weschler IV de Inteligencia. Resultados: Las covarianzas entre fluidez fonológica y todos los componentes del lenguaje (LG) fueron positivas; fluidez semántica (σxy=0,55), repetición de pseudopalabras (σxz=0,53), repetición de frases (σxw=0,64), denominación del LG (σxv=0,60), comprensión verbal (σxy=0,57), lo que indica una relación directa. En las personas con DS, a menor fluidez fonológica mayores deficiencias del LG. Conclusión: En la DS la fluidez fonológica y semántica es limitada y se relaciona de manera directa con las manifestaciones clínicas de este trastorno del neurodesarrollo (TN).

Abstract Introduction: The specific learning disorder is a nosological entity of neurodevelopment, the clinical manifestations become evident in the school stage and are persistent throughout life. Dyslexia (DS) is characterized by an impairment in the comprehension and fluency of the reading process, associated with neurocognitive deficits. Objective: To analyze the relationship between phonological fluency, repetition, naming and verbal comprehension in children diagnosed with dyslexia (DS). Method: A sample of (N=114) school patients with DS diagnosis between the ages of 7 and 16 years, selected by non-probability sampling, was used. We built a structural equation model (MEE) in RCran 4.0.4 software, to analyze the relationship between the latent variables (phonological fluency, semantic fluency, pseudoword repetition, sentence repetition, naming and verbal comprehension), through the results of standardized psychometric tests; Verbal Fluency Test, Boston Test, Child Neuropsychological Assessment and Weschler Intelligence Scale IV. Results: Covariances between phonological fluency and all language (LG) components were positive; semantic fluency (σxy=0.55), pseudoword repetition (σxz=0.53), sentence repetition (σxw=0.64), LG naming (σxv=0.60), verbal comprehension (σxy=0.57), indicating a direct relationship. In people with DS, the lower the phonological fluency the greater the language deficits. Conclusion: In DS, phonological and semantic fluency is limited and is directly related to the clinical manifestations of this neurodevelopmental disorder (TN).

Discalculia e educação: quais conhecimentos os professores possuem acerca deste tema / Dyscalculia and education: What knowledge the teachers have about this theme

A escola na atualidade enfrenta grandes desafios em relação às dificuldades de aprendizagem. É crescente o número de alunos que apresentam algum tipo de dificuldade de aprendizagem, sendo que as relacionadas à aprendizagem dos conceitos matemáticos aparecem como sendo um fator preponderante no que tange ao fracasso escolar. Escolares que não aprendem matemática podem possuir discalculia, uma dificuldade específica em matemática que está relacionada a uma desordem estrutural na área relacionada às habilidades matemáticas. O presente estudo divulga os resultados de uma pesquisa de natureza qualitativa e delineamento exploratório que visou investigar a percepção dos professores de escolas de anos iniciais do Ensino Fundamental em uma cidade do interior do estado de São Paulo, região de Marília, a respeito do transtorno de aprendizagem denominado discalculia, suas características, formas de manifestações entre as crianças. Tal pesquisa indicou que os entrevistados não possuem conhecimento teórico sobre o tema, o que denota a necessidade de reformulação do conteúdo programático dos cursos de pedagogia e nos cursos de educação continuada, para que esses profissionais estejam aptos a trabalhar com alunos com discalculia. E destacou a relevância da ludicidade na intervenção pedagógica junto ao discalcúlico.

The school today faces great challenges in relation to the learning difficulties, since the number of students with some type of learning difficulty is increasing, and the difficulties related to the learning of mathematical concepts appear as being a preponderant factor regarding the school failure. Schoolchildren who do not learn mathematics may have dyscalculia, a specific difficulty in mathematics that is related to a structural disorder in the area related to mathematical skills. This study discloses the results of a qualitative research and exploratory design that aimed to investigate the perception of teachers of elementary schools I in a city in the interior of the state of São Paulo, region of the city of Marília, regarding the learning disorder called dyscalculia, its characteristics, forms of manifestations among children, in view of possible strategies for psychopedagogical interventions based on playful practices that can be used to work in the classroom with students who have this disorder. We hope that this study can contribute to the expansion of discussions on dyscalculia.

Performance profile of reading and metalinguistic skills in students with dyslexia, learning difficulties and learning disorders / Perfil do desempenho em habilidades metalinguísticas e leitura de escolares com dislexia, dificuldades e transtornos de aprendizagem

INTRODUCTION: The reading process involves several cognitive skills, such as metalinguistic skills and memory. These processes lead the student to understand the ideas of a text for the creation of mental models, based on the context and your point of viewOBJECTIVE: To analyze the performance of metalinguistic and reading skills in students with dyslexia, learning difficulties, and learning disordersMETHODS: This is an observational and cross-sectional study. The group comprised 80 students from the 3rd to the 5th year of elementary, both gender, aged between eight and ten years and 11 months. The sample, distributed in four groups as follows: Group I composed of 20 students with an interdisciplinary diagnosis of dyslexia, Group II make up of 20 students with a multidisciplinary diagnosis of learning disorders, Group III by 20 students with learning difficulties and Group IV comprised 20 students with excellent academic performance. Every student, individually, underwent the application of the Metalinguistic and Reading Skills Tests ProtocolRESULTS: The Groups I and II had more errors than Group III and IV. Group III showed a higher number of mistakes than Group IV. Scores were obtained from the metalinguistic tests, word reading and pseudowords, and repetition of no -monosyllable and polysyllable wordsCONCLUSION: Students with dyslexia and learning disorders had a higher number of mistakes in syllabic and phonemic tests, reading words, and pseudowords than students with learning difficulties and excellent academic performance

INTRODUÇÃO: O processo de leitura envolve diversas habilidades cognitivas como a decodificação das palavras, a aquisição de vocabulário, a percepção dos sons, as habilidades metalinguísticas e a memória, de forma que esses processos levam o escolar à compreensão das ideias de um texto para a criação de modelos mentais, com base no contexto e no seu ponto de vistaOBJETIVO: Caracterizar e comparar o desempenho em habilidades metalinguísticas e leitura de escolares com dislexia, dificuldades e transtornos de aprendizagemMÉTODO: Este é um estudo observacional e descritivo de corte transversal. Participaram 80 escolares do 3º ao 5º ano do ensino fundamental, ambos os sexos, na faixa etária de oito a dez anos e 11 meses, distribuídos em quatro grupos, sendo Grupo I composto por 20 escolares com diagnóstico interdisciplinar de dislexia, Grupo II composto por 20 escolares com diagnóstico interdisciplinar de transtornos de aprendizagem, Grupo III composto por 20 escolares com dificuldades de aprendizagem e Grupo IV composto por 20 escolares com bom desempenho acadêmico. Todos os escolares foram submetidos à aplicação do Protocolo de provas de habilidades metalinguísticas e de leitura, individualmenteRESULTADOS: Os resultados foram analisados estatisticamente e revelaram maior número de erros de Grupo I e Grupo II em relação ao Grupo III, e Grupo IV e Grupo III em relação ao Grupo IV nas provas metalinguísticas, de leitura de palavras e de pseudopalavras e de repetição de não-palavras monossílabas e polissílabasCONCLUSÃO: A partir deste estudo foi possível concluir que escolares com dislexia e transtorno de aprendizagem apresentaram um maior número de erros em provas silábicas e fonêmicas e leitura de palavras e pseudopalavras quando comparados aos escolares com dificuldades de aprendizagem e bom desempenho acadêmico

Visual perception skill profile pattern in children with learning disorder

Background: Visual perception skill related problems are important in poor academic performance in learning disability (LD) children. Visual perception skill often not tested in LD children. The objective of the study is to explore visual perception skill pattern among children with learning disorder.Methods: Retrospective observational study was conducted at LD clinic of tertiary hospital. Children diagnosed with learning disorder were includes. Visual perception data were collected using predefined standard questionnaire of third edition total visual perception score (TVPS-3). Trained medical professional collected the details.Results: Total 103 children diagnosed with LD were evaluated for TVPS-3. Majority of the children had all three learning disorders-dyslexia, dysgraphia and dyscalculia. 58.42% children had co-morbid attention deficit hyperactivity disorder. From the 7 subtests of the TVPS visual discrimination, visual memory, form constancy and visual figure - ground affected more in boys and also in lower age children.Conclusions: Assessment of visual perception skill in children with learning disorder is crucial. Visual perception rehabilitation with other management of LD can benefit the overall functionality of these children.

Study of parenting styles, family functioning and its relation to coping strategies in children of specific learning disorder

Background: Families of children with disabilities otherwise experience higher stress; and relation between parenting styles and coping of children is well known. Parental factors and family functioning may play a role in shaping the child, especially having issues like SLD. The objective is to study was coping strategies of children with SLD, parenting styles of their parents, their family functioning and relation of these with each other.Methods: It is a cross-sectional study undertaken after Institutional Ethics Committee approval, parent's consent and child's assent. Participants were 100 consecutive children, diagnosed with SLD, 9-13 years of age. Tools used were: Semi-structured proforma, Parenting Practices Questionnaire, Family Assessment Device and Children's Coping Strategies Checklist Revision 1.Results: Authoritarian parenting style was significantly was associated with less use of 'active' and 'support seeking'; and increased use of 'distraction' and 'avoidance' strategies. High scores on Authoritative style was associated with 'active' and 'support seeking' strategies. Avoidance coping strategy was associated with poor (high scores) and active coping strategies with higher (low scores) on problem solving, communication, and general family functioning.Conclusions: Parenting practices and family functioning can be pivotal in determining child's attitude and coping. Assessment of this can be routinely included in child evaluation.

A associação entre os transtornos de linguagem receptivo e expressivo e os transtornos de aprendizagem / The association between receptive and expressive language disorders and learning disorders

O aprendizado e a linguagem são processos neuronais complexos, os quais possuem íntima ligação entre si. Diante disso, o transtorno de linguagem (TL) também está fortemente correlacionado aos transtornos de aprendizagem (TA), uma associação inicialmente observada no projeto de extensão "Construindo Histórias...", da PUC Minas, e confirmada pela literatura. Foi realizada uma busca de publicações dos últimos 15 anos, nas bases PubMed, LILACS, Up to Date e MedLine, utilizando os descritores Language Development Disorders, Child Languages, Language Development, Learning e Learning Disorders e suas traduções em português. Foram selecionadas 18 publicações e também o foi utilizado o livro Transtornos da aprendizagem. Os TL por definição são mudanças nos padrões normais do aprendizado da linguagem e podem ser classificados em expressivo e receptivo. Como resultado desse quadro, a criança apresenta dificuldades em compreender e de se expressar, o que está diretamente relacionado ao processo de aprendizagem e pode resultar em um TA. O diagnóstico desses transtornos deve ser realizado de maneira individualizada e observando a interação de fatores genéticos, fisiológicos, socioculturais e escolares. Conclui-se que os transtornos de linguagem e de aprendizado não afetam apenas a vida acadêmica, mas também a vida social, comportamental e psicológica e, por isso, é de extrema importância que ocorra um foco maior na detecção precoce desses transtornos, para que, assim, a criança receba um tratamento adequado e, consequentemente, tenha um prognóstico melhor. (AU)

Learning and language are complex neuronal processes, which have an intimate connection with each other. Therefore, language development disorder (LDD) or language impairment is also strongly correlated with learning disorders (LD), an association initially observed in the extension project "Constructing stories" at PUC Minas and confirmed by the literature. A search for publications from the last 15 years was carried out in the following outlets: PubMed, LILACS, Up to Date and MedLine using the descriptors Language Development Disorders, child languages, Language Development, Learning and Learning Disorders and their Portuguese version. Eighteen publications were selected and the book Transtornos da aprendizagem, 2016 was also used. LDD by definition are changes in normal language learning patterns and can be classified as expressive and receptive. Because of this situation, children have difficulties in understanding and expressing themselves, this is directly related to the learning process, which can result in an LD. The diagnosis of these disorders must be done individually and observing the interaction of genetic, physiological, sociocultural and school factors. It is worth noting that language and learning disorders not only affect academic life, but also social, behavioral and psychological life, and therefore it is extremely important that there is a greater focus on the early detection of these disorders, thus, children receive an appropriate treatment and, consequently, have a better prognosis. (AU)

Cognitive-linguistic performance of schoolchildren in the literacy cycle in the public school context: universal screening / Desempenho cognitivo-linguístico de escolares no ciclo de alfabetização no contexto da escola pública: rastreio universal

ABSTRACT Objective: to characterize the linguistic-cognitive performance of schoolchildren in the literacy cycle, in order to identify children at risk for learning disorders in the public school context. Methods: this study involved 88 children, aged 6 to 8 years, enrolled in the first, second and third year of elementary education I, from two schools in the city of Recife, Pernambuco, Brazil. The procedure used was the Cognitive-Linguistic Skills Evaluation Protocol, which has collective and individual versions, both being applied. The analysis of the groups was performed through the statistical non-parametric Kruskal-Wallis test with p <0.05. Results: all students were submitted to the individual version for presenting poor performance in the collective version of the protocol. Thus, the application of the collective version was not sufficient to identify children at risk for learning disorders, thus, the indication of the individual assessment. In the individual version, students from the 1st year showed a lower performance in most of the subtests that make up the instrument, whereas those from the 2nd and 3rd years had an average performance, which also deserves attention, according to the instrument of evaluation. These results, below the one expected for the age and school year, may be a consequence of poor learning opportunities within and outside school. There were also significant differences as a function of the schooling advance, revealing that the cognitive-linguistic skills, precursors of the reading and writing learning process, are only having a greater leap of development at the end of the literacy cycle, in the third year, which reveals a significant delay in terms of learning. Conclusion: the low performance observed in cognitive-linguistic abilities in schoolchildren hinders the early identification of children at risk for learning disorders and questions the quality of educational opportunities experienced by the students inside and outside the public school. Other factors, such as regional differences in language and linguistic context, need to be considered in the interpretation of tests that evaluate cognitive-linguistic abilities.

RESUMO Objetivo: caracterizar o desempenho cognitivo-linguístico de escolares no ciclo de alfabetização, a fim de identificar escolares em risco para os transtornos de aprendizagem no contexto da escola pública. Métodos: participaram do estudo 88 escolares, com faixa etária de 6 a 8 anos de idade, matriculados no 1º, 2º e 3º ano do ensino fundamental I, de duas escolas na cidade de Recife, PE, Brasil. Como procedimento foi utilizado o Protocolo de Avaliação de Habilidades Cognitivo-Linguísticas. Este protocolo possui uma versão coletiva e individual e ambas foram aplicadas. A análise dos grupos foi realizada por meio de estatística não-paramétrica de Kruskal-Wallis com p <0,05. Resultados: todos os escolares foram submetidos à versão individual por apresentarem desempenho inferior na versão coletiva do protocolo. Assim, a aplicação da versão coletiva não foi suficiente para identificar os escolares em risco para os transtornos de aprendizagem, sendo indicada a avaliação individual. Na versão individual, os escolares do 1º ano apresentaram desempenho inferior na maioria dos subtestes que compõem o instrumento, já o 2º e o 3º ano apresentaram desempenho médio, que também merece atenção de acordo com o instrumento da avaliação. Estes resultados, aquém do esperado para a idade e série, podem ser uma consequência de más oportunidades de aprendizagem dentro e fora da escola. Além disso, foram observadas diferenças significantes em função do avanço da escolaridade, revelando que as habilidades cognitivo-linguísticas, que são precursoras do processo de aprendizagem da leitura e escrita, só estão tendo um maior salto de desenvolvimento ao final do ciclo de alfabetização, no 3º ano, o que revela um atraso importante em termos de aprendizagem. Conclusão: o baixo desempenho nas habilidades cognitivo-linguísticas observado nos escolares dificulta a identificação precoce de escolares em risco para os transtornos de aprendizagem e questiona a qualidade das oportunidades socioeducativas vivenciadas pelos escolares dentro e fora da escola pública. Outros fatores linguísticos, como diferenças regionais e contexto linguístico, necessitam ser considerados na interpretação de testes que avaliam habilidades cognitivo-linguísticas.

A trajetória histórica dos estudos e pesquisas sobre a dislexia: a busca pela compreensão do fenômeno / The historical track of studies and research on dyslexia: the search for the understanding of the phenomenon / La história de la carrera de estudios y investigaciones sobre la dislexia: la búsqueda de la fenómeno de entendimiento

O objetivo deste texto é apontar o desenvolvimento histórico do conceito de dislexia por meio de uma breve análise da trajetória dos estudos e pesquisas constituídos. Conforme é possível constatar, os estudos sobre as dificuldades de aprendizagem da leitura e da escrita emergiram a partir de estudos da Neurologia, migrando para outros campos dentro da área médica, sem localizar a etiologia do fenômeno. Este fato pode ter contribuído para a proposição de teorias e hipóteses diferentes entre si, que não se confrontam e não se complementam, necessariamente, trazendo controvérsias e tensões ao campo. Finalizamos apontando a necessidade de estudos que avaliem fatores externos às crianças diagnosticadas como disléxicas, como a cultura na qual estão inseridas, suas vivências com a escrita, a metodologia de ensino aplicada, entre outros, a fim de se construir uma visão integral deste fenômeno da aprendizagem.

The aim of this article is showing historical development of the concept of dyslexia through an analysis of constituted researches. As it is possible to verify, studies about learning disabilities of reading and writing have emerged from Neurology Studies, which moved to the other field of medical area without find the etiology of the phenomenon. This fact may have contributed to the proposition of different theories and hypothesis, which does not confront and also does not complement each other. That promotes controversies and tension to the field. At last, this study shows the relevance of studies, which evaluate external facts to dyslexic children, such as their culture context, experiences with writing, teaching methodology, with the purpose of to construct an overview of this phenomenon of learning.

El objetivo de este texto es mostrar el desarrollo histórico del concepto de dislexia a través de una análisis corta de la trayectoria de los estudios y pesquisas constituidos. Como es posible verificar, los estudios acerca de las dificultades de aprendizaje de la lectura y de la escrita emergieron a partir de los estudios de la Neurología, cambiando para otros campos en el área medica sin localizar la etiología del fenómeno. Esto puede haber contribuido para la proposición de teorías e hipótesis diferentes entre si, pero que no se confrontan tampoco se complementan, promoviendo controversias y tensiones al campo. Finalizamos mostrando la necesidad de estudios que evalúen factores externos a los niños diagnosticados como disléxicos, la cultura en la cual están insertadas, sus vivencias con la escritura, la metodología de enseñanza aplicada, entre otros, con la finalidad de se construir una visión integral de este fenómeno del aprendizaje.

Caracterización cognitiva del trastorno de Tourette con comorbilidad TDAH: un estudio de caso / Cognitive characterization of Tourette disorder with ADHD comorbidity: a case study

El trastorno de Tourette (TT) es un trastorno del neurodesarrollo que aparece en la primera infancia caracterizado por la presencia de tics fónicos y motores que dificultan la socialización y el proceso de aprendizaje escolar. El TT posee una variada comorbilidad que incluye el trastorno por déficit de atención con hiperactividad (TDAH), el trastorno obsesivo compulsivo (TOC), y dificultades de aprendizaje y del comportamiento. Presentamos el caso de un adolescente de 13 años diagnosticado con TT y con TDAH a los 6 y 10 años respectivamente. El paciente ha tenido una escolarización dificultosa y se encuentra con tratamiento médico de clozapina, aripiprazol, haloperidol y litio. Se aplica una batería neuropsicológica para evaluar la atención e inhibición, organización visuoespacial, memoria de trabajo, flexibilidad cognitiva, memoria verbal y memoria no-verbal, con el propósito de describir su perfil cognitivo de funciones ejecutivas y memoria. El estudio reveló que la atención está deteriorada pero que la inhibición se encuentra preservada; esto confirma el diagnóstico de TDAH y establece el subtipo de inatento para el caso en estudio. Las demás funciones ejecutivas evaluadas se encuentran severamente descendidas, situación que es coincidente con el perfil desarrollado por otros autores para el TT con comorbilidad TDAH. Sin embargo, no es claro si la disfuncionalidad ejecutiva se debe al TDAH que presenta, o a factores sociales y culturales derivados de las dificultades de escolarización causadas por el TT.

Tourette's disorder (TD) is a neurodevelopmental disorder that appears in early childhood characterized by the presence of phonic and motor tics that hinder socialization and the school learning process. TD has a varied comorbidity that includes attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), learning and behavioral difficulties. We present the case of a 13-year-old adolescent diagnosed with TD and with ADHD at 6 and 10 years old respectively. The patient has had a difficult schooling and is under medical treatment of clozapine, aripiprazole, haloperidol and lithium. A neuropsychological battery is applied to evaluate the attention and inhibition, visuospatial organization, working memory, cognitive flexibility, verbal memory and non-verbal memory, with the purpose of describing its cognitive profile of executive functions and memory. The study revealed that the attention is impaired but that the inhibition is preserved; This confirms the diagnosis of ADHD and establishes the inattentive subtype for the case under study. The other executive functions evaluated are severely descended, a situation that coincides with the profile developed by other authors for TD with comorbid ADHD. However, it is not clear if the executive dysfunctionality is due to the ADHD it presents, or to social and cultural factors derived from the difficulties of schooling caused by the TD.

2nd to 4th Digit Ratio (2D:4D) – Is It a Marker for Dyslexia?

Background: Specific learning disorder in general called as dyslexia is a neuro developmental disorder,which occurs more commonly in males (Male:Female ratio is 4:1), there are evidence to suggest role ofprenatal gonadal hormone exposure in neurodevelopment. However, studies on association between 2nd to4th digit ratio and dyslexia are mixed. Objective: To compare the 2nd and 4th digit ratio (2D:4D) of bothhands between children with dyslexia and children without dyslexia.Methodology: A case control study, recruited 30 children with dyslexia and 30 age and education matchednormal controls, after getting informed consent from their parents. Collected socio demographic details,applied CARS, Schonell’s reading and spelling test, followed by detailed evaluation by psychiatrist andclinical psychologist, including psychological testing to confirm the diagnosis of dyslexia. The digit lengthof index and ring finger on both hands of all children were measured using Vernier Calliper by direct method.Results: In both the hands 2D:4D ratio was more in children with dyslexia than normal children, but thedifference was not significant (p – 0.146). Analysis of only male samples showed digit ratio is higher indyslexic children than normal children; which were significant (p – 0.03).Conclusion: Our study does not support an association between digit ratios and dyslexia; however, trendtowards higher ratio in dyslexia especially in male children are interesting and needs further exploration.Need more studies in this area to form a definite conclusion.

Dislexia y discalculia: una revisión sistemática actual desde la neurogenética / Dyslexia and Dyscalculia: a Current Systematic Revision from a Neurogenetics Perspective

Resumen Los Trastornos Específicos del Aprendizaje constituyen un grupo heterogéneo de alteraciones frecuentes que pueden generar problemas importantes no solo durante la etapa escolar, sino a lo largo de toda la vida. Las dificultades persistentes en lectura (dislexia) y en matemáticas (discalculia) son, por su relevancia y prevalencia, los dos Trastornos de Aprendizaje más importantes en la práctica educativa y clínica. El objetivo del estudio es realizar una síntesis de los descubrimientos científicos de los últimos diez años sobre las bases neuroanatómicas y genéticas de la dislexia y la discalculia. Se realizó un análisis exhaustivo bibliográfico desde 2006 hasta enero de 2017 en inglés y español centrados en neuroimagen y genética de dislexia y discalculia mediante las bases de datos Medline, PsyInfo, Scopus, Web of Science y Dialnet. Se incluyeron 38 artículos de los cuales se extrajeronn las aportaciones desde la neuroimagen y la genética tanto para la dislexia como de discalculia. Estos datos facilitaron herramientas para orientar al contexto psicológico y educativo, a su vez proporcionando respuestas definitivas.

Abstract The Specific Learning Disorders represent a heterogeneous group of common conditions that can generate important problems not only during schooling but also throughout life. The persistent difficulties in reading (dyslexia) and maths (dyscalculia) are, due to their significance and prevalence, the two most important learning disorders in both educational and clinical practice. The objective of this study is to make a synthesis of the scientific findings of the past ten years about neuroanatomical and genetic basis of dyslexia and dyscalculia. To this aim a comprehensive bibliographic analysis is conducted from 2006 until January, 2017 in English and Spanish from databases Medline, PsyInfo, Scopus, Web of Science y Dialnet. There were included 43 articles with contributions so much about dyslexia as dyscalculia from the neuroimagen and the genetics. This information will provide tools to guide psychological and educational environments and to provide definitive answers.

Vectoelectronystagmography in children with dyslexia and learning disorder / Vectoeletronistagmografia em crianças com dislexia e transtorno de aprendizagem

ABSTRACT Objective: to describe and compare the results of ocular (saccadic, screening, and optokinetic) tests of vectoelectronystagmography among the groups with dyslexia, learning disorder and control. Methods: 28 male and female students aged 8 to 11 years participated in this study. They were divided into three groups: Group I, 10 students with dyslexia, Group II, 9 students with learning disorders and Group III, 9 students with no learning disorders. In this research, digital vectoelectronystagmography - ocular test - was performed. Results: saccadic movement, optokinetic nystagmus, and pendular tracking tests were found to show subtle differences among the three groups. Comparing the saccadic eye movements and the optokinetic nystagmus tests, it was observed that the movement in the left eye was slower for Group I, and even slower for Group II. It was also observed that GI and GII were slower for the pendular tracking of luminous stimulus in relation to the control group. Conclusion: in general, there are differences among the groups in the vectoelectronystagmography, which indicated slower tracking and vestibulo-ocular reflex in children with dyslexia and learning disorders.

RESUMO Objetivo: descrever e comparar os resultados das provas oculares (sacádicos, rastreio, e optocinético) da vectoeletronistagmografia entre os grupos com dislexia, transtorno de aprendizagem e controle. Métodos: participaram deste estudo 28 estudantes do sexo masculino e feminino, com idade entre 8 e 11 anos. Foram divididos em três grupos, sendo Grupo I: Dez escolares com Dislexia, Grupo II: Nove escolares com Transtornos de Aprendizagem e Grupo III: Nove escolares sem dificuldades de aprendizagem. Nesta pesquisa foi realizada avaliação da vectoeletronistagmografia digital: provas oculares (sacádicos, rastreio, e optocinético). Resultados: verificou-se que as provas de movimento sacádico, nistagmo optocinético e rastreio pendular mostraram diferenças sutis entre os três grupos. Na comparação das provas de movimentos sacádicos dos olhos e pesquisa do nistagmo optocinético foi observada que a velocidade do movimento do olho esquerdo que se mostrou mais lento para o Grupo I, e ainda mais lentos para o Grupo II. Foi observado também que os grupos GI e GII foram mais lentos para o rastreio em pêndulo do estímulo luminoso em relação ao grupo controle. Conclusão: de modo geral, foi observada diferença entre os grupos para a medida da vectoeletronistagmografia, que indicam rastreios e reflexo vestibular-ocular mais lentos nas crianças com dislexia e transtornos de aprendizagem.

Investigation of distinctive characteristics of children with specific learning disorder and borderline intellectual functioning

Abstract Background Borderline intelligence function (BIF) and specific learning disorder (SLD) are common diagnoses in children who are brought up for learning problems and school failure. Objective The aim of our study was to determine whether there were distinctive aspects of cognitive testing routinely used in evaluating SLD and BIF and investigate emotion regulation skills and minor neurologic symptoms. Method Sixty children (30 SLD and 30 BIF) who are currently attending primary school are selected for study. Visual Aural Digit Span Test - Form B, Gessel Figure Drawing Test, Bender Gestalt Visual Motor Perception Test, WISC-R, Emotion Regulation Scale (ERS) and Neurological Evaluation Scale (NES) was administered. Results There was no statistically significant difference between groups in cognitive tests. The emotional regulation ability measured by the emotional regulation subscale was better in the SLD group than the BIF group (p = 0.014). In the NES, sensory integration (p = 0.008), motor coordination (p = 0.047) and other (p < 0.001) subscales showed higher scores in the BIF group. Discussion It has been shown that cognitive tests don't have distinguishing features in the evaluation of SLD and BIF. Emotion regulation subscale score of ERS and sensory integration, motor coordination, and total scores of NES can be used in both discrimination of groups.

The Relationship of Clinical Symptoms with Social Cognition in Children Diagnosed with Attention Deficit Hyperactivity Disorder, Specific Learning Disorder or Autism Spectrum Disorder

OBJECTIVE: One of the areas of social cognition is Theory of Mind (ToM) is defined as the capacity to interpret, infer and explain mental states underlying the behavior of others. When social cognition studies on neurodevelopmental disorders are examined, it can be seen that this skill has not been studied sufficiently in children with Specific Learning Disorder (SLD). METHODS: In this study, social cognition skills in children diagnosed with attention deficit hyperactivity disorder (ADHD), SLD or Autism Spectrum Disorder (ASD) evaluated before puberty and compared with controls. To evaluate the ToM skills, the first and secondorder false belief tasks, the Hinting Task, the Faux Pas Test and the Reading the Mind in the Eyes Task were used. RESULTS: We found that children with neurodevelopmental disorders as ADHD, ASD, and SLD had ToM deficits independent of intelligence and language development. There was a significant correlation between social cognition deficits and problems experienced in many areas such as social communication and interaction, attention, behavior, and learning. CONCLUSION: Social cognition is an important area of impairment in SLD and there is a strong relationship between clinical symptoms and impaired functionality.

Baicalin attenuates Aβ25-35 induced learning and memory disorders in mice and its possible mechanism / 中国药理学与毒理学杂志

OBJECTIVE To observe the effect of baicalin on Aβ25-35 induced learning and memory deficits and changes in autophagy-related genes in mice so as to explore the related mechanisms of Alzheimer disease (AD) treatment . METHODS C57 mice were administered with 3μL Aβ25-35 3 mmol·L-1 by intracerebroventricular injection to establish an AD model. Baicalin was given by intracerebroventricular injection at the dose of 25, 50 and 100 mg · kg-1 for 15 d, respectively. The total distance and the central grid residence time were measured in the open-field test. The escape latency and the time to reach the platform were monitored in the Morris water maze trial. The autophagic vacuoles in the hippocampus of the mice were observed by transmission electron microscopy before the protein expressions of microtu?bule-associated protein 1 light chain 3 (LC3) and Beclin1 in brain tissue were analyzed by Western blot?ting assay. RESULTS Intracerebroventricular injection of Aβ25-35 could reduce the total distance from (3984±321)cm to (2790±306)cm and extend central grid residence time from (3.6±1.2)s to (8.8±2.9)s in the open-field test. The escape latency of water maze also increased from (22.0 ± 1.9)s to (38.8 ± 2.2)s. Autophagic vacuoles or late autophagic vacuoles and increased Beclin1 and LC3 and protein level were observed in the hippocampus after Aβ25-35 injection. Intraperitoneal injection of Baicalin 50 and 100 mg · kg-1 for fifteen consecutive days extended the total distance in open-field test to (3705 ± 337)cm and (3968 ± 448)cm, respectively, while the central grid residence time was reduced to (5.6 ± 1.8)s and (3.9±1.5)s, respectively. The total time taken to reach the platform in water maze test was reduced to (28.6± 1.9)s, (22.9 ± 1.7)s. Mitochondrial swelling, vacuolar membrane structure or autophagic vacuoles were visible in the hippocampus. LC3 and Beclin1 protein expression was significantly up-regulated(P<0.01). CONCLUSION Baicalin shows protective effect against Aβ25-35 induced learning and memory deficits, and this effect may be related to the activation of autophagy in the mouse hippocampus.

Subtipos neuropsicológicos en dos grupos de niños mexicanos: con trastorno específico del aprendizaje o con buen desempeño académico / Neuropsychological subtypes in two groups of mexican children: with specific learning disability or good academic performance

En el presente trabajo se compararon dos grupos de niños mexicanos en edades comprendidas entre los 8 a 10 años, el primer grupo con trastorno específico en el aprendizaje (TEA), tanto en la precisión de la lectura como en el cálculo, y el otro con buen desempeño académico (BDA), por medio de Escala Wechsler de Inteligencia para Niños, en su cuarta versión (WISC-IV) y la batería de Evaluación Neuropsicológica Infantil (ENI), (subpruebas de Habilidades Académicas, Memoria, Atención y Habilidades Metalingüísticas), ambos instrumentos normados en población mexicana. Se encontraron diferencias significativas (p≤ 0.05) entre los niños BDA y TEA, mediante la U de Mann Whitney, en todas las subpruebas evaluadas a excepción del Índice Velocidad de Procesamiento (WISC), Conteo, Codificación/Evocación y Atención Auditiva, además de Atención visual (ENI). Mediante el Análisis de Componentes Principales se identificaron 5 subgrupos: 2 en los niños con BDA y 3 en los TEA. Las diferencias significativas (p≤ 0.05)entre las variables cognitivas y académicas fueron determinadas mediante la prueba de Kruskal-Wallis. Fue posible observar que los subgrupos TEA obtuvieron puntajes más bajos que los subgrupos BDA tanto en habilidades académicas como en otras variables cognitivas,siendo el Índice de Memoria de Trabajo en la escala Wechsler y las Habilidades Metalingüísticas de la ENI las que mejor diferenciaron a los subgrupos TEA de los BDA.Conclusión: La aplicación de instrumentos normados en la población bajo estudio resulta de gran utilidad para identificar subtipos neuropsicológicos tantoen niños con BDA como con TEA.

In this work two groups of Mexican children aged between 8 to 10 years old were compared, the first group with specific learningdisorder (SLD),in both reading accuracy as in the calculation, and the other compared to good performance academic (GPA) by Wechsler Intelligence Scale for Children, in its fourth version (WISC-IV) and battery Child Neuropsychological Assessment (ENI), (subtests Academic Skills, Memory, Attention and Metalinguistic Skills), both instruments normed in Mexican population. Significant differences (p ≤ 0.05) were found among SLD and GPA children, by Mann Whitney U Test, they were found in all subtests evaluated except Processing Speed Rate (WISC), Counting, Coding / Evocation and Auditory Attention, also Visual Attention (ENI). By the Principal Component Analysis were identified five subgroups: 2 children with GPA and 3 in the SLD. Significant differences (p ≤ 0.05) between cognitive and academic variables were determined by the Kruskal-Wallis Test. It was possible to observe that the TEA subgroups scored lower than the BDA subgroups in academic abilities as well as in other cognitive variables, with the Working Memory Index on the Wechsler scale as the subtests that evaluate the ENI Metalinguistic Skills the variables that give the best discrimination between the TEA and the BDA subgroups.Conclusion: The application of normed instruments in the population under study is useful to identify neuropsychological subtypes in children with GPA as SLD.

A Comparative Study of Parenting Styles, Parental Stress and Resilience among Parents of Children Having Autism Spectrum Disorder, Parents of Children Having Specific Learning Disorder and Parents of Children Not Diagnosed With Any Psychiatric Disorder.

Background: Raising a child is a big responsibility for the parents. This responsibility increases if the child has a disability like autism spectrum disorder (ASD) or specific learning disorder (SpLD). Objectives: To study and compare the parental stress, parenting style and resilience in parents of children having ASD, SpLD and children who do not have a psychiatric disorder. Methods: A cross-sectional study was done where we assessed the participants using the Parental stress scale, Parenting styles questionnaire and The Connor-Davidson Resilience Scale. Results: The study sample consisted of parents of 98 children, which included 53 mothers and 45 fathers. Mean stress scale score was significantly higher in parents having a child diagnosed with ASD than in parents having a child with specific learning disorder than in parents having a child with neither of these (p<0.001). Mean parental stress score was also significantly higher in parents with a male child than in parents with a female child (p=0.039) Stress score also was higher in female parents than in male parents (p=0.033). Housewives and unemployed parents had significantly higher mean stress scores than employed population (p=0.006). The mean resilience score was significantly higher (p =0.003) in authoritative parenting followed by permissive with authoritarian parents having the least score. Conclusion: Perceived level of stress in a parent is affected by the type of disability, time spent with the child and gender of the parent and child whereas parental resilience is affected by parenting styles.

Avaliação das estratégias de leitura em leitores típicos e disléxicos: abordagem neuropsicológica / Assessment of reading strategies in typical and dyslexic readers: a neuropsychological approach / Evaluación de las estrategias de lectura en lectores típicos y disléxicos: un enfoque neuropsicológico

O estudo investigou o uso e o comprometimento específico das estratégias de leitura em estudantes normoléxicos e disléxicos. No estudo 1, participaram 141 estudantes da 5ª à 8ª série (de 10 a 14 anos), avaliados no teste de competência de leitura de palavras e pseudopalavras (TCLPP). No estudo 2, participaram 15 estudantes com dislexia (de 10 a 13 anos), também cursando da 5ª à 8ª série, avaliados na versão computadorizada do TCLPP. No estudo 1, verificou-se efeito significativo do tipo de item do TCLPP, da série (5ª com desempenho inferior às 7ª e 8ª séries) e de interação item-série sobre o desempenho, sugerindo que as três estratégias de leitura estão consolidadas a partir da 6ª série. No estudo 2, houve efeito significativo do tipo de item, sugerindo prejuízos específicos nas estratégias alfabética e ortográfica nos indivíduos disléxicos. A identificação de processos específicos subjacentes aos desempenhos é característica da avaliação neuropsicológica cognitiva.

The study investigated the use and the specific commitment of reading strategies in normal and dyslexic students. In study 1, 141 5th to 8th graders students (10-14 years) were evaluated in Reading Competence Test of words and nonwords (RCTWN). In study 2, 15 students with dyslexia (10-13 years), also attending the 5th to 8th grade, participated and were assessed with the computerized version of RTCWN. In study 1, there was a significant effect of the RTCWN item type, grade (5th graders performed significantly worse than 7th and 8th graders) and item-grade interaction on performance, suggesting that the three reading strategies are consolidated from 6th grade on. In study 2, there was a significant effect of item type, suggesting specific deficits in alphabetic and orthographic strategies in dyslexics. The identification of specific processes underlying performance is characteristic of cognitive neuropsychological evaluation.

El estudio investigó el uso y comprometimiento específico de estrategias de lectura en estudiantes normales y disléxicos. En el estudio 1, participaron 141 estudiantes en el de la 5ª a la 8ª serie (10 a 14 años) fueran evaluados en el teste de competencia de lectura de palabras y no palabras (TCLPnP). En el estudio 2, participaron 15 estudiantes con dislexia (de 10 a 13 años), también desde la 5ª a la 8ª serie, fueron evaluados en la versión computadorizada del TCLPP. En el estudio 1, hubo un efecto significativo del tipo de ítem del TCLPP, de la serie (5º realizó significativamente peor que las 7ª y 8ª series) y de interacción ítem-serie en el rendimiento, lo que sugiere que las tres estrategias de lectura son consolidadas a partir de la 6ª serie. En el estudio 2, hubo efecto significativo del tipo de ítem, lo que sugiere déficits específicos en las estrategias alfabéticas y ortográficas en individuos disléxicos. La identificación de los procesos específicos subyacentes al rendimiento es característica de la evaluación neuropsicológica cognitiva.