Developmental and behavioral concerns of children in difficult circumstances

OBJECTIVE:This research was conducted to determine whether children exposed to the violence of war such as those who lived through the civil war of East Timor in 1999, suffer developmental concerns and behavioral problems as evidenced by abnormal development quotients in at least 4 components of cognition and identification of inappropriate behavior. METHODOLOGY:This was a descriptive cross-sectional study conducted in 1999 on children who lived in Liquica District, 25 km away from Dili, the capital city of East Timor during the massacres that took place between April-September 1999 during civil war of 1999 and who at that time were 2-4 years old but by the time they were tested were 7-9 years old. Healthy children who qualified and whose parents or guardians consented underwent a physical exam that included taking their height and weight. Their parents or guardians were given a questionnaire that included demographic, personal, family and social data as well as the child's school performance, health, and developmental status. RESULTS: Of the 100 children included in the study 69% were found to have difficulties in problem solving skills and below average skills in adapting (63%) and auditory memory (51%). Behavioral problems were identified in 92% of children manifested as temper tantrums, aggressive as well as timid behaviors. Thirty-seven percent had poor school performance noted as being retained in the same grade level and a mean grade of less than 6. CONCLUSION: Majority of children exposed to violence of war presented with developmental i.e. cognitive delays, behavioral problems and school difficulties.

Variable fMRI activation during two different language tasks in a patient with cognitive delay

Functional MRI produces a more accurate localization of the language areas for epilepsy surgery purpose, but requires the patient cooperation. We report a 34 years-old woman with mental retardation who underwent two different verbal fluency tasks, category and word naming. We found a strong activation of the Broca’s area in the most difficult task. We suggest that a multi-task fMRI study could be successful in patients with cognitive delay.

A ressonância magnética funcional permite uma localização acurada da área da linguagem para fins de cirurgia de epilepsia, mas requer a colaboração do paciente na execução da tarefa proposta, o que pode limitar a sua utilização em pacientes com retardo mental. Nós apresentamos o caso de uma mulher com 34 anos de idade, com retardo mental, que foi submetida a duas tarefas distintas de geração silenciosa de palavras, por categoria e letras. Encontramos forte ativação da área de Broca na tarefa mais complexa. Sugerimos que um estudo com múltiplas tarefas pode ser útil em pacientes com retardo mental.