Destrezas académicas y velocidad de procesamiento. Modelos predictivos del rendimiento escolar en básica primaria / Academic skills and processing speed. Predictive models of school achievement in primary school

Resumen El modelo de inteligencia de Cattell-Horn-Carroll (CHC) propone que los procesos cognitivos que componen la inteligencia pueden conceptualizarse como habilidades específicas, implicadas en tareas particulares, y habilidades generales, relacionadas con una amplia cantidad de contextos. Entre las habilidades más estudiadas bajo este modelo se encuentra la velocidad de procesamiento, identificada como uno de los mejores predictores del rendimiento académico y de la capacidad cognitiva general. En este artículo se presentan los resultados del análisis de la relación entre la velocidad de procesamiento y rendimiento académico general. Se evaluó una muestra de 223 estudiantes (53% mujeres) de Preescolar y básica primaria. Los resultados muestran una diferencia en la capacidad predictiva del componente perceptual (β =.76, p < .001) y conceptual (β =.09; p = .121) de la velocidad de procesamiento en procesos académicos básicos de lectura y matemática, así como ajustes similares en modelos de regresión a partir de su conceptualización como habilidad general (R2 = .68) o específica (R2 = .69). El análisis de la relación grado a grado mostró cambios en la capacidad predictiva de la velocidad de procesamiento sobre las habilidades académicas conforme avanza el proceso educativo, apoyando modelos previamente establecidos en el área (Cai, Li & Deng, 2013; Demetriou, Spanodius & Shayer, 2014). Finalmente, es generó un modelo de ecuaciones estructurales (X 2=1.431; p=.232; CFI=1.000; TLI=.999; NFI=.999; RFI=.996; RMSEA=.044) que permitió probar el ajuste de los modelos propuestos a los datos.

Abstract The Cattell-Horn-Carroll (CHC) intelligence model proposes that the cognitive processes that make up intelligence can be conceptualized as specific skills, involved in particular tasks, and general skills, related to a wide variety of contexts. Among the most studied skills under this model is the speed of processing, identified as one of the best predictors of academic performance and general cognitive ability. This article presents the results of the analysis of the relationship between processing speed and general academic performance. A sample of 223 students (53% women) of preschool and primary school was evaluated. The results show a difference in the predictive capacity of the perceptual component (β = .76, p < .001) and conceptual (β = .09; p = .121) of the processing speed in basic academic processes of reading and mathematics, as well as similar adjustments in regression models from their conceptualization as general (R 2 = .68) or specific (R 2 = .69) ability. The analysis of the grade-to-grade relationship showed changes in the predictive capacity of processing speed over academic skills as the educational process progresses, supporting previously established models in the area (Cai, Li & Deng, 2013; Demetriou, Spanodius & Shayer, 2014). Finally, a model of structural equations (X 2 = 1.431, p = .232, CFI = 1.000, TLI = .999, NFI = .999, RFI = .996, RMSEA = .044) was used to prove the adjustment of the proposed models to data.

Spinal muscular atrophy 5Q - Treatment with nusinersen

The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize producers to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.

Traducción transcultural al español de la clasificación neuromuscular NM-Score sobre funcionalidad motora gruesa, en pacientes con patología neuromuscular / Spanish crosscultural translation of the neuromuscularclassification NM-Score of gross motor function in patientswith neuromuscular diseases

Introduction: Cultural adaptation is a process that is applied in early phases of validation. The “Neuromuscular Score” is an instrument that classifies the gross motor function in people with neuromuscular diseases. It was created in France and has not yet been validated in Chile. Objectives: To carry out the cross cultural adaptation of the “NM Score” from the original version in French to Spanish according to the International standard of translation methodology. Patients and Method: The cross cultural adaptation is a descriptive and transversal study. This study is based on the FACIT methodologic process proposed by Eremenco. Seven health professionals, who achieved inclusion requirements, participated in the translation process. The reliability of the transcultural adaptation was determined with the final version. 30 patients from 6 to 26 years old, with neuromuscular pathology, were interviewed the Teletón Santiago Institute. Results: The methodologic process of translation and adaptation suggests that the translated version does not present great semantic differences. This process has a high global reliability measurements with Cronbach alpha coefficient = 0.93. Conclusion: The translation and adaptation process for NM Score obtained a reliable score and equivalence during its application, giving a representation of the functional compromise.

Introducción: La traducción y adaptación cultural de instrumentos de medición es un proceso que se aplica en las fases iniciales dentro de las etapas de validación de ellos. La Clasificación Puntaje Neuromuscular (NM-Score), es un instrumento que clasifica la severidad de la función motora gruesa en personas con patologías neuromusculares, creada en Francia y no validada en Chile. Objetivos: Realizar la adaptación transcultural de la clasificación NM-Score, desde la versión original en francés al español, según estándares internacionales de metodología de traducción y determinar su confiabilidad. Pacientes y Método: Estudio descriptivo, transversal, basado en metodología de traducción FACIT y medición de confiabilidad propuesto por Eremenco. Siete profesionales de la salud que cumplieron requisitos de inclusión participaron del proceso de traducción. La confiabilidad de la adaptación transcultural se determinó con la versión final de la Clasificación NM Score, que puede ser aplicada a pacientes y padres. Se entrevistaron a 30 usuarios, de 6 a 26 años, con diagnóstico de patología neuromuscular del Instituto Teletón Santiago. Resultados: El proceso metodológico de traducción y adaptación sugiere que la versión traducida no presenta grandes diferencias semánticas y tiene una alta confiabilidad global medido con α de Cronbach = 0,93. Conclusión: El proceso de traducción y adaptación de la Clasificación NM Score obtuvo una versión fiable y de equivalencia al momento de aplicarla a usuarios y padres, dando una representación del compromiso funcional.

Reliability of the Brazilian Portuguese version of the Gross Motor Function Measure in children with cerebral palsy

OBJECTIVE: To test the intra- and interrater reliability of the Brazilian Portuguese version of the 66-item Gross Motor Function Measure (GMFM-66). METHOD: The sample included 48 children with cerebral palsy (CP), ranging from 2-17 years old, classified at levels I to IV of the Gross Motor Function Classification System (GMFCS) and four child rehabilitation examiners. A main examiner evaluated all children using the GMFM-66 and video-recorded the assessments. The other examiners watched the video recordings and scored them independently for the assessment of interrater reliability. For the intrarater reliability evaluation, the main examiner watched the video recordings one month after the evaluation and re-scored each child. We calculated reliability by using intraclass correlation coefficients (ICC) with their respective 95% confidence intervals. RESULTS: Excellent test reliability was documented. The intrarater reliability of the total sample was ICC=0.99 (95% CI 0.98-0.99), and the interrater reliability was ICC=0.97 (95% CI 0.95-0.98). The reliability across GMFCS levels ranged from ICC=0.92 (95% CI 0.72-0.98) to ICC=0.99 (95% CI 0.99-0.99); the lowest value was the interrater reliability for the GMFCS IV group. Reliability in the five GMFM dimensions varied from ICC=0.95 (95% CI 0.93-0.97) to ICC=0.99 (95% CI 0.99-0.99). CONCLUSION: The Brazilian Portuguese version of the GMFM-66 showed excellent intra- and interrater reliability when used in Brazilian children with CP levels GMFCS I to IV.

Gross Motor Function Classification System Expanded & Revised (GMFCS E & R): reliability between therapists and parents in Brazil

BACKGROUND: Several studies have demonstrated the importance of using the Gross Motor Function Classification System (GMFCS) to classify gross motor function in children with cerebral palsy, but the reliability of the expanded and revised version has not been examined in Brazil (GMFCS E & R). OBJECTIVE:: To determine the intra- and inter-rater reliability of the Portuguese-Brazil version of the GMFCS E & R applied by therapists and compare to classification provided by parents of children with cerebral palsy. METHOD: Data were obtained from 90 children with cerebral palsy, aged 4 to 18 years old, attending the neurology or rehabilitation service of a Brazilian hospital. Therapists classified the children's motor function using the GMFCS E & R and parents used the Brazilian Portuguese version of the GMFCS Family Report Questionnaire. Intra- and inter-rater reliability was obtained through percentage agreement and Cohen's unweighted Kappa statistics (k). The Chi-square test was used to identify significant differences in the classification of parents and therapists. RESULTS: Almost perfect agreement was reached between the therapists [K=0.90 (95% confidence interval 0.83-0.97)] and intra-raters (therapists) with K=1.00 [95% confidence interval (1.00-1.00)], p<0.001. Agreement between therapists and parents was substantial (k=0.716, confidence interval 0.596-0.836), though parents classify gross motor impairment more severely than therapists (p=0.04). CONCLUSIONS: The Portuguese version of the GMFCS E & R is reliable for use by parents and therapists. Parents tend to classify their children's limitations more severely, because they know their performance in different environments. .

Desempeño funcional y asociación entre función motora gruesa y habilidad manual en niños con parálisis cerebral del Hogar Clínica San Juan de Dios, Lima-Perú / Functional performance and association between gross motor function and manual skills in children with cerebral palsy from the Hogar Clínica San Juan de Dios, Lima-Perú

Introduction: Children with cerebral palsy (CP) are a heterogeneous and difficult group to classify, therefore, we recommend using a functional approach based on the gross motor function and manual dexterity. We propose a transversal and descriptive study to 1) classify a population of children with CP and to determine the degree of association between Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) and 2) establish the relationship of GMFCS with age, gender, topographic distribution, predominant motor disorder and gross motor function. Patients and Methods: We evaluated 122 children (1-12 years) according to GMFCS, in the subgroup (81/122) of children over 4 years, MACS was applied. The relationship between variables was evaluated using the association test x2, and the association between GMFCS-MACS using Kappa statics with p < 0.05. Results: According to GMFCS, the level V predominates in the different groups: 44.4 percent in < 2 years, 34.8 percent in 2-4 years, and 40 percent in 6-12 years. 88.5 percent of the hemiplegic had level I or II and 75 percent of the quadriplegics had level IV or V (p < 0.01). In regards of manual dexterity, 38.3 percent had MACS I or II. In only 6.1 percent (5/81) we observed GMFCS and MACS level I. There is a relationship between the two systems, but the degree of agreement was low (weighted Kappa = 0.40). Conclusion: The use of both systems helps to functionally characterize our patients and therefore to establish impact measures in the clinical practice, reinforcing the interventions to improve the activities and participation.

Introducción: Los niños con parálisis cerebral (PC) constituyen un grupo heterogéneo de difícil clasificación, por tanto, se recomienda emplear un enfoque funcional basado en la función motora gruesa y la habilidad manual. Se plantea un estudio descriptivo de corte transversal para 1) clasificar una población de niños con PC y determinar el grado de asociación entre los sistemas Gross Motor Function Clasification System (GMFCS) y Manual Ability Classification System (MACS) y, 2) establecer la relación de GMFCS con edad, género, distribución topográfica, trastorno motor predominante y función motora gruesa. Pacientes y Métodos: Se evaluaron 122 niños (1-12 años) según GMFCS; en subgrupo (81/122) de niños mayores de 4 años, se aplicó MACS. La relación entre las variables fue evaluada con prueba de asociación basada en x2 y, la asociación GMFCS-MACS mediante estadística Kappa con p < 0,05. Resultados: Según GMFCS, el nivel V predomina en los distintos grupos: 44,4 por ciento en < 2 años; 34,8 por ciento de 2-4 años y 40 por ciento en 6-12 años. 88,5 por ciento de los hemipléjicos tenían nivel I o II y el 75 por ciento de los cuadripléjicos nivel IV o V (p <0,01). Según habilidad manual 38,3 por ciento tuvieron MACS I o II. En sólo el 6,1 por ciento (5/81) se observó un GMFCS y MACS nivel I. Existe una relación entre ambos sistemas, pero el grado de concordancia fue bajo (Kappa ponderado =0,40). Conclusión: El uso de ambos sistemas permite caracterizar funcionalmente a nuestros pacientes para establecer medidas de impacto en la práctica clínica, reforzando las intervenciones que mejoren las actividades y la participación.

Internal consistency of a Brazilian version of the unified Huntington's disease rating scale

Nosso estudo avaliou a confiabilidade da versão brasileira da escala unificada para avaliação da doença de Huntington (UHDRS) com o objetivo de estabelecer a reprodutibilidade dessa escala em uma população que difere significativamente daquela em que foi originalmente validada. Após um período de treinamento com um vídeo divulgado para esse objetivo e um manual solicitado aos idealizadores da escala, nós aplicamos a UHDRS, com exceção dos testes cognitivos, em um grupo de 21 pacientes brasileiros com diagnóstico molecular de doença de Huntington (DH). Nessa amostra nós encontramos uma elevada consistência interna na seção que avalia os sintomas motores (alfa de Cronbach= 0,841). Observamos uma correlação negativa entre o escore total da escala motora e as escalas de avaliação funcional, de independência e de capacidade funcional total; uma correlação positiva entre essas 3 últimas escalas; e uma correlação negativa entre a idade de início dos sintomas e o número de repetições CAG. As características clínicas dessa amostra de pacientes descritas segundo a UHDRS é de maneira comparativa similar às descritas nos estudos originais de validação da escala, assim como as correlações descritas são semelhantes às descritas previamente. Concluimos que a versão brasileira da UHDRS é confiável e válida para estudar pacientes com DH aqui no Brasil, que essa amostra, como era esperado, tem características semelhantes às descritas em outras regiões do mundo, e que o método utilizado para treinamento da aplicação da escala é válido.