ABSTRACT
BACKGROUND: Developmental Language Disorder (DLD) is frequent in childhood and may have long-term sequelae. By employing an evidence-based approach, this scoping review aims at identifying (a) early predictors of DLD; (b) the optimal age range for the use of screening and diagnostic tools; (c) effective diagnostic tools in preschool children. METHODS: We considered systematic reviews, meta-analyses, and primary observational studies with control groups on predictive, sensitivity and specificity values of screening and diagnostic tools and psycholinguistic measures for the assessment of DLD in preschool children. We identified 37 studies, consisting of 10 systematic reviews and 27 primary studies. RESULTS: Delay in gesture production, receptive and/or expressive vocabulary, syntactic comprehension, or word combination up to 30 months emerged as early predictors of DLD, a family history of DLD appeared to be a major risk factor, and low socioeconomic status and environmental input were reported as risk factors with lower predictive power. Optimal time for screening is suggested between age 2 and 3, for diagnosis around age 4. Because of the high variability of sensitivity and specificity values, joint use of standardized and psycholinguistic measures is suggested to increase diagnostic accuracy. CONCLUSIONS: Monitoring risk situations and employing caregivers' reports, clinical assessment and multiple linguistic measures are fundamental for an early identification of DLD and timely interventions.
ABSTRACT
Since the introduction of writing systems, reading comprehension has always been a foundation for achievement in several areas within the educational system, as well as a prerequisite for successful participation in most areas of adult life. The increased availability of technologies and web-based resources can be a really valid support, both in the educational and clinical field, to devise training activities that can also be carried out remotely. There are studies in current literature that has examined the efficacy of internet-based programs for reading comprehension for children with reading comprehension difficulties but almost none considered distance rehabilitation programs. The present paper reports data concerning a distance program Cloze, developed in Italy, for improving language and reading comprehension. Twenty-eight children from 3rd to 6th grade with comprehension difficulties were involved. These children completed the distance program for 15-20 min for at least three times a week for about 4 months. The program was presented separately to each child, with a degree of difficulty adapted to his/her characteristics. Text reading comprehension (assessed distinguishing between narrative and informative texts) increased after intervention. These findings have clinical and educational implications as they suggest that it is possible to promote reading comprehension with a distance individualized program, avoiding the need for the child displacements, necessary for reaching a rehabilitation center.
ABSTRACT
BACKGROUND: Despite the increasing number of cardiac implantable electronic devices (CIED) procedures worldwide, no guideline assessed postoperative mobilization protocols. Lacking evidences in literature, many centers require 24-hour immobilization and bed rest to minimize the risk of pacing lead (PL) dislodgement. Prolonged immobilization may futilely delay discharge, induce pain and reduced joint mobility especially in elderly patients. We examined whether early mobilization at 3-h after CIED surgery would result in higher complication rates, compared with standard 24-hour immobilization. METHODS: Consecutive patients undergoing CIED implantation were randomized to early (3-h) mobilization protocol with an arm sling support (E-motion group, EMG) vs. standard (24-h) immobilization (control group, CG). The primary end-point was 24-month PL dislodgement. Secondary safety end-point was any major intra-procedural complication (cardiac perforation, pericardial tamponade, valve damage, haemothorax, pneumothorax, myocardial infarction, peripheral embolus, TIA/stroke or death). RESULTS: Among 200 enrolled patients, 86% underwent pacemaker implantation (28% single-chamber, 72% dual-chamber device), 14% underwent ICD implantation (75% single-chamber, 25% dual-chamber device). PL fixation was mostly passive (97% atrial PL, 88% ventricular PL), without differences between EMG and CG (pâ¯=â¯0.99). No differences were observed in the incidence of 24-month PL dislodgement (3% in the EMG vs. 4% in the CG, pâ¯=â¯0.99). No major intra-procedural complications were observed. CONCLUSIONS: Early mobilization at 3-h following CIED surgery is safe and feasible compared with standard immobilization and is not associated with an increased risk of intra-procedural complications or 24-month lead dislodgment. So, same-day implantation and discharge might be possible.
