Evaluation of p300 and spectral resolution in children with attention deficit hyperactivity disorder and specific learning disorder.

This study aims to examine auditory processing, P300 values and functional impairment levels among children with Attention Deficit and Hyperactivity Disorder (ADHD), Specific Learning Disorder (SLD), ADHD+SLD and healthy controls. Children with ADHD (n = 17), SLD (n = 15), ADHD+SLD (n = 15), and healthy controls (n = 15) between the ages of 7-12 were evaluated with K-SADS, Weiss Functional Impairment Rating Scale, Turgay DSM-IV Disruptive Behavior Disorders Rating Scale, The Mathematics, Reading, Writing Assessment Scale and Children's Auditory Performance Scale (CHAPS). Auditory P300 event-related potentials and Spectral-Temporally Modulated Ripple Test (SMRT) were applied. Three patient groups were found to be riskier than healthy controls according to the CHAPS. There was no significant difference between the groups in the SMRT. In post-hoc analyses of P300 parietal amplitudes, ADHD, SLD, and ADHD+SLD were found to be significantly lower than the control group. The amplitudes of the ADHD+SLD were by far the lowest. It has been shown that auditory performance skills and p300 amplitudes are lower in children diagnosed with only ADHD or SLD compared to the control group, with the lowest values observed in ADHD+SLD. This study suggests that the difficulties with attention and cognitive functions in the ADHD+SLD are more severe than ADHD and/or SLD without comorbidity.

Investigation of the forkhead box protein P2 gene by the next-generation sequence analysis method in children diagnosed with specific learning disorder.

OBJECTIVE: It was aimed to investigate the role of the forkhead box protein P2 (FOXP2) gene in the cause of specific learning disorder (SLD) with the next-generation sequencing method. MATERIAL AND METHODS: The study included 52 children diagnosed with SLD and 46 children as control between the ages of 6-12 years. Interview Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present and Lifelong Version in Turkish, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)-Based Screening and Evaluation Scale for Attention Deficit and Disruptive Behavior Disorders, Specific Learning Disability Test Battery were applied to all participants. The FOXP2 gene was screened by the next-generation sequencing (NGS) method in all participants. RESULTS: A total of 17 variations were detected in the FOXP2 gene in participants. The number and diversity of variations were higher in the patient group. In the patient group, c.1914 + 8A>T heterozygous variation and three different types of heterozygous variation (13insT, 13delT and 4dup) in the c.1770 region were detected. It was found that the detected variations showed significant relationships with the reading phenotypes determined by the test battery. CONCLUSION: It was found that FOXP2 variations were seen more frequently in the patient group. Some of the detected variations might be related to the clinical phenotype of SLD and variations found in previous studies from different countries were not seen in Turkish population. Our study is the first to evaluate the role of FOXP2 gene variations in children with SLD in Turkish population, and novel variations in the related gene were detected.

Specific Learning Disorders and Eating Disorders: an Italian retrospective study.

BACKGROUND: Although Anorexia Nervosa (AN) patients show dysfunctional behaviour in information processing, visual and verbal memory performance, and different cognitive fields, regardless of their BMI, the literature on the correlations between Eating Disorders (ED) and Neurodevelopmental Disorders (NDD) does not provide conclusive data. Rather than a consequence of the mental disorder, cognitive dysfunctions may be a risk factor for AN. METHODS: Our retrospective study investigates the prevalence of Specific Learning Disorder (SLD) among patients with ED. We considered 262 patients being treated at the Emilia Romagna Feeding and Eating Disorders Outpatient Service in Bologna, Italy. We compared the results with the Italian reference values, according to the most recent data provided by the Italian Ministry of Education. RESULTS: We found that 25 patients out of 262 (9.54%) presented a comorbid diagnosis of SLD. This SLD prevalence is higher than the Italian reference values (4.9% in the school year 2018/19, p < 0.001). Comorbidity with SLD was significantly more frequent in males. A diagnosis of SLD was not associated with a higher frequency of any specific ED diagnosis or with psychiatric comorbidity in general. Positive family history for SLD was not significantly associated with either a positive family history for ED or a diagnosis of SLD. CONCLUSIONS: This is the first Italian study to investigate the prevalence of SLD in ED patients during childhood and adolescence. Our data support previous research documenting that neuropsychological deficit could lead to the development of ED.

Delayed Sleep-Wake Phase Disorder: Can Polysomnography Be Useful?

BACKGROUND: Delayed sleep-wake phase disorder (DSWPD) is a chronic condition with a multifactorial etiology that primarily affects adolescents, significantly influencing their quality of life. In clinical practice, the contribution of intrinsic and behavioral factors is difficult to determine. The aim of our study was to compare data from clinical interviews, sleep diaries, actigraphy, and nocturnal polysomnography (PSG) in a cohort of adolescents with DSWPD and to assess psychiatric/neurodevelopmental comorbidity. METHODS: Thirty-one patients (22 male; mean age 15.4 ± 2.2 years, range 12 to 19 years) with a diagnosis of DSWPD based on detailed history, sleep diary, and actigraphy underwent nocturnal polysomnography (PSG) and neurological, psychological, and psychiatric examination. RESULTS: Attention-deficit/hyperactivity disorder (ADHD) was present in 14 cases (45%), specific learning difficulties in nine (29%), and mood disorder (anxiety/depression) in 16 patients (52%). PSG revealed sleep-onset delay in only 12 (38%) cases. No differences in clinical data or psychiatric comorbidity between the group with sleep delay and the group with normal sleep onset were detected. Decreased total sleep time, sleep efficiency, rapid eye movement (REM) sleep, and prolonged REM sleep latency were observed in patients with delayed sleep onset. CONCLUSIONS: PSG showed delayed sleep timing in only 38% of patients with a diagnosis of DSWPD based on diagnostic criteria of the International Classification of Sleep Disorders. We suggest that PSG can provide useful information regarding the prevailing etiology (biological versus behavioral) if dim light melatonin onset testing is not available.

The prevalence and comorbidity rates of specific learning disorder among primary school children in Turkey.

Purpose: The aim of the present study was to investigate the prevalence of specific learning disorder (SLD), comorbid disorders, and risk factors in primary school children for the first time in two-stage design in Turkey.Materials and methods: Participants were 1041 pupils in 28 primary schools and aged from 7 to 11. The Mathematics, Reading, Writing Assessment Scale (MOYA) teacher and parent forms were used in the screening stage and parents and teachers of each child completed MOYA. Ninety-five children were screen positive and eighty-three of these children participated in the interview. SLD diagnoses were based on DSM V criteria. Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL) was used for the comorbid psychiatric disorders.Results and conclusions: The prevalence rate of the SLD was 6.6%, impairment in reading was 4%, in mathematics was 3.6%, and in written expression was 1.8%. About 62.75% of children with SLD had one or more comorbid diagnoses. ADHD was the most common comorbid mental disorder in SLD (54.9%). SLD prevalence was higher among males. The prevalence of SLD in primary school children in Turkey is consistent with previous studies.

Diagnosis and Treatment of Developmental Dyslexia and Specific Learning Disabilities: Primum Non Nocere.

Specific learning disabilities (SLDs) are increasingly being addressed by researchers, schools, and institutions, as shown by the increasing number of publications, guidelines, and incidence statistics. Although SLDs are becoming a major topic in education with the final goal of inclusive schools, consistent drawbacks may emerge, resulting in disadvantages instead of benefits for some children. Overdiagnosis and unnecessary interventions may harm children's neurodevelopment and families' quality of life more than previously thought. In this commentary, we discuss recent understandings, their practical and educational applications, and some considerations of the effects of these choices on children.

Examining the selection of university courses in young adults with learning disabilities.

The literature contains a great deal of research on Specific Learning Disorders (SpLDs). However, almost all of the studies related to SpLDs deal with the difficulties that said disorders cause during childhood or adolescence. An interest in adults with SpLDs is only recent, especially in university students like those in this study. In Italy, research on SpLDs in higher education is rather limited. This study aims to rectify this lack of data by making a brief analysis of the data on SpLDs prevalence in higher education and of the courses chosen by university students with SpLDs. Our sample consisted of 585 students with SpLDs enrolled at 19 public universities that communicated the number of students who contacted their offices of service for students with SpLDs. The prevalence of students with SpLDs in the higher education populations we sample had a mean of 0.13% (SD = 0.11) and ranged from 0.03% to 0.48%. The data showed that the higher education faculties with the highest number of reported SpLDs students in our sample were Statistics, Agriculture, Veterinary Science, Education, and Architecture. It is important to analyse the trend in university enrolment of student with SpLDs to protect the right to education for people with SpLDs.

The prevalence of specific learning disorder in mathematics and comorbidity with other developmental disorders in primary school-age children.

Mathematics difficulties are common in both children and adults, and they can have a great impact on people's lives. A specific learning disorder in mathematics (SLDM or developmental dyscalculia) is a special case of persistent mathematics difficulties, where the problems with maths cannot be attributed to environmental factors, intellectual disability, or mental, neurological or physical disorders. The aim of the current study was to estimate the prevalence rate of SLDM, any gender differences in SLDM, and the most common comorbid conditions. The DSM-5 provides details regarding these only for specific learning disorders in general, but not specifically for SLDM. We also compared the prevalence rates obtained on the basis of the DSM-IV and DSM-5 criteria. We investigated the performance of 2,421 primary school children on standardized tests of mathematics, English, and IQ, and several demographic factors over the primary school years. We applied the DSM-5 diagnostic criteria to identify children with a potential diagnosis of SLDM. Six per cent of our sample had persistent, severe difficulties with mathematics, and, after applying the exclusion criteria, 5.7% were identified as having an SLDM profile. Both persistent maths difficulties and consistently exceptionally high performance in maths were equally common in males and females. About half of the children with an SLDM profile had some form of language or communication difficulty. Some of these children also had a diagnosis of autism, social, emotional, and behavioural difficulties or attention deficit and hyperactivity disorder. Our findings have important implications for research and intervention purposes, which we discuss in the study.

Suicide Attempts Among Individuals With Specific Learning Disorders: An Underrecognized Issue.

Several studies have linked specific learning disorders (SLDs) with suicidal ideation, but less is known about the disorders' association with suicide attempts. This gap in the literature is addressed via the 2012 nationally representative Canadian Community Health Survey ( n = 21,744). The prevalence of lifetime suicide attempts among those with an SLD was much higher than those without (11.1% vs. 2.7%, p < .001). In comparison with their peers without SLDs, adults with SLDs had 46% higher odds of having ever attempted suicide, even after adjusting for most known risk factors (e.g., childhood adversities, history of mental illness and substance abuse, sociodemographics; odds ratio = 1.46, 95% CI [1.05, 2.04]). The largest attenuation in the association between SLD and suicidal attempts was accounted for by adverse childhood experiences. Among those with SLDs ( n = 745), a history of witnessing chronic parental domestic violence and ever having had a major depressive disorder were associated with substantially higher odds of suicide attempts.

Knowledge and Attitudes About Attention-Deficit/Hyperactivity Disorder and Specific Learning Disorder in an Urban Indian Population.

Attention-deficit/hyperactivity disorder (ADHD) and specific learning disorders (SLDs) are an important cause of scholastic backwardness among children and often go unrecognized. Few studies have examined knowledge and attitudes toward ADHD and SLD among school-aged children. To address this deficit, 120 school-aged children, attending a child guidance clinic in Mumbai, were interviewed using a questionnaire that examined children's knowledge and attitudes about ADHD and SLD. The results were compared both qualitatively and quantitatively with a frequently occurring medical illness, common cold. Approximately 80% to 100% of children were aware of their illness; however, a large variation was noted in the proportion of children (15%-80%) who could describe their symptoms, provide accurate attributions for their illness, and identify treatment modalities. Children with ADHD reported greater control over their illness. The study identified a significant lack of knowledge about ADHD and SLD among school-aged children in India and discusses implications of this finding.

A cross-sectional study to assess the prevalence of DSM-5 specific learning disorders in representative school samples from the second to sixth grade in Brazil.

Little is known about specific learning disorder (SLD) in low- and middle-income countries (LMICs), and even less from representative school samples in small size cities outside huge urban centers. Few studies addressed the new DSM-5 criteria for SLDs. We investigated the prevalence of DSM-5 SLDs, their comorbidities and correlates in school samples of students from the second to sixth grades living in median cities from four different geographic regions in Brazil. A national test for academic performance covering reading, writing and mathematical abilities was applied. Psychiatric diagnoses were assessed by the K-SADS-PL applied to the primary caregiver. A total of 1618 children and adolescents were included in the study. The following prevalence rates of SLDs were found: 7.6% for global impairment, 5.4% for writing, 6.0% for arithmetic, and 7.5% for reading impairment. Attention-deficit/hyperactivity disorder (ADHD) was the only comorbidity significantly associated with SLD with global impairment (p = 0.031). Anxiety disorders and ADHD were associated with SLD with arithmetic impairment. Significant differences were detected in prevalence rates among cities, and several socio-demographic correlates (age, gender, IQ, and socioeconomic status) were significantly associated with SLD with global impairment in our sample. Careful validation and normatization of instruments to assess academic performance is a major problem in LMICs. As expected, we found a significant heterogeneity in prevalence rates of SLD according to geographic regions considering that Brazil is a country with a robust diversity. SLD with global and arithmetic impairment was significantly associated with psychiatric comorbidities.

Cognitive Risk Factors for Specific Learning Disorder: Processing Speed, Temporal Processing, and Working Memory.

High comorbidity rates between reading disorder (RD) and mathematics disorder (MD) indicate that, although the cognitive core deficits underlying these disorders are distinct, additional domain-general risk factors might be shared between the disorders. Three domain-general cognitive abilities were investigated in children with RD and MD: processing speed, temporal processing, and working memory. Since attention problems frequently co-occur with learning disorders, the study examined whether these three factors, which are known to be associated with attention problems, account for the comorbidity between these disorders. The sample comprised 99 primary school children in four groups: children with RD, children with MD, children with both disorders (RD+MD), and typically developing children (TD controls). Measures of processing speed, temporal processing, and memory were analyzed in a series of ANCOVAs including attention ratings as covariate. All three risk factors were associated with poor attention. After controlling for attention, associations with RD and MD differed: Although deficits in verbal memory were associated with both RD and MD, reduced processing speed was related to RD, but not MD; and the association with RD was restricted to processing speed for familiar nameable symbols. In contrast, impairments in temporal processing and visuospatial memory were associated with MD, but not RD.

WISC-IV Intellectual Profiles in Italian Children With Specific Learning Disorder and Related Impairments in Reading, Written Expression, and Mathematics.

The fifth edition of theDiagnostic and Statistical Manual of Mental Disordersgrouped specific learning disabilities in the single diagnostic category of specific learning disorder (SLD), with specifiers for impairments in reading, written expression, and mathematics. This study aimed at investigating the intellectual profile, assessed with the fourth edition of theWechsler Intelligence Scale for Children(WISC-IV), of 172 children with a diagnosis of SLD, compared to 74 clinical referral controls. WISC-IV intellectual functioning in children with SLD was characterized by a significant discrepancy between general ability and cognitive proficiency (General Ability Index [GAI] > Cognitive Proficiency Index [CPI]), and worse performances on the Similarities, Digit Span, Letter-Number Sequencing, and Coding subtests, supporting models of multiple cognitive deficits at the basis of neurodevelopmental disorders as SLD. GAI was the best and more conservative measure provided by the WISC-IV to identify intellectual functioning in children with SLD, and the intellectual discrepancy between GAI and CPI could be considered a "cognitive sign" for the presence of SLD in a single diagnostic category. Cognitive deficits differed in subtypes of impairment (reading, written expression, and mathematics), supporting their distinction for empirical, educational, and rehabilitative purposes. These findings need further replication in larger samples and in comparison to typically developing children.

A screening on Specific Learning Disorders in an Italian speaking high genetic homogeneity area.

The aim of the present research is to investigate the prevalence of Specific Learning Disorders (SLD) in Ogliastra, an area of the island of Sardinia, Italy. Having experienced centuries of isolation, Ogliastra has become a high genetic homogeneity area, and is considered particularly interesting for studies on different kinds of pathologies. Here we are going to describe the results of a screening carried out throughout 2 consecutive years in 49 second grade classes (24 considered in the first year and 25 in the second year of the study) of the Ogliastra region. A total of 610 pupils (average age 7.54 years; 293 female, 317 male) corresponding to 68.69% of all pupils who were attending second grade in the area, took part in the study. The tool used for the screening was "RSR-DSA. Questionnaire for the detection of learning difficulties and disorders", which allowed the identification of 83 subjects at risk (13.61% of the whole sample involved in the study). These subjects took part in an enhancement training program of about 6 months. After the program, pupils underwent assessment for reading, writing and calculation abilities, as well as cognitive assessment. According to the results of the assessment, the prevalence of SLDs is 6.06%. For what concerns dyslexia, 4.75% of the total sample manifested this disorder either in isolation or in comorbidity with other disorders. According to the first national epidemiological investigation carried out in Italy, the prevalence of dyslexia is 3.1-3.2%, which is lower than the prevalence obtained in the present study. Given the genetic basis of SLDs, this result, together with the presence of several cases of SLD in isolation (17.14%) and with a 3:1 ratio of males to females diagnosed with a SLD, was to be expected in a sample coming from a high genetic homogeneity area.

Specific Learning Disorders and ADHD: Current Issues in Diagnosis Across Clinical and Educational Settings.

With the recent changes in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM), this article provides a comprehensive review of two high-incidence disorders most commonly seen in childhood and adolescence: specific learning disorder (SLD) and attention-deficit/hyperactivity disorder (ADHD). Updates regarding comorbidity, shared neuropsychological factors, and reasons for the changes in diagnostic criteria are addressed. Although the revisions in the DSM-5 may allow for better diagnostic sensitivity based on the symptomology, specifiers, and the clinical features outlined, there continues to be challenges in operationalizing SLD and implementing consistent assessment practices among mental health professionals particularly when considering the Individuals with Disabilities Education Act (IDEA), which provides guidelines in the evaluation of SLD in school settings. Clinical and educational assessment implications are discussed with special attention to develop a collaborative approach between psychiatrists, psychologists, and educators when providing service delivery for children and adolescents with neurodevelopmental disabilities.