Pediatric Acute-Onset Neuropsychiatric Syndrome: A Data Mining Approach to a Very Specific Constellation of Clinical Variables.

Objectives: Pediatric acute onset neuropsychiatric syndrome (PANS) is a clinically heterogeneous disorder presenting with: unusually abrupt onset of obsessive compulsive disorder (OCD) or severe eating restrictions, with at least two concomitant cognitive, behavioral, or affective symptoms such as anxiety, obsessive-compulsive behavior, and irritability/depression. This study describes the clinical and laboratory variables of 39 children (13 female and 26 male) with a mean age at recruitment of 8.6 years (standard deviation 3.1). Methods: Using a mathematical approach based on Artificial Neural Networks, the putative associations between PANS working criteria, as defined at the NIH in July 2010 (Swedo et al. 2012), were explored by the Auto Contractive Map (Auto-CM) system, a mapping method able to compute the multidimensional association of strength of each variable with all other variables in predefined dataset. Results: The PANS symptoms were strictly linked to one another on the semantic connectivity map, shaping a central "diamond" encompassing anxiety, irritability/oppositional defiant disorder symptoms, obsessive-compulsive symptoms, behavioral regression, sensory motor abnormalities, school performance deterioration, sleep disturbances, and emotional lability/depression. The semantic connectivity map also showed the aggregation between PANS symptoms and laboratory and clinical variables. In particular, the emotional lability/depression resulted as a highly connected hub linked to autoimmune disease in pregnancy, allergic and atopic disorders, and low Natural Killer percentage. Also anxiety symptoms were shown to be strongly related with recurrent infectious disease remarking the possible role of infections as a risk factor for PANS. Conclusion: Our data mining approach shows a very specific constellation of symptoms having strong links to laboratory and clinical variables consistent with PANS feature.

Silent reading fluency: Implications for the assessment of adults with developmental dyslexia.

INTRODUCTION: Understanding silent reading fluency (SRF) is of a paramount importance, given that silent reading is the principal manner of reading for capable readers. But the assessment of SRF is not commonly useful for identifying students with reading difficulties and monitoring their progress. The paper presents the SRF scores of adults with dyslexia compared to SRF scores of skilled readers and discusses the power of the SRF measure in identifying adults with specific learning disorders with impairment in reading. METHOD: Participants recruited were 68 dyslexic and age-matched skilled adult readers (18-48 years old). Among them, 24 were skilled readers with a university degree (GRS), 22 were skilled readers with a high school diploma (DSR), and 22 participants had been diagnosed with dyslexia (DR). We used a standardized oral reading fluency (ORF) test and an original SRF task to measure the reading fluency. RESULTS: All participants increased their reading fluency in silent mode (p < .001). Nonetheless, the average speed of the oral reading was 7.19 syllables per second (syl/s) for the GSR group, 7.11 syl/s for the DSR group, and 4.95 syl/s for the DR group. The average speed of the silent reading was 11.62 syl/s and 10.75 syl/s for GSR and DSR, respectively, and 6.15 syl/s for DR. The reading fluency differential (Δf) between ORF and SRF was significantly different among the dyslexic participants and the other two groups. CONCLUSIONS: Our results strongly suggest that dyslexic readers are less capable of significantly improve their reading speed when they read silently. Thus SRF could be considered a suitable parameter for identifying older students and adults with impairment in reading. A broader investigation of the issues surrounding silent reading is needed.

A Comparison between Children with ADHD and Children with Epilepsy in Self-Esteem and Parental Stress Level.

Attention-deficit/hyperactivity disorder (ADHD) is frequently associated with negative psychological outcomes. This study explores the relationship between self-esteem, ADHD symptoms and parental stress. It compares children with ADHD, children with epilepsy (E) and typical developmental controls (TD). Participants included 65 children (aged 9-12 yrs) and their parents. The assessment was conducted by Multidimensional Self-Concept Scale (MSCS), Parent Stress Index (PSI) and Conners' Parent Rating Scales-Revised. Significant differences were found in Social, Competence and Academic areas of self-esteem between children with ADHD, with E and TD. Moreover, parents of children with ADHD showed a higher overall stress than both other groups. In conclusion, it seems important to evaluate the psychological aspects of ADHD con-dition, both in children and in parents, in order to suggest an individual multimodal treatment.