Educational Implications Following Idiopathic Encephalopathy and Prolonged Coma: A Longitudinal Case Study

This paper explores standard considerations of accommodations for paediatric acquired brain injury (ABI) survivors as illustrated through an intensive case study. Specifically, we explore methods by which school systems can enhance a middle school student’s learning environment after losing 30 points in his intellectual functioning (IQ) following a rare coma recovery. For the purpose of this paper, coma is defined as a period following neurological injury or illness during which an individual does not open his/her eyes and does not have sleep–wake cycles. This case emphasises the use of current behavioural evidence-based treatments in young ABI patients. Multiple comparisons are especially beneficial in delineating the strength of intervention modalities and specific challenges unique to this population. Current data are of particular interest because measures of both pre- and post-morbid functioning are available, because of earlier school testing for a pre-existing learning disability. Finally, implications for prognosis and treatment of young ABI patients are discussed

The case of late preterm birth: sliding forwards the critical window for cognitive outcome risk

Many survivors of preterm birth experience neurodevelopmental disabilities, such as cerebral palsy, visual and hearing problems. However, even in the absence of major neurological complications, premature babies show significant neuropsychological and behavioural deficits during childhood and beyond. While the clinical tools routinely used to assess neurocognitive development in those infants have been useful in detecting major clinical complications in early infancy, they have not been equally sensitive in identifying subtle cognitive impairments emerging during childhood. These methodological concerns become even more relevant when considering the case of late preterm children (born between 34 and 36 gestational weeks). Although these children have been traditionally considered as having similar risks for developmental problems as neonates born at term, a recent line of research has provided growing evidence that even late preterm children display altered structural and functional brain maturation, with potential life-long implications for neurocognitive functioning. A recent study by Heinonen put forward the hypothesis that environmental factors, in this case educational attainment, could moderate the association between late preterm birth (LPT) and neuropsychological impairments commonly associated with aging. In this paper we bring together clinical literature and recent neuroimaging evidence in order to provide two different but complementary approaches for a better understanding of the "nature-nurture" interplay underlying the lifespan neurocognitive development of preterm babies

Rawan Atari - The Influence of Multi-Sensory Environment on Physiological Response in Children with Autism Spectrum Disorders and Children with Special Health Care Needs

A research study based on the sensory integration theory was conducted to examine the effects of multi-sensory environment (MSE) on physiological arousal in children with autism spectrum disorder (ASD) and special health care needs. Adapted environments may serve as a mechanism to treat anxiety levels in a population of children who experience more severe generalized anxiety symptoms than typically developing children. The sample consisted of children with community-based diagnoses of ASD and children with special health care needs, primarily children diagnosed with cerebral palsy (CP) from the Milwaukee Center for Independence (MCFI). Treatment for the autism sample was carried out by a trained MCFI staff member and treatment for children with special health care needs was carried out by a trained physical therapist. Electrodermal response was used as a measure to detect the “fight or flight” response of the sympathetic nervous system. The measurement of electrodermal activity was recorded by a wireless bracelet device that recorded the skin conductance level of the participant prior to entering the sensory room, during treatment in the sensory room, and after exiting the sensory room. Results indicated increased arousal in children with CP, as sensory stimulation was the main goal of physical therapists. Results for the autism sample varied by participant and indicated that treatment needs to be individualized for optimal benefits. Findings support the use of MSE as an alternative technique to improve therapeutic opportunities for children with cerebral palsy by stimulating sensations that are otherwise generally dormant.https://epublications.marquette.edu/mcnair_2014/1000/thumbnail.jp

Effects of gestational age at birth on cognitive performance : a function of cognitive workload demands

Objective: Cognitive deficits have been inconsistently described for late or moderately preterm children but are consistently found in very preterm children. This study investigates the association between cognitive workload demands of tasks and cognitive performance in relation to gestational age at birth. Methods: Data were collected as part of a prospective geographically defined whole-population study of neonatal at-risk children in Southern Bavaria. At 8;5 years, n = 1326 children (gestation range: 23–41 weeks) were assessed with the K-ABC and a Mathematics Test. Results: Cognitive scores of preterm children decreased as cognitive workload demands of tasks increased. The relationship between gestation and task workload was curvilinear and more pronounced the higher the cognitive workload: GA2 (quadratic term) on low cognitive workload: R2 = .02, p<0.001; moderate cognitive workload: R2 = .09, p<0.001; and high cognitive workload tasks: R2 = .14, p<0.001. Specifically, disproportionally lower scores were found for very (<32 weeks gestation) and moderately (32–33 weeks gestation) preterm children the higher the cognitive workload of the tasks. Early biological factors such as gestation and neonatal complications explained more of the variance in high (12.5%) compared with moderate (8.1%) and low cognitive workload tasks (1.7%). Conclusions: The cognitive workload model may help to explain variations of findings on the relationship of gestational age with cognitive performance in the literature. The findings have implications for routine cognitive follow-up, educational intervention, and basic research into neuro-plasticity and brain reorganization after preterm birth

'Everyday memory' impairments in autism spectrum disorders

‘Everyday memory’ is conceptualised as memory within the context of day-to-day life and, despite its functional relevance, has been little studied in individuals with autism spectrum disorders (ASDs). In the first study of its kind, 94 adolescents with an ASD and 55 without an ASD completed measures of everyday memory from the Rivermead Behavioural Memory Test (RBMT) and a standard word recall task (Children’s Auditory Verbal Learning Test-2: CAVLT-2). The ASD group showed significant impairments on the RBMT, including in prospective memory, alongside impaired performance on the CAVLT-2. Social and communication ability was significantly associated with prospective remembering in an everyday memory context but not with the CAVLT-2. The complex nature of everyday memory and its relevance to ASD is discussed

Sustained attention training reduces spatial bias in Parkinson’s disease: a pilot case series

Individuals with Parkinson’s disease (PD) commonly demonstrate lateralized spatial biases, which affect daily functioning. Those with PD with initial motor symptoms on the left body side (LPD) have reduced leftward attention, whereas PD with initial motor symptoms on the right side (RPD) may display reduced rightward attention. We investigated whether a sustained attention training program could help reduce these spatial biases. Four non-demented individuals with PD (2 LPD, 2 RPD) performed a visual search task before and after 1 month of computer training. Before training, all participants showed a significant spatial bias and after training, all participants’ spatial bias was eliminated.Published versio

Behaviour and school performance after brain injury

Primary Objective: To examine the relationship between behavioural problems and school performance following traumatic brain injury (TBI) Methods and Procedures: Subjects: 67 school-age children with TBI (35 mild, 13 moderate, 19 severe), and 14 uninjured matched controls. Parents and children were interviewed at a mean of two years post-TBI. Teachers reported on academic performance and educational needs. Children were assessed using the Vineland Adaptive Behaviour Scales (VABS) and the Weschler Intelligence Scale for Children (WISC-III). Main Outcomes and Results: Two-thirds of children with a TBI exhibited significant behavioural problems, significantly more than controls (p=0.02). Children with behavioural problems had a mean IQ approximately 15 points lower than those without (p=0.001, 95% CI:7 to 26.7). At school, 76%(19) of children with behavioural problems also had difficulties with schoolwork. Behavioural problems were associated with social deprivation and parental marital status (p ≤ 0.01). Conclusions: Children with TBI are at risk of developing behavioural problems which may affect school performance. Children with TBI should be screened to identify significant behavioural problems before they return to school