Developmental profile and diagnoses in children presenting with motor stereotypies

Introduction: Motor stereotypies represent a typical example of the difficulty in distinguishing non-clinical behaviors (physiological and transient) from symptoms or among different disorders (“primary stereotypies”, associated with Autistic Spectrum Disorder, Intellectual Disabilities, genetic syndromes, sensory impairment). Aim of this study was to get an accurate analysis on the relationship between stereotypies and neurodevelopmental disorders. Methods: We studied 23 children (3 girls) aged 36 to 95 months, who requested a consultation due to the persistence or the increase severity of motor stereotypies. None of patients had a previous diagnosis of ASD. The assessment included the Motor Severity Stereotypy Scale (MSSS), the Repetitive Behavior Scale-Revised (RBS-R), the Raven’s Colored Progressive Matrices (CPM), the Child Behavior Checklist for ages 1 ½ -5 or 4-18 (CBCL), the Social Responsiveness Scale (SRS) and the Autism Diagnostic Observation Schedule- Second edition (ADOS 2). Results: All patients were showing motor stereotypies for periods of time varying from 6 to 77 months. The MSSS showed each child had a limited number of stereotypies; their frequency and intensity were mild; the interference of stereotypies was variable; the impairment in the daily life was mild. The RBS-R scores resulted positive for the subscale of “Stereotypic behaviors” in all children; moreover, several children presented other repetitive behaviors, mainly “Ritualistic behavior” and “Sameness behavior”. All patients showed a normal cognitive level. The CBCL evidenced behavioral problems in 22% of the children: Internalizing problems, Attention and Withdrawn were the main complaints. On the SRS, all but one of the tested patients obtained clinical scores in the clinical range at least in one area. On the ADOS 2, four patients obtained scores indicating a moderate level of ASD symptoms, four had a mild level and fifteen showed no or minimal signs of ASD. Discussion: Motor stereotypies in children with normal cognitive level represent a challenging diagnostic issue for which a finely tailored assessment is mandatory in order to define a precise developmental profile. Notably, a careful and cautious use of standardized tests is warranted to avoid misdiagnosis. Furthermore, it is hard to consider motor stereotypies, even the primary ones, exclusively as a movement disorder

Developmental motor profile in preschool children with primary stereotypic movement disorder

Aim. Different neuropsychological dysfunctions have been described in children with primary Stereotypic Movement Disorder (SMD), mainly attention or motor coordination problems. Up to now with no study has evaluated psychomotor functions in preschoolers primary SMD. The aim of this observational study was to gather information on the motor profiles of SMD patients in this age range in comparison with typically developing children. Patients and Methods. Twenty-six children (four girls) aged 36 to 76 months (mean= 53 ±10) with primary SMD were assessed by a structured evaluation including the Movement Assessment Battery for Children-Second Edition (MABC-2), the Beery-Buktenica Developmental test of Visual-Motor Integration (VMI), the Repetitive Behaviour Scale-Revised (RBS-R), the Motor Severity Stereotypy Scale (MSSS), and the Child Behaviour Checklist (CBCL). The diagnoses of Intellectual Disability or Autism Spectrum Disorder were exclusion criteria from the study. A comparison group of twenty-seven (four girls) typically developing children without stereotypies aged 36 to 59 months (mean= 48 ±7) was also examined. Results. The MABC-2 total score was lower than 15th percentile in fifteen children with SMD (58%); the worst performances were observed in Balance and Manual Dexterity subtests. The motor coordination score of VMI was lower than 15th percentile in ten children (38%). The majority of the children with low scores at MABC-2 also had low scores at the motor coordination subscale of VMI. MABC-2 standard scores of the clinical group were significantly lower than those of controls on MABC-2 Total, Balance, and Ball Skills subtests. Conclusion. The finding of widespread dysfunction of gross and fine motor abilities in preschoolers with primary SMD seems to delineate a peculiar phenotype and could provide new approaches to the management of this neurodevelopment disorder

Regulating Fortress Britain: Migrants, Refugees and Asylum Applicants in the British Labour Market

The purpose of this chapter is to provide a detailed overview of the UK legal and institutional factors at the macro-level that can be regarded as decisive for explaining the effective capacity of the country to integrate migrants, refugees and asylum seekers into the labour market. By doing so, we aim to better understand the conditions within which integration policies for migrants, refugees and asylum applicants (MRA) may take place. We begin by providing an insight into the social and cultural context of migration in the UK, firstly by looking at the history of migration and the social and political instabilities of the country. Furthermore, we investigate how legislation concerning migration and asylum has developed within the UK context across the decades and analyse how legislation has been translated by UK policymakers in recent years. We then examine the current constitutional organisation of the British state, highlighting the importance of case law in developing MRA integration. Following this, we outline key legislation concerning the integration of MRA in the British labour market. The chapter then provides a critical overview of the integration strategies (or the lack thereof) promoted at the national level, outlining the institutional challenges that affect integration. We then conclude by highlighting the possible impact that Brexit will have on an already ‘hostile environment’ for migration

Introduction

The introductory chapter discusses key theoretical concepts upon which the book develops, such as the meaning of integration and inclusion, broadly understood but also with reference to the labour market and to the wider social context. Hence it reflects on how different labour outcomes affect empowerment and participation as key aspects of newcomers’ integration. It also introduces the reader to the multilevel (local–national–European) and multidimensional (micro–meso–macro) framework of the study underpinning the book, as well as to its large quantitative and qualitative empirical basis. The introduction also discusses ethical aspects which pertain to research with vulnerable individuals. Finally, the layout of the book is presented and explained

Examining Non-EU Migrants and Refugees’ Agency When Navigating the British Labour Markets

Migrants’ agency is a promising analytical tool and approach in migration and refugee studies as it shifts the focus of analysis (and attention) from the weaknesses or ‘faults’ of the migration experience to the opportunities and capacities it can generate for migrants and the community where they settle. Still, political, institutional, cultural, and economic contexts do keep exerting influence on migrants’ capacities to operate agency. This is particularly the case for migrants seeking humanitarian protection as they experience not only personal challenges and vulnerabilities, but also constraining legal and administrative barriers, preventing them, for example, to have their capacities duly recognised and valued. This chapter discusses how migrants, refugees, and asylum seekers’ agency helps them cope with adverse circumstances such as those promoted by obstructive policies and narratives in the United Kingdom. Eleven biographical interviews explore the life paths of migrants, refugees, and asylum seekers. The UK context presents a very challenging environment for their integration as legislation so far has been mainly based on increasing border control and decreasing entitlements, with scant attention to strategies of integration and inclusion. This chapter discusses how the political-institutional context influences the unfolding of such agency and how, in turn, agency provokes responses and adaptations from those contexts

Parallel and perpendicular cascades in solar wind turbulence

MHD-scale fluctuations in the velocity, magnetic, and density fields of the solar wind are routinely observed. The evolution of these fluctuations, as they are transported radially outwards by the solar wind, is believed to involve both wave and turbulence processes. The presence of an average magnetic field has important implications for the anisotropy of the fluctuations and the nature of the turbulent wavenumber cascades in the directions parallel and perpendicular to this field. In particular, if the ratio of the rms magnetic fluctuation strength to the mean field is small, then the parallel wavenumber cascade is expected to be weak and there are difficulties in obtaining a cascade in frequency. The latter has been invoked in order to explain the heating of solar wind fluctuations (above adiabatic levels) via energy transfer to scales where ion-cyclotron damping can occur. Following a brief review of classical hydrodynamic and magnetohydrodynamic (MHD) cascade theories, we discuss the distinct nature of parallel and perpendicular cascades and their roles in the evolution of solar wind fluctuations

Collaborator or competitor: assessing the evidence supporting the role of social enterprise in health and social care

In many countries, social enterprise has been introduced into a competitive market-oriented environment as a substitute for publicly owned services, particularly in healthcare. In the United Kingdom, evidence for this move seems to derive from case studies where social enterprise operates in collaboration – as opposed to competition – with publicly owned services. Our systematic review demonstrates that there is no evidence to support the role of social enterprise as a substitute for publicly owned services. However, there is evidence to show that where social enterprise operates in a collaborative environment, enhanced outcomes can be achieved, such as connectedness, well-being and self-confidence