Psychometric Properties and Validation of the Italian Version of Ages & Stages Questionnaires Third Edition

: Objectives: The Ages & Stages Questionnaires Third Version (ASQ-3) identifies the risk of developmental delay in children aged 1 to 66 months. The aim of this study was to determine a reliable and valid instrument for the Italian population to enable the screening of children's development. Methods: Data from 2278 Italian children (age range: 1-66 months) were used to evaluate item discrimination power using the corrected item-total correlation. Internal consistency was analyzed by Cronbach's alpha scores and a Confirmative Factor Analysis was conducted to test the factor structure of the test. Data were also collected to examine the ASQ-3 test-retest reliability and concurrent validity, which was investigated using the Griffiths Scales of Child Development, Third Edition, the Peabody Developmental Motor Scale, Second Edition, and the Developmental Profile, Third Edition tools. In order to evaluate discriminant validity, differences between typical development children and several clinical groups have been performed. Finally, two different cut-off scores have been proposed. Results: The results showed that the questionnaires are composed of high-quality items; the original factor structure has been confirmed and strong Pearson product-moment correlation coefficients between the overall and the total for each domain (ranging from 0.73 to 0.88). The Italian version of the ASQ-3 had adequate internal consistency and a strong agreement between observations with two weeks' intervals. Moreover, the test showed a high discriminant validity due to the possibility of fully discriminating between typical development children and several clinical groups. Finally, two different cut-off scores have been identified using ROC curves in order to have a screening and a diagnostic cut-off value. Conclusion: This study evaluated the psychometric properties of the Italian adaptation of ASQ-3 questionnaires. We demonstrated the validity of the ASQ-3 and determined new cut-off scores for Italian children. Early identification and accurate assessment are important starting points to better understand and anticipate the needs of children and their link to services

Sindrome di Tourette nel bambino

La sindrome di Tourette è un disturbo del neurosviluppo caratterizzato da tic motori multipli e uno o più tic fonici, della durata di almeno un anno, con esordio prima dei 18 anni di età. I tic sono movimenti o suoni involontari, improvvisi, rapidi, ripetitivi ma non ritmici. La sindrome di Tourette ha una prevalenza di 1 individuo affetto su 100 ed è più frequente nei maschi rispetto alle femmine (rapporto 4:1). L’eziopatogenesi del disturbo non è del tutto nota; studi recenti dimostrano che l’interazione di fattori genetici e ambientali risulta nella disfunzione di alcuni circuiti cerebrali. L’età di esordio tipica è tra i 5 e i 7 anni. Il 90% di pazienti affetti da sindrome di Tourette presenta una comorbidità, il 58% ne presenta due e circa il 30% di pazienti può presentare tre o più diagnosi psichiatriche in comorbidità nel corso della vita. La terapia comportamentale rappresenta la prima scelta di intervento in questi pazienti. Il trattamento farmacologico spesso non risulta necessario, ci si avvale di esso nei casi in cui i tic o le comorbidità interferiscano significativamente con le attività quotidiane, scolastiche o con la vita sociale dei pazienti

Rage attacks in Tourette syndrome and chronic tic disorder: a systematic review

Tourette syndrome (TS) and Chronic motor/vocal Tic Disorder (CTD) are neurodevelopmental conditions defined by the occurrence of multiple tics. Besides the well-known association with attention deficit/hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD), rage attacks (RA) represent common and detrimental symptoms for patients. In order to explore prevalence of RA in tic disorders, relation to tic severity/comorbidities and available treatments, we performed a systematic literature review based on PRISMA Guidelines. 32 studies published between January 2008 - December 2019 were deemed suitable for the analysis and provided a prevalence of 20-67%. Most findings showed a direct correlation with tic severity and a significant impact on psychosocial functioning. Although apparently related to comorbid ADHD, RA also frequently occur as independent manifestations. Association with other comorbidities, such as OCD, impulse control and mood disorders has also been reported, not yet fully established. Behavioral interventions appear to be effective, whereas there is limited evidence concerning the efficacy of medication. In TS/CTD, RA may be regarded as a major comorbidity that requires clinical investigation in order to develop personalized treatments

Studi Bitontini

‘Studi Bitontini’, rivista scientifica semestrale del Centro Ricerche di Storia e Arte-Bitonto, fondata nel 1969 e pubblicata regolarmente – con cadenza quadrimestrale fino al 1989 –, si propone quale sede privilegiata per ricerche, approfondimenti, confronti su temi, documenti, eventi, nonché problemi di tutela e gestione relativi alla storia, al paesaggio, al patrimonio tradizionale e alla cultura materiale della Puglia, con particolare riferimento al contesto di Bitonto. Nel numero 109-110 del 2020 sono stati affrontati i temi proposti dai contributi di seguito elencati, cui si aggiungono le sezioni dedicate alle recensioni e alla rassegna bibliografica nonché alle attività condotte dal Centro Ricerche di Storia e Arte-Bitonto e alle notizie di eventi di particolare importanza per il comprensorio considerato: • Epigrafi medievali inedite da Bitonto (Federico Marinelli) • «Trazesse zafran della Puia, de Terra de Barri e de Terra de Otrento». Note sulla coltivazione e il commercio dello zafferano in Puglia e a Bitonto tra XV e XVI secolo (Vito Ricci) • «Musica in ogni genere di eterna memoria»: l’immagine di Traetta a quarant’anni dalla morte (con un’appendice su Giuseppe Verdi) (Raffaele Mellace) • La bottega di Nicolantonio Brudaglio di Andria e suoi allievi: Francesco Paolo Antolini e Giuseppe Santoniccolo (Emilio Mastropasqua) • A lezione da Claudio Leonardi. Un ricordo (Francesca Sivo).‘Studi Bitontini’, semi-annual journal of the ‘Research Center of History and Art-Bitonto’, founded in 1969 and published regularly – every four months until 1989 –, is proposed as forum for researches, analysis, comparisons on topics, documents, events, and problems of protection and management relating to the history, the landscape, the traditional heritage and the material culture of Apulia, with particular reference to the context of Bitonto. In number 109-110 of 2020, the Journal have covered the topics proposed by the contributions listed below, in addition to the sections dedicated both to the bibliographical reviews and the activities conducted by the ‘Research Center of History and Art-Bitonto’ and several information about important events for the Apulian countryside: • Epigrafi medievali inedite da Bitonto (Federico Marinelli) • «Trazesse zafran della Puia, de Terra de Barri e de Terra de Otrento». Note sulla coltivazione e il commercio dello zafferano in Puglia e a Bitonto tra XV e XVI secolo (Vito Ricci) • «Musica in ogni genere di eterna memoria»: l’immagine di Traetta a quarant’anni dalla morte (con un’appendice su Giuseppe Verdi) (Raffaele Melalce) • La bottega di Nicolantonio Brudaglio di Andria e suoi allievi: Francesco Paolo Antolini e Giuseppe Santoniccolo (Emilio Mastrocinque) • A lezione da Claudio Leonardi. Un ricordo (Francesca Sivo)

K-SADS-PL DSM-5

La K-SADS-PL è un'intervista diagnostica per la valutazione dei disturbi psicopatologici (passati e attuali) in bambini e adolescenti secondo i criteri del DSM-5. Viene somministrata da psicologi o neuropsichiatri infantili sia ai ragazzi che ai loro genitori, e consente di ottenere un punteggio complessivo che tiene conto di tutti i dati raccolti dalle varie fonti disponibili (famigliari, bambini, insegnanti, pediatri, ecc.). Essa è composta da: un'intervista introduttiva non strutturata, un'intervista diagnostica di screening, una checklist per la somministrazione dei supplementi diagnostici, cinque supplementi diagnostici (disturbi dell'umore, disturbi psicotici, disturbi d'ansia, disturbi da deficit di attenzione e da comportamento dirompente, abuso di sostanze) per ciascuno dei quali sono forniti i criteri richiesti dal DSM, una checklist complessiva della storia clinica del paziente e una scala per la valutazione globale del funzionamento attuale del bambino (VGF).In particolare se utilizzata all'interno di una valutazione psichiatrica e psicodiagnostica completa e articolata, la K-SADS-PL si dimostra uno strumento fondamentale poiché permette di effettuare un corretto bilancio prognostico, indispensabile per programmare un adeguato intervento terapeutico

Epilepsy phenotype in patients with Xp22.31 microduplication

The clinical significance of Xp22.31 microduplication is still unclear. We describe a family in which a mother and two children have Xp22.31 microduplication associated with different forms of epilepsy and epileptiform EEG abnormalities. The proband had benign epilepsy with centrotemporal spikes with dysgraphia and dyscalculia (IQ 72), the sister had juvenile myoclonic epilepsy, and both had bilateral talipes anomalies. The mother, who was the carrier of the microduplication, was asymptomatic. The asymptomatic father did not possess the microduplication. These data contribute to delineate the phenotype associated with Xp22.31 microduplication and suggest a potential pathogenic role for an epilepsy phenotype. Keywords: Epilepsy, EEG abnormalities, Xp22.31 microduplication, Phenotyp

I sistemi motivazionali-emozionali: tavole sinottiche

Tavole sinottiche dei sistemi emozionali. Nelle tavole sinottiche vengono indicate le principali caratteristiche e funzioni dei sistemi motivazionali/emozionali quali la funzione evoluzionistica, le emozioni correlate, i comportamenti tipici associati, la localizzazione anatomica, le manifestazioni psicopatologiche associate, i neuro mediatori attivanti/inibenti e gli psicofarmaci e sostanze attive su tali sistemi

Unraveling the Relationship between Sleep Problems, Emotional Behavior Disorders, and Stressful Life Events in Preschool Children

Objectives: The aims of this study were to: (1) explore sleep problems in preschool children with generalized anxiety disorder (GAD), selective mutism (SM), and oppositional defiant disorder (ODD) and (2) examine the relationship between stressful life events, sleep problems, and emotional behavior disorders in preschoolers. Methods: The parents of 213 preschool children with SM, GAD, ODD, and TD (typical development, age range 2–6 years) completed the Children’s Sleep Habits Questionnaire (CSHQ), the Coddington Life Events Scale, preschool version (CLES-P), and the CBCL 1½–5. Results: Eighty-three subjects reported sleep problems before the age of 2 years. Seventy-five children (86.14%) with a clinical diagnosis and eight children with TD (8.4%) exceeded the threshold level on the CSHQ. For the bedtime resistance (p = 0.042) and sleep duration subscales (p = 0.038), the SM group had significantly higher scores in comparison to the ODD group. The same pattern was also true for the sleep onset (p = 0.024) and sleep anxiety subscales (p = 0.019). The linear regression analysis model showed that the impact of stressful life events and internalizing problems could predict sleep habits in children. Conclusions: Emotional behavior disorders and stress factors should be regularly investigated in children who are referred to clinics for sleep problems. Clinicians should consider how these symptoms may exacerbate sleep problems and/or interfere with treatment

Wearable heart rate monitoring as stress response indicator in children with neurodevelopmental disorder

In this paper, a wearable sensor system embedded in a belt for monitoring cardio-respiratory activity in children with neurodevelopmental disorder is presented. The sensors are integrated, using a micro-controller with a wireless interface, in a network that is able to transmit the monitored parameters to a data collection station. The data are acquired, processed and stored using a virtual instrument developed in the LabVIEW environment. The aim of the study is to evaluate the effectiveness of cardio-respiratory frequency, observed in structured and nonstructured situations of interactive session, as a possible indicator of stress response in children affected by autism spectrum disorder and by pre-school language disorders. Preliminary results evidence a correlation between specifically designed activities and the corresponding heart rate

Heart rate monitoring under stress condition during behavioral analysis in children with neurodevelopmental disorders

Monitoring physiological parameters under stress conditions – i.e., heart rate, breath frequency or heart rate variability - through non-invasive and comfortable wearable devices was a research topic of great interest in many medical fields. In the last decade, several wearable devices and methods have been developed for stress monitoring, showing suitable performance in estimating the stress indicator. In spite of the interest in the field, the development of wearable solutions suitable for child neuropsychiatry applications was still an open challenge. In this study, we evaluate the cardiac activity in children - with and without neurodevelopmental disorders - through a novel wearable solution in order to compare the stress response in different structured activities and games. Each subject was equipped with a 3-lead electrocardiograph device and a piezoelectric respiratory sensor embedded into a thoracic belt. Subjects were asked to carry out five different activities previously chosen from a subset of specific behavioral tests (three different free-games and two structured activities). All experimental sessions were video-recorded. Results highlighted how wearable devices could help in estimating stress indicators for long-tests (over twenty-five minutes). The clinical application was conducted on a cohort of 32 children so divided: 13 with Specific Language Disorder, 15 with Autism Spectrum Disorder, and 4 control children without neurodevelopmental disorders. Statistical differences were observed between populations in the heart rate. Moreover, all subjects experienced stress effects evidenced by variation of heart rate and standard deviation, which are supported by the video analysis