Psychological Preparations Affecting the Emotions of Children with Developmental Disorders Toward Hospitals

[Background] The psychological preparation factors associated with positive or negative emotions in pediatric patients with developmental disorders are not well known. We aimed to clarify which psychological preparation factors affect positive (favorable) or negative (fear) emotions toward hospitals in pediatric patients with autism spectrum disorder (ASD) or attention deficit hypertensive disorder (ADHD), using the questionnaires for the patients and guardians. [Methods] The questionnaires were sent by mail via prefectural patient-family groups to pediatric patients (6 to 15 years old; diagnosed with ASD or ADHD) and their guardians living in seven prefectures in Japan. Thereafter, we statistically analyzed the associations between the background factors or psychological preparations and the patients’ positive or negative emotions toward the hospital. [Results] The questionnaire results of 68 patients (age: 6–15 years; 15 = females; 53 = males) and their guardians indicated the main diagnoses for patients were ASD (n = 54) and ADHD (n = 14). Intellectual disability and hypersensitivity were positively associated with fear experiences in the hospital. In contrast, the staff’s explanations during interventions negatively associated with patients’ fear experiences. The psychological preparations performed by doctors during the medical checks were positively associated with the patient’s positive emotions toward the hospital. [Conclusion] Regarding the psychological preparations for patients with ASD or ADHD, interpersonal communication with doctors and staff promotes positive emotions and reduces anxiety in the hospital

Predicting Mathematical Learning Difficulties Using Fundamental Calculative Ability Test (FCAT)

Background: Mathematical learning difficulty (MLD) during school years results from several factors, including dyscalculia. Traditional diagnostic tests for dyscalculia are time intensive and require skilled specialists. This prospective cohort study aimed to reveal that the less time intensive Fundamental Calculative Ability Test (FCAT), administered in first grade, can predict the outcome of mathematical school achievement, which was measured with the curriculum-based mathematical test for second grade (1.2 years after FCAT). Methods: A total of 362 Japanese first- and second-grade children participated. A new quick test measuring fundamental calculative abilities, the FCAT, ordinal, radix, addition, and subtraction, was conducted for the first graders (mean age: 7.1 years). Mathematical school achievement was measured during the tests [mathematics curriculum-based test in Tottori Prefecture (MCBT)] for first (MCBT-1, mean age: 7.3 years) and second graders (MCBT-2, mean age: 8.3 years). We analyzed the associations between FCAT and MCBT-1 and 2 using univariate regression analysis, and cutoff values for mathematical learning difficulty (MLD) at MCBT-2 using the rating operation curve and Youden index. MLD was set as a score of lower than 20% on the MCBT. Results: The FCAT score was significantly associated with the MCBT-1 (regression coefficient: 0.67, P < 0.001) and MCBT-2 scores (regression coefficient: 0.50, P < 0.001). A cutoff value of 47 points (deviation score: 47) at the FCAT score predicted MLD at MCBT-2 (sensitivity: 0.77, specificity: 0.73). For 62 participants with MLD at MCBT-1 score, FCAT scores below the cutoff value of 40 points (deviation score: 35) were at high risk of MLD at MCBT-2 (odds ratio: 6.2). Conclusion: The FCAT is easily conducted in a short time during regular schools and can predict mathematical school achievement. It can be used for the early diagnosis of children with mathematical problems

c-jun is differentially expressed in embryonic and adult neural precursor cells

c-jun, a major component of AP-1 transcription factor, has a wide variety of functions. In the embryonic brain, c-jun mRNA is abundantly expressed in germinal layers around the ventricles. Although the subventricular zone (SVZ) of the adult brain is a derivative of embryonic germinal layers and contains neural precursor cells (NPCs), the c-jun expression pattern is not clear. To study the function of c-jun in adult neurogenesis, we analyzed c-jun expression in the adult SVZ by immunohistochemistry and compared it with that of the embryonic brain. We found that almost all proliferating embryonic NPCs expressed c-jun, but the number of c-jun immunopositive cells among proliferating adult NPCs was about half. In addition, c-jun was hardly expressed in post-mitotic migrating neurons in the embryonic brain, but the majority of c-jun immunopositive cells were tangentially migrating neuroblasts heading toward the olfactory bulb in the adult brain. In addition, status epilepticus is known to enhance the transient proliferation of adult NPCs, but the c-jun expression pattern was not significantly affected. These expression patterns suggest that c-jun has a pivotal role in the proliferation of embryonic NPCs, but it has also other roles in adult neurogenesis

A study of the utilization of welfare systems by patients with severe motor and intellectual disabilities and their families

The number of severe motor and intellectual disability（SMID）patients is increasing; however, the number of welfare systems to ease their families' burden, such as home nursing station and day-care center, are insufficient so far. The purpose of this study was to examine the utilization of welfare systems by SMID patients and their parents and determine the facilities required to live in their home. We interviewed parents of 30 SMID patients who visited our outpatient clinic in the Tottori University Hospital, according to a structured questionnaire. The results showed that the utilization of home nursing, day care, and respite care were low（23.3%, 40.0%, and 33.3%, respectively）, whereas the requirement for these services were high. In addition, a regional disparity was observed concerning the utilization of welfare systems. Therefore, there is a need for the establishment and expansion of welfare systems that support daily life of SMID patients and their families at home

A Study on the Incidence and Comorbidities of Autism Spectrum Disorders Accompanied by Intellectual Disabilities in Yonago City, Japan

[Background] Autism spectrum disorders (ASD) with intellectual disabilities may be associated with many factors. This study focused on patients with ASD with intellectual disabilities, defined by a threshold intelligence quotient (IQ) or development quotient (DQ) of 70. We also discuss comorbidities and other factors related to ASD. [Methods] We extracted case records of patients born between April 1995 and March 2001 who lived in Yonago City, as of January 2011, and had visited the two specialist institutions for consultation regarding developmental issues. The list was further narrowed down to patients identified, as having ASD by pediatric neurologists based on Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5). We selected patients with < IQ/DQ 70 using the most recent intelligence/development test to determine comorbidities and other factors related to ASD. [Results] The data of 81 patients (59 males and 22 females) were extracted, corresponding to an incidence of 76.2 patients out of every 10,000 births. The male-to-female ratio was 2.7:1. Comorbidities and related factors of ASD were observed in 25 cases (30.9%). Eleven cases had perinatal abnormalities. Other abnormalities were observed in 17 cases, including epilepsies in 7, chromosomal abnormalities in 4, familial mental retardation in 1, and acquired brain injury in 1. [Conclusion] It is important to treat and support individuals with ASD and intellectual disabilities taking into account the characteristics and prognosis of the comorbidities and related factors