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

Positive and negative effects of collaboration on suggestibility and false memory in online groups

Previous studies demonstrated the positive and negative efects of collaboration on memory (both veridical and false recall) and suggestibility in face-to-face contexts. However, it remains unclear whether the same results can be observed in a virtual context. To clarify this issue, the present study examined the performance of 10 nominal triads and 10 collaborative triads in a fully online setting. Participants interacted live, in videoconference and were tested with the Gudjonsson Suggestibility Scale (GSS) and the Deese/Roediger-McDermott (DRM) task. For the GSS, the results replicated the in-person pattern of results, with collaborative triads showing the standard inhibition efect in the immediate and delayed (after 24 h) recall tasks; in addition, collaborative triads were less suggestible than nominal triads. For the DRM, we likewise found that collaboration decreased the recall and recognition of both studied items (the standard inhibitory effect) and critical lures (the error-pruning effect). We therefore conclude that remembering in a virtual context exhibits the same general properties as its in-person counterpart, at least when using a videoconference setting

Autobiographical memory in contact tracing: evidence from the COVID-19 pandemic

IntroductionThe recent COVID-19 pandemic has compelled various governments to trace all contacts of a confirmed case, as well as to identify the locations visited by infected individuals. This task, that requires the activation of our autobiographical memories, can make a difference in the spread of the contagion and was based primarily on telephone interviews with infected people. In this study, we examined whether participants were able to provide contact tracing information and whether their memories were influenced by salient events occurring during the initial phases of the pandemic.MethodsParticipants were asked to fill in an online standardized form in which they recounted every day of the 2 weeks before, reporting as much information as possible. The time period selected included, among other things, the day on which the Italian government issued the decree initiating the COVID-19 lockdown. The task was completed twice, the first time relying solely on their memory, and the second time using external aids (diaries, mobile phones etc.). Reports were then coded using a scheme that segmented accounts into informational details, divided into two broad categories, internal and external.ResultsOur findings showed that (i) the use of external aids was effective only when participants had to recall the day furthest away or if to-be-recalled events have low distinctiveness, and (ii) memories of internal details were recalled better than memories of external details. Participants were overall accurate and reported a large amount of information about people and places. However, because of the connection with key pandemic-related events, the effect was somewhat stronger on specific days (e.g., the day in which the lockdown was announced).DiscussionThe results of this work could provide a useful tool for improving the design of contact tracing procedures in the event of an unwanted future public health crisis caused by a highly infectious agent

COVID-19: parental vaccine hesitancy and misinformation in Italy

According to the Strategic Advisory Group of Experts on Immunization (SAGE), vaccine hesitancy can be defined as the “delayed acceptance or refusal of vaccination despite the availability of vaccination services” (MacDonald, 2015) and it is one of the top 10 global health threats (WHO, 2019). From January 2021, the Italian Government implemented a vaccination program aiming at vaccinating most of the population (Bloom et al., 2020). It is important to point out that, following a general decrease in adherence to vaccination programs in Italy, in July 2017 the Parliament issued an ad-hoc decree law (n.119/2017), introducing compulsory vaccinations for infants and recommending their exclusion from nursery schools if not vaccinated. A controversy ensued, as a no-vax movement emerged to oppose to the new law and dispute its compliance with the Italian Constitution. The movement continued to develop during the COVID-19 pandemic, and anti-vax groups proliferated, particularly in the northern regions of the country (Moscardino et al., 2022). A crucial factor influencing vaccine hesitancy is the dissemination of false, misleading information, such as the proliferation of anti-Vax groups on social media (Johnson et al., 2020). A recent study found that belief in misinformation was associated with lower intention to be vaccinated against COVID-19 across 40 countries (Singh et al., Santirocchi et al., 2022). The present study investigates the factors influencing parents' hesitation to vaccinate their children against COVID-19. It aims to: 1) examine whether there are differences in the willingness to vaccinate children of different ages; 2) assess the role of exposure to fake news as a variable that could reduce the willingness to vaccinate one's children and receive the fourth dose. Method: A questionnaire assessing disinformation and vaccine availability towards children was prepared using Google Forms and disseminated to parents through different social media. All data were collected between 5th February and 5th June 2022 and is from an empirical study. We collected 100 participants. Results: We performed a one-way ANOVA with “child age” (18-15, 14-12, 11-5) as the independent variable and “availability” as the dependent variable. The results showed a significant difference between the three groups [F(2,97)=15.38, p<0.01]. Post hoc analysis revealed that the parents of the 15-18 group showed significantly lower availability compared to parents of the 12-14 group and of the 5-11 group. A negative correlation [r(98)=-0.35, p<0.001] emerged between belief of misinformation and availability to vaccinate children, showing that higher levels of misinformation are associated to higher hesitancy. Conclusions: High rates of parental hesitancy towards adolescents could be driven by a combination of low perception of infection susceptibility and higher protective behaviours aiming at exerting control (Musa et al., 2021). Furthermore, the results of our study highlight the danger of the “infodemic” the population is experiencing. In a historical period characterized by the fight against COVID-19, it is evident how fake news can undermine the population's choices on vaccines. We therefore consider it useful that strategies are developed to counteract misinformation and provide the appropriate means for the population to recognize them

Overcoming navigational challenges: A novel approach to the study and assessment of topographical orientation

Several studies investigating environmental navigation require participants to navigate in virtual environments, in which the proprioceptive and vestibular components present during real environmental navigation are lost. Here, we aimed to provide a novel computerized ecological navigational battery, investigating whether the absence of proprioceptive and vestibular inputs yields a representation of the navigational space comparable to that acquired ecologically. In Study 1, 38 participants underwent two sets of tasks, one performed in a laboratory-based setting (LBS) and the other in an ecological environment (EE), with both including evaluation of route, landmark, and survey knowledge and a landmark ordering task. All tasks, except the route task, significantly correlated between EE and LBS. In LBS, performance in the landmark ordering task was predicted by that in the survey task, but not by those in the route and landmark tasks. Results of Study 1 were replicated in Study 2, in which 44 participants completed a modified and shorter online version of LBS tests. Reliability of the online LBS tests was also tested and showed a moderate-to-high internal consistency. Overall, results show that the conditions in which tasks are performed affect the acquisition of route knowledge, likely due to the lack of proprioceptive and vestibular information in LBS. However, LBS tasks presented here provide a standard battery of tests that can overcome the replicability problems encountered by ecological navigation tests, while taking into consideration all the complexities of navigational processes in terms of the use of landmark, route, and survey strategies

PERCIVAL, Italian Intensive Outreach Team for the treatment of adolescent psychiatric emergency in the territory of Milan: preliminary results of nine months of activities

Rationale : PERCIVAL project is inspired by the international paradigm of Intensive Outreach Teams– IOT, and has three goals: 1. To Provide appropriate and prompt treatment for adolescents in psychiatric emergency living in Milan 2. To Determine the need of specific CANP inpatients beds in Milan 3. To Assess the effectiveness, costs and applicability of the IOT model in the Italian territory Methods: “PERCIVAL” project is aimed at adolescents 12-18 yrs with psychiatric symptoms in the 1 (life threatening conditions with an immediate need for treatment) and 2 (severe symptoms requiring an urgent response) Rosenn and Gail classification. The psychiatric evaluation and the treatment plan design are conducted by a multiprofessional team. The assessment is composed by: Crisis Assessment Tool-CAT, HoNOS-CA, HEADS-ED, CBCL, CGI, CGAS, Difficulties Emotion Regulation Scale, Barratt Impulsiveness Scale, Risk Taking-Self Harm Inventory, Personality Inventory DSM 5, Columbia Suicide Severity Rating Scale, Broset Violence Checklist, Pediatric Quality of life Inventory, Who Quality of Life, Score 15, Stress Index Parents of Adolescents, Orbetello Satisfaction Scale. This assessment is performed at the beginning and at the conclusion of the treatment and is completed again during follow up visits (6 and 12 months). The individual treatments can be developed at home with different level of intensity; in the outpatient clinic through individual and/or group therapy sessions; if necessary through hospitalization in pediatric ward or adult psychiatric ward (if the patient is ?16 years and Rosenn/Gail class I ). Results: During the first 9 months (1/9/15-30/6/16) 45 patients (18 males and 27 females, in the 11.2 to 18 years age range) have been evaluated.34 patients (76%) met inclusion criteria: 24% class I and 76% class II; 58.8% were females and 41.2% males.19 patients accessed “PERCIVAL” via emergency room (56%), 11 through hospitalization (32%) and 4 as outpatients (12%). 59% had depression with suicide attempts or thoughts, severe personality disorder, post traumatic stress disorders; 18% psychosis or bipolar disorder; 9% severe behavioral disorders; other disorder (14%) were individually unrepresentative. 9 patients (24%) were substance abusers (mainly cannabis). Intensive treatment has been activated for 31/34 patients; the remaining three patients have been reoriented to other services. 52% (16 patients) have only received intensive outpatient or home treatment; 48% (15 patients) have also received short term hospitalization. Conclusions: An Italian adaptation of IOT can represent an effective intervention for adolescents with acute psychiatric symptoms, nonetheless for a subset of patient with very complex needs specific inpatient CANP beds are mandator

PERCIVAL project: Italian adaptation of Intensive Outreach Teams for the treatment of psychiatric emergencies in adolescence

Rationale: “PERCIVAL” project is conceived to guarantee appropriateness of care for patients and families in a situation of shortage of inpatient beds in Child and Adolescent Neuropsychiatry in the Milan region. Its intent is to offer a prompt response to acute psychiatric adolescent patients and their families, through an intensive pathway of care that may act in an outpatient setting, at home and in hospital as needed, as an alternative to ordinary hospitalization and to prevent residential care. The project will test the feasibility, effectiveness, costs, sustainability and applicability to the Italian reality of a modified IOT (Intensive Outreach Team) paradigm. Methods: The intended target population of “PERCIVAL” project are adolescents in the 12-18 age range who show psychiatric symptoms in the I and II Rosenn and Gail classification. The psychiatric evaluation and the treatment plan design are conducted by a multiprofessional team which includes 4 neuropsychiatrists, 1 psychologist, 1 social worker, 2 professional educators and 2 psychiatric rehabilitation experts.Protocol Description. The treatment goals are differentiated according to the clinical stage (pre acute, acute and post acute), and work up includes the following: • Diagnostic assessment • Triggers checklist • Risk assessment and symptoms management • Design and sharing of a crisis plan shaped on the patient and his community context • Design of a therapy plan focused on the patient and caregiver’s needs and strengths with the intent of: i) reducing hospitalizations ii) managing the acute symptoms; ii) empowering the family in dealing with new breakdown episodes. • Facilitation of the post-emergency care treatments within the locally available outpatient units The treatment includes 4 stages: 1. 0-2 weeks: assessment, crisis plan design and individual intensive treatment. The assessment is aimed at identifying i) actual psychopathological condition underlying the acute breakdown, ii) presence of self and etero aggressive behaviors, iii) global and family functioning, iv) quality of life. The CANS communimetric tool and its related versions (HEADS-ED and CAT) are used in order to plan the intervention and to evaluate and monitor the results of the treatment 2. 2-12 weeks: multidisciplinary treatment at patient’s home and in the community with different levels of intensity (high intensity: 5-7 treatments/week; medium intensity: 2-3 treatments/week; low intensity: 1-2 treatments/week). Individual treatments or small groups treatments, focusing on self harming behaviors or other behaviors that may disrupt or impair the functioning of the patient may be provided. 3. 2-3 weeks: new psychiatric evaluation, assessment of fulfilled goals and design of a new management plan for the transition to the territorial healthcare service 4. Follow up at 6 and 12 months. Conclusions: “PERCIVAL” project aims at verifying an innovative clinical approach (outreach) able to offer immediate and multi professional responses to adolescent psychiatric emergencies by identifying new strategies aimed to deal with the patient crisis in his family context, facilitating natural networks response, and managing the transition to the proper healthcare providers for the future