Executive functions and their relationship with intellectual capacity and age in schoolchildren with intellectual disability

Background: There is certain empirical evidence of, on the one hand, a positive correlation between executive functions (EFs) and intelligence in people with intellectual disability (ID) and, on the other hand, a slower rate of development of EFs in these people relative to people without ID. This evidence is not, however, unequivocal, and further studies are required. Methods: We analysed the relationship between development of EFs and both age and intellectual capacity, in a sample of 106 students with either ID or borderline intellectual functioning (BIF) at a special education centre [63 boys and 43 girls, 11-18 years old, mean total intelligence quotient (TIQ) of 59.6]. We applied nine instruments to evaluate both neuropsychological development (working memory, inhibitory control, cognitive flexibility, planning, processing speed and verbal fluency) and behavioural development [teachers' perceptions of the EFs of their students by Behavior Rating Inventory of Executive Function - Second Edition (BRIEF-2) School]. ID and BIF groups were statistically compared in terms of mean performance measures in EF tests. We looked at the correlation between EFs and age, and correlations between EFs and intelligence: TIQ, fluid intelligence [measured by the perceptual reasoning (PR) sub-index of Wechsler Intelligence Scale for Children-IV (WISC-IV)] and crystallised intelligence (measured by the verbal comprehension (VC) sub-index of WISC-IV). Regression models were built for variables with strong correlation. Results: In most of the tests used to evaluate EFs, the ID subgroup performed significantly worse than the subgroup with BIF. In general, teachers' thought that participants had 'medium-low' levels of EFs. TIQ, by WISC-IV scale, correlated significantly with scores in all tests for all EFs. The PR sub-index correlated significantly with 14 of the tests for EFs; 35% of the variation in PR can be explained by variation in performance in Picture Span (working memory) and Mazes (planning). The VC sub-index correlated weakly with seven of the EF tests. We found significant correlations in the ID group between age and scores in all tests of working memory and inhibitory control. Age - considering all participants - did not correlate with any of the variables of teachers' perception except for working memory, and this correlation was not strong. Conclusions: The results of our study are consistent with descriptions of the typical population: (1) fluid intelligence is more related to EFs than crystallised intelligence is; and (2) working memory capacity is the EF most strongly related with general, fluid and crystallised forms of intelligence. The results suggest that as children and adolescents with ID/BIF get older, their capacities for working memory and inhibitory control increase; development of the other EFs studied was less evident. Teachers' perceptions of the EFs of children with ID or BIF were independent of intellectual capacity and age. More research is needed to delve further into the development of EFs in people with ID/BIF

Impact of Using Unedited CT-Based DIR-Propagated Autocontours on Online ART for Pancreatic SBRT

PURPOSE: To determine the dosimetric impact of using unedited autocontours in daily plan adaptation of patients with locally advanced pancreatic cancer (LAPC) treated with stereotactic body radiotherapy using tumor tracking. MATERIALS AND METHODS: The study included 98 daily CT scans of 35 LAPC patients. All scans were manually contoured (MAN), and included the PTV and main organs-at-risk (OAR): stomach, duodenum and bowel. Precision and MIM deformable image registration (DIR) methods followed by contour propagation were used to generate autocontour sets on the daily CT scans. Autocontours remained unedited, and were compared to MAN on the whole organs and at 3, 1 and 0.5 cm from the PTV. Manual and autocontoured OAR were used to generate daily plans using the VOLO™ optimizer, and were compared to non-adapted plans. Resulting planned doses were compared based on PTV coverage and OAR dose-constraints. RESULTS: Overall, both algorithms reported a high agreement between unclipped MAN and autocontours, but showed worse results when being evaluated on the clipped structures at 1 cm and 0.5 cm from the PTV. Replanning with unedited autocontours resulted in better OAR sparing than non-adapted plans for 95% and 84% plans optimized using Precision and MIM autocontours, respectively, and obeyed OAR constraints in 64% and 56% of replans. CONCLUSION: For the majority of fractions, manual correction of autocontours could be avoided or be limited to the region closest to the PTV. This practice could further reduce the overall timings of adaptive radiotherapy workflows for patients with LAPC

Estilo comportamental al inicio del segundo año de vida:estudio retrospectivo en escolares afectados de trastorno por deficit de atencion e hiperactividad

OBJECTIVES: To study the relationship between behavioural profile of children suffering from Attention Deficit Hyperactivity Disorder (ADHD) and the previous behavioural style of these patients as toddlers. SUBJECTS AND METHODS: We asked the parents of 50 schoolchildren with ADHD, and those of 30 controls, to fill in a Spanish version of the Toddler Behaviour Questionnaire (TBQ) from their retrospective perception of their children's behaviour as toddlers. TBQ items were grouped by factor analysis; t-Student between the scores of both groups and a multiple correlation analysis of TBQ and DSM-IV-ADHD-RS in each of the groups were used. RESULTS: Children in the ADHD group were reported by parents to have had a different toddler behavioural profile in comparison to that of control children (P<0.05). These differences were associated with adapting to new environments, mood, regularity and stability of play behaviour. A correlation was found between behavioural profile in DSM-IV-ADHD- RS and TBQ. CONCLUSIONS: The results of this study should be interpreted with caution. However, they suggest that in the fifth trimester of life a particular behavioural style as regards regularity, stability of play, and mood, could indicate a risk of developing ADHD in the future. This behavioural style should be taken into consideration in rearing and early education prospective studies

Technical feasibility of online adaptive stereotactic treatments in the abdomen on a robotic radiosurgery system

BACKGROUND AND PURPOSE: Stereotactic body radiotherapy (SBRT) has been proven to be beneficial for several disease sites in the (lower) abdomen. However, the quality of the treatment plan, based on a single planning computed tomography (CT), can be compromised due to large inter-fraction motion of the target and organs at risk (OARs) in this anatomical region. The aim of this study was to investigate the feasibility of online adaptive SBRT treatments on a robotic radiosurgery system and to record estimated total treatment times. MATERIALS AND METHODS: For two disease sites, locally advanced pancreatic cancer (LAPC) and oligometastatic lymph nodes, four patients with repeat CTs were included in the feasibility study. Quick treatment plan templates were generated based on the planning CT and validated by running them on the plan and fraction CTs. For two cases a dummy run was performed and the individual steps were timed. Dose delivery was the largest contributor to the total treatment time, followed by contour adaptation. RESULTS: Running the quick plan templates resulted in plans similar to unrestricted plans, obeying the OAR constraints. The dummy runs showed that online adaptive treatments were completed in 64 to 83 min respectively for oligometastases and LAPC, comparable to other clinically available solutions. CONCLUSIONS: This study showed the feasibility of online re-planning for two challenging disease sites within a clinically acceptable time frame on a robotic radiosurgery system, making use of commercially available elements that are not integrated by the vendor

Disfunción de la coherencia central en niños con trastorno de aprendizaje procedimental [réplica]

Introducción. Los niños con trastorno de aprendizaje procedimental (TAP) tienen dificultades para percatarse rápidamente de la coherencia o incoherencia de un material complejo y describirlo verbalmente. Objetivo. Estudiar la capacidad de escolares con TAP para percatarse de las incoherencias presentes en dos imágenes complejas. Sujetos y métodos. Se muestran el test de imagen quimérica y la escena visual incoherente a 200 escolares: 20 afectos de TAP, 60 con trastorno por déficit de atención/hiperactividad (TDAH), 60 con TDAH + TAP y 60 escolares típicos como grupo control. Se comparan las respuestas de todos los grupos mediante chi al cuadrado. Se calcula la sensibilidad, eficiencia y especificidad de cada prueba por separado y se realiza análisis discriminante según el rendimiento conjunto en ambas. Resultados. El rendimiento en los dos grupos con TAP es inferior al de los grupos control y TDAH, tanto en el test de imagen quimérica como en la escena visual incoherente. El 93 y el 92% de los niños que, respectivamente, rinden bajo en el test de imagen quimérica y en la escena visual incoherente están afectos de TAP (con o sin TDAH comórbido). El 87% de los sujetos con TDAH + TAP falla en una de las pruebas o en ambas, mientras que sólo lo hace el 15% de los niños con TDAH. Conclusiones. Las dificultades específicas para la comprensión rápida, simultánea y coherente de imágenes o escenas complejas, que forman parte del perfil neuropsicológico del TAP, son detectables mediante el test de imagen quimérica y la escena visual incoherente. Estos instrumentos se han revelado altamente sensibles, eficaces y específicos

I Jornada de experiencias del Programa de Psicología

Las Jornadas de experiencia pretenden ser una ocasión que brinde a los alumnos de Prácticum de todos los Grados de la Facultad de Educación y Psicología. Compartir su experiencia de prácticas entre ellos, con sus profesores y con los compañeros de otros cursos, especialmente con aquellos que todavía no han realizado el Prácticum o están buscando un centro para hacer prácticas voluntarias. A través de la presentación oral, de un póster o de un e-portafolio, los alumnos darán a conocer los proyectos de investigación-acción o de aprendizaje-servicio que han llevado a cabo durante el Prácticum. En sus exposiciones, mostrarán cómo han aplicado a la práctica la teoría aprendida en las diversas asignaturas de los Grados y compartirán el desarrollo competencial que esta experiencia les ha permitido realizar. Además, facilitarán a los profesores conocer, de una forma más directa, las necesidades o aspectos de mejora que los alumnos han detectado en los centros de prácticas y ayudarán a identificar posibles líneas de investigación y proyectos que podrán realizarse en colaboración con los colegios, gabinetes, hospitales, fundaciones, empresas y diversas instituciones en las que los alumnos realizan el Prácticum

La adaptación al castellano de la Children’s Communication Checklist permite detectar las dificultades en el uso pragmático del lenguaje y diferenciar subtipos clínicos

Introducción. La Children’s Communication Checklist (CCC) de Bishop es una prueba útil para la valoración de la pragmática verbal en los escolares. El objetivo del trabajo es comprobar la fiabilidad y la validez de esta escala en castellano. Sujetos y métodos. Se analiza la CCC contestada por los padres de 360 niños/as de 4-12 años, con inteligencia normal, 160 controles y 200 de cuatro grupos clínicos: trastorno por déficit de atención/hiperactividad (n = 68), trastorno de aprendizaje no verbal procedimental (n = 77), trastorno de la comunicación social (n = 25) y trastornos del espectro autista de nivel 1 (n = 30). Se realizan análisis: factorial para agrupar los ítems del cuestionario, de fiabilidad de las nuevas escalas y discriminante para comprobar si clasifica bien a los afectos de dificultades en el uso del lenguaje. Resultados. Se obtienen siete factores (Kaiser-Meyer-Olkin: 0,852) con moderada similitud a las de la CCC original: relaciones sociales, intereses y otros cinco que constituyen pragmática (habilidades conversacionales, coherencia-comprensión, compenetración, comunicación no verbal y pertinencia). La correlación es significativa entre todos ellos, en el grupo control, y entre los cinco que configuran pragmática, en los grupos clínicos (r de Pearson). La fiabilidad de las escalas es buena (alfa de Cronbach: 0,914). El cuestionario clasifica bien al 98,9% de los casos agrupados con y sin trastorno pragmático; y al 78% de los participantes en sus correspondientes grupos clínicos. Además, permite diferenciar las patologías según la presencia e intensidad de los síntomas. Conclusiones. Esta versión española de la CCC es altamente válida y fiable. Los estadísticos aportados pueden utilizarse como valores de referencia

Risk of unintentional injuries in children and adolescents with ADHD and the impact of ADHD medications: protocol for a systematic review and meta-analysis

Introduction Attention-deficit hyperactivity disorder (ADHD) has been related to increased rates of unintentional injuries. However, the magnitude of the effect and to which extent variables such as sex, age or comorbidity can influence this relationship is unknown. Additionally, and importantly, it is unclear if, and to which degree, ADHD medications can decrease the number of unintentional injuries. Due to the amount of economic and social resources invested in the treatment of injuries, filling these gaps in the literature is highly relevant from a public health standpoint. Here, we present a protocol for a systematic review and meta-analysis to estimate the relationship between ADHD and unintentional injuries and assess the impact of pharmacological treatment for ADHD Methods and analysis We will combine results from 114 bibliographic databases for studies relating ADHD and risk of injuries. Bibliographic searches and data extraction will be carried out independently by two researchers. The studies’ risk of bias will be assessed using the Newcastle-Ottawa Scale. Articles reporting ORs or HRs of suffering an injury in ADHD compared with controls (or enough data to calculate them) will be combined using Robust Variance Estimation, a method that permits to include multiple non-independent outcomes in the analysis. All analyses will be carried out in Stata. Age, sex and comorbid conduct disorders will be considered as potential causes of variance and their effect analysed through meta-regression and subgroup analysis. Sensitivity analyses will exclude articles with longer follow-ups, non-stringent definitions of ADHD or controls and statistically uncontrolled/controlled outcomes. Studies implementing a self-controlled case series methodology to investigate if ADHD drugs reduce the risk of injuries will be combined with a generalised linear mixed model using the Poisson distribution and a log link function