Differences in pragmatic communication skills of adults with intellectual disabilities and dual diagnoses.

Introduction: Pragmatics includes a set of skills related to language structure and meaning that allow the speaker to use the language appropriately and in accordance with different communication situations. The aim of this research was to determine the differences in pragmatic communication skills of adults with intellectual disabilities, dual diagnoses, and typical development, and to determine the effects of gender, age, the level of intellectual functioning and speech comprehension on their achievements on two assessment instruments. Methods: The sample included 180 adults (60 typically developing participants, 60 with intellectual disabilities, and 60 participants with dual diagnoses). We used two instruments to assess pragmatic communication skills - Communication Checklist - Adult, CC-A, and the Assessment Battery for Communication, ABaCo. In order to test the differences between the three groups of participants, we used canonical discriminant analysis. Results: Discriminant analysis revealed two significant canonical functions. Function one (speech comprehension and the level of intellectual disability, social engagement, and paralinguistic scale) differentiates between typically developing participants and participants with dual diagnoses the most. The second canonical function (language structure, linguistic scale, paralinguistic scale, extralinguistic scale, and context scale) differentiates between participants with intellectual disabilities and participants with dual diagnoses the most. According to the results, age did not affect pragmatic achievements. Discussion: Pragmatic skills are very complex, and different instruments measure different dimensions of these abilities. The results of this research lead to the conclusion that we can differentiate between the pragmatic abilities of typically developing people, people with intellectual disabilities, and those with dual diagnoses with the help of the ABaCo battery and the CC-A questionnaire.

Parent-teacher interactions, family stress, well-being, and parental depression as contributing factors to parental involvement mechanisms in education of children with autism.

Parental involvement (PI) in education contributes to numerous positive outcomes in children, including educational outcomes and social competence. The goal of the present study was to examine differences in PI mechanisms between parents of children with autism spectrum disorder (ASD) and parents of typically developing (TD) children. An additional goal was to examine factors affecting PI mechanisms in education in parents of children with ASD. The sample for this study consisted of 50 parents of children with ASD and 50 parents of TD children. The results of this study indicate that parents of children with ASD had lower levels of PI mechanisms in education than parents of TD children. The strongest predictors of PI mechanisms in education in parents of children with ASD were subjective well-being and child's emotional reactivity. Implications for future research and practice are discussed.

Searching for Best Predictors of Paralinguistic Comprehension and Production of Emotions in Communication in Adults With Moderate Intellectual Disability.

Paralinguistic comprehension and production of emotions in communication include the skills of recognizing and interpreting emotional states with the help of facial expressions, prosody and intonation. In the relevant scientific literature, the skills of paralinguistic comprehension and production of emotions in communication are related primarily to receptive language abilities, although some authors found also their correlations with intellectual abilities and acoustic features of the voice. Therefore, the aim of this study was to investigate which of the mentioned variables (receptive language ability, acoustic features of voice, intellectual ability, social-demographic), presents the most relevant predictor of paralinguistic comprehension and paralinguistic production of emotions in communication in adults with moderate intellectual disabilities (MID). The sample included 41 adults with MID, 20-49 years of age (M = 34.34, SD = 7.809), 29 of whom had MID of unknown etiology, while 12 had Down syndrome. All participants are native speakers of Serbian. Two subscales from The Assessment Battery for Communication - Paralinguistic comprehension of emotions in communication and Paralinguistic production of emotions in communication, were used to assess the examinees from the aspect of paralinguistic comprehension and production skills. For the graduation of examinees from the aspect of assumed predictor variables, the following instruments were used: Peabody Picture Vocabulary Test was used to assess receptive language abilities, Computerized Speech Lab ("Kay Elemetrics" Corp., model 4300) was used to assess acoustic features of voice, and Raven's Progressive Matrices were used to assess intellectual ability. Hierarchical regression analysis was applied to investigate to which extent the proposed variables present an actual predictor variables for paralinguistic comprehension and production of emotions in communication as dependent variables. The results of this analysis showed that only receptive language skills had statistically significant predictive value for paralinguistic comprehension of emotions (ß = 0.468, t = 2.236, p < 0.05), while the factor related to voice frequency and interruptions, form the domain of acoustic voice characteristics, displays predictive value for paralinguistic production of emotions (ß = 0.280, t = 2.076, p < 0.05). Consequently, this study, in the adult population with MID, evidenced a greater importance of voice and language in relation to intellectual abilities in understanding and producing emotions.

Positive Effects of the Caregiver Skill Training Program on Children With Developmental Disabilities: Experiences From Serbia.

Background: Intervention programs for children with developmental disabilities increasingly target caregiver training to implement effective strategies for child development. Research conducted in different countries shows that the Caregiver Skills Training Program (CST) developed by the World Health Organization and Autism Speaks could also be a recommended intervention. Methods: The pre-pilot phase included seven, and the pilot phase included 29 families of children with developmental disabilities trained to implement the intervention program. The caregivers were asked to complete the Autism Treatment Evaluation Checklist at the beginning and at the end of the program. Results: In the pre-pilot phase, the Wilcoxon signed-rank test determined a statistically significant improvement in Speech, Language and Communication (z = -2.99, p < 0.05) and Health/Physical/Behavior (z = -2.375, p < 0.05) after caregiver participation in the training program. In the pilot phase, the paired t-test also determined a statistically significant improvement in Speech, Language and Communication between the first (M = 24.52, SD = 5.57) and the second testing (M = 25.66, SD = 6.11), t(28) = -2.29, p < 0.05, as well as a significant improvement between the first (M = 36.62; SD = 7.15) and the second testing (M = 35.38; SD = 5.91), t(28) = 2.11, p < 0.05 in Health/Physical/Behavior. Eta squared values (0.16 and 0.14) indicate that the intervention effect was significant. No differences were determined in Sociability and Sensory/Cognitive Awareness between the first and the second testing. Conclusion: The initial results of the Caregiver Skills Training Program are encouraging. For this program to be recommended as an evidence-based intervention, further research should be conducted on larger samples, controlling possible intervening variables.

Social Cognition in Patients With Cerebellar Neurodegenerative Disorders.

OBJECTIVE: Cerebellar neurodegenerative disorders (CDs) are a heterogeneous group of disorders. It is known that the cerebellum plays a role not only in motor, but also in cognitive and social cognitive functions. The aim of this study was to investigate social cognition in patients with different CDs. MATERIALS AND METHODS: Social cognition was examined in 34 patients, 12 with spinocerebellar ataxia type 1 (SCA1), 6 with spinocerebellar ataxia type 2 (SCA2), and 16 with idiopathic late onset cerebellar ataxia (ILOCA). All patients were clinically evaluated using the Scale for the Rating and Assessment of Ataxia. In addition, 34 age, sex, and education-matched healthy control (HC) subjects were similarly analyzed. Social cognition was studied using two tests: the Faux Pas Recognition Test and the Reading the Mind in the Eyes Test (RMET). An appropriate array of neuropsychological tests was used to assess the global cognitive status as well as the frontal functions and mood. RESULTS: CD patients achieved significantly worse results on both tests of social cognition compared to the HCs. The SCA1 + 2 group achieved the poorest results on the Faux Pas Recognition Test and exhibited poor performance on all cognitive tests, but was only significantly worse compared to the ILOCA group on the Free and Cued Selective Reminding Test (FCSRT) - recognition. The patients in the SCA1 + 2 and ILOCA groups obtained similar scores on RMET. In the SCA1 + 2 group the findings significantly correlated with clinical parameters of disease severity and duration and executive functions (EFs), and with mood and executive functions in the ILOCA group. In the SCA group EFs appeared as the only significant predictor of RMET achievement. The Boston Naming Test (BTN) was a significant predictor of the CD patients' achievement on RMET, while the BTN, the Trail Making Test Part A and FCSRT - Delayed free recall predicted their performance on the Faux Pas Recognition Test. CONCLUSION: Patients with CD have social cognitive impairments as demonstrated by the Faux Pas Test and the RMET test results. The SCA1 and 2 patients exhibited a more pronounced impairment compared with the ILOCA patients. The independent cognitive predictors of social cognition impairment were EFs and language.

A Demonstration Project for the Utility of Kinect-Based Educational Games to Benefit Motor Skills of Children with ASD.

Motor disorders often accompany autism spectrum disorder (ASD), although they are not included in its diagnostic criteria. Slower motor development is evident in early childhood in this population, making early motor skills intervention advisable. As educational games and modern technology can represent new forms of treatment, this study evaluated four Kinect-based visuo-motor games called Fruits that were specially designed for this research. We sought to test whether children with ASD would show behavior changes during their game play and whether any effects would generalize to another game called Rackets. The study included 10 elementary school children with ASD, aged 9-13 years, who were divided into (a) an experimental group (n = 5) who, in addition to standard treatment, played Fruits once a week for a 5-week period and Rackets both before and after the 5-week period and (b) a control group (n = 5) who received only standard treatment during this period and also played Rackets before and after it. We found significant improvements in gross motor skills and successful generalization of acquired skills among children in the experimental group relative to the control group. The experimental group also showed an increase in positive emotions and a decrease in loss of attention while playing the games. These preliminary findings indicate a motor skill benefit for children with ASD who play Kinect-based educational games, but further research is needed to replicate and expand these findings with larger participant samples.

Paralinguistic abilities of adults with intellectual disability.

The aim of this research was to determine the ability level of paralinguistic production and comprehension in adults with intellectual disability (ID) with regard to the level of their intellectual functioning and presence of co-morbid psychiatric conditions or dual diagnosis (DD). The sample consisted of 120 participants of both genders, ranging in age between 20 and 56 years (M=31.82, SD=8.702). Approximately 50% of the sample comprised participants with a co-existing psychiatric condition. Each of these two sub-samples (those with ID only and those with DD) consisted of 25 participants with mild ID and 35 participants with moderate ID. The paralinguistic scale from The Assessment Battery for Communication (ABaCo; Sacco et al., 2008) was used to assess the abilities of comprehension and production of paralinguistic elements. The results showed that the participants with mild ID are more successful than the participants with moderate ID both in paralinguistic comprehension tasks (p=.000) and in paralinguistic production tasks (p=.001). Additionally, the results indicated the presence of separate influences of both ID levels on all of the paralinguistic abilities (F [116]=42.549, p=.000) and the existence of DD (F [116]=18.215, p=.000).

Population pharmacokinetics of 25-hydroxyvitamin D in healthy young adults.

OBJECTIVES: The aim of our study was to develop a population pharmacokinetic (PPK) model for 25-hydroxyvitamin D clearance in a healthy young adult population in Serbia. METHODS: Study sample consisted of 70 healthy young students of the Faculty of Medical Science, University of Kragujevac, Serbia, with a mean age and body mass index of 22.39 ± 1.82 years and 21.31 ± 2.69 kgm-2, respectively. Non-linear mixed-effect modeling (NONMEM) software was used for data analysis. A validation set of 16 participants was used to estimate the predictive performance of the pharmacokinetic model. RESULTS: In the base model (without covariates), we had parameter estimates of 0.01 L/h for apparent clearance, 0.25 L for apparent volume of distribution, while value of minimum objective function (MOF) was 383.468. The full regression model was established by estimating the effects of 12 covariates. Mean intake of vitamin D from foods (DD) and value of phosphate in serum (PHO) were covariates included in the final model, while others were excluded in this process. The estimated value in the final MOF model was 274.555. The final regression model formula was: clearance (CL) (L/h) = 0.0711 + 0.738 x DD + 0.618 x PHO. CONCLUSIONS: The PPK model obtained determined clearance of 25-hydroxyvitamin D in a healthy young adult population in Serbia. Mean intake of vitamin D from foods and serum phosphate level are the most important covariates that influence value of 25-hydroxyvitamin D clearance in healthy young adults.

Students' and teachers' perceptions of aggressive behaviour in adolescents with intellectual disability and typically developing adolescents.

This study investigated aggressive behaviour in Serbian adolescents with intellectual disability (ID) compared to typically developing peers. The sample consisted of both male and female adolescents aged 12-18 years. One hundred of the adolescents had ID, and 348 adolescents did not have ID. The adolescents were asked to complete the Reactive-Proactive Aggression Questionnaire (RPQ), and their teachers provided ratings of aggression for the adolescents using the Children's Scale of Hostility and Aggression: Reactive-Proactive (C-SHARP). Results indicated that adolescents reported a higher prevalence of aggressive behaviour than their teachers. Reactive aggression was more prevalent than proactive aggression in both subsamples. In the subsample of adolescents with ID, there were no sex or age differences for aggression. However, in the normative subsample, boys and older adolescents scored significantly higher on aggression. According to adolescent self-reports the prevalence of aggression was higher in adolescents without ID, while teachers perceived aggressive behaviour to be more prevalent in adolescents with ID. Scientific and practical implications are discussed.

Factor structure of the Serbian version of the Children's Communication Checklist-2.

Keeping in mind that traditional tests were largely insensitive to pragmatic impairment, Bishop (2003) created a second version of the Children's Communication Checklist (CCC-2) in order to identify pragmatic deficits in children with communication problems. Unfortunately, it was revealed that certain subscales of the Serbian version of the CCC-2 have unacceptably low internal consistency. Because dividing the test into original subscales did not apply for the Serbian population, the aim of this paper was to determine the factor structure of the CCC-2. The sample consisted of 1344 typically developing, monolingual participants of both sexes, aged from 4 to 17 (M = 9.52; SD = 2.72). Participants were recruited from three statistical regions in Serbia. All participants attended regular kindergarten, elementary or secondary schools. CCC-2 factor analysis was determined by using the principal component method, with Varimax rotation of principal axes. A factor analysis showed that the CCC-2 had three factors (General Communication Ability, Pragmatics and Structural Language Aspects), which accounted for 29.39% of the total variance. A three-factor solution should be further confirmed in the course of a clinical validation of the CCC-2.

Effects of exercise on physical fitness in children with intellectual disability.

This paper presents the results of the study which examined the effects of carefully designed physical exercise programs on the development of physical fitness in children with ID. The study sample consisted of 42 children with ID and 45 typically developing children. All the participants were assessed using Eurofit Test Battery. The results were analyzed in terms of participation in the exercise program and level of intellectual functioning. While ID children scored significantly lower on fitness tests when compared with typically developing children, the study revealed an association between degree of ID and physical fitness.