Exploring the impact of adverse childhood experiences on health and cognitive functions in older adults.

This study examines whether adverse childhood experiences (ACEs) predict long-term health issues and how ACEs, alongside stress, impact well-being and cognitive abilities in older adults. 279 adults were categorized into three age groups (30-46, 47-60, and 61-80). Participants completed an online survey assessing health problems, stress, resilience, and ACEs. Additionally, 32 older adults underwent cognitive tests. ACE scores predicted physical and psychological diseases in adults but not in older adults. However, a significant correlation between ACEs and cognitive abilities was evident in older participants. ACEs are significant indicators of long-term health issues and stress in adults but may not predict these factors in older individuals. Understanding ACEs' impact on cognitive abilities in older adults is crucial for tailored interventions and support.

Use of a low-tech tool in the improvement of social interaction of patients with Rett Syndrome: an observational study.

Introduction: The main aim of the present study was to examine whether the use of a low-tech tool, called click4all, inserted into cognitive and motor training can increase social interaction of patients with Rett Syndrome (RTT) with classmates in a school setting. Methods: Twenty-seven participants with RTT were randomly assigned to two groups: the experimental group received treatment with click4all, and the control group received traditional treatment without click4all. Parameters were measured before treatment (T1), 6 months after treatment (T2), 6 months after the second treatment phase (T3) and at the end of the third treatment phase (T4). Results: The results demonstrated an increase in levels of social interaction among classmates and patients with RTT in the experimental group, over time, compared to the control group, 95% CI [5.20-15.30]. Classmates also showed a higher level of knowledge related to participants of the experimental group, and this increased over time, 95% CI [24.98-63.52]. The level of knowledge related to the control group was stable over time and lower than the experimental group. Discussion: This study demonstrated that the use of a low-tech tool can increase social interactions of patients with RTT in a school setting. This is important, as patients with RTT are often restricted in an isolation condition.

Advancing theorizing about fast-and-slow thinking: The interplay between fast and slow processing.

We agree with the author's working model, but we suggest that (a) the classical distinction between fast and slow processes as separable processes can be softened, and (b) human performance might result from an interplay between fast and slow processing and these processes may be mediated by systems that evolve to satisfy the need for operation in a complex environment.

Repeated Motor Training on Attention Reaching Skills and Stereotypies in Rett Syndrome.

Background: Few studies investigated the effect of a structured and specific training for upper limb motor skills allowing complex movements such as reaching and grasping. Objective: The aim of this study was to examine the effects of motor training on attention, reaching skills, and stereotypies in patients with Rett syndrome (RTT). Methods: Twenty-eight participants with RTT underwent cognitive and motor assessment to evaluate attention, reaching skills and stereotypies with an ABABABA design: before training (pre-test phase), after a month of training (post-test phase 1), after a month of the second training phase (post-test phase 2) and at 1 month after the third training phase (post-test phase 3). In all three B phases, participants received 30 minutes of motor training for 5 days a week over a 1-month period. Results: Patients with RTT show long-term improvements in seconds of attention and reaching skills and decreases in the intensity of stereotypies. Conclusions: This study suggests that motor abilities of participants with RTT can be improved with repeated, individual, well-structured training.

Social Humanoid Robots for Children with Autism Spectrum Disorders: A Review of Modalities, Indications, and Pitfalls.

Robot-assisted therapy (RAT) is a promising area of translational neuroscience for children with autism spectrum disorders (ASDs). It has been widely demonstrated that this kind of advanced technological tool provides a reliable and efficient intervention for promoting social skills and communication in children with ASD. This type of treatment consists of a human-assisted social robot acting as an intervention mediator to increase competence and skills in children with ASD. Several social robots have been validated in the literature; however, an explicit technical comparison among devices has never been performed. For this reason, in this article, we provide an overview of the main commercial humanoid robots employed for ASD children with an emphasis on indications for use, pitfalls to be avoided, and recent advances. We conclude that, in the near future, a new generation of devices with high levels of mobility, availability, safety, and acceptability should be designed for improving the complex triadic interaction among teachers, children, and robots.

Static and Dynamic Assessment of Intelligence in ADHD Subtypes.

There is a debate about the measure of IQ in children with ADHD. Some studies report that, compared to static assessment procedures, dynamic assessment of intelligence can better measure cognitive modifiability and plasticity. The present study was designed to examine children belonging to different ADHD subtypes (inattentive, hyperactive/impulsive, and combined) in terms of both static (WISC scores) and dynamic measures (Modifiability index). Thirty-four children (12 ADHD-I, 10 ADHD-H, and 12 ADHD-C) were compared to a sample of 27 typically developing children. Results indicate that only the inattentive and the combined subtypes, compared with the normative sample, show lower IQ scores. The ADHD-I group presents generally low WISC scores and ADHD-H presents generally high WISC scores. Moreover, the ADHD-C group shows a low static score and a high dynamic score, indicating a wide breadth of Vygotskian children's zone of proximal development. Static and dynamic measurements together can indeed be considered a comprehensive examination of intelligence levels in ADHD children and may be essential in predicting learning capacities.

Visual-motor attention in children with ADHD: The role of automatic and controlled processes.

BACKGROUND: there are evidence that children with ADHD exhibit a deficit both in automatic and controlled processes. AIMS: the present study aimed to examine the visual-motor attention and the influence of cognitive load through a dual task paradigm in children with ADHD compared with typical developing children (TD). METHODS AND PROCEDURES: 113 children with ADHD: 40 with subtype inattentive (ADHD- I group), 16 with subtype hyperactive (ADHD-H group), 57 with subtype combined (ADHD-C group), and 113 TD children (TD group) were recruited. We used a dual-task paradigm in which the primary task was a figure-tracing test whereas the second task was a digit span test. A figure-tracing test was used to evaluate visual motor attention. Based on the length and intersection of the lines, the figures of the primary task were categorized into simple and complex. OUTCOMES AND RESULTS: the ADHD groups compared to the TD group showed a worse accuracy of performance in both condition with and without cognitive load. CONCLUSIONS AND IMPLICATIONS: The findings were discussed in light of the relationship between automatic and controlled processes involved in the visual-motor attention.

Comparing Advanced with Basic Telerehabilitation Technologies for Patients with Rett Syndrome-A Pilot Study on Behavioral Parameters.

The aim of this study is to compare the performances of patients with Rett syndrome that were undergoing advanced telerehabilitation (ATR) and patients that were undergoing basic telerehabilitation (BTR). It was hypothesized that patients that were undergoing ATR training would have better improvement in nearly all the motor and cognitive scale scoring activities that were administered, thus showing reduced disability. A total of 20 young girls and women with a diagnosis of RTT, ranging from age 4 to 31 years old (Median: 12.50; IQR: 9.50-17.25) underwent a pre-test, treatment post-test 1, treatment, and post-test 2 procedure. The treatment consisted of either ATR or BTR, lasting 10 weeks with three sessions a week of about an hour. The results showed that the group with advanced telerehabilitation improved their performance better than the control group only in some neuropsychological measurements. The results are discussed in the light of critical factors of telerehabilitation.

The role of automatic and controlled processes in the positivity effect for older adults.

BACKGROUND: The positivity effect can be defined as an age-related attentional preference for positive information. The age differences are due to an attentional bias in which the young focused more intently on the negative stimuli, whereas the older attend to capture positive stimuli. There are two cognitive-emotional models that can explain the positivity effect: the socio-emotional selectivity theory (SST) and the dynamic integration theory (DIT). The SST states that in the older the positivity effect is related to controlled attentional processes, on the opposite, the DIT states that the positivity effect is related to automatic processes. AIMS: The main aim of the present study was to examine automatic and controlled attentional orienting of young and older adults in the positivity effect. METHODS: To reach these goals and to verify the generalization of the previous results, we used two experimental paradigms: the dot-probe task and the visual discrimination task with facial stimuli with positive (happy and surprise), negative (fair and angry) and neutral emotional expressions. 50 older and 35 young adults participated in this study. RESULTS: The older adults reacted faster to positive emotions than neutral or negative ones. They had similar RTs for the three types of emotions in both automatic and controlled attention. DISCUSSION: The findings are discussed in light of SST and DIT theories. CONCLUSIONS: This study confirms the positivity effect for the older subjects and support the idea that both automatic and controlled processes play a key role in this effect.

Students with dyslexia between school and university: Post-diploma choices and the reasons that determine them. An Italian study.

Although the number of students with dyslexia enrolled in Italian universities is constantly growing, their presence remains relatively limited. The aim of this study was therefore to investigate the choices made by students with dyslexia in relation to university studies, and the underlying reasons for their choices. This study also compares these choices for students with and without dyslexia. In all, 440 high school students and their families agreed to take part in this project. Socio-demographic data was collected for the 47 students with dyslexia and 47 class-matched students without dyslexia, along with information on their current schools and their future educational plans. A specially developed questionnaire was used for the students, in combination with structured interviews with their families. The results show significant differences between these groups regarding both choices for university studies and the underlying motivations for these choices. Furthermore, certain psychological and emotional factors are implicated here in the decisions of the students with dyslexia regarding both university studies and their underlying reasons. Future research is needed to further investigate these factors in the educational choices of students with dyslexia.

Emotional Expression in Children With ASD: A Pre-Study on a Two-Group Pre-Post-Test Design Comparing Robot-Based and Computer-Based Training.

Several studies have found a delay in the development of facial emotion recognition and expression in children with an autism spectrum condition (ASC). Several interventions have been designed to help children to fill this gap. Most of them adopt technological devices (i.e., robots, computers, and avatars) as social mediators and reported evidence of improvement. Few interventions have aimed at promoting emotion recognition and expression abilities and, among these, most have focused on emotion recognition. Moreover, a crucial point is the generalization of the ability acquired during treatment to naturalistic interactions. This study aimed to evaluate the effectiveness of two technological-based interventions focused on the expression of basic emotions comparing a robot-based type of training with a "hybrid" computer-based one. Furthermore, we explored the engagement of the hybrid technological device introduced in the study as an intermediate step to facilitate the generalization of the acquired competencies in naturalistic settings. A two-group pre-post-test design was applied to a sample of 12 children (M = 9.33; ds = 2.19) with autism. The children were included in one of the two groups: group 1 received a robot-based type of training (n = 6); and group 2 received a computer-based type of training (n = 6). Pre- and post-intervention evaluations (i.e., time) of facial expression and production of four basic emotions (happiness, sadness, fear, and anger) were performed. Non-parametric ANOVAs found significant time effects between pre- and post-interventions on the ability to recognize sadness [t (1) = 7.35, p = 0.006; pre: M (ds) = 4.58 (0.51); post: M (ds) = 5], and to express happiness [t (1) = 5.72, p = 0.016; pre: M (ds) = 3.25 (1.81); post: M (ds) = 4.25 (1.76)], and sadness [t (1) = 10.89, p < 0; pre: M (ds) = 1.5 (1.32); post: M (ds) = 3.42 (1.78)]. The group*time interactions were significant for fear [t (1) = 1.019, p = 0.03] and anger expression [t (1) = 1.039, p = 0.03]. However, Mann-Whitney comparisons did not show significant differences between robot-based and computer-based training. Finally, no difference was found in the levels of engagement comparing the two groups in terms of the number of voice prompts given during interventions. Albeit the results are preliminary and should be interpreted with caution, this study suggests that two types of technology-based training, one mediated via a humanoid robot and the other via a pre-settled video of a peer, perform similarly in promoting facial recognition and expression of basic emotions in children with an ASC. The findings represent the first step to generalize the abilities acquired in a laboratory-trained situation to naturalistic interactions.

Social and Cognitive Interactions Through an Interactive School Service for RTT Patients at the COVID-19 Time.

Background: The closure of all educational institutions and most rehabilitation centres represents a precautionary measure to face the COVID-19 pandemic, but the isolation and social distancing may be particularly challenging for children with special needs and disabilities (SEND), such as Rett Syndrome (RTT). The main aim of this study was to promote cognitive and social interactions among children with RTT through an interactive school program. Methods: The Interactive School palimpsest was composed of moments in which a teacher spoke directly to children with RTT and expected a response through eye gaze, and moments in which storeys-cartoon were presented while tracking the eye gaze of children. We investigated behavioural, social and cognitive parameters. Results: Children participated in both social and cognitive tasks with the spontaneous reduction of stereotypies and with increase in attention. They recalled more significant indexes when music or a song was presented together with a cartoon or a cognitive task. Conclusions: This study provides initial insights in promoting cognitive and social interactions and in the support needs of families with a child with RTT during the COVID-19 pandemic.

The role of a virtual avatar in attention and memory tasks in Rett syndrome.

BACKGROUND: Since subjects with Rett syndrome (RTT) focus their attention mainly on the faces of people with whom they interact, in this study the role of a human-like smart interactive agent (an avatar) in enhancing cognitive processes is examined. More in depth, this study aimed to understand if, and to what extent, the use of an avatar can improve attention and memory abilities in subjects with RTT. METHOD: Thirty-six subjects with RTT participated in the study. All participants performed over-selectivity and memory tasks, for a total of six trials. These trials were randomly presented in two different conditions: with and without virtual avatar. RESULTS: The results indicated that the participants improved their attention and memory abilities when they performed the tasks with the avatar. There were no improvements when they performed the tasks without the avatar. DISCUSSION: The results were discussed considering the relationship between motivation, attention and memory in RTT.

Longitudinal cognitive rehabilitation applied with eye-tracker for patients with Rett Syndrome.

BACKGROUND: longitudinal effects of cognitive rehabilitation in Rett Syndrome (RTT) have been poorly investigated and the mechanisms do not appear to have been described in detail. AIMS: the aim of this study was to examine the effects of cognitive rehabilitation with eye-tracker technology on attention, choice behaviours and language over a 2-year period in patients with RTT. METHODS AND PROCEDURES: 28 participants with RTT, ranging from age 4-22 years old (M = 13.85 years, SD = 5.89), received 30 min of cognitive rehabilitation with eye-tracker for 3 days a week over a 1-month for 2 years. They then underwent cognitive assessment to evaluate attention, choice, language and global functioning in four specific times: before cognitive rehabilitation (T1), after six months of cognitive rehabilitation (T2), six months after the second cognitive rehabilitation phase (T3) and at the end of the third cognitive rehabilitation phase (T4). OUTCOME AND RESULTS: patients with RTT show long-term improvements in seconds of attention and number of choice behaviours, with barely any improvement in global functioning. No improvement in language was found. CONCLUSIONS AND IMPLICATIONS: this is the first study aimed at examining longitudinal effects of cognitive rehabilitation in patients with RTT, demonstrating a linear improvement across time in attention and choice.

Working memory and decision making in children with ADHD: an analysis of delay discounting with the use of the dual-task paradigm.

BACKGROUND: Deficits in working memory tasks have been widely documented in Attention Deficit Hyperactivity Disorder (ADHD) studies. The aim of this study is to evaluate the effects of working memory load in impulsivity during decision-making processes. A delayed discounting (DD) paradigm was used, comparing children with ADHD and age-matched controls. METHOD: Thirty-two children equally divided between typically developing and ADHD, from 8 to 10 years of age were assigned to sessions of a dual-task paradigm. In the primary task the child has to choose between two different amounts of money at different time delays, while in the secondary task the child has to repeat a random series of digits with different lengths. The experiment was conducted in a school setting. RESULTS: Compared to peers with typical development, delayed discounting was significantly stronger in children with ADHD and discounting rates increased in both groups for heavier memory loads. Furthermore, the memory load impact on frequency of immediate rewards was stronger in children with ADHD compared to typically developing children. DISCUSSION: Results are discussed in terms of the relation between working memory load and decision-making processes, their impact on impulsive behaviour in ADHD and the need for future research to understand possible neurocognitive correlates and use that information to develop better inclusive policies.

Effects of Combined Transcranial Direct Current Stimulation with Cognitive Training in Girls with Rett Syndrome.

BACKGROUND: Transcranial Direct Current Stimulation (tDCS) combined with traditional rehabilitative techniques has not been widely applied to Rett Syndrome (RTT). The aim of this study was to examine the effects of combined cognitive traditional training with tDCS applied to attention and language measures in subjects with RTT. METHODS: 31 subjects with RTT were randomly allocated into two groups: non-sham tDCS (n = 18) and sham tDCS (n = 13). The former received the integrated intervention non-sham tDCS plus cognitive empowerment during the treatment phase. The latter received sham stimulation plus cognitive empowerment. All participants underwent neurological and cognitive assessment to evaluate attention and language measures: before integrated treatment (pre-test phase), at the conclusion of the treatment (post-test phase), and at 1 month after the conclusion of the treatment (follow-up phase). RESULTS: the results indicated longer attention time in the non-sham tDCS group compared to the sham tDCS group with a stable trend also in the follow-up phase; an increase of the number of vowel/phoneme sounds in the non-sham tDCS group; and an improvement in the neurophysiological parameters in the non-sham tDCS group. CONCLUSIONS: This study supports the use of tDCS as a promising and alternative approach in the RTT rehabilitation field.

Gross Motor, Physical Activity and Musculoskeletal Disorder Evaluation Tools for Rett Syndrome: A Systematic Review.

In recent years, much attention has been paid to motor impairment of persons with Rett Syndrome (RTT), with increasing literature aimed to describe gross motor functioning and musculoskeletal disorders of the RTT population. The aim of this systematic review is to describe clinical evaluation tools used in the last decade to assess motor functioning and musculoskeletal abnormalities of patients with RTT. Thirty-four studies were reviewed and 20 tools were presented. Results showed that only two tools were used to measure functional change after rehabilitative or therapeutic interventions. This review underlies the lack of adequate evaluation tools to assess musculoskeletal abnormalities and deformities in RTT population. The absence of these assessments could be due to a statistical difficulty as it is challenging to build an evaluation tool that can score the entities of the abnormalities related to the amount of disability they cause.