Trastorno por déficit de atención/hiperactividad: Hábitos de estudio / Attention deficit/hyperactivity disorder. Study habits

El trastorno por déficit de atención/hiperactividad (TDAH) es uno de los trastornos más prevalentes en la población infanto-juvenil, con un impacto ya conocido sobre el aprendizaje y rendimiento escolar. La falta de atención, la disfunción ejecutiva asociada y los problemas comórbidos -particularmente los relacionados con el aprendizaje y la ansiedad-, condicionan marcadamente este dominio conceptual. Los jóvenes afectos, tienen más problemas para la toma de apuntes, finalización de trabajos, programación escolar y menor motivación al estudio. A pesar de una mayor dedicación al estudio y mayor uso de recursos de apoyo, el fracaso escolar y la no consecución de objetivos curriculares son más frecuentes en estos pacientes. El diagnóstico temprano del TDAH y sus comorbilidades, la intervención psicoeducativa y farmacológica adecuada e individualizada, han demostrado mejorar el pronóstico académico a corto y largo plazo. Para este propósito, es imprescindible la participación activa de profesionales de la salud y la educación.

Attention deficit / hyperactivity disorder (ADHD) is one of the most prevalent disorders in the child-youth population, with a known impact on learning and school performance. Lack of attention, associated executive dysfunction and comorbid problems -particularly those related to learning and anxiety-, strongly determine this conceptual domain. Affected youths have more problems for taking notes, completion of homework, school programming and less motivation to study. Despite greater dedication to homework and greater use of support resources, school failure and non-achievement of curricular objectives are more frequent in these patients. The early diagnosis of ADHD and its comorbidities, the adequate and individualized psychoeducational and pharmacological intervention, have been shown to improve academic prognosis in the short and long term. For this purpose, the active participation of health and education professionals is essential.

Diagnóstico tardio de síndrome de DiGeorge em criança hipocalcêmica: relato de caso / Late diagnosis of DiGeorge syndrome in hypocalcemic child: case report

A Síndrome de DiGeorge (SDG) decorre de uma microdeleção 22q11.2, sendo considerada uma das microdeleções mais frequentes em humanos. Caracteriza-se por espectro fenotípico bastante amplo, incluindo dificuldade de aprendizado, fácies dismórfica, anomalias cardíacas, hipocalcemia, hipoparatireoidismo, fenda palatina, anomalias do timo, insuficiência imunológica e problemas de fala e alimentação. Contudo, nenhum achado é patognomônico ou mesmo obrigatório. Este relato de caso pretende chamar a atenção para essa síndrome como causa potencial de hipocalcemia e convulsões hipocalcêmicas mesmo após o período neonatal. Reporta-se a história clinico-laboratorial e manejo de um menino de 12 anos, diagnosticado aos sete com SDG em decorrência de facies típica e crise convulsiva hipocalcêmica. O paciente apresentava diagnóstico prévio de transtorno do déficit de atenção e hiperatividade, atraso no desenvolvimento neuropsicomotor e fácies suspeita (micrognatia, orelhas de implantação baixa, hipertelorismo, nariz angular). A hipocalcemia que deflagrou a crise convulsiva foi secundária ao hipoparatireoidismo, sendo tratado com carbonato de cálcio e calcitriol. Houve melhora clínica, porém se manteve hipocalcêmico, apesar de dose otimizada da medicação. O caso é atípico, já que o diagnóstico de SDG foi feito tardiamente, visto que a maioria dos casos é diagnosticada no período neonatal. Além disso, o quadro demonstra a variabilidade de achados clínicos que podem ser encontrados nessa síndrome e a importância de se investigar a SDG em pacientes que apresentem hipocalcemia, mesmo em idades mais avançadas. Salienta-se que o diagnostico tem relevância na implicação dos cuidados à saúde, devido aos riscos imunológicos e cardiológicos apresentados pelos pacientes portadores, devendo ser realizado o mais precocemente possível.(AU)

The DiGeorge Syndrome (DGS) stems from a 22q11.2 microdeletion and is considered one of the most frequent microdeletions in humans. It is characterized by very wide phenotypic spectrum, including learning disability, dysmorphicfacies, cardiac abnormalities, hypocalcemia, hypoparathyroidism, cleft palate, thymus abnormalities, immune impairment and speech and feeding problems. However, any finding is pathognomonic or even mandatory. This case report aims to draw attention to this syndrome as a potential cause of hypocalcemia and hypocalcemic seizures even after the neonatal period. Refers to clinical and laboratory history and management of a boy of 12, diagnosed at 07 with DGS due to typical facies and hypocalcemic seizure. The patient had a previous diagnosis of attention deficit hyperactivity disorder, developmental delay and suspected facies (micrognathia, low-set ears, hypertelorism, angular nose). Hypocalcemia that triggered the seizure was secondary to hypoparathyroidism, being treated with calcium carbon- ate and calcitriol. There was clinical improvement, but hypocalcemic remained despite optimal medication dose. The case is atypical, since the diagnosis DGS was made later, as the majority of cases are diagnosed in the neonatal period. In addition, the table shows the variability of clinical findings that can be found in this syndrome and the importance of investigating the DGS in patients who have hypocalcaemia, even at older ages. Please note that the diagnosis is relevant in the involvement of health care due to immunological and cardiac risks posed by patients and should be done as early as possible.(AU)

Perfiles de funcionamiento comportamental en una población de niños con problemas de aprendizaje / Behavioral profiles operating in a population of children with learning disabilities

En el marco de un programa de intervención para favorecer la escolarización de niños de poblaciones vulnerables desde un punto de vista psicosocial, donde el psiquiatra pediátrico participa activamente en un equipo conformado también por psicólogos, psicomotricistas, fonoaudiólogos y maestros especializados, se mide la asociación entre patología conductual y problemas del aprendizaje. Se destaca la construcción de una escala de funcionamiento escolar, administrada al maestro de clase, aplicada a 4.642 niños, que confirma estadisticamente su unidimensionalidad para medir este atributo, donde los ítems académicos y comportamentales contribuyen a la escolarización y la aplicación de un protocolo de historia clínica médico-psicológica, aplicada a 334 niños seleccionados a través de la escala, que muestran la frecuencia de agrupaciones sintomáticas que deben tomarse en cuenta para que los abordajes terapéuticos sean eficientes.

Audiometric thresholds and auditory processing in children with early malnutrition: a retrospective cohort study / Limiares audiométricos e processamento auditivo em crianças com subnutrição precoce: um estudo retrospectivo de coorte

CONTEXT AND OBJECTIVE: Malnutrition is one of the causes of changes in cell metabolism. The inner ear has few energy reserves and high metabolism. The aim of this study was to analyze whether malnutrition at an early age is related to impairment of auditory processing abilities and hearing abnormalities. DESIGN AND SETTING: Retrospective cohort study conducted in a tertiary public hospital. METHODS: 45 children participated, divided as follows: G1, children diagnosed with malnutrition in their first two years of life; G2, children without history of malnutrition but with learning difficulties; G3, children without history of malnutrition and without learning difficulties. Tympanometry, pure-tone audiometry and the Staggered Spondaic Word (SSW) test (auditory processing) were performed. Statistical inferences were made using the Kruskal-Wallis test (α = 5%) and the test of equality of proportions between two samples (α = 1.7%). RESULTS: None of the 45 children participating in this study presented hearing deficiencies. However, at six of the eight frequencies analyzed, the children in G1 presented hearing thresholds lower than those of the other groups. In the auditory processing evaluation test, it was observed that 100% of the children in G1 presented abnormal auditory processing and that G1 and G2 had similar proportions of abnormalities (P-values: G1/G2 = 0.1; G1/G3 > 0.001; G2/G3 = 0.008). CONCLUSIONS: Malnutrition at an early age caused lowering of the hearing levels, although this impairment could not be considered to be a hearing deficiency. Every child in this group presented abnormalities in auditory processing abilities. .

CONTEXTO E OBJETIVO: A subnutrição é uma das causas das alterações no metabolismo celular. A orelha interna possui poucas reservas energéticas e alto metabolismo. O objetivo deste estudo foi de analisar se a subnutrição em idade precoce está relacionada a prejuízos em habilidades do processamento auditivo e a alterações auditivas. TIPO DE ESTUDO E LOCAL: Estudo de coorte retrospectivo conduzido em hospital público terciário. MÉTODOS: Participaram 45 crianças divididas em: G1, crianças que tiveram o diagnóstico de subnutrição nos dois primeiros anos de vida; G2, crianças sem histórico de subnutrição, mas com dificuldades de aprendizagem; G3, crianças sem histórico de subnutrição e sem dificuldades escolares. Realizou-se a timpanometria, audiometria tonal limiar e o teste de SSW [Staggered Spondaic Word] (processamento auditivo). Para a inferência estatística, usou-se o Kruskal-Wallis (α = 5%) e o teste igualdade de proporções entre duas amostras (α = 1,7%). RESULTADOS: Nenhuma das 45 crianças participantes neste estudo apresentou deficiência auditiva, porém em seis das oito frequências avaliadas, as crianças do G1 apresentaram limiares auditivos rebaixados quando comparadas às de outros grupos. No teste que avaliou o processamento auditivo, constatou-se que 100% das crianças do G1 possuem alteração do processamento auditivo, e que G1 e G2 possuem proporção semelhante de presença de alterações (valor de P: G1/G2 = 0,1; G1/G3 = > 0,001; G2/G3 = 0,008). CONCLUSÕES: A subnutrição em idade precoce causou rebaixamento nos níveis de audição, apesar de este prejuízo auditivo não ser considerado como deficiência auditiva. Todas as crianças ...

Nomeação rápida, leitura e compreensão em escolares com dificuldades de aprendizagem / Rapid naming, reading and comprehension in students with learning difficulties

OBJETIVO: Comparar e correlacionar o desempenho em nomeação rápida, leitura e compreensão de escolares com dificuldades de aprendizagem. MÉTODOS: Participaram deste estudo 32 escolares da 4ª série do ensino fundamental, de ambos os gêneros, com faixa etária entre 11 anos e 4 meses e 12 anos e 7 meses. Foram realizadas a primeira e a segunda tomada de leitura oral de um texto, selecionado a partir da indicação dos professores da 4ª série; a primeira e a segunda tomada de compreensão por meio de quatro perguntas apresentadas sequencialmente ao texto, em que os escolares deveriam responder oralmente; e a prova de nomeação rápida do Teste de Desempenho Cognitivo-Linguístico, versão individual. RESULTADOS: Houve diferença entre a primeira e a segunda compreensão e entre nomeação rápida, primeira e segunda leitura. Houve forte correlação entre compreensão e leitura, sugerindo que o desempenho na primeira tomada de leitura influenciou de forma significativa o desempenho na segunda tomada de leitura; o mesmo ocorreu para a compreensão. CONCLUSÃO: A defasagem na realização das atividades de nomeação, leitura e compreensão na primeira avaliação ocasionou falhas no mecanismo de conversão fonema-grafema que podem ser suficientes para desencadear dificuldades na aprendizagem da leitura.

PURPOSE: To compare and correlate the performance of students with learning difficulties in rapid naming, reading and comprehension. METHODS: Participants were 32 students from 4th grade of elementary school of both genders, with ages between 11 years and 4 months and 12 years and 7 months. The first and second oral reading of a text selected based on the indication of 4th grade teachers were conducted, as well as the first and second reading comprehension task composed by four questions presented right after the reading, to which students should answered orally, and the rapid naming task from the Test of Cognitive-Linguistic Performance, individual version. RESULTS: Differences were found between the first and the second comprehension scores, and between rapid naming, first and second reading. There was a strong correlation between comprehension and reading, suggesting that the performance in the first reading significantly influenced the performance in the second reading, which also occurred for comprehension. CONCLUSION: The delay in the activities of naming, reading and comprehension in the first evaluation provoked failures in the phoneme-grapheme conversion that may be enough to cause learning difficulties in reading.

Ocular disorders in children with learning disabilities in special education schools of Pune, India.

Aim: The aim was to study and treat ocular disorders in children with learning disabilities (cLDs) and explore associations with their perinatal history. Materials and Methods: cLDs attending 11 special schools were examined by a team consisting of an ophthalmologist, optometrist, and a social worker in 2007 and followed up in 2008. The students‘ intelligence quotient (IQ) and their medical histories were noted. Distant visual acuities were measured using Kay pictures or Snellen's tumbling E chart and complete ocular examination was performed. Students were assessed at the pediatric ophthalmology unit and low vision center, if needed. Statistical analysis was done with SPSS and the Chi-square test for ordinal data. Results: A total of 664 students were examined, 526 of whom were <16 years of age; 323 (61.4%) were male. A total of 326 (60%) had moderate-to-severe learning disabilities (IQs <50), and the mean IQ was 45.4. Two hundred and thirty-eight (45.3%) had ocular disorder; 143 (27.3%) had an uncorrected refractive error, followed by strabismus in 83 (15.8%), nystagmus in 36 (6.8%), optic atrophy in 34 (6.5%), and congenital anomalies in 13 (2.5%), 103 children had more than one abnormality. Only 12 of the 143 students with refractive errors were using spectacles. A total of 132 (48.7%) children with a history of perinatal insult had ocular problems. Ocular disorders were also common in those with a history of epilepsy, Down's syndrome, and cerebral palsy. Conclusion: Nearly half the cLDs in this study had ocular disorders and one-fourth had their vision improved.

Confiabilidad de un cuestionario para rastreo de trastorno de aprendizaje (CEPA) en niños en edad escolar / Reliability of a learning disabilities assessment questionnaire (CEPA) in school-aged children

The assessment questionnaires are basic tools used in research or in programs geared to the early, simple, and fast detection of a sickness in the general population, with a high level of accepted reliability and validity. Objective: to determine the reliability of an assessment cuestionnaire dealing with learning disabilities; which makes easy the detection of children who are more likely to have learning disabilities. Patients and Methods: a random sample of 681 children was chosen; they belonged to the 3rd and 4th socio-economic strata, aged 8 and 11, of primary basic schooling education, from 4 educational institutions of a neighboring village of the Metropolitan Area of Medellin and who willingly decided to participate in the study. From this population, a non-random sample of 80 individuals was taken who met the inclusion criteria to carry out a pilot test. The questionnaire comprises 39 items comprising 8 frequent areas of difficulties. It is designed to assess the cognitive and language processes.

Los cuestionarios de rastreo son herramientas básicas usadas en las investigaciones o en los programas dirigidos a la detección temprana,sencilla y rápida de una enfermedad en la población general, con un nivel de confiabilidad y de validez aceptados. Objetivo: Determinar la confiabilidad de un cuestionario de rastreo para la evaluación de las dificultades del aprendizaje que facilite la detección de los niños que tengan mayor probabilidad de tener trastornos del aprendizaje. Pacientes y métodos. Se seleccionóuna muestra aleatoria de 681 niños de estrato socio económico 3 y 4, en edades entre 8 y 11 años, de escolaridad básica primaria, de 4instituciones de un corregimiento adjunto al área metropolitana de la ciudad de Medellín y que aceptaron participar en el estudio. De este universo poblacional se retomo unamuestra no aleatoria de 80 sujetos quecumplieran los criterios de inclusión pararealizan una prueba piloto. El cuestionario comprende 39 ítemes que agrupa 8 áreas frecuentes de dificultades, está diseñado paraevaluar procesos cognoscitivos y del lenguaje.

Neuro-Cognitive Functioning in Children with Learning Difficulties.

Learning difficulties can occur due to complex interplay of factors that may reside in the child’s own constitution, temperament and cognitive abilities and/or in the background and quality of child’s schooling and/ or in family related factors that affect interactions and emotional well being of the child. Aims & Objectives: To study the neuro-cognitive functioning of children with learning difficulties . Method: Forty children studying in English medium schools in Delhi from Grade 2nd to 5th who were reported to be having learning difficulties. The children were divided into two groups (n=20, each.) One of the groups had children having learning disability. The other group had children with learning difficulties but without any diagnosable psychiatric/ emotional/ behavioural problems. All children were assessed for their intelligence, scholastic performance (on three basic subjects- Hindi, English and Mathematics)); Sustained attention; Verbal Working Memory, Visual Learning and Memory; Verbal Learning and Memory , Verbal Comprehension, Visuo-Constructive Ability and Visuo-Conceptual Skills. Conclusions:Both the groups had impairment in assessed neuro-cognitive skills. Children with learning disability had significantly poorer performance on tasks of sustained attention, visual memory and learning , delayed recall and visuo constructive skills. There were no differences among children on other assessed functions.

Efficacy of Cognitive Retraining Techniques in Children with Learning Disability.

Background :Cognitive Retraining(CR) is known to help in reattainment of cognitive abilities following brain injury.Due to high cerebral plasticity in children,CR can perhaps also be used to ameliorate known cognitive deficits in children with learning disability. Objectives: To study the efficacy of cognitive retraining techniques for enhancing cognitive skills and scholastic performance in children with learning disability. Sample & Methods: Pre and Post experimental design study was carried out with thirty children(between eight to ten years of age), with diagnosis of mixed disorder of scholastic skills(ICD-10). Each subject was given 36 hours of manualized CR package over 18weeks, consisting of activities for sustained attention,visuospatial skills,visual memory;and verbal learning and memory.Pre and post intervention assessment; was done using NIMHANS Index for Specific Learning Disability,Grade Level Assessment Device(GLAD) and Rey’s Auditory Verbal Learning Test(AVLT).SPSS version12.0 was used for descriptive and analytical statistical analysis. Results:Highly significant improvement was noted in total verbal learning, delayed verbal recall,visuo-spatial skills and mathematics(p>0.01).Also, there was significant improvement in sustained attention(time taken and errors),visual memory and immediate verbal recall(p>0.05). Conclusion:Manualized cognitive retraining over thirty six hours can help to partially remediate cognitive deficits in children with learning disability and improve their scholastic performance. The findings have implications for future educational curricula aiming at improved academic performance stemming from an enhanced skill base rather than from just educational based interventions.

Clinical and psychoeducational profile of children with specific learning disability and co-occurring attention-deficit hyperactivity disorder.

BACKGROUND: Almost 10% of school-going children have specific learning disability (SpLD) in the form of dyslexia, dysgraphia and/or dyscalculia. Attention-deficit hyperactivity disorder (ADHD) occurs as a comorbidity in about 20% of these children. AIMS: To document the clinical profile and academic history of children with SpLD and co-occurring ADHD. SETTINGS AND DESIGN: Prospective observational study conducted in our clinic. MATERIALS AND METHODS: From August to November 2004, 50 consecutively diagnosed children (34 boys, 16 girls) were included in the study. SpLD was diagnosed on the basis of psychoeducational testing. Diagnosis of ADHD was made by DSM-IV-revised criteria. Detailed clinical and academic history and physical and neurological examination findings were noted. STATISTICAL ANALYSIS: Chi-square test or unpaired student's t-test was applied wherever applicable. RESULTS: The mean age of children was 11.4 years (+/-SD 2.5, range 7-17.1). Fifteen (30%) children had a significant perinatal history, 12 (24%) had delayed walking, 11 (22%) had delayed talking, 5 (10%) had microcephaly, 27 (54%) displayed soft neurological signs and 10 (20%) had primary nocturnal enuresis. There were no differentiating features between the two gender groups. Their academic problems were difficulties in writing (96%), inattentiveness (96%), difficulties in mathematics (74%), hyperactivity (68%) and difficulties in reading (60%). All children had poor school performance, 15 (30%) had already experienced class retention and 20 (40%) had developed aggressive or withdrawn behavior. CONCLUSION: Children with SpLD and co-occurring ADHD need to be identified at an early age to prevent poor school performance and behavioral problems.

Transtorno de déficit de atenção com hiperatividade: abordagem neurobiológica / Attention deficit with hyperativity disorder: neuropsychological approach

O distúrbio do déficit de atenção com hiperatividade (TDAH) se caracteriza por dificuldade de manutenção do autocrontrole, dificuldades em manter a atenção e modular os impulsos. Baseado em vivência clínica e de pesquisa, os autores discutem a correlação neurofuncional, neuropsicológica e fonoaudiológica em crianças escolares com TDAH.

Comportamentos problemáticos em estudantes do ensino fundamental: características da ocorrência e relação com habilidades sociais e dificuldades de aprendizagem / Behavior problems in elementary school children and their relation to social skills and academic performance

Investigou-se as características sócio-demográficas da ocorrência de comportamentos problemáticos e suas relações com as habilidades sociais e dificuldades acadêmicas, em uma amostra de 257 estudantes de 1ª a 4ª séries do ensino fundamental de uma cidade de médio porte de Minas Gerais, utilizando-se a escala Social Skills Rating System (SSRS). Participaram ainda da pesquisa 185 pais e 12 professores destes estudantes. Os resultados mostraram que 6,65 por cento dos estudantes apresentavam muitos comportamentos problemáticos e 9,37 por cento apresentavam poucos, na classificação dos professores. A ocorrência de comportamentos problemáticos foi mais elevada em crianças do sexo masculino, de nível sócio-econômico mais baixo e com desempenho acadêmico mais deficitário. A freqüência de comportamentos problemáticos foi menor em crianças que apresentaram um nível mais adequado e elaborado de habilidades sociais. Os resultados levantados na presente pesquisa confirmam dados da literatura da área e indicam a necessidade de se desenvolver intervenções junto a esta população-alvo.

This research investigated the socio-demographic characteristics of the frequency of behavior problems and its relation to social skills and academic competence, in a sample of 257 elementary school students from the 1st to 4th grades, in a medium size city of Minas Gerais, Brazil, using the Social Skills Rating System Scale (SSRS). Participated in the research 185 parents and 12 teachers of these students. Results showed that 6,65 percent of the students had a high frequency of behavior problems and 9,37 percent had a moderate frequency, according to teachers classification. The frequency of behavior problems was higher in boys than in girls, in children with poorer level of academic competence and from lower social economic level. Behavior problems were less frequent in children having more adequate level of social skills. These results confirm data from the research literature and point to the need for developing interventions in elementary school to prevent future anti-social behaviors.

Impulsivity among adolescents with ADHD and bronchial asthma.

OBJECTIVE: To determine the level of impulsivity of adolescents diagnosed as suffering from ADHD, Bronchial Asthma and Healthy adolescents (without any chronic disease). METHODS: All participants (n=97) had completed the Barrett (Bis 10) questionnaire. RESULTS: The adolescents suffering from Attention-deficit hyperactivity disorder (ADHD) scored the highest points 51.6; the control group without any chronic disease was second with 25.2 and the asthmatic adolescents were third with 23.4 points for their impulsivity. CONCLUSION: It should be made clear to the people that the child comes in contact with his impulsive behavior is uncontrollable, and there is no justification for being angry with him nor any punishment. Patience and education is the answer. These adolescent should be under professional care in order to help him define more acceptable ways and means of deportment according to the norms and standards of his society.

High frequencies of plexiform neurofibromas, mental retardation, learning difficulties, and scoliosis in Brazilian patients with neurofibromatosis type 1

A clinical study of Brazilian patients with neurofibromatosis type 1 (NF1) was performed in a multidisciplinary Neurofibromatosis Program called CEPAN (Center of Research and Service in Neurofibromatosis). Among 55 patients (60 percent females, 40 percent males) who met the NIH criteria for the diagnosis of NF1, 98 percent had more than six café-au-lait patches, 94.5 percent had axillary freckling, 45 percent had inguinal freckling, and 87.5 percent had Lisch nodules. Cutaneous neurofibromas were observed in 96 percent, and 40 percent presented plexiform neurofibromas. A positive family history of NF1 was found in 60 percent, and mental retardation occurred in 35 percent. Some degree of scoliosis was noted in 49 percent, 51 percent had macrocephaly, 40 percent had short stature, 76 percent had learning difficulties, and 2 percent had optic gliomas. Unexpectedly high frequencies of plexiform neurofibromas, mental retardation, learning difficulties, and scoliosis were observed, probably reflecting the detailed clinical analysis methods adopted by the Neurofibromatosis Program. These same patients were screened for mutations in the GAP-related domain/GRD (exons 20-27a) by single-strand conformation polymorphism. Four different mutations (Q1189X, 3525-3526delAA, E1356G, c.4111-1G>A) and four polymorphisms (c.3315-27G>A, V1146I, V1317A, c.4514+11C>G) were identified. These data were recently published.

Comparison of cognition abilities between groups of children with specific learning disability having average, bright normal and superior nonverbal intelligence.

BACKGROUND: Specific learning disabilities (SpLD) viz. dyslexia, dysgraphia and dyscalculia are an important cause of academic underachievement. Aims: To assess whether cognition abilities vary in children with SpLD having different grades of nonverbal intelligence. SETTING: Government recognized clinic in a medical college. DESIGN: Cross-sectional study. SUBJECTS AND METHODS: Ninety-five children with SpLD (aged 9-14 years) were assessed. An academic achievement of two years below the actual grade placement on educational assessment with a Curriculum-Based test was considered diagnostic of SpLD. On basis of their nonverbal Intelligence Quotient (IQ) scores obtained on the Wechsler Intelligence Scale for Children test, the study children were divided into three groups: (i) average-nonverbal intelligence group (IQ 90-109), (ii) bright normal-nonverbal intelligence group (IQ 110-119), and (iii) superior-nonverbal intelligence group (IQ 120-129). A battery of 13 Cognition Function tests (CFTs) devised by Jnana Prabodhini's Institute of Psychology, Pune based on Guilford's Structure of Intellect Model was administered individually on each child in the four areas of information viz. figural, symbolic, semantic and behavioral. STATISTICAL ANALYSIS USED: The mean CFTs scores obtained in the four areas of information were calculated for each of the three groups and compared using one-way analysis of variance test. A P value < 0.05 was to be considered statistically significant. RESULTS: There were no statistically significant differences between their mean CFTs scores in any of the four areas of information. CONCLUSIONS: Cognition abilities are similar in children with SpLD having average, bright-normal and superior nonverbal intelligence.

Glutaric aciduria type I associated with learning disability.

The authors report a 7-year-8-months-old boy with glutaric aciduria type I who had associated dyslexia, dysgraphia and dyscalculia. The diagnosis of glutaric aciduria type I was confirmed on the basis of characteristic neuroimaging and biochemical findings. Axial T1-weighted magnetic resonance imaging scan of the brain showed fronto-temporal atrophy, open opercula and bat-wing dilatation of the sylvian fissures. Axial T[2]-weighted and FLAIR imaging showed hyperintense signal abnormality in both putamen and in the fronto-parietal deep white matter. Urinary aminoacidogram by thin layer chromatography revealed a generalized aminoaciduria. Urinary organic acid analysis by gas chromatography- mass spectroscopy revealed a marked excretion of glutaric acid. Psychoeducational testing was used to diagnose the learning disability. We postulate that the accumulation of glutaric acid and other metabolites was responsible for the child developing the associated learning disability.

Scholastic difficulties with behavioural problems.

OBJECTIVE: The study aimed at investigating behavioral problems in children with scholastic skill difficulties. METHOD: A sample of children (n=20) aged 5 to 8 years with scholastic difficulties with those who did not have difficulties was being compared. RESULT: It has revealed the number of externalizing, internalizing and learning problems in children with scholastic difficulties. CONCLUSION: Need for management of behavioral problems along with re-mediation of scholastic difficulties is highlighted.

Caracterizaçäo das alteraçöes encontradas em histórias do desenvolvimento de escolares com queixa de dificuldades do aprendizado / Characterization of the alteration in development history of a group of children whose complaints was academic

Neste trabalho, propusemo-nos a estudar a história de desenvolvimento de um grupo de crianças com queixas de dificuldade escolar e/ou no aprendizado da leitura e escrita. Realizamos uma análise do registro das informaçöes de anamnese contidas em 30 prontuários de escolares de ambos os sexos, com faixa etária entre 6 e 12 anos e 3 meses de idade, com graus de escolaridade variando de 1ª a 4ª série do Primeiro Grau de Escolas da Rede Pública de nsino. As principais alteraçöes relatadas e identificadas nas anamneses foram: alteraçöes da produçäo da fala (50,0 por cento). Alteraçöes gestacionais, do desenvolvimento de linguagem e do aspecto do desenvolvimento auditivo, intercorrências de parto, alteraçöes de voz e do desenvolvimento motor ocorreram em menores frequências