Diverse learners: learning disabilities and quality of life following mind-body and health education interventions for adults with neurofibromatosis.

PURPOSE: Neurofibromatosis (NF) is associated with low quality-of-life (QoL). Learning disabilities are prevalent among those with NF, further worsening QoL and potentially impacting benefits from mind-body and educational interventions, yet research on this population is scarce. Here, we address this gap by comparing NF patients with and without learning disabilities on QoL at baseline and QoL-related gains following two interventions. METHODS: Secondary analysis of a fully-powered RCT of a mind-body program (Relaxation Response Resiliency Program for NF; 3RP-NF) versus an educational program (Health Enhancement Program for NF; HEP-NF) among 228 adults with NF. Participants reported QoL in four domains (Physical Health, Psychological, Social Relationships, and Environmental). We compare data at baseline, post-treatment, and 12-month follow-up, controlling for intervention type. RESULTS: At baseline, individuals with NF and learning disabilities had lower Psychological (T = -3.0, p = .001) and Environmental (T = -3.8, p < .001) QoL compared to those without learning disabilities. Both programs significantly improved all QoL domains (ps < .0001-0.002) from baseline to post-treatment, regardless of learning disability status. However, those with learning disabilities exceeded the minimal clinically important difference in only one domain (Psychological QoL) compared to three domains in individuals without learning disabilities. Moreover, those with learning disabilities failed to sustain statistically significant gains in Psychological QoL at 12-months, while those without learning disabilities sustained all gains. CONCLUSION: Adults with NF and learning disabilities have lower Psychological and Environmental QoL. While interventions show promise in improving QoL regardless of learning disabilities, additional measures may bolster clinical benefit and sustainability among those with learning disabilities.

Music-based interventions for people with profound and multiple learning disabilities: A systematic review of the literature.

Music is motivational, accessible and engaging for individuals with learning disabilities. Several systematic reviews have addressed the effects of music activity on people with learning disabilities; however, none has specifically reviewed the use of musical activity with people with profound and multiple learning disabilities.This review aimed to: 1. identify peer-reviewed studies and describe the characteristics of evidence-based musical activity used with people with profound and multiple learning disabilities and 2. evaluate and analyse the effectiveness of these music-based interventions and identify gaps within current research. A systematic search was conducted in April 2021 identifying seven peer-reviewed studies which included music-based interventions with at least one person with profound and multiple learning disabilities.Findings reveal the interventions varied in their frequency, duration and content. The outcome of most (n=6) interventions documented the development of the participants' social skillset. Interventions were predominantly (n=6) implemented by facilitators with musical expertise. The diverse and novel nature of the reviewed studies highlights a need to expand and enhance research with this population.

Impact of dance therapy on children with specific learning disability: a two-arm cluster randomized control study on an Italian sample.

BACKGROUND: Dance therapy can improve the quality of life of a person with several conditions, especially psychological well-being and quality of life, in the short and long-term. The aim of the study was to examine the effects of the dance therapy (DT) on specific learning disability (SLD) children. We wanted to test the impact on cognitive and emotional patterns on children with learning disorders. METHODS: A two-arm cluster randomized control study was applied comparing 2 groups of SLD children (treated vs. non-treated). All children have been measured applying psychological battery before and at the end of the experimental protocol. RESULTS: Our data revealed significant differences between groups for auditory and visual recognition, for interpersonal relationships and for emotions recognition. DT seemed to provide positive evidence as an educational intervention for children with SLDs. CONCLUSIONS: Our results confirmed that DT protocol was an effective way to improve self-esteem, attention and concentration and emotional recognition in SLD children.

Management and Treatment Modalities in Traumatic Brain Injury.

Traumatic Brain Injury (TBI) is a very broad diagnosis. Some TBI patients have minimal complaints for a short period of time. Other TBI patients suffer from drastic life-altering, permanent brain damage. One particularly troubling class of TBI patients arises from people who experience one or more concussions in their youth. Later, as adults, the TBI manifests as multiple learning difficulties or even personality changes. As ophthalmic professionals, we are often the first to see potential TBI patients as they complain of visual disturbances. It is of utmost importance to find ways to help these people, but first we have to find the deficits. This paper will discuss some therapeutic measures given to TBI patients and the examinations that will provide vital information.

Facilitating pragmatic skills through role-play in learners with language learning disability.

BACKGROUND: Role-based learning involves the process whereby learners acquire skills, knowledge and understanding through the assumption of roles within real-life settings. Role-play holds potential as an effective learning strategy for children; however, there is limited research on the use of role-play as a therapy method within the field of speech-language pathology. Children with language learning disability (LLD) typically present with difficulties in social communication, which can negatively affect their social and academic achievement. AIM: The aim of this study was to determine the effectiveness of role-play as a therapy approach targeting the pragmatic skills of stylistic variation and requesting for clarification in learners with LLD. METHOD: The use of combined positivist and interpretivist paradigms allowed for the implementation of an embedded mixed methods design. An experimental pretest-posttest design was implemented. Eight participants, who were learners with a diagnosis of LLD, were purposefully selected. Data collection was conducted over five phases, utilising the Clinical Evaluation of Language Fundamentals (4th Ed.) Pragmatics Profile, discourse completion tasks, session plans and session records. Quantitative data were analysed using descriptive statistics and were supplemented by qualitative data from session records. RESULTS: Results revealed improvements in stylistic variation and requesting for clarification post role-play intervention, with minimal changes in the control group. Limitations of the study have been reported for consideration when interpreting results. CONCLUSION: Role-play as a therapy approach targeting two pragmatic skills, stylistic variation and requesting for clarification, was found to be beneficial for learners with LLD. Recommendations for the implementation of role-play as a therapy approach were made.

A Mindfulness-Based Intervention Pilot Feasibility Study for Elementary School Students With Severe Learning Difficulties: Effects on Internalized and Externalized Symptoms From an Emotional Regulation Perspective.

OBJECTIVE: Students with severe learning disabilities often show signs of anxiety, depression, and problem behaviors such as inattention and conduct problems. Mindfulness-based interventions (MBIs) in school settings constitute a promising option to alleviate these co-occurring symptoms. This pilot study aimed to evaluate the impact of an MBI on symptoms and behaviors of elementary school students with severe learning disabilities. METHOD: A one-group pretest-posttest design was used. The sample comprised 14 students aged 9 to 12 years with special education needs. Both student-report and teacher-report of the Behavior Assessment System for Children, Second Edition were used. RESULTS: Repeated-measures analyses of variance revealed a significant impact of the MBI on symptoms and behaviors such as anxiety, depression, inattention, aggression, and conduct problems. Effect sizes for all variables were considered large (partial η2 = .31-.61). CONCLUSION: These preliminary results indicate that MBIs can reduce the frequency of symptoms and problem behaviors often found in children with learning disabilities in elementary schools. Further multiple baseline experimental trials with a long-term follow-up are warranted to establish more robustly the effect of MBIs for children with learning disabilities.

An evaluation of a Singing for the Brain pilot with people with a learning disability and memory problems or a dementia.

This paper presents the findings from a pilot project introducing Singing for the Brain into care centres with people with a learning disability and a form of dementia or memory problem. Through participant observations, patient and staff feedback, there was strong support for the use of Singing for the Brain with this client group, with participants reporting high levels of enjoyment and engagement in the sessions. The potential for these sessions to support communication, memory, social engagement and choice was reported by staff and participants. Whilst anecdotal reports also suggested the sessions had a positive impact on elevating mood over a sustained period of time. The pilot sessions are discussed in reference to the regular sessions run for people with dementia and comparisons drawn across the two approaches. Further evidence is required to understand the potential impact on participant's well-being from attending these sessions.

Development and validation of the Learning Disabilities Needs Assessment Tool (LDNAT), a HoNOS-based needs assessment tool for use with people with intellectual disability.

BACKGROUND: In meeting the needs of individuals with intellectual disabilities (ID) who access health services, a brief, holistic assessment of need is useful. This study outlines the development and testing of the Learning Disabilities Needs Assessment Tool (LDNAT), a tool intended for this purpose. METHOD: An existing mental health (MH) tool was extended by a multidisciplinary group of ID practitioners. Additional scales were drafted to capture needs across six ID treatment domains that the group identified. LDNAT ratings were analysed for the following: item redundancy, relevance, construct validity and internal consistency (n = 1692); test-retest reliability (n = 27); and concurrent validity (n = 160). RESULTS: All LDNAT scales were deemed clinically relevant with little redundancy apparent. Principal component analysis indicated three components (developmental needs, challenging behaviour, MH and well-being). Internal consistency was good (Cronbach alpha 0.80). Individual item test-retest reliability was substantial-near perfect for 20 scales and slight-fair for three scales. Overall reliability was near perfect (intra-class correlation = 0.91). There were significant associations with five of six condition-specific measures, i.e. the Waisman Activities of Daily Living Scale (general ability/disability), Threshold Assessment Grid (risk), Behaviour Problems Inventory for Individuals with Intellectual Disabilities-Short Form (challenging behaviour) Social Communication Questionnaire (autism) and a bespoke physical health questionnaire. Additionally, the statistically significant correlations between these tools and the LDNAT components made sense clinically. There were no statistically significant correlations with the Psychiatric Assessment Schedules for Adults with Developmental Disabilities (a measure of MH symptoms in people with ID). CONCLUSIONS: The LDNAT had clinically utility when rating the needs of people with ID prior to condition-specific assessment(s). Analyses of internal and external validity were promising. Further evaluation of its sensitivity to changes in needs is now required.

La precisión del movimiento imaginado y la recepción de balón en niños / The accuracy of the motor imagery and the ball reception in children

Estudios recientes observaron que las imágenes motrices se desarrollan de forma entrelazada con el desarrollo de las habilidades motrices en niños. La finalidad de este estudio es analizar en qué medida la imagen motriz de los elementos necesarios para resolver un problema motor (la recepción de un balón), se relaciona con los niveles de habilidad en niños (3 - 9 años). La muestra estuvo formada por 215 participantes (87 chicos y 118 chicas), (M = 5,94, DT = 1,47). Se ha utilizado una metodología mixta: dibujos, indicaciones gestuales, verbalización del pensamiento y una prueba práctica de recepción de balón. El MANOVA reveló diferencias significativas en las capacidades meta-cognitivas y motrices en función de las etapas de desarrollo. Un análisis de ecuaciones estructurales reveló que las capacidades meta-cognitivas median la relación entre las etapas de desarrollo y la habilidad de recepción de móviles. Se discuten sus repercusiones en el aprendizaje motor (AU)

Recent studies have found that motor imaginery is developed linked to the development of motor skills in children. The purpose of this study is to analyze how the motor imaginery of theprincipal elements to solve a motor problem (ball reception) relates to the motor skill levels in children (3-9 years). The sample consisted of 215 participants (87 boys and 118 girls), (M = 5.94, SD = 1.47).We used a mixed methodology: drawings, gestural prompts, verbalization of thought and a practical test of ball reception. The MANOVA revealed significant differences in the meta-cognitive abilities and motor function of the developmental stages. A structural equation analysis revealed that meta-cognitive abilities mediate the relationship between the stages of development and the ability in the reception of moving objects. Their implications in motor learning are discussed (AU)

Early Child Development and Nutrition: A Review of the Benefits and Challenges of Implementing Integrated Interventions.

Poor nutrition (substandard diet quantity and/or quality resulting in under- or overnutrition) and the lack of early learning opportunities contribute to the loss of developmental potential and life-long health and economic disparities among millions of children aged <5 y. Single-sector interventions representing either early child development (ECD) or nutrition have been linked to positive child development and/or nutritional status, and recommendations currently advocate for the development and testing of integrated interventions. We reviewed the theoretical and practical benefits and challenges of implementing integrated nutrition and ECD interventions along with the evidence for best practice and benefit-cost and concluded that the strong theoretical rationale for integration is more nuanced than the questions that the published empirical evidence have addressed. For example, further research is needed to 1) answer questions related to how integrated messaging influences caregiver characteristics such as well-being, knowledge, and behavior and how these influence early child nutrition and development outcomes; 2) understand population and nutritional contexts in which integrated interventions are beneficial; and 3) explore how varying implementation processes influence the efficacy, uptake, and cost-benefit of integrated nutrition and ECD interventions.

Electrocortical Dynamics in Children with a Language-Learning Impairment Before and After Audiovisual Training.

Detecting and discriminating subtle and rapid sound changes in the speech environment is a fundamental prerequisite of language processing, and deficits in this ability have frequently been observed in individuals with language-learning impairments (LLI). One approach to studying associations between dysfunctional auditory dynamics and LLI, is to implement a training protocol tapping into this potential while quantifying pre- and post-intervention status. Event-related potentials (ERPs) are highly sensitive to the brain correlates of these dynamic changes and are therefore ideally suited for examining hypotheses regarding dysfunctional auditory processes. In this study, ERP measurements to rapid tone sequences (standard and deviant tone pairs) along with behavioral language testing were performed in 6- to 9-year-old LLI children (n = 21) before and after audiovisual training. A non-treatment group of children with typical language development (n = 12) was also assessed twice at a comparable time interval. The results indicated that the LLI group exhibited considerable gains on standardized measures of language. In terms of ERPs, we found evidence of changes in the LLI group specifically at the level of the P2 component, later than 250 ms after the onset of the second stimulus in the deviant tone pair. These changes suggested enhanced discrimination of deviant from standard tone sequences in widespread cortices, in LLI children after training.

Acupuncture reversed hippocampal mitochondrial dysfunction in vascular dementia rats.

Hippocampal mitochondrial dysfunction due to oxidative stress has been considered to play a major role in the pathogenesis of vascular dementia (VD). Previous studies suggested that acupuncture could improve cerebral hypoperfusion-induced cognitive impairments. However, whether hippocampal mitochondria are associated with this cognitive improvement remains unclear. In this study, an animal model of VD was established via bilateral common carotid arteries occlusion (BCCAO) to investigate the alterations of cognitive ability and hippocampal mitochondrial function. BCCAO rats showed impairments in hippocampal mitochondrial function, overproduction of reactive oxygen species (ROS) and learning and memory deficits. After two-week acupuncture treatment, BCCAO-induced spatial learning and memory impairments as shown in Morris water maze were ameliorated. Hippocampal mitochondrial respiratory complex enzymes (complex I, II, IV) activities and cytochrome c oxidase IV expression significantly increased, which might contribute to the reduction of hippocampal ROS generation. In addition, acupuncture significantly improve mitochondrial bioenergy parameters such as mitochondrial respiratory control rate and membrane potential not PDH A1 expression. Placebo-acupuncture did not produce similar therapeutic effects. These findings suggested that acupuncture reversed BCCAO-induced hippocampal mitochondrial dysfunction, which might contribute to its prevention on cognitive deficits.

[Effects of Electroacupuncture Intervention on Oxygen Free Radicals and Expression of Apoptosis-related Proteins in Rats with Ischemic Learning and Memory Disorder].

OBJECTIVE: To observe the effect of electroacupuncture (EA) therapy on levels of oxygen free radicals (OFR) and hippocampal apoptosis-related protein expression in ischemic learning-memory disorder rats so as to investigate its mechanisms underlying improvement of ischemic learning-memory impairment. METHODS: A total of 60 SD rats were randomly divided into sham operation (sham), model, medication, and EA groups, with 15 rats in each group. The learning-memory disorder model was made by occlusion of bilateral carotid arteries. EA (2- 3 Hz, 2 mA) was applied to "Zhi San Zhen" ["Shenting" (GV 24) and bilateral "Benshen" (GB 13)] for 30 min, once a day for 3 weeks. The rats of the medication group were treated by lavage of Aricept (0.03 mg . kg(-1) . d(-1)), once daily for 3 weeks. The rats' learning-memory ability was detected by Morris water maze tests and the state of hippocampal apoptosis cells was observed by light microscope after TUNEL staining and the expression of hippocampal Bcl-2, Bax and Caspase-3 proteins was detected by immunohistochemistry. Serum and hippocampal superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activity and malondialdehyde (MDA) contents were detected by chemical colorimetric analysis. RESULTS: Compared with the sham group, the escape latencies (place-navigation) after modeling were evidently prolonged, and the times of target-platform crossing in 90 sec (spatial probe test) considerably reduced in the model group (P<0.01), suggesting an impairment of learning-memory ability. After the treatment for 21 d, the increased escape latency and the reduced target-platform crossing time in both EA and medication groups were reversed in comparison with the model group (P<0.01), suggesting an improvement of memory ability, and the effect of the EA group was significantly superior to that of the medication group (P<0.05). Compared with the sham group, the number of apoptotic cells in hippocampal CA 1- CA 3 regions, and the expression levels of hippocampal Bcl-2, Bax and Caspase-3 proteins, and serum and hippocampal MDA contents were significantly increased in the model group (P<0.01), while serum and hippocampal SOD and GSH-Px levels obviously decreased in the model group (P<0.01). After the treatment for 21 days, compared to the model group, the number of the apoptotic cells, the expression levels of hippocampal Bax and Caspase--3 proteins, and the contents of serum and hippocampal MDA were notably decreased in the EA and medication groups (P<0.01), whereas, Bcl-2 protein expression levels, and serum and hippocampal SOD and GSH-Px activity were notably up-regulated in the EA and medication groups (P<0.01). The effects of EA group were obviously superior to those of medication group in increasing hippocampal Bcl-2 immunoactivity, serum SOD and GSH-Px and hippocampal GSH-Px activity and in down-regulating serum MDA level (P<0.01, P<0.05). CONCLUSION: Electroacupuncture intervention can improve learning-memory ability in ischemic learning-memory disorder rats which may be associated with its effects in reducing blood and hippocampal OFR contents and hippocampal cellular apoptosis.

Knowledge exchange and integrated services: experiences from an integrated community intellectual (learning) disability service for adults.

BACKGROUND: This paper examines knowledge exchange dynamics in a specialist integrated intellectual (learning) disability service, comprising specialist healthcare provision with social care commissioning and management, and considers their significance in terms of integrated service delivery. METHODS: A qualitative study focusing on knowledge exchange and integrated services. Semi-structured interviews (n = 25) were conducted with members of an integrated intellectual disability service in England regarding their perceptions of knowledge exchange within the service and the way in which knowledge exchange impinges on the operation of the integrated service. RESULTS: Exchange of 'explicit' (codifiable) knowledge between health and care management components of the service is problematic because of a lack of integrated clinical governance and related factors such as IT and care record systems and office arrangements. Team meetings and workplace interactions allowed for informal exchange of explicit and 'tacit' (non-codifiable) knowledge, but presented challenges in terms of knowledge exchange completeness and sustainability. CONCLUSIONS: Knowledge exchange processes play an important role in the functioning of integrated services incorporating health and care management components. Managers need to ensure that knowledge exchange processes facilitate both explicit and tacit knowledge exchange and do not rely excessively on informal, 'ad hoc' interactions. Research on integrated services should take account of micro-scale knowledge exchange dynamics and relationships between social dynamics and physical factors.

Quantitative EEG neurofeedback for the treatment of pediatric attention-deficit/hyperactivity disorder, autism spectrum disorders, learning disorders, and epilepsy.

Neurofeedback (NF) using surface electroencephalographic signals has been used to treat various child psychiatric disorders by providing patients with video/audio information about their brain's electrical activity in real-time. Research data are reviewed and clinical recommendations are made regarding NF treatment of youth with attention deficit/hyperactivity disorder, autism, learning disorders, and epilepsy. Most NF studies are limited by methodological issues, such as failure to use or test the validity of a full-blind or sham NF. The safety of NF treatment has not been thoroughly investigated in youth or adults, although clinical experience suggests reasonable safety.

Utilidad del dibujo para superar problemas en la escritura: estudio de un caso / Correction of problems in writing through drawing: a case study

En los problemas de aprendizaje los casos de dificultades en la escritura son muy frecuentes. Dichas dificultades pueden ser analizadas desde el punto de vista neuropsicológico a partir de la diferenciación de indicadores particulares de los errores que presentan los niños. A través del análisis neuropsicológico, es posible identificar los mecanismos cerebrales que subyacen a estas dificultades. La actividad gráfica (dibujo) comparte algunos mecanismos indispensables para la adquisición de la escritura, tales como: estrategia perceptiva; global y analítica, la organización cinética, la regulación y control así como las imágenes objetales. Estos mecanismos pueden ser desarrollados durante la corrección basada en la formación de la actividad gráfica. En este artículo se presenta el contenido de este tipo de corrección neuropsicológica, sus etapas y los resultados obtenidos a partir de su aplicación en un escolar del segundo grado de primaria con reportes de problemas de escritura y antecedentes de riesgo neurológico perinatal y TCE leve. Los resultados indican mejoría significativa en la acción de la escritura en la evaluación posterior a la aplicación del método. Se discuten amplias posibilidades del uso de la actividad gráfica durante los procedimientos de corrección en la etapa escolar...

In cases of the learning disabilities, the cases of writing difficulties are frequent. These difficulties can be analyzed from neuropsychological background based on differentiation of particular indicators of errors that children commit. Through neuropsychological analysis it is possible to identify the brain mechanisms that underlie those difficulties. Graphic activity (drawing) shares some essential mechanisms for the acquisition of writing, such as: perceptual strategy; global and analytical, kinetic organization, regulation and control, and the object images. These mechanisms may be developed during the correction based on the formation of the graphic activity. This article presents the content of such kind of neuropsychological correction, its stages and the results obtained from its application in a schoolboy of second grade with writing problems reports and a history of perinatal neurological risk and mild head injury. The results indicate significant improvement in writing actions during neuropsychological assessment after implementation of the method. Extensive possibilities are discussed about the use of the graphic activity during the correction procedures at school age...

Making music, making friends: Long-term music therapy with young adults with severe learning disabilities.

This collaborative practitioner research study emerged from music therapists' concerns about the value of improvisational, music-centred music therapy for young adults with severe learning disabilities (SLDs), given the long-term nature of such work. Concerns included the relevance, in this context, of formulating, and reporting on, therapeutic aims, development, change; and working in 'goal-oriented' way. Focus groups with the young adults' families and a range of professionals suggest that, rather than leading to developmental change, long-term shared therapeutic musicking provides young adults with ongoing opportunities for experiencing confidence and self-esteem, with feelings of shared acceptance and success, and also provides young adults and their families with opportunities for developing and sustaining friendships. In addition, families experienced meeting other parents and carers in the communal reception area as supportive and countering their isolation. Focus groups assigned intrapersonal, relational and social values to long-term music therapy for young adults with SLDs.

[Kinderpsychodrama in a child guidance centre]. / Kinderpsychodrama in der Erziehungsberatung.

Kinderpsychodrama allows conflicts of children to become apparent in a specific sheltered environment. These conflicts often arise when children's needs for relationship, self esteem and self efficacy either are not sufficiently recognized by their caregivers and/or cannot be answered in a helpful way. This can lead to internalizing disorders like loss of self reliance, social fear, and depressive withdrawal on the one hand or to externalizing symptoms like oppositional, impulsive and aggressive behavior disorders on the other hand which endanger socio-emotional development. Kinderpsychodrama is seen to cushion children's dysfunctional conflict solutions and solve them with the therapists' help. Therapists realize the themes set on the scene during the play of the children's group; they mirror the scenes and encourage children to act in a different way making use of children's creativity during play as well as the support of the group. Children's chosen role serves as a secure base allowing them to find solutions for their conflicts. The development of each child as well as his/her themes becoming evident during the course of the group are made transparent to their parents during accompanying counseling sessions. We illustrate this therapeutic method by casuistics of our children therapy group.