[Place of the BMT-i modular tool in the assessment of learning disabilities]. / Place de l'outil modulable BMT-i dans l'évaluation des troubles de l'apprentissage.

PLACE OF THE BMT-I MODULAR TOOL IN THE ASSESSMENT OF LEARNING DISABILITIES Twenty percent of children have difficulties learning to read, write, or count. Eight percent of children have a specific and durable impairment in the development of a learning or cognitive function or Learning Disabilities (LD), often called «dys¼ (dysphasia, dyslexia, dysorthography, dyscalculia, dysgraphia, etc.). This is a public health problem, which has been addressed by the Haute Autorité de Santé (HAS), which recommends a health program based on the needs of each child, coordinating education and health professionals - rehabilitation specialists and medical prescribers. The role of the child's doctor is essential in the first line of action to identify these problems, to examine the child, to prescribe reeducation when necessary and to follow the evolution. However, he has received little training. The modular BMT-i (computerized adaptable test battery) tool is validated, easy to use and reliable. It allows the screening of difficulties in each domain in 10 to 25 minutes in front of a complaint by selecting the appropriate tests. A choice of clinical situations helps to understand the disorders and the approach of the examination of the child, to inform the families of the results, to accompany them on the therapeutic project and to prescribe the care adapted to each situation.

PLACE DE L'OUTIL MODULABLE BMT-I DANS L'ÉVALUATION DES TROUBLES DE L'APPRENTISSAGE Vingt pour cent des enfants sont en difficulté pour apprendre à lire, écrire et/ou compter. Huit pour cent des enfants présentent une altération durable et spécifique du développement d'un apprentissage ou d'une fonction cognitive (« troubles spécifiques du langage et des apprentissages ¼ [TSLA]), souvent simplifié sous le terme « dys ¼ (dysphasie, dyslexie, dysorthographie, dyscalculie, dysgraphie, etc.). La Haute Autorité de santé s'est saisie de ce problème de santé publique et recommande un parcours de santé ciblé sur les besoins de chaque enfant, coordonnant professionnels de l'éducation et de la santé ­ rééducateurs et médecins prescripteurs. Le rôle du médecin est essentiel en premier recours pour identifier les enfants concernés, les examiner, prescrire les rééducations nécessaires et suivre l'évolution. L'outil modulable BMT-i (batterie modulable de tests informatisée) validé, simple d'utilisation et fiable, permet le dépistage des difficultés dans chaque domaine en dix à vingt-cinq minutes, en sélectionnant les épreuves adéquates. Un choix de situations cliniques aide à la compréhension des troubles et à la démarche de l'examen de l'enfant, afin d'informer les familles des résultats, les accompagner dans les actions à mener et prescrire les soins adaptés à chaque situation.

External Validation of BMT-i Computerized Test Battery for Diagnosis of Learning Disabilities.

Background: Learning disabilities (LDs) are a major public health issue, affecting cognitive functions and academic performance for 8% of children. If LDs are not detected early and addressed through appropriate interventions, they have a heavy impact on these children in the social, educational, and professional spheres, at great cost to society. The BMT-i (Batterie Modulable de Tests informatisée, or "computerized Adaptable Test Battery") enables fast, easy, reliable assessments for each cognitive domain. It has previously been validated in children ages 4-13 who had no prior complaints. The present study demonstrates the sensitivity of the BMT-i, relative to reference test batteries, for 191 children with cognitive difficulties. Materials and Methods: These 191 subjects were included in the study by the 14 pediatricians treating them for complaints in five cognitive domains: written language [60 (cases)]; mathematical cognition (40); oral language (60); handwriting, drawing, and visuospatial construction (45); and attention and executive functioning (45). In accordance with a predefined protocol, the children were administered BMT-i tests first, by their pediatricians, and reference tests later, by specialists to whom the BMT-i test results were not disclosed. Comparison of BMT-i and reference test results made it possible to evaluate sensitivity and agreement between tests. Results: For each of the five domains, the BMT-i was very sensitive (0.91-1), and normal BMT-i results were highly predictive of normal results for specialized reference tests [negative likelihood ratio (LR-): 0-0.16]. There was close agreement between BMT-i and reference tests in all domains except attention and executive functioning, for which only moderate agreement was observed. Conclusion: The BMT-i offers rapid, reliable, simple computerized assessments whose sensitivity and agreement with reference test batteries make it a suitable first-line instrument for LD screening in children 4-13 years old.

The Computerized Adaptable Test Battery (BMT-i) for Rapid Assessment of Children's Academic Skills and Cognitive Functions: A Validation Study.

Background: Learning disabilities in children are a major public health concern worldwide, having a prevalence of 8%. They are associated with lost social, educational, and ultimately, professional opportunities for individuals. These disabilities are also very costly to governments and raise the issue of the appropriate means of screening. Unfortunately, validated tools for preliminary appraisal of learning and cognitive function in struggling children are presently restricted to specific age ranges and cognitive domains. This study sought to validate a first-line battery for assessment of academic skills and cognitive functions. Materials and Methods: The computerized Adaptable Test Battery, or BMT-i, includes a panel of tests for the first-line assessment of children's academic skills and cognitive functions. The tests reflect expected abilities for the age group in question, exploring academic skills (written language and mathematical cognition) and cognitive domains (verbal, non-verbal, and attentional/executive functions). The authors relied on the results of these tests for a sample of 1,074 Francophone children representative of the mainland French school-age population (522 boys and 552 girls, ages 4-13, from 39 classes at 7 public and 5 private schools). Thirteen speech-language pathologists and neuropsychologists individually administered the tests. Results: The psychometric characteristics of the empirical data obtained showed acceptable to good test homogeneity, internal consistency (Cronbach's alpha: > 0.70), test-retest reliability (intraclass correlation coefficients: ~0.80), and consistency with reference test batteries (r: 0.44-0.96). Conclusion: The BMT-i was validated in a large sample of children in mainstream French schools, paving the way for its use in first-line screening of learning disabilities among children with complaints, whether their learning difficulties have been flagged by their parents or by their teachers.

Serial order short-term memory capacities and specific language impairment: no evidence for a causal association.

This study re-explored the nature of verbal short-term memory (STM) deficits in children with specific language impairment (SLI), by distinguishing item and serial order STM processes. Recent studies have shown serial order STM capacity to be a critical determinant of language development, relative to item STM. In Experiment 1, 12 children with SLI, 12 age-matched children and 12 language-matched children were administered serial order recognition and reconstruction tasks. Experiment 2 assessed implicit serial learning abilities via a Hebb learning task. The SLI group showed impaired performance for the serial order reconstruction and recognition tasks, relative to language-matched and/or age-matched control groups. However, normal serial position effects were observed in all SLI children in the serial order reconstruction task, suggesting normal coding of serial position information. Similarly, performance on the Hebb serial learning task was at chronological age appropriate levels. Experiment 3 showed that the group differences observed for the serial order STM tasks in Experiment 1 disappeared when the SLI group was compared to a mental age-matched control group. Experiment 4 showed similar performance levels in the SLI group and the mental age-matched control group for a nonword recognition task assessing item STM capacities. This study shows that children with SLI have no specific impairments for serial order and item STM components but that poorer general cognitive efficiency is related to functional limitations in verbal STM tasks. The data are in line with limited information processing accounts of SLI.

[Academic difficulties in hyperactive children]. / Difficultés scolaires de l'enfant hyperactif.

Hyperactive children frequently display academic difficulties. These may be the direct result of their behavioral characteristics (lack of attention, impulsiveness, hyperactivity), and/or may reflect specific learning disorders which are initially masked by significant behavioral problems. These learning disorders need to be diagnosed, so as to include specific therapeutic approaches into the overall treatment.