El proceso de transición desde la perspectiva del aprendizaje / The transition process from a learning perspective

El avance científico y tecnológico ha incrementado la supervivencia de niños, niñas y adolescentes (NNyA) con Enfermedad Crónica (EC). Ello ha generado un aumento significativo de la población adolescente con cuidados especiales de salud dentro del ámbito pediátrico. Esta situación da relevancia a la necesidad de institucionalizar líneas de acción específicas para acompañar el proceso de transición de estos pacientes hacia la atención de adultos. Dentro del abordaje interdisciplinario, cada especialidad define sus intervenciones. Partiendo de la perspectiva multidimensional del aprendizaje y del concepto de Alfabetización en Salud (AS), el equipo de psicopedagogía participa de la transición de grupos de pacientes a los que asiste en clínicas específicas. El objetivo central de esta participación es favorecer en cada consultante el mayor nivel de autonomía posible, considerando sus recursos cognitivos, educativos, familiares y contextuales. Las líneas de intervención, se dirigen a promover el manejo de información sobre la propia condición de salud y el aprendizaje de habilidades relacionadas con la autogestión de su enfermedad. Este escenario busca promover una transición efectiva involucrando no sólo al paciente y su familia sino que además al equipo de salud en dicho proceso (AU)

Scientific and technological progress has increased the survival of children and adolescents with Chronic Diseases (CD). This has led to a significant increase in the adolescent population with special healthcare needs in the pediatric setting. Consequently, there is a pressing need to institutionalize specific lines of action to facilitate the transition of these patients to adult care. Within an interdisciplinary approach, each specialty defines its interventions. The educational therapy team participates in the transition of patient groups in specific clinics, based on the multidimensional perspective of learning and the concept of health literacy (HL). The main objective of this participation is to promote the highest possible level of autonomy in each patient, considering their cognitive, educational, family, and contextual resources. The interventions aim to enhance the management of information about their health condition and the learning of skills related to self-management of their disease. This approach seeks to promote an effective transition involving not only the patient and their family but also the health team in this process (AU)

Significância clínica do uso do mapa mental na intervenção de escolares com transtornos de aprendizagem / Clinical significance of using the mental map in interventions on schoolchildren with learning disorders / Significado clínico del uso del mapa mental en la intervención de estudiantes con transtornos de aprendizaje

Introdução: Para um bom desempenho de leitura, o escolar precisa ser capaz de desenvolver habilidades específicas para compreensão da informação lida, criando estratégias como: construção de significado, assimilação do conteúdo, estabelecimento de relações, organização e avaliação das informações, bem como pensar na utilização dessas de forma correta. Objetivo: verificar o índice de mudança e significância clínica do Mapa Mental na intervenção de escolares com transtornos de aprendizagem em situação de pré e pós-testagem. Métodos: Este estudo se caracteriza por ser quase-experimental. Participaram deste estudo 7 escolares com diagnóstico interdisciplinar de transtornos de aprendizagem, de ambos os sexos, na faixa etária de 10 anos e 6 meses a 15 anos e 4 meses de idade. Os escolares foram submetidos à pré-testagem, intervenção e pós-testagem. A pré-testagem e a pós-testagem foram realizadas com o Protocolo de Avaliação de Compreensão de Leitura (PROCOMLE), e a intervenção foi realizada com o uso do mapa mental durante 4 meses, sendo trabalhados 15 textos. Os dados de pré e pós-testagem foram analisados por meio do Método JT. Resultados: na comparação da pré com a pós-testagem, foi possível verificar que os escolares S1, S2, S3 e S6 apresentaram mudança confiável nas questões literais de textos narrativos do Protocolo de Avaliação de Compreensão de Leitura. Os escolares S1, S3, S6 e S7 apresentaram mudança confiável nas questões inferenciais de textos narrativos do Protocolo de Avaliação de Compreensão de Leitura. Conclusão: a intervenção com o uso do Mapa Mental mostrou-se eficaz para escolares com Transtornos de Aprendizagem.

Introduction: For a good reading performance, the student needs to be able to develop specific skills to understand the information read, creating strategies such as: construction of meaning, assimilation of content, establishment of relationships, organization and evaluation of information, as well as thinking about using these correctly. Objective: to verify the rate of change and clinical significance of the Mind Map in the intervention of students with learning disorders in pre- and post-testing situations. Methods:This study is characterized as quasi-experimental. The pretest and post-test were done using the Reading Comprehension Evaluation Protocol (PROCOMLE), and the intervention was accomplished by applying mind mapping techniques on studies of 15 texts within 4 months. The pre and posttest data were analyzed using the JT Method. Results: Comparison of the pre- and post-testing, using the JT Method, showed that: students S1, S2, S3 and S6 presented a reliable change in the literal questions of narrative texts from the Reading Comprehension Assessment Protocol; and students S1, S3, S6 and S7 presented a reliable change in the inferential questions. Conclusion: The intervention using Mind Mapping proved to be effective for students with Learning Disorders.

Introducción: Para un buen desempeño de lectura, el estudiante debe ser capaz de desarrollar habilidades específicas para comprender la información leída, crear estrategias tales como: construcción de significado, asimilación de contenido, establecimiento de relaciones, organización y evaluación de información, así como pensar en úselos correctamente. Objetivo: verificar el índice de cambios y significado clínico del Mapa Mental en la intervención de estudiantes con trastornos de aprendizaje en situación de pre y post prueba. Métodos: Este estudio se caracteriza por ser cuasi-experimental. En este estudio participaron siete estudiantes con diagnóstico interdisciplinario de trastornos del aprendizaje, de ambos sexos, de 10 años y 6 meses a 15 años y 4 meses de edad. Los estudiantes fueron sometidos a pruebas previas, de intervención y posteriores. El pretest y el postest se realizaron mediante el Protocolo de Evaluación de Comprensión Lectora (PROCOMLE) y la intervención se realizó mediante un mapa mental durante 4 meses, trabajando en 15 textos. Los datos anteriores y posteriores a la prueba se analizaron mediante el método JT. Resultados: En la comparación de la pre con la post prueba, a partir del Método JT, ha sido posible comprobar que los estudiantes S1, S2, S3 y S6 han presentado cambios confiables en las preguntas literales de textos narrativos del Protocolo de Evaluación de Comprensión de Lectura. Los estudiantes S1, S3, S6 y S7 han presentado cambios confiables en las preguntas inferencias de textos narrativos del Protocolo de Evaluación de Comprensión de Lectura. Conclusión: La intervención con el uso del Mapa Mental resultó efectivo para estudiantes con Trastornos de Aprendizaje.

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.

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

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 nonachievement 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.

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.

Intermittent fasting uncovers and rescues cognitive phenotypes in PTEN neuronal haploinsufficient mice.

Phosphatase and tensin homolog (PTEN) is an important protein with key modulatory functions in cell growth and survival. PTEN is crucial during embryogenesis and plays a key role in the central nervous system (CNS), where it directly modulates neuronal development and synaptic plasticity. Loss of PTEN signaling function is associated with cognitive deficits and synaptic plasticity impairment. Accordingly, Pten mutations have a strong link with autism spectrum disorder. In this study, neuronal Pten haploinsufficient male mice were subjected to a long-term environmental intervention - intermittent fasting (IF) - and then evaluated for alterations in exploratory, anxiety and learning and memory behaviors. Although no significant effects on spatial memory were observed, mutant mice showed impaired contextual fear memory in the passive avoidance test - an outcome that was effectively rescued by IF. In this study, we demonstrated that IF modulation, in addition to its rescue of the memory deficit, was also required to uncover behavioral phenotypes otherwise hidden in this neuronal Pten haploinsufficiency model.

Management of Attention-Deficit/Hyperactivity Disorder by Developmental-Behavioral Pediatricians: A DBPNet Study.

OBJECTIVE: To describe practice patterns for developmental-behavioral pediatricians (DBPs) practicing within Developmental-Behavioral Pediatrics Research Network (DBPNet) academic medical centers providing follow-up for children with attention-deficit/hyperactivity disorder (ADHD) and determine how well they adhere to American Academy of Pediatrics ADHD Clinical Practice Guidelines. METHODS: Seventy-eight DBPs at 12 academic medical centers participating in the DBPNet were asked to complete follow-up encounter surveys for patients with ADHD or autism spectrum disorder seen from 12/2011 through 6/2012. Data regarding patient characteristics, comorbid conditions, and medication management were obtained at the time of each visit. RESULTS: Fifty-seven DBPs completed 301 ADHD follow-up encounter surveys; 75.3% of patients were male with mean age 9.57 years (SD = 3.3). Race/ethnicity was primarily white/non-Hispanic with similar numbers on private insurance (41.5%) versus Medicaid (45.5%). DBPs identified comorbid learning disorders in 27.6% of children ≥6 years. Only 58.3% of children <6 years received counseling/behavioral therapy or had it recommended during the visit. DBPs primarily (90.6%) prescribed medications FDA-approved for ADHD treatment and growth was monitored for >98% of visits during which stimulants were prescribed. Parent- and teacher-completed rating scales were reviewed/completed during 43.9% and 37.8% of visits, respectively. There were no child or physician factors consistently associated with variation in practice patterns. CONCLUSION: Developmental-behavioral pediatricians practicing within DBPNet medical centers adhere to the recommended medication prescribing practices for ADHD, including use of FDA-approved medications and monitoring growth. However, DBPs within DBPNet do not consistently review ADHD rating scales or recommend behavioral counseling for children <6 years of age as recommended.

Environmental stimulation improves performance in the ox-maze task and recovers Na+,K+-ATPase activity in the hippocampus of hypoxic-ischemic rats.

In animal models, environmental enrichment (EE) has been found to be an efficient treatment for alleviating the consequences of neonatal hypoxia-ischemia (HI). However the potential for this therapeutic strategy and the mechanisms involved are not yet clear. The aim of present study is to investigate behavioral performance in the ox-maze test and Na+,K+-ATPase, catalase (CAT) and glutathione peroxidase (GPx) activities in the hippocampus of rats that suffered neonatal HI and were stimulated in an enriched environment. Seven-day-old rats were submitted to the HI procedure and divided into four groups: control maintained in standard environment (CTSE), control submitted to EE (CTEE), HI in standard environment (HISE) and HI in EE (HIEE). Animals were stimulated with EE for 9 weeks (1 h/day for 6 days/week) and then behavioral and biochemical parameters were evaluated. Present results indicate learning and memory in the ox-maze task were impaired in HI rats and this effect was recovered after EE. Hypoxic-ischemic event did not alter the Na+,K+-ATPase activity in the right hippocampus (ipsilateral to arterial occlusion). However, on the contralateral hemisphere, HI caused a decrease in this enzyme activity that was recovered by EE. The activities of GPx and CAT were not changed by HI in any group evaluated. In conclusion, EE was effective in recovering learning and memory impairment in the ox-maze task and Na+,K+-ATPase activity in the hippocampus caused by HI. The present data provide further support for the therapeutic potential of environmental stimulation after neonatal HI in rats.

The effect of the Infant Health and Development Program on special education use at school age.

OBJECTIVES: To evaluate the effect of an intensive early intervention on special service use at school-age. STUDY DESIGN: The Infant Health and Development Program was a randomized controlled trial of an intervention for low birth weight (<2500 g) infants ages 0-3 years. We used multivariate logistic regression to test the association between intervention and risk of special education, remedial reading and math, and speech therapy at age 8 years. We also compared rates of service use between study arms among those with learning disabilities (LDs). RESULTS: There were 875 complete cases at 8-year follow-up. There were no statistically significant differences between groups in risk of special education (risk ratio [RR] 0.86, 95% CI 0.64-1.15), remedial reading (RR 0.88, 95% CI 0.68-1.14), remedial math (RR 0.92, 95% CI 0.63-1.34), or speech therapy (RR 0.87, 95% CI 0.62-1.23). The treatment arms did not differ in rates of LDs, and service use for those with LDs was low and unaffected by study group. CONCLUSIONS: Early gains in IQ from infant interventions may not protect children as they face the educational demands of grade school. Only a fraction of those having a LD were receiving school-based support services, indicating a high level of unmet need among low birth weight children with disabilities.

Syntactic Awareness and Text Production in Brazilian Portuguese Students with Learning Disabilities.

AIMS: This study compared the syntactic awareness and textual production skills of school children and teenagers with and without learning disabilities (LD) and related their performances in both skills. METHODS: The study group consisted of 15 children with an LD and 15 without language and learning alterations. To compare the performance of both groups, data were statistically analyzed using Fisher's exact test, and the association between the evidence in each group was demonstrated by Spearman's correlations, with a significance level of 5% (p < 0.05). RESULTS: Most subjects with LD showed a lower performance in tests of syntactic awareness and textual production. Statistical analysis indicated a significant difference in the performance of children with and without language disorders for both tested skills. A positive relationship was found between the children's performance in the test of textual production and the tasks of syntactic awareness. CONCLUSION: Our findings suggest that the ability to judge and correct grammatical structures can be an important factor in the development of the skills used to produce a text.

Seguimiento longitudinal en un caso de retardo en la formación de las funciones psicológicas superiores / Longitudinal study of a child with retardation in psychological superior function

En el artículo se describe el contenido del programa para la corrección y el desarrollo de las funciones psicológicas superiores. Se trata de un niño con problemas en el aprendizaje escolar. Se presentan los resultados de las evaluaciones neuropsicológicas, así como el contenido del programa de corrección. El programa se elaboró de acuerdo a las propuestas del diagnóstico diferencial individualizado. Se muestran las etapas del trabajo correctivo con el niño, así como los resultados de la intervención terapéutica...

The paper describes an individual program for remediation of a learning disable child. The program is based upon an integrated system of Lurian neuropsychological assessment. A follow-up of the child at all steps of remediation proved the efficiency of the remediative program...

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...

Efficacy of the reading and phonological remediation program in learning disabilities.

BACKGROUND: the Phonological and Reading Remediation Program in learning disabilities. AIM: to verify therapeutic effectiveness of the Phonological and Reading Remediation Program in students with learning disabilities. METHOD: participants of this study were 40 students who were divided in the following groups: GI, subdivided in: GIE (10 students without learning disabilities submitted to the Phonological and Reading Remediation Program), GIC (10 students without learning disabilities who were not submitted to the Phonological and Reading Remediation Program); and GII, subdivided in: GIIE (10 students with learning disabilities submitted to the Phonological and Reading Remediation Program), GIIC (10 students with learning disabilities who were not submitted to the Phonological and Reading Remediation Program). As a procedure, in pre and post testing situations, the Cognitive-Linguistic Performance Test was applied. RESULTS: the results showed statistically significant differences between GIE and GIC and between GIIE and GIIC, indicating that students who were submitted to the Program presented better performances in the post testing condition when compared to the pre-testing condition. CONCLUSION: this study showed that the Phonological and Reading Remediation Program was effective. The use of the Program improved perception, production and manipulation of sounds and syllables, interfering directly on the reading skills and comprehension of students with learning disabilities.

Eficácia do programa de remediação fonológica e leitura no distúrbio de aprendizagem / Efficacy of the reading and phonological remediation program in learning disabilities

BACKGROUND: the Phonological and Reading Remediation Program in learning disabilities. AIM: to verify therapeutic effectiveness of the Phonological and Reading Remediation Program in students with learning disabilities. METHOD: participants of this study were 40 students who were divided in the following groups: GI, subdivided in: GIE (10 students without learning disabilities submitted to the Phonological and Reading Remediation Program), GIC (10 students without learning disabilities who were not submitted to the Phonological and Reading Remediation Program); and GII, subdivided in: GIIE (10 students with learning disabilities submitted to the Phonological and Reading Remediation Program), GIIC (10 students with learning disabilities who were not submitted to the Phonological and Reading Remediation Program). As a procedure, in pre and post testing situations, the Cognitive-Linguistic Performance Test was applied. RESULTS: the results showed statistically significant differences between GIE and GIC and between GIIE and GIIC, indicating that students who were submitted to the Program presented better performances in the post testing condition when compared to the pre-testing condition. CONCLUSION: this study showed that the Phonological and Reading Remediation Program was effective. The use of the Program improved perception, production and manipulation of sounds and syllables, interfering directly on the reading skills and comprehension of students with learning disabilities.

TEMA: Programa de Remediação Fonológica e Leitura no distúrbio de aprendizagem. OBJETIVO: verificar a eficácia terapêutica do Programa de Remediação Fonológica e Leitura em escolares com distúrbio de aprendizagem. MÉTODO: participaram deste estudo 40 escolares, sendo que estes foram divididos em: GI, subdivididos em GIE (10 escolares sem dificuldade de aprendizagem submetidos ao Programa de Remediação Fonológica e leitura), GIC (10 escolares sem dificuldade de aprendizagem não submetidos ao Programa de Remediação Fonológica e Leitura) e GII, subdividido em GIIE (10 escolares com distúrbio de aprendizagem submetidos ao Programa de Remediação Fonológica e Leitura), GIIC (10 escolares com distúrbio de aprendizagem não submetidos ao Programa de Remediação Fonológica e Leitura). Como procedimento foi aplicado o Teste de Desempenho Cognitivo-Linguístico, em situação de pré e pós-testagem antes da realização do Programa de Remediação Fonológica e Leitura. RESULTADOS: os resultados evidenciaram diferença estatisticamente significante entre os GIE e GIC e GIIE e GIIC indicando que os escolares submetidos ao programa obtiveram melhor desempenho em situação de pós-testagem se comparado a pré-testagem. CONCLUSÃO: a realização deste estudo evidenciou que o Programa de Remediação Fonológica e Leitura foi eficaz, pois proporcionou melhora na percepção, produção e manipulação dos sons e sílabas, interferindo diretamente na habilidade de leitura e compreensão dos escolares com distúrbio de aprendizagem.

Hallazgos electroencefalográficos en niños con trastornos del aprendizaje / Electroencephalografic finding in children with learning disorders

Los trastornos del aprendizaje (TA) son alteraciones del desarrollo infantil que se manifiestan principalmente con dificultades en el aprendizaje de las habilidades académicas, con alta incidencia de anormalidades electroencefalográfícas de diferente grado, que incluyen ondas fusionadas (Pi) en áreas occipitales, paroxismos focales o generalizado de 6-14 Hertz, descargas de puntas (focales), especialmente en áreas temporales y occipitales. Correlacionar los hallazgos electroencefalográficos con los diferentes TA, en niños de 7 a 12 años, que acuden a la consulta de neuropediatría del Hospital Pediátrico “Dr. Agustín Zubillaga” de Barquisimeto. Se les practicó electroencefalograma a 31 niños que conformaron la muestra. Se realizó un estudio descriptivo y transversal, para determinar la correlación electroencefalográfica en niños escolares que cumplieron los criterios de inclusión. De los EEG realizados, 54,8 por ciento resultaron normales y 45,1 por ciento anormales. el mayor porcentaje de trazados fueron lentos (64,2 por ciento), seguidos de focales (35,6 por ciento) y generalizados 14,2 por ciento. se encontró un predominio de anormalidades electroencefalográfícas en varones (32,2 por ciento), en los que prevalecieron los trastornos focales (35,6 por ciento) vs las hembras (12,9 por ciento), en las que resaltaron los trazados generalizados (14,2 por ciento). El diagnóstico de los trastornos de aprendizaje es eminentemente clínico, psicológico y académico y no es descartado por un examen neurológico normal. El electroencefalograma constituye una herramienta útil en su valoración, con sensibilidad adecuada y especificidad baja. En muchas ocasiones es la única evidencia objetiva de la disfunción cerebral.

Learning disorders (ID) are alterations of the infantile development that are manifested mainly in difficulties for learning academic abilities, with high incidence of electroencephalographic abnormalities of different grades: fused waves (Pi) in occipital areas, focal or widespread paroxysms of 6-14 Hertz, tip discharges (focal), especially in temporal and occipital areas. To correlate the electroencephalographic findings with the different lD, in children between 7 and 12 years of age who attend the outpatient clinic of the department of neurology of the Pediatric Hospital "Dr. Agustín Zubillaga" of Barquisimeto, state of Lara, Venezuela. An electroencephalogram was performed in all patients and a descriptive and transversal study was carried out to determine the correlation in school children that completed the inclusion. In 31 children, 54.8% resulted normal, and 45.1% abnormal the largest percentage was of slow layouts, 64 and 2%, followed by focal 35.6% and widespread 14.2%. the abnormal electroencephalograms were more frequent in boys (32.2%), in whom the focal layouts prevailed (35.6%) vs. girls (12.9%), in whom prevailed widespread layouts (14.2%). The diagnosis of learning disorders is mainly clinical, psychological and academic, and is not ruled out by a normal neurological examination. the electroencephalogram constitutes a useful tool in its evaluation, with appropriate sensibility and low specificity. In many occasions, it is the only objective evidence of cerebral dysfunction.

Changes in EEG current sources induced by neurofeedback in learning disabled children. An exploratory study.

The objective of this work was to explore Neurofeedback (NFB) effects on EEG current sources in Learning Disabled (LD) children, and to corroborate its beneficial consequences on behavioral and cognitive performance. NFB was given in twenty 30-min sessions to 11 LD children to reduce their abnormally high theta/alpha ratios (Experimental Group). Another five LD children with the same characteristics received a placebo treatment (Control Group). In the Control Group no changes in behavior or EEG current source were observed. In the Experimental Group, immediately after treatment children showed behavioral and cognitive improvements, but current source analysis showed few modifications; however, 2 months after treatment many changes occurred: a decrease in current of frequencies within the theta band, mainly in left frontal and cingulate regions, and enhancement in current of frequencies within the alpha band, principally in the right temporal lobe and right frontal regions, and of frequencies within the beta band, mainly in left temporal, right frontal and cingulate cortex regions. In conclusion, NFB is a possibly efficacious treatment for LD children with an abnormally high theta/alpha ratio in any lead. The changes observed in EEG current sources may reflect the neurophysiological bases of the improvement that children experienced in their behavioral and cognitive activities.

Follow-up study of learning-disabled children treated with neurofeedback or placebo.

This report is a 2-year follow-up to a previous study describing positive behavioral changes and a spurt of EEG maturation with theta/alpha neurofeedback (NFB) training in a group of Learning Disabled (LD) children. In a control paired group, treated with placebo, behavioral changes were not observed and the smaller maturational EEG changes observed were easily explained by increased age. Two years later, the EEG maturational lag in Control Group children increased, reaching abnormally high theta Relative Power values; the absence of positive behavioral changes continued and the neurological diagnosis remained LD. In contrast, after 2 years EEG maturation did continue in children who belonged to the Experimental Group with previous neurofeedback training; this was accompanied by positive behavioral changes, which were reflected in remission of LD symptoms.