Navigating Intercultural Medical Encounters: An Examination of Patient-Centered Communication Practices with Italian and Foreign Cancer Patients Living in Italy.

Effective communication is crucial in cancer care due to the sensitive nature of the information and the psychosocial impact on patients and their families. Patient-centered communication (PCC) is the gold standard for providing quality cancer care, as it improves patient satisfaction, treatment adherence, clinical outcomes, and overall quality of life. However, doctor-patient communication can be complicated by ethnic, linguistic, and cultural differences. This study employed the ONCode coding system to investigate PCC practices in oncological visits (doctor's communicative behavior, patient's initiatives, misalignments, interruptions, accountability, and expressions of trust in participants' talk, Markers of uncertainty in doctor's talk, markers of emotions in doctor's talk). Forty-two video-recorded patient-oncologist encounters (with 22 Italian and 20 foreign patients), including both first and follow-up visits, were analyzed. Three discriminant analyses were conducted to assess differences in PCC between patient groups (Italian or foreign patients) according to the type of encounter (first visit or follow-up) and the presence or absence of companions during the encounters. Multiple regression analyses were performed to evaluate the PCC differences by oncologist age, patient age, and patient sex, controlling for the type of encounter, the presence of a companion during the visit, and patient group on ONCode dimensions. No differences were found in PCC by patient group in discriminant analyses and regressions. Doctor communication behavior, interruptions, accountability, and expressions of trust were higher in first visits than in follow-ups. The disparities in PCC were primarily linked to the type of visit and the age of the oncologist. However, a qualitative analysis showed notable differences in the types of interruptions during visits with foreign patients compared to Italian patients. It is essential to minimize interruptions during intercultural encounters to foster a more respectful and conducive environment for patients. Furthermore, even when foreign patients demonstrate sufficient linguistic competence, healthcare providers should not solely rely on this factor to ensure effective communication and quality care.

Improving the Ability to Write Persuasive Texts in a Boy with Autism Spectrum Disorder: Outcomes of an Intervention.

In this paper, we describe an intervention implemented to assist a 13.2-year-old boy with Autism Spectrum Disorder, G, without intellectual disability, aimed at improving his ability to compose persuasive texts. There was an initial assessment (baseline), an intermediate assessment after two weeks, a six-session intervention phase, and a post-intervention assessment. Our intervention applied two procedures. The first aimed at enhancing general composition abilities in terms of picking (P) ideas, organizing (O) notes, and writing (W) them down (POW), while the second specified the steps to write a persuasive text addressing a possible reader: a topic sentence (T), reasons (R), an explanation (E) for the reasons and the end of the sentence (E) (TREE). These procedures were termed POW + TREE. To analyze G's texts, three types of measures were used by two raters at baseline, intermediate and post-test time: (a) the presence of the TREE components; (b) the quality of the reasons and explanations for the reasons; (c) the number of mental state terms. All these measures showed relevant quantitative improvements, as well as qualitative changes. In addition, when G's performance at the end of the intervention was compared to that of typically developing controls, no statistical difference appeared. The results are discussed in light of the potentialities offered by the type of intervention described here.

Case Report: Theory of Mind and Figurative Language in a Child With Agenesis of the Corpus Callosum.

In this case report, we studied Theory of Mind (ToM) and figurative language comprehension in a 7.2-year-old child, conventionally named RJ, with isolated and complete agenesis of the corpus callosum (ACC), a rare malformation due to the absence of the corpus callosum, the major tract connecting the two brain hemispheres. To study ToM, which is the capability to infer the other's mental states, we used the classical false belief tasks, and to study figurative language, i.e., those linguistic usages involving non-literal meanings, we used tasks assessing metaphor and idiom comprehension. RJ's intellectual level and his phonological, lexical, and grammatical abilities were all adequate. In both the ToM false belief tasks and novel sensory metaphor comprehension, RJ showed a delay of 3 years and a significant gap compared to a typically developing control group, while in idioms, his performance was at the border of average. These outcomes suggest that RJ has a specific pragmatic difficulty in all tasks where he must interpret the other's communicative intention, as in ToM tasks and novel sensory metaphor comprehension. The outcomes also open up interesting insights into the relationships between ToM and figurative language in children with isolated and complete ACC.

Executive Functions and Symptom Severity in an Italian Sample of Intellectually Able Preschoolers with Autism Spectrum Disorder.

A novel battery (BAFE; Valeri et al. 2015) was used in order to assess three executive function (EF) abilities (working memory, inhibition and shifting) in a sample of 27 intellectually able preschoolers with autism spectrum disorder (ASD) compared with 27 typically developing children matched on age and nonverbal IQ. Differences in EF skills were analyzed in participants with distinct ASD symptom severity. Children with ASD performed worse than typical controls on both set-shifting and inhibition, but not on visuo-spatial working memory. Additionally, children with more severe ASD symptoms showed a worse performance on inhibition than children with milder symptoms. These results confirm the presence of EF deficits and highlight a link between ASD symptoms and EF impairments in preschool age.

Reasoning on Figurative Language: A Preliminary Study on Children with Autism Spectrum Disorder and Klinefelter Syndrome.

In this study we explored metaphor and idiom competencies in two clinical populations, children with autistic spectrum disorder (ASD) and children with Klinefelter syndrome (KS), (age range: 9⁻12), compared to typically developing (TD) children of the same age. These three groups were tested with two multiple-choice tests assessing idiom comprehension through iconic and verbal alternatives and a metaphor comprehension test composed of novel, physical-psychological metaphors, requesting verbal explanations. To these instruments, another test was added, assessing basic sentence comprehension. Performances on the different linguistic tasks were examined by means of discriminant analysis which showed that idiom comprehension had a very small weight in distinguishing children with ASD from TD controls, whereas metaphor explanation did distinguish them. This study suggests that figurative language comprehension is not a "core deficit" per se in individuals with ASD. Only when the task requires to explicitly construct and explain a semantic mapping between the two terms of a metaphor does the performance of children with ASD significantly deviate from the typical population. These results are interpreted in terms of a difficulty in children with ASD and KS with complex cognitive and linguistic processes and also in relation with clinical assessment.

Training Verbal Working Memory in Children with Mild Intellectual Disabilities: Effects on Problem-solving / El entrenamiento de la memoria de trabajo verbal en niños con discapacidad intelectual leve: sus efectos en la resolución de problemas

This multiple case study explores the effects of a cognitive training program in children with mild to borderline intellectual disability. Experimental training effects were evaluated comparing pre-/post-test changes of (a) a baseline phase versus a training phase in the same participant, (b) an experimental training versus either a no intervention phase or a control training in two pairs of children matched for cognitive profile. Key elements of the training program d (1) exercises and card games targeting inhibition, switching, and verbal working memory, (2) guided practice emphasizing concrete strategies to engage in exercises, and (3) a variable amount of adult support. The results that both verbal working memory d with the listening span test and problem-solving tested with the Raven’s Matrices were significantly enhanced after the experimental training

Este estudio de caso múltiple explora los efectos de un programa de entrenamiento cognitivo en niños con discapacidad intelectual entre leve y límite. Se evaluaron los efectos de entrenamiento experimental comparándose los cambios pre/posprueba de (a) una fase basal frente a una fase de entrenamiento en el mismo participante y (b) un entrenamiento experimental frente a una fase sin intervención o un entrenamiento de control en dos pares de niños emparejados en el perfil cognoscitivo. Los elementos clave del programa de entrenamiento constaban de: (1) ejercicios y juegos de cartas cuyo objetivo es la atención, inhibición, conmutación y memoria de trabajo verbal, (2) práctica guiada enfatizando estrategias para realizar ejercicios y (3) un grado variable de apoyo por parte del adulto. Los resultados demuestran que tanto la memoria de trabajo verbal analizada mediante la prueba de capacidad de escucha como la resolución de problemas medida a través de las Matrices de Raven mejoraron significativamente después del entrenamiento experimental

Unique designs, errors and strategies in the Five-Point Test: The contribution of age, phonemic fluency and visuospatial abilities in Italian children aged 6-11 years.

Performances on the Five-Point Test of 161 Italian children aged 6 to 11 years were investigated, along with phonemic fluency, visual-motor integration, visual perception, motor coordination, visuospatial memory, and fluid intelligence. Five-Point Test accuracy was significantly related to phonemic fluency and visual-motor integration, while phonemic fluency was linked to motor coordination. The two fluency measures increased linearly with age, but the developmental progression of Five-Point Test accuracy was less influenced by age. Different age effects were also found on the relationship between fluid intelligence and the two fluency measures. The inspection of qualitative aspects of Five-Point Test performance (errors and strategies) suggested that strategy usage enhanced both productivity and accuracy in children; age-related changes were observed in the relationship between the number of errors and the total number of designs produced.

Psychiatric disorders and headache familial recurrence: a study on 200 children and their parents.

The main aim of the study was to examine the relationship between headache and familial recurrence of psychiatric disorders in parents and their children. Headache history and symptomatology have been collected in a clinical sample of 200 patients and their families, using a semi-structured interview (ICHD-II criteria). Psychiatric comorbidity was assessed by DSM-IV criteria. Chi squares and a loglinear analysis were computed in order to evaluate the main effects and interactions between the following factors: frequency and headache subtypes (migraine/not-migraine) in children, headache (migraine/not-migraine-absent/present) in parents, headache (absent/present) in grandparents, and psychiatric comorbidity (absent/present) have been analyzed: 94 mothers (47%) and 51 fathers (25.5%) had at least one psychiatric disorder, mainly mood and anxiety disorders. Considering the significant prevalence of Psi-co in children (P < 0.0001), we compared it with the presence of familiarity to headache: a significant interaction has been found (P < 0.05) showing that migraineurs with high familial recurrence of headache had a higher percentage (74.65%) of psychiatric disorders, than no-migraineurs (52.17%). Absence of headache familial loading seems to be related to psi-co only in no-migraine headache (87.5 vs. 45.5%). The occurrence of psychiatric disorders is high in children with headache, but a very different pattern seems to characterize migraine (familial co-transmission of migraine and Psi-Co?) if compared with non-migraine headache.