A Multidisciplinary Telerehabilitation Approach for Supporting Social Interaction in Autism Spectrum Disorder Families: An Italian Digital Platform in Response to COVID-19.

Due to its complexity and high variability in symptomology, autism spectrum disorder (ASD) requires a coordinated and multidisciplinary intervention to better support the different programs over time and to promote social interactions in all contexts of life. Telemedicine can offer a valuable contribution in this regard, providing low-cost and portable applications. In this paper, we presented an Italian project, SUPER, which aimed to foster collaboration and information sharing between ASD families, health services, and schools. SUPER provided a digital platform with several tools that were useful both to enhance general and specific ASD knowledge and to promote personalized programs for children with ASD. We conducted a preliminary user test for the platform with 30 participants (18 therapists and 12 parents of children with ASD) using the system usability scale (SUS). The total mean SUS score (89.2) showed that SUPER is an excellent, usable system. Moreover, we extracted the usability and learnability mean components from the SUS scores, which were 96.1 and 61.7, respectively. Our preliminary results indicate that SUPER is a very user-friendly application and its innovative telemedicine approach could be ahelpful communication and collaboration tool among the different contexts of care for children with ASD.

Nutritional problems in children with neuromotor disabilities: an Italian case series.

BACKGROUND AND AIMS: Several neuromotor disorders share exclusive, although often overlooked, nutritional problems. The objective of this study is therefore to delineate the frequency of malnutrition, evaluate the effectiveness of nutritional care, and identify issues needing to be possibly strengthened when caring for these patients into a general pediatrics department. PATIENTS AND METHODS: The study included 30 patients, 21 males and 9 females, aged between 2 and 15 years, affected by cerebral palsy, epileptic encephalopathy, and severe psychomotor developmental delay.Nutritional status was assessed by a dietary questionnaire administered to parents to investigate feeding difficulties; 3 days food diary to quantify daily calorie intake; anthropometrical (weight, height/length, body mass index percentiles, plicometry, specific body segments measurement) and blood (blood count, serum iron, albumin, transferrin, calcium, phosphorus) parameters. RESULTS: More than 44% individuals of the study population was at risk of malnutrition, according to feeding difficulties, progressive depletion of weight, reduced daily calorie intake, reduced albumin and transferrin levels. This occurred despite a massive caregivers commitment, as documented by almost universal parental constant assistance during their long-duration meals. CONCLUSIONS: Our results individuate the nutritional aspect being still a problem in the care of children with severe neuromotor disability.

Motor coordination impairment and migraine in children: a new comorbidity?

Migraine without aura (MoA) could be considered the most frequent form of primary headache in children, associated with many known comorbidities, but only the recent literature has begun to consider the importance of motor impairment linked to the attacks. The developmental coordination disorder (DCD) is a very common problem among children, with a prevalence ranging up to 19 %. The aim of this study was to evaluate the presence of motor coordination impairment in a population of children affected by MoA, and its role as putative risk factor for motor skills impairment. This observational study was performed in the Clinic of Child and Adolescent Neuropsychiatry of the Second University of Naples. MoA was diagnosed according to the International Classification of Headache Disorders (IHS-2) criteria. The study population consisted of 27 patients affected by MoA (16 females, 11 males) (mean age: 8.7 ± 2.15 years) and 59 typically developing children (34 females, 25 males) (mean age: 8.0 ± 2.1 years). The whole population underwent a clinical evaluation in order to assess the total IQ level, the visual motor integration skills, and the presence of DCD. Our results showed that MoA children had more impairments in motor coordination (p < 0.001) and visual motor integration (p < 0.001) than control group. To our knowledge, this is the first study to assess the association of poor motor coordination and MoA in children using objective measurements. These findings suggest a new perspective in the management of migraine disease in children, pinpointing that the relationship between DCD and migraine could represent a not yet understood or identified comorbidity, even if further reports are necessary, and that migraine probably could be considered not only a painful syndrome in future.

Is there a distinct form of developmental dyslexia in children with specific language impairment? Findings from an orthographically regular language.

OBJECTIVES: The aim of this study was to identify quantitative and qualitative differences between the reading and writing skills of children with developmental dyslexia and those of dyslexic children with a specific language impairment (SLI). BACKGROUND: It is suggested that although the etiology of developmental dyslexia and SLI may be diverse, dyslexic children with SLI and their language-intact peers are comparable on a behavioral level. METHODS: Three groups of second-grade children were compared on reading and writing tests with single words and nonwords: 15 dyslexic children with a history of SLI (SLI group), 15 dyslexic children with a typical pattern of language development (non-SLI group), and a control group of 30 children with no clinical history of learning disabilities or communication disorders. RESULTS: Analysis of the results revealed the performances of both SLI and non-SLI dyslexic groups to be comparable in terms of speed, accuracy, and error typology. CONCLUSIONS: This study confirms that there are parallels between dyslexic children with language disorders and their dyslexic peers with intact language skills, at least in terms of their performance on reading and writing tests.

Impact of malnutrition on gastrointestinal disorders and gross motor abilities in children with cerebral palsy.

UNLABELLED: Children with cerebral palsy (CP) often demonstrate abnormal feeding behaviours, leading to reduced food consumption and malnutrition. Moreover, most of them present with gastrointestinal disorders, such as gastroesophageal reflux disease (GERD) and/or chronic constipation (CC), and poor motor function rehabilitation. The aim of our study was to assess the possible relationship between malnutrition and gastrointestinal problems and to evaluate the role of nutrition on their gross motor abilities in a population of children with CP and mental retardation. PATIENTS: Twenty-one consecutive children (10 boys; mean age: 5.8+/-4.7 years; range: 1-14 years) with CP and severe mental retardation. METHODS: Nutritional assessment included the measurement of body mass index (BMI=W/H2), fat body mass (FBM) and fat free mass (FFM). Children with symptoms suggesting GERD underwent prolonged 24h intraesophageal pH monitoring and/or upper GI endoscopy with biopsies before and after a 6 months of pharmaceutical (omeprazole) and nutritional (20% increment of daily caloric intake) treatments. The motor function was evaluated by "The Gross Motor Function Measure" (GMFM) before and after the 6 months on nutritional rehabilitation. RESULTS: BMI for age was or=25 degrees percentile, five of nine (55.5%) patients had persistent GERD when they were taken off the medication. CONCLUSIONS: Malnutrition and gastrointestinal disorders are very common in children with cerebral palsy. Improved nutritional status, particularly fat free mass gain, appears to have an impact on motor function in children with CP.

[The role of the environmental factors on the development of adaptive skills in intellectual disabilities subjects]. / Il ruolo dei fattori ambientali sullo sviluppo delle competenze adattive nei soggetti con disabilità intellettiva.

AIMS: The aims of the study was to evaluate if environmental factors can influence the effectiveness of therapeutic intervention of subjects with intellectual disabilities. METHODS: 46 adolescents and adults with mental retardation, in semi-residential rehabilitative treatment, have been assessed over a 2-years period. The evolution of adaptive functioning over time has been assessed through the AAMD-ABS. The development of the adaptive skills at follow-up has been correlated with socio-economic and cultural factors. RESULTS: Linear regression showed that age of both parents, mother's health status, lack of one parent, SES, and housing conditions, represent significant covariates to predicting evolution of the adaptive functioning; these factors independently influence effectiveness of the therapy from the kind of treatment. CONCLUSION: The results demonstrate that effectiveness of the therapy can be conditioned from ability to fulfil the needs of the families, through social and supporting programs.