Bone-Anchored Hearing Devices for Single-Sided Deafness: A New Preoperative Evaluation Protocol and Widening of Indications Proposal.

INTRODUCTION: Bone-anchored hearing devices (BAHD) are well-known good solution for single-sided deafness (SSD). Despite power extension of recently introduced BAHD with implanted active transducer, with indications up to 65 dB Hl of bone conduction (BC) threshold on the implanted side, their indications for SSD still remain better than 25 dB on the good ear, with regards to bone conduction thresholds. The aim of this study was to assess the possibility to enlarge BAHD indications for SSD by means of a newly proposed candidacy evaluation protocol, which includes a new software-aided method. METHODS: 20 SSD patients (mean age 56 years, 9 females, and 11 males) were divided into two groups: group A (10 patients, BC <25 dB Hl on the hearing side) and group B (10 patients, BC between 25 and 35 dB Hl). Recipients were submitted to bisyllabic words speech audiometry in silence and to authors' newly proposed IFastSRT50 test by means of software which shift noise intensity of a single word list on the basis of correct recipient recognition responses. A sound speaker for signal (bisyllabic words) and noise (babble) was disposed at 1 m from the deaf side of the patient. An earphone covering only the good ear of the recipient was used in order to perform its air conduction masking with white noise. A BAHD test device was disposed on the mastoid of the deaf side. Both signal and masking intensities were set to 55 dB SPL in order to mask airway conduction on the good ear without masking its bone way interaural conduction from the BAHD tester. RESULTS: With BAHD tester turned off, no recognition was detected. Speech audiometry with BAHD tester turned on revealed mean values of 92% for group A and 89% for group B, with a difference of 3.0% (χ2 = 0.285 and p = 0.5935). As for IFastSRT50 with BAHD tester turned on, mean signal-to-noise ratio value to obtain 50% of recognition was -6.89 for group A and -6, with a difference of 0.89 (t = 1,201 and p = 0.2453). CONCLUSION: BAHD are confirmed to be a good solution for SSD cases. The absence of statistically significant differences in our two tested groups suggests that newer implanted active transducer device indications should be extended up to 35 dB Hl on the hearing ear. The IFastSRT50 is a reliable and quick method to enhance preoperative candidacy evaluation.

Children on the Autism Spectrum and the Use of Virtual Reality for Supporting Social Skills.

BACKGROUND: Autism spectrum disorders (ASDs) are characterized by differences in socio-pragmatic communication. These conditions are allocated within a "spectrum" of phenotypic variability. Virtual reality (VR) is a useful tool for healthcare intervention and particularly safely advancing social abilities in children with ASD. METHODS: In our study two types of intervention for improving social skills were compared: (i) emotional training obtained by the use of virtual reality (Gr1), (ii) traditional emotional training performed individually with a therapist (Gr2). We aimed to identify the intervention with the shortest acquisition time for the proposed social tasks. RESULTS: Our findings show that both types of intervention had the same acquisition time for the recognition of primary emotions. However, for the use of primary and secondary emotions, the group using VR showed shorter acquisition times. CONCLUSIONS: These findings together with previous preliminary datasuggest that VR can be a promising, dynamic and effective practice for the support of basic and complex social skills of these individuals.

Emotional Rational Education Training Associated with Mindfulness for Managing Anxiety within Adolescents Affected by High-Functioning Autism: A Descriptive Study.

BACKGROUND: Autism spectrum disorder (ASD) is a chronic and persistent pervasive developmental disorder (PDD) whose characteristic deficit is represented by social difficulties, semantic-pragmatic alterations and a limited, unusual and repetitive pattern of interests and behaviors. Specifically, individuals with high-functioning autism (HFA) frequently exhibit associated internalizing symptoms that are not part of the diagnostic criteria but which, nonetheless, tend to impair daily functioning. In this study, we investigated how some forms of treatment could be useful in subjects with HFA who display internalizing symptoms. Theoretical background relates to standard cognitive therapy (SCT) and rational education training with mindfulness (M-ERE). METHODS: In this study, we investigated how some forms of treatment could be useful in subjects with HFA and internalizing symptoms, focusing on standard cognitive therapy (SCT) and mindfulness associated with emotional rational education training (M-ERE). We selected two groups of HFA patients with significant internalizing symptoms and performed two different forms of treatment for six months: SCT and M-ERE. The aim of the study was to verify the effectiveness of an M-ERE protocol with respect to anxious and depressive symptoms in subjects with HFA. Furthermore, we wanted to compare the results obtained with this combined treatment with those obtained in HFA subjects treated with SCT. RESULTS: Our analyses showed an improvement in the internalizing symptoms (especially those related to the anxiety dimension) of the group that followed a treatment based on mindfulness and rational emotional education for 6 months compared to the group that had instead performed a 6-month treatment based on the SCT. CONCLUSIONS: Our hypotheses were supported by the results, which highlighted the efficacy of mindfulness-based interventions in the treatment of internalizing symptoms in adolescents with HFA, and specifically showed that an M-ERE intervention appears more effective in managing anxiety compared to treatment with SCT and appears to be equally effective in the management of depressive symptoms. Not only was the M-ERE treatment effective for the management of anxious and depressive symptoms in subjects with HFA, but the efficacy for the management of anxious symptoms was greater than the SCT treatment.

The Impact of COVID-19 on Cognitive Development and Executive Functioning in Adolescents: A First Exploratory Investigation.

BACKGROUND: The rapid expansion and severity of the COVID-19 contagion has had negative physical and psychological health implications for millions of people around the world, but even more so among children and adolescents. Given the severity of the situation and the small number of studies on the direct influence of viral infection on the cognitive development within adolescents, the present study aims at understanding the consequences of contracting the virus and being hospitalized in relation to cognitive functioning, in particular, for executive functioning, among adolescents. METHODS: To all subjects included in the sample, divided into four groups based on the severity of the COVID-19 infection, were administered the WISC-IV in order to evaluate the global cognitive functioning, and subsequently, the subtests Courses and Tower of London (ToL), both part of the BVN 12-18, were administered for the evaluation of executive operation. RESULTS: Our analyses showed that between subjects who did not contract the viral infection and those who contracted it in an asymptomatic form, there are no significant differences in cognitive functioning, but only in executive functioning. Furthermore, in both hospitalized and non-hospitalized subjects, we found lower scores especially for WM skills, while IQ scores are in a medium range. CONCLUSION: the present study shows that contracting the viral infection and, thus, being hospitalized, caused greater problems and difficulties as compared to those who were not hospitalized, impacting global cognitive (and executive) functioning, especially the WM. We believe that these results could allow an early detection of alterations in cognitive and executive functioning, a fundamental aspect of the interventions that occur in evolutionary phases such as those related to pre-adolescence, allowing, therefore, the activation of functional recovery pathways in a short time.

Parent Training and Therapy in Children with Autism.

With the introduction of the Diagnostic and Statistical Manual of Mental Disorders-5th ed. (DSM-5) autism spectrum disorders (ASD) fall into the category of neurodevelopmental disorders. ASD is characterized by the inhibitory mechanisms responsible for social adaptation and emotional expression being underdeveloped, causing a child's recognition and understanding of emotions to be impaired. Our study hypothesizes that early intervention using behavioral interventions such as Applied Behavior Analysis (ABA) and reflexive functions (RF) training on parents can improve the development of joint attention (JA), a cognitive precursor to the theory of mind (ToM) and mentalization processes. We considered a sample of 84 children aged between 20 and 30 months who had received a diagnosis of risk of autism spectrum disorder (level 1). The sample was divided into two groups of 42 subjects, in the first group we carried out a weekly behavioral parent training (PT) based only on ABA principles, while in the second group we carried out a weekly PT aimed at improving reflective functions and parental awareness according to a model inspired by the model based on emotional mirroring and mentalization of Fonagy. Our study shows that parents who are able to make sense of both their own mental state and that of their child can serve as a protective factor for the child's development even in atypical developmental situations such as in ASD.

Cognitive Development and Cannabis Use in Adolescents.

Heavy exposure to cannabis during adolescence can cause significant neurocognitive changes. It can alter emotional responsiveness and social behavior, and cause impairments in sustained attention, learning, working memory (WM), cognitive flexibility, and the speed of information processing. It also has a significant impact on executive functions. In this study we investigated how global cognitive functions can be affected by the frequency of cannabinoid consumption in different categories of consumers (chronic, occasional, and non-users), through the evaluation of executive functions. Statistical analysis showed a significant decrease in performance in working memory tasks and processing speed by subjects using cannabis chronically (group 1) as compared to non-consumers (group 3), and occasional consumers (group 2). Future studies could verify the extent of neurocognitive alterations through re-evaluations with controlled follow-up and the addition of neuro-functional data.