Iodine Intake and Related Cognitive Function Impairments in Elementary Schoolchildren.

Iodine deficiency, the most common cause of preventable mental impairment worldwide, has been linked to poorer intellectual function in several studies. However, to our knowledge, no studies have been performed in moderate iodine-deficient schoolchildren using the complete form of Wechsler Intelligence Scale for Children (WISC-III; Portuguese version). The main purpose of this study was to ascertain whether moderate iodine deficiency would affect the cognitive function of schoolchildren (7-11 years old; 3rd and 4th grades). Raven's Colored Progressive Matrices (CPM; Portuguese version) were used for measuring the intelligence quotient (IQ) of the total population (n = 256; median UIC = 66.2 µg/L), and the WISC-III was used to study two selected subgroups: one moderately iodine-deficient (n = 30) and the other with adequate iodine intake (n = 30). WISC-III was shown to be the prime instrument for cognitive function assessment among moderate iodine-deficient schoolchildren; this subgroup had a Full-Scale IQ 15.13 points lower than the adequate iodine intake subgroup, with a magnitude effect of d = 0.7 (p = 0.013). Significant differences were also registered in 6 of the 13 Verbal-Performance IQ subtests. Moderate iodine deficiency has a substantial impact on mental development and cognitive functioning of schoolchildren, with significant impairment in both Performance IQ and Verbal IQ spectrum, adversely impacting their educational performance.

[The profile of reading and cognitive skills of children with a history of specific developmental language disorder].

The present study aimed to investigate the profile of reading and cognitive skills of primary school' students with a history of specific developmental language disorder during preschool years. The sample comprised 247 children referred for assessment of their reading difficulties to the University Child Psychiatry Department, at the "Aghia Sophia" Children's Hospital, Athens, Greece. The study was retrospective utilizing medical records from where the following information was drawn: demographic data, presence of a diagnosis of a specific developmental language disorder, results of Reading Test-A and WISC-III. Among the 247 children with normal intelligence IQ>80 (mean age: 10.5 years, 61.5% boys) included in the study, 226 (92.5%) were identified as having significant reading difficulties in at least one of the four subtests of the Reading-A Test (≤ 30 percentile); 72% performed poorly in reading fluency, 67.1% in decoding familiar and pseudowords, 52.8% in reading comprehension and 49.8% in morphosyntax subtest. When comparing children with severe reading difficulties (≤ 10 percentile on the Reading Test A) with a history of specific developmental language disorder (N=110) and no relevant history (N=116), the findings indicated that a significantly higher proportion of children with a history of specific language disorder had severe difficulty in morphosyntax (χ2=21.94, p<0.001) and reading comprehension subtests (χ2=8.89, p <0,001) than those with no history. In terms of the cognitive profile of children with severe reading difficulties, the results showed that a significantly higher proportion of children with a history of developmental language disorder than those with no history had low performance (<7TB) on all WISC-III subtests, however the difference between the two groups was found to be statistically significant on three subtests: "Vocabulary" (p=0.014), Arithmetic (p=0.006), and "Information" (p=0.005). Multiple linear stepwise regression analysis showed that lower levels of the verbal IQ (ß=-0.121, p=0.042) and positive history of developmental language disorder during preschool years (ß=0.537, p<0.001) were independently related to the severity of reading disability. In conclusion, the findings of the present study highlight the importance of early detection of language deficits during the preschool years and timely speech and language therapy intervention.

Long-Term Outcomes of Perinatal Hypoxia and Asphyxia at an Early School Age.

Background and Objectives: Late long-term outcomes of perinatal asphyxia (PA) in school-age are often unclear. To assess long-term outcomes at an early school age in children who had experienced perinatal hypoxia or asphyxia, where therapeutic hypothermia was not applied. Materials and Methods: The case group children were 8-9-year-old children (n = 32) who were born at full term and experienced hypoxia or asphyxia at birth, where therapeutic hypothermia (TH) was not applied. The control group consisted of 8-9-year-old children (n = 16) born without hypoxia. A structured neurological examination was performed at an early school age. The neuromotor function was assessed using the Gross Motor Function Classification System (GMFCS). Health-related quality-of-life was assessed using the Health Utilities Index (HUI) questionnaire. Intellectual abilities were assessed using the Wechsler Intelligence Scale for Children (WISC). Results: The case group, compared with controls, had significantly (p = 0.002) lower mean [SD] full-scale IQ (87(16.86) vs. 107(12.15)), verbal-scale IQ (89(17.45) vs. 105(11.55)), verbal comprehension index (89(17.36) vs. 105(10.74)), working memory index (89(15.68) vs. 104(11.84)), performance IQ (87(16.51) vs. 108(15.48)) and perceptual organization index (85(15.71) vs. 105(15.93)). We did not find any significant differences in the incidence of disorders of neurological examination, movement abilities and health-related quality of life at an early school age between the case and the control group children. Conclusion: In children who experienced perinatal asphyxia but did not have cerebral paralysis (CP), where therapeutic hypothermia was not applied, cognitive assessment scores at an early school age were significantly lower compared to those in the group of healthy children, and were at a low average level.

Outcomes of hydrocephalus secondary to congenital toxoplasmosis.

OBJECTIVE: Hydrocephalus occurs in children with congenital toxoplasmosis and can lead to severe disability. In these cases, the decision to intervene is often influenced by the expectation of neurological recovery. In this study, clinical responses to neurosurgical intervention in children with hydrocephalus secondary to congenital toxoplasmosis are characterized. METHODS: Sixty-five participants with hydrocephalus due to congenital Toxoplasma gondii infection were evaluated as part of the National Collaborative Chicago-based Congenital Toxoplasmosis Study, and their neuroradiographic findings were reviewed. Clinical outcomes were scored on the basis of cognition and motor skills through the use of IQ scores and Gross Motor Function Classification System (GMFCS) level. Outcomes were then analyzed in relation to approach to management, anatomy of hydrocephalus, and time from diagnosis of hydrocephalus to surgical intervention. RESULTS: There was considerable variation in the outcomes of patients whose hydrocephalus was treated in early life, ranging from normal cognitive and motor function to profound developmental delay and functional limitation. Of the 65 participants included in the study, IQ and GMFCS level were available for 46 (70.8%). IQ and motor score were highly correlated (r = -0.82, p < 0.001). There were people with differing patterns of hydrocephalus or thickness of cortical mantle on initial presentation who had favorable outcomes. Time to neurosurgical intervention data were available for 31 patients who underwent ventriculoperitoneal (VP) shunt placement. Delayed shunt placement beyond 25 days after diagnosis of hydrocephalus was associated with greater cognitive impairment (p = 0.02). Motor impairment also appeared to be associated with shunt placement beyond 25 days but the difference did not achieve statistical significance (p = 0.13). Among those with shunt placement within 25 days after diagnosis (n = 19), the mean GMFCS level was 1.9 ± 1.6 (range 1-5). Five (29.4%) of 17 of these patients were too disabled to participate in formal cognitive testing, after excluding 2 patients with visual difficulties or language barriers that precluded IQ testing. Of the patients who had VP shunt placement 25 or more days after diagnosis (n = 12), the mean GMFCS level was 2.7 ± 1.4 (range 1-4). Of these, 1 could not participate in IQ testing due to severe visual difficulties and 8 (72.7%) of the remaining 11 due to cognitive disability. CONCLUSIONS: VP shunt placement in patients with hydrocephalus caused by congenital toxoplasmosis can contribute to favorable clinical outcomes, even in cases with severe hydrocephalus on neuroimaging. Shunt placement within 25 days of diagnosis was statistically associated with more favorable cognitive outcomes. Motor function appeared to follow the same pattern although it did not achieve statistical significance.

Phenylketonuric patients represent their disease.

Background Phenylketonuria (PKU) is a metabolic disorder resulting in high phenylalanine (Phe) blood concentrations due to the deficiency of the hepatic enzyme Phe hydroxylase. High Phe levels are currently treated with diet, thus avoiding mental retardation, psychomotor delay, etc. The aim of this study was to find out the self-presentation of the disease by the patients. Methods A total number of 110 patients self-represented their disease: food allergy (Phe allergy) n = 34/110 (30.9%), health problems n = 31/110 (28.2%), severe health problems n = 26/110 (23.6%), very severe health problems n = 19/110 (17.3%). The Wechsler Intelligence Scale for Children (WISC III) psychometric test was utilized for the evaluation of IQ scores of each participant. A special questionnaire was used focusing on quality of life (QL), social discrimination (SD) and anxiety or depression (AD). Results IQ scores were found to be higher in food allergy self-represented patients than those of the other tested groups. The lowest IQ scores were observed in those who represented very severe disease. QL, SD and AD were not observed in the food allergy groups. On the contrary, those who self-presented as very severe diseased patients felt high a disturbance of QL, SD and AD. Conclusions The food allergy group seemed to be a very clever excuse for adhering to PKU treatment resulting in high IQ scores and absence of the mentioned upsets. In contrast, in the other groups of patients' IQ scores were found to be lower than that of food allergy group. Damage of QL, SD, AD were also apparent.

The association of epileptic focus estimated by magnetoencephalography with cognitive function in non-lesional epilepsy with continuous spikes and waves during slow wave sleep (ECSWS) children.

OBJECTIVE: Epilepsy with continuous spikes and waves during slow sleep (ECSWS) is associated with cognitive deficits. The underlying mechanism is thought to relate to disturbance of functions of the foci by the persistent epileptic activity. However, the relationship between epileptic foci and cognitive deficits remains largely unknown, except for in Landau-Kleffner syndrome. The aim of this study was to evaluate the relationship of epileptic foci estimated from magnetoencephalography (MEG) with cognitive functions at the period of diagnosis in non-lesional ECSWS children, excluding those with Landau-Kleffner syndrome. METHODS: MEG data and the Wechsler intelligence scale for children-III scores at ECSWS diagnosis, and medical records, were reviewed. Multiple regression analysis was performed to examine the relationship of parameters of MEG spike dipole clusters, including anatomical location or laterality, with the Wechsler intelligence scale for children-III scores at ECSWS diagnosis. RESULTS: Sixteen patients were included, all of whom were right-handed. Epilepsy onset (first unprovoked seizure) ranged from 31 to 110 months (mean, 68.5). The age at ECSWS diagnosis ranged from 72 to 156 months (mean, 108.9). The dipole clusters were estimated on the right Rolandic area (RA) in 4 patients (25%), right supramarginal gyrus (SMG) in 3 (19%), left RA in 2 (13%), left SMG in 2 (13%), bilateral RA in 3 (19%), multiple anatomical locations in 2 (13%). The age at epilepsy onset had the strongest prognostic effect, and full-scale intelligence quotient was relatively less-affected if the cluster was found on the SMG (ß = 14.7, p = 0.031). Cases with only a right side cluster exhibited reduced impairment of perceptual organization compared with those with only a left side cluster or bilateral clusters (ß = 17.48, p = 0.02). In 12 patients, long-term intellectual prognosis was evaluated, and was associated with intellectual level at the period of ECSWS diagnosis. CONCLUSION: In non-lesional ECSWS, the relationship between epileptic focus and cognitive deficits differs from that observed in adults. Rather, it is similar to epilepsies associated with congenital or early infantile brain insults, in that the left epileptic foci in right-handed patients were associated with lower non-verbal functions. Future studies are required to determine the role of plasticity of the immature brain in driving these differences.

A comparison of three-factor structure models using WISC-III in Greek children with learning disabilities.

BACKGROUND: Children with learning disabilities are a heterogeneous group of children with a common characteristic discrepancy on the progress and development of their individual learning abilities. A few statistical analyses have been published regarding the factor analysis of the Greek Edition of Wechsler Intelligence Scale for Children-III. The aim of the research is the emergence of a new factorial model which describes the General Intelligence (g) of children and adolescents with learning disabilities, and that differs from the already existing intelligence models. This study aims to compare three-factor structure models of WISC-III in children with learning disabilities in the Greek population. METHODS: A sample of 50 children were selected on the basis of research criteria from a total of 122 children who evaluated in a child psychiatric service in a general hospital, in a residential area in Greece. The Wechsler Intelligence Scale for Children-Third Edition was used to assess children's cognitive function. Using multi-factor analysis, three alternative factor models were compared. RESULTS: Analysis of factor structure models suggests a new bi-factorial model that more appropriately describes the areas of cognitive development of children with learning disabilities. The first factor includes Comprehension, Picture Arrangement, Coding, Block Design, and Object Assembly, whereas the second one combines Information, Similarities, Arithmetic, Vocabulary, and Picture Arrangement. CONCLUSIONS: The present study shows the existence of a factorial model with two factors: one aggregating the Comprehension verbal subtest with four performance subtests and the other the Picture Arrangement performance subtest with four verbal subtests. This two-factor model includes the loadings in two factors that relate to sequencing abilities and verbal reasoning abilities of children. These findings assert the clinical utility of the intelligence evaluation in the specific population.

WISC-III: Instrumento para Confirmação de Altas Habilidades:superdotação / WISC-III: Instrument for Confirmation of Giftedness / WISC-III: Instrumento para la Confirmación de Altas Habilidades:superdotación

A identificação de alunos com altas habilidades/superdotação (AH/SD) é um processo complexo e necessário. Em uma escola estadual de uma cidade do interior do estado de São Paulo, os 326 alunos que frequentavam os primeiros anos do ensino fundamental participaram de uma triagem para identificação de AH/SD. Utilizaram-se o teste das Matrizes Progressivas de Raven, o Teste de Desempenho Escolar (TDE) e a indicação do professor, via um protocolo de avaliação. Setenta e quatro alunos, de seis a 11 anos de idade, apresentaram indicadores de AH/SD em pelo menos dois dos instrumentos. O presente estudo pretendeu confirmar o alto desempenho intelectual deles utilizando o WISC-III. Para confirmar as AH/SD, adotou-se o critério de pelo menos dois indicadores, dos quatro instrumentos aplicados: apresentar um percentil de 90 ou mais no Raven; ter pelo menos dois resultados superiores nos subtestes do TDE; ser indicado pelo professor ou apresentar um QI de 130 ou mais em qualquer um dos subgrupos (QI Verbal, QI de Execução e QI Total) no WISCIII. Foram confirmados 11 alunos utilizando os critérios definidos. Também foram identificados 14 alunos que obtiverem pelo menos um QI superior no WISC-III. Os resultados apontaram que o WISC-III se mostrou adequado para confirmar a identificação de alunos com AH/SD e, também, apontar um grupo de alunos que apresentaram resultados superiores, potencialmente com AH/ SD, que se beneficiariam de serviços específicos. Considerando a idade dos participantes, sugerese que o WISC-III seja utilizado para monitorar sistematicamente o seu desempenho intelectual juntamente com instrumentos que avaliem seus interesses e habilidades....(AU)

The identification of students with giftedness is a complex and necessary process. In a state school located in a city of the State of São Paulo, 326 pupils who have attended to the early years of elementary school were evaluated in order to identify giftedness. Raven's Progressive Matrices test, the School Achievement Test and teacher`s indication through an evaluation protocol were used. ness indicators in two instruments at least. This study intended to confirm the high intellectual development of those pupils using the WISC-III. In order to confirm giftedness, the chosen criterion was to consider at least two indicators of the four instruments used: presenting a percentile of 90 or higher in Raven's test; obtaining at least two higher results in School Achievement Test subtests; being pointed by the teacher or achieving a result of 130 or higher in any subgroups (Verbal IQ, Execution IQ and Total IQ) on WISC-III. Eleven students were confirmed by these criteria. Fourteen students who reached at least one higher IQ on WISC-III were identified as well. The WISC-III results were considered suitable to confirm the identification of students with giftedness and, also, pointed a group of pupils who showed higher results, potentially with giftedness, and were benefited from specific services. Considering the age of the participants, it is suggested that WISC-III could be used to track their intellectual development with instruments which could evaluate their interests and skills....(AU)

La identificación de alumnos con altas habilidades/superdotación (AH/SD) es un proceso  complejo y necesario. En una escuela estatal de una ciudad del interior del Estado de São Paulo, los 326 alumnos que frecuentaban los primeros años de la enseñanza primaria participaron en una selección para identificación de AH/SD. Se utilizó la prueba de las Matrices Progresivas de Raven, la Prueba de Desempeño Escolar y la indicación del profesor, a través de un protocolo de evaluación. 74 alumnos, de seis a 11 años de edad, presentaron indicadores de AH/SD en al menos dos de los instrumentos. El presente estudio pretendió confirmar el alto desempeño intelectual de ellos utilizando el WISC-III. Para confirmar las AH/ SD, se adoptó el criterio de al menos dos indicadores, de los cuatro instrumentos aplicados: presentar un percentil de 90 o más en el Raven; tener por lo menos dos resultados superiores en las subpruebas de la Prueba de Desempeño Escolar; ser indicado por el profesor o presentar un CI de 130 o más en cualquiera de los subgrupos (CI Verbal, CI de Ejecución y CI Total) en el WISC-III. Se han confirmados 11 alumnos utilizando los criterios definidos. También se han identificados 14 alumnos que obtienen al menos un CI superior WISC-III. Los resultados apuntaron que el WISC-III se mostró adecuado para confirmar la identificación de alumnos con AH/SD y, también, apuntar un grupo de alumnos que presentaron resultados superiores, potencialmente con AH/SD, que se beneficiaría de servicios específicos. Considerando la edad de los participantes, se sugiere que el WISC-III se utiliza para supervisar sistemáticamente su rendimiento intelectual junto con instrumentos que evalúen sus intereses y habilidades....(AU)

MRI-guided stereotactic radiofrequency thermocoagulation for 100 hypothalamic hamartomas.

OBJECT The aim of this study was to elucidate the invasiveness, effectiveness, and feasibility of MRI-guided stereotactic radiofrequency thermocoagulation (SRT) for hypothalamic hamartoma (HH). METHODS The authors examined the clinical records of 100 consecutive patients (66 male and 34 female) with intractable gelastic seizures (GS) caused by HH, who underwent SRT as a sole surgical treatment between 1997 and 2013. The median duration of follow-up was 3 years (range 1-17 years). Seventy cases involved pediatric patients. Ninety percent of patients also had other types of seizures (non-GS). The maximum diameter of the HHs ranged from 5 to 80 mm (median 15 mm), and 15 of the tumors were giant HHs with a diameter of 30 mm or more. Comorbidities included precocious puberty (33.0%), behavioral disorder (49.0%), and mental retardation (50.0%). RESULTS A total of 140 SRT procedures were performed. There was no adaptive restriction for the giant or the subtype of HH, regardless of any prior history of surgical treatment or comorbidities. Patients in this case series exhibited delayed precocious puberty (9.0%), pituitary dysfunction (2.0%), and weight gain (7.0%), besides the transient hypothalamic symptoms after SRT. Freedom from GS was achieved in 86.0% of patients, freedom from other types of seizures in 78.9%, and freedom from all seizures in 71.0%. Repeat surgeries were not effective for non-GS. Seizure freedom led to disappearance of behavioral disorders and to intellectual improvement. CONCLUSIONS The present SRT procedure is a minimally invasive and highly effective surgical procedure without adaptive limitations. SRT involves only a single surgical procedure appropriate for all forms of epileptogenic HH and should be considered in patients with an early history of GS.

Normalization of brain morphology after surgery in sagittal craniosynostosis.

OBJECT Nonsyndromic craniosynostosis (NSC) is associated with significant learning disability later in life. Surgical reconstruction is typically performed before 1 year of age to correct the cranial vault morphology and to allow for normalized brain growth with the goal of improving cognitive function. Yet, no studies have assessed to what extent normalized brain growth is actually achieved. Recent advances in MRI have allowed for automated methods of objectively assessing subtle and pronounced brain morphological differences. The authors used one such technique, deformation-based morphometry (DBM) Jacobian mapping, to determine how previously treated adolescents with sagittal NSC (sNSC) significantly differ in brain anatomy compared with healthy matched controls up to 11.5 years after surgery. METHODS Eight adolescent patients with sNSC, previously treated via whole-vault cranioplasty at a mean age of 7 months, and 8 age- and IQ-matched control subjects without craniosynostosis (mean age for both groups = 12.3 years), underwent functional 3-T MRI. Statistically significant group tissue-volume differences were assessed using DBM, a whole-brain technique that estimates morphological differences between 2 groups at each voxel (p < 0.01). Group-wise Jacobian volume maps were generated using a spacing of 1.5 mm and a resolution of 1.05 × 1.05 × 1.05 mm(3). RESULTS There were no significant areas of volume reduction or expansion in any brain areas in adolescents with sNSC compared with controls at a significance level of p < 0.01. At the more liberal threshold of p < 0.05, two areas of brain expansion extending anteroposteriorly in the right temporooccipital and left frontoparietal regions appeared in patients with sNSC compared with controls. CONCLUSIONS Compared with previous reports on untreated infants with sNSC, adolescents with sNSC in this cohort had few areas of brain dysmorphology many years after surgery. This result suggests that comprehensive cranioplasty performed at an early age offers substantial brain normalization by adolescence, but also that some effects of vault constriction may still persist after treatment. Specifically, few areas of expansion in frontoparietal and temporooccipital regions may persist. Overall, data from this small cohort support the primary goal of surgery in allowing for more normalized brain growth. Larger samples, and correlating degree of normalization with cognitive performance in NSC, are warranted.

Parietal dysfunction during number processing in children with fetal alcohol spectrum disorders.

Number processing deficits are frequently seen in children prenatally exposed to alcohol. Although the parietal lobe, which is known to mediate several key aspects of number processing, has been shown to be structurally impaired in fetal alcohol spectrum disorders (FASD), effects on functional activity in this region during number processing have not previously been investigated. This fMRI study of 49 children examined differences in activation associated with prenatal alcohol exposure in five key parietal regions involved in number processing, using tasks involving simple addition and magnitude comparison. Despite generally similar behavioral performance, in both tasks greater prenatal alcohol exposure was related to less activation in an anterior section of the right horizontal intraparietal sulcus known to mediate mental representation and manipulation of quantity. Children with fetal alcohol syndrome and partial fetal alcohol syndrome appeared to compensate for this deficit by increased activation of the angular gyrus during the magnitude comparison task.

Altered brain connectivity in sagittal craniosynostosis.

OBJECT: Sagittal nonsyndromic craniosynostosis (sNSC) is the most common form of NSC. The condition is associated with a high prevalence (> 50%) of deficits in executive function. The authors employed diffusion tensor imaging (DTI) and functional MRI to evaluate whether hypothesized structural and functional connectivity differences underlie the observed neurocognitive morbidity of sNSC. METHODS: Using a 3-T Siemens Trio MRI system, the authors collected DTI and resting-state functional connectivity MRI data in 8 adolescent patients (mean age 12.3 years) with sNSC that had been previously corrected via total vault cranioplasty and 8 control children (mean age 12.3 years) without craniosynostosis. Data were analyzed using the FMRIB Software Library and BioImageSuite. RESULTS: Analyses of the DTI data revealed white matter alterations approaching statistical significance in all supratentorial lobes. Statistically significant group differences (sNSC < control group) in mean diffusivity were localized to the right supramarginal gyrus. Analysis of the resting-state seed in relation to whole-brain data revealed significant increases in negative connectivity (anticorrelations) of Brodmann area 8 to the prefrontal cortex (Montreal Neurological Institute [MNI] center of mass coordinates [x, y, z]: -6, 53, 6) and anterior cingulate cortex (MNI coordinates 6, 43, 14) in the sNSC group relative to controls. Furthermore, in the sNSC patients versus controls, the Brodmann area 7, 39, and 40 seed had decreased connectivity to left angular gyrus (MNI coordinates -31, -61, 34), posterior cingulate cortex (MNI coordinates 13, -52, 18), precuneus (MNI coordinates 10, -55, 54), left and right parahippocampus (MNI coordinates -13, -52, 2 and MNI coordinates 11, -50, 2, respectively), lingual (MNI coordinates -11, -86, -10), and fusiform gyri (MNI coordinates -30, -79, -18). Intrinsic connectivity analysis also revealed altered connectivity between central nodes in the default mode network in sNSC relative to controls; the left and right posterior cingulate cortices (MNI coordinates -5, -35, 34 and MNI coordinates 6, -42, 39, respectively) were negatively correlated to right hemisphere precuneus (MNI coordinates 6, -71, 46), while the left ventromedial prefrontal cortex (MNI coordinates 6, 34, -8) was negatively correlated to right middle frontal gyrus (MNI coordinates 40, 4, 33). All group comparisons (sNSC vs controls) were conducted at a whole brain-corrected threshold of p < 0.05. CONCLUSIONS: This study demonstrates altered neocortical structural and functional connectivity in sNSC that may, in part or substantially, underlie the neuropsychological deficits commonly reported in this population. Future studies combining analysis of multimodal MRI and clinical characterization data in larger samples of participants are warranted.

WISC-III cognitive profiles in children with developmental dyslexia: specific cognitive disability and diagnostic utility.

This study analysed the usefulness of the Wechsler Intelligence Scale for Children-Third Edition in identifying specific cognitive impairments that are linked to developmental dyslexia (DD) and the diagnostic utility of the most common profiles in a sample of 100 Portuguese children (50 dyslexic and 50 normal readers) between the ages of 8 and 12 years. Children with DD exhibited significantly lower scores in the Verbal Comprehension Index (except the Vocabulary subtest), Freedom from Distractibility Index (FDI) and Processing Speed Index subtests, with larger effect sizes than normal readers in Information, Arithmetic and Digit Span. The Verbal-Performance IQs discrepancies, Bannatyne pattern and the presence of FDI; Arithmetic, Coding, Information and Digit Span subtests (ACID) and Symbol Search, Coding, Arithmetic and Digit Span subtests (SCAD) profiles (full or partial) in the lowest subtests revealed a low diagnostic utility. However, the receiver operating characteristic curve and the optimal cut-off score analyses of the composite ACID; FDI and SCAD profiles scores showed moderate accuracy in correctly discriminating dyslexic readers from normal ones. These results suggested that in the context of a comprehensive assessment, the Wechsler Intelligence Scale for Children-Third Edition provides some useful information about the presence of specific cognitive disabilities in DD. Practitioner Points. Children with developmental dyslexia revealed significant deficits in the Wechsler Intelligence Scale for Children-Third Edition subtests that rely on verbal abilities, processing speed and working memory. The composite Arithmetic, Coding, Information and Digit Span subtests (ACID); Freedom from Distractibility Index and Symbol Search, Coding, Arithmetic and Digit Span subtests (SCAD) profile scores showed moderate accuracy in correctly discriminating dyslexics from normal readers. Wechsler Intelligence Scale for Children-Third Edition may provide some useful information about the presence of specific cognitive disabilities in developmental dyslexia.

Intellectual functioning in children with epilepsy: frontal lobe epilepsy, childhood absence epilepsy and benign epilepsy with centro-temporal spikes.

PURPOSE: The purpose of our study is to describe intellectual functioning in three common childhood epilepsy syndromes - frontal lobe epilepsy (FLE), childhood absence epilepsy (CAE) and benign epilepsy with centro-temporal spikes (BECTS). And also to determine the influence of epilepsy related variables, type of epilepsy, age at epilepsy onset, duration and frequency of epilepsy, and treatment on the scores. METHODS: Intellectual functioning was examined in a group of 90 children with epilepsy (30 FLE, 30 CAE, 30 BECTS), aged 6-15 years, and compared with a control group (30). All subjects obtained a Full Scale IQ ≥ 70 and they were receiving no more than two antiepileptic medications. Participants completed the Wechsler Intelligence Scale for Children - Third Edition. The impact of epilepsy related variables (type of epilepsy, age at epilepsy onset, duration of epilepsy, seizure frequency and anti-epileptic drugs) on intellectual functioning was examined. RESULTS: Children with FLE scored significantly worse than controls on WISC-III Verbal IQ, Full Scale IQ and Processing Speed Index. There was a trend for children with FLE to have lower intelligence scores than CAE and BECTS groups. Linear regression analysis showed no effect for age at onset, frequency of seizures and treatment. Type of epilepsy and duration of epilepsy were the best indicators of intellectual functioning. CONCLUSION: It is crucial that children with FLE and those with a longer active duration of epilepsy are closely monitored to allow the early identification and evaluation of cognitive problems, in order to establish adequate and timely school intervention plans.

Fidedignidade do WISC-III com base na concordância entre avaliadores / WISC-III reliability based in inter-rater agreement

Este trabalho pretendeu estabelecer os índices de fidedignidade do WISC-III, utilizando a técnica de concordância entre avaliadores, tendo em vista, que a subjetividade dos profissionais que utilizam o teste pode interferir diretamente em seus resultados. Foram selecionados, aleatoriamente, da amostra de padronização ao contexto brasileiro, protocolos dos testes de três crianças com a mesma idade, os quais foram pontuados por 42 psicólogos de diferentes estados do Brasil. Baseando-se nos escores totais, a precisão foi calculada através do índice de correlação intra-classe e os coeficientes, em geral, foram considerados fortes. Os subtestes não-verbais, com exceção de Completar Figuras, apresentaram os índices mais altos, sendo que as correlações dos subtestes verbais foram menores. Os resultados evidenciaram que a correção objetiva dos itens propicia maior consenso entre os avaliadores e quando as respostas a serem pontuadas envolvem verbalizações, existem maiores dificuldades.(AU)

This work aimed to establish Wechsler Intelligence Scale for Children - Third Edition (WISC-III) reliability indexes through the inter-rater agreement technique, keeping in mind that the scores could be influenced by subjective factors of the raters. Three WISC-III protocols of children of the same age were randomly selected from the Brazilian standardization sample and were scored by 42 psychologists from different States of Brazil. Reliability was assessed through the intraclass correlation index, on the base of total scores. Coefficients were considered strong in general. All nonverbal subtests, except Picture Completion, presented higher indexes than the verbal subtests. Results suggest that objective scoring propitiates greater consensus between the raters, and verbal answers produce more scoring difficulties.(AU)

Fidedignidade do WISC-III com base na concordância entre avaliadores / WISC-III reliability based in inter-rater agreement

Este trabalho pretendeu estabelecer os índices de fidedignidade do WISC-III, utilizando a técnica de concordância entre avaliadores, tendo em vista, que a subjetividade dos profissionais que utilizam o teste pode interferir diretamente em seus resultados. Foram selecionados, aleatoriamente, da amostra de padronização ao contexto brasileiro, protocolos dos testes de três crianças com a mesma idade, os quais foram pontuados por 42 psicólogos de diferentes estados do Brasil. Baseando-se nos escores totais, a precisão foi calculada através do índice de correlação intra-classe e os coeficientes, em geral, foram considerados fortes. Os subtestes não-verbais, com exceção de Completar Figuras, apresentaram os índices mais altos, sendo que as correlações dos subtestes verbais foram menores. Os resultados evidenciaram que a correção objetiva dos itens propicia maior consenso entre os avaliadores e quando as respostas a serem pontuadas envolvem verbalizações, existem maiores dificuldades...

This work aimed to establish Wechsler Intelligence Scale for Children - Third Edition (WISC-III) reliability indexes through the inter-rater agreement technique, keeping in mind that the scores could be influenced by subjective factors of the raters. Three WISC-III protocols of children of the same age were randomly selected from the Brazilian standardization sample and were scored by 42 psychologists from different States of Brazil. Reliability was assessed through the intraclass correlation index, on the base of total scores. Coefficients were considered strong in general. All nonverbal subtests, except Picture Completion, presented higher indexes than the verbal subtests. Results suggest that objective scoring propitiates greater consensus between the raters, and verbal answers produce more scoring difficulties...

Características do desempenho no WISC-III em crianças com dislexia do desenvolvimento / Characteristics of the WISC-III performance in children with developmental dyslexia

Esta pesquisa teve como objetivo analisar e comparar o desempenho no WISC-III de crianças com dislexia do desenvolvimento com o de dois grupos controle, a fim de verificar a existência de características específicas no desempenho desta escala no grupo com dislexia. Ao todo foram 57 sujeitos, divididos entre o grupo dos disléxicos (n=20), o grupo controle 1 (GC1) formado por crianças sem queixa de dificuldade escolar da mesma idade cronológica e série dos disléxicos (n=21), e grupo controle 2 (GC2) formado por alunos do segundo ano do Ensino Fundamental, que ainda estavam no processo inicial de aprendizagem da leitura e da escrita (n=16). Os dados do grupo dos disléxicos foram coletados a partir dos registros da Clínica Psicológica da Universidade Estadual de Londrina, em que constava o diagnóstico de dislexia no período de 2006 a 2011. Para o delineamento dos grupos controle, levou-se em consideração também a escola em que os disléxicos estavam matriculados na época da avaliação (estadual, municipal e particular). Para análise estatística, foi utilizado o programa SPSS para Windows, sendo que a significância adotada foi menor que 0,05. Quanto aos resultados, o grupo dos disléxicos, quando comparado aos dois grupos controle, teve pior desempenho nas Escalas de Resistência à Distração e Velocidade de Processamento. Pesquisas mostram que os disléxicos geralmente apresentam baixo desempenho em alguns subtestes, descrito como perfil ACID. Nesta pesquisa, o grupo dos disléxicos teve desempenho menor que os dois grupos controle nos subtestes Dígitos, Código e Procurar Símbolos, mas este dado não foi encontrado no subteste Aritmética. O desempenho dos disléxicos também foi menor nos subtestes Informação e Semelhanças, mas apenas em comparação ao GC1, o que sugere que esse resultado seja devido à dificuldade escolar do disléxico vivenciada através dos anos.(AU)

This study aimed to analyze and compare the performance on WISC-III in children with developmental dyslexia with the two control groups in order to check for specific performance characteristics of this scale in the group with dyslexia. Altogether, there were 57 subjects, divided between the group of dyslexics (n = 20), the control group 1 (GC1) formed by children without school difficulties of the same chronological age and grade of dyslexics (n = 21) and control group 2 (CG2) formed by students of the second year of elementary school, that were still in the initial process of reading and writing (n= 16). Data from the group of dyslexics were collected from the records of the Psychological Clinic at the Universidade Estadual de Londrina, which appeared the diagnosis of dyslexia in the period from 2006 to 2011. For the design of the control groups, the school that dyslexics were enrolled at the time of assessment (state, municipal and private) was considered. Statistical analysis was performed using the SPSS program for Windows, and the significance adopted was less than 0.05. As for the results, the group of dyslexics when compared to control groups had lower performance in sub scales Freedom from Distractibility and Processing Speed. Research shows that dyslexics often have low performance on some subtests, described as ACID profile. In this study, the dyslexic group had lower performance than the two control groups on Digit Span, Coding and Symbol Search, but this finding was not found in the Arithmetic subtest. The performance of dyslexics was also lower in Information and Similarities subtests, but only compared to the GC1, suggesting that this result is due to the difficulty of dyslexic school experienced through the years.(AU)

Caracterización de los resultados del Test WISC–III aplicado a 50 niños con trastornos del aprendizaje en Asunción del Paraguay / Characterization of WISC-III Test Results Applied to 50 Children with Learning Disorders in Asuncion, Paraguay

El presente trabajo reporta la investigación de diseño descriptivo, con enfoque cuantitativo, comparativo y transversal que responde a la problemática de identificación de los resultados del Test de Inteligencia para Niños de Wechsler Tercera Edición (WISC-III) en 50 escolares con Trastornos del Aprendizaje de Asunción, Paraguay. Tiene como objetivos caracterizar las derivaciones obtenidas en referencia a los cocientes de inteligencia, a los análisis factoriales, a los 13 subtest y al perfil ACID (suma de los puntajes equivalentes para Aritmética, Claves, Información y Retención de Dígitos), comparándolas con las logradas por investigadores independientes, en una exploración similar efectuada en Estados Unidos. El presente estudio fue realizado durante el año 2010, a través del relevamiento de datos de los resultados de la aplicación del Test WISC–III a 37 niños y 13 niñas con edades comprendidas entre los 6 y 11 años, evaluados y diagnosticados como portadores de Trastornos del Aprendizaje (TA) en el Instituto de Neuropsicología del Aprendizaje y del Lenguaje (INPAL). Se concluye que el rendimiento de los niños con dicho trastorno en el test WISC-III se caracteriza por un Cociente de Inteligencia Verbal levemente inferior al Cociente de Inteligencia de Ejecución, un Índice de Comprensión Verbal menor al Índice de Organización Perceptual, con cocientes deprimidos en el Índice de Ausencia de Distractibilidad e Índice de Velocidad de Procesamiento con respecto a los demás puntajes Índices. Los subtest con puntuaciones medias más elevadas fueron: Completamiento de Figuras y Composición de Objetos mientras que los más bajos se presentaron en Ordenamiento de Historias e Información, lográndose determinar la presencia del Perfil ACID pleno en el 6 % de los casos y del parcial en el 8,1 % de los mismos .

We report the quantitative results of a comparative crosssectional and descriptive study of problems in identifying the results of the Wechsler Intelligence Scale for Children, Third Edition (WISC-III) in 50 schoolchildren with learning disorders in Asunción, Paraguay. Our objective was to describe the results obtained for intelligence quotients, factor analyses, the 13 subtests, and the ACID profile (which summarizes the equivalent scores for arithmetic, coding, information and digit span), and compare them to those obtained by independent investigators in a similar study done in the United States. Our study was carried out during 2010 using the results on the WISCIII test from 37 male and 13 female children aged 6 to 11 years who were assessed and diagnosed as having learning disabilities at the Instituto de Neuropsicología del Aprendizaje y del Lenguaje (INPAL). On the WISC-III test, children with learning disorders showed a verbal intelligence quotient slightly lower than their performance intelligence quotient and a verbal comprehension index lower than their perceptual organization index, as well as lower scores on the freedom from distractibility and processing speed indexes compared to other indexes. The subtests with the highest median scores were picture completion and block design, while the lowest were in picture arrangement and information, with full ACID profiles found in 6% of children and partial ACID profile in 8.1%

Versão abreviada do WISC-III: correlação entre QI estimado e QI total em crianças brasileiras / Abbreviated version of the WISC-III: correlation between estimated IQ and global IQ of brazilian children

Com o objetivo de correlacionar o QI Estimado com o QI Total, quatro bancos de dados do WISC III de 207 crianças foram associados: 1) crianças com desenvolvimento típico; 2) crianças com diagnóstico do transtorno do déficit de atenção e hiperatividade; 3) crianças referenciadas por dificuldades de aprendizagem em consultório particular; e 4) crianças com sequela neurológica avaliadas em ambulatório universitário. Os dados do QI total foram correlacionados aos do QI estimado, correspondentes à soma dos pontos ponderados dos subtestes Vocabulário e Cubos. Os resultados sugerem que o QI Estimado pode ser adotado quando há restrição de tempo e quando o desempenho intelectual está sendo usado como triagem em pesquisa, ou como ponto de referência dentro de uma avaliação neuropsicológica.

In order to calculate the correlation between the Estimated IQ and the Full Scale IQ of children submitted to the WISC III, four different data banks with a total of 207 children were integrated: (1) typically developing children, (2) children diagnosed as having Attention Deficit/ Hyperactivity Disorder, (3) children identified by private clinics as having learning disabilities (4) children with neurological sequelae diagnosed by a public university outpatient treatment program. Results suggest that the Estimated IQ, which is based on the weighted sum of the subtest scores of Cubes and Vocabulary, may be used in the presence of time constraints, when intellectual performance is important for screening in research procedures, and as a reference within a broader neuropsychological evaluation.

Versão abreviada do WISC-III: correlação entre QI estimado e QI total em crianças brasileiras / Abbreviated version of the WISC-III: correlation between estimated IQ and global IQ of brazilian children

Com o objetivo de correlacionar o QI Estimado com o QI Total, quatro bancos de dados do WISC III de 207 crianças foram associados: 1) crianças com desenvolvimento típico; 2) crianças com diagnóstico do transtorno do déficit de atenção e hiperatividade; 3) crianças referenciadas por dificuldades de aprendizagem em consultório particular; e 4) crianças com sequela neurológica avaliadas em ambulatório universitário. Os dados do QI total foram correlacionados aos do QI estimado, correspondentes à soma dos pontos ponderados dos subtestes Vocabulário e Cubos. Os resultados sugerem que o QI Estimado pode ser adotado quando há restrição de tempo e quando o desempenho intelectual está sendo usado como triagem em pesquisa, ou como ponto de referência dentro de uma avaliação neuropsicológica.

In order to calculate the correlation between the Estimated IQ and the Full Scale IQ of children submitted to the WISC III, four different data banks with a total of 207 children were integrated: (1) typically developing children, (2) children diagnosed as having Attention Deficit/ Hyperactivity Disorder, (3) children identified by private clinics as having learning disabilities (4) children with neurological sequelae diagnosed by a public university outpatient treatment program. Results suggest that the Estimated IQ, which is based on the weighted sum of the subtest scores of Cubes and Vocabulary, may be used in the presence of time constraints, when intellectual performance is important for screening in research procedures, and as a reference within a broader neuropsychological evaluation.