Borderline intellectual functioning: an increased risk of severe psychiatric problems and inability to work.

BACKGROUND: The use of facilities such as disability pension, psychiatric care, health care and services for people with intellectual disabilities and borderline intellectual functioning (BIF) were compared with the general population and two other study groups comprising people with mild intellectual disabilities (MIDs) and learning problems (LPs). METHODS: The population-based sample (N = 416,973), 'Finland-in-Miniature', was gathered in 1962 and followed until 1998. For the purpose of the present study, three groups were formed: BIF (n = 416), MID (n = 312) and LP (n = 284). The use of services was examined with the help of national registers. RESULTS: As compared with the general population, people with BIF had been granted disability pension 2.7 times more often and had been patients in psychiatric care 3.4 times more often. They had also systematically used more services than people with LP. CONCLUSIONS: People with BIF are at risk of inability to work and facing severe mental health problems. They also seem to have more severe psychiatric problems than people with MID and LP. There is, therefore, a crucial need for increasing the awareness in society of BIF. Although this study's follow-up data were collected about 20 years ago, it is still relevant because people with BIF are a neglected group and still face growing demands in school and work life with no marked changes in services.

Psychometric properties of observational tools for identifying motor difficulties - a systematic review.

BACKGROUND: Early identification of children with motor difficulties, such as developmental coordination disorder (DCD), is essential. At present only a fraction of children with DCD are identified. The purpose of the study was to systematically review the literature from 1994 to 2017 on observational screening tools and to evaluate the validity, reliability and usability of the questionnaires used. METHODS: The review of the literature was conducted to synthesize the data from five electronic databases for children aged 6-12 years. The following databases were searched: Academic search Elite (EBSCO), ERIC (ProQuest), MEDLINE (Ovid), PsycINFO (ProQuest), and SPORTDiscus with Full Text (EBSCO). The studies meeting our inclusion criteria were analyzed to assess the psychometric properties and feasibility of the measures. RESULTS: The literature search retrieved 1907 potentially relevant publications. The final number of studies that met the inclusion criteria of our systematic review was 45. There were 11 questionnaires for parents, teachers and children. None of the questionnaires was valid for population-based screening as the only measurement tool. CONCLUSIONS: There are many challenges in using initial screening tools to identify children with motor difficulties. Nevertheless, many promising questionnaires are being developed that can provide information on functional skills and limitations across a variety of tasks and settings in the daily lives of children with DCD. The review provides much needed information about the current scales used in many clinical, educational and research settings. Implications for assessing psychometric properties of the developed questionnaires and further research are discussed. TRIAL REGISTRATION: PROSPERO, CRD42018087532 .

Psychosocial Functioning of Children with and without Dyslexia: A Follow-up Study from Ages Four to Nine.

This longitudinal study compares developmental changes in psychosocial functioning during the transition into school of children with and without dyslexia. In addition, it examines the effects of gender and family risk for dyslexia in terms of the associations between dyslexia and psychosocial functioning. Children's psychosocial functioning (social skills, inattention and externalizing and internalizing problems) was evaluated by their parents at ages 4, 6 and 9, and diagnosis for dyslexia was made at age 8 (in grade 2). The findings indicated that children with dyslexia were already rated as having poorer social skills and being more inattentive than were typical readers before their entry into school. Significant interactions of gender and diagnosis of dyslexia emerged for social skills and inattention. The social skills of boys with dyslexia improved after school entry as compared to the level of girls without dyslexia, whereas the social skills of girls with dyslexia did not improve. Boys with dyslexia were rated as showing a high level of inattention both prior to and after school entry, whereas, for girls with dyslexia, inattention ratings increased after school entry, eventually matching the boys' levels.

The association of adiponectin and low-grade inflammation with the course of metabolic syndrome.

BACKGROUND AND AIMS: Metabolic syndrome (MetS) is associated with low-grade inflammation. The connections of adiponectin and inflammatory cytokines with the course of MetS are not well-known. The aim of this study was to investigate the relation of adiponectin and low-grade inflammation with the development or resolution of MetS. METHODS AND RESULTS: In the town of Pieksämäki, Finland, five complete age groups (n = 1.294) were invited for health check-ups in 1997-1998 for the first time and in 2003-2004 for the second time. The final study population included 284 men and 396 women. MetS was defined according to the National Cholesterol Education Program criteria in the beginning and at the end of the 6-year research period, and adiponectin, high-sensitivity C-reactive protein (hs-CRP), interleukin-1 receptor antagonist (IL-1Ra) and interleukin-1 beta (IL-1ß) levels were determined from baseline samples. Both male and female study subjects were divided into four groups according to the diagnosis of MetS in the two check-ups: not diagnosed at either check-up (No MetS), diagnosed only at the second check-up (Incident MetS), diagnosed only at the first check-up (Resolute MetS), and diagnosed at both check-ups (Persistent MetS). Baseline adiponectin, IL-1Ra and IL-1ß levels and IL-1ß/IL-1Ra -ratio were found to predict Incident MetS, when adjusted for the change in BMI, age, smoking status and physical activity. Our data also suggested that a high adiponectin level and low hs-CRP and IL-1Ra levels predict the resolution of MetS. CONCLUSION: Adiponectin and inflammatory markers can predict the course of MetS.

Do fatty acids help in overcoming reading difficulties? A double-blind, placebo-controlled study of the effects of eicosapentaenoic acid and carnosine supplementation on children with dyslexia.

BACKGROUND: There are claims that dietary supplementation of unsaturated fatty acids could help children with dyslexia to overcome their reading problems. However, these claims have not yet been empirically tested. METHODS: This study was designed to test whether dietary supplementation was superior to placebo in treating reading, spelling or other reading-related skills of children with dyslexia. The experimental group (eicosapentaenoic acid, EPA, n = 30) ate dietary supplements and the control group (placebo, n = 31) placebos during the 90-day treatment period. The supplements contained omega-3 fatty acid (ethyl-EPA, 500 mg/day) and carnosine (400 mg/day). The groups were matched for reading skills, grade, gender, attention problems, intelligence and amount of special education. The literacy-related skills of the two groups were assessed before and after the treatment period. RESULTS: No group differences were observed between EPA and placebo in measures of reading accuracy or speed, spelling, decoding fluency, arithmetical skills, reading-related language skills, attention or behavioural problems. CONCLUSION: The present findings do not support the hypothesis that omega-3 fatty acid (ethyl-EPA) or carnosine has a role in the treatment of reading and spelling problems in children with dyslexia.

In vivo response-based identification of direct hormone target cell populations using high-density tissue arrays.

To identify cell populations directly responsive to prolactin (PRL), GH, erythropoietin, or granulocyte-colony stimulating factor within the physiological setting of an intact mammal, we combined in situ detection of hormone-activated signal transducer and activator of transcription (Stat)-5 in rats with high-throughput tissue array analysis using cutting-edge matrix assembly (CEMA). Inducible activation of Stat5a/b, as judged by levels of nuclear-localized, phosphoTyr694/699-Stat5a/b, served as an immediate and sensitive in situ marker of receptor signaling in rat tissues after injection into male and female rats of a single, receptor-saturating dose of hormone for maximal receptor activation. CEMA tissue arrays facilitated analysis of most tissues, including architecturally complex, thin-walled, and stratified tissues such as gut and skin. In 40 tissues analyzed, 35 PRL-responsive and 32 GH-responsive cell types were detected, of which 22 cell types were responsive to both hormones. Interestingly, PRL but not GH activated Stat5 in nearly all of the endocrine glands. In mammary glands, PRL activated Stat5 in a majority of luminal epithelial cells but not myoepithelial cells, stromal fibroblasts, or adipocytes, whereas GH activated Stat5 in a significant fraction of myoepithelial cells, fibroblasts, and adipocytes but only in a minority of luminal cells. Finally, the organism-wide screening revealed a yet-to-be identified erythropoietin-responsive cell type in connective tissue. CEMA tissue arrays provide cost-effective in situ analysis of large numbers of tissues. Biomarker-based identification of cell populations responsive to individual hormones may shed new light on endocrine disease as well as improve understanding of effects and side effects of hormones and drugs.

Reliability and validity of the Finnish version of the motor observation questionnaire for teachers.

OBJECTIVES: Observational screening instruments are often used as an effective, economical first step in the identification of children with Developmental Coordination Disorder (DCD). The aim was to investigate the psychometric properties of the Finnish version of the Motor Observation Questionnaire for Teachers (MOQ-T-FI). METHODS: The psychometric properties were tested using two separate samples (S1: age range 6-12, M 9y 5mo, females 101, males 92; S2: age range 6-9, M 7y 7mo, females 404, males 446). Teachers completed the MOQ-T-FI in both samples, and in sample 2 teachers' ratings were compared to student's performance on the Movement Assessment Battery for Children-Second Edition (MABC-2). Internal consistency was investigated by using Cronbach's alpha, predictive validity by receiver operating characteristic (ROC) analysis, concurrent validity by correlation analysis, and construct validity by factor analysis. RESULTS: The MOQ-T-FI behaves consistently with its original Dutch version. The internal consistency was excellent (α=0.97). The bifactor model, with one general factor and two specific factors, fit the data significantly better than the first-order model. The concurrent validity with the MABC-2 was moderate (r=0.37 p<0.001). Sensitivity was 82.5% and specificity 44.5%, respectively. CONCLUSION: Notwithstanding the low specificity the MOQ-T-FI can be considered as a promising screening tool in the school environment for Finnish children at risk of motor learning problems.

A dominant gene for developmental dyslexia on chromosome 3.

Developmental dyslexia is a neurofunctional disorder characterised by an unexpected difficulty in learning to read and write despite adequate intelligence, motivation, and education. Previous studies have suggested mostly quantitative susceptibility loci for dyslexia on chromosomes 1, 2, 6, and 15, but no genes have been identified yet. We studied a large pedigree, ascertained from 140 families considered, segregating pronounced dyslexia in an autosomal dominant fashion. Affected status and the subtype of dyslexia were determined by neuropsychological tests. A genome scan with 320 markers showed a novel dominant locus linked to dyslexia in the pericentromeric region of chromosome 3 with a multipoint lod score of 3.84. Nineteen out of 21 affected pedigree members shared this region identical by descent (corrected p<0.001). Previously implicated genomic regions showed no evidence for linkage. Sequencing of two positional candidate genes, 5HT1F and DRD3, did not support their role in dyslexia. The new locus on chromosome 3 is associated with deficits in all three essential components involved in the reading process, namely phonological awareness, rapid naming, and verbal short term memory.

Prolactin is a survival factor for androgen-deprived rat dorsal and lateral prostate epithelium in organ culture.

PRL is one of several polypeptide factors that regulate growth and differentiation of prostate epithelium besides steroid hormones. This hormone may also participate in the development of pathologic changes of the prostate, as evidenced by marked prostate hyperplasia in hyperprolactinemic mice. We have previously demonstrated expression of PRL receptors and androgen-dependent local production of PRL in rat and human prostate epithelium, suggesting the existence of an autocrine loop. We now show that PRL acts as a survival factor for epithelial cells of rat dorsal and lateral prostate but not ventral prostate, using long-term organ cultures as an in vitro model. Culture of prostate explants in androgen-free medium was associated with a transient surge of apoptosis during the first 2-4 days of culture in rat ventral, dorsal, and lateral prostate tissues, as quantified by either nuclear morphology or in situ DNA fragmentation analysis. PRL significantly inhibited apoptosis in androgen-deprived dorsal and lateral prostate cultures, by 40-60%, as determined by the two methods. The present study has established conditions and methodology for analysis of apoptosis in organ cultures of rat prostate and suggests a physiological role for PRL as a survival factor for prostate epithelium.

Performance of Zambian children on the NEPSY: a pilot study.

Forty-five literate schoolchildren aged 9 (n = 25) and 11 (n = 20) from urban Zambia were given core and expanded tests on the NEPSY and their performance was scored according to age-equivalent norms for U.S. children. This study indicates that in urban, literate Zambian children, the NEPSY is relatively insensitive to language and cultural influences that often compromise the applicability of Western tests in the developing world. No consistent improvement in the standard scores was found as a function of educational experience. Comparison against the U.S. normative average revealed that both age groups were poorer in the domains of language and attention and executive functions, whereas their performance was better in the visuospatial processing domain. It is concluded that the NEPSY in its present form may be clinically useful, but its results should still be treated with caution, taking into account cultural, language, and personal demographic information. More studies, with divergent and larger samples of varying age ranges are required. It seems that the NEPSY could serve as the initial step in the development of neuropsychological practices in Zambia.

Developmental pathways of children with and without familial risk for dyslexia during the first years of life.

Comparisons of the developmental pathways of the first 5 years of life for children with (N = 107) and without (N = 93) familial risk for dyslexia observed in the Jyväskylä Longitudinal study of Dyslexia are reviewed. The earliest differences between groups were found at the ages of a few days and at 6 months in brain event-related potential responses to speech sounds and in head-turn responses (at 6 months), conditioned to reflect categorical perception of speech stimuli. The development of vocalization and motor behavior, based on parental report of the time of reaching significant milestones, or the growth of vocabulary (using the MacArthur Communicative Development Inventories) failed to reveal differences before age 2. Similarly, no group differences were found in cognitive and language development assessed by the Bayley Scales of Infant Development and the Reynell Developmental Language Scales before age 2.5. The earliest language measure that showed lower scores among the at-risk group was maximum sentence length at age 2. Early gross motor development had higher correlation to later language skills among the at-risk group rather than the control children. The most consistent predictor of differential development between groups was the onset of talking. Children who were identified as late talkers at age 2 were still delayed at the age 3.5 in most features of language-related skills-but only if they belonged to the group at familial risk for dyslexia. Several phonological and naming measures known to correlate with reading from preschool age differentiated the groups consistently from age 3.5. Our findings imply that a marked proportion of children at familial risk for dyslexia follow atypical neurodevelopmental paths. The signs listed previously comprise a pool of candidates for early predictors and precursors of dyslexia, which await validation.

Clinical significance of test refusal among young children.

The present study describes the incidence of test refusal at neuropsychological assessment, investigates its correlates, and its stability. The participants were 124 children aged 3.5 years whose development has been followed from birth in the Jyväskylä Longitudinal Study of Dyslexia (JLD). The frequency of test refusal on the Finnish version of the NEPSY was analyzed with respect to the children's concurrent and earlier cognitive and language skills, assessed using tests and parental ratings. Refusal during test-taking was found to be relatively common at this age, and high frequency of refusal at an earlier age was associated with similar tendency at a later age. High test refusal was associated with compromised neuropsychological and linguistic test scores. Missing data due to refusal were more common in neuropsychological tasks requiring verbal production. It is concluded that test refusals reflect a child's poor underlying skills and an attempt to avoid failure, rather than noncompliant or oppositional behavior.

Predicting delay in reading achievement in a highly transparent language.

A random sample of 91 preschool children was assessed prior to receiving formal reading instruction. Verbal and nonverbal measures were used as predictors for the time of instruction required to accurately decode pseudowords in the highly orthographically regular Finnish language. After 2 years, participants were divided into four groups depending on the duration of instruction they had required to reach 90 % accuracy in their reading of pseudowords. Participants were classified as precocious decoders (PD), who could read at school entry; early decoders (ED), who learned to read within the first 4 months of Grade 1; ordinary decoders (OD), who learned to read within 9 months; and late decoders (LD), who failed to reach the criterion after 18 months of reading instruction at Grade 2. Phonological awareness played a significant role only in differentiating PD from ED and OD. However, phonological awareness failed to predict the delayed learning process of LD. LD differed from all other groups in visual analogical reasoning in an analysis not containing phonological awareness measures. Letter knowledge and visual analogical reasoning explained above 90% of the PD-LD difference. Preschool composite (objects, colors, and digits) naming speed measures best predicted reading fluency at the end of Grade 2. The supportive role of orthographic knowledge in phonological awareness, the role of visual analogical reasoning, and the inability of phonological measures to discriminate late decoders are discussed.

Mother-child teaching strategies and learning disabilities.

The teaching strategies used by mothers of sons with learning disabilities (LD) (n = 30) and normally achieving sons (NLD) (n = 30) were examined. The children were matched for age (8- to 11-year-olds) and for parents' socioeconomic status. The behavior of mother-child pairs was videotaped in a teaching task that was constructed to resemble a homework assignment. The results showed that the mothers of children with LD used fewer high-level strategies, and their total time used in teaching was less than that of the mothers of NLD children. The mothers of children with LD exhibited more dominance and less emotionality and cooperation than did the mothers of NLD children; however, the mothers did not differ in task motivation. The children with LD seemed to have more inactive learning strategies, evident in their weaker initiative and greater dependence on their mothers. Analyses concerning the variation of maternal strategies within the LD group revealed that the mothers' motivation, combined with their emotionality and proportion of high-level strategies, had a strong positive association with their children's success in learning.

Two-year group treatment for children with learning difficulties: assessing effects of treatment duration and pretreatment characteristics.

The results of a 2-year treatment study of children with learning problems are reported. During the first treatment year, half of the children participated in a multifaceted neurocognitive treatment and the other half in a treatment that provided supervision of school tasks and peer group support. During the second treatment year, all children participated in the neurocognitive treatment. The participants were 74 Chilean children 6 to 11 years old. The issues under investigation were the effect of treatment duration, and the relationship between pretreatment neurocognitive and behavioral characteristics and academic treatment outcome. The results indicated that significant gains occurred during both the first and the second treatment year. No major differences were found between the treatment groups. Pretreatment negative behavioral traits were associated with lesser academic growth in the group participating in the homework supervision treatment but not in the neurocognitive treatment group.

Language problems in children with learning disabilities: do they interfere with maternal communication?

In this study, parent-child interaction in two carefully matched subgroups-school-age boys with learning disabilities (LD) who showed a discrepancy between their verbal IQ and performance IQ and had more extensive difficulties in higher-level language abilities (VIQ < PIQ, n = 8) and boys with LD who did not manifest a discrepancy between verbal IQ and performance IQ (VIQ = PIQ, n = 8), were investigated. The effects of the child's language problems on child task performance and on the quality of maternal communication were analyzed in a mother-child problem solving task. Children in the VIQ < PIQ group were found to be less successful on the task than children in the VIQ = PIQ group, and their mothers exhibited lower communication clarity in their instructions than the mothers of the children in the VIQ = PIQ group. An interesting interaction effect was found for communication deviances. For mothers in the VIQ < PIQ group the extent of deficient communication increased from the monologue to the dialogue situation, whereas communication deviances decreased for mothers in the VIQ = PIQ group. Three possible models are discussed in light of the differences between the subgroups.

The development of phonological abilities and their relation to reading acquisition: case studies of six Finnish children.

The relation between phonological abilities and reading acquisition and the interindividual variation in the development of different phonological manipulation skills were assessed for six 7-year-old Finnish nonreaders. Intensive time series data were collected by following the children for 13 months. Assessments were conducted every 4 weeks with five phonological manipulation tests. The results indicated gradual progress at the group level. However, analysis of the individual profiles indicated large interindividual variation in the rate of improvement and in the relation between different manipulation skills and reading acquisition.

Comparing efficacies of neurocognitive treatment and homework assistance programs for children with learning difficulties.

The purpose of the study was to analyze the relative efficacies of two treatments for children with learning difficulties. The first treatment consisted of multiple training components targeting specific cognitive and behavioral factors; the second treatment provided emotional support and supervision of school tasks. The participants were 94 Chilean schoolchildren (6 to 11 years of age). The efficacies were compared on (a) neurocognitive tests, (b) school achievement tests, and (c) behavior in school and at home. The results indicated that both groups improved on most of the outcome measures. The first group showed best results in parents' rating of home behavior, and the second group in reading. The findings also emphasized the importance of emotional support and the inclusion of a parents' group in treatment for children with learning difficulties.

Suggestions for revised scoring of the Tower of Hanoi test.

Detailed time and error analyses of the Tower of Hanoi (TOH) test was performed using four repeated assessments of eight children (ages 9-12 years), who had perceptual and problem solving deficits. The time before each move was measured. In addition to the traditionally counted time scores, new, relative time scores were computed in order to separate the planning time from the general reaction speed. New error scores were defined and sum scores of serious errors (perserative moves, illegal moves, and wrong results) and mild errors (self-corrected moves, almost performed moves, and interrupted trials) were computed. The relative planning time correlated positively with the achieved score, and negatively with the serious errors. The serious errors correlated negatively with the achieved score. The relative planning time seems to measure the quality of planning better than does the raw planning time, and it is a recommended score for TOH analysis. The value of new error scores requires additional research.

Repeated assessment of the Tower of Hanoi test: reliability and age effects.

The purpose of this research was to analyze the effects of repeating an executive function test. Three versions of the Tower of Hanoi (TOH) test were repeated three times each, with test-retest intervals of 2 months. Two groups of children participated in the research (7.7 and 11.6 years, n = 22 and n = 28). Repeating the assessment improved the performance and decreased the total performance time in both of the groups. The older participants improved their performance faster than the younger ones. The reliability of all the scores, besides the error scores, seemed to be satisfactory after the first few assessments. The stability of the scores was maintained through all the assessments. The planning time did not explain the variations of the achieved score. The reasons for the initially low reliabilities are discussed, and modifications for the test administration and scoring are suggested.