Universal Design for Learning for Children with ADHD.

Attention Deficit-Hyperactivity Disorder (ADHD) is a psychiatric condition that shows developmentally inappropriate levels of inattention, hyperactivity, or impulsivity. Symptoms begin at a young age and usually include a lack of attention, poor concentration, disorganization, difficulty completing tasks, forgetfulness, and losing things. It is important to diagnose and treat the disorder at a young age so that the symptoms do not persist into adulthood and cause other comorbid conditions. Learning difficulties, motor impairment, anxiety, or depressive disorders may occur with this condition. To improve the academic careers of children with ADHD, we focused on a specific innovative educational approach (Universal Design for Learning) that could improve basic learning skills (reading, writing, and arithmetic skills) to prevent or manage any learning difficulty that could occur with ADHD. The Universal Design for Learning is an individualized approach that combines current neuroscientific knowledge, creating personalized teaching based on the strengths and weaknesses of the student. The goal of this study is to analyze the impact that this approach has on basic learning abilities. We found that both interventions led to improvements in test performance, indicating that interventions were necessary to enhance reading, writing, and arithmetic skills. Furthermore, the group that received an educational intervention based on Universal Design for Learning demonstrated a more significant improvement in these areas. Additionally, we propose that the set of techniques implemented by teachers in the classroom helped children to read, write, and perform math tasks correctly and more fluently.

Narrative Approach and Mentalization.

The core focus of this research centered on the intricate relationship between mentalization, the fundamental mental process underlying social interactions, and the narrative approach proposed by Bruner. Mentalization, encompassing both implicit and explicit interpretations of one's and others' actions, plays a pivotal role in shaping the complexity of social interactions. Concurrently, the narrative approach, as elucidated by Bruner, serves as the primary interpretative and cognitive tool through which individuals derive meaning from their experiences. Narrative, in essence, empowers individuals to imbue their experiences with significance, constructing knowledge and enabling a reinterpretation of their lives by reconstructing the meanings attached to events. This intertwining of mentalization and the narrative approach is particularly salient, given their shared reliance on autobiographical narratives and the inference of mental states. In the context of this study, our primary objective was to explore how practical and theoretical activities, rooted in the re-elaboration of personal life information and events, could serve as a catalyst for enhancing mentalization skills. By engaging students in activities specifically designed to encourage the reinterpretation of their life experiences, we aimed to bolster their ability to infer mental states effectively. These enhanced mentalization skills, we hypothesized, form the foundational basis for executing complex educational tasks rooted in constructed teaching methodologies. In summary, this research serves as a pioneering exploration into the synergistic interrelation of mentalization and the narrative approach, offering valuable insights for educators and practitioners aiming to foster enhanced social cognition and enriched educational experiences.

AAC and Autism: Manual Signs and Pecs, a Comparison.

Autism Spectrum Disorders (ASD) represent a heterogeneous group of disorders, with onset in developmental age, which present a clinical expressiveness that varies from subject to subject and in the same subject over time. The DSM 5 defines Autism Spectrum Disorders according to two main criteria: persistent deficits in social communication and social interaction in multiple contexts and limited and repetitive patterns of behavior, interests or activities. This disorder can manifest itself across a broad spectrum of severity levels. Indeed, ASD includes clinical conditions from low functioning (LF-Low Functioning) to high functioning (HF-High Functioning), taking cognitive and adaptive functioning as a reference. One of the main characteristics of individuals with ASD is a delay in receptive and expressive communication. These deficits have led to the identification of evidence-based practices, particularly for those with severe communication difficulties. Augmentative Alternative Communication (AAC) has been implemented to compensate for deficits in functional communication and language skills in individuals with complex communication deficits. The AAC comprises communication systems including the Manual Signs, speech and image output devices (Communicators), and Image Exchange Systems (PECS); these systems have been shown to actually improve various abilities in autism such as social skills, modify and improve dysfunctional behaviors and, above all, improve learning. Recent meta-analyses have shown how PECS and Manual Sign can have great effects on the communication skills of young people with autism. The aim of this study is to compare these two types of intervention to improve communication in terms of vocalization in subjects with ASD and try to understand which of the two lead to more significant and rapid improvements.

Executive Functions and Foreign Language Learning.

Executive functions (EFs) serve as an umbrella term to describe a set of higher-order cognitive abilities that include working memory, inhibitory control, cognitive flexibility, planning, reasoning, and problem-solving. Various studies suggest that foreign language learning likely promotes executive functions, but others suggest that executive functions could improve foreign language learning. The aim of this study is to investigate the relationship between executive functions and foreign language learning and how these processes could interact. The sample included 64 children from kindergarten, aged 4-5 years, with no documented neuropsychiatric disorders, and from the middle-high literacy group. They were divided into three groups based on the level of their knowledge of the foreign language. A significant effect of the group on the executive tasks is shown in the comparison of the groups. Children who belonged to a group that had advanced foreign language proficiency had better results in executive tasks. Our results suggest that the higher the level of foreign language proficiency, the higher the performance of the executive tasks. However, we do not know if there is a causal effect between these variables.

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.

Autism, Therapy and COVID-19.

While numerous treatments for ASD are available, intervention based on the principles and procedures of Applied Behavior Analysis (ABA) has garnered substantial scientific support. In this study we evaluated the effects of the lockdown during the COVID-19 pandemic outbreak, followed by quarantine provisions and during the three months after the resumption of activities. The study was conducted on a group of children taking part on a ABA-based intervention funded by the Local Health Authority (ASL) of the province of Caserta. In this study we considered a sample of 88 children who had been diagnosed with Autism Spectrum Disorder, aged between 18 and 30 months. The following inclusion criteria were observed: age at the time of diagnosis less than 30 months, absence of other neurological, genetic, or sensorineural pathologies, and severity level 1 measured by symptoms evaluation based on the ADOS 2 module T (used for diagnosis). During the lockdown children experienced improvements in communication, socialization, and personal autonomy. During the three months after the ABA treatment, the acquired skills were maintained but no significant improvement was demonstrated. In this study, we describe how parent training was significant in avoiding delays in the generalization of socially significant behaviors, following the drastic interruption of the treatment in this group of children.

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.

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.

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.

Video Modeling and Social Skills Learning in ASD-HF.

Autism spectrum disorders represent a heterogeneous group of clinical situations, and are mainly represented by a deficit of social communication. In this study, we compare two strategies to enhance communicative/social skills, namely self-video modeling and peer video modeling. The subjects were divided into two groups treated via the method of self-video modeling (group 1) or peer video modeling (group 2). For both groups of subjects affected by ASD-HF (Autism Spectrum Disorder-high-functioning), three different activities were proposed: (a) interacting with a salesperson while making a purchase, (b) initiating and maintaining a conversation with peers, and (c) starting and maintaining an enjoyable activity with a peer. The ability to rapidly accomplish the task was used as the main criteria to appraise the groups' responses to the proposed activities. In group 1, the use of self-video modeling procedures demonstrated a faster and correct execution of the three proposed tasks (especially task 3) when compared to group 2. In group 2, the use of peer video modeling has instead led to a slower acquisition of abilities to process and perform the tasks. The use of self-video modeling speeds up the acquisition of skills to perform communicative/social tasks, compared to peer video modeling's slower performance in subjects with ASD-HF. Results could be related to either the amount of time the subject is exposed to the task or to the capacity of ASD-HF subjects to self-value one's own actions more than others. In our work, we have tried to reset the differences in exposure time. Therefore, self-video modeling is demonstrated to be more effective, as it produces a response to the signification/mirroring characteristic of ASD-HF.

Emotional Education in Early Onset Schizophrenia and Asperger's Syndrome.

In this study, we aim to verify how emotional training can improve empathy and theory of mind (ToM) in patients diagnosed with early onset schizophrenia and Asperger's syndrome. The study design includes 100 subjects divided into two experimental groups and two control groups. The two experimental groups followed a rational emotive behavior therapy (REBT) protocol. The two control groups instead underwent cognitive behavioral psychotherapy training. Analysis of Variance (ANOVA) was applied to analyze the difference between the Asperger's syndrome (AS) and early onset schizophrenia (EOS) groups, pre and post training. Our analysis shows that the AS group improved post emotional training but only when emotions were internalized, as demonstrated by the improvement of the scores in the post-treatment eye test (ET) but not in the emotional quotient (EQ) test. The EOS group instead showed post-training improvement, not only concerning skills leading to internalizing emotions but also in empathy, as demonstrated by the improvement of EQ and Reflective Functioning Questionnaire (RFQ) test scores. These scores remained lower than in the control group. Finally, our findings reveal that the value of the treatment was more considerable for the EOS group than for the AS group due to the improvement in first- and second-order ToM skills and an improvement of empathic skills in the first group, followed by the group comprising AS subjects. In the AS group, the treatment only favored the enhancement of first-order ToM skills; however, this improved quality of life and social adaptation.