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Abstract: The study was designed to investigate selected aspects of language and communicative functions as well as verbal fluency in children with HFA. The study group comprised 51 children, aged 10-12, including 23 subjects diagnosed with High-Functioning Autism, with normal IQ and able to communicate verbally, as well as a group of 28 controls. The applied tools included RHLB-PL Battery, a verbal fluency task and WISC-R Vocabulary subtest. The findings show significantly varied profiles of the investigated functions in the group of children with HFA. In comparison with their peers, they have greater difficulties drawing logical conclusions from stories. They find it difficult to grasp humour conveyed by linguistic expression and by metaphors, presented with the use of both linguistic materials and drawings. They have lower capacitates for understanding prosodic (emotional and language) aspects of utterances addressed to them. It has been established that they are able to correctly understand isolated words and recognize their designates despite the present distractors. No generalized deficits have been found in the subjects’ verbal fluency. In comparison to the controls, the children with HFA generated similar number of words matching the phonemic criterion. Furthermore, their performance showed no perseverations, and comparably frequent clustering and switching. Lexicon matching the semantic criterion was more difficult to access for the children with HFA than for the controls. Children with HFA had difficulties in defining familiar words. Keywords: Humour, prosody, metaphors, defining words, inferential language.Download Full Article |
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Abstract: Senior citizens generally face more challenging life situations than other people (death of people close to them, deteriorating health, loss of social status, leaving home, etc.) – even multiple such situations at one time – and must cope with them. The focus of this report is one of these situations: the life of senior citizens in a retirement home, which is a type of residential social services. Objective: The objective of this research was to map the living conditions of seniors living in 1 retirement home in the Písek region (Czech Republic) and in 1 retirement home in the Innsbruck region (Austria). METHODS: The enquiry method was chosen for the research. A semi-standardised interview with 40 seniors was carried out as part of routine data collection. The topics of the interview were compiled as to cover areas related to residential standards, eating, economic situation, maintaining of social contacts, use of free time and assessment of health care. RESULTS: The research showed that both Czech and Austrian seniors assess their living conditions in the home as good. The respondents gave positive feedback on the clean environment, health and nursing care and the rate of participation in events organised in the homes. What the seniors found positive is maintaining social contacts and they prefer the availability of the above-standard service provided in the home. CONCLUSION: The research also showed that the reason for moving into the retirement home is primarily health problems and the related fear of compromised independence. Keywords: Retirement home, living conditions, senior, residential care, social services.Download Full Article |
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Abstract: Background: Children with intellectual disability (CWID) in the USA are typically referred to child neurologists (CN) and developmental-behavioral pediatricians (DBP) for medical evaluation. Although the American Academy of Neurology/Child Neurology Society (AAN/CNS) and the American Academy of Pediatrics (AAP) have published evaluation guidelines, experience suggests CN and DBP do not consistently follow them. Our goal was to assess CN’s and DBP’s approach to evaluating CWID and overall compliance with published guidelines. Methods: Questionnaires were mailed to CN and DBP in the U.S. (n=1897). Physicians were asked demographic information and which laboratory tests they would "routinely order" for the hypothetical case of a 3½ year old boy with Full Scale IQ=58 and unremarkable neurological history and exam. Chi-square tests were performed to compare sub-specialists’ ordering practices. Results: 127 CN and 140 DBP responded. 7.1% CN (n=9) and 11.4% DBP (n=16) complied with AAN/CNS and AAP guidelines, respectively. Although routinely indicated, 36.2% CN and 31.4% DBP would not routinely order chromosomal microarray (CMA), and 42.5% CN and 26.4% DBP would not routinely order DNA for Fragile X (χ2=7.67, p=0.006). 7.9% CN and 7.1% DBP would order a karyotype without CMA. Although not indicated, 7.1% CN and 0.7% DBP noted they would routinely order an EEG (χ2=7.50, p=0.006). A brain MRI is only recommended by AAN/CNS guidelines; 49.6% CN and 12.9% DBP reported they would routinely order it (χ2=42.55, p<.0001). Conclusion: Few CN and DBP follow published guidelines for laboratory evaluation of CWID. Relative to DBP, CN more frequently order EEGs and MRIs but less frequently order recommended genetic tests. Keywords: Intellectual disability, etiology, clinical practice guidelines, medical evaluation, chromosomal microarray.Download Full Article |
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Abstract: To determine the average medical cost incurred for early identification of intellectual and developmental disabilities in children, we retrieved the records of 264 children who had visited our consulting unit from 2005 until the end of March 2012. In the evaluation process, each child took psychological assessments and the parents were provided with solutions to enable the children to overcome their delay in school. As a whole, while the average number of visits did not differ by the diagnosis, the average medical cost differed by the diagnosis. The consultation unit was effective for gradually diminishing the medical costs incurred. Our in-clinic consultation system proved useful for early identification of intellectual and developmental disabilities in children and minimization of the medical costs incurred for the process. Keywords: AD/HD, medical cost, PDD.Download Full Article |
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Abstract: Introduction: Cholinergic dysfunction has been proposed to play a role in autistic symtomatology. However, to date, its structural correlates are poorly understood. Methods: Twenty-five low-functioning, non-verbal males with Autism Spectrum Disorders (ASD) and 25 controls were enrolled in the study. All underwent MR T1-weighted 3D Structural Imaging and Diffusion Tensor Imaging. Grey and white matter components of the Meynert’s Nucleus Complex were then identified on MR images, and both grey matter density and white matter mean Fractional Anisotropy in the Meynert’s Nucleus region of interest were quantified for each subject. Non-verbal IQ was assessed in all subjects with ASD. Results: We showed reduced white matter Fractional Anisotropy in the bundles surrounding the Meynert’s Nucleus in ASD subjects compared to controls. Fractional Anisotropy in these bundles was positively associated with non-verbal IQ, independently from whole brain white matter mean Fractional Anisotropy. ASD subjects did not show significant abnormalities in Meynert’s Nucleus grey matter density. Conclusions: Our findings suggest that white matter abnormalities in the Meynert’s Nucleus might be involved in the cholinergic deficits of ASD. Keywords: Autism, cholinergic system, Meynert’s nucleus, diffusion tensor imaging, white matter.Download Full Article |