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Abstract: Sensory Processing (SP) difficulties in children are seen to be increasing in today’s world. Quite a few typically developing children are reported to have difficulties in coping with school, home and play environments. Their difficulties are mostly labeled abnormal behaviors and with superficial assessments these children often receive traditional treatments that marginally decrease their problems without giving long term functional gains. Hence their SP dysfunctions make them adopt pathological behaviors as they grow, making them incompetent as compared to their peers. One of the factors behind these children getting unnoticed at an early age is lack of awareness about SP difficulties among the parents, teachers and medical fraternity in India. The other important factors include unavailability of contributory study in this area done on the Indian population and the use of non-normated, generalized evaluation tools done for evaluation of these difficulties. Further less information on what is age related typical SP makes it trickier to differentiate between a typical behavior and SP difficulty. The present study is the first study that would make an effort to understand the age related SP in Indian preschoolers aged 3-7 years. The QOSP includes observations based on literature and theoretical constructs of SP which are graded and made quantitative for ease of administration and interpretation. This study intends to establish the age appropriate expected response and estimate the children posing risk to develop SP dysfunctions. The study further attempts to understand correlations between the different parameters of QOSP and tries to identify those parameters that can be considered red flags for SP difficulties. The results of the study suggest about 3% of children in the typically developing group to be at the risk of having SP difficulties. About 20% are estimated to be having difficulties in at least one of the SP areas when compared with behaviors rated on Sensory Processing Measure. Apart from typically developing children the tool was also used in co-morbid conditions and was found to be useful in understanding the underlying Sensory Processing difficulties. Thus the QOSP can be considered a good measure not only in screening children with suspected sensory processing difficulties but also to gear the intervention program to be streamlined and goal oriented. Keywords: Rehabilitation personnel, Sensory Processing Measure, Sensory systems, Play, Behavior disorders.Download Full Article |
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Abstract: Contemporary recommended practices in early childhood assessment strive to gain a holistic picture of child learning and development to inform screening, eligibility, and program planning decisions. These practices have traditionally focused on competencies reflected in developmental domains with limited attention to the approaches-to-learning used to acquire those competencies. In this article, we call for the examination of early childhood constructs that impact a child’s ability to learn and develop, such as executive function (EF), mastery motivation, self-regulation and self-determination, specifically in the infant-toddler period. With EF defined as a wide range of central control processes in the brain that link and categorize information that is discernible in cognitive, motor, and behavioral responses [1], we propose a model of EF as the core construct that drives and unites these learning processes and describe how the model can be applied to Part C early intervention screening, assessment, eligibility determination, and program planning, as well as identify future directions in research and personnel preparation. Keywords: Assessment, early intervention, approaches-to-learning, executive function, eligibility, program planning.Download Full Article |
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Abstract: Objective: To identify evidence-based behavioural interventions used to decrease restricted and repetitive behaviour (RRB) in children with autism (ages 0-18); to understand the application of these strategies within the PEO (Person, Environment, Occupation) Model of Occupational Performance and the role of the occupational therapist in addressing this limitation. Background: RRB is a core feature of autism that often impedes functional behaviour. Decreasing RRB to enable functional behaviours is central to the occupational therapist’s role with this population. Many interventions identified as effective for this impairment are based on the principles of applied behaviour analysis (ABA). Method: An integrative review of the literature was completed to identify interventions targeting RRBs. Those found to be effective are described within an ABA framework and within the PEO Model of Occupational Performance. Results: This review identified twenty-eight effective interventions used to treat RRBs in autism relevant to the field of occupational therapy. Categorization of interventions using an ABA framework and the PEO Model allowed comparison between approaches and application to occupational therapy practice. Conclusion:A functional behaviour approach (FBA) used in combination with the PEO model will enable greater understanding of RRBs and provide a more comprehensive approach to the treatment of RRBs in children with autism. Keywords: Autism, repetitive behaviour, occupational therapy, PEO model, behavioural intervention. |
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Abstract: Currently more than 15% of children have an emotional, behavioral, or developmental concern. In spite of recommendations by the American Academy of Pediatrics and the Centers for Disease Control and Prevention to conduct universal developmental surveillance and screening with children at 9, 18, and 24 months of age, fewer than 30% of children under 6 years of age ever receive a developmental screening. Children in low-income and diverse communities are even less likely to be screened by a medical provider and/or referred for further diagnostic evaluation when predictive concerns are identified. As part of a cross-agency collaborative effort involving a family resource center, a child care resource and referral agency, a regional center for developmental disabilities, and a master’s degree program in early childhood education, the Mobile Developmental Screening Van Project conducted outreach to provide free developmental screening with families of children 0-8 years of age in diverse and low-income communities within the greater Los Angeles County. Using the Parent Evaluation of Developmental Status (PEDS) screening tool, 94 children were screened over the course of 6 months, with 33% showing 2 or more predictive concerns that resulted in referrals for further diagnostic evaluation. The feasibility of reaching families in hard to reach communities using a mobile screening van, as well as study limitations and recommendations for next steps, are discussed. Keywords: Developmental screenings, low-income, mobile screening, early childhood, community collaboration.Download Full Article |
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Abstract: Angelman Syndrome (AS) is due to the loss of function of the single UBE3A gene, mapping to chromosome 15q11-q13 and encoding the E6AP ubiquitin ligase. Expression of UBE3A is subject to genomic imprinting which is restricted to the brain, where only the maternal allele is transcribed. AS pathogenetic mechanisms include deletion of the maternal 15q11-13 chromosomal region, chromosome 15 paternal uniparental disomy (UPD), Imprinting Defects (ImpD) leading to silencing of the maternal allele and intragenic mutations of the maternal UBE3A allele. From our AS cohort we sorted out for detailed clinical-molecular characterization six mosaic cases, five with ImpD epimutations and one with patUPD15. This latter case referred for intellectual disability and fortuitously solved by SNP array, is, to our knowledge, the unique patient reported with mosaic patUPD of this imprinted region. Somatic epimutation mosaicism represents a challenge for both clinical and molecular diagnostics. The described patients, referred to our center either for uncertain AS or simply for intellectual disability, could be molecularly characterized by applying a multi-method approach including Methylation-Sensitive PCR and MS-MLPA without a strict cut off. The percentage of normal cells detected ranged up to 40%. We confirm the mild phenotype reported in mosaic AS ImpD and provide a detailed analysis of IQ. Mild mental retardation, with significant difficulties in language expression, but only mildly impaired performance skills, together with pathognomonic EEG, is a cue not to overlook in mosaic AS patients. Mosaic epimutations should be searched also in patients with minor AS features and presenting only with intellectual disability Keywords: Mosaicism, intellectual disability, Angelman syndrome, epimutation, uniparental disomy. |