Task instructions for persons with severe intellectual disability: reducing the number of instruction occasions after the acquisition phase

During the first part of the study, eight tasks were taught to four participants with severe intellectual disability. A portable computer‐aided system was used that presented one pictorial instruction per task step, individually. During the second part of the study, the same computer‐aided system was used but the number of instruction occasions available for the tasks was reduced. In one condition, the system presented all the step instructions but mostly in small clusters rather than individually. In another condition, the system presented only some of the instructions. Data for the first part of the study showed that the participants managed to perform 83–97% of the task steps correctly. Data for the second part of the study showed that the condition in which instructions were clustered was more effective in maintaining high percentages of correct performance. Implications of the findings are discussed. Copyright © 1999 John Wiley & Sons, Ltd.     

BRIEF REPORT: ENABLING BLIND PERSONS WITH SEVERE OR PROFOUND MENTAL RETARDATION TO OPERATE AN ACOUSTIC ORIENTATION SYSTEM INDEPENDENTLY

The aim of this study was to assess new technology for enabling two blind persons affected by severe or profound mental retardation to operate an acoustic orientation system independently. By operating this system, the subjects could move to different activity destinations within an occupational setting and carry out activities free from external assistance. The results showed that both subjects learned to operate the system on their own. The high level of independence they achieved is reviewed in relation to the new technology and the simplified responding it requires     

The effect of inpatient cognitive-behavioral therapy for eating disorders on temperament and character

Personality traits seem to have an important role in the development, clinical expression, course, and treatment response in eating disorders (EDs). We investigated the effects of an inpatient cognitive-behavioral treatment (CBT) on the measures of temperament and character (Temperament and Character Inventory (TCI)) in 149 consecutive patients with EDs. Baseline assessment included anthropometry, the Eating Disorder Examination (EDE), the Beck Depression Inventory (BDI), and the TCI. Treatment was based on the transdiagnostic cognitive behavior theory and treatment of ED, adapted for an inpatient setting. Treatment effects were tested by paired ANOVA, adjusted for covariates. No effects were found on Novelty Seeking, Reward Dependence, and Cooperativeness. Harm Avoidance (F=18.17, p<0.001), Persistence (F=7.71, p=0.006), Self-Directedness (F=27.55, p<0.001), and Self Transcendence (F=16.38, p<0.001) significantly changed after treatment. Changes in TCI scores were wholly dependent on the changes in BDI and EDE, and independent of ED diagnosis and behavior and of BMI changes. We conclude that in ED, a few scales of both temperament and character are significantly modified by CBT, in relation to changes in psychopathology and depression, independently of nutrition. These results are relevant for future studies based on TCI.     

Acute inhibition of calcineurin restores associative learning and memory in Tg2576 APP transgenic mice

Misfolded amyloid beta peptide (Abeta) is a pathological hallmark of Alzheimer's disease (AD), a neurodegenerative illness characterized by cognitive deficits and neuronal loss. Transgenic mouse models of Abeta over-production indicate that Abeta-induced cognitive deficits occur in the absence of overt neuronal death, suggesting that while extensive neuronal death may be associated with later stages of the human disease, subtle physiological changes may underlie initial cognitive deficits. Therefore, identifying signaling elements involved in those Abeta-induced cognitive impairments that occur prior to loss of neurons may reveal new potential pharmacological targets. Here, we report that the enzymatic activity of calcineurin, a key protein phosphatase involved in phosphorylation-dependent kinase activity crucial for synaptic plasticity and memory function, is upregulated in the CNS of the Tg2576 animal model for Abeta over-production. Furthermore, acute treatment of Tg2576 mice with the calcineurin inhibitor FK506 (10mg/kg i.p.) improves memory function. These results indicate that calcineurin may mediate some of the cognitive effects of excess Abeta such that inhibition of calcineurin shall be further explored as a potential treatment to reverse cognitive impairments in AD.     

Learning as a possible sign of non-reflective consciousness in persons with a diagnosis of vegetative state and pervasive motor impairment

A diagnosis of vegetative state represents a serious predicament, which basically precludes/minimizes rehabilitation perspectives. Reliability of the assessment approach in these situations is of paramount importance, but not easy to achieve. In recent studies, a learning assessment procedure has been suggested as a supplement in the diagnostic process and assessed with eight patients. The procedure involves an ABABCB sequence in which A represents baseline phases with no stimulation available, B intervention phases with stimuli delivered contingently on target responses, and C a control condition. This condition involves stimulation presented non-contingently. The patients’ ability to associate responding with environmental stimuli and thus increase such responding during the B phases, and reduce it during the A and C phases, may be considered a sign of learning. Learning might be viewed as representative of forms of concrete knowledge and presumably basic levels of consciousness. Preliminary results indicate that (a) signs of learning may appear in patients with a previous diagnosis of vegetative state and (b) the presence of those signs may require a revision of their diagnostic label and a reappraisal of their rehabilitation perspectives.     

Children do not recalibrate motor‐sensory temporal order after exposure to delayed sensory feedback

Prolonged adaptation to delayed sensory feedback to a simple motor act (such as pressing a key) causes recalibration of sensory‐motor synchronization, so instantaneous feedback appears to precede the motor act that caused it (Stetson, Cui, Montague & Eagleman, 2006). We investigated whether similar recalibration occurs in school‐age children. Although plasticity may be expected to be even greater in children than in adults, we found no evidence of recalibration in children aged 8–11 years. Subjects adapted to delayed feedback for 100 trials, intermittently pressing a key that caused a tone to sound after a 200 ms delay. During the test phase, subjects responded to a visual cue by pressing a key, which triggered a tone to be played at variable intervals before or after the keypress. Subjects judged whether the tone preceded or followed the keypress, yielding psychometric functions estimating the delay when they perceived the tone to be synchronous with the action. The psychometric functions also gave an estimate of the precision of the temporal order judgment. In agreement with previous studies, adaptation caused a shift in perceived synchrony in adults, so the keypress appeared to trail behind the auditory feedback, implying sensory‐motor recalibration. However, school children of 8 to 11 years showed no measureable adaptation of perceived simultaneity, even after adaptation with 500 ms lags. Importantly, precision in the simultaneity task also improved with age, and this developmental trend correlated strongly with the magnitude of recalibration. This suggests that lack of recalibration of sensory‐motor simultaneity after adaptation in school‐age children is related to their poor precision in temporal order judgments. To test this idea we measured recalibration in adult subjects with auditory noise added to the stimuli (which hampered temporal precision). Under these conditions, recalibration was greatly reduced, with the magnitude of recalibration strongly correlating with temporal precision.