Short-term memory impairment in vestibular patients can arise independently of psychiatric impairment,fatigue, and sleeplessness

Vestibular dysfunction is associated with visual short-term memory impairment; however, it remains unclear if this impairment arises as a direct result of the vestibular dysfunction or is a consequence of comorbid changes in mood, affect, fatigue, and/or sleep. To this end, we assessed the concurrence and interdependence of these comorbidities in 101 individuals recruited from a tertiary balance clinic with a neuro-otological diagnosis. Over fifty per cent of the sample showed reduced visuospatial short-term memory, 60% and 37% exceeded cut-off on the Beck Anxiety and Depression Inventories, respectively, 70% exceeded cut-off on the Fatigue Severity Scale, 44% reported daytime sleepiness on the Epworth Sleepiness Scale, and 78% scored above cut-off on the Pittsburgh Sleep Quality Index. The high concurrence of these symptoms gives reason to infer the existence of a vestibular cognitive affective syndrome. Structural equation modelling indicated that the significant statistical association between general unassisted posture (a marker of chronic vestibular dysfunction and strong predictor of falls risk) and short-term memory was not mediated by mood and wakefulness. Instead, the memory impairment related more directly to vestibular dysfunction. From a rehabilitation perspective, the implication is that if the vestibular disorder is treated successfully then the memory problem will likewise improve.     

Intelligence, Callous-Unemotional Traits, and Antisocial Behavior

Research has consistently shown that children with severe conduct problems often exhibit intellectual deficits, especially in their verbal abilities. We investigated whether or not this finding only applies to certain subgroups of children with severe conduct problems. In a sample of 117 clinic-referred children between the ages of 6 and 13, we assessed for Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) symptoms using a structured diagnostic interview with each child's parent and teacher, callous and unemotional traits using parent and teacher ratings, and intellectual functioning using a standard individually administered intelligence test. Children with an ODD or CD diagnosis who did not show callous and unemotional traits showed a deficit on subtests measuring verbal reasoning ability relative to a clinic control group. Children with an ODD or CD diagnosis who also showed callous and unemotional traits did not show a verbal deficit and, in fact, showed a trend toward having weaker nonverbal abilities. These results highlight the importance of recognizing distinct subgroups of children with severe conduct problems when studying potential intellectual deficits in these children.     

Enrichment and Stress in Families Caring for a Child with a Serious Emotional Disorder

We examined enrichment and stress in 214 families who had children with severe emotional disorders. Caregivers' ratings of enrichment and stress were obtained through a newly developed instrument, the Effects of the Situation Questionnaire, which used parallel items covering 17 life areas. While ratings of stress were generally higher than enrichment, caregivers reported some enrichment in areas encompassing self concept and family relationships, Bivariate and multivariate analyses using various child, family, and service-system variables revealed that stress was notably associated with severity of the child's disorder, low empowerment, and a lack of coordination among service providers. Enrichment was unrelated to severity but associated with high empowerment and spiritual support. Our findings suggest that families' experiences of caregiving can have both positive and negative aspects and that a comprehensive approach to serving and studying families should take both into account.     

Using Community Partnerships to Better Understand the Barriers to Using an Evidence‐Based,Parent‐Mediated Intervention for Autism Spectrum Disorder in a Medicaid System

Service use disparities have been noted to impede under‐resourced families' ability to access high‐quality services for their child with autism spectrum disorder (ASD). These disparities are particularly relevant for parent‐mediated interventions and may suggest a lack of fit between these interventions and the needs of under‐resourced community settings. This study used Roger's Diffusion of Innovations theory to guide community partnerships aimed at understanding the perceived compatibility, complexity, and relative advantage of using an evidence‐based, parent‐mediated intervention (Project ImPACT) within a Medicaid system. Three focus groups were conducted with 16 Medicaid‐eligible parents, and three focus groups were conducted with 16 ASD providers operating within a Medicaid system. Across all groups, parents and providers reported general interest in using Project ImPACT. However, primary themes emerged regarding the need to (a) reduce the complexity of written materials; (b) allow for a more flexible program delivery; (c) ensure a strong parent–therapist alliance; (d) involve the extended family; and (e) help families practice the intervention within their preexisting routines. Results are discussed as they relate to the design and fit of evidence‐based, parent‐mediated interventions for under‐resourced community settings.     

Linguistic and emotional-valence characteristics of reading passages for clinical use and research

PurposeFluency assessment in people who stutter (PWS) includes reading aloud passages. There is little information on properties of these passages that may affect reading performance: emotional valance, arousal, word familiarity and frequency and passage-readability. Our first goal was to present an extensive examination of these factors in three commonly used (“traditional”) passages. The second goal was to compare a traditional passage to a new passage, designed to minimize the impact of these properties.MethodsContent words were rated (129 participants) on arousal, valence and familiarity. Other linguistic features were analyzed based on available datasets. This information was used to assess traditional passages, and to construct a new well-balanced passage, made of neutral, low-arousal and highly-familiar words. Readability for all passages was tested using formula-based and CLOZE tests (31 participants). Finally, 26 PWS were evaluated on fluency comparing the commonly used “Rainbow” passage with the novel one.ResultsThe three traditional passages contain a share of emotionally valenced (22-34%), high arousal (15-18%), lower familiarity (6-8%) and polysyllabic (5-9%) content words. Readability was highest for the novel passage (on formula-based scales). Average disfluencies percent for the Rainbow and our novel passage were not significantly different. Yet half of the individuals in this sample showed a large difference between the two passages.ConclusionWe provide detailed information on potential sources of variance using the traditional passages. Knowledge about these characteristics can inform clinical practice (and research). We suggest a combined procedure, using more than one passage to assess stuttering in individual cases.     

Systemizing in autism: The case for an emotional mechanism

More often than others, people with autism engage in systemizing – attempts to understand and build rule-based systems. The mechanism behind the increased frequency of such behavior in autism is unknown, however. The assumption has long existed that emotions exist to motivate behavior, and there is now much evidence that people with autism tend to have stronger, more easily elicited emotions than the average person. This appears to be the cause of increased systemizing in autism – through a negative and a positive emotional pathway: There is evidence that autistic people want control more strongly than do others. This is often so, says the hypothesis, because strong negative emotions, other things equal, make lack of control feel more aversive than it does for most people. Systemizing can increase the feeling of control and hence reduce the negative emotion. Positive emotion can also motivate systemizing in autism – fascination and attraction more strongly felt and more easily elicited than in other people.     

Concurrent validity of the differential ability scales,second edition with the Mullen Scales of Early Learning in young children with and without neurodevelopmental disorders

Estimates of intelligence in young children with neurodevelopmental disorders are critical for making diagnoses, in characterizing symptoms of disorders, and in predicting future outcomes. The limitations of standardized testing for children with developmental delay or cognitive impairment are well known: Tests do not exist that provide developmentally appropriate material along with norms that extend to the lower reaches of ability. Two commonly used and interchanged instruments are the Mullen Scales of Early Learning (MSEL), a test of developmental level, and the Differential Ability Scales, second edition (DAS-II), a more traditional cognitive test. We evaluated the correspondence of contemporaneous MSEL and the DAS-II scores in a mixed sample of children aged 2–10 years with autism spectrum disorder (ASD), non-ASD developmental delays, and typically developing children across the full spectrum of cognitive ability. Consistent with published data on the original DAS and the MSEL, scores on the DAS-II and MSEL were highly correlated. However, curve estimation revealed large mean differences that varied as a function of the child’s cognitive ability level. We conclude that interchanging MSEL and DAS-II scores without regard to the discrepancy in scores may produce misleading results in both cross-sectional and longitudinal studies of children with and without ASD, and, thus, this practice should be implemented with caution.     

Current knowledge on motor disorders in children with autism spectrum disorder (ASD)

Motor symptomatology in autism is currently poorly understood, and still not included in the autism spectrum disorder (ASD) diagnostic criteria, although some studies suggest the presence of motor disturbances in this syndrome. We provide here a literature review on early motor symptoms in autism, focusing on studies on psychomotor issues (tone, postural control, manual dexterity, handedness, praxis). The approach adopted in research to study altered motor behaviors is generally global and there is no detailed semiology of the motor or neuromotor disorders observed in people with ASD. This global approach does not enable understanding of the neuro-developmental mechanisms involved in ASD. Identification of clinical neuro-psychomotor profiles in reference to a standard would help to better understand the origin and the nature of the disorders encountered in ASD, and would thus give new directions for treatment.