A progressive model for teaching children with autism to follow gaze shift

Gunby, Rapp, Bottoni, Marchese and Wu (2017) taught three children with autism spectrum disorder to follow an instructor's gaze shift to select a specific item; however, Gunby et al. used different types of prompts with each participant. To address this limitation, we used a progressive training model for increasing gaze shift for three children with autism spectrum disorder. Results show that each participant learned to follow an adult's shift in gaze to make a correct selection. In addition, two participants displayed the skill in response to a parent's gaze shift and with only social consequences; however, the third participant required verbal instruction and tangible reinforcement to demonstrate the skill outside of training sessions.     

Changes in schemas of patients with severe borderline personality disorder: The Oulu BPD study

Borderline personality disorder (BPD) is a relatively common and severe psychiatric disorder that can impair quality of life in many ways. The aim of this study was to determine whether a combined treatment model for BPD patients, utilising major principles from schema‐focused therapy (SFT) and dialectical behavioral therapy (DBT), could be more effective in relieving early maladaptive schemas of BPD patients, compared to treatment as usual (TAU). This study is a part of the Oulu BPD study conducted at mental health care services run by Oulu city social and health care services. The study is a multisite, randomized controlled trial conducted over a one year period, involving two groups of patients with severe BPD: (1) Community Treatment By Experts (CTBE) patients (n = 18) receiving the combined treatment model, and 2) TAU patients (n = 27). The patients' schemas were assessed using the Young Schema Questionnaire (YSQ‐L3a) before and after one year of treatment. The results reveal that CTBE patients who attended the combined treatment model showed a statistically significant reduction in eight out of 18 early maladaptive schemas, while patients receiving treatment as usual did not demonstrate any significant changes in schemas. The cognitive therapeutic treatment model can be applied for clinical use in public mental health settings using existing professionals, and appears to produce positive changes in patients with BPD.     

The Role of Religious Coping and Resilience in Individuals With Dissociative Identity Disorder

Survivors with dissociative identity disorder (DID) often report a history of traumatic events in their lives. Past studies indicated a link between trauma, resilience, and spiritual coping in both positive and negative aspects of a survivor's life. This article includes a review of existing literature salient to these constructs in relation to i ndividuals with DID, as well as results from a study examining the relationships between these constructs and individuals with DID (N = 52). Implications are discussed based on the findings for counselors treating individuals with DID.     

Motor imagery ability and internal representation of movement in children with probable developmental coordination disorder

It has been hypothesised that deficits in the functioning of the mirror neuron system (MNS) and internal modelling may contribute to the motor impairments associated with DCD. These processes can be explored behaviourally through motor imagery paradigms. Motor imagery proficiency of children with and without probable DCD (pDCD) was examined using a complex hand rotation task to explore whether motor imagery strategies could be used during more complex tasks. Forty-four boys aged 7–13 years participated, 22 with pDCD (mean = 9.90 years ± 1.57) and 22 controls (mean = 9.68 years ± 1.53). Participants completed the task twice: with and without motor imagery instructions. Stimuli were presented in two rotational axes – palm/back, and eight 45° rotational steps. Both groups showed evidence of following the biomechanical and postural constraints of actual movements. Responses of children with pDCD were slower and less accurate than controls, with group differences increasing alongside task complexity. A greater impact of biomechanical constraints for accuracy was observed in the DCD group. The response characteristics of children with pDCD likely reflects a reduced capacity to mentally manipulate a body schema and reduced visuo-motor processing capabilities. Behaviourally, these processes are linked to MNS and internal modelling function, suggesting deficits in these systems may contribute to the movement difficulties characteristic of DCD.     

Reprint of “Co-occurring motor,language and emotional–behavioral problems in children 3–6 years of age”

PurposeDevelopmental Coordination Disorder (DCD) has been shown to co-occur with behavioral and language problems in school-aged children, but little is known as to when these problems begin to emerge, or if they are inherent in children with DCD. The purpose of this study was to determine if deficits in language and emotional–behavioral problems are apparent in preschool-aged children with movement difficulties.MethodTwo hundred and fourteen children (mean age 4 years 11 months, SD 9.8 months, 103 male) performed the Movement Assessment Battery for Children 2nd Edition (MABC-2). Children falling at or below the 16th percentile were classified as being at risk for movement difficulties (MD risk). Auditory comprehension and expressive communication were examined using the Preschool Language Scales 4th Edition (PLS-4). Parent-reported emotional and behavioral problems were assessed using the Child Behavior Checklist (CBCL).ResultsPreschool children with diminished motor coordination (n = 37) were found to have lower language scores, higher externalizing behaviors in the form of increased aggression, as well as increased withdrawn and other behavior symptoms compared with their typically developing peers.ConclusionsMotor coordination, language and emotional–behavioral difficulties tend to co-occur in young children aged 3–6 years. These results highlight the need for early intervention.     

Procedural learning and automatization process in children with developmental coordination disorder and/or developmental dyslexia

ObjectiveThere is increasing evidence to suggest that developmental dyslexia (DD) and developmental coordination disorder (DCD) actually form part of a broader disorder. Their frequent association could be justified by a deficit of the procedural memory system, that subtends many of the cognitive, motor and linguistic abilities that are impaired in both DD and DCD. However, studies of procedural learning in these two disorders have yielded divergent results, and in any case no studies have so far addressed the issue of automatization (dual-task paradigm).MethodsWe administered a finger tapping task to participants aged 8–12 years (19 DCD, 18 DD, and 22 with both DD and DCD) to explore procedural learning and automatic movements in these three groups of children, comparing motor performances at the prelearning stage, after 2 weeks of training, and in a post-training dual-task condition.ResultsFirst, results indicated that all the children were able to learn a sequence of movements and even automatize their movements. Second, they revealed between-groups differences in procedural/automatization learning abilities, setting the DCD group apart from the other two. Third, contrary to our expectations concerning comorbidity, they suggested that the DD + DCD association does not have an additional impact on behavioral performances.     

Object relational disturbances that may underlie the diagnosis of attention-deficit disorder in adults

Extensive case material is used to show how some adult patients who have been diagnosed with and medicated for attention-deficit disorder (ADD) may be actually suffering from underlying unconscious object relational conflicts that interfere with their ego-functioning, creating an inhibition of basic concentration, focus, expression, and learning. Early childhood experiences of trauma and neglect can create destructive patterns of projective identification based paranoia, guilt, and intense anxiety. The author proposes that these patients have to sacrifice their own identity, psychological organization, and ability to learn or teach in order to keep the peace with others. In order to avoid conflict, difference, and uncertainty, these patients do whatever they can to placate, please, and not disturb the object. However, they often end up extremely resentful, oppositional, and passive-aggressive in reaction. The overwhelming anxiety these patients experience in relationship to the object and to their own internalized demanding critic blocks their ability to learn and grow. In addition, new knowledge, mastery, and creativity are seen as dangerous, forced upon them, or bringing unsafe attention to them. So, in defense, they adapt an inert, scattered, or formless way of living to keep under the radar. This paper advocates the psychoanalytic treatment of such internal conflicts over the popular diagnosis of ADD. Difficulties of learning, attention, concentration, and organization can be better understood and treated as a set of core psychological issues open to gradual working through and healing rather than neurological defects that can only be controlled or managed with strong medication and behavioral exercises.