Children

Research

15 pages, 525 KiB

Open AccessArticle

Patterns of Response to Methylphenidate Administration in Children with ADHD: A Personalized Medicine Approach through Clustering Analysis

by Silvia Grazioli, Eleonora Rosi, Maddalena Mauri, Alessandro Crippa, Federica Tizzoni, Arianna Tarabelloni, Filippo Maria Villa, Federica Chiapasco, Maria Reimers, Erika Gatti, Silvana Bertella, Massimo Molteni and Maria Nobile

Children 2021, 8(11), 1008; https://doi.org/10.3390/children8111008 - 4 Nov 2021

Cited by 3 | Viewed by 2417

Abstract

Individual responses to methylphenidate (MPH) can significantly differ in children with attention-deficit/hyperactivity disorder (ADHD) in terms of the extent of clinical amelioration, optimal dosage needed, possible side effects, and short- and long-term duration of the benefits. In the present repeated-measures observational study, we [...] Read more.

Individual responses to methylphenidate (MPH) can significantly differ in children with attention-deficit/hyperactivity disorder (ADHD) in terms of the extent of clinical amelioration, optimal dosage needed, possible side effects, and short- and long-term duration of the benefits. In the present repeated-measures observational study, we undertook a proof-of-concept study to determine whether clustering analysis could be useful to characterize different clusters of responses to MPH in children with ADHD. We recruited 33 children with ADHD who underwent a comprehensive clinical, cognitive, and neurophysiological assessment before and after one month of MPH treatment. Symptomatology changes were assessed by parents and clinicians. The neuropsychological measures used comprised pen-and-paper and computerized tasks. Functional near-infrared spectroscopy was used to measure cortical hemodynamic activation during an attentional task. We developed an unsupervised machine learning algorithm to characterize the possible clusters of responses to MPH in our multimodal data. A symptomatology improvement was observed for both clinical and neuropsychological measures. Our model identified distinct clusters of amelioration that were related to symptom severity and visual-attentional performances. The present findings provide preliminary evidence that clustering analysis can potentially be useful in identifying different responses to MPH in children with ADHD, highlighting the importance of a personalized medicine approach within the clinical framework. Full article

(This article belongs to the Special Issue Neurodevelopmental Disorders: Diagnosis, Psychiatric Comorbidities and Treatment)

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12 pages, 1848 KiB

Open AccessArticle

Service Quality in Early Intervention Centres: An Analysis of Its Influence on Satisfaction and Family Quality of Life

by Inmaculada-Concepción Jemes-Campaña, Rita-Pilar Romero-Galisteo, Pablo Gálvez-Ruiz, Maria-Teresa Labajos-Manzanares and Noelia Moreno-Morales

Children 2021, 8(8), 716; https://doi.org/10.3390/children8080716 - 21 Aug 2021

Cited by 2 | Viewed by 2147

Abstract

Early Intervention (EI) is a set of interventions focused on responding to the needs of children with or at risk of developmental problems. This study aimed to investigate the relationships between the perceived quality of service, satisfaction and family quality of life. Methods: [...] Read more.

Early Intervention (EI) is a set of interventions focused on responding to the needs of children with or at risk of developmental problems. This study aimed to investigate the relationships between the perceived quality of service, satisfaction and family quality of life. Methods: to conduct a multi-centre, transversal study with a non-probabilistic sample. The participants (N = 1551) were families from 24 Early Intervention Centres (EICs) located in Spain. Results: The results indicated an adequate fit of the measurement and structural models, with the latter showing a capacity of 73% to predict the family quality of life. The structural model established that the perceived service quality was a positive and significant predictor of satisfaction (β = 0.85; p < 0.001). Both the perceived quality of service (β = 0.28; p < 0.001) and satisfaction (β = 0.33; p < 0.001) obtained a similar positive and significant relationship with family quality of life, which was slightly stronger than satisfaction. Conclusions: This study provided a better understanding of the importance of the services offered in EICs and their influence on the satisfaction and family quality of life of their users. Thus, delving into these relationships was highly relevant for decision-making in the context of EI. Full article

(This article belongs to the Special Issue Neurodevelopmental Disorders: Diagnosis, Psychiatric Comorbidities and Treatment)

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23 pages, 7429 KiB

Open AccessArticle

Shining a Light on the Challenging Behaviors of Adolescents with Comorbid Diagnoses: Use of Pictorial Concurrent Operant Preference Assessment

by Zhichun Zhou, David Burrell McAdam, Deborah Ann Napolitano and Kathryn Douthit

Children 2021, 8(8), 683; https://doi.org/10.3390/children8080683 - 8 Aug 2021

Viewed by 2914

Abstract

Currently, there are no published studies that have used the concurrent operant preference assessment procedure to identify functions of challenging behaviors displayed by individuals with comorbid diagnoses. Four participants (aged 11–16 years) with comorbid diagnoses who displayed multiple challenging behaviors were referred to [...] Read more.

Currently, there are no published studies that have used the concurrent operant preference assessment procedure to identify functions of challenging behaviors displayed by individuals with comorbid diagnoses. Four participants (aged 11–16 years) with comorbid diagnoses who displayed multiple challenging behaviors were referred to this study. We modified the standard concurrent operant preference assessment and used the new modified version, the pictorial concurrent operant preference assessment, to identify the functions of the challenging behaviors. Utilizing the triangulation mixed-methods design, we compared the indirect functional behavioral assessment (FBA) and the direct FBA with the pictorial concurrent operant preference assessment. The results obtained successfully demonstrated the concordance among these assessments in identifying the behavioral function for each participant. The results further showed that (1) the preferences served the same functional effects on both the challenging behaviors and the adaptive behaviors and (2) the pictorial concurrent operant preference assessment can be used independently to identify potential behavioral function and to specify the reinforcing potency of each behavioral function. The significance of the study results, limitations of this study, and directions for future research and clinical practice are discussed. Full article

(This article belongs to the Special Issue Neurodevelopmental Disorders: Diagnosis, Psychiatric Comorbidities and Treatment)

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12 pages, 873 KiB

Open AccessFeature PaperArticle

Sex Differences in Autism Spectrum Disorder: Repetitive Behaviors and Adaptive Functioning

by Martina Siracusano, Valentina Postorino, Assia Riccioni, Leonardo Emberti Gialloreti, Monica Terribili, Paolo Curatolo and Luigi Mazzone

Children 2021, 8(5), 325; https://doi.org/10.3390/children8050325 - 22 Apr 2021

Cited by 16 | Viewed by 3953

Abstract

Sex differences in restricted and repetitive behaviors (RRBs) in individuals with Autism Spectrum Disorder (ASD) have been explored with mixed findings. We aimed to investigate sex differences in RRBs through a specific measure—i.e., the Repetitive Behavior Scale Revised (RBS-R)—in a sample of preschool-age [...] Read more.

Sex differences in restricted and repetitive behaviors (RRBs) in individuals with Autism Spectrum Disorder (ASD) have been explored with mixed findings. We aimed to investigate sex differences in RRBs through a specific measure—i.e., the Repetitive Behavior Scale Revised (RBS-R)—in a sample of preschool-age and school-age children with ASD. Additionally, we evaluated if RRBs were differently related to adaptive functioning within the male and the female age groups. A sample of 210 ASD individuals (3–18 years; 145 males, 65 females) underwent an in-depth assessment including a cognitive, adaptive functioning evaluation (i.e., the Adaptive Behavior Assessment System, Second Edition (ABAS-II)) and RRBs assessment (i.e., RBS-R). No significant sex differences on the RBS-R total score or any RBS-R subscale emerged. Within the group of older participants, RRBs were negatively associated with all adaptive skill domains independently from sex and age. Our results suggest a lack of sex differences in RRBs in our sample. Additionally, our findings highlight the possible negative impact of RRBs on adaptive skills in older individuals with autism, emphasizing the need for autistic individuals of both sexes to undergo an early intervention targeting RRBs, in order to improve their adaptive skills. Full article

(This article belongs to the Special Issue Neurodevelopmental Disorders: Diagnosis, Psychiatric Comorbidities and Treatment)

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13 pages, 218 KiB

Open AccessCommunication

The Effectiveness of Lurasidone Add-On for Residual Aggressive Behavior and Obsessive Symptoms in Antipsychotic-Treated Children and Adolescents with Tourette Syndrome: Preliminary Evidence from a Case Series

by Marco Colizzi, Riccardo Bortoletto and Leonardo Zoccante

Children 2021, 8(2), 121; https://doi.org/10.3390/children8020121 - 9 Feb 2021

Cited by 4 | Viewed by 3633

Abstract

Children and adolescents with Tourette syndrome may suffer from comorbid psychological and behavioral difficulties, primarily Attention-Deficit Hyperactivity Disorder-related manifestations including impulsive, aggressive, and disruptive behavior, and Obsessive-Compulsive Disorder-related disturbances. Often, such additional problems represent the major cause of disability, requiring their prioritization above [...] Read more.

Children and adolescents with Tourette syndrome may suffer from comorbid psychological and behavioral difficulties, primarily Attention-Deficit Hyperactivity Disorder-related manifestations including impulsive, aggressive, and disruptive behavior, and Obsessive-Compulsive Disorder-related disturbances. Often, such additional problems represent the major cause of disability, requiring their prioritization above the tic symptomatology. Here, we present six cases of children and adolescents with treatment-resistant Tourette syndrome aged 11–17 years, whose symptoms, especially the non-tic symptoms such as aggressive behavior and obsessive symptoms, failed to respond adequately to at least two different antipsychotics and, where deemed appropriate, to a combination with a medication with a different therapeutic indication or chemical class (e.g., antidepressant or anticonvulsant). Such symptomatic manifestations were significantly reduced by the time of the subsequent control visit planned 30 days later, by using lurasidone as an add-on therapy to risperidone or aripiprazole (all p ≤ 0.009). No significant neuromotor or metabolic side effects were reported in all cases in a follow-up period ranging from 4 months to 6 months, supporting the stability of the observed clinical improvement. While still investigational, the preliminary evidence presented here gives reason to hope that lurasidone could possibly be an effective option in Tourette syndrome, warranting further investigation of its potential benefits in neurodevelopmental conditions. Full article

(This article belongs to the Special Issue Neurodevelopmental Disorders: Diagnosis, Psychiatric Comorbidities and Treatment)

14 pages, 632 KiB

Open AccessArticle

The Impact of COVID-19 on the Adaptive Functioning, Behavioral Problems, and Repetitive Behaviors of Italian Children with Autism Spectrum Disorder: An Observational Study

by Martina Siracusano, Eugenia Segatori, Assia Riccioni, Leonardo Emberti Gialloreti, Paolo Curatolo and Luigi Mazzone

Children 2021, 8(2), 96; https://doi.org/10.3390/children8020096 - 2 Feb 2021

Cited by 29 | Viewed by 6349

Abstract

Children with autism spectrum disorder (ASD) and their families have represented a fragile population on which the extreme circumstances of the COVID-19 outbreak may have doubly impaired. Interruption of therapeutical interventions delivered in-person and routine disruption constituted some of the main challenges they [...] Read more.

Children with autism spectrum disorder (ASD) and their families have represented a fragile population on which the extreme circumstances of the COVID-19 outbreak may have doubly impaired. Interruption of therapeutical interventions delivered in-person and routine disruption constituted some of the main challenges they had to face. This study investigated the impact of the COVID-19 lockdown on adaptive functioning, behavioral problems, and repetitive behaviors of children with ASD. In a sample of 85 Italian ASD children (mean age 7 years old; 68 males, 17 females), through a comparison with a baseline evaluation performed during the months preceding COVID-19, we evaluated whether after the compulsory home confinement any improvement or worsening was reported by parents of ASD individuals using standardized instruments (Adaptive Behavior Assessment System (Second Edition), Achenbach Child Behavior Checklist, Repetitive Behavior Scale-Revised). No significant worsening in the adaptive functioning, problematic, and repetitive behaviors emerged after the compulsory home confinement. Within the schooler children, clinical stability was found in reference to both adaptive skills and behavioral aspects, whereas within preschoolers, a significant improvement in adaptive skills emerged and was related to the subsistence of web-delivered intervention, parental work continuance, and online support during the lockdown. Full article

(This article belongs to the Special Issue Neurodevelopmental Disorders: Diagnosis, Psychiatric Comorbidities and Treatment)

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Review

Jump to: Research, Other

17 pages, 773 KiB

Open AccessReview

Fundamental Motor Skills Intervention for Children with Autism Spectrum Disorder: A 10-Year Narrative Review

by Silvia Busti Ceccarelli, Camilla Ferrante, Erica Gazzola, Gian Marco Marzocchi, Maria Nobile, Massimo Molteni and Alessandro Crippa

Children 2020, 7(11), 250; https://doi.org/10.3390/children7110250 - 23 Nov 2020

Cited by 19 | Viewed by 8105

Abstract

In the past decade, converging evidence has suggested that motor impairment is one of the most consistent markers, alongside sociocommunicative difficulties, for autism spectrum disorder (ASD). Indeed, widespread anomalies of movement have been described in the ASD context. These motor abnormalities could have [...] Read more.

In the past decade, converging evidence has suggested that motor impairment is one of the most consistent markers, alongside sociocommunicative difficulties, for autism spectrum disorder (ASD). Indeed, widespread anomalies of movement have been described in the ASD context. These motor abnormalities could have critical implications for subsequent cognitive and social development. Nevertheless, this area of development is particularly underexamined in the autism-related context, and early intervention programs commonly focus on the core symptoms of the condition. In the present work, we review and discuss the findings from recent studies that investigated the effect of interventions regarding fundamental motor skills in autistic children. Although the limited nature of the literature prevents researchers from drawing definitive conclusions, the results from the studies discussed here demonstrated potentially significant improvements in the motor abilities of autistic children after the interventions. Only a subset of the reviewed studies explored possible changes in the sociocommunicative domain after the motor skills improvements, and they had not concordant, although promising, conclusions. Overall, in consideration of the well-documented motor impairment people with the condition, the present findings highlight the importance of including motor skills training within the rehabilitation programs designed for autistic children. Furthermore, this narrative review encourages future interventional trials to consider motor skills as a possible target for reducing activity limitations and participation restrictions of autistic children. Full article

(This article belongs to the Special Issue Neurodevelopmental Disorders: Diagnosis, Psychiatric Comorbidities and Treatment)

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Other

Jump to: Research, Review

7 pages, 500 KiB

Open AccessCase Report

Neuro-Behavioral Phenotype in 16p11.2 Duplication: A Case Series

by Annio Posar and Paola Visconti

Children 2020, 7(10), 190; https://doi.org/10.3390/children7100190 - 19 Oct 2020

Cited by 3 | Viewed by 2443

Abstract

Duplications of chromosome 16p11.2, even though rare in the general population, are one of the most frequent known genetic causes of autism spectrum disorder and of other neurodevelopmental disorders. However, data about the neuro-behavioral phenotype of these patients are few. We described a [...] Read more.

Duplications of chromosome 16p11.2, even though rare in the general population, are one of the most frequent known genetic causes of autism spectrum disorder and of other neurodevelopmental disorders. However, data about the neuro-behavioral phenotype of these patients are few. We described a sample of children with duplication of chromosome 16p11.2 focusing on the neuro-behavioral phenotype. The five patients reported presented with very heterogeneous conditions as for characteristics and severity, ranging from a learning disorder in a child with normal intelligence quotient to an autism spectrum disorder associated with an intellectual disability. Our case report underlines the wide heterogeneity of the neuropsychiatric phenotypes associated with a duplication of chromosome 16p11.2. Similarly to other copy number variations that are considered pathogenic, the wide variability of phenotype of chromosome 16p11.2 duplication is probably related to additional risk factors, both genetic and not genetic, often difficult to identify and most likely different from case to case. Full article

(This article belongs to the Special Issue Neurodevelopmental Disorders: Diagnosis, Psychiatric Comorbidities and Treatment)

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