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PURPOSE: This study aimed to 1) investigate the convergent and discriminant validity, internal consistency, and test-retest reliability of the Canadian English version of the Computer-Based instrument for Low motor Language Testing (C-BiLLT-CAN), and 2) explore feasibility of the C-BiLLT assessment for children with cerebral palsy (CP) and complex communication needs in the Canadian health care context. METHODS: Eighty typically developing children between 1.5 and 8.5 years of age completed the C-BiLLT-CAN, the Peabody Picture Vocabulary Test-IV (PPVT-4), the receptive language sub-test of the New Reynell Developmental Language Scales (NRDLS), and/or the Raven's 2. Correlations between raw scores were calculated for estimates of convergent and discriminant validity. Internal consistency was calculated for all items and separately for items pertaining to vocabulary and grammar. To calculate the standard error of measurement (SEM) and intraclass correlation coefficient (ICC), 33 participants were re-tested with the C-BiLLT within three weeks. Feasibility was explored with nine participants with CP. RESULTS: C-BiLLT-CAN's convergent validity was good to excellent (Spearman's rho > 0.78) and discriminant validity was higher than hypothesized (Spearman's rho > 0.8). Internal consistency (Cronbach's alpha = 0.96), test-retest reliability (ICC > 0.9), and measurement error (SEM < 5%) were excellent. The feasibility study could not be fully completed due to the COVID-19 pandemic. Preliminary data demonstrated some technical and practical barriers for using the C-BiLLT in children with CP in Canada. CONCLUSION: The C-BiLLT-CAN showed good to excellent psychometric properties in a sample of typically developing children, indicating that it is an adequate test for measuring language comprehension in English-speaking Canadian children. Further research is needed to investigate the feasibility of the C-BiLLT-CAN in children with CP. [ABSTRACT FROM AUTHOR]

PURPOSE: The purpose of the study was to explore whether a developmental test provides enough information to estimate a child's functional independence. The strength of the relationship between developmental level and functional independence of different skills was investigated. METHODS: The participants were 397 children (age 0–7 years) who were referred to NCCHD for suspected developmental delay. The participants' developmental level was measured with the Kyoto Scale of Psychological Development (KSPD) and their functional independence was assessed through a Japanese version of the WeeFIM II®. To calculate the strengths of the relationship between developmental age (DA) in different domains of the KSPD and WeeFIM II item scores, partial correlation analyses were conducted, controlling for chronological age. RESULTS: Partial correlation coefficients between the score of each of the 18 WeeFIM II items and each of the three KSPD domain DAs (controlling chronological age) fell in the ranges of r = 0.169–0.581 (Posture-Motor; P-M), r = 0.377–0.627 (Cognitive-Adaptive; C-A), and r = 0.332–0.655 (Language-Social; L-S). When the participants were divided into three age groups, the correlations ranged from –0.095 to 0.552 for the youngest group (mean age = 14.21 months), from 0.283 to 0.653 for the middle group (mean age = 32.98 months), and from 0.345–0.692 for the oldest group (mean age = 57.48 months), depending on the combinations of the WeeFIM II items/developmental domains of the KSPD. The results indicated that for most of the daily living skills, its functional independence was only partially explained by the scores of a developmental test, once chronological age was controlled. CONCLUSION: This study showed the limitation of a developmental test as a tool to measure the functional independence of children and the necessity of using an independent tool, such as WeeFIM II, to evaluate the level of required support for each daily living skill. [ABSTRACT FROM AUTHOR]

PURPOSE: Cognitive impairments frequently occur in children and adolescents with acquired brain injury (ABI), causing significant disabilities in daily life. Current paper-and-pencil neuropsychological tests do not capture the complexity of daily life activities, often failing to objectify subtle cognitive impairments. Virtual Reality (VR) simulations might overcome this discrepancy, as it resembles daily life situations. The aim of this study was to evaluate the feasibility, user-experience and preference of a VR simulation with a non-immersive (computer monitor; CM)) and immersive (head mounted display; HMD)) VR setup. METHODS: Children and adolescents with ABI (n = 15) and typically developing children and adolescents (n = 21) completed a VR-task with a CM and HMD. RESULTS: Both VR setups were feasible for children and adolescents with ABI. User-experience was enhanced with the HMD compared to CM in both groups. Side effects were low and comparable for both groups, and there were no differences between setups (HMD and CM). The majority of the children and adolescents with ABI preferred the HMD. CONCLUSION: VR simulations appear feasible to use in paediatric rehabilitation. The preference for a VR setup should be discussed with the child. Further research is needed to develop more sensitive measures to further explore the potential of VR for cognitive assessment. [ABSTRACT FROM AUTHOR]

PURPOSE: This study explores non-motor impairment of the upper dominant limb in children with diplegic cerebral palsy (CP). Specifically, it firstly investigates sense of position without visual control, ability to compare visual and proprioceptive information, and capacity to recognize effects of self-movement. Secondly, it explores the possible association between these items with cognitive function, perceptual disorder (PD), and manual ability (Manual Ability Classification System -MACS). METHODS: Ten subjects (7 female; 3 male) were tested with three protocols: the first one (A) explored sense of position, the second one (B) collimation between visual and proprioceptive information, and the last one (C) sense of agency with the use of videogames. RESULTS: All subjects executed Protocol A without making any mistakes, while in Protocol B the median percentage of mistakes was 4.8%. Mistakes were recorded more frequently in positions characterized by wrist extension. Data reported a significant correlation with Processing Speed Index (PSI). Sense of agency was positively associated with cognitive functioning, with a significant correlation with PSI. PD, MACS, and Video-Gaming Experience (VGE) showed no correlation with Protocol C. CONCLUSION: In the observed sample with diplegic CP, preliminary data support the hypothesis that there is an alteration of both sense of position and sense of agency. They were both associated to PSI, with a positive trend of correlation with cognitive functioning. PD seemed to have no influence. Further studies, with a larger sample size, a control group, and involving children without CP, are required to corroborate the results obtained. [ABSTRACT FROM AUTHOR]

PURPOSE: To assess hand dexterity in children with myelomeningocele (MMC) and to explore factors related to hand dexterity in these children. METHODS: Ninety-four children with myelomeningocele, aged 4 to 18 years, were assessed. Demographic characteristics, disease factors, visual perception (Beery test of Visual Motor Integration), cognition (WeeFunctional Independence Measure), and self-care (Pediatric Evaluation of Disability Inventory) were assessed in relation to the Nine-Hole Peg Test (9HPT) for hand dexterity using Spearmen correlations and linear regressions. RESULTS: The children's performance on the 9HPT in both hands was significantly slower than the norms for their age groups. Children without a shunt showed significantly better function in both hands (p =.005) than those with a shunt. Factors most related to hand dexterity were neurological spinal level of MMC, presence of shunt, age, cognitive ability, and years of mother's education. CONCLUSION: Children with MMC appear to have poorer hand skills than typically developed children, which was related to pathology as well as functional and environmental factors. When addressing hand dexterity in children with MMC, it is important that rehabilitation professionals continue to work with these children as they get older, and put greater emphasis on parent education using materials that are adapted to varying educational levels. [ABSTRACT FROM AUTHOR]

Anti-N-Methyl-D-Aspartate Receptor Encephalitis (ANMDARE) is one of the most common autoimmune encephalitis in the pediatric population. Patients with ANMDARE initially present with a prodrome of neuropsychiatric symptoms followed by progressively worsening seizures, agitation, and movement disorders. Complications can include problems such as aggression, insomnia, catatonia, and autonomic instability. Due to the complexity of this disease process, symptom management can be complex and may lead to significant polypharmacy. The goal of this review is to educate clinicians about the challenges of managing this disorder and providing guidance in symptom management. [ABSTRACT FROM AUTHOR]

BACKGROUND: There is strong evidence that cognitive skills and executive functions are skills that children need in order to successfully learn in school. Although executive function disorders are not considered a learning disability, weaknesses in executive functioning are often observed in students with learning disabilities or ADHD. Cognitive games are a type of educational games which focus on enhancing cognitive functioning in children with different profiles of cognitive development, including students with neurocognitive and/or learning disabilities. Self-regulation and metacognitive skills also play an important role in academic performance. OBJECTIVE: In this work, we highlight the need of monitoring and supporting metacognitive skills (self-regulation) in the context of a cognitive training game. We propose a system for self-regulated cognitive training for children which supports metacognitive strategies allowing the child to reflect on their own progress, weaknesses and strengths, self-arrange the training content, and thus to promote their self-regulated learning skills. METHODS: We provide a narrative review of research in cognitive training, self-regulated learning and explainable recommendation systems for children in educational settings. RESULTS AND CONCLUSIONS: Based on the review, an experimental testbed is proposed to explore how transparency, explainability and persuasive strategies can be used to promote self-regulated learning skills in children, considering individual differences on learning abilities, preferences, and needs. [ABSTRACT FROM AUTHOR]

BACKGROUND: A major concern that is being increasingly addressed in modern educational environments is the ability to present equal accessibility opportunities to students with neurodevelopmental conditions and disorders as for typically developing children. OBJECTIVE: The main objective of the paper is to employ innovative technological advancements merged with evidence-based practices in order to teach, improve and generalise social skills for children with neurodevelopmental disorders, specifically children with High Functioning Autism (HFA) as well as children with Attention Deficit Disorder (ADD). METHODS: The development of a personalized solution adapted to the needs of each student is proposed. The platform will be composed of three main modules (Content Management, Emotional Analysis and Personalization). The target group is students of the Primary Years Program and Middle Years Program. EXPECTED RESULTS: Improved communicational and interactional capability of people with disabilities and facilitate social innovation; more affordable technologies and products that support interactions for people with disabilities, and new generation of services that are highly adaptable and personalisable to individual contexts. CONCLUSIONS: In order to achieve the optimum output/result of the system the procedure need to be implemented and reviewed by all involved parties. [ABSTRACT FROM AUTHOR]

BACKGROUND: Pediatric acquired brain injury may result in a significant gap between the "pre" and "post-injury" child. OBJECTIVE: We aimed to quantitatively explore the mechanism underlying parents' loss experience by examining the mediating role of behavioral outcomes (observed-problems and perceived-change) in the relationship between injury severity and grief. METHOD: The study employed a cross-sectional retrospective design and comprised 40 parents of children (aged 3–18 years) with moderate-severe brain injury. Data for each parent included an adapted version of the Two-Track Bereavement Questionnaire and Socio-demographics; Data for each child included the child's Information Processing Speed Index; the Child Behavioral Checklist and Parental Perception of Behavioral Changes scale. RESULTS: Slowed information processing speed was significantly associated with elevated ratings on both measures of behavioral outcomes and with intensified grief. Mediation analyses revealed that parental perceived behavioral change, significantly mediate the relationship between information processing speed and grief; the Child Behavioral Checklist total score also mediated the same relationship but only in 90% confidence interval. CONCLUSIONS: Findings reveal the adverse impact of behavioral outcomes on grief and suggest parents' loss experience to be stemming primarily from their subjective perception over their "changed-child", rather than the observed problems. Implications for clinical practice are discussed. [ABSTRACT FROM AUTHOR]

BACKGROUND: Autism spectrum disorders are complex neurodevelopmental disorders. Early intervention training is a very important treatment strategy. Under the current background of rehabilitation supply in China, the long-term efficacy of intervention is unexplored. OBJECTIVE: This study aimed to investigate the effects of long-term rehabilitation and related factors affecting the recovery of autistic children. METHODS: A total of 137 autistic children were followed up for 3 years. They received two neuropsychological assessments at the first visit and 3 years after referral. Assessments included Childhood Autism Rating Scale (CARS), Autism Behavior Checklist (ABC), and Developmental Diagnostic Scale of Children Aged 0–6 Years. All children were asked to visit rehabilitation centers for rehabilitation training. In the study, 105 children with autism spectrum disorders (ASD) received rehabilitation training according to the physician's orders (the rehabilitation group), and 32 patients did not receive rehabilitation training (the nonrehabilitation group). RESULTS: The ABC, CARS, and developmental quotient scores of the rehabilitation group were statistically significant between initial assessment and reassessment. No significant difference was observed in the nonrehabilitation group. CONCLUSIONS: Rehabilitation training significantly improved the core symptoms and cognitive function in children with ASD, exerting a long-term rehabilitation effect. The initial language development quotient, children's training time, and parental participation time of autistic children significantly impacted the change in ABC. [ABSTRACT FROM AUTHOR]

BACKGROUND: There are several gaps in the literature related to the prognosis and care of children who have experienced a brain injury then develop paroxysmal sympathetic hyperactivity (PSH). OBJECTIVE: : The objective of the present study was to explore the characteristics and prognosis of children who have experienced severe brain injury and developed PSH. METHODOLOGY: A secondary analysis was conducted using an established clinical dataset of children who had experienced severe brain injury and were admitted to an academic children's rehabilitation center (n = 83). RESULTS: Those children with PSH had a significantly longer acute care length of stay (p = 0.024) and total length of stay (p = 0.034) compared with those without PSH. There was no significant difference in cognitive and motor function or transition to rehabilitation between those with and those without PSH after controlling for age and etiology of injury. IMPLICATIONS: The findings from the present study reveal factors regarding the elusive phenomenon of PSH among children. [ABSTRACT FROM AUTHOR]

Given the epidemiological trends of increasing Alzheimer's disease (AD) and growing evidence that exposure and lifestyle factors contribute to AD risk and pathogenesis, attention should be paid to variables such as air pollution, in order to reduce rates of cognitive decline and dementia. Exposure to fine particulate matter (PM2.5) and ozone (O3) above the US EPA standards is associated with AD risk. Mexico City children experienced pre- and postnatal high exposures to PM2.5, O3, combustion-derived iron-rich nanoparticles, metals, polycyclic aromatic hydrocarbons, and endotoxins. Exposures are associated with early brain gene imbalance in oxidative stress, inflammation, innate and adaptive immune responses, along with epigenetic changes, accumulation of misfolded proteins, cognitive deficits, and brain structural and metabolic changes. The Apolipoprotein E (APOE) 4 allele, the most prevalent genetic risk for AD, plays a key role in the response to air pollution in young girls. APOE 4 heterozygous females with >75% to <94% BMI percentiles are at the highest risk of severe cognitive deficits (1.5-2 SD from average IQ). This review focused on the relationships between gender, BMI, systemic and neural inflammation, insulin resistance, hyperleptinemia, dyslipidemia, vascular risk factors, and central nervous system involvement in APOE4 urbanites exposed to PM2.5 and magnetite combustion-derived iron-rich nanoparticles that can reach the brain. APOE4 young female heterozygous carriers constitute a high-risk group for a fatal disease: AD. Multidisciplinary intervention strategies could be critical for prevention or amelioration of cognitive deficits and long-term AD progression in young individuals at high risk. [ABSTRACT FROM AUTHOR]

Children's urban air pollution exposures result in systemic and brain inflammation and the early hallmarks of Alzheimer's disease (AD). The apolipoprotein E (APOE) ε4 allele is the most prevalent genetic risk for AD. We assessed whether APOE in healthy children modulates cognition, olfaction, and metabolic brain indices. The Wechsler Intelligence Scale for Children (WISC-R) and the University of Pennsylvania Smell Identification Test were administered to 50 Mexico City Metropolitan Area children (13.4 ± 4.8 years, 28 APOE ε3 and 22 APOE ε4). N-acetylaspartate (NAA)/creatine (Cr), choline (Cho)/Cr, myo-inositol (mI)/Cr, and NAA/mI were calculated using proton magnetic resonance spectroscopy in the white matter of the frontal and parietal lobes, hippocampus, and pons. APOE ε4 versus ε3 children had a reduced NAA/Cr ratio in the right frontal white matter and decrements on attention, short-term memory, and below-average scores in Verbal and Full Scale IQ (>10 points). APOE modulated the group effects between WISC-R and left frontal and parietal white matter, and hippocampus metabolites. Soap was the predominantly failed odor in urban children and, in APOE ε4 versus ε3 carriers, strongly correlated with left hippocampus mI/Cr ratio. APOE modulates responses to air pollution in the developing brain. APOE ε4 carriers could have a higher risk of developing early AD if they reside in a polluted environment. APOE, cognition, and olfaction testing and targeted magnetic resonance spectroscopy may contribute to the assessment of urban children and their results could provide new paths toward the unprecedented opportunity for early neuroprotection and AD prevention. [ABSTRACT FROM AUTHOR]

Purpose: Evidence suggests that deafness-induced changes in visual perception, cognition and attention may compensate for a hearing loss. Such alterations, however, may also negatively influence adaptation to a cochlear implant. This study investigated whether involuntary attentional capture by salient visual stimuli is altered in children who use a cochlear implant. Methods: Thirteen experienced implant users (aged 8-16 years) and age-matched normally hearing children were presented with a rapid sequence of simultaneous visual and auditory events. Participants were tasked with detecting numbers presented in a specified color and identifying a change in the tonal frequency whilst ignoring irrelevant visual distractors. Results: Compared to visual distractors that did not possess the target-defining characteristic, target-colored distractors were associated with a decrement in visual performance (response time and accuracy), demonstrating a contingent capture of involuntary attention. Visual distractors did not, however, impair auditory task performance. Importantly, detection performance for the visual and auditory targets did not differ between the groups. Conclusion: These results suggest that proficient cochlear implant users demonstrate normal capture of visuospatial attention by stimuli that match top-down control settings. [ABSTRACT FROM AUTHOR]

BACKGROUND: Many studies have investigated the impact of pediatric Cognitive Rehabilitation Therapy (CRT) upon intellectual functioning after traumatic brain injury; however, relatively few have identified efficacious treatment in a school setting. OBJECTIVE: The purpose is to present a variety of CRT strategies that would be useful to a teacher or therapist working with students who are learning disabled or who have who have had a traumatic brain injury (TBI). METHODS: This article investigates the particular challenges in learning which result from impaired cognition, and suggests techniques for improving memory and executive functioning. RESULTS: Students who are learning disabled or who have TBI face social and emotional issues that impact their learning. Special therapeutic interventions are necessary to assist with orienting to their setting, integrating with peers, and coping with distressing emotions. CONCLUSIONS: Students with TBI can adapt and flourish in a school based setting provided that therapies and learned strategies are targeted to their specific needs. [ABSTRACT FROM AUTHOR]

Air pollution exposures are linked to neuroinflammation and neuropathology in young urbanites. Forty percent of exposed children and young adults exhibit frontal tau hyperphosphorylation and 51% have amyloid-β diffuse plaques compared to 0% in low pollution controls. In older adults, white matter hyperintensities (WMH) are associated with cognitive deficits while inflammatory markers correlate with greater atrophy than expected for age. We investigated patterns of WMH, magnetic resonance imaging (MRI) volume growth, blood inflammatory mediators, and cognition in matched children from two urban cohorts: one severely and one minimally exposed to air pollution. Baseline and one year follow-up measurements of cognitive abilities, brain MRI volumes, and blood were collected in 20 Mexico City (MC) children (10 with WMH+, and 10 without WMH-) and 10 matched controls (WMH-). MC WMH- children display the profile of classical pro-inflammatory defensive responses: high interleukin 12, production of powerful pro-inflammatory cytokines, and low concentrations of key cytokines and chemokines associated with neuroprotection. MC WMH+ children exhibit a response involved in resolution of inflammation, immunoregulation, and tissue remodeling. The MC WMH+ group responded to the air pollution-associated brain volumetric alterations with white and grey matter volume increases in temporal, parietal, and frontal regions and better cognitive performance compared to MC WMH-. We conclude that complex modulation of cytokines and chemokines influences children's central nervous system structural and volumetric responses and cognitive correlates resulting from environmental pollution exposures. Identification of biomarkers associating systemic inflammation to brain growth is critical for detecting children at higher risk for cognitive deficits and neurodegeneration, thereby warranting early implementation of neuroprotective measures. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this randomized clinical trial study was to evaluate the efficacy of an intervention program based on social mediation, cooperative learning and metacognition (Metacognitive Dimension) in preadolescents with acquired brain injury (ABI). Participants/Methods: Participants were 29 ABI preadolescents: 14 in the experimental group and 15 in the control group (average age, 10.4 y.o.; average time of lesion, 5.3 years). Evaluations were conducted 3 months after the start of the intervention, using the Evaluation Scale of Elementary School Learning Strategies (ESESLS) to assess metacognitive strategies, Self-Concept Scale for Children (SCSC) and Behavioral Rating Inventory of Executive Functions (BRIEF). Results: The experimental group had superior outcomes to the control. The results of metacognitive strategies (ESESLS) and self-concept (SCSC) were better in the experimental than in the control group (p< 0.05). BRIEF did not reveal any significant differences between the groups, although we observed better results in the experimental group for 5 sub items of the scale, in the broader index and global executive composite score. Conclusion: Three months of an intervention based on cooperative learning helped preadolescents with acquired brain injury develop metacognitive strategies and improve self-concept, thereby helping empower the preadolescents in their social relationships. [ABSTRACT FROM AUTHOR]

Robots have been widely used in rehabilitation. Among the various applications, robots have been developed to assist children with motor disabilities in play and academic activities. Several studies have shown the efficacy of these robotic tools, not only for allowing children to actively participate in the activities, with direct impact on the development of their cognitive, social, and linguistic skills, but also as a means to assess children's understanding of cognitive concepts, when standard tests cannot be used due to physical or language limitations. In this paper the use of robots for assistive play is reviewed from the perspectives of rehabilitation engineering and robot design, aiming at defining a set of desirable characteristics for such robots. Commercially available robots are then surveyed in comparison to the defined characteristics to evaluate to what extent they can be used as assistive robots for play, learning and cognitive development. [ABSTRACT FROM AUTHOR]