Children and adolescents in full-time special education : an epidemiological and magnetic resonance imaging study

The need for special education (SE) is increasing. The majority of those whose problems are due to neurodevelopmental disorders have no specific aetiology. The aim of this study was to evaluate the contribution of prenatal and perinatal factors and factors associated with growth and development to later need for full-time SE and to assess joint structural and volumetric brain alterations among subjects with unexplained, familial need for SE. A random sample of 900 subjects in full-time SE allocated into three levels of neurodevelopmental problems and 301 controls in mainstream education (ME) provided data on socioeconomic factors, pregnancy, delivery, growth, and development. Of those, 119 subjects belonging to a sibling-pair in full-time SE with unexplained aetiology and 43 controls in ME underwent brain magnetic resonance imaging (MRI). Analyses of structural brain alterations and midsagittal area and diameter measurements were made. Voxel-based morphometry (VBM) analysis provided detailed information on regional grey matter, white matter, and cerebrospinal fluid (CSF) volume differences. Father’s age ≥ 40 years, low birth weight, male sex, and lower socio-economic status all increased the probability of SE placement. At age 1 year, one standard deviation score decrease in height raised the probability of SE placement by 40% and in head circumference by 28%. At infancy, the gross motor milestones differentiated the children. From age 18 months, the fine motor milestones and those related to speech and social skills became more important. Brain MRI revealed no specific aetiology for subjects in SE. However, they had more often ≥ 3 abnormal findings in MRIs (thin corpus callosum and enlarged cerebral and cerebellar CSF spaces). In VBM, subjects in full-time SE had smaller global white matter, CSF, and total brain volumes than controls. Compared with controls, subjects with intellectual disabilities had regional volume alterations (greater grey matter volumes in the anterior cingulate cortex bilaterally, smaller grey matter volume in left thalamus and left cerebellar hemisphere, greater white matter volume in the left fronto-parietal region, and smaller white matter volumes bilaterally in the posterior limbs of the internal capsules). In conclusion, the epidemiological studies emphasized several factors that increased the probability of SE placement, useful as a framework for interventional studies. The global and regional brain MRI findings provide an interesting basis for future investigations of learning-related brain structures in young subjects with cognitive impairments or intellectual disabilities of unexplained, familial aetiology.

Keitä huonokuuloiset oikein ovat? : Lähtökohtia huonokuuloisten sosiaalisten identiteettien tutkimukselle

To be hard-of-hearing (HOH) isn t only a hearing-related phenomenon. Some HOH people identify themselves with the majority population, where as others identify themselves with culturally Deaf or with other HOH people. This results in three different kinds of groups. The original aim of this study was to interview HOH people in order to discover the social identities of these three groups. It turned out, however, that there are only few studies exploring this subject. It was therefore first necessary to develop sustainable and suitable starting points for the examination of the information produced by the interviews. In other words, the construction of the theoretical and conceptual frame of reference became the objective of this study. It is, on one hand, the personal experiences of the researcher s mingling with different kinds of HOH people and with culturally Deaf and, on the other, the literature concerning identities that lie in the background of this study. The analysis concentrated on the studies of identities in general and on the previous works dealing with the identities of the HOH people as well as on other studies with reference to HOH people. The choice between mainstream education and special education is one of the main factors affecting the development of the identity. Yet, it became apparent that identifying with the relevant reference group (majority population, culturally Deaf or other HOH people) had an even greater influence than the school. The hard of hearing define themselves differently and take different views on being HOH, depending on their social relations, their values and on their communicative and cultural features. The conclusion is that HOH people should be examined as different groups, not as one group, since they differ clearly from each other.