La Educación Especial en Asturias.

Ofrecer nuevos datos sobre la Educación Especial en Asturias que puedan ser útiles en planificaciones futuras. Poner de relieve la diferencia entre estimaciones y censos sobre deficientes y alumnos escolarizados, divergencia clásica en este tipo de trabajos. Establecer una hipótesis que explique esta divergencia efectuando una estimación entre el número de sujetos escolarizados en régimen normal, que necesitan una atención especial, es decir que también son sujetos de educación Especial. Por último se trata de explicar las características de estos sujetos y cómo tratarlos. La situación de la Educación Especial en Asturias. Aspectos estudiados: situación de la Educación Especial en Asturias: en el curso 84-85, áreas educativas, equipamiento, cualificación profesional, por sectores geográficos, servicios del área, etc. La formación del profesorado de Educación Especial: títulos, organismos encargados, cursos, la formación especializada en las Escuelas Universitaria, etc. Investigaciones realizadas en la región asturiana sobre el tema, hasta el momento. Estimación de alumnos con dificultades de aprendizaje en la población asturiana de EGB: por curso, por sexo, por edad, por comarcas, etc. Diagnóstico de alumnos con dificultades de aprendizaje: concepto y definición, métodos de exploración, pruebas de diagnóstico, información sociofamiliar, etc. Bibliografía; datos del MEC, y de informes e investigaciones sobre el tema realizadas en Asturias. Se elaboran índices de retraso de la población total, por curso, sexo, según el tipo de enseñanza, según curso y sexo, por comarcas. Se plantea la necesidad de una planificación adecuada para la creación de aulas integradas y currículums integradores adecuados a los alumnos de Educación Especial, a la articulación de un servicio de coordinación de la Educación Especial por sectores y áreas geográficas y una atención a la formación psicopedagógica del profesorado de EGB. Si se consideran sujetos con dificultades de aprendizaje aquellos que presentan dos o más cursos de retraso respecto al que deberían estar según la edad, dicha población asciende a 6503. Según se avanza en el análisis del retraso por cursos, se encuentra un mayor desajuste, las cotas más altas están en el séptimo curso. Se ofrecen como pruebas standard para el examen diagnóstico de las dificultades de aprendizaje las siguientes: el Wisc y el Wisc-R, el ITPA (Illinois Test of Psycholinguistic Abilities), el K-ABC (kaufman Assessment Battery for Children). Todo intento de sanear el Sistema Educativo pasa por la atención diferenciada al contingente de alumnos retrasados. En Asturias existen en el momento en que se realiza esta investigación unos 10000 sujetos escolarizados en régimen normal que reclaman una atención especializada.

Processament de la informació en nens de pre-escolar de les comarques gironines. Implicacions pedagògiques

La nostra investigació s'inscriu en la concepció dinàmica de la intel·ligència, i concretament en el processos que configuren el processament cerebral en el Model d'integració de la informació descrit per Das, Kirby i Jarman (1979). Els dos processos cerebrals que constitueixen la base de la conducta intel·ligent són el processament simultani i el processament seqüencial; són les dues estratègies principals del processament de la informació. Tota classe d'estímul és susceptible d'ésser processat o bé seqüencialment (seriació, verbal, anàlisi), o be simultàniament (global, visual, síntesi). Basant-nos en el recull bibliogràfic i amb la convicció de que apropant-nos al coneixement de les peculiaritats del processament de la informació, ens endinsem en la comprensió del procés que mena a la conducta intel·ligent, i per tant, a l'aprenentatge, formulem la següent hipòtesi de treball: en els nens de preescolar (d'entre els 3 i els sis anys) es donaran aquest dos tipus de processament i variaran en funció de l'edat, el sexe, l'atenció, les dificultats d'aprenentatge, els problemes de llenguatge, el bilingüisme, el nivell sociocultural, la dominància manual, el nivell mental i de la presència de patologia. Les diferències que s'esdevinguin ens permetran de formular criteris i pautes per a la intervenció educativa. Els nostres objectius es refonen en mesurar el processament en nens de preescolar de les comarques gironines, verificar la relació de cada tipus de processament amb les variables esmentades, comprovar si s'estableix un paral·lelisme entre el processament i les aportacions de concepció localitzacionista de les funcions cerebrals en base als nostres resultats, i pautes per a la intervenció pedagògica. Quant al mètode, hem seleccionat una mostra representativa dels nens i nenes matriculats a les escoles publiques de les comarques gironines durant el curs 92/93, mitjançant un mostreig aleatori estratificat i per conglomerats. El tamany real de la mostra és de dos-cents seixanta un subjectes. Els instruments emprats han estat els següents: el Test K-ABC de Kaufman & Kaufman (1983) per a la avaluació del processament; un formulari dirigit als pares per a la recollida de la informació pertinent; entrevistes amb les mestres, i el Test de la Figura Humana de Goodenough. Pel que fa referència als resultats de la nostra recerca i en funció dels objectius proposats, constatem els fets següents. En els nens de preescolar, amb edats d'entre els tres i els sis anys, es constata l'existència dels dos tipus de processament cerebral, sense que es doni un predomini d'un sobre de l'altre; ambdós processaments actuen interrelacionadament. Ambdós tipus de processament milloren a mesura que augmenta l'edat, però es constaten diferències derivades del nivell mental: amb un nivell mental normal s'hi associa una millora d'ambdós processaments, mentre que amb un nivell mental deficient només millora fonamentalment el processament seqüencial. Tanmateix, el processament simultani està més relacionat amb les funcions cognitives complexes i és més nivell mental dependent que el processament seqüencial. Tant les dificultats d'aprenentatge com els problemes de llenguatge predominen en els nens i nenes amb un desequilibri significatiu entre ambdós tipus de processament; les dificultats d'aprenentatge estan més relacionades amb una deficiència del processament simultani, mentre que els problemes de llenguatge es relacionen més amb una deficiència en el processament seqüencial. Els nivells socioculturals baixos es relacionen amb resultats inferiors en ambdós tipus de processament. Per altra part, entre els nens bilingües és més freqüent el processament seqüencial significatiu. El test de la Figura Humana es comporta com un marcador de processament simultani i el nivell atencional com un marcador de la gravetat del problema que afecta al processament i en el següent ordre: nivell mental deficient, dificultats, d'aprenentatge i problemes de llenguatge . Les deficiències atencionals van lligades a deficiències en el processament simultani i a la presencia de patologia. Quant a la dominància manual no es constaten diferències en el processament. Finalment, respecte del sexe només podem aportar que quan un dels dos tipus de processament és deficitari,i es dóna per tant, un desequilibri en el processament, predomina significativament el nombre de nens afectats per sobre del de nenes.

Efficacy and Acceptability of Reduced Intensity Constraint-Induced Movement Therapy for Children Aged 9–11 years with Hemiplegic Cerebral Palsy: A Pilot Study

OBJECTIVE: Assess efficacy and acceptability of reduced intensity constraint-induced movement therapy (CIMT) in children with cerebral palsy (CP).

METHODS: Single-subject research design and semi-structured interviews. Children (9-11y) with hemiplegia underwent five baseline assessments followed by two weeks CIMT. Six further assessments were performed during treatment and follow-up phases. The primary outcome was the Melbourne Assessment of Unilateral Upper Limb Function (MUUL). Quantitative data were analysed using standard single-subject methods and qualitative data by thematic analysis.

RESULTS: Four of the seven participants demonstrated statistically significant improvements in MUUL (3-11%, p < .05). Two participants achieved significant improvements in active range of motion but strength and tone remained largely unchanged. Qualitative interviews highlighted limitations of the restraint, importance of family involvement, and coordination of treatment with education.

CONCLUSIONS: Reduced intensity CIMT may be effective for some children in this population; however it is not suitable for all children with hemiplegia.

The role of imitation in video-based interventions for children with autism.

Objective: The aim of this paper is to bridge the gap between the corpus of imitation research and video-based intervention (VBI) research, and consider the impact imitation skills may be having on VBI outcomes and highlight potential areas for improving efficacy.

Method: A review of the imitation literature was conducted focusing on imitation skill deficits in children with autism followed by a critical review of the video modelling literature focusing on pre-intervention assessment of imitation skills and the impact imitation deficits may have on VBI outcomes.

Results: Children with autism have specific imitation deficits, which may impact VBI outcomes. Imitation training or procedural modifications made to videos may accommodate for these deficits.

Conclusions: There are only six studies where VBI researchers have taken pre-intervention imitation assessments using an assortment of imitation measures. More research is required to develop a standardised multi-dimensional imitation assessment battery that can better inform VBI.

Motor deficits in children with autism spectrum disorder: A cross-syndrome study

Recent research suggests that children with autism spectrum disorder (ASD) experience some level of motor difficulty, and that this may be associated with social communication skills. However, other studies show that children with language impairments, but without the social communication problems, are at risk of motor difficulties as well. The aim of the present study was to determine if children with ASD have syndrome specific motor deficits in comparison to children with specific language impairment (SLI). We used an independent groups design with three groups of children (8-10 years old) matched on age and nonverbal IQ; an ASD group, an SLI group, and a typically developing (TD) group. All of the children completed an individually administered, standardized motor assessment battery. We found that the TD group demonstrated significantly better motor skills than either the ASD or SLI groups. Detailed analyses of the motor subtests revealed that the ASD and SLI groups had very similar motor profiles across a range of fine and gross motor skills, with one exception. We conclude that children with ASD, and SLI, are at risk of clinically significant motor deficits. However, future behavioural and neurological studies of motor skills in children with ASD should include an SLI comparison group in order to identify possible autism specific deficits.

Social development of primary aged children through a movement education program

Unique in Canada, is a university based movement program offered to children aged 1-12 which is diverse and inclusive in its design to foster healthy physical, cognitive, affective and social development. The purpose of this study is to investigate how children's involvement in a weekly movement education program influences their social development. The primary-aged children involved in this research are participants in the university based Saturday morning program, The Children's Movement Program (CMP), in which creative dance, educational gymnastics and developmental games are employed to enhance optimal development. The 15 participants were systematically observed for 8 weeks as they naturally engaged in the program's activities. Interviews were conducted with both children and their caregivers throughout the duration of the program. Particular attention was paid to the perceptions of caregivers regarding the advantages of a program based upon principles of movement education. Results indicate that participation in the program increases children's opportunity to interact socially and address ways in which program content, pedagogy and context encourage social development. A figure was developed with these components to assist teachers in creating inclusive and meaningful movement experiences. 'Content' is referred to as the material to be learned or the desired outcome for the learner. 'Pedagogy' refers to the process in which the student will engage and 'Context' refers to the environment in which the experience occurs (eg. skating rink with playground balls). It is recommended that each is thoroughly addressed individually for its potential in lesson design.

A randomized controlled trial of an early-intervention, computer-based literacy program to boost phonological skills in 4- to 6-year-old children

Background: Many school-based interventions are being delivered in the absence of evidence of effectiveness (Snowling & Hulme, 2011, Br. J. Educ. Psychol., 81, 1).Aim: This study sought to address this oversight by evaluating the effectiveness of the commonly used the Lexia Reading Core5 intervention, with 4- to 6-year-old pupils in Northern Ireland.Sample: A total of 126 primary school pupils in year 1 and year 2 were screened on the Phonological Assessment Battery 2nd Edition (PhAB-2). Children were recruited from the equivalent year groups to Reception and Year 1 in England and Wales, and Pre-kindergarten and Kindergarten in North America.
Methods: A total of 98 below-average pupils were randomized (T0) to either an 8-week block (inline image = 647.51 min, SD = 158.21) of daily access to Lexia Reading Core5 (n = 49) or a waiting-list control group (n = 49). Assessment of phonological skills was completed at post-intervention (T1) and at 2-month follow-up (T2) for the intervention group only.
Results: Analysis of covariance which controlled for baseline scores found that the Lexia Reading Core5 intervention group made significantly greater gains in blending, F(1, 95) = 6.50, p = .012, partial η2 = .064 (small effect size) and non-word reading, F(1, 95) = 7.20, p = .009, partial η2 = .070 (small effect size). Analysis of the 2-month follow-up of the intervention group found that all group treatment gains were maintained. However, improvements were not uniform among the intervention group with 35% failing to make progress despite access to support. Post-hoc analysis revealed that higher T0 phonological working memory scores predicted improvements made in phonological skills.
Conclusions: An early-intervention, computer-based literacy program can be effective in boosting the phonological skills of 4- to 6-year-olds, particularly if these literacy difficulties are not linked to phonological working memory deficits.

Assessment of visual function in children with multiple disabilities: two case studies of children with cerebral palsy

Purpose: a) multiply handicapped children have a high incidence of disorders affecting the visual system; b) assessment and management of visual disorders in this group of children presents a complex challenge; c) this study describes the results of visual function assessment in two children with neurological disability over a one-year period.

Handgrip strength cut-off for cardiometabolic risk index among Colombian children and adolescents : the FUPRECOL study

Abstract Objective: Evidence shows an association between muscular strength (MS) and health among youth, however low muscular strength cut-points for the detection of high metabolic risk in Latin-American populations are scarce. The aim of this study was two-fold: to explore potential age- and sex-specific thresholds of MS, for optimal cardiometabolic risk categorization among Colombian children and adolescents; and to investigate if cardiometabolic risk differed by MS group by applying the receiver operating characteristic curve (ROC) cut point. Methods: This is a secondary analysis of a cross-sectional study (the FUPRECOL study), published elsewhere. The FUPRECOL study assessments were conducted during the 2014– 2015 school year. MS was estimated by a handle dynamometer on 1,950 children and adolescents from Colombia, using the MS relative to weight (handgrip strength/body mass). A metabolic risk score was computed from the following components: waist circumference, triglycerides, HDL-c, glucose, systolic and diastolic blood pressure. ROC analysis showed a significant discriminatory accuracy of MS in identifying the low/high metabolic risk in children and adolescents and both gender. Results: In children, handgrip strength/body mass level for a low metabolic risk were 0.359 and 0.376 in girls and boys, respectively. In adolescents, these points were 0.440 and 0.447 in girls and boys, respectively. Conclusion: In conclusion, the results suggest a hypothetical MS level relative to weight for having a low metabolic risk, which could be used to identify youths at risk.

Children, Obesity and Exercise: Prevention, Treatment and Management of Childhood and Adolescent Obesity

Throughout the developed world there is an increasing prevalence of childhood obesity. Because of this increase, and awareness of the risks to long term health that childhood obesity presents, the phenomena is now described by many as a global epidemic. Children, Obesity and Exercise provides sport, exercise and medicine students and professionals with an accessible and practical guide to understanding and managing childhood and adolescent obesity. It covers: overweight, obesity and body composition; physical activity, growth and development; psycho-social aspects of childhood obesity; physical activity behaviours; eating behaviours; measuring childrens behaviour; interventions for prevention and management of childhood obesity. Children, Obesity and Exercise addresses the need for authoritative advice and innovative approaches to the prevention and management of this chronic problem.

The role of vision in obese and normal-weight children's gait control

Previous research has suggested that perceptual-motor difficulties may account for obese children's lower motor competence; however, specific evidence is currently lacking. Therefore, this study examined the effect of altered visual conditions on spatiotemporal and kinematic gait parameters in obese versus normal-weight children. Thirty-two obese and normal-weight children (11.2 ± 1.5 years) walked barefoot on an instrumented walkway at constant self-selected speed during LIGHT and DARK conditions. Three-dimensional motion analysis was performed to calculate spatiotemporal parameters, as well as sagittal trunk segment and lower extremity joint angles at heel-strike and toe-off. Self-selected speed did not significantly differ between groups. In the DARK condition, all participants walked at a significantly slower speed, decreased stride length, and increased stride width. Without normal vision, obese children had a more pronounced increase in relative double support time compared to the normal-weight group, resulting in a significantly greater percentage of the gait cycle spent in stance. Walking in the DARK, both groups showed greater forward tilt of the trunk and restricted hip movement. All participants had increased knee flexion at heel-strike, as well as decreased knee extension and ankle plantarflexion at toe-off in the DARK condition. The removal of normal vision affected obese children's temporal gait pattern to a larger extent than that of normal-weight peers. Results suggest an increased dependency on vision in obese children to control locomotion. Next to the mechanical problem of moving excess mass, a different coupling between perception and action appears to be governing obese children's motor coordination and control.

Constructing a frame of cube : connecting 3D shapes with direction, location and movement

With the advancement of new technologies, this author has in 2010 started to engineer an online learning environment for investigating the nature and development of spatial abilities, and the teaching and learning of geometry. This paper documents how this new digital learning environment can afford the opportunity to integrate the learning about 3D shapes with direction, location and movement, and how young children can mentally and visually construct virtual 3D shapes using movements in both egocentric and fixed frames of reference (FOR). Findings suggest that year 4 (aged 9) children can develop the capacity to construct a cube using egocentric FOR only, fixed FOR only or a combination of both FOR. However, these young participants were unable to articulate the effect of individual or combined FOR movements. Directions for future research are proposed.

The impact of diabetic ketoacidosis and age on behavior six months post-diagnosis in children with type 1 diabetes

Objectives: Children with type 1 diabetes mellitus (DM1) may be at increased risk of psychosocial and adjustment difficulties. We examined behavioral outcomes six months post-diagnosis in a group of children with newly diagnosed DM1. Methods: This study formed part of a larger longitudinal project examining pathophysiology and neuropsychological outcomes in diabetic patients with or without diabetic ketoacidosis (DKA). Participants were 61 children (mean age 11.8 years, SD 2.7 years) who presented with a new diagnosis of DM1 at the Royal Children’s Hospital, Melbourne. Twenty-three (11 female) presented in DKA and 38 (14 female) without DKA. Parents completed the behavior assessment system for children, second edition six months post-diagnosis. Results: There was a non-linear relationship between age and behavior. Internalising problems (i.e. anxiety depression, withdrawal) peaked in the transition from childhood to adolescence; children aged 10–13 years had elevated rates relative to the normal population (t = 2.55, P = 0.018). There was a non-significant trend for children under 10 to display internalising problems (P = 0.052), but rates were not elevated in children over 13 (P = 0.538). Externalising problems were not significantly elevated in any age group. Interestingly, children who presented in DKA were at lower risk of internalising problems than children without DKA (t = 3.83, P < 0.001). There was no effect of DKA on externalising behaviors. Conclusions: Children transitioning from childhood to adolescence are at significant risk for developing internalising problems such as anxiety and lowered mood after diagnosis of DM1. Somewhat counter-intuitively, parents of children presenting in DKA reported fewer internalising symptoms than parents of children without DKA. These results highlight the importance of monitoring and supporting psychosocial adjustment in newly diagnosed children even when they seem physically well.

Estudio de asociación entre genotipo de DAT1 y transtorno por déficit de atención / hiperactividad

Introducción: El TDAH tiene un componente genético importante; el gen de transportador de Dopamina (DAT1) se ha asociado con susceptibilidad al TDAH y con sus endofenotipos. El VNTR de 40pb en la región 3’UTR aumenta la expresión del DAT1. En Colombia no hay ningún estudio previo que indique evidencia de la asociación genética entre TDAH y el gen DAT1. Objetivo: Determinar asociación entre el VNTR del DAT1 y el fenotipo y/o endofenotipos del TDAH. Métodos: Se seleccionaron 73 pacientes con TDAH y 75 controles, se valoró en los casos inteligencia y funciones ejecutivas. Mediante (PCR) se amplificó el VNTR DAT1. Se establecieron estadísticos genético poblacionales, análisis de asociación y de regresión logística entre las pruebas neuropsicológicas y genotipo. Resultado: El polimorfismo del DAT1 no mostró asociación con TDAH, ni con alteraciones en las funciones ejecutivas. El genotipo 10/10 del VNTR DAT1 se encontró asociado con el índice de velocidad de procesamiento (p <0,05). En el subgrupo hiperactividad hubo asociación con algunas subpruebas de flexibilidad cognitiva, número de respuestas correctas, total de errores, número de respuestas perseverativas (p ≤ 0.01). En el subgrupo mixto se asoció con índice de comprensión verbal (p <0,05). Conclusiones: No hubo asociación entre el polimorfismo VNTR (DAT1) y el fenotipo de TDAH. Se encontraron asociaciones entre genotipo y algunos test de flexibilidad cognitiva e índice de comprensión verbal. Se establecieron los estadísticos genético poblacionales de este polimorfismo para la población analizada, el cual corresponde al primer reporte de una muestra de nuestro país.

Impacto funcional con el uso de clavo telescopico tipo Fassier Duval en pacientes con osteogénesis imperfecta

Introducción: la osteogénesis es una patología de origen genético caracterizada por fragilidad ósea, en su curso natural los pacientes que la padecen se enfrentan a múltiples fracturas y múltiples intervenciones quirúrgicas, este tipo de pacientes por ser de alto riesgo necesitan técnicas quirúrgicas que aumenten el tiempo entre cada intervención y que demuestren un mayor impacto en el estado funcional. Objetivo: Determinar el impacto en el estado funcional de los pacientes con osteogénesis imperfecta llevados a tratamiento quirúrgico con clavos telescopados tipo Fassier Duval. Diseño: Estudio descriptivo prospectivo en el que se incluyeron 8 pacientes con diagnóstico de osteogénesis imperfecta, llevados a tratamiento quirúrgico con clavos telescopados tipo Fassier Duval desde el 2009 al 2013 a los cuales se les realizó seguimiento menor de 1 año del post operatorio. Resultados: La respuesta encontrada fue satisfactoria en la mayoría de los pacientes analizados 6 de 8, con cercanía a un estado funcional normal; un riesgo de caída bajo, incorporación y deambulación adecuada y una valoración funcional motora gruesa con valores cercanos al 100% identificando un buen nivel de independencia funcional. Se pudo demostrar que existieron cambios en los valores de la escala y que estos fueron estadísticamente significativos con p=0,028 indicando que el aumento dichos valores en el posoperatorio están relacionados con el procedimiento quirúrgico al utilizado en este grupo de pacientes. Conclusión: El tratamiento quirúrgico con el clavo telescopado de Fassier Duval en nuestra experiencia demostró tener una mejoría en el estado funcional de los pacientes del presente estudio, por lo tanto se sugiere la posibilidad de implementar su uso según este indicado con el fin de obtener un mejor resultado quirúrgico y funcional. Palabras clave: Osteogénesis Imperfecta, Clavo de Fassier Duval, Valoración Funcional Motora