Integrated analysis environment for the Movement Assessment Battery for Children

Developmental Coordination Disorder (DCD), a chronic and usually permanent condition found in children, is characterized by motor impairment that interferes with a child's activities of daily living and with academic achievement. One of the most popular tests for the quantitative diagnosis of DCD is the Movement Assessment Battery for Children (MABC). Based on the Battery's standardized scores, it is possible to identify children with typical development, children at risk of developing DCD, and children with DCD. This article describes a computational system we developed to assist with the analysis of results obtained in the MABC test. The tool was developed for the web environment and its database provides integration of MABC data. Thus, researchers around the world can share data and develop collaborative work in the DCD field. In order to help analysis processes, our system provides services for filtering data to show more specific sets of information and present the results in textual, table, and graphic formats, allowing easier and more comprehensive evaluation of the results.

Indícios de subjetividade na fala de uma criança psicótica: um olhar para as hesitações

This study, performed under a linguistic-discoursive prism, aimed to: (1) describe the moments in which occurred hesitations in the utterances of a psychotic child diagnosed with Language Disorder; and (2) determine the extent to which these moments (also) can indicate aspects of a subjectivity trying to emerge in this child. Data were extracted from a speech therapy session with a ten year old female child. Concerning the fi rst goal, from a total of 362 utterances produced by the child, only 74 (20%) had hesitation traces, while 288 (80%) did not. Concerning the second goal, the utterances with hesitation traces occurred in situations of: topic development, especially in the form of complementarity; introduction of new topic; return to the previous topic; refuses to the topic; enunciative incompleteness. The high percentage of utterances without hesitation traces (80%) is explained because they are highly predictable from the context, mostly in situations of ritualized adjacent pairs, oftentimes in situations of immediate specularity. The reduced percentage of utterances with hesitation traces are explained precisely by the fact that, unlike those without traces, in these ones, signs of a subjectivity that tries to emerge and show itself in the discourse production are detected. With the development of this study, we tried to emphasize the view at the hesitations as marks of subjectivity – in other words, evidences of confl icting relationships between the subject and the others that constitute the utter. The concern was also about bringing to the fi eld of Speech Pathology discoursive linguistic refl ections based on data extracted from symptomatic contexts of language.

Caracterização do perfil motor de escolares com transtorno autístico

Thematic focus: The motor abnormalities may be part of so-called comorbidities that can coexist with autistic disorder. Objective: To characterize the motor profile of students with autistic disorder. Method: the study included six children with years and 9 months. After signing the consent form by parents or guardians, the students were submitted to the Motor Development Scale for assessment of fine motor, gross motor performance, balance, body scheme, spatial organization, temporal organization and laterality. Results: The results revealed a significant difference between the motor age and chronological age. According to the classification of the Scale of Motor Development, students in this study showed motor development lower than expected for age. Conclusion: The students with autistic disorder in this study presented a profile of Developmental Coordination Disorder in comorbidity, showing that participants of this research presented difficulties in activities that required skills such as handwriting. Thus, motor and psychomotor needs of these students were focused on educational and clinical environment to reduce the impact of behavioral and social manifestations.

Motor profile of students with dyslexia

In the presence of developmental dyslexia, there is high probability of motor difficulties being present as well purposes: The purposes of this study were to characterize and compare the motor performance of students with dyslexia with students with good academic performance and to identify the presence of the DCD (developmental coordination disorder) co-occurring with developmental dyslexia. A total of 79 students participated in the research, both genders, from 8 to 11 years old, from 3rd to 5th grades, and were divided into Group I: 19 students with developmental dyslexia and Group II: 60 students with good academic performance. All the students were assessed using “The Bruininks-Oseretsky Test of Motor Proficiency” (second edition), to measure the motor skills and the pattern and differences between groups. The results of this study showed that the motor performance of Group II students was superior to the performance of students of Group I in almost all motor areas assessed but both groups performed less well than they should have for their chronological age. The results of this study indicate that occupational therapists, speech therapists and educators need to be aware of the presence of motor impairments and the need for early intervention in both the academic and clinical environments, in order to ensure that early identification and diagnosis of possible co-occurrences, such as DCD, and the impact on learning to guarantee more appropriate clinical and educational assistance for this population. This may also indicate that increased exposure to movement may be important to limit some of the secondary health consequences in children in Brazil.

A coordenação motora de indivíduos com Transtorno do Desenvolvimento da Coordenação (TDC): o ritmo em foco

The aim of the present study was to examine tapping synchronization in children with and without Developmental Coordination Disorder (DCD). Participants were 27 children from which 13 diagnosed with motor difficulties composed the DCD group and 14 children with typical development (TD) the comparison group. The experimental task consisted of performing 25 continuous tapping on a surface of an electronic drum with the preferred hand. Participants were required to tap in synchrony with an auditory bip generated by customized software. Three interval values the tapping task were tested: 470 ms, 1000 ms, 1530 ms. The dependent variables were constant error (CE) and absolute error (AE) and standard deviation of absolute error (SD of AE). The ANOVA 2 x 3 x 3 (Group X Age x Interval) with repeated measures in the last factor for the CE indicated significant interaction among Group X Age X Interval. For the AE and SD of AE the ANOVAs yielded significant main effect of Interval and a significant interaction between Group X Interval. The results of the present study indicated that children with DCD were less accurate and more variable in the tapping synchronization than children with TD. Differences in performance between DCD and children with TD become larger as the interval of the auditory signal increases.

Análise cinemática e cinética do salto vertical de crianças com transtorno do desenvolvimento da coordenação (TDC)

Due to motor difficulties, children with developmental coordination disorder (DCD) doesn't feel motivated to do physical activities, sometimes resulting in a decline of their physical fitness, but it isn't really known for sure the reasons that induct children with DCD to low performances in physical fitness tests, because a lot of tasks that are part of the battery of tests of physical performance are complex in the coordination and/or motor control point of view, like the vertical jump for example. Therefore, the objective of this study was to investigate the factors that induct children with DCD to low performances in physical fitness tests, especially in the vertical jump task. For that, cinematic (duration of the eccentrical phase, duration of the concentrical phase, shift of the mass center and velocity of the mass center), kinetic (potency peak and force peak) and vertical jump performance analysis in two conditions (with the use of arms and without it) were realized in a force platform. The results indicated that children with DCD show a lower performance compared to their peers with typical development (TD), due to a lower potency production

Intervenção e identificação precoce do Transtorno do Desenvolvimento da Coordenação em escolares no início da alfabetização

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Transtorno do desenvolvimento da coordenação: efeito do foco de atenção em tarefa bimanual

Pós-graduação em Desenvolvimento Humano e Tecnologias - IBRC

Modulação autonômica cardíaca em crianças com transtorno de linguagem

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Do children with motor difficulties show low levels of physical fitness?

The aim of the present study was to examine whether children with motor difficulties would show levels of health-related components of physical fitness lower than children without such difficulties. Sixteen children with motor difficulties with approximately 8 years of age were age-and gender-matched with other 16 children without motor difficulties. Participants completed the test batteries for physical fitness (seat and reach, standing long jump, sit-up, modified pull-up and 9-minute run) and for motor coordination (MABC-2). The results indicated significant differences in standing long jump, sit-up, modified pull-up tests, but not for the seat and reach and the 9-minute run tests. Overall, the results are similar to those published in the international literature, with the exception of cardiorespiratory fitness. The idea that at to some degree coordination is required to perform physical fitness tasks and might impact on physical fitness performance is further discussed in the present work.

Dicas de aprendizagem auxiliam as crianças com TDC na aquisição de uma habilidade motora complexa?

O objetivo do estudo foi analisar se as dicas de aprendizagem auxiliam crianças com TDC na aquisição de uma habilidade motora complexa. Dez crianças com TDC e 14 de desenvolvimento típico, de 9 a 11 anos, foram divididas nos grupos TDC com dicas (TDCD), TDC sem dicas (TDCS), desenvolvimento típico com dicas (GDTD) e desenvolvimento típico sem dicas (GDTS). As crianças participaram de sete aulas, durante três semanas, para a aprendizagem do rolamento peixe, com o uso das dicas "empurre o chão", "coloque a mão o mais longe possível" e "queixo no peito". Os resultados não foram estatisticamente significantes entre os grupos, o que evidencia que as dicas não apresentaram efeito positivo na aprendizagem do rolamento peixe.

Crianças com dificuldades motoras apresentam baixos níveis de aptidão física?

O presente estudo tem como objetivo analisar se crianças com dificuldades motoras apresentariam baixos níveis de aptidão física relacionada à saúde em relação aos seus pares sem dificuldades. Dezesseis crianças com dificuldades motoras com aproximadamente oito anos foram pareadas em gênero e idade com outras 16 sem dificuldades motoras. Os participantes completaram os testes de aptidão física (sentar e alcançar, salto em distância parado, puxada em suspensão na barra modificado, abdominal e corrida de 9 minutos) e os de coordenação motora (MABC-2). Os resultados indicaram diferenças significativas no salto em distância parado, puxada em suspensão na barra modificado, abdominal, mas não para sentar e alcançar e corrida de 9-m. Os resultados são semelhantes aos publicados na literatura internacional, com exceção da corrida de 9 minutos. A ideia de que em algum grau a coordenação é necessária para executar tarefas de aptidão física e pode impactar no desempenho da aptidão física é discutida no presente trabalho.

É possível predizer o tempo de terapia das alterações específicas no desenvolvimento da linguagem?

OBJETIVO: Explorar quais medidas poderiam predizer a persistência de alterações específicas no desenvolvimento da linguagem (AEDL) a partir da associação entre os dados do desempenho na primeira avaliação fonoaudiológica e do prognóstico terapêutico da criança. MÉTODOS: Neste estudo retrospectivo, foram analisados 42 prontuários pertencentes a crianças com diagnóstico de AEDL. As idades variavam entre 21 e 63 meses no momento da primeira avaliação fonoaudiológica, que incluiu as provas de vocabulário, fonologia, pragmática e fluência. O desempenho dos sujeitos em cada prova foi pontuado de 0 a 4, com base na gravidade das alterações, sendo a pontuação máxima a adequada para a idade. Como medida prognóstica, contabilizamos o tempo de terapia (em sessões) dos pacientes que receberam alta, foram encaminhados (o quadro havia se tornado muito leve), ou permaneceram em terapia (dificuldades persistentes de linguagem). RESULTADOS: Houve associação entre os dados da avaliação inicial (classificação normal ou levemente alterada no vocabulário e pragmática) e o prognóstico (<135 sessões terapêuticas). A variável referente ao vocabulário foi a única capaz de predizer o tempo de terapia. A classificação como grave nesta medida aumentou, em média, 112 sessões na estimativa do tratamento. CONCLUSÃO: A primeira avaliação do vocabulário pode contribuir para predizer o prognóstico terapêutico da criança. Este achado é de relevância clínica e científica para a Fonoaudiologia, visto que oferece um recurso auxiliar para a realização do prognóstico e planejamento terapêutico nos quadros de AEDL.

[Hyena disease in a Brown Swiss heifer]

A heifer with developmental skeletal disorder was presented to the ruminant clinic of the University of Berne. Abnormal long bone growth and a wobbling gait were the main clinical signs. All long bones were examined radiologically, several parameters of body size were measured and the results were compared to the measurements of a healthy control animal. Haematology and blood chemistry were normal. Based on the poor prognosis the animal was slaughtered. The final diagnosis of hyena disease was based on the characteristic growth disturbances in the caudal parts of the body, giving the animal a hyena-like appearance. For the first time a case of hyena disease is reported in Switzerland.

Propuesta de un sistema para detección precoz de trastornos del lenguaje en niños de 0 a 6 años

Las Tecnologías de la Información y las Comunicaciones han propiciado avances en el contexto de la salud tanto en la gestión efectiva de información socio‐sanitaria de forma electrónica, como en la provisión de servicios de e‐salud y telemedicina. Los antecedentes de investigación publicados en esta área corroboran este hecho presentando las mejoras experimentadas en la atención de la población y en la provisión de servicios sanitarios. La atención temprana, cuyos principios científicos se fundamentan en los campos de la pediatría, neurología, psicología, psiquiatría, pedagogía, fisiatría y lingüística, entre otros, tiene como finalidad ofrecer a los niños con déficit o con riesgo de padecerlos un conjunto de acciones optimizadoras y compensadoras, que faciliten su adecuada maduración en todos los ámbitos y que les permita alcanzar el máximo nivel de desarrollo personal y de integración social. La detección de posibles alteraciones en el desarrollo infantil es un aspecto clave de la atención temprana en la medida en que puede posibilitar la puesta en marcha de diversos mecanismos de actuación disponibles en las entidades implicadas, valiosos para la calidad de vida de la persona. Cuanto antes se realice la detección, existen mayores garantías de prevenir patologías añadidas, lograr mejoras funcionales y posibilitar un ajuste más adaptativo entre el niño y su entorno. El objetivo de la investigación presentada en esta tesis doctoral es analizar, diseñar, verificar y validar un sistema de información abierto, basado en conocimiento, que facilite efectivamente a los profesionales que trabajan con la población infantil entre 0 y 6 años la detección precoz de posibles trastornos del lenguaje. Desde el punto de vista metodológico, la Ingeniería del Conocimiento ofrece un marco conceptual sólido que permite desarrollar y validar Sistemas de Ayuda a la Toma de Decisiones distribuidos y escalables, capaces de ayudar al pediatra de Atención Primaria y al educador infantil en la detección precoz de posibles trastornos del lenguaje en niños. La evaluación del sistema se ha realizado de forma incremental mediante el diseño y validación de pruebas de campo experimentales consistentes en la evaluación de niños en dos escenarios distintos: la escuela infantil y el centro de atención temprana. Los experimentos realizados en poblaciones distintas con alrededor de 344 niños durante 2 años, han permitido contrastar la buena adecuación del sistema propuesto a las necesidades de detección de los profesionales que trabajan con niños entre 0 y 6 años. La tesis resultante ha permitido caracterizar el uso del sistema en entornos reales, conocer la aceptación entre los usuarios y su impacto en la provisión de un servicio de atención temprana como el descrito para el correcto seguimiento del desarrollo del lenguaje en los niños, además de proponer un nuevo modelo de atención y evaluación cooperativa que permita incrementar el conocimiento experimental existente al respecto. ABSTRACT The Information and Communication Technology have led to advances in the context of health both in the effective management of socio‐health information electronically, and in the provision of e‐health and telemedicine. The history of research published in this area confirm this fact by presenting the improvements in the care of the population and the provision of health services. Early attention, whose scientific principles are based on the fields of pediatrics, neurology, psychology, psychiatry, pedagogy, physical medicine and linguistics, among others, aims to provide children with deficits or risk of suffering a set of enhancer actions, which facilitate adequate maturation in all areas and allow them to achieve the highest level of personal development and social integration. The detection of possible changes in child development is a key aspect of early intervention to the extent that it can enable the implementation of different mechanisms of action available to the entities involved, valuable to the quality of life of the person. The earlier the detection is made, there are more guarantees added to prevent diseases, achieving functional improvements and enable a more adaptive fit between the child and his environment. The aim of the research presented is to analyze, design, verify and validate an open information system, based on knowledge, which effectively provide professionals working with the child population between 0 and 6 years, in processes of early detection of language disorders. From the methodological point of view, Knowledge Engineering provides a solid conceptual framework to develop and validate a distributed and scalable decision support systems aim to assist pediatricians and language therapists at early identification and referral of language disorder in childhood. The system evaluation was performed incrementally with the design and validation of consistent experimental field tests in the assessment of children in two different scenarios: the nursery and early intervention center. Experiments in different populations with about 344 children over 2 years, allowed to testing the adequacy of the proposed good detection needs of professionals working with children between 0 and 6 years old system. The resulting thesis has allowed to formalizing the system at real environments and to identifying the acceptance by users as well as its impact on the provision of an early intervention service, such as the one described for the proper monitoring of language development in children. In addition, it proposes a new model of care and cooperative evaluation that lets to increase the existing experimental knowledge about it.