Borderline Intelligence Research Articles

Evaluation of Behavior and Cognitive Function in Children with Myoclonic Astatic Epilepsy

Background: Myoclonic astatic epilepsy (MAE) is an idiopathic and generalized childhood epileptic syndrome. Although several studies have reported on cognitive function and intellectual outcome in MAE, little is known about the behavioral problems associated with this disease. The aim of this study was to clarify behavior and cognitive function in children with MAE. Methods: Four children who were diagnosed as having MAE using the proposed criteria of the International Classification of Epilepsies were retrospectively analyzed using patient records with regard to clinical and neuropsychological findings such as age of seizure onset, semiology and severity of seizures, treatment course, behavioral problems, EEG findings, and WISC-III and Pervasive Developmental Disorders Autism Society Japan Rating Scale (PARS) scores that indicate the tendency of autistic behaviors. Results: Disease onset in our cohort ranged from 9 to 35 months of age. Seizures were controlled within 3-8 months over a follow-up period of 4-12 years. All patients had borderline normal intelligence (mean IQ: 75.8 at 5-7 years of age) and exhibited impaired coordination, clumsiness, hyperactivity or impulsivity, and impaired social interaction after improvement of seizures. Though these autistic social problems manifested gradually, the children were able to adapt to school life with appropriate support. Interestingly, the behaviors of impaired social interaction and hyperactivity or impulsivity had already been observed before the onset of MAE in most patients, whose PARS scores were all higher than reference values (<9) during infancy. Conclusion: Our results showed that children with MAE tend to have autistic behavioral problems and mild intellectual impairment along with wide ranges in WISC-III subtest scores. These behavioral and cognitive features appear to exist before the onset of epilepsy.

Re-Examination of the Rey Word Recognition Test

The Rey Word Recognition Test, a brief and simple to administer free-standing neurocognitive performance validity test, was examined in a large known-groups sample (122 credible patients and 134 non-credible patients). Total correctly recognized was the most sensitive score, identifying 54% of non-credible participants using a cut-off of ≤6, while maintaining specificity of approximately 90%. However, specifically rates were somewhat lower in credible individuals with <12 years of education or borderline intelligence, or who were bilingual (spoke English as a second language, or learned English concurrently with another language), indicating that cut-offs may require minor adjustment in these groups. Sensitivity rates were much higher in non-credible female versus male mild traumatic brain injury patients (mTBI; 68% versus 48% for total correct), suggesting that the Rey Word Recognition Test is particularly effective in identifying performance invalidity in female mTBI compensation seekers.

Intelligence quotient and cognitive functions in severe restricting-type anorexia nervosa before and after weight gain

ObjectiveRestricting-type anorexia nervosa (AN-R), characterized by severe emaciation with long-term food restriction, is often difficult to treat. The present study investigated the overall intelligence quotient (IQ) scores and cognitive functions of patients with AN-R. MethodsFourteen female inpatients with AN-R (body mass index 12.84 ± 0.41 kg/m2) and 10 healthy female participants participated in this study from 2007 through 2010. The Wechsler Adult Intelligence Scale, Third Edition and the Eating Disorder Inventory–II were administered. This research was performed at Kagoshima University Hospital. ResultsIn the AN-R group, overall IQ scores showed borderline intelligence (e.g., full-scale IQ 75.86 ± 1.79, P < 0.01); the scores were significantly lower than those in the comparison group. There were negative correlations between lower IQs and higher Eating Disorder Inventory–II scores. After the weight restoration, the IQ scores of subjects with AN-R with regard to the visuospatial scales were significantly higher than before (P < 0.01); however, the auditory cognitive scores were unchanged. ConclusionThese lower IQ scores could be connected to the psychological and behavioral traits in patients with AN-R. These problems should be considered by medical staff members who seek to treat patients with AN-R successfully.

STRATEGIES OF MEMORIZATION AND THEIR INFLUENCE ON THE LEARNING PROCESS AMONG INDIVIDUALS WITH BORDERLINE INTELLECTUAL FUNCTIONING

Borderline Intellectual Functioning (BIF), or borderline intelligence, is defined as an intelligence quotient from 1.01 to 2.00 standard deviations below average, that is, a level between average intelligence and intellectual impairment. This level of mental functioning may still belong to a broadly understood norm. The purpose of the present study is to present the current state of knowledge on the subject of memory-related processes in persons with BIF, and in particular schoolchildren. Children with borderline intelligence are at risk for chronic educational failure, absence from school, repetition of grades, and dropout or expulsion from school. We have concen trated primarily on discussing the relationship between me mo ry-related processes and the characteristic thought processes of these individuals, including a preference for operating with concrete material, rigid and insufficiently critical thinking, and difficulties in organizing and generalizing knowledge, all of which cause serious deficits in academic achievement and effective learning. The article begins with an introduction to the problems of borderline intelligence, including the differential diagnosis, classification, and cognitive functioning of these persons. Then, based on the results of national and international research, we discuss the deficits of short-term and working memory that cause difficulties in processing and organizing, impair the effectiveness of long term memory, and thus cause specific learning strategies to be adopted. Pupils with BIF most often master their school knowledge by using rote memory, the functioning of which is discussed at the end of the article.

Psychiatric and cognitive phenotype of childhood myotonic dystrophy type 1

To investigate the psychiatric and cognitive phenotype in young individuals with the childhood form of myotonic dystrophy type 1 (DM1). Twenty-eight individuals (15 females, 13 males) with childhood DM1 (mean age 17y, SD 4.6, range 7-24y) were assessed using standardized instruments and cognitive testing of general intelligence, visual attention, and visual-spatial construction abilities. Nineteen patients had repeated a school grade. The mean (SD) Full-scale IQ was 73.6 (17.5) and mean Verbal IQ was significantly higher than the mean Performance IQ: 80.2 (19.22) versus 72.95 (15.58), p=0.01. Fifteen patients had one or more diagnoses on the DSM-IV axis 1, including internalizing disorders (phobia, n=7; mood disorder, n=6; other anxiety disorders, n=5) and attention-deficit-hyperactivity disorder, inattentive subtype (n=8). Twelve out of 22 patients had alexithymia (inability to express feelings with words and to recognize and share emotional states). Cognitive testing found severe impairments in visual attention and visual-spatial construction abilities in four out of 18, and 14 out of 24 patients respectively. No diagnosis was correlated with the transmitting parent's sex or with cytosine-thymine-guanine (CTG) repeat numbers. Patients with severe visual-spatial construction disabilities had a significantly longer CTG expansion size than those with normal visual-spatial abilities (p=0.04). Children and adolescents with childhood DM1 have frequent diagnoses on DSM-IV axis 1, with internalizing disorders being the most common type of disorder. They also have borderline low intelligence and frequent impairments in attention and visual-spatial construction abilities.

Psychiatric phenotype of juvenile myotonic dystrophy 1 includes internalising disorder, borderline intelligence, visual spatial construction disability and attention deficit disorder

Psychiatric phenotype of juvenile myotonic dystrophy 1 includes internalising disorder, borderline intelligence, visual spatial construction disability and attention deficit disorder

Neurofeedback in Residential Children and Adolescents with Mild Mental Retardation and ADHD Behavior

Neurofeedback (NFB) research has reported improved concentration and attention in children with attention deficit/hyperactivity disorder (ADHD) and progress maintained over time. Would that also apply to children with an IQ between 50 and 70 (mild mental retardation [MMR]) and an IQ between 70 and 85 (borderline retardation [BR]) with characteristics of ADHD? To our knowledge this is the first NFB treatment study with long-term follow-up in this particular group. Ten adolescents with MMR and BR and ADHD received 30 sessions of quantitative electroencephalogram (QEEG)-based NFB. QEEG differences with a gender- and age-matched group without mental handicap and ADHD (data provided by BRAINnet) were investigated, at pre- and posttreatment and at 6-month follow-up. Neuropsychological functioning was tested administering the Bourdon-Vos, and the Amsterdam Neuropsychological Testing Program subscales SA DOTS and SSV. Pretreatment eyes-closed EEGs were not statistically different in the children with MMR compared...

High-functioning autism spectrum disorder and fragile X syndrome: report of two affected sisters

BackgroundFragile X syndrome (FXS) is the most common inherited cause of intellectual disability (ID), as well as the most frequent monogenic cause of autism spectrum disorder (ASD). Men with FXS exhibit ID, often associated with autistics features, whereas women heterozygous for the full mutation are typically less severely affected; about half have a normal or borderline intelligence quotient (IQ). Previous findings have shown a strong association between ID and ASD in both men and women with FXS. We describe here the case of two sisters with ASD and FXS but without ID. One of the sisters presented with high-functioning autism, the other one with pervasive developmental disorder not otherwise specified and low normal IQ.MethodsThe methylation status of the mutated FMR1 alleles was examined by Southern blot and methylation-sensitive polymerase chain reaction. The X-chromosome inactivation was determined by analyzing the methylation status of the androgen receptor at Xq12.ResultsBoth sisters carried a full mutation in the FMR1 gene, with complete methylation and random X chromosome inactivation. We present the phenotype of the two sisters and other family members.ConclusionsThese findings suggest that autistic behaviors and cognitive impairment can manifest as independent traits in FXS. Mutations in FMR1, known to cause syndromic autism, may also contribute to the etiology of high-functioning, non-syndromic ASD, particularly in women. Thus, screening for FXS in patients with ASD should not be limited to those with comorbid ID.

Intellectual quotient score comparison between HIV-infected and HIV exposed children at the Peruvian National Institute of Child Health, Lima Peru

Pediatric HIV encephalopathy includes motor and cognitive deficits and can result in poor school performance, borderline intelligence or mental retardation. We compared intellectual quotient (IQ) between HIV-infected children and a group of HIV-negative children at the National Institute of Child Health in Peru. In addition, we studied the relationship between verbal and executive function and the clinical stage of HIV infection (CDC classification), HIV viral load, CD4 count and other potential risk factors.

Isolated corpus callosum agenesis: a ten‐year follow‐up after prenatal diagnosis (How are the children without corpus callosum at 10 years of age?)

Corpus callosum agenesis (CCA) is generally diagnosed in utero. Outcome appears to be better if the malformation is isolated. The aim of this study, which is the first one with a long (10 years) and standardized follow up, was to report cognitive abilities of children with isolated CCA diagnosed prenatally. We prospectively evaluated 17 children. Clinical examinations, neuropsychological tests were performed each year. School achievement and personal and familial data were collected. Twelve children completed the entire follow up. One child was finally considered to have associated CCA, because signs of fetal alcohol syndrome had become obvious. Of the 11 other children, three (27%) had borderline intelligence whereas the intelligence levels of eight (73%) were in the normal range, although half of these children experienced some difficulties in scholastic achievement. Neither epilepsy nor intellectual deficiency was noted and intellectual quotient scores correlated strongly with the mother's education level. Although prenatal diagnosis of isolated CCA is reliable, false postnatal diagnoses remain possible (10-20%) even with complete prenatal screening. Outcome is mostly favorable because intelligence is within the normal range for nearly 3/4 of the children. However, they frequently have mild learning difficulties.

A new lysosomal storage disorder resembling Morquio syndrome in sibs

We report two male sibs, born from unrelated French Caribbean parents, presenting with an unclassifiable storage disorder. Pregnancy and delivery were uneventful. Stunted growth was noted during the first year of life. Both children have short stature (below - 4SD) with short trunk, barrel chest, micromelia with rhizomelic shortening, severe kyphoscoliosis, pectus carinatum, short hands and feet with metatarsus adductus, and excessive joint laxity of the small joints. Learning difficulties with borderline intelligence quotient (IQ) were noted in one of them. They had no hepatomegaly, no splenomegaly, and no dysmorphism. Skeletal X-rays survey demonstrated generalized platyspondyly with tongue-like deformity of the anterior part of the vertebral bodies, hypoplasia of the odontoid process, generalized epiphyseal dysplasia and abnormally shaped metaphyses. The acetabular roofs had a trident aspect. Ophthalmologic and cardiac examinations were normal. Spine deformity required surgical correction in one of the patient at age 4 years. Lysosomal enzymes assays including N-acetylgalactosamine-6-sulfate sulfatase and β-galactosidase were normal, excluding mucopolysaccharidoses type IV A and IV B (Morquio syndrome), respectively. Qualitative analysis found traces of dermatan and chondroitin-sulfates in urine, but quantitative glycosaminoglycan excretion fell within normal limits. They were no vacuolated lymphocytes. Abnormal coarse inclusions were present in eosinophils. Mild Alder anomaly was observed in polymorphonuclears. Granulations were discretely metachromatic with toluidine blue. Those morphological anomalies are in favor of a lysosomal storage disease. No inclusions were found in skin fibroblasts. We hypothesize that these two boys have a distinct autosomal recessive or X-linked lysosomal storage disorder of unknown origin that shares clinical and radiological features with Morquio disease.

Detailed neuropsychological evaluation in a patient with Floating Harbor syndrome

The Floating Harbor syndrome is a rare genetic disease characterized by a triad of clinical signs: specific dysmorphic facial features, short stature with delayed bone age, and language and speech disorders. These signs are, in most cases, associated with borderline normal intelligence to moderate delay concerning intellectual functioning. We report an extensive neuropsychological evaluation for an adult female patient and show, in particular, a severe visuospatial impairment. We discuss this deficit in the light of the previous reported cases and suggest that visuospatial abilities should be explored more systematically.

The Effect of Mentoring Program for Social Maturity &amp; Self-esteem of the School-aged Children with Borderline Intelligence - focus on benefits of mentoring on mentee and metor -

The Effect of Mentoring Program for Social Maturity &amp; Self-esteem of the School-aged Children with Borderline Intelligence - focus on benefits of mentoring on mentee and metor -

A study of educational underachievement in Indian children with epilepsy

Background: Epilepsy is a chronic disorder that significantly affects learning and behavior. Children with epilepsy are much more vulnerable for educational problems than with any other chronic illness. Objectives: The study was conducted to assess the extent of educational problems and factors associated with educational underachievement in Indian children with epilepsy. Methods: It was a case control study and included 100 cases of 6–16years age of epilepsy, 50 healthy children (control A) and 50 children with persistent asthma (control B). Their demographic and disease variables were evaluated. The educational performance was assessed by using a predesigned semi structured open ended questionnaire to parents and by teacher’s report. Psychological evaluation was done in first step by using a standard questionnaire, childhood psychopathology measurement schedule. In second step, those have shown poor educational performance or significant score in standard questionnaire underwent detailed psychiatric evaluation. Results: Educational problems were reported in cases (36%), control A (2%) and control B (16%). Demographic or disease variables were not associated with educational problems in cases except that boys were more affected than girls. On psychiatric evaluation psychopathological illnesses (47%) like attention deficit hyperkinetic disorder, conduct disorder and depression were found to be commonly associated with poor educational performance (47%) followed by decreased learning opportunities (22.2%) and borderline intelligence (19.4%) in children with epilepsy. Conclusion: Educational problems are commoner in children with epilepsy than with asthma. Psychopathological problems are commonly associated with educational underachievement in children with epilepsy. Therefore periodic psychosocial assessment, counseling and support must be provided to improve the psychosocial adjustment in children with epilepsy.

IQ predicts word decoding skills in populations with intellectual disabilities

This is a study of word decoding in adolescents with Down syndrome and in adolescents with Intellectual Deficits of unknown etiology. It was designed as a replication of studies of word decoding in English speaking and in Hebrew speaking adolescents with Williams syndrome (Levy & Antebi, 2004; Levy, Smith, & Tager-Flusberg, 2003). Participants' IQ was matched to IQ in the groups with Williams syndrome and was within the range of mental retardation or borderline intelligence. Our aim was to investigate the impact of IQ on word decoding in these populations, rather than estimate their overall reading level. Similar to the results seen in people with Williams syndrome, word decoding was correlated with auditory short term memory and with phonological awareness tasks yet these correlations were mediated by IQ. It is argued that learning to decode is an explicit task that relies primarily on general cognitive resources of the kind that are most vulnerable in people with sub-normal IQ.

Efficacy of atypical antipsychotic medication in the management of behaviour problems in children with intellectual disabilities and borderline intelligence: A systematic review

The use of medications to manage problem behaviours is widespread. However, robust evidence to support their use seems to be lacking. The aim was to review research evidence into the efficacy of atypical antipsychotic medication in managing problem behaviour in children with intellectual disabilities and borderline intelligence. A systematic review was conducted for placebo-controlled randomised double-blind trials. The included studies (N = 6) showed that risperidone was significantly more effective than placebo in managing problem behaviours. However, most studies highlighted adverse events primarily somnolence and weight gain. There is now some evidence in favour of the use of risperidone. However, because of possible adverse events, these medications have to be used with caution.

SP5-5 Risk factors associated with borderline intelligence in schoolchildren: a case-control study

ObjectiveTo determine risk factors associated with borderline intelligence during intra-uterine life, delivery and the neonatal periods.MethodsIn a case-control study, 200 year one schoolchildren aged 6 years were recruited. A standard...

Children with Medically Unexplained Pain Symptoms: Categorization and Effective Management

Context:Medically unexplained pain symptoms are common in children, and their incidence is on the rise. There is often a lack of clearly articulated pathophysiology in these patients. There is need to improve understanding about varied causes and presentations of these patients which would generate further insight in management of these patients. Documentation and detailed assessment of such children in Indian setting is not seen in literature.Materials and Methods:A series of 17 cases, 10 boys and 7 girls referred from pediatrics department is discussed, so as to categorize them in three different subgroups for management.Result and Discussion:Although there were often no overt anxiety or depressive features, some psychosocial stress which was mostly unnoticed by the child, the parents and the doctor, preceded such a pain. It was often an academic stress, familial separation or parental psychiatric illness. They were at times not able to verbalize their distress, which was revealed with the help of Children's Apperception Test (C.A.T.). They mainly had anxieties about loss of love or disapproval by parents and also fear of harm or injury. They used defence mechanisms like denial, reaction formation and repression, which were ineffective in handling the overwhelming anxiety. Most of these children had either above average or borderline intelligence. Somatic expression of emotional needs and fears in these children was managed effectively by supportive therapy and antidepressant drugs.

Cognitive and psychosocial development in children with familial hypomagnesaemia

Familial hypomagnesaemia (FH) is a rare genetic condition. Neuromuscular and cardiovascular manifestations are well described, whereas cognitive and psychosocial development of children with FH is generally overlooked. Nine patients with FH were evaluated with psychiatric examination and psychometric tests for cognitive and psychosocial outcome. Nine children (median age 10.1 yrs, range 3-16.3 yrs, 5 boys and 4 girls) with FH participated. Psychiatric symptoms were hyperactivity, irritability, sleep and speech problems and finger sucking. Common psychiatric diagnoses were Attention Deficit Hyperactivity Disorder, borderline intelligence, mild mental retardation and speech disorders. Parent-rated Child Behavior Checklist and Child Health Questionnaire mean scores were between 0.32-0.79, and 0.4-2.12, respectively; indicating the worsened psychosocial well-being besides considerable psychiatric diagnoses. Cognitive and psychosocial outcome in FH may influence morbidity, quality of life and social performance. Neuropsychiatric evaluation should be a routine part of management of children with FH.

A pilot study of social competence group training for adolescents with borderline intellectual functioning and emotional and behavioural problems (SCT‐ABI)

Emotional and behavioural problems as well as a lack of social competence are common in adolescents with borderline intellectual functioning and impair their social and vocational integration. Group interventions specifically developed for this target group are scarce and controlled evaluation studies are absent. A cognitive-behavioural group training (Social Competence Training for Adolescents with Borderline Intelligence) was developed and its effectiveness was examined in students attending special vocational schools. A total of 77 adolescents with borderline intelligence were randomised either to the intervention (n=40) or to the control group (n=37). Outcome measures at post-treatment and at a 6-month follow-up comprised self-reports, caregiver reports and behavioural observations. The adolescents in the intervention group showed temporally stable improvement in their social competence, especially in social problem solving (F=17.6, P<0.001) and attainment of individual behavioural goals in everyday life (self-reports: F=15.9, P<0.001; caregiver reports: F=87.9, P<0.001). Effects of the intervention on other outcomes such as problem-solving competence and skills performed in standardised role plays were weak or absent. Social Competence Training for Adolescents with Borderline Intelligence is a promising treatment for adolescents with borderline intellectual functioning and associated emotional/behavioural symptoms. Further studies examining long-term effects on the participants' social and vocational integration are needed.