Core Deficit Research Articles

40 Years Later: Reassessing Views on the Core Deficit, Variability, Relapse/Recovery, and Attention in Stuttering

The current article reassessed the views expressed in two articles written 40 years ago about the core deficit, variability, relapse and recovery, and the role of attention in stuttering. Motor factors are now generally agreed to be the core deficit underlying stuttering, but they interact dynamically over time with other factors (Smith & Weber). Variability and unpredictability of stuttering are the norm (Tichenor & Yaruss), not the exception and should be directly addressed in therapy. PWS do think too much about speech production and this negatively impacts fluency (Eichorn et al.). In the last 40 years, it has become clear that PWS have different views about recovery and relapse. There is now less emphasis on fluency itself and more about managing impacts and quality of life. This is a dramatic change from how recovery and relapse were viewed 40 years ago.

Is it up to language? Pragmatic competence in Croatian preschool children with autism and typical development

Objectives The relationship between structural language ability and pragmatics is not fully understood, in either individuals with autism or those with typical development (TD). Despite the well-established understanding that core deficits in autism lie in pragmatics, specific pragmatic behaviours that distinguish autistic children (AC) from their TD peers are not sufficiently described. The aims of this study were as follows: to investigate the differences in language abilities and pragmatic competence between AC and those with TD; to examine the relationship between language comprehension/production and pragmatic competence in both groups; and to identify the items of pragmatic composite that are most discriminative in detecting AC. Methods The participants in this study were preschool-aged children with TD (N = 45; mean age 65.5 months) and AC with average nonverbal IQ scores (N = 32; mean age 72.9 months). Language production and comprehension abilities were assessed using the New Reynell Developmental Language Scales (4th edition), and pragmatic competence was measured using the Children’s Communication Checklist (CCC). Results For all language and pragmatic variables, AC performed worse than those with TD. Pragmatic competencies did not correlate with structural language skills in either group, except for a correlation between language production and coherence in the TD. Finally, certain pragmatic behaviours common to many AC and rarely found in children with TD were identified as potential distinguishing features between the two groups. Conclusions This study underscores the importance of incorporating pragmatic assessments alongside traditional language evaluations and suggests that interventions should target pragmatic competence specifically, especially in preschool AC.

The Impact of Cues on Joint Attention in Children with Autism Spectrum Disorder: An Eye-Tracking Study in Virtual Games.

Joint attention (JA), a core deficit in children with autism spectrum disorder (ASD), is crucial for social interaction, emotional understanding, and cognitive development. This study aims to compare and analyze the eye-tracking data of ASD and typically developing children (TDC) during virtual games, exploring how different cue types affect JA performance in ASD children. A total of 31 TDC and 40 ASD children participated in the study. Using eye-tracking devices, we recorded the children's eye movements as they played virtual games, selecting the correct target based on cues provided by virtual characters. Our findings revealed that different cue types significantly impacted the game scores of ASD children but had no significant effect on TDC, highlighting a notable disparity between the two groups. ASD children showed a lower fixation frequency, irregular fixation paths, and increased attention to non-target objects compared to TDC. Interestingly, among the three cue types, ASD children exhibited a preference for the third type, leading to longer fixation on the region of interest and higher game scores. These results underscore the importance of cue selection in enhancing JA in ASD children. This study provides novel insights into the JA deficits in ASD children and offers a scientific basis for the development of targeted and individualized intervention programs.

The developmental dyslexia scale for standard mandarin: A study among early primary students

BackgroundDevelopmental dyslexia (DD) is a prevalent neurodevelopmental disease that poses challenges in both early intervention and long-term development for children with DD. However, there is a lack of a standardized and comprehensive tool for the diagnosis of DD in Mainland China. AimTo develop a standardized tool (i.e., Developmental Dyslexia Scale for Standard Mandarin [DDSSM]) for the diagnosis of DD in Mainland China and evaluate its reliability and validity. Methods and proceduresDDSSM consists of 10 subtests. The initial draft was created after Delphi expert consultation, and the final version was revised to improve discriminability with a pilot study involving 450 children from grades 1–3. The reliability and validity were then confirmed with 53 children from grades 1–2. Outcomes and resultsThe Delphi expert consultation demonstrated that the expert panel had good authority, and that all agreed on the subtest setup. The DDSSM exhibited great internal consistency. Confirmatory factor analysis revealed that the model aligns with the theoretical structure (P > 0.05, χ2/df < 2.00, root-mean-square error of approximation (RMSEA) < 0.08, comparative fit index (CFI) > 0.90, TLI > 0.90). The Dyslexia Checklist for Chinese Children and children’s academic performance agreed well with the DDSSM. Conclusions and implicationsThe DDSAM is reliable and valid for assessing and diagnosing DD in Standard Mandarin-speaking primary school children from grades 1–2. What this paper adds?Although a number of scales and tools have been proposed for assessing developmental dyslexia (DD) in Chinese, there is still a lack of diagnostic tools for Mandarin Chinese in Mainland China. In this study, we developed one of the most comprehensive diagnostic tools for DD in Mandarin Chinese for lower graders. We included visual-spatial attention (VA) and compounding awareness (CA), two tests that have been recently suggested as reliable measures for identifying DD in the Chinese language. This assessment tool has been verified for robust reliability and validity.This study also provided confirmation of the core deficits of DD in Chinese, which were orthographic awareness (OA). In addition, VA, rapid automatized naming (RAN) and morphological awareness (MA) were found to be the most important cognitive abilities for word reading in Chinese lower graders in this study.

Dissociable effects of mild COVID-19 on short- and long-term memories.

Recent studies have highlighted the presence of cognitive deficits following COVID-19 that persist beyond acute infection, regardless of the initial disease severity. Impairments in short- and long-term memory are among the core deficits reported by patients and observed in objective tests of memory performance. We aimed to extend previous studies by examining performance in a task that allows us to directly compare and contrast memories at different timescales. More specifically, we assessed both short- and long-term memories for contextual-spatial associations encoded during a common session and probed at different durations using an equivalent task in non-hospitalized individuals recovering from mild COVID-19 compared to healthy controls. The approach equated all aspects of memory materials and response demands, isolating performance changes resulting only from memory timescales and thus allowing us to quantify the impact of COVID-19 on cognition. In addition to providing measures of accuracy and response times, the task also provided a sensitive continuous readout of the precision of memory representations, specifically by examining the resolution with which spatial locations were retained in memory. The results demonstrated selective impairment of long-term memory performance in individuals recovering from mild COVID-19 infection. Short-term memory performance remained comparable to healthy controls. Specifically, poor precision of long-term memory representations was demonstrated, which improved with days since diagnosis. No such relationship was observed for short-term memory performance. Our findings reveal a specific impairment to the precision of spatial-contextual long-term memory representations in individuals recovering from mild COVID-19 and demonstrate evidence of recovery in long-term memory over time. Further, the experimental design provides a carefully controlled and sensitive framework to assess memory across different durations with the potential to provide more detailed phenotyping of memory deficits associated with COVID-19 in general.

Multivariate brain-cognition associations in euthymic bipolar disorder.

People with bipolar disorder (BD) tend to show widespread cognitive impairment compared to healthy controls. Impairments in processing speed (PS), attention and executive function (EF) may represent 'core' impairments that have a role in wider cognitive dysfunction. Cognitive impairments appear to relate to structural brain abnormalities in BD, but whether core deficits are related to particular brain regions is unclear and much of the research on brain-cognition associations is limited by univariate analysis and small samples. Euthymic BD patients (n = 56) and matched healthy controls (n = 26) underwent T1-weighted MRI scans and completed neuropsychological tests of PS, attention and EF. We utilised public datasets to develop normative models of cortical thickness (n = 5977) to generate robust estimations of cortical abnormalities in patients. Canonical correlation analysis was used to assess multivariate brain-cognition associations in BD, controlling for age, sex and premorbid IQ. BD showed impairments on tests of PS, attention and EF, and abnormal cortical thickness in several brain regions compared to healthy controls. Impairments in tests of PS and EF were most strongly associated with cortical thickness in the left inferior temporal, right entorhinal and right temporal pole areas. Impairments in PS, attention and EF can be observed in euthymic BD and may be related to abnormal cortical thickness in temporal regions. Future research should continue to leverage normative modelling and multivariate methods to examine complex brain-cognition associations in BD. Future research may benefit from exploring covariance between traditional brain structural morphological metrics such as cortical thickness, cortical volume and surface area.

Dopamine Dysregulation in Reward and Autism Spectrum Disorder.

Autism spectrum disorder (ASD) is primarily characterized by core deficits in social skills, communication, and cognition and by repetitive stereotyped behaviors. These manifestations are variable between individuals, and ASD pathogenesis is complex, with over a thousand implicated genes, many epigenetic factors, and multiple environmental influences. The mesolimbic dopamine (DA) mediated brain reward system is held to play a key role, but the rapidly expanding literature reveals intricate, nuanced signaling involving a wide array of mesolimbic loci, neurotransmitters and receptor subtypes, and neuronal variants. How altered DA signaling may constitute a downstream convergence of the manifold causal origins of ASD is not well understood. A clear working framework of ASD pathogenesis may help delineate common stages and potential diagnostic and interventional opportunities. Hence, we summarize the known natural history of ASD in the context of emerging data and perspectives to update ASD reward signaling. Then, against this backdrop, we proffer a provisional framework that organizes ASD pathogenesis into successive levels, including (1) genetic and epigenetic changes, (2) disrupted mesolimbic reward signaling pathways, (3) dysregulated neurotransmitter/DA signaling, and finally, (4) altered neurocognitive and social behavior and possible antagonist/agonist based ASD interventions. This subdivision of ASD into a logical progression of potentially addressable parts may help facilitate the rational formulation of diagnostics and targeted treatments.

Brain activations during execution and observation of visually guided sequential manual movements in autism and in typical development: A study protocol.

Motor issues are frequently observed accompanying core deficits in autism spectrum disorder (ASD). Impaired motor behavior has also been linked to cognitive and social abnormalities, and problems with predictive ability have been suggested to play an important, possibly shared, part across all these domains. Brain imaging of sensory-motor behavior is a promising method for characterizing the neurobiological foundation for this proposed key trait. The present functional magnetic resonance imaging (fMRI) developmental study, involving children/youth with ASD, typically developing (TD) children/youth, and neurotypical adults, will investigate brain activations during execution and observation of a visually guided, goal-directed sequential (two-step) manual task. Neural processing related to both execution and observation of the task, as well as activation patterns during the preparation stage before execution/observation will be investigated. Main regions of interest include frontoparietal and occipitotemporal cortical areas, the human mirror neuron system (MNS), and the cerebellum.

Quantifying the Core Deficit in Classical Schizophrenia From Three Independent Samples of Psychosis Spectrum Patients

Quantifying the Core Deficit in Classical Schizophrenia From Three Independent Samples of Psychosis Spectrum Patients

Implication of the endocannabidiome and metabolic pathways in fragile X syndrome pathophysiology

Fragile X Syndrome (FXS) results from the silencing of the FMR1 gene and is the most prevalent inherited cause of intellectual disability and the most frequent monogenic cause of autism spectrum disorder. It is well established that Fragile X individuals are subjected to a wide array of comorbidities, ranging from cognitive, behavioural, and medical origin. Furthermore, recent studies have also described metabolic impairments in FXS individuals. However, the molecular mechanisms linking FMRP deficiency to improper metabolism are still misunderstood. The endocannabinoidome (eCBome) is a lipid-based signalling system that regulates several functions across the body, ranging from cognition, behaviour and metabolism. Alterations in the eCBome have been described in FXS animal models and linked to neuronal hyperexcitability, a core deficit of the disease. However, the potential link between dysregulation of the eCBome and altered metabolism observed in FXS remains unexplored. As such, this review aims to overcome this issue by describing the most recent finding related to eCBome and metabolic dysfunctions in the context of FXS. A better comprehension of this association will help deepen our understanding of FXS pathophysiology and pave the way for future therapeutic interventions.

Investigating gene-environment interaction on attention in a double-hit model for Autism Spectrum Disorder.

Autism Spectrum Disorder (ASD) is a neurodevelopmental behavioral disorder characterized by social, communicative, and motor deficits. There is no single etiological cause for ASD, rather, there are various genetic and environmental factors that increase the risk for ASD. It is thought that some of these factors influence the same underlying neural mechanisms, and that an interplay of both genetic and environmental factors would better explain the pathogenesis of ASD. To better appreciate the influence of genetic-environment interaction on ASD-related behaviours, rats lacking a functional copy of the ASD-linked gene Cntnap2 were exposed to maternal immune activation (MIA) during pregnancy and assessed in adolescence and adulthood. We hypothesized that Cntnap2 deficiency interacts with poly I:C MIA to aggravate ASD-like symptoms in the offspring. In this double-hit model, we assessed attention, a core deficit in ASD due to prefrontal cortical dysfunction. We employed a well-established attentional paradigm known as the 5-choice serial reaction time task (5CSRTT). Cntnap2-/- rats exhibited greater perseverative responses which is indicative of repetitive behaviors. Additionally, rats exposed to poly I:C MIA exhibited premature responses, a marker of impulsivity. The rats exposed to both the genetic and environmental challenge displayed an increase in impulsive activity; however, this response was only elicited in the presence of an auditory distractor. This implies that exacerbated symptomatology in the double-hit model may situation-dependent and not generally expressed.

The interplay between polygenic score for tumor necrosis factor-α, brain structural connectivity, and processing speed in major depression

Reduced processing speed is a core deficit in major depressive disorder (MDD) and has been linked to altered structural brain network connectivity. Ample evidence highlights the involvement of genetic-immunological processes in MDD and specific depressive symptoms. Here, we extended these findings by examining associations between polygenic scores for tumor necrosis factor-α blood levels (TNF-α PGS), structural brain connectivity, and processing speed in a large sample of MDD patients. Processing speed performance of n = 284 acutely depressed, n = 177 partially and n = 198 fully remitted patients, and n = 743 healthy controls (HC) was estimated based on five neuropsychological tests. Network-based statistic was used to identify a brain network associated with processing speed. We employed general linear models to examine the association between TNF-α PGS and processing speed. We investigated whether network connectivity mediates the association between TNF-α PGS and processing speed. We identified a structural network positively associated with processing speed in the whole sample. We observed a significant negative association between TNF-α PGS and processing speed in acutely depressed patients, whereas no association was found in remitted patients and HC. The mediation analysis revealed that brain connectivity partially mediated the association between TNF-α PGS and processing speed in acute MDD. The present study provides evidence that TNF-α PGS is associated with decreased processing speed exclusively in patients with acute depression. This association was partially mediated by structural brain connectivity. Using multimodal data, the current findings advance our understanding of cognitive dysfunction in MDD and highlight the involvement of genetic-immunological processes in its pathomechanisms.

Needs and Coping during the COVID-19 Pandemic among Families of Children with Autism Spectrum Disorder in a Government Tertiary Hospital.

The COVID-19 pandemic has affected the well-being of children with Autism Spectrum Disorder (ASD) and their families. The core deficits of the condition and increased parental stress during this time made them more vulnerable. This study aims to explore how the pandemic has affected these families by identifying their needs and capabilities in order to provide support. A total of 227 parents of children with ASD completed an online survey consisting of items on socio-demographics, family needs, and coping strategies. Descriptive statistics were used and t-test and ANOVA/Kruskal Wallis were used to determine the relationship between parent and child factors with needs and coping. Needs for Information, Community Services, and Finances are the top categories while the greatest identified need during this pandemic was for financial assistance. Religiosity, Problem-Solving, and Cognitive Reappraisal were the widely used coping strategies by the parents. Fathers, younger children, daughters with ASD, and having more than one child with ASD showed significant association with needs. Parents with primary and tertiary education were associated with use of the cognitive reappraisal strategy and those with jobs were associated with substance use. Families of children with ASD have multiple needs during this pandemic, from autism-specific information and services, to more generic concerns such as financial assistance. Despite these challenges, these families have positive strategies in place to facilitate coping mechanisms.

No clear evidence of a difference between individuals who self-report an absence of auditory imagery and typical imagers on auditory imagery tasks.

Aphantasia is characterised by the inability to create mental images in one's mind. Studies investigating impairments in imagery typically focus on the visual domain. However, it is possible to generate many different forms of imagery including imagined auditory, kinesthetic, tactile, motor, taste and other experiences. Recent studies show that individuals with aphantasia report a lack of imagery in modalities, other than vision, including audition. However, to date, no research has examined whether these reductions in self-reported auditory imagery are associated with decrements in tasks that require auditory imagery. Understanding the extent to which visual and auditory imagery deficits co-occur can help to better characterise the core deficits of aphantasia and provide an alternative perspective on theoretical debates on the extent to which imagery draws on modality-specific or modality-general processes. In the current study, individuals that self-identified as being aphantasic and matched control participants with typical imagery performed two tasks: a musical pitch-based imagery and voice-based categorisation task. The majority of participants with aphantasia self-reported significant deficits in both auditory and visual imagery. However, we did not find a concomitant decrease in performance on tasks which require auditory imagery, either in the full sample or only when considering those participants that reported significant deficits in both domains. These findings are discussed in relation to the mechanisms that might obscure observation of imagery deficits in auditory imagery tasks in people that report reduced auditory imagery.

A comparative study on fundamental movement skills among children with autism spectrum disorder and typically developing children aged 7-10.

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition with unique differences in social interaction, communication, and a spectrum of behavioral characteristics. In the past, motor disturbance in individuals with ASD has not been considered a significant core deficit due to the predominant focus on sociability and communication issues. However, recent studies indicate that motor deficits are indeed associated with the fundamental symptoms of ASD. As there is limited research on the motor behavior of children with ASD, particularly in China, the objective of this study is to investigate the development of fundamental movement skills (FMS) in children with ASD and compare them to typically developing children. The study recruited 108 children with ASD (87 boys, 21 girls) aged 7-10 years from two special education rehabilitation centers in Wuhan, China. For comparison, a control group of 108 typically developing children, matched by age and gender, was randomly selected from three local primary schools. FMS were assessed using the Movement Assessment Battery for Children - Second Edition (MABC-2), which evaluates manual dexterity, aiming and catching, as well as static and dynamic balance. Group differences on MABC-2 percentile scores were analyzed using descriptive statistics and Mann-Whitney U test. Effect sizes were also calculated for practical significance. Findings from the study showed that a significant majority, around 80%, of children with ASD either displayed motor challenges or were at risk of developing such delays. When comparing to their typically developing peers, children with ASD scored notably lower in areas of manual dexterity, ball skills, and both static and dynamic balance (with all these findings being statistically significant at p < 0.001). Interestingly, gender did not show a significant influence on these results (p > 0.05). In addition to addressing the other skill development areas outlined in the diagnostic manual for ASD, clinicians diagnosing and treating children with ASD should also assess the presence of motor skill development. For individuals with ASD who have co-existing motor difficulties, it is essential to offer evidence-based interventions tailored to their specific needs.

Personalized repetitive transcranial magnetic stimulation guided by the spectral electroencephalogram may enhance and democratize therapy for autism spectrum disorder

Autism spectrum disorder (ASD) is a genetically heterogeneous group of neurodevelopmental disorders that affect 1 in 36 children (CDC data) and have recognizable core deficits in common, including repetitive stereotyped behaviors and difficulties in social interaction and communication. Pharmacological interventions moderate some ASD comorbidities, but do not alleviate core deficits and have significant side effects. While many behavioral therapies are inadequate, a very intensive form called applied behavioral analysis (ABA) is demonstrably effective. ABA is based on graded progression and immediate feedback. ABA has raised concerns over its intensive nature and has triggered unease about being too harsh. One solution may derive from a widespread hypothesis of ASD pathogenesis, which posits that the brain in ASD is overexcited, i.e., excitation dominates over inhibition, and electroencephalographic (EEG) alpha band oscillatory activity is altered, which degrades sensory input and task management. This may also disrupt the brain mesolimbic dopaminergic reward cascade causing social interactions to be unrewarding, leading to deleterious social behavior and poor communication. We hypothesize that a comprehensive, personalized form of spectral EEG guided repetitive transcranial magnetic stimulation that we term PrTMS, can normalize alpha EEG oscillations, E/I balance, and dopaminergic reward signaling, to facilitate improved psychosocial behavior. The goal is for PrTMS to synergize with behavioral interventions, so that ABA for example, could be less intensive. This may hold the promise of making self-determination more readily attainable for ASD persons, and could also democratize ASD therapy by rendering it more affordable.

Automatic evaluation of the Nine-Hole Peg Test in multiple sclerosis patients using machine learning models

Neurological damage in Multiple Sclerosis (MS) affects the motor, sensory, visual, cognitive and sphincteric systems, resulting in different degrees of disability. Upper limb dysfunction is a core deficit affecting MS patients. However, since upper limb function impairment is not properly recorded in the Expanded Disability Status Scale (EDSS) for MS, other tests have been developed in the last decades. The Nine Hole Peg Test (9HPT) is widely considered a gold standard metric for manual dexterity. Unfortunately, its quantification strongly depends on the subjectivity of each clinician.The aim of this work is to standardize the measurement process of the 9HPT. Instead of a human interpretation of the time needed to complete the exercise, this paper aims to objectively extract multiple kinematic information of the subject’s hand (period, velocity, time). This information is used to detect the presence and the state of the disease more accurately and classify the patients automatically. The manuscript describes a developed framework to automate and objectivize the 9HPT. The framework evaluates the performance of different Machine Learning models and Artificial Neural Networks on MS diagnosis. The built system analyzes videos of subjects performing the 9HPT, extracts the hand’s pose using Convolutional Neural Networks, acquires the hand’s kinematic features and classifies the severity of the disease using Machine Learning algorithms. For the framework validation, two classification approaches are proposed. The first one is a binary classification problem, separating the subjects between control and patients. The second one is a multiclass classification problem, where the patients are separated into three different classes based on the severity assessed by the clinicians. A technical validation has been implemented with an accuracy of up 96.67% for the binary classification and 92.22% for the multiclass classification.

A neuroanatomical and cognitive model of impaired social behaviour in frontotemporal dementia.

Impaired social cognition is a core deficit in frontotemporal dementia (FTD). It is most commonly associated with the behavioural-variant of FTD, with atrophy of the orbitofrontal and ventromedial prefrontal cortex. Social cognitive changes are also common in semantic dementia, with atrophy centred on the anterior temporal lobes. The impairment of social behaviour in FTD has typically been attributed to damage to the orbitofrontal cortex and/or temporal poles and/or the uncinate fasciculus that connects them. However, the relative contributions of each region are unresolved. In this review, we present a unified neurocognitive model of controlled social behaviour that not only explains the observed impairment of social behaviours in FTD, but also assimilates both consistent and potentially contradictory findings from other patient groups, comparative neurology and normative cognitive neuroscience. We propose that impaired social behaviour results from damage to two cognitively- and anatomically-distinct components. The first component is social-semantic knowledge, a part of the general semantic-conceptual system supported by the anterior temporal lobes bilaterally. The second component is social control, supported by the orbitofrontal cortex, medial frontal cortex and ventrolateral frontal cortex, which interacts with social-semantic knowledge to guide and shape social behaviour.

Screening of children attending well baby clinic for risk of autism using modified checklist for autism in toddlers in a pediatric tertiary care Centre in Chennai

Background: Autism spectrum disorder is a common neurodevelopmental disorder with core deficits in social communication, interaction, and restrictive/repetitive behavior. Early intervention provides opportunity for good functional outcome. The study aimed to screen children attending well baby clinic for risk of autism using modified checklist for autism in toddlers (MCHAT) questionnaire. Methods: This descriptive cross-sectional study was conducted on 302 children attending the pediatric well baby clinic. The children aged 16-30 months who met the inclusion criteria were screened for risk of autism using MCHAT. Results: 20 out of 302 children failed the MCHAT screening, 6.6% of the children were found to be at risk of autism. Boys: girls’ ratio was 2:1. Advanced parental age and higher socioeconomic status were found to have significant association with the risk of autism. 70% of children in the at-risk group were first born, 70% of children who failed the MCHAT screen were from a nuclear family. Conclusions: All toddlers attending the well-baby clinic should be screened for autism by pediatricians. MCHAT is a simple easy to use validated tool to screen for autism in a busy pediatric OPD. Timely referral for comprehensive assessment and intervention can help to improve the outcome in children with autism.

A new soil protection legislation for Germany – challenges, conceptual approaches and next steps

The chapter provides information on the ongoing legislative process to draft a fundamentally amended soil protection act in order to cope with climate change and adaptation, the maintenance of biodiversity and additional challenges. The current German government has agreed to this endeavor in 2021. First, the chapter offers information on the importance of soils for the society. In addition, the main challenges that soils are facing in Germany, the status quo of the soil legislation and the core deficits of the current regulatory regime will be outlined. The chapter will furthermore inform about the conceptual regulatory approaches under consideration, taking also into account the ongoing deliberations at EU level on an EU Soil Law. It will also be explained how political buy-in should be achieved considering both the ecological and social services of soils and competing interests and stakes. The chapter ends with some conclusions and observations.