Persistent Difficulties Research Articles

Self-reported mental health in adolescents attending school and its association with later school dropout: A prospective 2.5-year follow-up study.

Mental health problems in young people are associated with educational outcomes. There are persistent difficulties in screening for these problems and mapping the trajectories of mental health in relation to academic and work outcomes. We investigated whether Strength and Difficulties Questionnaire (SDQ) scores in adolescents attending school were associated with school dropout in upper secondary school, both in adolescents with already recognised mental disorders and adolescents without known mental disorders. The data consisted of a questionnaire targeting 13,100 adolescents attending the final year of compulsory school combined with data derived from a national register. SDQ scores were divided into normal, borderline and abnormal scores. School dropout in upper secondary school was identified during a 2.5-years follow-up period. We stratified the data by recognised mental disorders. Logistic regression was performed to examine the association between SDQ scores and later school dropout with adjustment for parents' mental disorders, parents' educational level, sex, suicidal thoughts, school absence and negative childhood events. During follow-up, 18.5% of adolescents experienced school dropout. Adolescents with abnormally high SDQ scores and borderline SDQ scores had higher odds for school dropout than adolescents with SDQ scores in the normal range. The association remained in the adjusted analysis, although more covariates showed independent contributions in association with school dropout. Self-reported SDQ scores in adolescents attending school were associated with later school dropout irrespective of recognised mental disorders, indicating that markers such as the SDQ might contribute to the identification of vulnerable adolescent groups, although the findings of multifactorial contributions suggest we should consider more indicators in a risk assessment for school dropout.

Using Single-Photon Emission Computerized Tomography on Patients With Positive Quantitative Electroencephalogram to Evaluate Chronic Mild Traumatic Brain Injury With Persistent Symptoms.

BackgroundFollowing mild traumatic brain injury (mTBI), also known as concussion, many patients with chronic symptoms (>3 months post injury) receive conventional imaging such as computed tomography (CT) or magnetic resonance imaging (MRI). However, these modalities often do not show changes after mTBI. We studied the benefit of triaging patients with ongoing symptoms >3 months post injury by quantitative electroencephalography (qEEG) and then completing a brain single positron emission computed tomography (SPECT) to aid in diagnosis and early detection of brain changes.MethodsWe conducted a retrospective case review of 30 outpatients with mTBI. The patients were assessed by a neurologist, consented, and received a qEEG, and if the qEEG was positive, they consented and received a brain SPECT scan. The cases and diagnostic tools were collectively reviewed by a multidisciplinary group of physicians in biweekly team meetings including neurology, nuclear medicine, psychiatry, neuropsychiatry, general practice psychotherapy, neuro-ophthalmology, and chiropractic providers. The team noted the cause of injury, post injury symptoms, relevant past medical history, physical examination findings, and diagnoses, and commented on patients' SPECT scans. We then analyzed the SPECT scans quantitatively using the 3D-SSP software.ResultsAll the patients had cerebral perfusion abnormalities demonstrated by SPECT that were mostly undetectable by conventional imaging (CT/MRI). Perfusion changes were localized primarily in the cerebral cortex, basal ganglia, and cingulate cortex, and correlated with the patients' symptoms and examination findings. Qualitative and quantitative analyses yielded similar results. Most commonly, the patients experienced persistent headache, memory loss, concentration difficulties, depression, and cognitive impairment post mTBI. Because of their symptoms, most of the patients were unable to return to their previous employment and activity level.ConclusionOur findings outline the physical basis of neurological and psychiatric symptoms experienced by patients with mTBI. Increased detection of mTBI can lead to development of improved targeted treatments for mTBI and its various sequelae.

Broken or socially mistuned mirroring in ASD? An investigation via transcranial magnetic stimulation.

Individuals with an autism spectrum disorder (ASD) experience persistent difficulties during social interactions and communication. Previously, it has been suggested that deficits in the so-called "mirror system," active during both action execution and observation, may underlie these social difficulties. It is still a topic of debate however whether deficiencies in the simulation of others' actions (i.e., "broken" mirroring) forms a general feature of ASD, or whether these mostly reflect a lack of social attunement. The latter would suggest an overall intact mirror system, but an impaired modulation of mirror activity according to variable social contexts. In this study, 25 adults with ASD and 28 age- and IQ-matched control participants underwent transcranial magnetic stimulation during the observation of hand movements under variable conditions. Hand movements were presented via a live interaction partner, either without social context to assess basic motor mirroring or in combination with direct and averted gaze from the actor to assess socially modulated mirroring. Overall, no significant group differences were revealed, indicating no generally diminished mirror activity in ASD. Interestingly however, regression analyses revealed that, among ASD participants, higher symptom severity was associated with both reduced basic motor mirroring and aberrant socially modulated mirroring (i.e., no enhancement of mirror system activity upon observation of the interaction partner's direct vs. averted gaze). These findings further challenge the notion that mirror system dysfunctions constitute a principal feature of ASD, but demonstrate that variations in mirroring may be related to differential expressions of ASD symptom severity. LAY SUMMARY: Our findings show similar activity levels in brain regions responsible for action simulation and understanding in adults with autism, compared to adults without autism. However, the presence of more severe autism symptoms was linked to reduced activity in these regions. This suggests lower levels of brain activity during action understanding in some, but not all, persons with autism, which may contribute to the social difficulties these persons experience in daily life.

Indeterminacy in L1 French grammars: the case of gender and number agreement

AbstractAlthough L1 French speakers (FS) acquire the formal features of gender and number early, agreement appears to take longer, leading to persistent difficulties even for cases of straightforward agreement within a nominal or verbal phrase. This begs the questions of how adult FSs (n = 168) may fare with idiosyncratic cases of agreement such as nominal affective constructions and past participles as measured by a written grammaticality judgment /correction task and preference/grammaticality judgment task. The findings showing that participants performed better at correctly accepting than rejecting stimuli, are consistent with an increasing number of empirical studies revealing individual differences among adult L1 speakers. The findings are discussed from a generative perspective and the usage-based perspective of the Basic Language Cognition-High Language Cognition theory of L1 proficiency (Hulstijn, 2015).

The Impact of Parents’ Emotional Expression on Their Children with Specific Learning Disorders: The Role of Parental Educational Counseling Program

Background: According to the diagnostic and statistical manual of mental disorders, the fifth edition (DSM-5), specific learning disorders (SLDs) are neurodevelopmental disorders that share common features of persistent difficulty in learning key academic skills like reading, writing, or mathematics. Some children in different countries worldwide suffer from various forms of SLDs, which can be highly frustrating for a schoolchild, especially if associated with high (negative) parents' emotional expression (PEE).Aim: This study aimed to identify the relation between PEE and anxiety in children with SLD, and evaluate the effect of a parental educational counselling program (PECP) on the emotional expressions (EE) of parents and anxiety in children with SLD.Methods: A randomized controlled trial was conducted on 140 children with SLD and their parents at the Helwan University Educational Hospital's Learning Disability Unit (LDU) in Cairo, Egypt. The emotional expression scale (EES) of parents and Taylor manifest anxiety scale (TMAS) of children were used, and children's serum cortisol levels were measured as an anxiety marker. TMAS and EES were repeated after the conduction of 10 sessions of PECP. Serum cortisol samples were taken before PECP.Results: The study was revealed that more than half (60%) of studied children are suffered from morbid anxiety, and 80% of their parents practised high EE. Cortisol levels were significantly higher in children with severe& morbid anxiety, and in children whose parents practised high EE (P<0.001). After applying PECP, scores of TMAS demonstrated a significant drop from 33.06±10.4 to 25.85±10.4, and scores of EES showed a significant drop from 61.31±16.84 to 36.51±13.89. Conclusions: There was a statistically significant positive correlation between scores of TMAS& EES before and after PECP (r=0.533) and (r=0.309), respectively, proving the presence of a direct impact of PEE on the anxiety of studied children with SLDs.

Asymptomatic Middle Ear Dysfunction in Children with Upper Respiratory Infection – Analytical Cross Sectional Study

Introduction Otitis Media with Effusion (OME) is the commonest cause of hearing difficulty and one of the most frequent reasons for elective admission to the hospital for surgery during childhood. The condition starts with dysfunction of middle ear due to poor ventilation through Eustachian tube or extension of the inflammatory process from nasopharynx. In the natural history of the disease, there may be a period of the pre-clinical stage without symptoms or signs of OME. If the disease is identified in this stage, the further sequel of it (like persistent hearing difficulty or retraction pocket formation) may be prevented. Materials and Methods A hospital based analytical cross-sectional study was conducted among the children below 12 years of age to assess the middle ear function (by tympanometry) in children having upper respiratory tract infection (but no ear related complaints) and comparing them with the middle ear function in children not having such infection or any recent history of the same. Age and sex matched control group having no such symptoms was constructed. There were 25 children in both study and control group selected from Otorhinolaryngology and Pediatrics outpatient department (OPD). So total numbers of children were 50. Results There was no statistically significant difference in background characteristics (age, sex) of the of study and control groups. There was no statistically significant difference when the tympanic membrane retraction or middle ear pressure is taken into account. But significant difference found in the parameters like middle ear compliance (68% children have low compliance in the study group vs 20% in control, with df= 1, ϰ2 = 11.688 and p value was 0.001) and tympanogram curve type (48% in study group have B or C type and 8% have such in control group). Conclusion Early diagnosis of the middle ear dysfunction among the children with upper respiratory infection, by clinical examination and suitable audiological investigation in the pre-clinical stage with appropriate intervention can prevent further progression of the disease, causing hearing loss as well as retraction pocket formation.

Clinical outcomes in transient epileptic amnesia: A 10-year follow-up cohort study of 47 cases.

ObjectiveTransient epileptic amnesia (TEA) is a form of adult‐onset epilepsy where presenting features are well described, but little is known regarding prognosis. This study aimed to elucidate the long‐term prognosis of TEA regarding seizure control, memory, medical comorbidities, and life expectancy.MethodsUp‐to‐date clinical information was collected for 47 people diagnosed with TEA who had joined the The Impairment of Memory in Epilepsy (TIME) study 10 years earlier. At entry to the study, information about comorbid conditions was systematically collected. Details regarding subsequent diagnoses, seizure activity, changes to treatment, or reports of cognitive impairment were obtained through the family doctor. The variables of interest were compared with UK population data.ResultsMortality in the cohort was 21 of 47 (45%), with an average age at death of 82.5 years. Seizures remained well controlled for the majority but medications required adjustments in dose and type for some (28%). A small number (three cases) remained seizure‐free without medication. History of cardiovascular disorders was frequent (78.7%), typically involving hypertension (55.3%). Autoimmune disorders (25.5%), cancer (23.4%), and depression (21.3%) were also commonly reported. Although persisting memory problems were often noted, dementia was diagnosed in seven cases (14.9%). Life expectancy and comorbidities in TEA did not differ from available population norms.SignificanceResults suggest that life expectancy is not reduced in TEA. Although TEA does not appear to be a self‐limiting form of epilepsy, seizures are typically well controlled via medication. Because adjustments to medication may be required, even after long periods of stability, ongoing medical monitoring is recommended. Comorbid vascular disorders are frequent but appear similar to general population estimates. Monitoring mood may be important, given that people with chronic conditions are often vulnerable to depression. Because of persisting memory difficulties, the development of effective memory interventions for people with TEA is warranted.

Knowledge of Fractions of Learners in Slovakia

In this research, we set two main goals: to provide empirical data that point to the knowledge of fractions among fifth-grade primary school pupils on a national scale; and to determine the level of knowledge about fractions among university students, including future primary school teachers. We used two tests—the national-wide test T5 for the fifth-graders (a research sample of approximately 45,000 pupils), and the modified fraction test based on Sfard’s theory of reification, for the university students (162 students). At the end of the study, we focused on a content analysis of the university students’ solutions. We identified persistent difficulties with concepts of fractions not only by fifth graders but also by future primary school teachers.

Longitudinal Course of Sleep Disturbance and Relationship With Itch in Adult Atopic Dermatitis in Clinical Practice.

Sleep disturbance (SD) is common in atopic dermatitis (AD). We examined the longitudinal course of SD and relationship with itch in AD patients. A prospective, dermatology practice-based study was performed (N = 1295) where patients were assessed at baseline and follow-up visits. At baseline, 16.9% of the patients had severe SD based on Patient-Reported Outcomes Information System (PROMIS) SD T scores, 19.1% had difficulty falling asleep, 22.9% had difficulty staying asleep, and 34.2% had SD from AD. A total of 31.4% of the patients with difficulty staying asleep at baseline experienced persistent difficulties (for 3 follow-ups or more). Only 17.7% with baseline difficulty falling asleep had persistent disturbance. Despite significant fluctuation in sleep scores, SD generally improved over time. Of the patients facing baseline SD from AD, 31.5% experienced SD at the first visit, and only 12.3% experienced persistent SD at the second follow-up visit. Predictors of increased PROMIS sleep-related impairment T scores over time included baseline PROMIS sleep-related impairment T scores (0.74 [0.68-0.80]), having 3 to 6 nights of itch (2.22 [0.85-3.59]), and severe/very severe AD (4.40 [2.60-6.20]). A significant proportion of adult AD patients, particularly those with moderate-severe AD and frequent itch, had baseline SD. Although sleep scores generally improved over time, many patients experienced a fluctuating or persistent course.

EP188: Novel HECW2 variant presenting with tachypnea and multisystemic congenital malformations

HECW2, otherwise known as NEDL2, encodes for a member of the HECT family of E3 ubiquitin ligases and stabilizes p73, a key mediator in neurodevelopment. HECW2 is primarily expressed in the brain, heart, and lungs. Heterozygous variants have been associated with developmental delays, intellectual disability, epilepsy, hypotonia, scoliosis and dysmorphic features. Systemic complications which have been reported include cardiomyopathy, skeletal abnormalities including pectus excavatum, and various brain abnormalities including white matter disease, cortical atrophy, ex-vacuo ventriculomegaly, and thinning of the corpus callosum. While many reported cases of HECW2-related disorder have been from de novo variants, there have been reports of familial inheritance with variable expressivity. To date, there have been no reported cases of HECW2-related disorder presenting with persistent tachypnea. A newborn male with a history of intrauterine growth restriction born at 39 2/7 weeks gestation to a 31 year old G4P0212 mother and a 35 year old father presented in the perinatal period with unexplained persistent tachypnea, difficulty feeding, persistent diaphoresis and failure to thrive. Pectus excavatum was noted at birth and initial evaluation for the persistent tachypnea showed multiple vertebral anomalies, congenital scoliosis and mild cardiomegaly on chest X-ray. Renal ultrasound demonstrated left central calyceal dilation. Echocardiogram and CT heart with contrast demonstrated multiple abnormalities including anomalous pulmonary venous return with right upper pulmonary vein draining into the superior vena cava (SVC), secundum atrial septal defect (ASD), dilated main pulmonary artery, right atrium and ventricle, mild right and left ventricular hypertrophy, mild tricuspid regurgitation and mild to moderate pulmonary regurgitation. CT imaging also demonstrated severe tracheobronchomalacia associated with left mainstem bronchus compression resulting in air trapping within the left lung. Cardiac catheterization was attempted for possible closure of the patient’s secundum ASD, but was unsuccessful due to inability to capture retroaortic rim. Diagnostic evaluation during catheterization demonstrated mild pulmonary hypertension, normal pulmonary vascular resistance (PVR) and a Qp:Qs of 1.9:1 consistent with pulmonary overcirculation. Tachypnea and significantly increased work of breathing persisted despite initiation of furosemide diuresis to manage pulmonary overcirculation. The patient ultimately required BiPap for respiratory support, though tachypnea persisted. A G-tube was placed to ensure safe formula administration. Additional physical exam findings included hypotonia, macrocephaly, infraorbital creases with almond-shaped eyes, ocular hypertelorism, broad nasal bridge and tip, mild retrognathia, arachnodactyly with larger hands and feet compared to growth centiles and Y-shaped gluteal fold. Family history was remarkable for White ancestry. A maternal half-sister was healthy. A 2 year old brother had speech delay. The patient’s father had a history of mild congenital scoliosis, heart murmur and intellectual disability. The patient’s mother had a history of anemia, heart murmur and learning delays. There was no history of genetic conditions, recurrent pregnancy loss, or infant death. Chromosomal microarray analysis (CMA) demonstrated no clinically significant findings (ISCN: arr[hg19](1-22x2,(X,Y)x1). Trio exome sequencing with mitochondrial analysis, performed from a peripheral blood sample, demonstrated a paternally inherited likely pathogenic variant in HECW2 (NM_020760.1:c.2581 C>T) in exon 11. While this variant has not been previously published as benign or pathogenic, in silico analysis demonstrated a potential deleterious effect of the arginine to tryptophan substitution on structure and/or function. Mitochondrial analysis was negative/normal. We present the first documented case of HECW2-related disorder presenting with perinatal tachypnea. The patient’s hypotonia, feeding difficulties, dysmorphic features, pectus excavatum, vertebral malformations, scoliosis, and cardiac involvement correlate with previously described manifestations of HECW2-related disorder.

481 Subacute Cell Specific Gene Expression Changes After Experimental TBI Suggest Target Genes for Cognitive Dysfunction

INTRODUCTION: Approximately 1.8 million Americans suffer from traumatic brain injury (TBI) each year, many of whom develop persistent cognitive difficulties. Understanding gene expression changes in cell types important for cognitive function may provide insight for therapeutic targets. METHODS: The dentate gyrus was dissected from the hippocampi of adult Sprague Dawley rats three weeks after either control or moderate lateral fluid percussion injury. Nuclei were isolated, the RNA was extracted, and sequenced using 10X Genomics technology. The RNA sequences were mapped to the rat genome (Rnor 6.0), quantified, and their expression normalized. Clustering of nuclei based on their gene expression profiles was done using Seurat (v4.0.1; R version 4.0.5). The granule cell cluster from each sample was identified based on expression of Prox1 and Rfx3, along with other neuronal markers. Genes with significant negatively correlated expressions between conditions were identified as differentially expressed and their functions were explored through Gene Ontology (GO). RESULTS: We identified a total of 14819 genes expressed in the granule cell clusters. Of these, 85 were differentially expressed. We identified twelve statistically significant biological processes using GO terms. GO terms with implications for cognitive function included: memory (p=0.000191, GO:0007613), negative regulation of amyloid-beta formation (p=0.000192, GO:1902430), and protein-lipid complex assembly (p=0.000192, GO:0065005). Statistically significant genes of interest associated with GO terms were under-expressed in the TBI condition: Apoe (p=0.00039), Atad1 (p=0.000013), Cpe (p=0.000438), and Dbn1 (0.002505). CONCLUSION: Three weeks after experimental TBI, hippocampal dentate granule cells under-express genes important for neurotransmitter receptor trafficking and neuronal survival. Future studies with cell-specific methodologies may yield targets for therapeutic strategies to improve cognitive dysfunction after TBI.

Serological survey of anti-Leptospira spp. antibodies in individuals with animal hoarding disorder and their dogs in a major city of Southern Brazil.

BackgroundIndividuals with hoarding disorder (HD) presented a persistent difficulty in detaching from objects and/or animals. Unhealthy conditions, frequently found in cases of animal HD (AHD), may favour environmental contamination and the spread of zoonotic pathogens. Despite that, only one study of zoonotic diseases in individuals with AHD and their companion animals has been conducted to date.ObjectivesThis study aimed to assess the seroprevalence of anti‐Leptospira spp. antibodies in individuals with AHD and their dogs in a major city of Southern Brazil.MethodsBlood samples were obtained from 264 dogs (21 households) and 19 individuals with AHD (11 households) and tested by microscopic agglutination test.ResultsAll human samples were seronegative. Seropositivity was found in 16/264 (6.1%; CI 95% 3.3–9.6%) dogs from 11/21 (52.38%) households, with titres ranging from 100 up to 400, and Copenhageni (10/16; 62.5%) was the most frequent serovar. Surprisingly, seropositivity of hoarded dogs found herein was among the lowest reportedly observed in other dog populations of Brazil. Two epidemiological variables were significantly associated with seropositivity in dogs: the presence of cat hoarding (p = 0.004) and the report of flood occurrence in the household (p = 0.031).ConclusionsNo individuals with AHD were seropositive, and besides the lower seroprevalence of dogs, they probably had contact with Leptospira spp. at some point in their life. Since dogs can be considered potential sentinels in leptospirosis, public health programs must become aware of the risk of leptospirosis cases in households of individuals with AHD and nearby communities.

Positive Emotion Dysregulation in Posttraumatic Stress Disorder

Although PTSD is associated with both emotion regulation (ER) difficulties and persistent difficulties experiencing positive emotions, research concerning positive ER in PTSD is still scarce. We aimed to clarify whether PTSD patients show dysfunctional responses to positive emotions and whether positive ER is associated with PTSD symptom severity. PTSD patients (N=59) were compared to healthy controls (HC, N=58) with respect to their self-reported regulation of positive and negative emotions. We used the Responses to Positive Affect Questionnaire to assess positive ER and the Difficulties in Emotion Regulation Scale and Response Styles Questionnaire to assess negative ER. PTSD patients showed deficient negative as well as deficient positive ER as compared to HC. Both dampening of positive emotions as well as positive rumination were associated with self-reported symptom severity. Furthermore, dampening contributed to the prediction of PTSD symptom severity beyond depressive symptoms and negative rumination. This study supports and expands previous findings of dysfunctional positive ER in PTSD. Further research is needed to clarify whether deficits in positive ER contribute to the onset and maintenance of PTSD. If so, therapeutic approaches should aim to help PTSD patients build up adequate skills to handle positive emotions in PTSD.

Despite Addition to DSM, Few Treatments Emerge for Hoarding Disorder

Despite Addition to <i>DSM</i>, Few Treatments Emerge for Hoarding Disorder

Effects of COVID-19 on child health services utilization and delivery in rural Mozambique: a qualitative study.

Little is known about the COVID-19 pandemic-related disruptions in health services and the resilience of the health system response in rural low-resource settings. We conducted a phenomenological qualitative study (October-November 2020) to understand COVID-19-related influences on the utilisation and delivery of child health services in Monapo district, rural Mozambique. We interviewed 36 caregivers with children <2.5 years, 21 health providers, and 4 district health services staff using in-person in-depth interviews. Data were analysed using inductive thematic content analysis. Our findings showed that caregivers, providers, and district health services staff unanimously reported a decrease in child consultations at the start of the pandemic. Administrative data from health facilities confirmed persisting declines in monthly consultations. Respondents explained reductions due to miscommunication about health facility operations, fear of COVID-19, reduced consultation schedules, and reduced household incomes. Providers reported several challenges in delivering services including lack of caregiver compliance with risk mitigation measures, caregivers’ fear of risk mitigation measures, perceived lack of caregiver knowledge about COVID-19, and lack of supplies and protective equipment. All respondents described how COVID-19 had increased food insecurity and food prices, and reduced incomes and livelihoods. These negative economic consequences were perceived as the main reason for reported increases in cases of child malnutrition. Despite reductions, child health service utilisation and delivery has largely continued throughout the COVID-19 pandemic, indicating an adaptive and resilient primary health system response in Monapo district. Our findings highlighted the persistent difficulties providers and caregivers face adhering to COVID-19 prevention and risk mitigation measures. A coordinated multi-sectoral response is needed to address the persistent negative economic impacts of the pandemic for young children and their families in rural areas.

Post-traumatic Stress Disorder Symptoms and Quality of Life of COVID-19 Survivors at 6-Month Follow-Up: A Cross-Sectional Observational Study.

Background: Post-traumatic stress disorder (PTSD) is the most common psychiatric sequelae among novel coronavirus disease (COVID-19) patients. The aim of this study was to determine the prevalence of PTSD symptoms, PTSD-related factors, and its relationship with quality of life at long-term follow-up in hospitalized COVID-19 survivors.Methods: A cross-sectional study was undertaken to evaluate the health consequences of hospitalized COVID-19 survivors. All participants were interviewed face-to-face through a series of questionnaires: a researcher-developed symptom questionnaire, the Post-traumatic Stress Disorder Checklist–Civilian Version, the Generalized Anxiety Disorder 7-item, and the 36-item Short Form.Results: A total of 574 participants were enrolled with an average age of 57 years. The median follow-up time post-discharge was 193.9 days (SD = 15.32). Among the participants, 77.9% of survivors presented with at least one symptom, where fatigue or muscle weakness (47.9%) was reported the most frequently, followed by chest distress (29.4%) and sleep difficulty (29.4%). The prevalence of PTSD was 11.15% [95% confidence interval (CI): 8.56, 13.73] with a cut-off score of 44. Factors such as respiratory symptoms [odds ratio (OR): 3.53; 95% CI: 1.68–7.42], anxiety (OR: 14.64; 95% CI: 7.09–30.21), and sleep difficulty (OR: 2.17; 95% CI: 1.14–4.16) were positively related to PTSD. Those COVID-19 survivors with potential PTSD had significantly lower quality of life than those without (P < 0.05).Conclusion: Our study illustrated that a significant number of COVID-19 survivors were suffering from physical or mental distress to varying degrees at 6 months post-discharge. People with PTSD were more likely to experience persistent respiratory symptoms and sleep difficulty, as well as anxiety and a decreased quality of life. Such survivors require greater attention to their mental health, particularly the PTSD symptoms at the early phase, which may play an important role in the recovery of both the physical and psychological health of COVID-19 survivors.

Development of communicative competencies among junior schoolchildren with learning difficulties in e-learning conditions

The article reviews the problem of forming communicative competencies among junior schoolchildren with persistent learning difficulties. Features of speech development of this category of students are disclosed. Modern scientific ideas about the structure of communicative universal educational actions are considered. Speech and socio-psychological skills are defined, which form the basis of each structural component of communicative universal educational actions. Method of diagnostics of communicative universal actions in students with persistent learning difficulties and peculiarities of development of communicative universal educational actions identified in them during diagnostics are presented. The stages of pedagogical activity on formation of communicative universal educational actions in junior schoolchildren with persistent difficulties in learning are indicated.

Modelo RTI em escolas públicas e transtorno de aprendizagem: uma revisão sistemática da literatura

The Response to Intervention (RTI) model is an early detection and intervention system at three levels (classroom intervention by the teacher, by specialists in small groups and individual) to identify signs of Learning Disorder (LD). LD is a neurodevelopmental disorder that is characterized by persistent difficulties in reading, writing and/or math skills. In the United States the model is used and presents statistically significant results, but in Brazil there is little research and investment about it. It is common to use it to identify signs of LD, but there are no studies with consistent evidence on improvement results outside the United States. The objective is to systematically review the literature on the RTI model for the identification and intervention of signs and symptoms of LD; identify the study site, method used, assessment and intervention instruments, and results; identify methodological gaps and make suggestions for future studies; provide guidelines for possible applications in Brazil. Hypotheses: RTI indicates signs of disorders other than LD; there are variations in the assessment and intervention instruments; there is a shortage of Brazilian studies. For this, articles published in PubMed, Scielo and Google Scholar, from 2005 to 2022, will be selected, with the descriptors “RTI” or “Resposta à Intervenção", “E”, “Transtorno específico de Aprendizagem” and in English “Response to Intervention" and "AND", "Specific learning disorder". Duplicates will be removed. The review will be carried out by a Psychology evaluator and a Pedagogy evaluator. Screening will be carried out through the reading of abstracts, controlled clinical studies, randomized or not, with control groups; in Elementary Education of public schools; with N≥30. A new screening will be done based on compliance with ethical assumptions. There will be a critical analysis of the methods, results, suggestions for future studies and applications in Brazil.

A systematic review of the academic achievement of primary and secondary school-aged students with developmental language disorder.

The ability to communicate is a fundamental skill required to participate in school. Students with Developmental Language Disorder (DLD) have persistent and significant language difficulties that impact daily functioning. However, the impact of DLD on the academic achievement of primary and secondary school-aged students has received limited attention. A systematic review of the empirical research published between 2008 and 2020 was undertaken to identify studies that have examined the academic achievement of school-aged students with DLD within curriculum areas. A total of 44 studies were identified that met inclusion criteria for review. Students with DLD demonstrated difficulties with academic achievement across all measured curriculum areas compared to their typically developing peers. Most studies focused on literacy skills, including reading, spelling, writing and narratives. The performance of students with DLD was heterogeneous with individual students demonstrating relative strengths in some areas of academic achievement. The implications of these results for educational practices and future research are discussed.

Structural language impairment in Autism Spectrum Disorder versus Loss of Autism Diagnosis: Behavioral and neural characteristics

This study probed for structural language impairment using behavioral and functional neuroimaging methods in individuals with Autism Spectrum Disorder (ASD) and those diagnosed with ASD in childhood who no longer meet criteria for ASD, referred to as Loss of Autism Diagnosis (LAD1). Participants were drawn from Fein et al. (2013): ASD (n = 35), LAD (n = 31), and Neurotypical (NT; n = 34). Criteria for structural language impairment were: Scores ≤ 82 on Clinical Evaluation of Language Fundamentals-4 (CELF) Core Language, an omnibus measure of language; and scores ≤ 7 on CELF Recalling Sentences, a clinical marker of structural language impairment. Task-based fMRI examined lateralization of significantly activated language-related brain regions in groups with structural language impairment (LI2) versus normal-range language (LN3), collapsed across ASD, LAD1, and NT status. Results showed no ASD versus LAD group differences in the proportion of participants with structural language impairment according to either metric (Recalling Sentences or Core Language). Functional MRI results indicated greater left hemisphere lateralization within significantly activated regions in the LI2 group. Structural language abilities were not meaningfully associated with either social abilities or lifetime ADHD symptoms in LI2 subgroups, further suggesting the presence of structural language impairment. Findings indicate the presence of persistent structural language difficulty even in the absence of ASD symptoms in some individuals within the LAD1 group and unique patterns of language-related neural specialization for language function in LI2 relative to LN3.