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Sensors (Basel, Switzerland) Oct 2021Five to ten percent of school-aged children display dysgraphia, a neuro-motor disorder that causes difficulties in handwriting, which becomes a handicap in the daily...
Five to ten percent of school-aged children display dysgraphia, a neuro-motor disorder that causes difficulties in handwriting, which becomes a handicap in the daily life of these children. Yet, the diagnosis of dysgraphia remains tedious, subjective and dependent to the language besides stepping in late in the schooling. We propose a pre-diagnosis tool for dysgraphia using drawings called graphomotor tests. These tests are recorded using graphical tablets. We evaluate several machine-learning models and compare them to build this tool. A database comprising 305 children from the region of Grenoble, including 43 children with dysgraphia, has been established and diagnosed by specialists using the BHK test, which is the gold standard for the diagnosis of dysgraphia in France. We performed tests of classification by extracting, correcting and selecting features from the raw data collected with the tablets and achieved a maximum accuracy of 73% with cross-validation for three models. These promising results highlight the relevance of graphomotor tests to diagnose dysgraphia earlier and more broadly.
Topics: Agraphia; Algorithms; Child; Data Management; Handwriting; Humans; Machine Learning
PubMed: 34770333
DOI: 10.3390/s21217026 -
Deep Learning and Procrustes Analysis for Early Dysgraphia Risk Detection with a Tablet Application.Life (Basel, Switzerland) Feb 2023Dysgraphia is a neurodevelopmental disorder specific to handwriting. Classical diagnosis is based on the evaluation of speed and quality of the final handwritten text:...
Dysgraphia is a neurodevelopmental disorder specific to handwriting. Classical diagnosis is based on the evaluation of speed and quality of the final handwritten text: it is therefore delayed as it is conducted only when handwriting is mastered, in addition to being highly language-dependent and not always easily accessible. This work presents a solution able to anticipate dysgraphia screening when handwriting has not been learned yet, in order to prevent negative consequences on the individuals' academic and daily life. To quantitatively measure handwriting-related characteristics and monitor their evolution over time, we leveraged the Play-Draw-Write iPad application to collect data produced by children from the last year of kindergarten through the second year of elementary school. We developed a meta-model based on deep learning techniques (ensemble techniques and Quasi-SVM) which receives as input raw signals collected after a processing phase based on dimensionality reduction techniques (autoencoder and Time2Vec) and mathematical tools for high-level feature extraction (Procrustes Analysis). The final dysgraphia classifier can identify "at-risk" children with 84.62% Accuracy and 100% Precision more than two years earlier than current diagnostic techniques.
PubMed: 36983754
DOI: 10.3390/life13030598 -
Cureus Apr 2024Alexia without agraphia is a striking vascular syndrome of the acquired inability to read words just written down. This syndrome occurs after lesions in the splenium of...
Alexia without agraphia is a striking vascular syndrome of the acquired inability to read words just written down. This syndrome occurs after lesions in the splenium of the corpus callosum that disconnect the angular gyrus from the visual pathway. Most of the time, a lesion in the left occipital lobe is also present, and patients present with a visual field deficit. It is a classic neurological syndrome that is rarely seen. We present two cases of alexia without agraphia seen in our hospital the same week.
PubMed: 38752100
DOI: 10.7759/cureus.58309 -
The American Journal of Occupational... Sep 2023Handwriting legibility and speed assessments have a critical role in identifying and evaluating handwriting problems, which are common among children.
IMPORTANCE
Handwriting legibility and speed assessments have a critical role in identifying and evaluating handwriting problems, which are common among children.
OBJECTIVE
The objective was to evaluate the psychometric properties and clinical utility of handwriting assessments for children ages 3 to 16 yr.
DATA SOURCES
A systematic review was conducted in CINAHL, PubMed (MEDLINE), Scopus, and education databases, with no time limits. The search strategy included a combination of the following keywords: handwriting, write, children, assessment, and validity. The exclusion criteria were assessment tools that were electronic, that focused on cognitive components of handwriting, or that only evaluated alphabets other than Latin.
STUDY SELECTION AND DATA COLLECTION
The systematic review was carried out on the basis of the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. The protocol was registered in the Prospective Register of Systematic Reviews (PROSPERO).
FINDINGS
The 14 included instruments had a total sample of 4,987 children. Internal consistency ranged from moderate (.73; Writing Readiness Inventory Tool in Context) to high (.98; Letter Writing). The interexaminer reliability values of the 11 direct assessment instruments ranged from .77 (Systematic Screening for Handwriting Difficulties) to 1.00 (Handwriting Speed Test).
CONCLUSIONS AND RELEVANCE
In this systematic review, existing tools were evaluated by clinical utility and the quality of psychometric properties. Direct assessments showed good psychometric properties. Indirect and self-assessment tools demonstrated poor psychometric properties. Further research on screening tools and tools in other languages is needed. What This Article Adds: Specific learning disorders (e.g., dysgraphia) negatively affect academic learning and, when prolonged in time, self-concept. However, handwriting legibility and speed assessments could be used to identify and evaluate these learning disorders if an early referral to occupational therapy is carried out.
Topics: Humans; Child; Psychometrics; Reproducibility of Results; Handwriting; Agraphia; Checklist
PubMed: 37877571
DOI: 10.5014/ajot.2023.050174 -
Neuropsychologia Dec 2019The semantic variant of primary progressive aphasia (sv-PPA) is a degenerative condition which causes surface dyslexia/dysgraphia, resulting in reading/writing errors of...
The semantic variant of primary progressive aphasia (sv-PPA) is a degenerative condition which causes surface dyslexia/dysgraphia, resulting in reading/writing errors of irregular words with non-transparent grapheme-to-phoneme correspondences (e.g., 'plaid') as opposed to regular words (e.g., 'cat'). According to connectionist models, most authors have attributed this deficit to semantic impairments, but this assumption is at odds with symbolic models, such as the DRC account, stating that the reading/writing of irregulars relies on the mental lexicon. Our study investigated whether sv-PPA affects the lexicon in addition to the semantic system, and whether semantic or lexical deficits cause surface dyslexia/dysgraphia, while challenging the two major models of written language. We explored a cohort of 12 sv-PPA patients and 25 matched healthy controls using a reading and writing task, a semantic task (category decision: living vs. non-living), and a lexical task (lexical decision: word vs. no-neighbor non-word). Correlation analyses were conducted to assess the relationship between reading/writing scores of irregulars and semantic vs. lexical performance. Furthermore, item-by-item analyses explored the consistency of reading/writing errors with item-specific semantic and lexical errors. Results showed that sv-PPA patients are impaired at reading and writing irregular words, and that they have impaired performance in both the semantic and the lexical task. Reading/writing scores with irregulars correlated significantly with performance in the lexical but not the semantic task. Item-by-item analyses revealed that failure in the lexical task on a given irregular word is a good predictor of reading/writing errors with that item (positive predictive value: 77.5%), which was not the case for the semantic task (positive predictive value: 42.5%). Our findings show that sv-PPA is not restricted to semantic damage but that it also comprises damage to the mental lexicon, which appears to be the major factor for surface dyslexia/dysgraphia. Our data support symbolic models whereas they challenge connectionist accounts.
Topics: Aged; Agraphia; Aphasia, Primary Progressive; Cohort Studies; Decision Support Techniques; Dyslexia; Female; Humans; Language Tests; Male; Middle Aged; Neuropsychological Tests; Semantics
PubMed: 31682928
DOI: 10.1016/j.neuropsychologia.2019.107241 -
International Journal of Language &... Mar 2022Intervention studies aimed to improve the written production of single words by persons with aphasia have yielded promising results and there is growing interest in...
BACKGROUND
Intervention studies aimed to improve the written production of single words by persons with aphasia have yielded promising results and there is growing interest in interventions targeting text writing. The development of technical writing aids offers opportunities for persons with aphasia, and studies have shown that using them can have a positive impact on written output.
AIMS
The aim was to investigate what impact training to use a computerised spell checker had on text writing in persons with aphasia.
METHODS & PROCEDURES
The study had a multiple-baseline single-case experimental design replicated across six male Swedish participants with mild-to-moderate post-stroke aphasia. The participants received training twice a week during 8 weeks, learning how to use the spell checker. At baseline and before every session, the participants wrote two texts which were logged in a keystroke-logging tool. Dependent variables were continuously measured in the texts, and the participants performed tests of language function and answered questionnaires on reading and writing habits and health-related quality of life before and after the intervention. The participants were also interviewed about how they had experienced the training. The results were evaluated on individual and group level.
RESULTS
The study showed that systematic individual training involving a spell checker was experienced as positive by the participants and that they all described their writing ability in more positive terms after the intervention. Evaluation showed statistically significant improvements on group level for the dependent variables of spelling accuracy, rated syntax, writing speed and proportion of unedited text during text writing when using the spell checker. The intervention also had a generalising effect on writing speed and editing during text writing without the spell checker and on spelling accuracy in a dictation test. The participants who had the greatest spelling problems were the ones who showed the most progress, but participants with only minor writing difficulties at baseline also improved.
CONCLUSIONS & IMPLICATIONS
The study shows that a digital spelling aid constitutes effective support for people with aphasia and may also affect levels other than spelling. The training had a generalising positive effect on text writing and spelling in a test. Although writing difficulties is a persisting symptom in aphasia, it can be supported and improved through use of digital spelling aids. Hence, treatment of writing ability should always be included in the rehabilitation of people with aphasia.
WHAT THIS PAPER ADDS
What is already known on this subject Use of a technical writing aid can have a positive impact on the written output of persons with aphasia. Using a digital spell checker may improve spelling as well as other levels of writing, but it has not been investigated using a keystroke-logging tool in combination with language-test scores and results from questionnaires. What this paper adds to existing knowledge Through analyses on both individual and group level, this study shows that a digital spelling aid constitutes effective support for people with aphasia and also affects levels other than spelling. The training had a generalising positive effect on text writing and spelling in a test. What are the potential or actual clinical implications of this work? Digital spelling support, which is a relatively simple and inexpensive technology, can support and improve text writing in persons with post-stroke aphasia.
Topics: Humans; Male; Agraphia; Aphasia; Language; Quality of Life; Writing
PubMed: 35092331
DOI: 10.1111/1460-6984.12696 -
Brain Communications 2022The Gerstmann syndrome is a constellation of neurological deficits that include agraphia, acalculia, left-right discrimination and finger agnosia. Despite a growing...
The Gerstmann syndrome is a constellation of neurological deficits that include agraphia, acalculia, left-right discrimination and finger agnosia. Despite a growing interest in this clinical phenomenon, there remains controversy regarding the specific neuroanatomic substrates involved. Advancements in data-driven, computational modelling provides an opportunity to create a unified cortical model with greater anatomic precision based on underlying structural and functional connectivity across complex cognitive domains. A literature search was conducted for healthy task-based functional MRI and PET studies for the four cognitive domains underlying Gerstmann's tetrad using the electronic databases PubMed, Medline, and BrainMap Sleuth (2.4). Coordinate-based, meta-analytic software was utilized to gather relevant regions of interest from included studies to create an activation likelihood estimation (ALE) map for each cognitive domain. Machine-learning was used to match activated regions of the ALE to the corresponding parcel from the cortical parcellation scheme previously published under the Human Connectome Project (HCP). Diffusion spectrum imaging-based tractography was performed to determine the structural connectivity between relevant parcels in each domain on 51 healthy subjects from the HCP database. Ultimately 102 functional MRI studies met our inclusion criteria. A frontoparietal network was found to be involved in the four cognitive domains: calculation, writing, finger gnosis, and left-right orientation. There were three parcels in the left hemisphere, where the ALE of at least three cognitive domains were found to be overlapping, specifically the anterior intraparietal area, area 7 postcentral (7PC) and the medial intraparietal sulcus. These parcels surround the anteromedial portion of the intraparietal sulcus. Area 7PC was found to be involved in all four domains. These regions were extensively connected in the intraparietal sulcus, as well as with a number of surrounding large-scale brain networks involved in higher-order functions. We present a tractographic model of the four neural networks involved in the functions which are impaired in Gerstmann syndrome. We identified a 'Gerstmann Core' of extensively connected functional regions where at least three of the four networks overlap. These results provide clinically actionable and precise anatomic information which may help guide clinical translation in this region, such as during resective brain surgery in or near the intraparietal sulcus, and provides an empiric basis for future study.
PubMed: 35706977
DOI: 10.1093/braincomms/fcac140 -
Cognitive Neuropsychology 2023We report on two types of developmental surface dysgraphia. One type, exhibited by 8 participants, is , which involves an impairment in the orthographic output lexicon,...
We report on two types of developmental surface dysgraphia. One type, exhibited by 8 participants, is , which involves an impairment in the orthographic output lexicon, leading to nonword phonologically-plausible misspellings. The other type, shown by 3 participants, is . In this type, the orthographic output lexicon is disconnected from the semantic system and from the phonological input lexicon, but still contributes to spelling via support to the orthographic output buffer, resulting in mainly lexical phonologically-plausible misspellings (writing as "bee" but not "bea").The specific localization of the impairment in spelling, in the lexicon or in its connections, allowed us to examine the question of one or two orthographic lexicons; four participants who had a deficit in the orthographic output lexicon itself in writing had intact orthographic-input-lexicon in reading. They made surface errors in writing but not in reading the same words, supporting separate input and output orthographic lexicons.
Topics: Humans; Bees; Animals; Dyslexia; Agraphia; Phonetics; Language; Semantics
PubMed: 38062780
DOI: 10.1080/02643294.2023.2280220 -
Scientific Reports Apr 2021Language outcomes after speech and language therapy in post-stroke aphasia are challenging to predict. This study examines behavioral language measures and resting state...
Language outcomes after speech and language therapy in post-stroke aphasia are challenging to predict. This study examines behavioral language measures and resting state fMRI (rsfMRI) as predictors of treatment outcome. Fifty-seven patients with chronic aphasia were recruited and treated for one of three aphasia impairments: anomia, agrammatism, or dysgraphia. Treatment effect was measured by performance on a treatment-specific language measure, assessed before and after three months of language therapy. Each patient also underwent an additional 27 language assessments and a rsfMRI scan at baseline. Patient scans were decomposed into 20 components by group independent component analysis, and the fractional amplitude of low-frequency fluctuations (fALFF) was calculated for each component time series. Post-treatment performance was modelled with elastic net regression, using pre-treatment performance and either behavioral language measures or fALFF imaging predictors. Analysis showed strong performance for behavioral measures in anomia (R = 0.948, n = 28) and for fALFF predictors in agrammatism (R = 0.876, n = 11) and dysgraphia (R = 0.822, n = 18). Models of language outcomes after treatment trained using rsfMRI features may outperform models trained using behavioral language measures in some patient populations. This suggests that rsfMRI may have prognostic value for aphasia therapy outcomes.
Topics: Aged; Aphasia; Brain; Brain Mapping; Female; Humans; Language Therapy; Magnetic Resonance Imaging; Male; Middle Aged; Patient-Specific Modeling; Prognosis; Stroke; Stroke Rehabilitation; Treatment Outcome
PubMed: 33875733
DOI: 10.1038/s41598-021-88022-z -
PloS One 2022Adults with specific learning disabilities (e.g., dyslexia, dysgraphia, and dyscalculia) reveal limitations in daily functioning in various life domains. Following...
Adults with specific learning disabilities (e.g., dyslexia, dysgraphia, and dyscalculia) reveal limitations in daily functioning in various life domains. Following previous evidence of deficient executive functions and unique sensory patterns in this population, this study examined how relationships between these two domains are expressed in daily functioning. Participants included 55 adults with specific learning disabilities and 55 controls matched by age, gender, socioeconomic status, and education. Participants completed a sociodemographic questionnaire, the Behavioral Rating Inventory of Executive Functions-adult version, and the Adolescent/Adult Sensory Profile. Results indicated significant relationships between executive functions (per the Behavioral Rating Inventory of Executive Functions-adult version) and sensory patterns (per the Adolescent/Adult Sensory Profile) as reflected in daily functioning. The low sensory registration pattern predicted 12% to 16% of the variance in the behavioral regulation index, metacognitive index, and general executive composite scores and was a significant predictor of specific executive function abilities. Results indicated that the difficulties of adults with specific learning disabilities in using executive function abilities efficiently might be tied to a high sensory threshold and passive self-regulation strategies. A deeper understanding of this population's sensory-executive mechanisms may improve evaluation and intervention processes. This understanding can consequently increase executive abilities for improved daily functioning and life satisfaction.
Topics: Adolescent; Adult; Executive Function; Humans; Learning Disabilities; Surveys and Questionnaires
PubMed: 35390062
DOI: 10.1371/journal.pone.0266385