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Journal of Learning Disabilities Jan 2024Handwriting deficits, or dysgraphia, are present in several neurodevelopmental disorders. To investigate whether dysgraphia differs according to the associated disorder,...
Handwriting deficits, or dysgraphia, are present in several neurodevelopmental disorders. To investigate whether dysgraphia differs according to the associated disorder, we performed a detailed analysis of handwriting in children with developmental coordination disorders (DCD), reading disorder (RD), or comorbid RD and DCD. Handwriting deficits were investigated at the product (quality of the trace) and the process (movement that generates the trace) levels. Nineteen children with singular RD (among which eight with dysgraphia), 13 children with singular DCD (among which seven with dysgraphia), 16 children with comorbid RD+DCD (among which 11 with dysgraphia), and 20 typically developing children, age 7 to 12, performed the BHK (Brave Handwriting Kinder) test, a standardized assessment of handwriting, on a graphic tablet. Developmental coordination disorders primarily affected handwriting quality, while RD affected slowness and, to a lesser extent, quality. Children with RD, solely or comorbid with DCD, wasted time by lifting and stopping the pen when writing. The comorbidity added to but did not worsen, handwriting difficulties. These results reflect distinct motor impairments and/or strategies in children with DCD or RD. We identified subtypes of dysgraphia and advocated for a fine-grained analysis of the writing process and the assessment of motor and reading skills when studying dysgraphia.
PubMed: 38284390
DOI: 10.1177/00222194231223528 -
Children (Basel, Switzerland) Dec 2023Handwriting abnormalities in children with attention deficit hyperactivity disorder (ADHD) have sometimes been reported both (i) at the product level (i.e.,... (Review)
Review
Is There a Deficit in Product and Process of Handwriting in Children with Attention Deficit Hyperactivity Disorder? A Systematic Review and Recommendations for Future Research.
Handwriting abnormalities in children with attention deficit hyperactivity disorder (ADHD) have sometimes been reported both (i) at the product level (i.e., quality/legibility of the written trace and speed of writing) and (ii) at the process level (i.e., dynamic and kinematic features, such as on-paper and in-air durations, pen pressure and velocity peaks, etc.). Conversely, other works have failed to reveal any differences between ADHD and typically developing children. The question of the presence and nature of handwriting deficits in ADHD remains open and merits an in-depth examination. The aim of this systematic review was, therefore, to identify studies that have investigated the product and/or process of handwriting in children with ADHD compared to typically developing individuals. This review was conducted and reported in accordance with the PRISMA statement. A literature search was carried out using three electronic databases. The methodological quality of the studies was systematically assessed using the Critical Appraisal Skills Program (CASP) criteria. Twenty-one articles were identified. Of these, 17 described handwriting quality/legibility, 12 focused on speed and 14 analyzed the handwriting process. All the studies (100%) with satisfactory methodology procedures reported an impaired product and process in children with ADHD, while 25% evidenced a difference in the speed of production. Most importantly, the studies differed widely in their methodological approaches. Substantial gaps remain, particularly with regard to ascertaining comorbidities, ADHD subtypes and the medical status of the included children. The lack of overall homogeneity in the samples calls for higher quality studies. We conclude with recommendations for further studies.
PubMed: 38255345
DOI: 10.3390/children11010031 -
International Journal of Geriatric... Jan 2024We have previously demonstrated difficulties in written production in dementia with Lewy bodies (DLB) patients. We now aim to determine the neural correlates of writing...
OBJECTIVES
We have previously demonstrated difficulties in written production in dementia with Lewy bodies (DLB) patients. We now aim to determine the neural correlates of writing production in DLB, combining clinical data and structural MRI measures.
METHOD
Sixteen prodromal to mild DLB patients were selected to participate in the study. The GREMOTS test was used to assess writing production. Using three-dimensional T1 brain MRI images, correlations between the GREMOTS test and grey matter (GM) volume were performed using voxel-based morphometry (VBM; SPM12, XjView and Matlab R2021b softwares).
RESULTS
VBM analysis (p < 0.001, uncorrected) revealed a positive and significant correlation between both left anterior insula and left supramarginal gyrus GM volumes and DLB patients' ability to write logatoms using the phonological route. The handwriting deficit was negatively and significantly correlated to the supplementary motor area. The parkinsonism-like characteristics of agraphia were negatively and significantly correlated with both right anterior and right posterior cerebellum GM volumes. Our study also revealed a negative and significant correlation between grammatical spelling impairments and an area of the orbitofrontal gyrus, and a negative and significant correlation between supramarginal gyrus and general slowness in dictation tasks.
CONCLUSION
Writing disorders in early DLB patients appears to be GM decreases in several brain regions, such as the left anterior insula, the left supramaginal gyrus, as well as two areas of the right cerebellum.
Topics: Humans; Lewy Body Disease; Dementia; Brain; Gray Matter; Magnetic Resonance Imaging; Writing
PubMed: 38229210
DOI: 10.1002/gps.6056 -
Children (Basel, Switzerland) Dec 2023Handwriting is a complex perceptual motor task that requires years of training and practice before complete mastery. Its acquisition is crucial, since handwriting is the... (Review)
Review
Handwriting is a complex perceptual motor task that requires years of training and practice before complete mastery. Its acquisition is crucial, since handwriting is the basis, together with reading, of the acquisition of higher-level skills such as spelling, grammar, syntax, and text composition. Despite the correct learning and practice of handwriting, some children never master this skill to a sufficient level. These handwriting deficits, referred to as developmental dysgraphia, can seriously impact the acquisition of other skills and thus the academic success of the child if they are not diagnosed and handled early. In this review, we present a non-exhaustive listing of the tools that are the most reported in the literature for the analysis of handwriting and the diagnosis of dysgraphia. A variety of tools focusing on either the final handwriting product or the handwriting process are described here. On one hand, paper-and-pen tools are widely used throughout the world to assess handwriting quality and/or speed, but no universal gold-standard diagnostic test exists. On the other hand, several very promising computerized tools for the diagnosis of dysgraphia have been developed in the last decade, but some improvements are required before they can be available to clinicians. Based on these observations, we will discuss the pros and cons of the existing tools and the perspectives related to the development of a universal, standardized test of dysgraphia combining both paper-and-pen and computerized approaches and including different graphomotor and writing tasks.
PubMed: 38136127
DOI: 10.3390/children10121925 -
Frontiers in Psychiatry 2023Language-based learning disabilities (LBLD) refers to a spectrum of neurodevelopmental-associated disorders that are characterized by cognitive and behavioral...
INTRODUCTION
Language-based learning disabilities (LBLD) refers to a spectrum of neurodevelopmental-associated disorders that are characterized by cognitive and behavioral differences in comprehending, processing and utilizing spoken and/or written language. The focus of this work was on identifying early predictors of three main specific LBLD including dyslexia, dyscalculia, and dysgraphia.
METHODS
The Web of Science (WoS) was searched for literature related to (neurocognitive, neurophysiological, and neuroimaging) measurements used to identify early predictors of LBLD from 1991 to 25 October 2021. A retrospective bibliometric analysis was performed to analyze collaboration among countries, institutions, authors, publishing journals, reference co-citation patterns, keyword co-occurrence, keyword clustering, and burst keywords using Biblioanalytics software.
RESULTS
In total, 921 publications related to the identification of LBLD using (neurocognitive, neurophysiological, and neuroimaging) modalities were included. The data analysis shows a slow growth in research on the topic in the 90s and early 2000 and growing trend in recent years. The most prolific and cited journal is Neuroimage, followed by Neuropsychologia. The United States and Finland's Universities Jyvaskyla and Helsinki are the leading country and institution in this field, respectively. "Neuroimaging," "brain," "fMRI," "cognitive predictor," "comorbidity," "cortical thickness" were identified as hotspots and trends of (neurocognitive, neurophysiological, and neuroimaging) modalities in the identification of LBLD.
DISCUSSION
Early predictors of LBLDs would be useful as targets for specific prevention and intervention programs to be implemented at very young ages, which could have a significant clinical impact. A novel finding of neuroimaging predictors combined with neurocognitive and neuropsychological batteries may have implications for future research.
PubMed: 38111620
DOI: 10.3389/fpsyt.2023.1229580 -
Cold Spring Harbor Molecular Case... Dec 2023Rare genetic conditions are challenging for the primary care provider to manage without proper guidelines. This clinical review is designed to assist the pediatrician,...
Rare genetic conditions are challenging for the primary care provider to manage without proper guidelines. This clinical review is designed to assist the pediatrician, family physician, or internist in the primary care setting to manage the complexities of 16p11.2 deletion syndrome. A multidisciplinary medical home with the primary care provider leading the care and armed with up-to-date guidelines will prove most helpful to the rare genetic patient population. A special focus on technology to fill gaps in deficits, review of case studies on novel medical treatments, and involvement with the educational system for advocacy with an emphasis on celebrating diversity will serve the rare genetic syndrome population well.
Topics: Child; Humans; Adolescent; Chromosome Deletion; Chromosome Disorders; Autistic Disorder; Intellectual Disability; Chromosomes, Human, Pair 16
PubMed: 38050025
DOI: 10.1101/mcs.a006316 -
Brain & NeuroRehabilitation Nov 2023Crossed aphasia (CA) is a type of aphasia caused by cerebral hemispheric lesions on the same side of the dominant hand. The prevalence of CA is extremely rare. To the...
Crossed aphasia (CA) is a type of aphasia caused by cerebral hemispheric lesions on the same side of the dominant hand. The prevalence of CA is extremely rare. To the best of our knowledge, this is the first case report in Korea to conduct 6 years of long-term speech therapy in a case of a patient with CA. The patient was a 57-year-old right-handed man with aphasia caused by extensive acute infarction in the right middle cerebral artery territory. He presented with global aphasia, right-left disorientation, and agraphia. Language function recovered in the first 6 months and then plateaued.
PubMed: 38047091
DOI: 10.12786/bn.2023.16.e23 -
Clinical Genetics Mar 2024Calmodulin-binding transcriptional activator 1 (CAMTA1) is highly expressed in the brain and plays a role in cell cycle regulation, cell differentiation, regulation of...
Calmodulin-binding transcriptional activator 1 (CAMTA1) is highly expressed in the brain and plays a role in cell cycle regulation, cell differentiation, regulation of long-term memory, and initial development, maturation, and survival of cerebellar neurons. The existence of human neurological phenotypes, including cerebellar dysfunction with variable cognitive and behavioral abnormalities (CECBA), associated with CAMTA1 variants, has further supported its role in brain functions. In this study, we phenotypically and molecularly characterize the largest cohort of individuals (n = 26) with 23 novel CAMTA1 variants (frameshift-7, nonsense-6, splicing-1, initiation codon-1, missense-5, and intragenic deletions-3) and compare the findings with all previously reported cases (total = 53). We show that the most notable phenotypic findings are developmental delay/intellectual disability, unsteady or uncoordinated gait, hypotonia, behavioral problems, and eye abnormalities. In addition, there is a high incidence of dysarthria, dysgraphia, microcephaly, gastrointestinal abnormalities, sleep difficulties, and nonspecific brain MRI findings; a few of which have been under-reported. More than one third of the variants in this cohort were inherited from an asymptomatic or mildly affected parent suggesting reduced penetrance and variable expressivity. Our cohort provides a comprehensive characterization of the spectrum of phenotypes and genotypes among individuals with CECBA and the large data will facilitate counseling and formulating management plans and surveillance recommendations for these individuals.
Topics: Humans; Brain; Calcium-Binding Proteins; Genotype; Intellectual Disability; Phenotype; Trans-Activators; Transcription Factors
PubMed: 38044714
DOI: 10.1111/cge.14464 -
Psychiatria Danubina Dec 2023Cerebral maturation is characterized by different age-dependent molecular and cellular processes and follows a different course for grey matter (GM) and white matter...
Cerebral maturation is characterized by different age-dependent molecular and cellular processes and follows a different course for grey matter (GM) and white matter (WM). During brain development, a crucial point seems to be represented by the establishment of a hemispheric specialization with the left hemisphere dominant for language and motor control and the right hemisphere dominant for visuospatial processing and attention. Therefore, motor and cognitive development are strongly connected. Atypical motor development and lateralization can be associated with neurodevelopmental disorders, such as Language Disorder, Learning Disorders (Dysgraphia and Dyslexia), Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorder. The aim of our research was to investigate the possible effects of intensive motor training on WM plasticity and writing skills in children with Developmental Dysgraphia through a tractography study of the main WM tracts. Considering the effect of training for the Mean Diffusivity (MD) over 18 WM tracts, in 6 collaborating dysgraphic patient MD decrease (-4.3%) and in 3 not. Intensive motor training affects both stimulated and not stimulated WM tracts and showed a double not-specificity: for not stimulated hemilate and for not directly stimulated WM tracts. Intensive motor training improves both some lateralized brain functions and intra- and inter-hemispheric connectivity in our patients with good compliance with motor treatment. Moreover, our findings have shown that WM plasticity improvement concerned cortical areas responsible for both motor and cognitive functions.
Topics: Child; Humans; White Matter; Magnetic Resonance Imaging; Diffusion Tensor Imaging; Autism Spectrum Disorder; Gray Matter; Brain
PubMed: 37994059
DOI: No ID Found -
International Journal of Language &... 2024Stroke profoundly affects quality of life (QOL), including loss of employment, reduced social activity, shrinking social networks and low mood. Dysgraphia (impaired...
BACKGROUND
Stroke profoundly affects quality of life (QOL), including loss of employment, reduced social activity, shrinking social networks and low mood. Dysgraphia (impaired writing) is a common symptom of aphasia yet is rarely targeted in rehabilitation. Recent technological advances might challenge this, since much communication is now conducted digitally through writing. The rehabilitation of writing may therefore help to address the wider consequences of stroke and aphasia.
AIMS
Can assistive technology (AT) training for people with dysgraphia: (1) improve written output, and are gains achieved only with AT? (2) improve reading comprehension scores, and are gains achieved only with AT? and (3) affect social participation, mood or QOL METHODS AND PROCEDURES: DESIGN: A mixed-methods, repeated measures, small group study design was adopted (qualitative outcomes will be reported elsewhere).
PARTICIPANTS
Recruited from community settings, for example, Stroke Association communication support groups.
INCLUSION CRITERIA
over 18 years old, aphasia due to stroke, acquired dysgraphia, writing more impaired than speech, fluent English prior to stroke, access to computer and Internet.
EXCLUSION CRITERIA
currently receiving speech and language therapy, significant cognitive impairment, neuromuscular/motor-speech impairments/structural abnormalities, developmental dyslexia, uncorrected visual/auditory impairments.
PROCEDURES
Screening and diagnostic assessments at time T1 (first baseline). Outcome measures at T1; repeated at T2 (second baseline), T3 (end of intervention), T4 (3-month follow up). Social participation assessment and cognitive monitoring at T2, T3, T4.
INTERVENTION
Seven-ten hours individual therapy weekly and additional email support. Participants were trained to operate Dragon NaturallySpeaking (speech to text package) and ClaroRead (read writing aloud). Outcome measures were administered on pen and paper (control) and on computer, with AT enabled only at T3, T4.
OUTCOMES AND RESULTS
Computer narrative writing was significantly improved by AT training (Friedman's χ (3) = 8.27, p = 0.041), indicating a compensatory effect of AT. Though reading comprehension significantly improved in the computer condition (Friedman's χ (3) = 21.07, p = 0.001), gains could not be attributed to the AT. Gains were achieved only when measures were administered on the keyboard, with AT enabled. Thus, a compensatory rather than remediatory effect was suggested. Social network size significantly increased; there were no significant changes in mood/QOL. Individual success rates varied.
CONCLUSION AND IMPLICATIONS
The customisable AT training was acceptable to participants and resulted in significantly improved narrative writing. Compensatory AT interventions are a useful adjunct to remediatory writing interventions and may particularly support functional writing.
WHAT THIS PAPER ADDS
What is already known on this subject Writing is rarely spared in aphasia and may present as the most impaired communication modality. Yet, people with aphasia report that writing is seldom included in their rehabilitation. Many communication activities are now conducted digitally through writing, therefore rehabilitation of this is more important than ever before. This study sought to address whether an assistive technology (AT) software package can improve writing and whether any changes were compensatory or remediatory. What this study adds to existing knowledge This group study found that AT training led to gains in written discourse and social network in people with aphasia and dysgraphia. Gains were not replicated in handwritten tasks, suggesting this was a compensatory therapeutic approach. What are the clinical implications of this work? AT programs such as this may present speech and language therapists with a practical, pragmatic adjunct to writing or typing therapy, particularly for clients with chronic, intractable impairments for whom remediatory therapy may have a low chance of success.
Topics: Humans; Aphasia; Agraphia; Female; Writing; Reading; Male; Middle Aged; Aged; Comprehension; Self-Help Devices; Adult; Software; Stroke Rehabilitation; Stroke; Quality of Life; Treatment Outcome; Therapy, Computer-Assisted
PubMed: 37966065
DOI: 10.1111/1460-6984.12975