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Clinical & Experimental Optometry Sep 2020This systematic review presents the existing scientific evidence for oculomotor anomalies in children with three different types of learning disorders - namely,...
This systematic review presents the existing scientific evidence for oculomotor anomalies in children with three different types of learning disorders - namely, dyslexia, dyspraxia and attention deficit-hyperactivity disorder (ADHD). This review was registered in the PROSPERO database (registration number: 139317). The QUADAS-2 tool was used to systematically evaluate the quality of the diagnostic tests used in the evaluated studies and to confirm whether the oculomotor alterations observed in the different groups of children with various learning disorders had a consistent diagnostic basis. Using this tool, the design of the articles was well elaborated, although concerns exist regarding the selection of patients and the diagnostic criteria for the binocular conditions. All the studies reviewed conclude that a pattern of oculomotor anomalies exist in the groups of children with these three types of learning disorders compared to healthy children. However, there is a concern regarding the diagnostic methodology, as no clear range of normality for the parameters used to characterise ocular motility was identified and no gold standard or reference test has been defined. In future studies, this range of normality must be developed for different oculomotor skills, and a reference test (possibly video-oculography) for the measurement of these skills must be established.
Topics: Attention Deficit Disorder with Hyperactivity; Child; Dyslexia; Eye Movements; Humans; Ocular Motility Disorders; Oculomotor Muscles
PubMed: 31869866
DOI: 10.1111/cxo.13024 -
Neuropsychologia Jan 2020The voice-tagging hypothesis claims that individuals who better represent pitch information in a speaker's voice, as measured with the frequency following response...
The voice-tagging hypothesis claims that individuals who better represent pitch information in a speaker's voice, as measured with the frequency following response (FFR), will be better at speech-in-noise perception. The hypothesis has been provided to explain how music training might improve speech-in-noise perception. This paper reviews studies that are relevant to the voice-tagging hypothesis, including studies on musicians and nonmusicians. Most studies on musicians show greater f0 amplitude compared to controls. Most studies on nonmusicians do not show group differences in f0 amplitude. Across all studies reviewed, f0 amplitude does not consistently predict accuracy in speech-in-noise perception. The evidence suggests that music training does not improve speech-in-noise perception via enhanced subcortical representation of the f0.
Topics: Discrimination, Psychological; Humans; Music; Pitch Perception; Speech Perception; Voice
PubMed: 31715197
DOI: 10.1016/j.neuropsychologia.2019.107256 -
Drugs & Aging Apr 2019We aimed to assess the safety of topical non-steroidal anti-inflammatory drugs (NSAIDs) in the management of osteoarthritis (OA) in a systematic review and meta-analysis... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
We aimed to assess the safety of topical non-steroidal anti-inflammatory drugs (NSAIDs) in the management of osteoarthritis (OA) in a systematic review and meta-analysis of randomized, placebo-controlled trials.
METHODS
A comprehensive literature search was undertaken in the MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus electronic databases. Randomized, double-blind, placebo-controlled, parallel-group trials that assessed adverse events (AEs) with topical NSAIDs in patients with OA were eligible for inclusion. Authors and/or study sponsors were contacted to obtain the full report of AEs. The primary outcomes were overall severe and serious AEs, as well as the following MedDRA System Organ Class (SOC)-related AEs: gastrointestinal, vascular, cardiac, nervous system, skin and subcutaneous tissue, musculoskeletal and connective tissue.
RESULTS
The search strategy identified 1209 records, from which 25 papers were included in the qualitative synthesis and 19 were included in the meta-analysis, after exclusions. Overall, more total AEs (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.04-1.29; I = 0.0%) and more withdrawals due to AEs (OR 1.49, 95% CI 1.15-1.92; I = 0.0%) were observed with topical NSAIDs compared with placebo. The same results were achieved with topical diclofenac, largely driven by an increase in skin and subcutaneous tissue disorders (OR 1.73, 95% CI 0.96-3.10), although the difference was not statistically significant compared with placebo. No significant difference in the odds for gastrointestinal disorders was observed between topical NSAIDs and placebo (OR 0.96, 95% CI 0.73-1.27).
CONCLUSIONS
Topical NSAIDs may be considered safe in the management of OA, especially with regard to low gastrointestinal toxicity. The use of topical NSAIDs in OA should be considered, taking into account their risk: benefit profile in comparison with other anti-OA treatments.
Topics: Administration, Cutaneous; Anti-Inflammatory Agents, Non-Steroidal; Diclofenac; Drug-Related Side Effects and Adverse Reactions; Humans; Osteoarthritis; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 31073923
DOI: 10.1007/s40266-019-00661-0 -
Arquivos de Neuro-psiquiatria Mar 2019Scotopic sensitivity syndrome, later called Meares-Irlen syndrome or simply Irlen syndrome (IS) has been described as symptoms of poor reading ability due to poor color...
BACKGROUND
Scotopic sensitivity syndrome, later called Meares-Irlen syndrome or simply Irlen syndrome (IS) has been described as symptoms of poor reading ability due to poor color matching and distorted graphic images. Individuals with this syndrome are considered slow, ineffective readers with low comprehension and visual fatigue. It is still uncertain whether the disease pathophysiology is an independent entity or part of the dyslexia spectrum. Nevertheless, treatments with lenses and colored filters have been proposed to alleviate the effect of the luminous contrast and improve patients' reading performance. However, no evidence of treatment effectiveness has been achieved.
OBJECTIVE
The aim of the present study was to obtain evidence about IS etiology, diagnosis and intervention efficacy.
METHODS
A systematic review was performed covering the available studies on IS, assessing the available data according to their level of evidence, focusing on diagnostic tools, proposed interventions and related outcomes.
RESULTS
The data showed high heterogeneity among studies, and lack of evidence on the existence of IS and treatment effectiveness.
CONCLUSION
The syndrome as described, as well as its treatments, require further strong evidence.
Topics: Contact Lenses; Dyslexia; Humans; Night Vision; Syndrome; Vision Disorders
PubMed: 30970133
DOI: 10.1590/0004-282X20190014 -
Deutsches Arzteblatt International Feb 20193-7% of all children, adolescents, and adults suffer from dyscalculia. Severe, persistent difficulty performing arithmetical calculations leads to marked impairment in... (Meta-Analysis)
Meta-Analysis
BACKGROUND
3-7% of all children, adolescents, and adults suffer from dyscalculia. Severe, persistent difficulty performing arithmetical calculations leads to marked impairment in school, at work, and in everyday life and elevates the risk of comorbid mental disorders. The state of the evidence underlying various methods of diagnosing and treating this condition is unclear.
METHODS
Systematic literature searches were carried out from April 2015 to June 2016 in the PsycInfo, PSYNDEX, MEDLINE, ProQuest, ERIC, Cochrane Library, ICTRP, and MathEduc databases. The main search terms on dyscalculia were the German terms "Rechenstörung," "Rechenschwäche," and "Dyskalkulie" and the English terms "dyscalculia," "math disorder, and "math disability." The data from the retrieved studies were evaluated in a meta-analysis, and corresponding recommendations on the diagnosis and treatment of dyscalculia were jointly issued by the 20 societies and associations that participated in the creation of this guideline.
RESULTS
The diagnosis of dyscalculia should only be made if the person in question displays below-average mathematical performance when seen in the context of relevant information from the individual history, test findings, clinical examination, and further psychosocial assessment. The treatment should be directed toward the individual mathematical problem areas. The mean effect size found across all intervention trials was 0.52 (95% confidence interval [0.42; 0.62]). Treatment should be initiated early on in the primary-school years and carried out by trained specialists in an individual setting; comorbid symptoms and disorders should also receive attention. Persons with dyscalculia are at elevated risk of having dyslexia as well (odds ratio [OR]: 12.25); the same holds for attention deficit/hyperactivity disorder and for other mental disorders, both internalizing (such as anxiety and depression) and externalizing (e.g., disorders characterized by aggression and rule-breaking).
CONCLUSION
Symptom-specific interventions involving the training of specific mathematical content yield the best results. There is still a need for high-quality intervention trials and for suitable tests and learning programs for older adolescents and adults.
Topics: Dyscalculia; Humans
PubMed: 30905334
DOI: 10.3238/arztebl.2019.0107 -
Neuroscience and Biobehavioral Reviews May 2019Dyslexia is associated with phonological and visuo-attentional deficits. Phonological interventions improve word accuracy and letter-sound knowledge, but not reading...
Dyslexia is associated with phonological and visuo-attentional deficits. Phonological interventions improve word accuracy and letter-sound knowledge, but not reading fluency. This systematic review evaluated the effectiveness of dynamic computerized visuo-attentional interventions aimed at improving reading for dyslexic and neurotypical children aged 5-15. Literature searches in Medline, PsycINFO, EMBASE, Scopus, ERIC, PubMed, Web of Science, and Cochrane Library identified 1266 unique articles, of which 18 met inclusion criteria (620 participants; 91.40% dyslexic). Three types of visuo-attentional interventions were identified. Results show that visual perceptual training (n = 5) benefited reading fluency and comprehension, visually-based reading acceleration programs (n = 8) improved reading accuracy and rate, and action video games (n = 5) increased rate and fluency. Visuo-attentional interventions are effective options for treating childhood dyslexia, improving reading generally equal to or greater than other strategies. Initial evidence indicates that visuo-attentional interventions may be efficacious in different orthographies, and improve reading for at least two months after intervention. Larger sample interventions on a wider range of reading skills with follow-up assessment are needed to further clarify their effectiveness.
Topics: Adolescent; Attention; Child; Dyslexia; Humans; Pattern Recognition, Visual; Reading; Treatment Outcome; Video Games
PubMed: 30802473
DOI: 10.1016/j.neubiorev.2019.02.015 -
Frontiers in Psychology 2019In the last years, there has been a growing interest in the application of different non-invasive brain stimulation techniques to induce neuroplasticity and to modulate...
In the last years, there has been a growing interest in the application of different non-invasive brain stimulation techniques to induce neuroplasticity and to modulate cognition and behavior in adults. Very recently, different attempts have been made to induce functional plastic changes also in pediatric populations. Importantly, not only sensorimotor processing, but also higher-level functions have been addressed, with the aim to boost rehabilitation in different neurodevelopmental disorders. However, efficacy and safety of using these techniques in pediatric population is still debated. The current article aims to review the non-invasive brain stimulation studies conducted in pediatric populations using Transcranial Magnetic Stimulation or transcranial Direct Current Stimulation. Specifically, the available proofs concerning the efficacy and safety of these techniques on Autism Spectrum Disorder, Attention-deficit/hyperactivity disorder, Dyslexia, Tourette syndrome, and tic disorders are systematically reviewed and discussed. The article also aims to provide an overview about other possible applications of these and other stimulation techniques for rehabilitative purposes in children and adolescents.
PubMed: 30787895
DOI: 10.3389/fpsyg.2019.00135 -
The Cochrane Database of Systematic... Dec 2018Wrist fractures, involving the distal radius, are the most common fractures in children. Most are buckle fractures, which are stable fractures, unlike greenstick and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Wrist fractures, involving the distal radius, are the most common fractures in children. Most are buckle fractures, which are stable fractures, unlike greenstick and other usually displaced fractures. There is considerable variation in practice, such as the extent of immobilisation for buckle fractures and use of surgery for seriously displaced fractures.
OBJECTIVES
To assess the effects (benefits and harms) of interventions for common distal radius fractures in children, including skeletally immature adolescents.
SEARCH METHODS
We searched the Cochrane Bone, Joint and Muscle Trauma Group's Specialised Register, the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, trial registries and reference lists to May 2018.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) and quasi-RCTs comparing interventions for treating distal radius fractures in children. We sought data on physical function, treatment failure, adverse events, time to return to normal activities (recovery time), wrist pain, and child (and parent) satisfaction.
DATA COLLECTION AND ANALYSIS
At least two review authors independently performed study screening and selection, 'Risk of bias' assessment and data extraction. We pooled data where appropriate and used GRADE for assessing the quality of evidence for each outcome.
MAIN RESULTS
Of the 30 included studies, 21 were RCTs, seven were quasi-RCTs and two did not describe their randomisation method. Overall, 2930 children were recruited. Typically, trials included more male children and reported mean ages between 8 and 10 years. Eight studies recruited buckle fractures, five recruited buckle and other stable fractures, three recruited minimally displaced fractures and 14 recruited displaced fractures, typically requiring closed reduction, typically requiring closed reduction. All studies were at high risk of bias, mainly reflecting lack of blinding. The studies made 14 comparisons. Below we consider five prespecified comparisons:Removable splint versus below-elbow cast for predominantly buckle fractures (6 studies, 695 children)One study (66 children) reported similar Modified Activities Scale for Kids - Performance scores (0 to 100; no disability) at four weeks (median scores: splint 99.04; cast 99.11); low-quality evidence. Thirteen children needed a change or reapplication of device (splint 5/225; cast 8/219; 4 studies); very low-quality evidence. One study (87 children) reported no refractures at six months. One study (50 children) found no between-group difference in pain during treatment; very low-quality evidence. Evidence was absent (recovery time), insufficient (children with minor complications) or contradictory (child or parent satisfaction). Two studies estimated lower healthcare costs for removable splints.Soft or elasticated bandage versus below-elbow cast for buckle or similar fractures (4 studies, 273 children)One study (53 children) reported more children had no or only limited disability at four weeks in the bandage group; very low-quality evidence. Eight children changed device or extended immobilisation for delayed union (bandage 5/90; cast 3/91; 3 studies); very low-quality evidence. Two studies (139 children) reported no serious adverse events at four weeks. Evidence was absent, insufficient or contradictory for recovery time, wrist pain, children with minor complications, and child and parent satisfaction. More bandage-group participants found their treatment convenient (39 children).Removal of casts at home by parents versus at the hospital fracture clinic by clinicians (2 studies, 404 children, mainly buckle fractures)One study (233 children) found full restoration of physical function at four weeks; low-quality evidence. There were five treatment changes (home 4/197; hospital 1/200; 2 studies; very low-quality evidence). One study found no serious adverse effects at six months (288 children). Recovery time and number of children with minor complications were not reported. There was no evidence of a difference in pain at four weeks (233 children); low-quality evidence. One study (80 children) found greater parental satisfaction in the home group; low-quality evidence. One UK study found lower healthcare costs for home removal.Below-elbow versus above-elbow casts for displaced or unstable both-bone fractures (4 studies, 399 children)Short-term physical function data were unavailable but very low-quality evidence indicated less dependency when using below-elbow casts. One study (66 children with minimally displaced both-bone fractures) found little difference in ABILHAND-Kids scores (0 to 42; no problems) (mean scores: below-elbow 40.7; above-elbow 41.8); very low-quality evidence. Overall treatment failure data are unavailable, but nine of the 11 remanipulations or secondary reductions (366 children, 4 studies) were in the above-elbow group; very low-quality evidence. There was no refracture or compartment syndrome at six months (215 children; 2 studies). Recovery time and overall numbers of children with minor complications were not reported. There was little difference in requiring physiotherapy for stiffness (179 children, 2 studies); very low-quality evidence. One study (85 children) found less pain at one week for below-elbow casts; low-quality evidence. One study found treatment with an above-elbow cast cost three times more in Nepal.Surgical fixation with percutaneous wiring and cast immobilisation versus cast immobilisation alone after closed reduction of displaced fractures (5 studies, 323 children)Where reported, above-elbow casts were used. Short-term functional outcome data were unavailable. One study (123 children) reported similar ABILHAND-Kids scores indicating normal physical function at six months (mean scores: surgery 41.9; cast only 41.4); low-quality evidence. There were fewer treatment failures, defined as early or problematic removal of wires or remanipulation for early loss in position, after surgery (surgery 20/124; cast only 41/129; 4 studies; very low-quality evidence). Similarly, there were fewer serious advents after surgery (surgery 28/124; cast only 43/129; 4 studies; very low-quality evidence). Recovery time, wrist pain, and satisfaction were not reported. There was lower referral for physiotherapy for stiffness after surgery (1 study); very low-quality evidence. One USA study found similar treatment costs in both groups.
AUTHORS' CONCLUSIONS
Where available, the quality of the RCT-based evidence on interventions for treating wrist fractures in children is low or very low. However, there is reassuring evidence of a full return to previous function with no serious adverse events, including refracture, for correctly-diagnosed buckle fractures, whatever the treatment used. The review findings are consistent with the move away from cast immobilisation for these injuries. High-quality evidence is needed to address key treatment uncertainties; notably, some priority topics are already being tested in ongoing multicentre trials, such as FORCE.
Topics: Adolescent; Bandages; Child; Female; Fracture Fixation; Fracture Healing; Humans; Immobilization; Male; Pain Measurement; Radius Fractures; Randomized Controlled Trials as Topic; Splints; Time Factors; Treatment Failure; Wrist Injuries
PubMed: 30566764
DOI: 10.1002/14651858.CD012470.pub2 -
Clinical Psychology Review Feb 2019Numerous studies have demonstrated an association between learning disabilities and internalising problems such as anxiety and depression. However, our understanding of... (Meta-Analysis)
Meta-Analysis
Numerous studies have demonstrated an association between learning disabilities and internalising problems such as anxiety and depression. However, our understanding of this association for people with specific types of learning disability - such as poor reading - is poorly understood. Here, we present the first systematic review and meta-analysis of studies that have examined associations between poor reading and internalising problems - including anxiety and depression - in children, adolescents, and adults. Our systematic search identified 34 studies comprising 16,275 participants (N = 2491 poor readers). Our meta-analysis revealed statistically significant differences between poor readers and typical readers on general measures of internalising problems (d = 0.41), as well as specific measures of anxiety (d = 0.41) and depression (d = 0.23). These outcomes suggest that poor readers are at moderate risk for experiencing internalising problems compared to typical readers, which appears to stem from a greater risk for anxiety than depression.
Topics: Adolescent; Adult; Anxiety Disorders; Child; Comorbidity; Depressive Disorder; Dyslexia; Humans; Psychological Distress; Reading; Young Adult
PubMed: 30528985
DOI: 10.1016/j.cpr.2018.09.002 -
The Cochrane Database of Systematic... Nov 2018The reading skills of 16% of children fall below the mean range for their age, and 5% of children have significant and severe reading problems. Phonics training is one... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The reading skills of 16% of children fall below the mean range for their age, and 5% of children have significant and severe reading problems. Phonics training is one of the most common reading treatments used with poor readers, particularly children.
OBJECTIVES
To measure the effect of phonics training and explore the impact of various factors, such as training duration and training group size, that might moderate the effect of phonics training on literacy-related skills in English-speaking poor readers.
SEARCH METHODS
We searched CENTRAL, MEDLINE, Embase, 12 other databases, and three trials registers up to May 2018. We also searched reference lists of included studies and contacted experts in the field to identify additional studies.
SELECTION CRITERIA
We included studies that used randomisation, quasi-randomisation, or minimisation to allocate participants to a phonics intervention group (phonics training only or phonics training plus one other literacy-related skill) or a control group (no training or non-literacy training). Participants were English-speaking poor readers with word reading one standard deviation below the appropriate level for their age (children, adolescents, and adults) or one grade or year below the appropriate level (children only), for no known reason. Participants had no known comorbid developmental disorder, or physical, neurological, or emotional problem.
DATA COLLECTION AND ANALYSIS
We used standard methodological procedures expected by Cochrane.
MAIN RESULTS
We included 14 studies with 923 participants in this review. Studies took place in Australia, Canada, the UK, and the USA. Six of the 14 included studies were funded by government agencies and one was funded by a university grant. The rest were funded by charitable foundations or trusts. Each study compared phonics training alone, or in conjunction with one other reading-related skill, to either no training (i.e. treatment as usual) or alterative training (e.g. maths). Participants were English-speaking children or adolescents, of low and middle socioeconomic status, whose reading was one year, one grade, or one standard deviation below the level expected for their age or grade for no known reason. Phonics training varied between studies in intensity (up to four hours per week), duration (up to seven months), training group size (individual and small groups), and delivery (human and computer). We measured the effect of phonics training on seven primary outcomes (mixed/regular word reading accuracy, non-word reading accuracy, irregular word reading accuracy, mixed/regular word reading fluency, non-word reading fluency, reading comprehension, and spelling). We judged all studies to be at low risk of bias for most risk criteria, and used the GRADE approach to assess the quality of the evidence.There was low-quality evidence that phonics training may have improved poor readers' accuracy for reading real and novel words that follow the letter-sound rules (standardised mean difference (SMD) 0.51, 95% confidence interval (CI) 0.13 to 0.90; 11 studies, 701 participants), and their accuracy for reading words that did not follow these rules (SMD 0.67, 95% CI 0.26 to 1.07; 10 studies, 682 participants). There was moderate-quality evidence that phonics training probably improved English-speaking poor readers' fluency for reading words that followed the letter-sounds rules (SMD 0.45, 95% CI 0.19 to 0.72; 4 studies, 224 participants), and non-word reading fluency (SMD 0.39, 95% CI 0.10 to 0.68; 3 studies, 188 participants), as well as their accuracy for reading words that did not follow these rules (SMD 0.84, 95% CI 0.30 to 1.39; 4 studies, 294 participants). In addition, there was low-quality evidence that phonics training may have improved poor readers' spelling (SMD 0.47, 95% CI -0.07 to 1.01; 3 studies, 158 participants), but only slightly improve their reading comprehension (SMD 0.28, 95% CI -0.07 to 0.62; 5 studies, 343 participants).
AUTHORS' CONCLUSIONS
Phonics training appears to be effective for improving literacy-related skills, particularly reading fluency of words and non-words, and accuracy of reading irregular words. More studies are needed to improve the precision of outcomes, including word and non-word reading accuracy, reading comprehension, spelling, letter-sound knowledge, and phonological output. More data are also needed to determine if phonics training in English-speaking poor readers is moderated by factors such as training type, intensity, duration, group size, or administrator.
Topics: Adolescent; Adult; Australia; Canada; Child; Comprehension; Dyslexia; Female; Humans; Language; Male; Phonation; Phonetics; Randomized Controlled Trials as Topic; Reading; Socioeconomic Factors; United Kingdom; United States
PubMed: 30480759
DOI: 10.1002/14651858.CD009115.pub3