Educating Children with Autism

In childhood, attention deficit/hyperactivity disorder (ADHD) is characterized by age-inappropriate levels of inattentiveness/disorganization, hyperactivity/impulsiveness, or a combination thereof. Although the criteria for ADHD are well defined, the long-term consequences in adults and children need to be more comprehensively understood and quantified. We conducted a systematic review evaluating the long-term outcomes (defined as 2 years or more) of ADHD with the goal of identifying long-term outcomes and the impact that any treatment (pharmacological, non-pharmacological, or multimodal) has on ADHD long-term outcomes. Studies were identified using predefined search criteria and 12 databases. Studies included were peer-reviewed, primary studies of ADHD long-term outcomes published between January 1980 to December 2010. Inclusion was agreed on by two independent researchers on review of abstracts or full text. Published statistical comparison of outcome results were summarized as poorer than, similar to, or improved versus comparators, and quantified as percentage comparisons of these categories. Outcomes from 351 studies were grouped into 9 major categories: academic, antisocial behavior, driving, non-medicinal drug use/addictive behavior, obesity, occupation, services use, self-esteem, and social function outcomes. The following broad trends emerged: (1) without treatment, people with ADHD had poorer long-term outcomes in all categories compared with people without ADHD, and (2) treatment for ADHD improved long-term outcomes compared with untreated ADHD, although not usually to normal levels. Only English-language papers were searched and databases may have omitted relevant studies. This systematic review provides a synthesis of studies of ADHD long-term outcomes. Current treatments may reduce the negative impact that untreated ADHD has on life functioning, but does not usually 'normalize' the recipients.

/pdf/a-systematic-review-and-analysis-of-long-term-outcomes-in-253es18qjl.pdf

A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: effects of treatment and non-treatment

Objective: Autism spectrum disorders are considered to be among the most heritable mental disorders, a notion based on surprisingly sparse data from small clinical studies. Population-based studies of the heritability of other neuro-psychiatric disorders and comorbidities among them have also been sparse. The authors sought to address both of these issues. Method: Parents of all Swedish 9- and 12-year-old twin pairs born between 1992 and 2000 (N=10,895) were interviewed regarding autism spectrum disorders and associated conditions (response rate, 80%). Concordance rates and structural equation modeling were used for evaluating causes for familial aggregation and overlap between conditions. Results: Monozygotic twins had higher concordance rates than dizygotic twins for autism spectrum disorders, attention defcit hyperactivity disorder (ADHD), developmental coordination disorder, and tic disorder. Genetic effects accounted for 80% (95% CI=29-91) of the variation in liability for autism spectrum disorders, 79% (95% CI=61-88) for ADHD, 70% (95% CI=35-83) for developmental coordination disorder, and 56% (95% CI=37-68) for tic disorder. Among monozygotic co-twins of children with autism spectrum disorders, the probability of having a diagnosis of ADHD was 44%, compared with 15% for dizygotic co-twins. Differences in cross-disorder effects between monozygotic and dizygotic twins were observed for most other comorbidities, and substantial proportions of the genetic variance for autism spectrum disorders was shared with each of the other disorders. Conclusions: Different neuropsychiatric disorders seem to have a common genetic etiology, suggesting caution in the use of diagnostic entities and proband status in efforts to uncover genes predisposing to autism spectrum disorders.

The genetics of autism spectrum disorders and related neuropsychiatric disorders in childhood

Psychoanalysis has long represented itself as being not only a treatment tool but a method of research. The reason, of course, is that this method of recollection presumably helps the individual to re-experience the feelings he had during significant events or periods of his life-time and, in doing so, to understand why he behaves and feels as he does. Sometimes it seems that the psychoanalyst claims that this is indeed the only way to self-understanding, but even the most died-in-the-wool, orthodox analyst would not in this day and age claim that self-understanding can come in no other ways than through his chosen discipline.

The Empty Fortress: Infantile Autism and the Birth of the Self

https://iris.unica.it/bitstream/11584/281982/2/NBBR%20Krizinger%20019%20%28open%29.pdf

Neurological and psychiatric adverse effects of long-term methylphenidate treatment in ADHD: A map of the current evidence

Introduccion. Distintos autores han propuesto que los ninos con trastorno por deficit de atencion con hiperactividad (TDAH) presentan una alteracion en el proceso de flexibilidad cognitiva (FC). El test de clasificacion de tarjetas de Wisconsin (WCST) es uno de los tests neuropsicologicos mas empleado para evaluar este proceso. Estudios previos han descrito la presencia de un subgrupo de ninos con TDAH que presentan una baja FC. Ademas, este subgrupo muestra una alta resistencia al tratamiento con farmacos estimulantes. Objetivos. El objetivo del presente estudio fue examinar si diferentes subgrupos de TDAH presentaban distintos patrones de actividad magnetica cerebral durante la ejecucion de una tarea de FC (WCST). Pacientes y metodos. La muestra consistio en 18 ninos, divididos en tres grupos de acuerdo con los criterios diagnosticos del DSM-IV-R. En este trabajo presentamos datos preliminares basados en una submuestra de nueve ninos. Se realizo un registro de la actividad magnetica cerebral mientras los ninos realizaban el WCST, por medio de la magnetoencefalografia (MEG). Esta es una tecnica de neuroimagen no invasiva y con una elevada resolucion espaciotemporal. Resultados. Los resultados preliminares mostraron que el grupo TDAH-combinado tuvo un mayor numero de respuestas perseverativas. Ademas, este grupo presento un patron diferente de actividad magnetica cerebral, y mostro una menor activacion en el cingulo anterior y la corteza prefrontal dorsolateral del hemisferio izquierdo durante los primeros 400 ms. Conclusiones. La MEG parece ser una herramienta util para describir cual es el circuito cerebral subyacente al proceso de FC en diferentes grupos de ninos. Esto podria tener importantes repercusiones en la clasificacion del TDAH, tanto desde un punto de vista neuropsicologico como farmacologico.

Sustrato neurofuncional de la rigidez cognitiva en el trastorno por déficit de atención con hiperactividad:: resultados preliminares

Introduccion. El trastorno por deficit de atencion e hiperactividad (TDAH) y las dificultades del aprendizaje son dos categorias diagnosticas de gran relevancia e impacto social, que se encuentran asociadas en torno al 25-35%. Una explicacion que ofrece la investigacion sobre este solapamiento es el deficit en el funcionamiento ejecutivo (FE). Objetivos. 1) Comparar el FE y el conocimiento matematico aplicado en ninos con TDAH, dificultades del aprendizaje de las matematicas (DAM) o TDAH + DAM e identificar los deficit que experimentan; 2) Comprobar si se cumple la hipotesis de la fenocopia en el caso de la condicion TDAH + DAM. Sujetos y metodos. Se planteo un diseno casi experimental 2 × 2, cuya muestra estaba formada por 78 participantes (6-13 anos) repartidos en cuatro grupos: TDAH (n = 33), DAM (n = 15), TDAH + DAM (n = 15) y control (n = 15). Se administraron tests dirigidos a evaluar diferentes procesos cognitivos ademas del conocimiento matematico aplicado: control inhibitorio (go/no go); memoria de trabajo verbal (digitos-recuerdo inverso y tarea de memoria de conteo) y temporovisuoespacial (MTVE); memoria a corto plazo (digitos-recuerdo directo), atencion (TEC); velocidad en calculo (Canals) y problemas de la vida real. Resultados y conclusiones. Considerando las variables edad, genero y cociente intelectual como covariables, los resultados indicaron que los tres grupos con problemas mostraron deficit de atencion y en la memoria de trabajo, y destacaba el grupo con DAM al presentar un deficit especifico en el recuerdo de informacion temporovisuoespacial. En cambio, el deficit en el control inhibitorio se mostro especifico del TDAH. Finalmente, los resultados no apoyaron la hipotesis de la fenocopia, por lo que se trataba de un perfil acumulativo.

Dificultades en el aprendizaje de matemáticas en niños con trastorno por déficit de atención e hiperactividad

Diagnóstico interdisciplinar en atención temprana

Procesamiento fonológico en niños con trastorno por déficit de atención e hiperactividad ¿es eficaz el metilfenidato?

Efficacy of Pharmacological therapies for attention deficit hyperactivity disorder (ADHD) treatment. The present work synthesizes, integrates and discuses major outcomes reported in research about efficacy of pharmacological interventions, most often used in hyperactivity treatment. This work represents the first part of a more extensive study, based in a selective review and qualitative analysis of published literature about this topic in the last seven years. Beside of methodology employed, we offer selected characteristics of studies included in the analysis, as well as a general description of samples and subject characteristics. Conclusions about psychological and combined (psychological and pharmacological) treatments are presented in a complementary work.

Eficacia de las intervenciones farmacológicas en el tratamiento de la hiperactividad

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