Clinical profile of reading ability and reading and writing achievement of children with borderline full-scale intellectual quotient: a prospective study

Background Poor reading ability is one of the common causes of low academic performance. In previous studies, children with dyslexia were found to demonstrate poor academic achievement due to poor reading ability. However, the relationship between academic achievement and reading ability in children with a borderline full-scale intellectual quotient (FSIQ) is unknown. This study aimed to clarify the clinical characteristics of children with borderline FSIQ and poor reading ability, and differentiate these characteristics from those of children with higher FSIQ and poor reading ability. Methods A total of 126 children (aged 6–15 years) identified as having low academic performance were enrolled. The reading ability of children was assessed through their performance on the hiragana (Japanese syllabary) reading task, while their reading and writing achievement was assessed through their reading and writing score on the Kaufman Assessment Battery for Children, Second Edition. Children were categorized into two groups based on their FSIQ score (FSIQ > 85 and 85 ≥ FSIQ ≥ 70). Reading ability in children was evaluated by referring to the linear relationship between FSIQ and the standard deviation value of reading tasks in typically developing children. A one-way analysis of variance (ANOVA) was performed to examine clinical characteristics between higher and lower FSIQ groups. Associations between reading and writing achievement, reading ability, and ages of children were assessed using Pearson’s product-moment correlation coefficients for the higher and lower FSIQ groups. Results Poorer reading and writing achievement was associated with poorer reading ability in the higher FSIQ group. Conversely, poorer reading and writing achievement and poor reading ability were associated with older age in the lower FSIQ group. Conclusions Poor reading and writing achievement were associated with older age, not with poor reading ability in the lower FSIQ group. Children with lower FSIQ need appropriate educational interventions based on independent assessments to further their academic achievement and reading ability. Moreover, they need more frequent evaluations of their academic achievement than do children with higher FSIQ and poor reading ability since they are more likely to be at a lower academic achievement level at an older age.

Shifting Paradigm: From Intellectual Quotient, Emotional Quotient, and Spiritual Quotient toward Ruhani Quotient (Ruhiology Perspectives)

There are three theories of human intelligence, namely Intellectual Quotient (IQ), Emotional Quotient (EQ), and Spiritual Quotient (SQ). In its subsequent development, following the SQ era that considered the God Spot in the human brain as a source of intelligence, the concept of the Heart's Code (HC) indicates that the source of intelligence lies in the heart, not the brain. The SQ model proposed by Zohar-Marshall and the HC model suggested by Pearsall only touched the biological and psychological realms, namely the material brain and the material heart. Both have yet to touch upon the transcendental level of divinity, namely the spiritual brain and the spiritual heart. By using Thomas Kuhn’s scientific revolution approach, the current article intends to prove that the source of intelligence is not the brain but the ruh. When God has perfected the creation of man by blowing ruh in him, the sense of hearing subsequently radiates through the ears, sight through the eyes, smell through the nose, speech through the mouth, taste through the tongue, and intelligence through the brain. As a consequence, the brain is but a tool, it is not a source of intelligence. If IQ, EQ, and SQ are regarded as intelligence models originating from the human mind, which is certainly artificial in nature, then Ruhani Quotient (RQ) is an intelligence model originally created by God. Ruhani Quotient (RQ), which is based on the ruh, has implications on new studies pertaining to ruhiology.

Neuropsychiatric Functioning in CDLS: A Detailed Phenotype and Genotype Correlation

Background: Cornelia de Lange Syndrome (CdLS) is a rare genetic disorder and its phenotype clinical expression is widely variable. Despite the growing interest on genotype-phenotype correlations and on behaviour phenotype of genetic syndromes, specific studies in CdLS cohorts evaluating the correlations between genotype and neurodevelopmental characteristics, Behaviour and communicative aspects are limited, most of these studies are descriptive and there is a lack of specific assessment protocols.Methods: Neurodevelopmental and Behavioural phenotype of all the patients (N = 38) was assessed using a specific neuropsychiatric protocol, concerning Intellectual Quotient (IQ), General Quotient of Development (GQ), communicative skills, behavioural aspects and adaptive behaviour based on direct and indirect evaluation. Subsequently, we searched for possible genotype–phenotype correlations comparing individuals with NIPBL variants (CdLS NIPBL mutated group) and patients with negative molecular results (CdLS clinical diagnosis group). Results: The first part of the study showed a higher percentage of subjects with normal Intellectual Quotient (IQ) and Borderline Intellectual Functioning if compared with previous data; adaptive skills were lower than expected for age in all participants and the weakest areas were Socialization, Motor Skills, and Communication. Expressive language was more compromised than receptive language, nevertheless receptive abilities were also impaired. 39.5% of the sample presented with Autism Spectrum Disorder (ASD). By stratifying CdLS phenotypes by genetic, NIPBL mutated individuals demonstrated a worse trend in cognitive functioning, in communication expressive skills, in motor skills and in ASD symptoms in comparison with the Clinical Diagnosis Group. Individuals with non-Truncating mutation (mostly missense) displayed better abilities in Communication and in relational aspects with no ASD while Truncating individuals presented with worse abilities in Daily Living Skills, Socialization, Motor Skills, and Communicative abilities. Conclusions: These findings should increase our awareness of the strengths and weaknesses points in CdLS individuals to guide appropriate targeted management; interventions addressing communicative impairments represent a clinical priority in CdLS patients.

MENYUSUI DARI PERSPEKTIF SOSIAL BUDAYA

Air susu ibu (ASI) adalah makanan terbaik dan satu-satunya makanan yang dibutuhkan bayi untuk enam bulan pertama. Bayi yang diberi ibunya susu formula, air, teh, atau sereal sebelum enam bulan akan kurang menerima air susu ibu. Hal ini membuat ibu kurang menghasilkan air susu. Makanan-makanan lain ini juga dapat mengakibatkan diare, alergi, atau masalah-masalah lain pada bayi kecil (Klein, 2004). ASI sangat diperlukan untuk pertumbuhan dan perkembangan kecerdasan anak.Menurut penelitian, anak-anak yang tidak diberi ASI mempunyai IQ (Intellectual Quotient) lebih rendah 7-8 poin dibandingkan dengan anak-anak yang diberi ASI secara eksklusif (Yuliarti, 2010). Bayi akan mendapatkan kolostrum yaitu berupa cairan emas yang kaya akan antibodi dan sangat penting untuk pertumbuhan yang sangat dibutuhkan bayi, dapat dilakukan dengan mengupayakan bayi menyusu secara dini (Maryunani, 2005). ASI jika dikonsumsi bayi dapat menambah kadar DHA (Docosahexaenoic Acid) dalam otak. ASI mengandung banyak sekali DHA dan zat kebal yang mencegah infeksi atau penyakit pada bayi. Perkembangan otak bayi akan semakin baik apabila bayi semakin banyak meminum ASI (Pasiak, 2006).

MENYUSUI DARI PERSPEKTIF SOSIAL BUDAYA

Air susu ibu (ASI) adalah makanan terbaik dan satu-satunya makanan yang dibutuhkan bayi untuk enam bulan pertama. Bayi yang diberi ibunya susu formula, air, teh, atau sereal sebelum enam bulan akan kurang menerima air susu ibu. Hal ini membuat ibu kurang menghasilkan air susu. Makanan-makanan lain ini juga dapat mengakibatkan diare, alergi, atau masalah-masalah lain pada bayi kecil (Klein, 2004). ASI sangat diperlukan untuk pertumbuhan dan perkembangan kecerdasan anak.Menurut penelitian, anak-anak yang tidak diberi ASI mempunyai IQ (Intellectual Quotient) lebih rendah 7-8 poin dibandingkan dengan anak-anak yang diberi ASI secara eksklusif (Yuliarti, 2010). Bayi akan mendapatkan kolostrum yaitu berupa cairan emas yang kaya akan antibodi dan sangat penting untuk pertumbuhan yang sangat dibutuhkan bayi, dapat dilakukan dengan mengupayakan bayi menyusu secara dini (Maryunani, 2005). ASI jika dikonsumsi bayi dapat menambah kadar DHA (Docosahexaenoic Acid) dalam otak. ASI mengandung banyak sekali DHA dan zat kebal yang mencegah infeksi atau penyakit pada bayi. Perkembangan otak bayi akan semakin baik apabila bayi semakin banyak meminum ASI (Pasiak, 2006).

Are HFOs in the Intra-operative ECoG Related to Hippocampal Sclerosis, Volume and IQ?

Temporal lobe epilepsy (TLE) is the most common form of refractory focal epilepsy and is often associated with hippocampal sclerosis (HS) and cognitive disturbances. Over the last decade, high frequency oscillations (HFOs) in the intraoperative electrocorticography (ioECoG) have been proposed to be biomarkers for the delineation of epileptic tissue but hippocampal ripples have also been associated with memory consolidation. Healthy hippocampi can show prolonged ripple activity in stereo- EEG. We aimed to identify how the HFO rates [ripples (80–250 Hz, fast ripples (250–500 Hz); prolonged ripples (80–250 Hz, 200–500 ms)] in the pre-resection ioECoG over subtemporal area (hippocampus) and lateral temporal neocortex relate to presence of hippocampal sclerosis, the hippocampal volume quantified on MRI and the severity of cognitive impairment in TLE patients. Volumetric measurement of hippocampal subregions was performed in 47 patients with TLE, who underwent ioECoG. Ripples, prolonged ripples, and fast ripples were visually marked and rates of HFOs were calculated. The intellectual quotient (IQ) before resection was determined. There was a trend toward higher rates of ripples and fast ripples in subtemporal electrodes vs. the lateral neocortex (ripples: 2.1 vs. 1.3/min; fast ripples: 0.9 vs. 0.2/min). Patients with HS showed higher rates of subtemporal fast ripples than other patients (Z = −2.51, p = 0.012). Prolonged ripples were only found in the lateral temporal neocortex. The normalized ratio (smallest/largest) of hippocampal volume was correlated to pre-resection IQ (r = 0.45, p = 0.015). There was no correlation between HFO rates and hippocampal volumes or HFO rates and IQ. To conclude, intra-operative fast ripples were a marker for HS, but ripples and fast ripples were not linearly correlated with either the amount of hippocampal atrophy, nor for pre-surgical IQ.

The quality of life of children with neurodevelopmental disorders and their parents during the Coronavirus disease 19 emergency in Japan

This study aimed to reveal how the COVID-19 stay-at-home period has affected the quality of life (QOL) of children with neurodevelopmental disorders and their parents and to identify possible factors that enabled them to maintain their QOL. We enrolled 136 school-aged children (intellectual quotient ≥ 50) and their parents and administered QOL questionnaires to assess the maladaptive behavior of the children; depression, anxiety, and stress of the parents; and activities of their daily lives. The relationship between their QOL and clinical features was examined. The decrease in QOL of children and parents was associated with the mother’s limited job flexibility. Decreased QOL was also associated with changes in the sleep rhythms of the children. Maladaptive behaviors in children were associated with parental stress. However, maintained QOL of some families who faced these same conditions of job stress and sleep disorders was associated with less parental stress, less parental depression and anxiety, and milder maladaptive behavior in children. Both mothers with limited job flexibility and changes in the sleep rhythm of children were associated with reduced QOL of children and their parents. Low parental stress was associated with decreased maladaptive behavior in children and with maintained QOL of the family.

MBCL-02. ROLE OF PREOPERATIVE CHEMOTHERAPY IN METASTATIC MEDULLOBLASTOMA: A COMPARATIVE STUDY IN 92 CHILDREN

BACKGROUND Previous pilot studies have shown the feasibility of preoperative chemotherapy in patients with medulloblastoma, but benefits and risks compared with initial surgery have not been assessed. METHODS Two therapeutic strategies were retrospectively compared in 92 patients with metastatic medulloblastoma treated at Gustave Roussy, France, between 2002 and 2015: surgery at diagnosis (n=54; group A) and surgery delayed after carboplatin and etoposide-based preoperative therapy (n=38; group B). Treatment strategies were similar in both groups. RESULTS The rate of complete tumor excision was significantly higher in group B than in group A (93.3% versus 57.4%, p=0.0013). Post-operative complications, chemotherapy-associated side effects and local progressions were not increased in group B. Preoperative chemotherapy led to a decrease in the primary tumor size in all patients, 4/38 patients experiencing meanwhile a distant progression. The histological review of 19 matched tumor pairs (before and after chemotherapy) showed that proliferation was reduced and histological diagnosis feasible and accurate even after preoperative chemotherapy. The 5-year progression-free and overall survival rates were comparable between groups. Comparison of the longitudinal neuropsychological data showed that intellectual outcome tended to be better in group B (the mean predicted intellectual quotient value was 6 points higher throughout the follow-up). CONCLUSION Preoperative chemotherapy is a safe and efficient strategy for metastatic medulloblastoma. It increases the rate of complete tumor excision and may improve the neuropsychological outcome without jeopardizing survival.