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Two placebo-controlled trials involving pregnant women with subclinical hypothyroidism or hypothyroxinemia showed that levothyroxine beginning between 8 and 20 weeks of gestation did not significantly improve cognitive outcomes in children through 5 years of age. Observational studies spanning almost three decades suggest that subclinical thyroid disease during pregnancy is associated with adverse outcomes. 1 – 5 In 1999, interest in undiagnosed maternal thyroid dysfunction was heightened by studies suggesting an association between subclinical thyroid hypofunction and impaired fetal neuropsychological development. 6 , 7 In one report, children of women whose serum thyrotropin levels during pregnancy were greater than the 98th percentile had a lower IQ than children of matched controls who had a normal thyrotropin level. 6 In another study, children whose mothers had a serum free thyroxine (T 4 ) level of less than the 10th percentile in early . . .

In this randomized trial, antenatal screening (at a median gestational age of 12 weeks 3 days) and treatment for hypothyroidism did not result in improved cognitive function in children at 3 years of age. Active secretion of thyroid hormone in the fetus does not start until about 18 to 20 weeks' gestation. 1 Studies in animals suggest that until fetal hormone secretion begins, the fetus is dependent on circulating free thyroxine (T 4 ) in the mother for growth and development, including central nervous system maturation. 1 Iodine is essential for free T 4 synthesis, and in iodine-deficient populations, an increase in cognitive performance has been observed after iodine supplementation before pregnancy. 2 – 4 High levels of thyrotropin in women during pregnancy have been associated with impaired cognitive development in their offspring. This finding suggests that antenatal . . .

Children with intellectual and developmental disabilities (IDD) experience significant difficulties in attention, learning, executive functions, and behavioral regulation. Emerging evidence suggests that computerized cognitive training may remediate these impairments. In a double blind controlled trial, 76 children with IDD (4–11 years) were randomized to either an attention training (n = 38) or control program (n = 38). Both programs were completed at home over a 5-week period. Outcome measures assessed literacy, numeracy, executive functioning, and behavioral/emotional problems, and were conducted at baseline, post-training, and 3-month follow-up. No training effects were observed at post-training; however, children in the training group showed greater improvements in numeracy skills at the 3-month follow-up. These results suggest that attention training may be beneficial for children with IDD; however, the modest nature of the intervention effects indicate that caution should be taken when interpreting clinical significance.

Background People with mild intellectual disabilities (MID) are at elevated risk of substance-use problems. Beat the Kick is a motivation-focused, MID-adapted pre-treatment program. This trial aims to test whether Beat the Kick increases autonomous motivation to enter substance-use treatment versus care-as-usual (CAU), and to examine effects on substance use, satisfaction of basic psychological needs, treatment engagement, and acceptability. Methods Open-label, multicenter superiority randomized controlled trial in the Netherlands. We will recruit 138 adults (≥ 18 years) with MID or borderline intellectual functioning (intelligence quotient (IQ) 50–85 with adaptive limitations) and hazardous substance use (Alcohol Use Disorders Identification Test (AUDIT) ≤ 19 or Drug Use Disorders Identification Test (DUDIT) ≤ 24; ≥ 12 months) from six intellectual-disability care organizations. Recruitment will be conducted jointly by researchers from Tilburg University and care professionals at the participating organizations. In a Zelen pre-randomization design, eligible clients will be randomized 1:1 to Beat the Kick or CAU using a centralized computer-generated sequence with variable block sizes, stratified by addiction type (alcohol vs cannabis/other drugs). Tilburg researchers will obtain informed consent after allocation (intervention: consent for intervention + assessments; CAU: consent for assessments only). As an open-label trial, only the statistical analyst will remain blinded to allocation via A/B-coded datasets; the allocation key is held by an independent coordinator until primary analyses are complete. Assessments occur at T1 (pre), T2 (post), T3 (1 month), and T4 (6 months). Safety is monitored at T2–T4 through systematic adverse event (AE) and serious adverse event (SAE) recording, and serious events are reported to the Ethics Review Board within 24 h.Primary outcome: autonomous motivation (Treatment Self-Regulation Questionnaire; 15 items; 1–5 scale). Secondary outcomes: substance use ( Substance Use and Misuse in Intellectual Disability Questionnaire (SumID-Q) with AUDIT (0–40; ≥ 8 hazardous; ≥ 20 probable dependence) and DUDIT (0–44; ≥ 6 men/ ≥ 2 women hazardous; ≥ 25 probable dependence)), satisfaction and frustration of psychological needs (Basic Psychological Need Satisfaction and Frustration Scale – Intellectual Disability Version (BPNSFS-ID); 24 items; 1–5), treatment engagement (yes/no), and participant satisfaction. Primary analyses will use intention-to-treat linear mixed-effects models with fixed effects for group, time, and group × time, adjusting for the stratification variable. Discussion This study evaluates a motivation-focused, MID-adapted program under routine conditions. Anticipated challenges (open-label bias, retention) are addressed through exclusive trainer allocation per arm, supportive scheduling, and caregiver involvement. If effective, Beat the Kick could be integrated into standard practice to improve readiness for treatment, substance-use outcomes, and overall well-being in adults with MID. Trial registration ISRCTN Registry, ISRCTN12571979. Registered on 11 June 2025. This trial was prospectively registered.

This randomized controlled trial examined the efficacy of peer network interventions to improve the social connections of 47 high school students with severe disabilities. School staff invited, trained, and supported 192 peers without disabilities to participate in individualized social groups that met throughout one semester. Compared to adolescents in the “business-as-usual” control group (n = 48), students receiving peer networks gained significantly more new social contacts and friendships. Although many peer relationships maintained one and two semesters later, their spill over beyond the school day was limited. Students and staff affirmed the social validity of the interventions. We offer recommendations for research and practice aimed at improving the implementation and impact of peer network interventions in secondary schools.

Background Siblings of children with disabilities also need support. However, there are only a few evidence-based interventions for these siblings. The current study aims to assess the effectiveness of a newly developed serious game for young siblings of children with intellectual disability (ID) and/or visual impairment (VI). This serious game is hypothesized to improve sibling’s quality of life, adjustment to their brother’s or sister’s disability, and multiple aspects of psychosocial well-being. Methods The intervention consists of a serious game called “Broodles” (in Dutch: “Broedels”) that helps children to recognize and deal with thoughts, feelings, and difficult situations. The game consists of eight 20-minute levels that all have the same structure with eight game elements. Each level addresses a domain of sibling quality of life and combines animations, mini-documentaries, fun mini-games, and multiple-choice questions. In addition to the game, siblings make a worksheet after playing each level. In order to support the child, the parents or caregivers receive a short brochure with information and tips. The effectiveness of the intervention will be investigated among a sample of 154 children aged 6–9 years and their parents or caregivers, using a two-arm parallel RCT design. The experimental group will play the serious game “Broodles” over a period of 4 weeks, whereas the control group will be placed on a waiting list. Assessments will take place at three time points: pre-test (week 1), post-test (week 5), and follow-up (weeks 12–14). At each timepoint, children and parents will complete several questionnaires on quality of life and different aspects of psychosocial well-being. In addition, children will make drawings to assess the sibling relationship. Next to that, parents and children will answer closed and open-ended questions about the sibling adjustment to their brother or sister’s disability. Finally, parents and children will evaluate the serious game through closed and open-ended questions. Discussion This study contributes to the knowledge about sibling interventions and serious games. Additionally, if the serious game is proven to be effective, it will be a readily available, easily accessible, and free of charge intervention for siblings. Trial registration ClinicalTrials.gov, NCT05376007, registered prospectively on April 21, 2022.

ObjectivesOne in five children have a learning and attentional disability (LAD). Parents of children with LAD are vulnerable to distress, but an evidence-based treatment has not been developed.MethodsFrom June 2016 to November 2017, we conducted a mixed methods study to adapt and assess the virtual delivery of a mind-body group resiliency program, the Stress Management and Resiliency Training-Relaxation Response Resiliency Program (SMART-3RP), to meet the needs of parents of children with LAD; this is an 8-session weekly group intervention. In the first phase, we conducted 4 parent focus group interviews, 2 professional focus group interviews, and 5 professional individual interviews, and 1 pilot group to adapt the SMART-3RP to target the needs of parents of children with LAD. In the second phase, we conducted a pilot wait-list controlled study to assess the feasibility, acceptability, and preliminary efficacy of a videoconferencing delivery of the adapted program. Parents were randomized to an immediate intervention group (IG) or wait-list control group (WC). Surveys were administered at baseline (time 1), end of intervention for the IG or 3 months post-baseline for the WC (time 2), and 3 months post treatment for the IG or end of intervention for the WC (time 3).ResultsQualitative findings illustrated high levels of parental stress, with primary stressors including navigating the educational system, interactions with other parents, familial concerns, and financial and professional sacrifices. We adapted the manual to target these stressors and modified session logistics and delivery. Fifty-three parents (mean age = 46.8; 90.6% female) participated nationally in the pilot trial. 62.5% of participants completed ≥ 6/8 sessions; 81.8% reported continued daily/weekly relaxation response exercise practice. T1–T2 comparisons found that IG versus WC participants showed significant improvements in distress [VAS], ∆M = − 1.95; d = .83 and resilience [CES], ∆M = 6.38; d = .83, as well as stress coping [MOCS-A] ∆M = 8.69; d = 1.39; depression and anxiety [PHQ-4], ∆M = − 1.79; d = .71; social support [MOS-SSS], ∆M = 5.47; d = .71; and empathy [IRI], ∆M = 3.17; d = .77; improvements were sustained at the 3 month post intervention follow-up.ConclusionPilot wait-list randomized trial findings showed promising feasibility, acceptability, and preliminary efficacy for the SMART-3RP intervention adapted for parents of children with LAD. This virtually-delivered resiliency intervention improved parents’ distress, resiliency, and stress coping, which were sustained.Clinical Trials IDNCT02772432.

Background Persons with mild to borderline intellectual disabilities generally show dysfunctions in mentalization and stress regulation, resulting in problematic social relationships and personal distress. Intervention programs may improve mentalizing abilities. The aim of this study is to examine the effectiveness of the serious game ‘You & I’ in changing mentalizing abilities and stress regulation in adults with mild to borderline intellectual disabilities. Methods A two-arm, parallel, superiority randomized controlled trial will be used with 172 adults with mild to borderline intellectual disabilities. Participants will be randomly assigned to either the experimental group to play the serious game ‘You & I’ or a waitlist control group. Participants will be assessed at baseline, post intervention (5 weeks after baseline), and follow-up (6–8 weeks after post intervention). They also will fill in questionnaires for personal factors, personal development, personal well-being, social validity, autism spectrum quotient (demographic variables), mentalizing abilities (primary outcome measure), and stress regulation (secondary outcome measure). Discussion The serious game ‘You & I’ aims to improve mentalizing abilities in adults with mild to borderline intellectual disabilities, which is expected to lead to improved regulation of stress in social relationships. The study’s unique feature is the use of a serious game to improve mentalizing abilities. If the intervention is effective, the serious game can be implemented on a broad scale in Dutch care organizations for people with intellectual disabilities as an effective preventive tool to improve mentalizing abilities. Trial registration Netherlands Trial Register, NTR7418 . Registered on 2 August 2018.

Lennox-Gastaut syndrome (LGS) is a devastating and refractory generalized epilepsy affecting children and adolescents. In this study we report the results of resective surgery in 18 patients with LGS phenotype who underwent single-lobe/lesionectomy or multilobe resection plus multiple subpial transection and/or callosotomy. After surgery, seven patients became completely seizure-free (Engel Class I) and five almost seizure-free (Engel Class II). Additional four had significant seizure control (Engel Class III), and two had no change in seizure frequency (Engel Class IV). Of the 4 patients without any lesion on brain MRI, 2 ended with Engel Class II, 1 with III and the other with IV in Engels’ classification. Mean intelligence quotient (IQ) increased from 56.1 ± 8.1 (mean ± SD) before operation to 67.4 ± 8.2 (mean ± SD) after operation, a significant improvement (P=0.001). Results also indicated that the younger the patient at surgery, or the shorter the interval between onset of seizure and resective operation, the better the intellectual outcome. Our data suggest that resective epilepsy surgery can be successful in patients with LGS phenotype as long as the EEG shows dominance of discharges in one hemisphere and corresponding ipsilateral imaging findings, even with contralateral ictal discharges.

Background Extended brief interventions (EBIs) are effective in targeting alcohol misuse in the general population. However, little is known of the effects of EBI in adults with intellectual (also known as learning) disabilities. In this feasibility trial we compared EBI with usual care for alcohol misuse in adults with mild to moderate Intellectual Disability (ID). Methods The study took place in three community ID networks of services in England. Participants aged 18–65 years with reported alcohol problems, a score ≥8 on the Alcohol Use Disorder Identification Test (AUDIT), and IQ <70 (+/5%CI) were recruited and were randomly allocated to either EBI (five weekly sessions and one follow-up at 8 weeks) and usual care or usual care alone. Research assistants were blind to arm allocation. Research assessments took place at baseline, 2 and 3 months. The primary outcome was reduction in alcohol consumption measured by the AUDIT. Preliminary health economic analysis was performed to investigate the costs of delivering EBI and the feasibility of a cost-effectiveness analysis in a full trial. The trial is closed. Results Participants were recruited from January 2014 to August 2015. Thirty individuals were randomised (15 in each arm) and provided primary outcome data. In regard to harmful drinking, at baseline, all the participants exceeded the relevant threshold. At 8 weeks, the proportion of participants with harmful drinking had decreased to 60% for both groups, and at 12 weeks it had decreased by 66°7% and 46°7% for the intervention and the control groups, respectively. The unit cost for the delivery of EBI is £430. Conclusions Recruitment to this trial has been proven challenging as prevalence of alcohol misuse in the targeted population was lower than anticipated. EBI may provide an effective low-intensity treatment for this population. Participants’ and carers’ feedback on their experience was overall positive. Further work needs to be undertaken to ascertain the group of participants that should be participating in a future definitive trial. Trial registration Psychological Intervention Alcohol Misuse Learning Disability; isrctn.com, identifier: ISRCTN58783633 . Registered on 17 December 2013.