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Diagnosing learning disorders : from science to practice
\"A definitive reference--now extensively revised with 70% new material--this book presents cutting-edge knowledge on how learning disorders develop and how to diagnose and treat them effectively. In additional to dyslexia and mathematics disabilities, the book covers speech and language disorders, attention-deficit/hyperactivity disorder, autism spectrum disorder, and intellectual disability. Accessibly written, it is grounded in genetics, neuroscience, and developmental neuropsychology. Clinicians and educators are guided to make sense of children's impairments and strengths and make sound diagnostic decisions. Best practices in intervention are reviewed. User-friendly features include case examples and summary tables in each disorder-specific chapter. New to This Edition *Revised throughout to reflect major theoretical, empirical, and technological advances. *Chapters on etiology, brain development, and comorbidity. *Chapters on DSM-5 diagnosis of specific learning disorder, evidence-based assessment, and achievement gaps\"-- Provided by publisher.
Book
Executive functions and school readiness intervention: Impact, moderation, and mediation in the Head Start REDI program
Despite their potentially central role in fostering school readiness, executive function (EF) skills have received little explicit attention in the design and evaluation of school readiness interventions for socioeconomically disadvantaged children. The present study examined a set of five EF measures in the context of a randomized-controlled trial of a research-based intervention integrated into Head Start programs (Head Start REDI). Three hundred fifty-six 4-year-old children (17% Hispanic, 25% African American; 54% girls) were followed over the course of the prekindergarten year. Initial EF predicted gains in cognitive and social–emotional skills and moderated the impact of the Head Start REDI intervention on some outcomes. The REDI intervention promoted gains on two EF measures, which partially mediated intervention effects on school readiness. We discuss the importance of further study of the neurobiological bases of school readiness, the implications for intervention design, and the value of incorporating markers of neurobiological processes into school readiness interventions.
Journal Article
Supplemental choline to prevent and treat learning and memory deficits of early-life iron deficiency (The SupCHO Study): study protocol for a randomized, placebo-controlled trial in Ugandan infants with iron deficiency anemia
Background
Iron deficiency (ID) limits the neurodevelopmental potential of more than 200 million children each year. Iron therapy started when IDA is first diagnosed—typically by screening for anemia or detection of clinical symptoms of IDA at 12 months of age—does not fully correct earlier ID-mediated brain dysfunction, underscoring the need for low-cost, easily implementable adjunct therapies to iron to treat or prevent this dysfunction in high-risk populations. Supplementation with the essential nutrient choline lessens damage done to the developing hippocampus when given with iron in pre-clinical rodent models, and choline supplementation improves hippocampus-mediated memory and learning in 2–3-year-old children with Fetal Alcohol Spectrum Disorders, a condition associated with hippocampal damage and one for which ID is a component of the neuropathology. Choline has not been tested in children with IDA. Our overall aim is to conduct a randomized, placebo-controlled clinical trial to test whether nine months of daily choline supplementation along with standard iron therapy improves hippocampus-dependent neurobehavioral outcomes in Ugandan infants with IDA.
Methods
Three hundred 6-month-old infants with IDA who present to immunization clinics at Mulago and Kawempe National Referral Hospitals in Kampala, Uganda, will be randomized to iron plus choline or iron plus placebo. Iron (oral ferrous sulfate 2 mg/kg/day) will be given for the first 3 months of follow-up, and a dispersible tablet of choline (200 mg as choline bitartrate) or identical placebo will be given daily for all 9 months of follow-up. We will conduct neurobehavioral tests assessing hippocampus-specific memory and attention and global cognition at enrollment (when each infant is 6 months of age) and after 9 months of follow-up (when each infant is 15 months of age).
Discussion
If we find a neurobehavioral benefit when choline is given along with iron, choline could be added immediately to standard of care treatment for IDA. This low-cost intervention could safely mitigate the brain dysfunction of early-life ID that is often not diagnosed until the hippocampal critical window is closing, providing life-long benefit for both the individual and the economic and social prosperity of entire regions.
Trial registration
Clinical trials.gov NCT06527391. Registered on 24 July 2024.
Journal Article
Supported self-management for adults with type 2 diabetes and a learning disability (OK-Diabetes): study protocol for a randomised controlled feasibility trial
Background
Individuals with a learning disability (LD) are at higher risk of developing type 2 diabetes, but LD is not straightforward to define or identify, especially at the milder end of the spectrum, which makes case finding difficult. While supported self-management of health problems is now established, current material is largely educational and didactic with little that facilitates behavioural change. The interaction between the person with diabetes and others supporting their care is also largely unknown. For these reasons, there is considerable work needed to prepare for a definitive trial. The aim of this paper is to publish the abridged protocol of this preparatory work.
Methods/Design
Phase I is a prospective case-finding study (target n = 120 to 350) to identify and characterise potential participants, while developing a standardised supported self-management intervention. Phase II is a randomised feasibility trial (target n = 80) with blinded outcome assessment. Patients identified in Phase I will be interviewed and consented prior to being randomised to (1) standard treatment, or (2) supported self-management. Both arms will also be provided with an ‘easy read’ accessible information resource on managing type 2 diabetes. The intervention will be standardised but delivered flexibly depending on patient need, including components for the participant, a supporter, and shared activities. Outcomes will be (i) robust estimates of eligibility, consent and recruitment rates with refined recruitment procedures; (ii) characterisation of the eligible population; (iii) a standardised intervention with associated written materials, (iv) adherence and negative outcomes measures; (v) preliminary estimates of adherence, acceptability, follow-up and missing data rates, along with refined procedures; and (vi) description of standard treatment.
Discussion
Our study will provide important information on the nature of type 2 diabetes in adults with LD living in the community, on the challenges of identifying those with milder LD, and on the possibilities of evaluating a standardised intervention to improve self-management in this population.
Trial registration
Current Controlled Trials
ISRCTN41897033
(registered 21 January 2013).
Journal Article
Facilitating pragmatic skills through role-play in learners with language learning disability
Background: Role-based learning involves the process whereby learners acquire skills, knowledge and understanding through the assumption of roles within real-life settings. Roleplay holds potential as an effective learning strategy for children; however, there is limited research on the use of role-play as a therapy method within the field of speech-language pathology. Children with language learning disability (LLD) typically present with difficulties in social communication, which can negatively affect their social and academic achievement. Aim: The aim of this study was to determine the effectiveness of role-play as a therapy approach targeting the pragmatic skills of stylistic variation and requesting for clarification in learners with LLD. Method: The use of combined positivist and interpretivist paradigms allowed for the implementation of an embedded mixed methods design. An experimental pretest-posttest design was implemented. Eight participants, who were learners with a diagnosis of LLD, were purposefully selected. Data collection was conducted over five phases, utilising the Clinical Evaluation of Language Fundamentals (4th Ed.) Pragmatics Profile, discourse completion tasks, session plans and session records. Quantitative data were analysed using descriptive statistics and were supplemented by qualitative data from session records. Results: Results revealed improvements in stylistic variation and requesting for clarification post role-play intervention, with minimal changes in the control group. Limitations of the study have been reported for consideration when interpreting results. Conclusion: Role-play as a therapy approach targeting two pragmatic skills, stylistic variation and requesting for clarification, was found to be beneficial for learners with LLD. Recommendations for the implementation of role-play as a therapy approach were made.
Journal Article
Wordless intervention for epilepsy in learning disabilities (WIELD): study protocol for a randomized controlled feasibility trial
Background
Epilepsy is the most common neurological problem that affects people with learning disabilities. The high seizure frequency, resistance to treatments, associated skills deficit and co-morbidities make the management of epilepsy particularly challenging for people with learning disabilities. The Books Beyond Words booklet for epilepsy uses images to help people with learning disabilities manage their condition and improve quality of life. Our aim is to conduct a randomized controlled feasibility trial exploring key methodological, design and acceptability issues, in order to subsequently undertake a large-scale randomized controlled trial of the Books Beyond Words booklet for epilepsy.
Methods/Design
We will use a two-arm, single-centre randomized controlled feasibility design, over a 20-month period, across five epilepsy clinics in Hertfordshire, United Kingdom. We will recruit 40 eligible adults with learning disabilities and a confirmed diagnosis of epilepsy and will randomize them to use either the Books Beyond Words booklet plus usual care (intervention group) or to receive routine information and services (control group). We will collect quantitative data about the number of eligible participants, number of recruited participants, demographic data, discontinuation rates, variability of the primary outcome measure (quality of life: Epilepsy and Learning Disabilities Quality of Life scale), seizure severity, seizure control, intervention’s patterns of use, use of other epilepsy-related information, resource use and the EQ-5D-5L health questionnaire. We will also gather qualitative data about the feasibility and acceptability of the study procedures and the Books Beyond Words booklet. Ethical approval for this study was granted on 28 April 2014, by the Wales Research Ethics Committee 5. Recruitment began on 1 July 2014.
Discussion
The outcomes of this feasibility study will be used to inform the design and methodology of a definitive study, adequately powered to determine the impact of the Books Beyond Words intervention to improve the management of epilepsy in people with learning disabilities.
Trial registration
http://ISRCTN80067039
(Date of ISRCTN assignation: 23 April 2014).
Journal Article
Seven steps to separating difference from disability
“This is a complete book for practitioners, helping me determine at what stage in the process my child study team is and where we should go next.”—Margarete Couture, Principal, Seneca Central School District, Interlaken, NY“This book contributes significantly to the body of literature on RTI. No professional library will be complete without this book for addressing the multicultural perspective.”—Karen Kozy-Landress, Speech/Language Pathologist, MILA Elementary School, Merritt Island, FLEnsure appropriate placement and services for your school's diverse students!When a culturally and linguistically diverse (CLD) student struggles in school, how can you tell whether language or cultural differences are the cause, or if the student has a learning or behavioral disability? Because the reason can be difficult to pinpoint, having the right assessment process in place is crucial. Seven Steps to Separating Difference From Disability shows how educators can adapt the widely used Response to Intervention (RTI) model to make sound decisions regarding a student's education.Catherine Collier presents a framework that breaks down the process into seven clear steps for determining each student's unique strengths and needs, helping educators make appropriate decisions regarding resources, referrals, and integrated services. Principals, school administrators, and RTI team members will find:Develop your team's ability to distinguish between learning differences and disabilities so you can better serve all students!
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