Strategies for analyzing complex cognitive impairments – a dynamic testing approach
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AbstractResearch strategies can be related to pragmatic or epistemic goals. The strategies presented in this paper are mainly developed within the framework of a pragmatic perspective of generating knowledge: The research questions which are formulated are guided by goals of integration (rehabilitation) or symptom reduction (therapy) with handicapped persons. Critical issues of this approach are the selection of the specific cognitive variables and of particular methods of intervention. These issues are addressed in cognitive remediation research by three types of interrelated studies: Feasibility studies, studies of functional relations (with regard to indicators of goals) and generalizability studies (with regard to performance change). We proposed to extend this approach by adding the component of interindividual differences in modifiability. This component is theoretically and methodologically addressed by the Dynamic Assessment approach. In Dynamic Assessment, domains of analyzing modifiability refer to the characteristics of the task, of the person, and the type of intervention applied. A corollary to this is the identification of groups of persons that are different in modifiability, thus indicating different educational or therapeutic needs
The metalinguistic benefits of italian–vernacular bilingualism. Studies in some southern regions of italy
AbstractThe aim of present research is to study the relationships between Italian-vernacular bilingualism and metalinguistic development in primary school children of some southern regions of Italy, namely Sicily, Campania and Calabria. Authoritative linguists have demonstrated on structural linguistic grounds that Italian vernaculars are in fact neo-latin languages on their own, standing in a low variety position towards the national language, following a typical diglossic pattern. In the introduction, it is argued that in contexts where a local vernacular and Italian are learnt simultaneously in early childhood, children who develop through these two codes must be considered as bilinguals just as other types of bilinguals with two national languages. A first explorative study, carried out by the authors in Sicily, produced convincing evidence that balanced Italian-vernacular 5th graders were more advanced than their unbalanced counterparts matched by age, sociocultural background and non verbal intelligence, when assessed through a metalinguistic ability test in Italian. A more complex design was applied afterwards in two other regions, the results of which are partly referred to in the present study. A total sample of 202 5th graders (mean age: 10,6 years) was selected on the following grounds: a) balanced and unbalanced Italian-vernacular bilingualism, assessed through a sociolinguistic questionnaire; b) sociocultural status, low and middle class level, from a village and from a city in Campania; c) an experimental factor, consisting of a short translation task from Italian into vernacular. Half of the total sample was asked to perform it, and thus constituted the Experimental Group (EG), as opposed to the Control Group (CG) who did not perform it. In both EG and CG, half of the children were randomly selected from the balanced and the unbalanced group. Metalinguistic abilities were assessed through 4 tasks of MAT-2, a specific Italian metalinguistic ability test for ages 9 to 14, administered at the pre-test and at the post-test to the whole sample, with a 4 months interval, whereas the translation task was only administered to the EG in between. Results show that: a) balanced bilinguals always are metalinguistically superior to the unbalanced, both at the pre-test and at the post-test; b) the Italian-vernacular translation task has an even more powerful effect on metalinguistic scores at the post-test, significantly enhancing the performances of the whole EG; c) sociocultural background has an indirect influence on metalinguistic awareness, i.e. only when combined with the language balance factor, low status unbalanced children performing the worst and low status balanced children performing just as middle class ones. Results, which are very consistent in Campania and in Calabria, are discussed in the light of the unexplored potential of this type of bilingualism, especially relevant to low sociocultural status children.
Transcultural valences in children's drawings as an instrument of communication. A comparison between children from sicily and kosovo
AbstractThe cross-cultural studies on children’s drawings have pointed out two fundamental applications: the first is in projective sphere, in which psychic factors show themselves in an unconscious way; the latter is the so-called "eye's primacy", distinguished by a phenomenological approach to experiential data. This research, connected to the first application, studies the differences between the drawing productions of two primary school children groups, the first group of children coming from Kosovo, during their sojourn in Comiso, the second group coming from Ragusa and belonging to the two branch houses of a primary school - the first urban the other rural. The study of drawing outputs, through the use of paper-pencil tests, intended to explore some psychological factors such as self-cohesion and body image, affective anchorage to parents, richness of the symbolic expression of affect and thought, the ability to symbolize. The outcome, enucleated through statistical analysis of the drawings, pointed out a different degree of symbolical competence not between the children from Kosovo and those from Ragusa, but between rural (Kosovo+ rural ragusan children) and urban (urban ragusan children) children. The former show a self- perception that is more closed and less oriented toward the external context. Also evidenced was the tendency of the children from rural areas (of whatever origin) to have a documentary approach to free-drawing and express a lower ability of creative elaboration of directions.
Happiness and optimism in istitutionalized elderly
AbstractIn this work we want to study the relationship between perceived happiness and some characteristics of personality, in the general perspective of quality of life. In particular we have studied how personal inclinations for optimism or pessimism, or expectations for positive and negative outcomes influence the individual’s well-being level (measured as happiness). The construct of happiness we have considered is that Kozma, Stone, Stones, Hannah, & McNeil, (1990) proposed as a character disposition or inclination expressed as the prevalence of positive affects. The scale they constructed, the “Memorial University of Newfoundland Scale of Happiness” or MUNSH (Kozma & Stones, 1980), aims at underlining the relationship between positive affects and negative affects and their persistence over time. Another important purpose of our research was to verify the psychometric properties of the MUNSH. 300 elderly people that lived in institutions (range 65-107 years old) were interviewed and assessed with the following questionnaires: MUNSH, ELOT and EPQ-r. A satisfactory level of subjective perception of happiness was found in the subjects of our sample, even in their present condition of institutionalization, and their past stressful experiences. From the statistical analyses carried out, positive relationships between scores of happiness and personality characteristics have emerged. Besides confirming the existence of a significant relation between happiness and optimism-pessimism, the statistics of our study have shown that both these dispositions are stable over time.
From mild traumatic brain injury to persistent postconcussive syndrome: a forced development to chronic disability?
AbstractMild head injury represents a complex pathology, in which many somatic and psychological factors are involved, especially when symptoms enlarge and last in persistent postconcussive syndrome (PPCS). However, minor head injury should not be undervalued. Its natural history, in fact, is much longer than physicians allow, but it can’t be considered per se the first step of a forced development to a chronic disability. Mild traumatic brain injury, in fact, neuropathologically, differs from severe traumatic brain injury only on a quantitative standpoint. As in severe trauma, the primary neuropathology is diffuse axonal injury. However, in most cases, neurobehavioral and neuropsychological symptoms gradually improve, although there are some risk factors for developing persistent symptoms and chronic disability. In fact, the brain injured, may be, frequently, rewarded by financial awards for exhibiting and persisting impairment. Yet, the severity of trauma is defined by the acute injury features and not by severity of symptoms long after trauma. Additionally, for any symptom to be considered as a consequence of trauma it must be consistent and in accordance with neuropathology of injury, systemic organization of damaged cortical functions, premorbid personality and post trauma context of patient. A basic assumption is that all patients improve, both neurologically and neuropsychologically, although the time course of full recovery may be much longer than once considered. In fact we do not know of any features of trauma that per se, neurologically speaking, lead to progressive deterioration. With regards to somatic and psychological symptoms associated with traumatic neurologic injury, it is very important to differentiate them from primary neural injury. PPCS must be understood through a diagnostic approach able to differentiate the role of associated somatic and psychological symptoms from the primary neuropathology, that gradually improves to full recovery according to acute injury characteristics. PPCS doesn’t result from the trauma per se or single psychological and somatic symptoms, but instead from variables such as age of patient, premorbid personality, complicating factors, context after trauma, psychological and emotional characteristics and severity of associated symptoms. Only an holistic approach which considers the patient’s personal history, trauma characteristics, quality and consistency of the symptoms, and neuropsychological data provides an adequate understanding of symptomatological progress, its real significance and the factors that cause it.
Early prediction of reading and writing disabilities: some methodological problems in the assessment of tasks validity.
AbstractThe applied research on reading and writing disabilities, is increasingly interested in the identification of children at risk in preschool children. This kind of investigation presents both theoretical and methodological problems such as: the selection of fitting models and instruments and the high cost of screening whole classes. The aim of this paper consists in proposing a two-stage method of cognitive assessment of learning disabilities: a) a preliminary screening of the population using “critical” and non redundant measures and b) a deeper stage of analysis of children identified as disabled during the first assessment. Three secondary aims were also considered: a) to recover the research tradition on visuo-spatial components of reading and writing after a long period in which it was overlooked, b) to obtain, by means of a statistical procedure, groups of children with similar profiles in reading and writing, c) to detect the best criteria for the selection of the control groups. In the present work a recent instrument (PACSI) for the evaluation of cognitive abilities in pre-readers has been used. A cluster analysis (method of k-means) identified a group of learning-disabled children who did not differ from the other children with regards to IQ. Re-sampling children without learning disabilities, nine different control groups were formed and subsequently compared in an equal number of discriminate analyses with the group of disabled children. This procedure has led to a reliable result indicating that four tests, out of the 12 enclosed in PACSI, were able to predict the children’s reading and writing performances. Such tests were: Naming, Working Memory, Visual Search and Segmentation. This result suggests a re-examination of the phonological-core hypothesis of reading and writing disabilities, since other functions seem to be implied in these processes: e.g. semantic and working memory and visual scanning. PACSI should be adopted both in its reduced format- as a efficient instrument for wide screening of the population- and as a complete instrument to study cognitive profiles of pre-readers or beginning readers with reading and writing disabilities.
Icf – international classification of functioning, disability and health.
AbstractIn 1980 the WHO published a classification of consequences of diseases and impairments, titled ICIDH, in which concepts of Impairments, Disability and Handicap are defined. In 1997, after many years of experimental research, a revised version named ICDH-2 was published. It is divided in three sessions, which indicate the areas involved with the diseases: Body Functions and Structures, Activities, Participation. The last version, namely the International Classification of Functioning, Disability and Health, ICF, unlike the 1980 ICIDH, is not a classification of “diseases’ consequences”; it is rather a classification of “health components”, namely all the basic and relevant factors which form health and well-being. It is a useful tool for statistical, clinical, rehabilitative and educational planning purposes. For those who deal with research, it helps to detect relevant data from a scientific point of view, in order to understand and examine patient’s health and related conditions. In this paper, language development and disability concepts, structures and basic concepts of the ICF are presented. The ICF is the latest tool of the WHO for the classification of “health components”.
Educational interventions in psychiatry: school in the communities
AbstractAccording to the OMS reports, four mental pathologies (affective disorders, mental weakness, schizophrenia and dementia) are among the twelve pathologies that, world-wide, cause a long time term disability most frequently. Therapy, rehabilitation and integration of the psychiatric patients involve different professional figures and different Institutions. In this paper we present an inter-institutional collaboration experience between the School and the Local Service for Mental Health, started at the beginning of the ‘90, in Padua. A team of teachers operates full time in some psychiatric communities, where they are part of the multidisciplinary team, with adults affected with chronic psychosis. The aims of this project are: Contributing to curb the pathological symptoms; Promoting and increasing self-efficacy and personal autonomy; Contributing to the improvement of self-confidence; Increasing the social-relational abilities; Contributing to restore acceptable psycho-physical conditions; Facing problems connected to the use of the new technologies. The proposed activities include: an expressive-linguistic laboratory with the editing of a Communities Newspaper, an informatics laboratory, a biological horticulture laboratory, an adapted physical activity programme and a musical-artistic laboratory that includes a chorus. The integration of different roles, competencies and Institutions in the management of a rehabilitative path is a complex process, in which identity affirmation of the different figures (psychiatrists, psychologists, nurses, teachers, educators) represents a key point. The need to connote (in a non regressive manner) the presence of the school represents an ulterior difficulty. Despite this, the presence of the “Institution School” in the psychiatric territory has been positively valued, regarding different aspects: the percentage of patients that regularly attend the courses is very high; for many patients the participation has contributed to an increase in personal autonomy, it has promoted social abilities and has allowed the acquisition of competencies in different fields. Attending the courses has significantly facilitated the passage of any patients to rehabilitative-relief structures with a lower degree of protection.