RESUMEN
INTRODUCTION: Non-verbal learning disorder (NVLD) is the name given to a complex group of difficulties with a well-defined biological substrate. Their clinical manifestations affect the motor area, visuospatial organisation and the social competencies. AIM: To analyse the semiology that differentially identifies NVLD by means of a model of interpretation based on the experience gained in a non-verbal learning disorder service (NVLDS) and in the neuropaediatric unit of a hospital. PATIENTS AND METHODS: The study included 65 cases: 22 from a NVLDS (20 boys/2 girls), 17 between 6-11 years old and 5 between 12-16 years of age; and 43 cases from a hospital unit, with a mean age of 9.7 years (range: 8-16 years), of whom 59 were males (91%) and 6 were females (9%). The phenotype analysis was designed using a clinical inventory divided into four blocks (social, graphomotor, perceptive and attentional). Hospital sample: deficits in attention, motor control and perception (DAMP) (58%), graphomotor (18%), attentional (16%) and social (8%). NVLDS sample: graphomotor (35.8%), DAMP (29.8%), social (21%) and attentional (12%). RESULTS AND CONCLUSIONS: Clinical experience in NVLD is scarce. The early findings of this research encourage us to defend this 'NVLD continuum' model, in which the therapeutic response to psychopharmaceuticals is very similar to that of other processes, such as attention deficit hyperactivity disorder, although it does possess its own particularities especially with regard to distractibility and a misinterpreted paradoxical effect of methylphenidate.
Asunto(s)
Estimulantes del Sistema Nervioso Central/uso terapéutico , Discapacidades para el Aprendizaje , Metilfenidato/uso terapéutico , Comunicación no Verbal , Adolescente , Trastorno por Déficit de Atención con Hiperactividad/tratamiento farmacológico , Trastorno por Déficit de Atención con Hiperactividad/fisiopatología , Niño , Femenino , Humanos , Discapacidades para el Aprendizaje/tratamiento farmacológico , Discapacidades para el Aprendizaje/fisiopatología , Masculino , Pruebas Neuropsicológicas , Fenotipo , Desempeño Psicomotor , Conducta Social , Percepción Espacial/fisiología , Percepción Visual/fisiologíaRESUMEN
Introducción. El trastorno del aprendizaje no verbal (TANV) es un grupo complejo de dificultades con sustrato biológico definido. Sus manifestaciones clínicas afectan al área motora, a la organización visuoespacial y a las competencias sociales. Objetivo. Analizar la semiología que identifica diferencialmente al TANV a través de un modelo de interpretación que parte de la experiencia acumulada en una consulta de dificultades del aprendizaje no verbal (CDANV) y en una unidad de neuropediatría hospitalaria. Pacientes y métodos. 65 casos: 22 casos procedentes de la CDANV (20 niños/2 niñas), 17 entre 6-11 años y 5 entre 12-16 años; y 43 casos procedentes de la unidad hospitalaria, con una edad media de 9,7 años (rango: 8- 16 años). 59 hombres (91%) y 6 mujeres (9%). El análisis fenotípico se diseñó mediante un inventario clínico distribuido en cuatro bloques (social, grafomotor, perceptivo y atencional). Muestra hospitalaria: déficit de atención, del control motor y de la percepción (DAMP) (58%), grafomotor (18%), atencional (16%) y social (8%). Muestra CDANV: grafomotor (35,8%), DAMP (29,8%), social (21%) y atencional (12%). Resultados y conclusiones. Existe escasa experiencia clínica en el TANV. Los primeros resultados de esta investigación nos animan a defender este modelo de continuo TANV, en el que la respuesta terapéutica a los psicofármacos es muy parecida a la de otros procesos, como el trastorno por déficit de atención/hiperactividad, aunque con ciertas particularidades, especialmente las referentes a la distrabilidad y a un malinterpretado efecto paradójico al metilfenidato (AU)
Introduction. Non-verbal learning disorder (NVLD) is the name given to a complex group of difficulties with a well-defined biological substrate. Their clinical manifestations affect the motor area, visuospatial organisation and the social competencies. Aim. To analyse the semiology that differentially identifies NVLD by means of a model of interpretation based on the experience gained in a non-verbal learning disorder service (NVLDS) and in the neuropaediatric unit of a hospital. Patients and methods. The study included 65 cases: 22 from a NVLDS (20 boys/2 girls), 17 between 6-11 years old and 5 between 12-16 years of age; and 43 cases from a hospital unit, with a mean age of 9.7 years (range: 8-16 years), of whom 59 were males (91%) and 6 were females (9%). The phenotype analysis was designed using a clinical inventory divided into four blocks (social, graphomotor, perceptive and attentional). Hospital sample: deficits in attention, motor control and perception (DAMP) (58%), graphomotor (18%), attentional (16%) and social (8%). NVLDS sample: graphomotor (35.8%), DAMP (29.8%), social (21%) and attentional (12%). Results and conclusions. Clinical experience in NVLD is scarce. The early findings of this research encourage us to defend this NVLD continuum model, in which the therapeutic response to psychopharmaceuticals is very similar to that of other processes, such as attention deficit hyperactivity disorder, although it does possess its own particularities especially with regard to distractibility and a misinterpreted paradoxical effect of methylphenidate (AU)