RESUMO

Specific learning disorder (SLD) is a neurodevelopmental disorder that affects 5-15% of school-aged children worldwide. Often, difficulties in reading (SLD-RD) and mathematics (SLD-MD) occur together. Deficits in phonological awareness (PA) have been identified as the common factor between the two difficulties. Intervention in PA has been shown to be effective in SLD-RD; however, it is not clear whether it is also effective in SLD-MD. Neuropsychological intervention is usually conducted face-to-face, but when the patient is in a remote location or during extraordinary situations such as the COVID-19 pandemic, tele neuropsychology (TeleNP) may be a suitable alternative. The objective of this study was to evaluate the efficacy of a telerehabilitation program for PA to improve math skills in children with SLD-RD/SLD-MD. The study had an N-of-1 SCED design, and included six children aged 10-12 years with SLD-RD/SLD-MD. After four baseline measurements with an arithmetic verification paradigm, they were treated with TeleNP-PA. The effect on each participant was evaluated using visual analysis and the reliable change index. After the intervention, all participants showed improvement in arithmetic tasks, suggesting that the PA intervention had a positive influence on these skills.

RESUMO

INTRODUCTION: The use of teleneuropsychology (TeleNP) increased as a result of the COVID-19 pandemic; however, there have been no studies of the benefits and difficulties with this modality in middle-income countries. This study aimed to assess the current use of TeleNP in Mexico. METHOD: Mexican neuropsychologists were invited to participate in an online survey regarding the use of TeleNP during the COVID-19 pandemic. The survey was based on issues from a literature review and consisted of 36 questions requiring yes/no, multiple choice, or ordinal answers. The survey was created using Google Forms and asked respondents to provide informed consent. A total of 107 clinical neuropsychologists completed the survey. RESULTS: 82% of participants currently use TeleNP, and most reported learning about TeleNP through personal experience, literature research, and colleagues. Brief evaluations, delivery of results, and intervention were the principal services provided, most frequently on a home-to-home basis. Almost 30% of clinicians reported not requiring informed consent for use of the modality. Consultations included children, adolescents, and adults in similar numbers; older adults were less frequent. Technological limitations were the most frequent reason for ruling out the modality with particular patients. Perceived benefits included the ability to continue consultations despite social distancing measures, lesser risk of COVID-19 infection, and the possibility of seeing patients with limited access to neuropsychological services. Reasons for not using TeleNP included a lack of standardized instruments, not feeling comfortable with the modality, and lack of technological resources and skills. CONCLUSIONS: Despite the socioeconomic differences between Mexico and high-income countries, most of our findings were similar to reports from those countries. However, technological limitations were common, and smartphones were commonly used, contrary to recommendations in the literature. The future use of TeleNP in Mexico should include formal training and ethical guidelines.

Assuntos

COVID-19 , Criança , Humanos , Idoso , Adolescente , Pandemias , México/epidemiologia , Testes Neuropsicológicos , Inquéritos e Questionários

RESUMO

Social cognition (SC) deficits have been linked to Parkinson's disease (PD) but have been less well researched than general cognitive processes, especially in early-onset PD (EOPD), despite this population often having greater social and family demands. Most studies focus on recognition of facial emotion, theory of mind (ToM), and decision-making domains, with limited research reporting on social reasoning. The main objective of this work was to compare SC ability across four domains: emotional processing, social reasoning, ToM, and decision-making between patients with EOPD and healthy controls. Twenty-five nondemented patients with EOPD and 25 controls matched for sex, age, and educational level were enrolled. A battery that included six SC tests was administered to all study participants; a decision-making scale was completed by participants' partners. Statistically significant differences were found between patients with EOPD and controls in all subtests across the four SC domains studied. The EOPD group demonstrated worse performance on all tasks, with large effect sizes. Differences remained significant after adjusting for Montreal Cognitive Assessment (MoCA) test scores for all SC subtests except the decision-making scale and the Iowa gambling task. No significant correlations between SC and other clinical PD variables were found. Our study shows that patients with EOPD perform significantly below controls in multiple SC domains affecting recognition of facial emotion, social reasoning, ToM, and decision-making. Only decision-making seems to be mediated by overall cognitive ability. The confounding or contributing effect of other clinical PD variables should be studied further.