Marie-Claire Haelewyck

The Symbol Digit Modalities Test as sentinel test for cognitive impairment in multiple sclerosis

Cognitive impairment (CI) is found in about half of the multiple sclerosis (MS) population and is an important contributor to employment status and social functioning. CI is encountered in all disease stages and correlates only moderately with disease duration or Expanded Disability Status Scale scores. Most present neuropsychological test batteries are time‐demanding and expensive. The Symbol Digit Modalities Test (SDMT) has been suggested as a screening tool for CI in MS. In this paper, we aim to assess the performance of the SDMT in predicting the outcome of an extensive battery.

Reduced information processing speed as primum movens for cognitive decline in MS

Background: Cognitive impairment affects half of the multiple sclerosis (MS) patient population and is an important contributor to patients’ daily activities. Most cognitive impairment studies in MS are, however, cross-sectional or/and focused on the early disease stages. Objective: We aim to assess the time course of decline of different cognitive domains. Methods: We collected neuropsychological data on 514 MS patients to construct Kaplan-Meier survival curves of the tests included in the Neuropsychological Screening Battery for MS (NSBMS) and the Symbol Digit Modalities Test (SDMT). Cox-proportional hazard models were constructed to examine the influence of MS onset type, age at onset, gender, depression and level of education on the time course, expressed as age or disease. Results: Survival curves of tests focusing on information processing speed (IPS) declined significantly faster than tests with less specific demands of IPS. Median age for pathological decline was 56.2 years (95% CI: 54.4–58.2) on the SDMT and 63.9 years (95% CI: 60–66.9) on the CLTR, a memory task. Conclusion: In conclusion, IPS is the cognitive domain not only most widely affected by MS but it is also the first cognitive deficit to emerge in MS.

Facilitating self-determination in adolescents with intellectual disabilities: a curriculum.

Taking an active part and responsibilities in one’s own life is not always easy, particularly at adolescence, which is a very important period in which people progressively find their identity and life project. This article describes the social validation analyses of a Belgian self-determination curriculum that was adapted from a French-Canadian curriculum. It was done with the participation of adolescents with intellectual disabilities, teachers, and experts from the field. Overall, results indicate a satisfying to very satisfying appreciation of the social utility of the training manual. The findings also highlighted that the curriculum actually supports the conceptual framework of self-determination.

Does including the full CVLT-II and BVMT-R improve BICAMS? Evidence from a Belgian (Dutch) validation study

BACKGROUND The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) is a fast, easy-to-administer and already widely validated neuropsychological battery for cognition in multiple sclerosis. OBJECTIVE The goals of our study were to validate the BICAMS in a Belgian Dutch-speaking population and to investigate to what extent including extensive versions of two of the three BICAMS subtests improved its psychometric qualities. METHODS Ninety-seven persons with MS and ninety-seven healthy controls were included and group-matched on age, education level and gender. All participants performed the BICAMS with an extensive version of the CVLT-II and BVMT-R. RESULTS The SDMT and BVMT-R were able to dissociate between the MS and healthy control group, while the CVLT-II was not. Distributions of CVLT-II scores suggest learning effects in the MS group, indicating the need for alternative word lists or the construction of an adapted version fitted for repeated administration. Including the full CVLT-II and BVMT-R did not markedly improve the psychometric qualities of the BICAMS. CONCLUSION This study validates the BICAMS in a Belgian Dutch-speaking population and facilitates the use of it in clinical practice, while providing evidence that including full versions of the CVLT-II and BVMT-R does not increase its psychometric qualities markedly.

The production of intervocalic glides in non dysarthric Parkinsonian speech

In the context of a research project aiming at investigating the relationships between speech disorders, quality of life and social participation in Parkinsons Disease (PD), we report here on an acoustic study of glides and steady vowels by non dysarthric parkinsonian and control speakers. Our specific aim is to explore the dynamics of supra-laryngeal articulators in PD. Results suggest that non dysarthric Parkinsonian speakers maintain an accurate production of glides in VC[glide]V pseudo-words at the expense of articulatory undershoot in the surrounding vowels, and some asymmetry between the V1-toglide and glide-to-V2 articulatory movements. We discuss how these results both support and challenge the accuracytempo trade-off hypothesis (Ackermann and Ziegler, 1991).

Comment favoriser l'autodétermination des jeunes en situation de handicap afin de développer leur identité personnelle ?

Cet article met en evidence l’importance du concept d’autodetermination dans l’emergence de l’identite personnelle de l’adolescent en situation de handicap. Deux recherches ont ete menees. La premiere decrit la mise en œuvre d’un nouvel outil pedagogique visant le developpement de l’autodetermination de cette population. La seconde decrit les effets benefiques d’une formation au concept d’autodetermination aupres des parents et des intervenants proches des adolescents. Les resultats ont montre un impact positif sur la qualite de vie, le concept de soi, la communication et l’autodetermination. Des perspectives sont envisagees en fin d’article.