Pieter Jelle Vuijk

Motor performance of children with mild intellectual disability and borderline intellectual functioning.

BACKGROUND There is a relatively small body of research on the motor performance of children with mild intellectual disabilities (MID) and borderline intellectual functioning (BIF). Adequate levels of motor skills may contribute to lifelong enjoyment of physical activity, participation in sports and healthy lifestyles. The present study compares the motor skills of children with intellectual disability (ID) to the abilities observed in typically developing children. It also aimed to determine whether there is an association between degree of ID and motor performance. METHODS A total of 170 children between 7 and 12 years old with MID or BIF, who attended schools for special education, were examined on the test component of the Movement Assessment Battery for Children (MABC) test. Both groups were compared with the norm scores of the total score, sub-scale scores and individual items of the MABC test. RESULTS Of the children, 81.8% with MID and 60.0% with BIF performed below the 16th percentile on the total score of the MABC. Both groups demonstrated a relative weakness in the area of manual dexterity. Comparisons between both groups showed small to moderate effect sizes on the total score of the MABC, as well as for all three sub-scales, favouring the children with BIF. CONCLUSIONS Children with ID had significantly more borderline and definite motor problems than the normative sample and there was an association between degree of ID and performance of manual dexterity, ball skills and balance skills. This study highlights the importance of improving motor skill performance in both children with borderline and mild ID, and the results support the notion that the level of motor and cognitive functioning are related in children with ID.

Pain assessment in patients with possible vascular dementia

Abstract Previous studies comparing Alzheimers disease (AD) patients with the normal elderly suggest that AD patients experience less pain. In the present study, pain reporting in 20 patients with possible vascular dementia (VaD) was compared to 20 nondemented elderly who had comparable pain conditions. It was hypothesized that, due to de-afferentiation, the possible VaD patients would experience more pain than the cognitively intact elderly. Pain assessment was conducted using three visual analogue scales, (1) the Coloured Analogue Scale (CAS) for Pain Intensity, (2) the CAS for Pain Affect, and (3) the Faces Pain Scale (FPS); a verbal pain questionnaire, Number of Words Chosen—Affective (NWC-A) of the McGill Pain Questionnaire; and an observation scale, the Checklist of Nonverbal Pain Indicators (CNPI). Results showed a significant increase in the scores on the CAS for Pain Affect and the FPS in the demented patients compared to the control group. There was a tendency for an increase in scores on the CNPI in the VaD group. These results suggest that patients with possible VaD suffer more pain than healthy elderly without cognitive impairment.

Relationship between chronic pain and cognition in cognitively intact older persons and in patients with Alzheimer's disease

Background: Brain areas that are involved in cognition and mood also play a role in pain processing. Objective: The goal of the present study was to examine the relationship between chronic pain and cognition [executive functions (EF) and memory], while controlling for mood, in cognitively intact older persons and in patients with Alzheimer’s disease (AD). Methods: Two groups of subjects participated: 20 older persons without dementia and 19 patients in an early stage of probable AD who suffered from arthrosis/arthritis. Pain intensity and pain affect were assessed by the Colored Analogue Scale for Pain Intensity and for Pain Affect, the Faces Pain Scale (FPS) and the Number of Words Chosen-Affective (NWC-A). Level of depression and anxiety were evaluated by questionnaires. EF and memory were assessed by neuropsychological tests. Results: The results show that significant correlations between specific cognitive functions, pain intensity and pain affect were lacking in the cognitively intact older persons. Cognition, in particular memory, appeared to be related to depressive symptoms. In contrast, a significant positive correlation was observed between EF, pain intensity and pain affect measured by the FPS in the AD group. Conclusions: Although older persons with depression were excluded, in studies on pain and cognition one should control for the presence of depressive symptoms in older persons with and without dementia.

The Dutch Central Sensitization Inventory (CSI) : factor analysis, discriminative power, and test-retest reliability

Objectives:A standardized assessment of central sensitization can be performed with the Central Sensitization Inventory (CSI), an English questionnaire consisting of 25 items relating to current health symptoms. The aim of this study was to translate the CSI into Dutch, to perform a factor analysis to reveal the underlying structure, examine its discriminative power, and test-retest reliability. Methods:The CSI was first translated into Dutch. A factor analysis was conducted on CSI data of a large group of chronic pain patients (n=368). The ability to discriminate between chronic pain patients (n=188) and pain-free controls (n=49) was determined and the test-retest reliability for chronic pain patients (n=36) and controls (n=45) with a time interval of 3 weeks was evaluated. Results:The exploratory factor analysis resulted in a 4-factor model based on 20 items, representing the domains “General disability and physical symptoms” (Cronbach &agr;=0.80), “Higher central sensitivity”(Cronbach &agr;=0.78), “Urological and dermatological symptoms”(Cronbach &agr;=0.60), and “Emotional distress”(Cronbach &agr;=0.80). Furthermore, a parsimonious second-order factor model was found, where the factor “General central sensitization” was underlying the 4 first-order factors. Chronic pain patients scored significantly worse on all 4 factors. The test-retest reliability was excellent values in both chronic pain patients (ICC=0.88) and controls (ICC=0.91). Discussion:The original CSI was translated into Dutch and did not reveal any problems during data acquisition. The domains represented by the 4 factors may be useful in setting up specific patient profiles and treatment targets. To conclude, the Dutch CSI revealed 4 distinguishable domains, showed good internal consistency for the total score and 3 out of 4 domains, good discriminative power, and excellent test-retest reliability.

Associations Between Academic and Motor Performance in a Heterogeneous Sample of Children With Learning Disabilities

A heterogeneous sample of 137 school-aged children with learning disabilities (IQ > 80) attending special needs schools was examined on the Movement Assessment Battery for Children (MABC). The results show that compared to the available norm scores, 52.6% of the children tested performed below the 15th percentile on manual dexterity, 40.9% on ball skills, and 33.7% on balance skills. Furthermore, after controlling for IQ, significant small to moderate partial correlations were found between spelling and mathematics and the MABC total score, as well as small to moderate correlations between mathematics and balance, between reading and ball skills, and between spelling and manual dexterity. The present findings are compared with previously reported results obtained in more homogenous groups, and based on the resultant relationships between academic performance and motor development, recommendations for future motor intervention studies are made.

Functional status of masticatory system, executive function and episodic memory in older persons

Findings from human experimental studies suggest that mastication positively influences cognitive function. The participants in those studies were relatively young. The goal of this study was to examine the relationship between the functional status of the masticatory system, episodic memory, and executive functions in elderly people. The participants, elderly people living independently at home, were divided into two groups. One group had a full complement of natural teeth (n = 19) and the other group had full dentures (n = 19). The functional status of the masticatory system was assessed by measuring mandibular excursions (i.e. the distances over which the mandible can move in the open, lateral, and forward directions), bite force, number of occluding pairs and complaints of the masticatory system (facial pain, headaches/migraine). Executive functions and episodic memory were assessed by neuropsychological tests. Backward regression analysis showed that only in the group of elderly people with full dentures, 22% of executive functions were predicted by complaints of the masticatory system and 19.4% of episodic memory was predicted by masticatory performance (composed of mandibular excursions and bite force). The conclusion of this study is that only in older persons with full dentures the relationship between mastication, episodic memory, and executive function becomes evident when the functional status of the masticatory system decreases.

Paternal Age and Risk of Autism in an Ethnically Diverse, Non-Industrialized Setting: Aruba

Objective The aim of this study was to examine paternal age in relation to risk of autism spectrum disorders (ASDs) in a setting other than the industrialized west. Design A case-control study of Aruban-born children (1990–2003). Cases (N = 95) were identified at the Child and Adolescent Psychiatry Clinic, the only such clinic in Aruba; gender and age matched controls (N = 347) were gathered from public health records. Parental age was defined categorically (≤29, 30–39, 40–49, ≥50y). The analysis was made, using conditional logistic regression. Results Advanced paternal age was associated with increased risk of ASDs in offspring. In comparison to the youngest paternal age group (≤29y), risk of autism increased 2.18 times for children born from fathers in their thirties, 2.71 times for fathers in their forties, and 3.22 thereafter. Conclusion This study, part of the first epidemiologic study of autism in the Caribbean, contributes additional evidence, from a distinctive sociocultural setting, of the risk of ASD associated with increased paternal age.

Development, cognition, and behaviour in Pitt-Hopkins syndrome

Aim  The aim of the study was to collect detailed data on behavioural, adaptive, and psychological functioning in 10 individuals with Pitt–Hopkins syndrome (PTHS), with specific attention to manifestations of autism spectrum disorder (ASD).

Visual sensory and perceptive functioning in 5-year-old very preterm/very-low-birthweight children

To examine visual sensory and perceptive functions, study their interrelations, and explore associations between visual dysfunctions and intelligence in very preterm/very‐low‐birthweight (VP/VLBW) children.

The Factor Structure of the Brief Psychiatric Rating Scale (Expanded Version) in a Sample of Forensic Psychiatric Patients

Severe behavioral problems, aggression, unlawful behavior, and uncooperativeness make the forensic psychiatric population both hard to treat and study. To fine-tune treatment and evaluate results, valid measurement is vital. The Brief Psychiatric Rating Scale–Extended (BPRS-E) is a widely used scale for assessing psychiatric symptoms, with a stable factor structure over various patient groups. For the first time, its usefulness for forensic psychiatric patients was studied by means of an exploratory factor analysis on 302 patients in a penitentiary psychiatric center. A five-factor solution fitted the data best and showed large overlap with previous research done in both in- and outpatient populations with schizophrenia and mixed diagnoses. Around 45% of the patients did not fully comply. Items relying most on self-report caused the most non-adherence, possibly because of difficulty with verbalizing distress. These items loaded on the factors psychosis and affect. The BPRS-E is a suitable instrument for forensic use. Future research and clinical practice should focus on alignment with forensic patients to improve measurement, understanding, and eventually therapeutic interventions.