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      Movement cognition and narration of the emotions treatment versus standard speech therapy in the treatment of children with borderline intellectual functioning: a randomized controlled trial

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          Abstract

          Background

          Borderline intellectual functioning (BIF) is defined as a “health meta-condition… characterized by various cognitive dysfunctions associated with an intellectual quotient (IQ) between 71 and 85 which determines a deficit in the individual’s functioning both in the restriction of activities and in the limitation of social participation”. It can be caused by many factors, including a disadvantaged background and prematurity. BIF affects 7–12% of primary school children that show academic difficulties due to poor executive functioning. In many children with BIF, language, movement and social abilities are also affected, making it difficult to take part in daily activities. Dropping out of school and psychological afflictions such as anxiety and depression are common in children with BIF.

          This study investigates whether an intensive rehabilitation program that involves all of the areas affected in children with BIF (Movement, Cognition and Narration of emotions, MCNT) is more effective than Standard Speech Therapy (SST).

          Methods

          This is a multicenter interventional single blind randomized controlled study. Children aged between 6 to 11 years who attend a mainstream primary school and have multiple learning difficulties, behavioral problems and an IQ ranging between 85 to 70 have been enrolled. Participants are randomly allocated to one of three groups. The first group receives individual treatment with SST for 45 min, twice a week for 9 months. The second group receives the experimental treatment MCNT for 3 h per day, 5 days/ week for 9 months and children work in small groups. The third group consists of children on a waiting list for the SST for nine months.

          Discussion

          BIF is a very frequent condition with no ad hoc treatment. Over the long term, there is a high risk to develop psychiatric disorders in adulthood. Due to its high social impact, we consider it very important to intervene during childhood so as to intercept the remarkable plasticity of the developing brain.

          Trial registration

          “Study Let them grow: A new intensive and multimodal Treatment for children with borderline intellectual functioning based on Movement, Cognition and Narration of emotions”, retrospectively registered in ISRCTN Register with ISRCTN81710297 at 2017–01-09.

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          Most cited references52

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          Neural consequences of environmental enrichment.

          Neuronal plasticity is a central theme of modern neurobiology, from cellular and molecular mechanisms of synapse formation in Drosophila to behavioural recovery from strokes in elderly humans. Although the methods used to measure plastic responses differ, the stimuli required to elicit plasticity are thought to be activity-dependent. In this article, we focus on the neuronal changes that occur in response to complex stimulation by an enriched environment. We emphasize the behavioural and neurobiological consequences of specific elements of enrichment, especially exercise and learning.
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            Specific impairments of planning.

            T Shallice (1982)
            An information-processing model is outlined that predicts that performance on non-routine tasks can be impaired independently of performance on routine tasks. The model is related to views on frontal lobe functions, particularly those of Luria. Two methods of obtaining more rigorous tests of the model are discussed. One makes use of ideas from artificial intelligence to derive a task heavily loaded on planning abilities. A group of patients with left anterior lesions has a specific deficit on the task. Subsidiary investigations support the inference that this is a planning impairment.
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              Close interrelation of motor development and cognitive development and of the cerebellum and prefrontal cortex.

              Motor development and cognitive development may be fundamentally interrelated. Contrary to popular notions that motor development begins and ends early, whereas cognitive development begins and ends later, both motor and cognitive development display equally protracted developmental timetables. When cognitive development is perturbed, as in a neurodevelopmental disorder, motor development is often adversely affected. While it has long been known that the striatum functions as part of a circuit with dorsolateral prefrontal cortex, it is suggested here that the same is true for the cerebellum and that the cerebellum may be important for cognitive as well as motor functions. Like prefrontal cortex, the cerebellum reaches maturity late. Many cognitive tasks that require prefrontal cortex also require the cerebellum. To make these points, evidence is summarized of the close co-activation of the neocerebellum and dorsolateral prefrontal cortex in functional neuroimaging, of similarities in the cognitive sequelae of damage to dorsolateral prefrontal cortex and the neocerebellum, of motor deficits in "cognitive" developmental disorders, and of abnormalities in the cerebellum and in prefrontal cortex in the same developmental disorders.
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                Author and article information

                Contributors
                +39 02 40308074 , vblasi@dongnocchi.it
                Journal
                BMC Psychiatry
                BMC Psychiatry
                BMC Psychiatry
                BioMed Central (London )
                1471-244X
                20 April 2017
                20 April 2017
                2017
                : 17
                : 146
                Affiliations
                [1 ]ISNI 0000 0001 1090 9021, GRID grid.418563.d, , IRCCS, Fondazione don Carlo Gnocchi ONLUS, ; Via Capecelatro 66, 20148 Milan, Italy
                [2 ]ISNI 0000 0004 1757 2822, GRID grid.4708.b, Department of Health Sciences, , University of Milan, Milan, Italy; ASST S. Paolo and S. Carlo Hospital, ; Milan, Italy
                Author information
                http://orcid.org/0000-0002-8395-0452
                Article
                1309
                10.1186/s12888-017-1309-z
                5397820
                28427388
                20fdc66b-3637-496d-82ea-577741193102
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 11 March 2017
                : 11 April 2017
                Funding
                Funded by: Lombardy Region, Italy
                Categories
                Study Protocol
                Custom metadata
                © The Author(s) 2017

                Clinical Psychology & Psychiatry
                borderline intellectual functioning,development,movement,cognition,narration of emotions,speech therapy,rehabilitation

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