Introduction. The first sign of problems of dyslexia appears in phonographic decoding when the child tries to associate graphic signs with phonological sequences so as to pronounce words. During this process the child tries to recognise words visually and associate them with the names of objects. Development. Spatial agnosia is a very common symptom in children with dyslexia and may be detected at preschool age. This spatial disorientation is closely linked with the notion of body, time and sometimes rhythm. Difficulty in identifying colours is an early symptom of dyslexia. Drawing up a plan of work, taking into account the systems for processing cerebral information, allows us to recreate habits of multisensorial perceptive processing; motor, oral and cognitive production, after executive levels of thought, button-up and top-down systems for processing. Fast For Word (FFW) training helps to achieve advances in phonemic consciousness whilst other linguistic abilities such as phonological, semantic, syntactic and grammatical consciousness, working memory and sequencing of events are integrated. Hamlet is a programme for working in phonological concepts based on classification activities. It aims to favour the analysis of segments of words, syllables or phonemes and the classification of a particular segment as belonging to a particular phonological or orthographical category or not.
OBJETIVOS El funcionamiento de los lóbulos frontales se asocia con los COGNITIVE FLEXIBILITY, AN ADDITIONAL SYMPTOM OF ATTENTION DEFICIT HYPERACTIVITY DISORDER. IS IT A THERAPEUTICALLY PREDICTIVE ELEMENT? Summary. Introduction. Cognitive flexibility is a capability acquired during infancy that can be evaluated from the age of 8 onwards. This executive function can affect patients with dorsolateral frontal lesions. Involvement of this function in some children with attention deficit hyperactivity disorder (ADHD) would point to an additional disorder. Aims. The objective of this study was to report on the involvement of cognitive flexibility in patients with ADHD from the age of 8 years onwards, to establish a correlation with the progressive phenomenon in its development, and to relate the findings from the study of cognitive flexibility with those of the attentional function. Subjects and methods. A group of 50 children diagnosed as suffering from ADHD (8-21 years old) and 50 normal children were evaluated. The same subjects were submitted to a study of their attentional functions, their inhibitory control mechanisms as well as their cognitive flexibility. Results. At least 38% of the patients studied showed involvement of cognitive flexibility. No statistically significant relation was observed when data were linked to the age variable, which could point to the absence of the maturation factor, unlike the results observed in the case of sustained attention. Patients with poor cognitive flexibility also present disorders involving attentional discrimination, the control of impulses and interference control. Conclusions. The group with cognitive rigidity as a symptom added to the attentional disorder could correspond to a complex subtype that does not respond so successfully to stimulants. Consequently, cognitive flexibility studies could reflect an indicator for selecting the type of pharmacological treatment to be employed.
Introducción. En julio del año 2013, la Food and Drug Administration estadounidense aprobó el NEBA como el primer dispositivo para la evaluación complementaria del trastorno por déficit de atención/hiperactividad (TDAH), basado en el electroencefalograma cuantificado (EEGq) e incluyendo la relación theta/beta estandarizada, cuyos resultados fueron consistentes con la evaluación clínica, tanto médica como psicológica, y es una herramienta útil para determinar si el TDAH es primario, secundario o comórbido a otro trastorno. Sin embargo, ninguna de las publicaciones, hasta la fecha, especifica si se trata de un cociente theta/beta total, o theta/beta-1 y theta/beta-2, como tampoco se aportan datos para discriminar entre subtipos diagnósticos del TDAH.Objetivo. Cuantificar los cocientes theta/beta, a través del EEGq, en una muestra de pacientes rioplatenses con diagnóstico principal confirmado de TDAH, para comparar el patrón neurofisiológico según el subtipo diagnóstico.Pacientes y métodos. Muestra aleatoria estratificada de 62 sujetos de ambos sexos, de 8 a 17 años, distribuidos en dos grupos según subtipo diagnóstico, TDAH subtipo déficit de atención (n = 31) y TDAH subtipo combinado (n = 31).Resultados. Se confirman cocientes altos theta/beta-1 y theta/beta-2 en la región Cz, mayores a los cocientes en las áreas C3 y C4. Se encontraron diferencias moderadas y estadísticamente significativas entre los dos subtipos sólo en la banda beta-1 en las regiones occipitales. El análisis de la coherencia interhemisférica sugiere una asociación del pico de potencia cruzada con el subtipo diagnóstico, que para el subtipo combinado es el pico más rápido (10 Hz). No se encuentran diferencias importantes al analizar los espectros de fase, ni los cocientes theta/alfa. Conclusiones.Si bien la bibliografía científica, específicamente el sistema NEBA, plantea la importancia del cociente theta/beta en el diagnóstico diferencial del TDAH de muestras controles y otros trastornos del neurodesarrollo, es necesario discriminar entre beta-1 y beta-2.Palabras clave. Cociente theta/beta. Coherencia interhemisférica. EEGq. Espectro de fase. NEBA. TDAH.
Taking into account the systems for the treatment of brain information when drawing up a work plan allows us to recreate processing routines that go from multisensory perception to motor, oral and cognitive production, which is the step prior to executive levels of thought, bottom-up and top-down processing systems. In recent years, the use of phonological methods to prevent or resolve reading disorders has become the fundamental mainstay in the treatment of dyslexia. The work is mainly based on phonological proficiency, which enables the patient to detect phonemes (input), to think about them (performance) and to use them to build words (output). Daily work with rhymes, the capacity to listen, the identification of phrases and words, and handling syllables and phonemes allows us to perform a preventive intervention that enhances the capacity to identify letters, phonological analysis and the reading of single words. We present the different therapeutic models that are most frequently employed. Fast For Word (FFW) training helps make progress in phonematic awareness and other linguistic skills, such as phonological awareness, semantics, syntax, grammar, working memory and event sequencing. With Deco-Fon, a programme for training phonological decoding, work is carried out on the auditory discrimination of pure tones, letters and consonant clusters, auditory processing speed, auditory and phonematic memory, and graphophonological processing, which is fundamental for speech, language and reading-writing disorders. Hamlet is a programme based on categorisation activities for working on phonological conceptualisation. It attempts to encourage the analysis of the segments of words, syllables or phonemes, and the classification of a certain segment as belonging or not to a particular phonological or orthographical category. Therapeutic approaches in the early phases of reading are oriented towards two poles based on the basic mechanisms underlying the process of learning to read, the grapheme-phoneme transformation process and global word recognition. The interventionalist strategies used at school are focused on the use of cognitive strategy techniques. The purpose of these techniques is to teach pupils practical strategies or resources aimed at overcoming specific deficiencies.
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