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Persistent Difficulties (persistent + difficulty)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

Worster-Drought syndrome: poorly recognized despite severe and persistent difficulties with feeding and speech

DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 1 2010
MARIA CLARK
Aim, Worster-Drought syndrome (WDS), or congenital suprabulbar paresis, is a permanent movement disorder of the bulbar muscles causing persistent difficulties with swallowing, feeding, speech, and saliva control owing to a non-progressive disturbance in early brain development. As such, it falls within the cerebral palsies. The aim of this study was to describe the physical and neuropsychological profiles of children with WDS. Method, Forty-two children with WDS (26 males, 16 females; mean age 7y 10mo, SD 3y 1mo; range 2y 6mo to 16y 5mo) were studied prospectively using a standard protocol. Results, All of the children had severe bulbar dysfunction; 36 out of 42 had feeding difficulties and 23 of 38 had unintelligible speech, which was poorly compensated for by augmentative communication. There were accompanying disturbances in cognition (mean non-verbal IQ 59), behaviour (12/40 attention-deficit,hyperactivity disorder [ADHD]), social communication (8/42 autism), and epilepsy (12/39). The severity of bulbar dysfunction and impact of additional impairments made it difficult to use formal assessments. Interpretation, WDS causes severe and persistent bulbar dysfunction that is often accompanied by additional impairments, as in other cerebral palsies. Speech prognosis is particularly poor. Early diagnosis with appreciation of the underlying neurology would encourage critical evaluation of interventions and long-term planning to improve outcome. [source]

Depressive Symptoms in Middle Age and the Development of Later-Life Functional Limitations: The Long-Term Effect of Depressive Symptoms

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2010
Kenneth E. Covinsky MD
OBJECTIVES: To determine whether middle-aged persons with depressive symptoms are at higher risk for developing activity of daily living (ADL) and mobility limitations as they advance into older age than those without. DESIGN: Prospective cohort study. SETTING: The Health and Retirement Study (HRS), a nationally representative sample of people aged 50 to 61. PARTICIPANTS: Seven thousand two hundred seven community living participants in the 1992 wave of the HRS. MEASUREMENTS: Depressive symptoms were measured using the 11-item Center for Epidemiologic Studies Depression Scale (CES-D 11), with scores of 9 or more (out of 33) classified as significant depressive symptoms. Difficulty with five ADLs and basic mobility tasks (walking several blocks or up one flight of stairs) was measured every 2 years through 2006. The primary outcome was persistent difficulty with ADLs or mobility, defined as difficulty in two consecutive waves. RESULTS: Eight hundred eighty-seven (12%) subjects scored 9 or higher on the CES-D 11 and were classified as having significant depressive symptoms. Over 12 years of follow-up, subjects with depressive symptoms were more likely to reach the primary outcome measure of persistent difficulty with mobility or difficulty with ADL function (45% vs 23%, Cox hazard ratio (HR)=2.33, 95% confidence interval (CI)=2.06,2.63). After adjusting for age, sex, measures of socioeconomic status, comorbid conditions, high body mass index, smoking, exercise, difficulty jogging 1 mile, and difficulty climbing several flights of stairs, the risk was attenuated but still statistically significant (Cox HR=1.44, 95% CI=1.25,1.66). CONCLUSION: Depressive symptoms independently predict the development of persistent limitations in ADLs and mobility as middle-aged persons advance into later life. Middle-aged persons with depressive symptoms may be at greater risk for losing their functional independence as they age. [source]

Language Impairment and Reading Disability: Connections and Complexities Introduction to the Special Issue

LEARNING DISABILITIES RESEARCH & PRACTICE, Issue 1 2006
Elaine R. Silliman
Researchers and practitioners in the fields of reading and language are well informed about the importance of phonological awareness in beginning reading. The purpose of this special issue of Learning Disabilities Research & Practice is to present recent research that extends the search for language and reading connections beyond the realm of phonological awareness. Many children with language impairment (LI) identified before formal schooling experience persistent difficulty in learning to read. Two interrelated issues are prerequisite for understanding the developmental course of events that might link language and reading (dis)ability in these children. One is an appreciation of exactly what is meant by LI, while the second concerns how LI should be explained. In this introductory article, we explore the complexities of these two issues, in particular the controversy between the domain-specific perspective and the domain-general perspective on the nature of specific LI (SLI). Consistent with these perspectives, future studies on possible language-reading links will need to measure language and related processes in greater breadth and depth, over time, and within a variety of experiential contexts. The five articles in this issue represent a critical first step in this direction. [source]