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Ruth S Shalev

Publications and source records attributed to Ruth S Shalev.

14 recordsLinked to original sources
PubMed2006

Evidence of a developmental cerebello-cerebral disorder.

The objective of this study was to examine the cognitive and neuroanatomical features of an adolescent with developmental hypoplastic left cerebellum who presented with executive and visuo-spatial deficits, nonverbal learning disabilities and interpersonal difficulties. He underwent a neuropsychological assessment, MRI and diffusion tensor imaging MRI. The neuropsychological impairments were primarily in executive functions, spatial and visual perception, graphomotor skills, arithmetic, social perception and comprehension. Fractional anisotropy, which is measured by diffusion tensor imaging and enables assessment of axonal integrity, was reduced in the right cerebral peduncle and right hemisphere white matter (p < 0.001). Based on the results, we hypothesize that disruption of neural circuits linking the hypoplastic left cerebellum to the right hemisphere may contribute to the evolution of a neurocognitive syndrome with characteristics of the developmental right hemisphere syndrome and suggestive of the cerebellar cognitive-affective syndrome.

Adolescent↗
PubMed2005

Age and medication effects on rhythmic responses in ADHD: possible oscillatory mechanisms?

Voluntary motor responses in children with attention-deficit hyperactivity disorder (ADHD) may reflect underlying neuronal oscillatory mechanisms. The aims of this study were: (1) to corroborate the presence of rhythmic motor abnormalities on tapping test in children with attention-deficit hyperactivity disorder, shown in previous studies; (2) to delineate the characteristics of ADHD children demonstrating these rhythmic abnormalities; (3) to assess the impact of methylphenidate (Ritalin) on this abnormal motor phenomenon. The study was designed in a double blind manner. Sixty-four ADHD children aged 6-12 years and 60 matched controls underwent a finger tapping test (1-5 Hz). We measured the abnormal rhythmic tapping with and without methylphenidate treatment in a double blind design. Conventional statistical analysis was used to assess the correlation of the presence of motor abnormality with various clinical characteristics (such as degree of hyperactivity/impulsivity). Fifty-six percent of children with ADHD compared to 8% of controls demonstrated abnormal rhythmic responses at a mean frequency of 3.1+/-0.9 Hz. These erroneous voluntary movements were more common in children with a greater degree of hyperactivity, in younger children but not significantly altered by methylphenidate treatment. Surprisingly, abnormal rhythmic responses showed less variability than found for responses for which the tapping was adequately paced, suggesting different motor control processes for normal and abnormal paced tapping. We speculate that rhythmic tapping responses reflect abnormal oscillatory mechanisms involved in ADHD, exacerbated in younger children with ADHD and in those in whom the hyperactivity/impulsivity is more pronounced.

Age Factors↗
PubMed2005

Developmental dyscalculia: a prospective six-year follow-up.

To determine the natural history of developmental dyscalculia (DC) and factors impacting on its prognosis, we performed a prospective six-year longitudinal study. One hundred and forty children of normal intelligence diagnosed with DC in the fifth grade of elementary school were re-examined for dyscalculia three and six years later, in eighth (n=123) and eleventh (n=104; 41 males, 63 females) grades respectively. Mean age of the children in fifth grade was 11 years 1 month (SD 4 months), in eighth grade 14 years 2 months (SD 1 month), and in eleventh grade 17 years 2 months (SD 5 months). The assessment included standardized arithmetic, reading and writing tests, behavioural rating scales, information on socioeconomic status, educational interventions, and familial learning problems. Participants in eleventh grade were recategorized as having DC if their score on the arithmetic test was not more than the fifth centile for grade. At the six-year follow-up, 99/104 (95%) children diagnosed with dyscalculia in fifth grade were still performing poorly in arithmetic, scoring within the lowest quartile for their grade, and 42/104 (40%) were recategorized with DC. Chronicity of DC was associated with severity of the dyscalculia in fifth grade (p<0.05), lower IQ (p<0.01), inattention (p<0.01), and writing problems (p<0.01). Thus, DC is an enduring specific learning difficulty, persisting into late adolescence in almost half of affected individuals.

Adolescent↗
PubMed2004

Malignant migrating partial seizures in infancy.

Malignant migrating partial seizures in infancy is a rare, age-specific epileptic encephalopathy. It is characterized by onset before age 6 months, virtually continuous multifocal seizures with ictal electrical encephalographic activity shifting from one hemisphere to the other, no identifiable immediate or remote causes, intractability to antiepileptic drugs, and developmental arrest. This report adds two patients to the 21 previously described in the literature. One infant, microcephalic at birth, developed at age 4 months clusters of nearly continuous multifocal seizures with secondary generalization, refractory to antiepileptic drugs. By age 4.5 years she was seizure-free but remains without any cognitive or motor function. Patient 2, born with a normal head circumference, began seizures at age 3 months, never became seizure-free, and died at age 18 months. Electroencephalograms of both children were characteristic, and the neuroimaging finding was one of progressive cortical and subcortical atrophy. It has been hypothesized that neurotransmitter dysfunction with persistent, pronounced excitatory or cytotoxic mechanisms may explain the continuous, erratic epileptic activity. Awareness of malignant migrating partial seizures in infancy and research focused on its pathophysiologic mechanisms may reveal innovative treatments of this devastating, age-specific disorder.

Developmental Disabilities↗
PubMed2004

Social and emotional adjustment of siblings of children with autism.

BACKGROUND: Social and emotional adjustment of siblings of children with autism was examined, to explore their risk or resilience to effects of genetic liability and environmental factors involved in having a sibling with autism. METHOD: Social-emotional adjustment, behavior problems, socialization skills, and siblings' relationships were compared among 30 siblings of children with autism, 28 siblings of children with mental retardation of unknown genetic etiology (MR), and 30 siblings of children with developmental language disorders (DLD). Groups were matched by probands' gender, siblings' chronological age, gender, IQ, and birth order, and by family size, ethnicity, and parental income, employment, and stress level. RESULTS: Four siblings of children with autism, three siblings of children with MR, and seven siblings of children with DLD received DSM-IV diagnoses. Nevertheless, most of the siblings were well adjusted. CONCLUSIONS: The adjustment of siblings of children with autism is in sharp contrast to the severe social and emotional disabilities characteristic of autism, and is noteworthy considering the stress involved in having a sibling with autism.

Adaptation, Psychological↗
PubMed2004

Developmental dyscalculia.

Developmental dyscalculia is a specific learning disability affecting the normal acquisition of arithmetic skills. Genetic, neurobiologic, and epidemiologic evidence indicates that dyscalculia, like other learning disabilities, is a brain-based disorder. However, poor teaching and environmental deprivation have also been implicated in its etiology. Because the neural network of both hemispheres comprises the substrate of normal arithmetic skills, dyscalculia can result from dysfunction of either hemisphere, although the left parietotemporal area is of particular significance. The prevalence of developmental dyscalculia is 5 to 6% in the school-aged population and is as common in girls as in boys. Dyscalculia can occur as a consequence of prematurity and low birthweight and is frequently encountered in a variety of neurologic disorders, such as attention-deficit hyperactivity disorder (ADHD), developmental language disorder, epilepsy, and fragile X syndrome. Developmental dyscalculia has proven to be a persisting learning disability, at least for the short term, in about half of affected preteen pupils. Educational interventions for dyscalculia range from rote learning of arithmetic facts to developing strategies for solving arithmetic exercises. The long-term prognosis of dyscalculia and the role of remediation in its outcome are yet to be determined.

Adolescent↗
PubMed2003

Retinal function abnormalities in patients treated with vigabatrin.

OBJECTIVE: To evaluate central and peripheral retinal function in patients treated with vigabatrin, an antiepileptic drug associated with peripheral visual field constriction (VFC). METHODS: Six patients with epilepsy treated with vigabatrin as add-on therapy for at least 3 years were included in this observational case series. All patients underwent a clinical ophthalmologic examination, color vision testing, standard perimetry, and full-field and focal foveal cone electroretinography. Four patients, 3 of whom had VFC, completed specialized computerized static light- and dark-adapted perimetry. RESULTS: In 9 of 11 eyes tested, foveal cone electroretinographic amplitudes were at or below the lower limit of normal. Dark-adapted perimetry demonstrated abnormal rod-derived visual fields in the 3 patients with vigabatrin-attributed VFC, whereas rod-derived thresholds were within normal limits throughout the visual field in the patient who did not have VFC. CONCLUSIONS: Our results suggest that vigabatrin not only impairs peripheral cone-derived function as manifested by VFC but also affects foveal cone electroretinographic amplitudes and rod-derived visual fields. The clinical dilemma regarding the use of vigabatrin therapy is further complicated since central as well as peripheral visual function seems to be adversely affected.

Adolescent↗
PubMed2003

Use of complementary medicine in children with attention deficit hyperactivity disorder and epilepsy.

We retrospectively studied use of complementary medicine in children with Attention Deficit Hyperactivity Disorder, epilepsy, and controls. Parents of patients with Attention Deficit Hyperactivity Disorder (n = 120; mean age 11.0 +/- 3.1 years), epilepsy (n = 115; 10.9 +/- 5.5), and healthy children seen in the emergency room during an acute illness (n = 115; 5.0 +/- 4.9) were individually interviewed regarding past and present use of complementary medicine. We found that 34 children with Attention Deficit Hyperactivity Disorder, 37 with epilepsy, and 24 controls had, at some time during their life, received complementary medicine: diet (n = 50), homeopathy (n = 46), acupuncture (n = 23), and biofeedback (n = 9). Current use was significantly less: Attention Deficit Hyperactivity Disorder- 7.5%, epilepsy-14%, and controls-7%. No differences among groups were found for either past use or method of complementary medicine employed. However, the most significant predictor for current use of complementary medicine was past use (OR 3.2, P < 0.001), followed by level of father's education (OR = 1.16, P = 0.01). There was a trend for more children with epilepsy (OR = 1.7) and children from religious families (OR = 1.51) to be currently receiving complementary medicine. In summary, only a small minority of patients with either Attention Deficit Hyperactivity Disorder or epilepsy used complementary medicine as part of their current medical regimen, although during their lifetime a third had received complementary medicine. Complementary medicine was more consistently used in children who had previously received complementary medicine, regardless of their medical diagnosis.

Adolescent↗
PubMed2003

Abnormal rhythmic motor response in children with attention-deficit-hyperactivity disorder.

Children with attention-deficit-hyperactivity disorder (ADHD) have difficulties with motor control, inhibition of motor responses, motor flexibility, and motor preparedness. We proposed that motor abnormalities in ADHD might result, at least in part, from an abnormal neuronal oscillatory mechanism necessary for motor temporal regulation. The aim of this study was to assess pacing in children with ADHD, by testing for rhythmic abnormalities of motor activity using a tapping test. Twenty-seven children (21 males, six females; aged 6 to 14 years 6 months; mean age 11 years 4 months, SD 2 years 2 months) diagnosed with ADHD according to DSM-IV clinical criteria, and 33 controls (25 males, eight females; aged 6 to 14 years 6 months; mean 11 years 1 month, SD 2 years 2 months), underwent a finger-tapping test requiring rhythmic responses to frequencies from 1 to 6 Hz. All participants who were treated on a daily basis with methylphenidate (n = 22) were medication-free on the day of the test. Most of the children with ADHD responded at a constant rate regardless of stimulus frequency, a phenomenon only seen in a small number of the controls. This specific error pattern, also seen in Parkinson's disease, has been attributed to an abnormal oscillatory mechanism mediated by dopaminergic fronto-striatal circuitry, which might also be pathophysiologically relevant for ADHD.

Adolescent↗
PubMed2003

Language abilities of siblings of children with autism.

BACKGROUND: Language abilities of siblings of children with autism were examined to explore the possibility that language abilities are behavioral markers specific to the genetic liability for autism, as part of the broader phenotype. METHOD: Language abilities were compared among 27 siblings of children with autism, 23 siblings of children with mental retardation of unknown etiology (MR), and 22 siblings of children with developmental language disorders (DLD). Groups were matched by siblings' age, gender, birth order, family size, ethnicity, family income and by probands' gender and mental age. RESULTS: Siblings of children with autism achieved higher scores than siblings of children with DLD on receptive, expressive, and total language scales of the Children's Evaluation of Language Fundamentals and on verbal IQ. Moreover, within the DLD group, school problems in the domains of reading and arithmetic were more prevalent than within the other two groups. Only 2 siblings of children with autism received clinical diagnoses based on DSM-IV criteria compared to 3 siblings of children with MR and 7 siblings of children with DLD. CONCLUSIONS: After excluding data of the diagnosed siblings, no differences in language abilities could be discerned among the groups, except that more siblings in the DLD group were identified as having language difficulties. In summary, although language deficits characterize autism, siblings of children with autism were not found to demonstrate deficits in language skills assessed by formal language tests, IQ, or academic skills.

Adolescent↗
PubMed2003

Speed of performance of children with developmental right hemisphere syndrome and with attention-deficit hyperactivity disorder.

Slowness is a common complaint in children with attention-deficit hyperactivity disorder (ADHD) and with developmental right hemisphere syndrome. However, it was our clinical impression that slowness in developmental right hemisphere syndrome was more prominent than in ADHD. Our objective was to assess slowness as operationalized by speed of performance in children with developmental right hemisphere syndrome, children with ADHD, and controls. The research sample comprised 19 children in each group, matched for age, gender, socioeconomic status, IQ, and handedness. The subjects were administered a reaction time battery assessing speed of performance. Overall, the average performance differed among the three study groups (F(2,53) = 2.40, P < .01). Children with developmental right hemisphere syndrome were slower than their peers with ADHD (t(35) = 1.99, P < .05) and slower than controls (t(35) = 4.55, P < .001). Children with ADHD performed more slowly than controls, although for the majority of tasks, this was nonsignificant. We conclude that slowness is an integral and consistent component of developmental right hemisphere syndrome and cannot be attributed only to the ADHD symptomatology.

Adolescent↗
PubMed2002

Efficacy of methylphenidate in patients with cerebral palsy and attention-deficit hyperactivity disorder (ADHD).

Our objective was to study the short-term efficacy and safety of methylphenidate in patients with the dual diagnosis of cerebral palsy and attention-deficit hyperactivity disorder (ADHD). Twenty-nine patients (8.0 +/- 4.0 years old) with cerebral palsy and ADHD completed the study. In a prospective, crossover, double-blind paradigm, patients were treated with methylphenidate or placebo, each for 4 weeks. Parents and teachers completed a modified Abbreviated Conners' Rating Scale at the beginning of the study and the end of the first and second months of treatment with methylphenidate or placebo. Parents were contacted weekly to report side effects. Methylphenidate treatment, as assessed by teachers' ratings, resulted in a significant improvement in ADHD symptomatology (t = 2.29, df = 27, P < .05); however, a trend for improvement was noted only on the parents' ratings. After the conclusion of the study, 12 patients continued methylphenidate for 20 +/- 10 months. Side effects were minimal, with the exception of transient hallucinations in one patient. In children with cerebral palsy and ADHD, methylphenidate is effective, rendering it a valuable adjunct to their overall medical therapy.

Adolescent↗