DEVELOPMENT PROFILES OF EXECUTIVE FUNCTIONS IN PRESCHOOL AGE: OBSERVATIONAL STUDY IN GENERALIZED DEVELOPMENT DISORDER

Valeria Flori, Mariangela Lettieri, Rebecca Prandi
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Abstract

Executive functions (EF) play a fundamental role when it is necessary to implement behaviors aimed at achieving a goal; they are in fact widely studied and described in the literature, especially within neurodevelopment. Matura-tion of executive functions is described as a key component of typical as well as atypical development; their deficit is found in numerous neurodevelopmental and behavioral disorders. There are studies in literature that are intere-sted in the impairment of executive functions in Autism and Generalized Developmental Disorders (DGS). These disorders include a spectrum of clinical pictures characterized by social impairments, communicative impairments, restricted interests and stereotyped behaviors (Valeri, 2006), (APA - Amerian Psychiatric Association, 2013). However, none of these studies concerns the Italian pre-school population nor does it use assessment tools born in the Italian context; the studies in question also find confirmation above all in research conducted on adolescent and adult patients, while studies conducted with pre-school children provide conflicting results (Griffith, et al., 1999). Both in relation to these contradictory results and to the highly adaptive role of this domain for so-cio affective development, learning and quality of life, this study stands as a contribution to the research on exe-cutive function disorders on a sample of children with Generalized Developmental Disorder (DGS) in preschool age (3-6 years), with the aim of providing operational reflections for the best practice for functional assessment in the presence of this disorder, adding useful knowledge to Developmental Neuro and Psychomotor Therapist when drafting his own rehabilitation program. To meet the identified objectives, a sample with a diagnosis of Genera-lized Developmental Disorder (11 subjects) and a control sample, which did not present any neurodevelopmental disorder (39 subjects), were selected. The evaluation tool used is the Battery for the evaluation of executive func-tions in preschool age (FE-PS 2-6; Usai et al. 2017), intentionally selected among the tools developed in the Italian context and specific for the preschool age. The test results, taken from the Battery reference manual, were sub-jected to statistical analysis and subsequently to qualitative analysis, aimed at detecting further aspects of interest on the evolutionary profiles. 2 The research results show a difference in the average performance of the subjects belonging to the DGS group, which appear to be globally lower than those of the subjects belonging to the control group. Particular difficulties are found in all inhibition processes and are above all the characteristics of impulsi-vity and the management of interference. The greatest difficulty in children behavior therefore appears to be pre-sent in their ability to initiate a response and to inhibit actions in the service of general goals to be achieved. This difficulty appears as a dysfunctional characteristic in all the age groups covered by our study, as a constant cha-racteristic at all ages to be considered as a maladaptive functional profile.
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学龄前儿童执行功能发展概况:广泛性发展障碍的观察研究
当需要实施旨在实现目标的行为时,执行职能(EF)起着根本性的作用;事实上,它们在文献中得到了广泛的研究和描述,特别是在神经发育方面。执行功能的成熟被描述为典型和非典型发展的关键组成部分;在许多神经发育和行为障碍中都发现了它们的缺陷。已有文献对自闭症和广泛性发育障碍(DGS)的执行功能障碍进行了研究。这些障碍包括一系列以社交障碍、交流障碍、限制兴趣和刻板行为为特征的临床表现(Valeri, 2006), (APA -美国精神病学协会,2013)。然而,这些研究都没有涉及意大利学龄前人口,也没有使用在意大利背景下诞生的评估工具;上述研究首先在对青少年和成人患者进行的研究中得到了证实,而对学龄前儿童进行的研究提供了相互矛盾的结果(Griffith, et al., 1999)。考虑到这些相互矛盾的结果,以及这一领域在so-cio情感发展、学习和生活质量方面的高度适应性作用,本研究对学龄前(3-6岁)广泛性发展障碍(DGS)儿童执行功能障碍的研究做出了贡献,旨在为这种障碍存在时的功能评估提供最佳实践反思。在起草自己的康复方案时,为发育神经和精神运动治疗师增加了有用的知识。为了达到确定的目标,我们选择了一个诊断为广泛性发育障碍的样本(11名受试者)和一个没有任何神经发育障碍的对照样本(39名受试者)。使用的评价工具为学龄前儿童执行功能评价量表(FE-PS 2-6;Usai et al. 2017),有意选择了在意大利背景下开发的工具,专门针对学龄前儿童。测试结果取自《电池参考手册》,对其进行统计分析,随后进行定性分析,旨在检测进化概况中感兴趣的进一步方面。2 .研究结果显示,DGS组受试者的平均表现存在差异,总体上似乎低于对照组受试者的平均表现。在所有抑制过程中都发现了特别的困难,尤其是冲动和干扰管理的特征。因此,儿童行为的最大困难似乎在于他们有能力主动作出反应,并抑制为实现一般目标而采取的行动。在我们的研究涵盖的所有年龄组中,这种困难表现为一种功能失调的特征,作为一种恒定的特征,在所有年龄段都被认为是一种适应不良的功能特征。
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