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Intervening on the Developmental Course of Children With Borderline Intellectual Functioning With a Multimodal
Valeria Blasi1, Michela Zanette1, Gisella Baglio1
1IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.
Insights
An intensive, integrated intervention (MCNT) improved intellectual, adaptive, and behavioral functioning in children with borderline intellectual functioning (BIF) more than standard speech therapy. This approach offers protective factors against future challenges like school failure and poverty.
Area of Science:
- Neurodevelopmental disorders
- Child psychology
- Intervention studies
Background:
- Borderline intellectual functioning (BIF) is linked to adverse social environments and difficulties in academic and adaptive behaviors.
- Children with BIF exhibit impairments in cognitive, emotional, and social domains, increasing risks for school failure, mental health issues, and adult poverty.
- Early, effective interventions are crucial for improving the neurodevelopmental trajectory of children with BIF.
Purpose of the Study:
- To compare the effectiveness of an intensive, integrated Movement Cognition and Narration of Emotions (MCNT) intervention against standard speech therapy (SST) for children with BIF.
- To evaluate the impact of MCNT on intellectual, adaptive, behavioral, and motor functions in children with BIF.
Main Methods:
- A multicenter, single-blind, randomized controlled trial (RCT) involving two groups of children with BIF: MCNT (experimental) and SST (control).
- Primary outcome measures included WISC III, Child Behavior Checklist (CBCL), Vineland II, and Movement ABC.
- Mixed factorial ANOVA was used to analyze treatment effectiveness.
Main Results:
- The MCNT intervention significantly increased full-scale IQ, performance IQ, socialization abilities, and improved behavior compared to SST.
- Both MCNT and SST led to improvements in verbal memory, selective attention, planning, and language comprehension.
- No motor ability improvements were observed; however, SST group showed significant behavioral worsening.
Conclusions:
- Intensive, multimodal treatments like MCNT are more effective for improving intellectual, adaptive, and behavioral outcomes in children with BIF than single-domain therapies.
- These improvements may serve as protective factors against long-term risks such as school failure, poverty, and psychopathology.
- Study limitations include a small sample size and the absence of a no-treatment control group.
Abstract:
An adverse social environment is a major risk factor for borderline intellectual functioning (BIF), a condition characterized by an intelligence quotient (IQ) within the low range of normality (70-85) with difficulties in the academic achievements and adaptive behavior. Children with BIF show impairments in planning, language, movement, emotion regulation, and social abilities. Moreover, the BIF condition exposes children to an increased risk of school failures and the development of mental health problems, and poverty in adulthood. Thus, an early and effective intervention capable of improving the neurodevelopmental trajectory of children with BIF is of great relevance.
Aim:
The present work aims to report the results of a randomized controlled trial (RCT) in which an intensive, integrated and innovative intervention, the movement cognition and narration of the emotions (MCNT) was compared to standard speech therapy (SST) for the treatment of children with BIF.
Methods:
This was a multicenter, interventional, single blind RCT with two groups of children with BIF: the experimental treatment (MCNT) and the treatment as usual (SST). A mixed factorial ANOVA was carried out to assess differences in the effectiveness between treatments. Primary outcome measures were: WISC III, Child Behavior Checklist (CBCL), Vineland II, and Movement ABC.
Results:
MCNT proved to be more effective than SST in the increment of full-scale IQ (p = 0.0220), performance IQ (p < 0.0150), socialization abilities (p = 0.0220), and behavior (p = 0.0016). No improvement was observed in motor abilities. Both treatments were linked to improvements in verbal memory, selective attention, planning, and language comprehension. Finally, children in the SST group showed a significant worsening in their behavior.
Conclusion:
Our data show that an intensive and multimodal treatment is more effective than a single domain treatment for improving intellectual, adaptive and behavioral functioning in children with BIF. These improvements are relevant as they might represent protective factors against the risk of school failure, poverty and psychopathology to which children with BIF are exposed in the adult age. Limitations of the study are represented by the small number of subjects and the lack of a no-treatment group.
Clinical Trial Registration:
ISRCTN Registry (isrctn.com), identifier ISRCTN81710297.
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