Baglio Gisella, Zanette Michela, Di Cesare Monica, Di Tella Sonia, Clerici Mario, Baglio Francesca, Blasi Valeria
Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Don Carlo Gnocchi Foundation Onlus, Milan, Italy.
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
Front Psychiatry. 2021 Jan 25;11:609819. doi: 10.3389/fpsyt.2020.609819. eCollection 2020.
Adverse Childhood Experiences (ACE) are associated with an increased risk of cerebral, behavioral, and cognitive outcomes, and vulnerability to develop a Borderline Intellectual Functioning (BIF). BIF is characterized by an intelligence quotient (IQ) in the range 70-85, poor executive functioning, difficulties in emotion processing, and motor competencies. All these difficulties can lead to mental and/or neurodevelopmental disorders that require long-term care. Accordingly, we developed an intensive and multidomain rehabilitation program for children with ACE and BIF, termed the Movement Cognition and Narration of emotions Treatment (MCNT1.0). The efficacy of MCNT1.0 on cognitive and social functioning was demonstrated with a previously reported randomized controlled trial (RCT). To extend the impact of the treatment also to the motor domain a new version, called MCNT2.0, was implemented. The present study aims to verify the feasibility of MCNT2.0 and its effects on the motor domain. A quasi-experimental approach was used in which a group of 18 children with ACE and BIF were consecutively recruited and participated in the MCNT 2.0 program. Participants were compared with the MCNT1.0 group as an active comparator, using the dataset of the RCT. The two groups received a full evaluation comprising: the Wechsler Intelligent Scale for Children-IV (WISC-IV), the Movement-ABC (M-ABC), the Test of Gross Motor Development (TGMD), the Social Skills from Vineland Adaptive Behavioral Scale-II (VABS-II) and the Child Behavior Check List 6-18 (CBCL). An ANCOVA was carried out on changes in the scale scores from baseline with age and baseline score as covariates. Results showed a mean adherence to treatment of 0.85 ( = 0.07), with no differences between groups in IQ, and Social Skills changes, while greater improvements for motor abilities were shown in the MCNT 2.0 group: M-ABC ( = 0.002), and TGMD ( = 0.002). Finally, greater improvement in the CBCL scale was observed in the MCNT 1.0 group ( = 0.002). Results indicate that due to its positive effects on cognitive, social participation and motor domains, MCNT2.0 may represent a protective factor against maladaptive outcomes of children with ACE and BIF.
童年不良经历（ACE）与大脑、行为和认知方面出现不良后果的风险增加以及发展为边缘智力功能（BIF）的易感性相关。BIF的特征是智商（IQ）在70 - 85之间，执行功能较差，情绪处理困难以及运动能力不足。所有这些困难都可能导致需要长期护理的精神和/或神经发育障碍。因此，我们为患有ACE和BIF的儿童开发了一个强化的多领域康复计划，称为情绪运动认知与叙述疗法（MCNT1.0）。先前一项随机对照试验（RCT）证明了MCNT1.0对认知和社会功能的疗效。为了将治疗的影响扩展到运动领域，实施了一个新版本，称为MCNT2.0。本研究旨在验证MCNT2.0的可行性及其对运动领域的影响。采用了一种准实验方法，连续招募了18名患有ACE和BIF的儿童并让他们参与MCNT 2.0计划。使用RCT的数据集，将参与者与作为积极对照的MCNT1.0组进行比较。两组都接受了全面评估，包括：韦氏儿童智力量表第四版（WISC-IV）、运动ABC量表（M-ABC）、粗大运动发展测试（TGMD）、文兰适应行为量表第二版（VABS-II）中的社交技能以及儿童行为检查表6 - 18（CBCL）。以年龄和基线分数作为协变量，对基线时量表分数的变化进行协方差分析。结果显示平均治疗依从性为0.85（标准差 = 0.07），两组在智商和社交技能变化方面没有差异，而MCNT 2.0组在运动能力方面有更大改善：M-ABC量表（P = 0.002）和TGMD（P = 0.002）。最后，在MCNT 1.0组中观察到CBCL量表有更大改善（P = 0.002）。结果表明，由于MCNT2.0对认知、社会参与和运动领域有积极影响，它可能是预防患有ACE和BIF儿童出现适应不良后果的一个保护因素。
