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Article ; Online: Questionnaires as screening tools for children with cerebral visual impairment.

Fazzi, Elisa / Micheletti, Serena

Developmental medicine and child neurology

2020 Volume 62, Issue 8, Page(s) 891

MeSH term(s)	Brain Diseases ; Child ; Humans ; Mass Screening ; Surveys and Questionnaires ; Vision Disorders/diagnosis ; Vision Disorders/etiology
Language	English
Publishing date	2020-02-21
Publishing country	England
Document type	Journal Article ; Comment
ZDB-ID	80369-8
ISSN	1469-8749 ; 0012-1622
ISSN (online)	1469-8749
ISSN	0012-1622
DOI	10.1111/dmcn.14497
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Article ; Online: Visual intervention in early onset visual impairment: A review.

Micheletti, Serena / Merabet, Lotfi B / Galli, Jessica / Fazzi, Elisa

The European journal of neuroscience

2022 Volume 57, Issue 12, Page(s) 1998–2016

Abstract: Vision is a primary and motivating sense. Early visual experience derived from the external world is known to have an important impact on the development of central visual pathways, and not surprisingly, visual impairment constitutes a risk factor for ... ...

Abstract	Vision is a primary and motivating sense. Early visual experience derived from the external world is known to have an important impact on the development of central visual pathways, and not surprisingly, visual impairment constitutes a risk factor for overall development. In light of the role of vision in early brain development, infants and young children with visual impairment should be thus entitled to early and effective visual intervention programmes. In this review, we discuss early visual interventions in infants and young children with visual impairment, focusing on their contents and outcomes. We defined a PICO format to critically review different models with a particular focus on parent-mediated and therapist-mediated approaches. We consider protocols that involved direct manipulation or improvement of the infants' visual inputs or were based on behavioural strategies and communication towards infants with visual impairment. We also provide an overview of the effectiveness of these protocols. A total of nine intervention protocols were selected for the purposes of this review. Substantial agreement regarding the importance of promoting the enrichment of infant environments, and more specifically in the context of active play that engages the whole family, has been reported in most of the studies. However, there is no clear agreement on methodological aspects, including clinical population characteristics, outcome measures, length of treatment and follow-up programmes. Further high-quality, carefully designed and adequately reported studies are needed in order to improve the clinical efficacy of these approaches to treating infants with visual impairment.
MeSH term(s)	Infant ; Child ; Humans ; Child, Preschool ; Vision, Ocular ; Vision Disorders/therapy
Language	English
Publishing date	2022-11-16
Publishing country	France
Document type	Review ; Journal Article
ZDB-ID	645180-9
ISSN	1460-9568 ; 0953-816X
ISSN (online)	1460-9568
ISSN	0953-816X
DOI	10.1111/ejn.15841
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Article ; Online: Long-Term Visual and Neurodevelopmental Outcomes in Two Children with Congenital Nystagmus Secondary to Methadone Exposure In utero.

Galli, Jessica / Loi, Erika / Franzoni, Alessandra / Accorsi, Patrizia / Micheletti, Serena / Pansera, Laura / Fazzi, Elisa

Neuropediatrics

2023 Volume 54, Issue 6, Page(s) 412–416

Abstract: Methadone is used as a substitute for illicit opioids during pregnancy. However, the real effect of this molecule on visual and neurodevelopmental outcomes of the children exposed is not fully understood, since studies considered subjects born to ... ...

Abstract	Methadone is used as a substitute for illicit opioids during pregnancy. However, the real effect of this molecule on visual and neurodevelopmental outcomes of the children exposed is not fully understood, since studies considered subjects born to polydrug-dependent mothers and followed for few months/years. We report the long-term outcomes of two infants with congenital nystagmus solely exposed to methadone in utero. Neurological and neurovisual evaluations were performed every year from the first year of life to 11 years of age. One child was diagnosed with developmental coordination disorder. Both cases presented with ophthalmologic (refractive errors), oculomotor (nystagmus and fixation, smooth pursuit, and saccades dysfunctions), and perceptive problems (reduced visual acuity and contrast sensitivity). While nystagmus and other oculomotor dysfunctions remained stable over time, visual acuity and contrast sensitivity improved; refractive errors worsened and required corrective lenses. Both children showed normal neurodevelopmental and cognitive profile. This report highlights the long-term visual and developmental outcomes of two children exclusively exposed to methadone underlining the possibility of a visual dysfunction and motor coordination disorder. These observations prompt the need to investigate prenatal drug exposure as a cause of congenital nystagmus.
MeSH term(s)	Child ; Female ; Humans ; Infant ; Pregnancy ; Methadone/adverse effects ; Nystagmus, Congenital/chemically induced ; Prenatal Exposure Delayed Effects/chemically induced ; Refractive Errors ; Vision Disorders/chemically induced ; Vision Disorders/diagnosis
Chemical Substances	Methadone (UC6VBE7V1Z)
Language	English
Publishing date	2023-08-14
Publishing country	Germany
Document type	Case Reports ; Journal Article
ZDB-ID	573291-8
ISSN	1439-1899 ; 0174-304X
ISSN (online)	1439-1899
ISSN	0174-304X
DOI	10.1055/s-0043-1771388
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Article ; Online: Benign Hereditary Chorea as a Manifestation of HPCA Mutation.

Brunetti, Sara / Micheletti, Serena / Palmieri, Ilaria / Valente, Enza Maria / Fazzi, Elisa

Movement disorders clinical practice

2022 Volume 10, Issue 1, Page(s) 130–134

Language	English
Publishing date	2022-10-10
Publishing country	United States
Document type	Case Reports
ISSN	2330-1619
ISSN (online)	2330-1619
DOI	10.1002/mdc3.13572
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Article ; Online: Object identification in cerebral visual impairment characterized by gaze behavior and image saliency analysis.

Manley, Claire E / Walter, Kerri / Micheletti, Serena / Tietjen, Matthew / Cantillon, Emily / Fazzi, Elisa M / Bex, Peter J / Merabet, Lotfi B

Brain & development

2023 Volume 45, Issue 8, Page(s) 432–444

Abstract: Individuals with cerebral visual impairment (CVI) have difficulties identifying common objects, especially when presented as cartoons or abstract images. In this study, participants were shown a series of images of ten common objects, each from five ... ...

Abstract	Individuals with cerebral visual impairment (CVI) have difficulties identifying common objects, especially when presented as cartoons or abstract images. In this study, participants were shown a series of images of ten common objects, each from five possible categories ranging from abstract black & white line drawings to color photographs. Fifty individuals with CVI and 50 neurotypical controls verbally identified each object and success rates and reaction times were collected. Visual gaze behavior was recorded using an eye tracker to quantify the extent of visual search area explored and number of fixations. A receiver operating characteristic (ROC) analysis was also carried out to compare the degree of alignment between the distribution of individual eye gaze patterns and image saliency features computed by the graph-based visual saliency (GBVS) model. Compared to controls, CVI participants showed significantly lower success rates and longer reaction times when identifying objects. In the CVI group, success rate improved moving from abstract black & white images to color photographs, suggesting that object form (as defined by outlines and contours) and color are important cues for correct identification. Eye tracking data revealed that the CVI group showed significantly greater visual search areas and number of fixations per image, and the distribution of eye gaze patterns in the CVI group was less aligned with the high saliency features of the image compared to controls. These results have important implications in helping to understand the complex profile of visual perceptual difficulties associated with CVI.
MeSH term(s)	Humans ; Eye Movements ; Attention ; Fixation, Ocular ; Visual Perception ; Brain Diseases ; Vision Disorders
Language	English
Publishing date	2023-05-13
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	604822-5
ISSN	1872-7131 ; 0387-7604
ISSN (online)	1872-7131
ISSN	0387-7604
DOI	10.1016/j.braindev.2023.05.001
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Article ; Online: Academic skills in children with cerebral palsy and specific learning disorders.

Micheletti, Serena / Galli, Jessica / Vezzoli, Marika / Scaglioni, Vera / Agostini, Stefania / Calza, Stefano / Merabet, Lotfi B / Fazzi, Elisa

Developmental medicine and child neurology

2023

Abstract: Aim: To investigate the prevalence and clinical manifestations of reading, writing, and mathematics disorders in children with cerebral palsy (CP). We explored how the clinical profile of these children differed from those with specific learning ... ...

Abstract	Aim: To investigate the prevalence and clinical manifestations of reading, writing, and mathematics disorders in children with cerebral palsy (CP). We explored how the clinical profile of these children differed from those with specific learning disorders (SLDs), taking into account several factors, particularly IQ scores, neuropsychological aspects, and the presence of a visual impairment. Method: A prospective cross-sectional study was conducted in 42 children with CP (mean age 9 years 8 months; SD = 2 years 2 months) and 60 children with SLDs (mean age 10 years; SD = 1 year 7 months). Clinical characteristics, neuromotor and cognitive profiles, neuropsychological aspects (speech performance, academic skills, visual attention, phonological awareness, working memory), and signs of visual impairment (visual acuity, contrast sensitivity, visual field, oculomotor functions) were assessed. A machine learning approach consisting of a random forest algorithm, where the outcome was the diagnosis and the covariates were the clinical variables collected in the sample, was used for the analyses. Results: About 59% of the children with CP had reading, writing, or mathematics disorders. Children with CP with learning disorders had a low performance IQ, normal phonological awareness, and working memory difficulties, whereas children with SLDs had normal performance IQ, impaired phonological awareness, and mild working memory difficulties. There were no differences in verbal IQ between the two groups. Interpretation: Learning disorders are frequently associated with CP, with different clinical characteristics, compared with SLDs. Assessment of academic skills is mandatory in these children, even if the IQ is normal. At school age, specific interventions to promote academic skills in children with CP could be a major rehabilitative goal.
Language	English
Publishing date	2023-11-21
Publishing country	England
Document type	Journal Article
ZDB-ID	80369-8
ISSN	1469-8749 ; 0012-1622
ISSN (online)	1469-8749
ISSN	0012-1622
DOI	10.1111/dmcn.15808
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Article ; Online: Social attention and social-emotional modulation of attention in Angelman syndrome: an eye-tracking study.

Micheletti, Serena / Vivanti, Giacomo / Renzetti, Stefano / Lanaro, Matteo Paolo / Martelli, Paola / Calza, Stefano / Fazzi, Elisa

Scientific reports

2023 Volume 13, Issue 1, Page(s) 3375

Abstract: Individuals with Angelman syndrome (AS) present with severe intellectual disability alongside a social phenotype characterised by social communication difficulties and an increased drive for social engagement. As the social phenotype in this condition is ...

Abstract	Individuals with Angelman syndrome (AS) present with severe intellectual disability alongside a social phenotype characterised by social communication difficulties and an increased drive for social engagement. As the social phenotype in this condition is poorly understood, we examined patterns of social attention and social modulation of attention in AS. Twenty-four individuals with AS and twenty-one young children with similar mental age were shown videos featuring unfamiliar actors who performed simple actions across two conditions: a playful condition, in which the actor showed positive facial emotions, and a neutral condition, in which the actor showed a neutral facial expression. During the passive observation of the videos, participants' proportion of time spent watching the two areas of interest (faces and actions) was examined using eye-tracking technology. We found that the playful condition elicited increased proportion of fixations duration to the actor's face compared to the neutral condition similarly across groups. Additionally, the proportion of fixations duration to the action area was similar across groups in the two conditions. However, children with AS looked towards the actor's face for a shorter duration compared to the comparison group across conditions. This pattern of similarities and differences provides novel insight on the complex social phenotype of children with AS.
MeSH term(s)	Humans ; Angelman Syndrome ; Eye-Tracking Technology ; Intellectual Disability ; Emotions ; Attention
Language	English
Publishing date	2023-02-28
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-30199-6
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Article: Long-Term Visual and Neurodevelopmental Outcomes in Two Children with Congenital Nystagmus Secondary to Methadone Exposure In utero

Galli, Jessica / Loi, Erika / Franzoni, Alessandra / Accorsi, Patrizia / Micheletti, Serena / Pansera, Laura / Fazzi, Elisa

Neuropediatrics

2023 Volume 54, Issue 06, Page(s) 412–416

Abstract	Methadone is used as a substitute for illicit opioids during pregnancy. However, the real effect of this molecule on visual and neurodevelopmental outcomes of the children exposed is not fully understood, since studies considered subjects born to polydrug-dependent mothers and followed for few months/years. We report the long-term outcomes of two infants with congenital nystagmus solely exposed to methadone in utero. Neurological and neurovisual evaluations were performed every year from the first year of life to 11 years of age. One child was diagnosed with developmental coordination disorder. Both cases presented with ophthalmologic (refractive errors), oculomotor (nystagmus and fixation, smooth pursuit, and saccades dysfunctions), and perceptive problems (reduced visual acuity and contrast sensitivity). While nystagmus and other oculomotor dysfunctions remained stable over time, visual acuity and contrast sensitivity improved; refractive errors worsened and required corrective lenses. Both children showed normal neurodevelopmental and cognitive profile. This report highlights the long-term visual and developmental outcomes of two children exclusively exposed to methadone underlining the possibility of a visual dysfunction and motor coordination disorder. These observations prompt the need to investigate prenatal drug exposure as a cause of congenital nystagmus.
Keywords	methadone ; congenital nystagmus ; pregnancy ; neurovisual profile ; children
Language	English
Publishing date	2023-08-14
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	573291-8
ISSN	1439-1899 ; 0174-304X
ISSN (online)	1439-1899
ISSN	0174-304X
DOI	10.1055/s-0043-1771388
Database	Thieme publisher's database

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Article ; Online: Promoting Language Skills in Children With Neuromotor and Intellectual Disorders: Telepractice at the Time of SARS-CoV-2.

Micheletti, Serena / Galli, Jessica / Scaglioni, Vera / Renzetti, Stefano / Scarano, Elisa / Foresti, Valentina / Fazzi, Elisa

American journal of speech-language pathology

2021 Volume 30, Issue 4, Page(s) 1866–1879

Abstract: Purpose The aim of this pilot study is to gather preliminary results on the effectiveness of intensive, parent-oriented, telepractice-based intervention to improve language skills in preschool children with neuromotor and intellectual disorders. Method ... ...

Abstract	Purpose The aim of this pilot study is to gather preliminary results on the effectiveness of intensive, parent-oriented, telepractice-based intervention to improve language skills in preschool children with neuromotor and intellectual disorders. Method Nine preschool children (
MeSH term(s)	COVID-19 ; Child, Preschool ; Humans ; Language ; Pilot Projects ; SARS-CoV-2 ; Speech
Language	English
Publishing date	2021-07-07
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1154406-5
ISSN	1558-9110 ; 1058-0360
ISSN (online)	1558-9110
ISSN	1058-0360
DOI	10.1044/2021_AJSLP-20-00222
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Article ; Online: Early visual training and environmental adaptation for infants with visual impairment.

Fazzi, Elisa / Micheletti, Serena / Calza, Stefano / Merabet, Lotfi / Rossi, Andrea / Galli, Jessica

Developmental medicine and child neurology

2021 Volume 63, Issue 10, Page(s) 1180–1193

Abstract: Aim: To evaluate the effectiveness of early visual training and environmental adaptation on visual function and neurological development in infants with visual impairment.: Method: This was a pilot intervention clinical trial study. Thirty infants ( ... ...

Abstract	Aim: To evaluate the effectiveness of early visual training and environmental adaptation on visual function and neurological development in infants with visual impairment. Method: This was a pilot intervention clinical trial study. Thirty infants (mean age 5.9mo, SD 2.1mo, range 4-11mo; 16 males, 14 females) with peripheral visual impairment (PVI, n=15) or cerebral visual impairment (CVI, n=15) participated in a 6-month visual intervention programme. Thirty matched infants (mean age 6mo, SD 1.4mo, range 4-9mo; 18 males, 12 females) served as a comparison group. Primary outcome measures were visual acuity, contrast sensitivity, and qualitative ocular motor functions. Secondary outcomes were scores on the Griffiths Mental Developmental Scales (GMDS). Results: The treatment group showed a significant improvement in all the primary outcomes (p<0.01). The comparison group improved only in visual acuity and contrast sensitivity (p<0.01). The treatment group showed greater improvement than the comparison group in visual fixation (p=0.033) and smooth pursuit (p<0.01). The CVI subgroup showed greater improvement in visual acuity than the PVI subgroup (p<0.01). GMDS subscales of hand-eye coordination (p=0.01) and performance (p<0.01) increased in the treatment group, while the total score of the comparison group decreased, driven by language (p=0.039) and hand-eye coordination (p=0.025) subscales. Interpretation: Results suggest that, in infants with visual impairment, visual function and certain developmental outcomes improve in response to early visual training and environmental adaptation, in an interactive context. What this paper adds Early visual training and environmental adaptation are associated with enhanced visual acuity and smooth pursuit. Early visual training and environmental adaptation are associated with an improvement of neurological developmental outcome. Performance, hand-eye coordination, and language scores in Griffiths Mental Developmental Scales increase after visual training. After training, visual acuity improves more in infants with cerebral rather than anterior visual impairment. Type and complexity of visual impairment contribute to determine infants' response to training.
MeSH term(s)	Child Development ; Female ; Humans ; Infant ; Male ; Physical Therapy Modalities ; Pilot Projects ; Pursuit, Smooth ; Treatment Outcome ; Vision Disorders/congenital ; Vision Disorders/therapy ; Visual Acuity
Language	English
Publishing date	2021-05-04
Publishing country	England
Document type	Clinical Trial ; Journal Article
ZDB-ID	80369-8
ISSN	1469-8749 ; 0012-1622
ISSN (online)	1469-8749
ISSN	0012-1622
DOI	10.1111/dmcn.14865
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