Floriana Costanzo | Children's Hospital 'Bambino Gesù' Rome (original) (raw)

Papers by Floriana Costanzo

Frontiers in psychology, Feb 6, 2024

Background: Subclinical hypothyroidism (SH) is particularly frequent in individuals with Down syn... more Background: Subclinical hypothyroidism (SH) is particularly frequent in individuals with Down syndrome (DS). Despite the amount of evidence suggesting SH is associated with psychopathological symptoms and sleep problems in general population, poor is known about the emotional and behavioral features associated with SH in children with DS. Objective: The first aim of the current study was to investigate differences in emotional and behavioral profiles between a group of children with DS exhibiting co-occurring SH and a group of age and BMI-matched children with DS without co-occurring SH. The second aim of the present study was to investigate differences in sleep disturbances between these groups. Methods: We included in this retrospective study 98 participants with DS aged 3-18 years with the aim to explore differences in emotional/behavioral problems as well as in sleep difficulties between children with DS with or without co-occurring SH. Results: Participants with co-occurring SH exhibited significantly higher scores at several scales of the Conners' Parent Rating Scales Long Version-Revised. However, they did not exhibit more sleep problems than control group. Conclusion: These results provide specific indications for psychological and neuropsychiatric evaluation of children with DS with suspected or diagnosed SH, highlighting the importance of a multidisciplinary approach in clinical care for children and adolescents with DS.

Frontiers in Psychology, Jun 6, 2023

Introduction: Individuals with Down syndrome (DS) often exhibit a severe speech impairment, with ... more Introduction: Individuals with Down syndrome (DS) often exhibit a severe speech impairment, with important consequences on language intelligibility. For these cases, the use of Augmentative Alternative Communication instruments, that increase an individual's communication abilities, becomes crucial. Talkitt is a mobile application created by Voiceitt Company, exploiting speech recognition technology and artificial intelligence models to translate in real-time unintelligible sounds into clear words, allowing individuals with language production impairment to verbally communicate in real-time. Methods: The study evaluated the usability and satisfaction related to the Talkitt application use, as well as effects on adapted behavior and communication, of participants with DS. A final number of 23 individuals with DS, aged 5.54 to 28.9 years, participated in this study and completed 6 months of training. The application was trained to consistently recognize at least 20 different unintelligible words (e.g., nouns and/or short phrases)/person. Results: Results revealed good usability and high levels of satisfaction related to the application use. Moreover, we registered improvement in linguistic abilities, particularly naming. Discussion: These results paves the road for a potential role of Talkitt application as a supportive and rehabilitative tool for DS.

Frontiers in Psychiatry, Jun 9, 2023

Background: Individuals with Down syndrome (DS) are at risk of developing sleep problems. In spit... more Background: Individuals with Down syndrome (DS) are at risk of developing sleep problems. In spite of the well-established knowledge on the presence of sleep di culties in DS individuals and the associated emotional and behavioral problems, less is known about the possible di erences in the kind of associations between sleep and emotional/behavioral problems across di erent age ranges. Methods: In this retrospective study, we included participants with DS aged-years with the aims to explore di erences in the distribution of sleep problems between specific age groups (school age vs. adolescence) and to identify specific age-based associations between sleep problems and emotional/behavioral problems. Results: Some di erences in the distribution of sleep problems have emerged between age groups. Moreover, di erences in the patterns of association between emotional/behavioral di culties and sleep problems-in particular, sleep-related breathing di culties and parasomnias-have been observed. However, sleepwake transition disorders and excessive daily somnolence appear to be related to emotional and behavioral problems (both internalizing and externalizing), in general, across school age and adolescence. Discussion: These results remark the importance of appropriate neuropsychiatric and psychological evaluation taking into account the age-specific needs and features of individuals with DS.

International Journal of Environmental Research and Public Health, May 9, 2021

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

International Journal of Environmental Research and Public Health, Oct 16, 2022

Frontiers in Psychology, Jul 18, 2022

Sleep is a major concern, especially in people with Down Syndrome (DS). Beyond Obstructive Sleep ... more Sleep is a major concern, especially in people with Down Syndrome (DS). Beyond Obstructive Sleep Apnea, a number of other sleep difficulties have been reported in children with DS, such as delayed sleep onset, night-time awakenings, and early morning awakenings. The detrimental effect of sleep difficulties seems to contribute to and exacerbate the cognitive and behavioral outcomes of DS. Although the screening for sleep disorders is recommended early in age in DS, only a few studies have evaluated the sleep profile in preschool-age children with DS. The aim of the current study was to assess the association between sleep disturbances and behavioral problems in a group of preschool-age children with DS, by means of a feasible and easy-to-administer parent-report questionnaires. Seventy-one preschool-age children with DS, ranging in age from 3 to 5.11 years, were included in this retrospective study. Sleep disturbances were evaluated by means of the Sleep Disturbance Scale for Children, while emotional and behavioral problems by means of the Child Behavior Checklist. Sleep breathing disorders were the most frequent sleep difficulties reported by parents. Moreover, children with clinical scores in total sleep problems exhibited elevation of psychopathological symptoms, namely Total problems, Affective problems, Anxiety problems, Pervasive Developmental Problems, and Attention Deficit/Hyperactivity Problems. The identification of the broader connection between sleep difficulties and emotional and behavioral problems in preschoolage children with DS leads to important considerations for intervention. KEYWORDS trisomy 21 (Down syndrome), behavior, child behavior checklist, sleep disturbance scale for children, preschoolers TYPE

Frontiers in Psychiatry, Aug 12, 2022

Down Syndrome (DS) is the most common chromosome abnormality and the most frequent cause of devel... more Down Syndrome (DS) is the most common chromosome abnormality and the most frequent cause of developmental delay/intellectual disabilities in children. Although the investigation of the quality of life (QoL) is crucial in children with DS, relatively poor attention has been paid to this topic. The current study aimed to evaluate parent-reported QoL in a group of children with DS and identify children's individual and clinical features associated with di erent levels of QoL. We included in the study children with DS (-years) and investigated the parent-reported levels of QoL by means of the Pediatric Quality of Life Inventory. Cognitive level and the presence of behavioral di culties were also evaluated. The overall parent-reported QoL of children with DS was high; emotional functioning was the domain with the highest level of QoL. Moreover, parents perceived low levels of QoL in children who exhibited low IQ, worse analogical reasoning, worse adaptive skills, more frequent challenging behaviors, more ritualistic/sameness behavior and more autistic symptoms. No di erences emerged for family variables, namely parental education and employment, between the two groups with high and low QoL, as perceived by parents. The understanding of cognitive and behavioral factors-such as analogical reasoning, socio-communication abilities and challenging behaviors-related with di erent degrees of QoL in children with DS is crucial for the development of e ective strategies to promote the improvement of the QoL.

International Journal of Environmental Research and Public Health, Mar 9, 2021

Journal of Clinical Medicine, Feb 23, 2022

This study's main aim was to explore practitioner's views regarding the use of the Griffiths Scal... more This study's main aim was to explore practitioner's views regarding the use of the Griffiths Scales of Child Development-3 rd Edition (Griffiths III) as a measure of children's development. The Griffiths III has been researched and used in countries such as Australia,

Journal of Eating Disorders

Background Current psychological and pharmacological treatments for Anorexia Nervosa (AN) provide... more Background Current psychological and pharmacological treatments for Anorexia Nervosa (AN) provide only moderate effective support, and there is an urgent need for research to improve therapies, especially in developing age. Non-invasive brain stimulation has suggested to have the potential to reducing AN symptomatology, via targeting brain alterations, such as hyperactivity of right prefrontal cortex (PFC). We suppose that transcranial direct current stimulation (tDCS) to the PFC may be effective in children and adolescents with AN. Methods We will conduct a randomized, double blind, add-on, placebo-controlled trial to investigate the efficacy of tDCS treatment on clinical improvement. We will also investigate brain mechanisms and biomarkers changes acting in AN after tDCS treatment. Eighty children or adolescent with AN (age range 10–18 years) will undergo treatment-as-usual including psychiatric, nutritional and psychological support, plus tDCS treatment (active or sham) to PFC (F...

Frontiers in Neuroscience

IntroductionAttention-deficit/hyperactivity disorder (ADHD) is characterized by an inappropriate,... more IntroductionAttention-deficit/hyperactivity disorder (ADHD) is characterized by an inappropriate, pervasive and persistent pattern of inattention, hyperactivity, and/or impulsivity and associated with substantial functional impairment. Despite considerable advances in the understanding and management of ADHD, some patients do not respond well to methylphenidate (MPH), the first-choice pharmacological treatment. Over the past decades, among non-invasive brain stimulation techniques, transcranial direct current stimulation (tDCS) has proven to be an effective and safe technique to improve behavior and cognition in children with neurodevelopmental disorders, including ADHD, by modifying cortical excitability. However, the effect of tDCS has never been directly compared with that of the MPH. The present randomized sham-controlled trial evaluated the effect of a single session of anodal tDCS compared with the administration of a single dose of MPH in children and adolescents with ADHD.Me...

Clinical Neurophysiology, Sep 1, 2022

Brain Stimulation, 2019

This study aims to improve the effects of DBS by increasing the recognition accuracy of character... more This study aims to improve the effects of DBS by increasing the recognition accuracy of characteristics in EEG signal, and enabling adaptive setting of stimulation parameters (e.g., frequency and time interval). Methods: We first recorded scalp EEG signals in 20 people with epilepsy. The standard EEG signal was extracted using wavelet packet decomposition. Then we sampled and combined 20 groups of features in EEG, which formed 100 new training sets and 40 test sets. This avoided potential bias due to consistent distribution in training data and testing data. We used large margin projected transductive transfer learning (i.e.,LMPROJ) as the classifier in the model. This LMPROJ technique can minimize the distribution distance between source domain(training data) and target domain(test data) by finding a feature transformation. Next, the results of classification were mapped to treatment parameters of stimulation signal after the calibration from experienced doctors. We adopted two strategies: data balance and cross validation to improve the stability and accuracy of our model. Results: (1) The average recognition accuracy of 40 test sets reached 0.976, and AUC value reached 0.876. We tested 10 new patients' data, the accuracy was 0.965, much better than traditional machine learning algorithm (LDA:0.845,SVM:0.879,KNN:0.813,Decision Tree:0.826).(2)The treatment parameters of output stimulation were significantly correlated with realtime extraction features (r 2 ¼0.883,p¼0.032), and matched with doctor's calibration in 94.2% of cases. Conclusion: Our closed-loop neuromodulation algorithm based on transfer learning provides excellent recognition performance when there are distribution differences between multiple individuals. Besides, this novel algorithm can adaptively adjust the stimulation parameters, which may serve as a promising strategy for optimal neuromodulation protocol in epilepsy.

Contemporary clinical neuroscience, 2023

Frontiers in Psychology

IntroductionIndividuals with Down syndrome (DS) often exhibit a severe speech impairment, with im... more IntroductionIndividuals with Down syndrome (DS) often exhibit a severe speech impairment, with important consequences on language intelligibility. For these cases, the use of Augmentative Alternative Communication instruments, that increase an individual’s communication abilities, becomes crucial. Talkitt is a mobile application created by Voiceitt Company, exploiting speech recognition technology and artificial intelligence models to translate in real-time unintelligible sounds into clear words, allowing individuals with language production impairment to verbally communicate in real-time.MethodsThe study evaluated the usability and satisfaction related to the Talkitt application use, as well as effects on adapted behavior and communication, of participants with DS. A final number of 23 individuals with DS, aged 5.54 to 28.9 years, participated in this study and completed 6 months of training. The application was trained to consistently recognize at least 20 different unintelligible...