Patterns:

• Cognitive impairment can be a major problem in children and adolescents with DM1, while muscle symptoms may be relatively discrete or absent within the childhood-onset form.

• Children diagnosed with DM1 can present with a range of complex physical, cognitive, behavioral, and personality features that can have a substantial impact upon development and quality of life status in childhood and during transition to adulthood.

Symptoms:

• Reduced perceptive organization skills.

• Slowed speed of processing.

• Deficits in visual attention, visual constructive abilities, working memory, planning and cognitive flexibility.

• Communication issues.

• Social anxiety.

• Hyperactivity.

Diagnosis:

• Discuss the following tests with your child’s doctor: these assessments should be performed at diagnosis, in preschool if applicable, and should be repeated, depending on the level of functioning, 2-3 times before adulthood.

• Psychometric assessment of global intellectual ability and adaptive functioning.

• Assessment of executive functions.

• Assessment of social cognition.

• Assessment of visuomotor integration and visuospatial ability.

• Assessment of receptive and expressive language ability.

• Assessment of excessive daytime sleepiness (EDS).

• Assessment of learning disability (specific tests for dyscalculia, dyslexia, and dyspraxia).

• Get a referral to a mental health care professionals for psychiatric or behavioral issues for the assessment of Autism Spectrum Disorders, attention deficit disorders with or without hyperactivity, and other behavioral problems.

Treatment:

• Discuss the following treatment options with your doctor:

  • Psychostimulants if attention deficits are associated with an impairing level of fatigue or excessive daytime sleepiness.

  • Serotonin-enhancing antidepressants if excessive anxiety or other treatable psychiatric symptoms are present.

  • Specific cognitive remediation programs to enhance social abilities (visual contact, joint attention, emotional regulation) or executive functions efficiency (impulsivity, attention, working memory, and mental flexibility) using dedicated software (e.g., Cogmed®).

  • Language remediation and reading therapy in the presence of cognitive deficits, even in children with normal intelligence. These deficits, including attention deficit, fatigability, and visual-spatial construction disability, can result in reading and spelling difficulties as well as mathematical impairment.