Central Nervous System - CDM

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.

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