Margherita La Fauci

Background/Objectives: Digital technologies are increasingly explored as complementary tools in speech and language therapy for children with neurodevelopmental disorders. However, evidence on virtual reality-based interventions for children with developmental language disorder (DLD) remains limited. This study aimed to evaluate the effects of a Virtual Reality Rehabilitation System (VRRS)-based language intervention combined with standard speech therapy in preschool children with DLD. Secondary objectives included assessing the feasibility, usability, and safety of the VRRS-integrated intervention. Methods: A randomized controlled pilot study was conducted in preschool children diagnosed with DLD. Participants were allocated to an experimental group receiving VRRS-based language intervention integrated with conventional therapy or to a control group receiving standard speech therapy alone. Both groups attended two 60 min sessions per week for six months. Clinical language outcomes were assessed at baseline (T0) and post-intervention (T1). Feasibility was evaluated through adherence and retention rates, usability through a therapist-completed questionnaire, and safety through monitoring of adverse events during sessions. Results: All participants in the experimental group completed the intervention (100% retention). No adverse events were observed. Therapists reported good usability of the VRRS system, highlighting ease of exercise customization, intuitive monitoring of progress, and good integration into routine therapy. Conclusions: VRRS-based activities integrated into conventional speech therapy appear feasible, safe, and well accepted in preschool children with DLD. Further controlled studies with larger samples are needed to confirm these findings. Trial Registration: ClinicalTrials.gov (NCT07438639).

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder frequently associated with impairments in executive functions (EF). These deficits have been linked to difficulties across various cognitive domains, including metaphonological skills (MS), essential for phonological awareness and processing abilities. Background/Objectives: This pilot study examines the correlations between EF and MS in ADHD children. Methods: A total of 84 children aged 6–14 years, diagnosed with ADHD and an IQ ≥ 70, were assessed using the NEPSY-II test to evaluate executive functions and the Assessment of Metaphonological Skills Test to assess phonological processing abilities. Results: Correlational analyses and multiple regression models were employed to explore the relationships between EF and MS, focusing on attention, cognitive flexibility, and response inhibition. Rhyme was positively correlated with processing speed and negatively correlated with response inhibition. Phonemic segmentation was significantly related to auditory attention and response inhibition. Age emerged as a significant predictor of phonemic synthesis and final syllable deletion, consistent with the developmental maturation of executive and phonological abilities. Conclusions: The findings suggest that deficits in executive functioning in ADHD children are closely linked to metaphonological abilities, which play a crucial role in the acquisition of reading and writing skills. Integrating EF training into phonological interventions can help reduce learning difficulties and improve cognitive and language outcomes.

Background/Objectives: Minimally verbal autistic children face significant communication challenges, often unmet by traditional therapies. Social robots, like NAO, offer predictable, structured interactions that may improve engagement and language skills. This study aimed to evaluate the effectiveness of NAO-assisted therapy in improving communication and social interaction in minimally verbal autistic children compared to standard therapeutic approaches. Methods: In a single-blind, randomized, controlled study, 37 autistic children aged 4–12 years were assigned to either NAO-assisted therapy or standard speech therapy. Participants were assigned to either an NAO-assisted therapy group or a standard speech therapy control group. The intervention included 12 weekly 45 min sessions. Communication outcomes were measured using the Language Development Level Test (TVL) and mand request observations. Results: All 37 participants completed the 12 sessions without adverse events, highlighting the intervention’s feasibility and safety. Children in the NAO-assisted therapy group showed greater improvements in verbal communication (on average, 159 ± 49% more children exhibited improvement across verbal aspects (range: 107–284%; p < 0.001)) particularly in spontaneous communication, compared to the control group. The therapy also increased mand production (from 6.8 ± 4.3 in session 1 to 16.7 ± 7.7 in session 12; p < 0.001; average gain: 0.9 per session), demonstrating steady growth in communicative initiative. These findings underscore the structured and engaging nature of NAO-assisted therapy in supporting consistent progress in communication skills. Conclusions: NAO-assisted therapy is a promising, safe, and effective intervention for enhancing communication in minimally verbal autistic children, offering unique benefits in promoting spontaneous and consistent verbal engagement.

Language disorders are characterized by impairments in verbal expression/understanding, including difficulties with one or more language components. The Virtual Reality Rehabilitation System (VRRS) is a bioelectromedical device equipped with exercise sections aimed at improving cognitive and language deficits. It also increases patient motivation and engagement. The aim of our study was to test the feasibility and efficacy of VRRS intervention to improve speech therapy treatment for children with speech disorders. Thirty-two patients were enrolled in this study and randomly assigned to the experimental (EG) or control group (CG). The CG underwent conventional speech therapy, while EG underwent VRRS-implemented speech therapy. Both groups were evaluated before (T0) and after (T1) the intervention using the Language Assessment Test. The results showed improvements in both groups. However, the EG group showed greater improvement in various areas, including comprehension of total words, repetition, naming of body parts, naming of everyday objects, total naming, morphosyntactic accuracy, sentence construction, average length of utterance, and spontaneous word production. This study demonstrated that VRRS can be a valuable tool for implementing effective speech rehabilitation. Further studies are needed, as the use of VRRS is still in its early stages, requiring larger samples sizes and long-term follow-up.

Global developmental delay (GDD) is a complex disorder that requires multimodal treatment involving different developmental skills. The objective of this single-blind, randomized, controlled pilot study is to evaluate the feasibility and effectiveness of conventional rehabilitation programs integrated with the BTs-Nirvana virtual reality system. Patients with GDD aged 12 to 66 months were enrolled and treated for a 48-session cycle. Patients were randomized into two groups, (1) conventional treatment and (2) conventional treatment supplemented with the use of BTs-Nirvana, in a 1:1 ratio. Before and after treatments, areas of global development were tested with the Griffiths-III Mental Developmental Scale and the clinical indicator of global improvement were measured with the Clinical Global Impressions-Improvement (CGI-I). Feasibility was confirmed by the high retention rate. The experimental group presented a significantly improvement in General Quotient (GQ) after treatment (GQ, p = 0.02), and the effect of the two treatments was significantly different in both the GQ (t =2.44; p = 0.02) and the Foundations of Learning subscale (t =3.66; p < 0.01). The overall improvement was also confirmed by the CGI-I (p = 0.03). According to these preliminary data, virtual reality can be considered a useful complementary tool to boost the effectiveness of conventional therapy in children with GDD.