Michele Zappella | |
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Born | |
Nationality | Italian |
Michele Zappella (born 4 March 1936) is an Italian psychiatrist and scholar of Child Neuropsychiatry. He is a native of Viareggio, Italy.
Zappella graduated in 1960 in Medicine and Surgery in Rome, Italy. He initially relocated to London, where he worked with the Fountain Hospital of London from 1961 to 1963. He then moved back to Rome, where he worked in the medical field and specialized in Pediatrics. As winner of a Fulbright grant for the United States, he became a Fellow of Neurology in the Department of Child Neurology at Children's Hospital in Washington D.C., serving there from 1964 to 1965. In 1966, he moved to Pisa, Italy, where he specialized first in Child Neuropsychiatry and then, in 1968, in Nervous and Mental Diseases. In 1970 he became Lecturer in Mental Health.
He was head of the Department of Child Neuropsychiatry of Siena Hospital from 1973 to 2006. As of 2011 [update] , he is teaching Child Neuropsychiatry in the Schools of Specialization of the University of Siena [1] and serves as a consultant in the Rett Center of Versilia Hospital in Italy.
Zappella is an honorary member of the Society for the Study of Behavioural Phenotypes in London and of the Italian Society of Pedagogy. He was the President of the Italian Society of Tourette's syndrome from 1999 to 2003, and Vice President of the Italian Society of Child Neuropsychiatry from 1976 to 1978.
He has been involved in social integration and education of disabled children. From 1969 through 1970, he was focused on publishing the first papers on this subject.
In the 1960s, Zappella studied the Placing Reflex [2] [3] and its connections with the early diagnosis of severe mental retardation. His studies on Rett syndrome have shown that there is a milder variant of this syndrome in which children acquire late some manual skills and spoken language. This variant is known as the Zappella variant of Rett syndrome [4] [5] [6] [7] [8] [9] (OMIM [10] ) in the scientific community. [11] [12] [13]
Zappella has extensively studied Autistic Disorders, discovering the dysmaturational syndrome, [14] which manifests as a transitional autistic behavior, associated with motor and vocal tics, which has a genetic cause Tourette-like, quite different from stable Autistic Disorders. He introduced a form of rehabilitative therapy, known as Emotional Activation through Body Reciprocity (AERC).
In 1981, in recognition of his studies on Autism, Zappella received the Gold Medal and the Honorary Citizenship of the town of Sesto San Giovanni, Italy.
Zappella is the author of over 300 scientific publications, 105 indexed on PubMed - U.S. National Library of Medicine of National Institutes of Health. In 1980, he won the Glaxo Award for Science diffusion (Verona - Italy). He is currently Scientific Director of the magazine Autismo e Disturbi dello Sviluppo. [15]
Asperger syndrome (AS), also known as Asperger's syndrome, formerly described a neurodevelopmental disorder characterized by significant difficulties in social interaction and nonverbal communication, along with restricted and repetitive patterns of behavior, interests, and activities. The syndrome has been merged with other disorders into autism spectrum disorder (ASD) and is no longer considered a stand-alone diagnosis. It was considered milder than other diagnoses that were merged into ASD due to relatively unimpaired spoken language and intelligence.
Rett syndrome (RTT) is a genetic disorder that typically becomes apparent after 6–18 months of age and almost exclusively in females. Symptoms include impairments in language and coordination, and repetitive movements. Those affected often have slower growth, difficulty walking, and a smaller head size. Complications of Rett syndrome can include seizures, scoliosis, and sleeping problems. The severity of the condition is variable.
The diagnostic category pervasive developmental disorders (PDD), as opposed to specific developmental disorders (SDD), was a group of disorders characterized by delays in the development of multiple basic functions including socialization and communication. It was defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM), and the International Classification of Diseases (ICD).
Echolalia is the unsolicited repetition of vocalizations made by another person. In its profound form it is automatic and effortless. It is one of the echophenomena, closely related to echopraxia, the automatic repetition of movements made by another person; both are "subsets of imitative behavior" whereby sounds or actions are imitated "without explicit awareness". Echolalia may be an immediate reaction to a stimulus or may be delayed.
High-functioning autism (HFA) was historically an autism classification where a person exhibits no intellectual disability, but may experience difficulty in communication, emotion recognition, expression, and social interaction.
Neuropsychiatry is a branch of medicine that deals with psychiatry as it relates to neurology, in an effort to understand and attribute behavior to the interaction of neurobiology and social psychology factors. Within neuropsychiatry, the mind is considered "as an emergent property of the brain", whereas other behavioral and neurological specialties might consider the two as separate entities. Those disciplines are typically practiced separately.
Neurodevelopmental disorders are a group of conditions that begin to emerge during childhood. According to the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (DSM-5) published in 2013, these conditions generally appear in early childhood, usually before children start school, and can persist into adulthood. The key characteristic of all these disorders is that they negatively impact a person's functioning in one or more domains of life depending on the disorder and deficits it has caused. All of these disorders and their levels of impairment exist on a spectrum, and affected individuals can experience varying degrees of symptoms and deficits, despite having the same diagnosis.
The heritability of autism is the proportion of differences in expression of autism that can be explained by genetic variation; if the heritability of a condition is high, then the condition is considered to be primarily genetic. Autism has a strong genetic basis. Although the genetics of autism are complex, autism spectrum disorder (ASD) is explained more by multigene effects than by rare mutations with large effects.
Many causes of autism, including environmental and genetic factors, have been recognized or proposed, but understanding of the theory of causation of autism is incomplete. Attempts have been made to incorporate the known genetic and environmental causes into a comprehensive causative framework. ASD is a neurodevelopmental disorder marked by impairments in communicative ability and social interaction and restricted/repetitive behaviors, interests, or activities not suitable for the individual's developmental stage. The severity of symptoms and functional impairment vary between individuals.
Stereotypic movement disorder (SMD) is a motor disorder with onset in childhood involving restrictive and/or repetitive, nonfunctional motor behavior, that markedly interferes with normal activities or results in bodily injury. To be classified as SMD, the behavior in question must not be due to the direct effects of a substance, autism, or another medical condition. The cause of this disorder is not known.
The autism-spectrum quotient (AQ) is a questionnaire published in 2001 by Simon Baron-Cohen and his colleagues at the Autism Research Centre in Cambridge, UK. Consisting of fifty questions, it aims to investigate whether adults of average intelligence have symptoms of autism spectrum conditions. More recently, versions of the AQ for children and adolescents have also been published.
Tourettism refers to the presence of Tourette-like symptoms in the absence of Tourette syndrome, as the result of other diseases or conditions, known as "secondary causes".
A retrospective diagnosis is the practice of identifying an illness after the death of the patient using modern knowledge, methods and disease classifications. Alternatively, it can be the more general attempt to give a modern name to an ancient and ill-defined scourge or plague.
Classic autism, also known as childhood autism, autistic disorder, (early) infantile autism, infantile psychosis, Kanner's autism,Kanner's syndrome, or (formerly) just autism, is a neurodevelopmental condition first described by Leo Kanner in 1943. It is characterized by atypical and impaired development in social interaction and communication as well as restricted, repetitive behaviors, activities, and interests. These symptoms first appear in early childhood and persist throughout life.
Susan Swedo is a researcher in the field of pediatrics and neuropsychiatry. Beginning in 1998, she was Chief of the Pediatrics & Developmental Neuroscience Branch at the US National Institute of Mental Health. In 1994, Swedo was lead author on a paper describing pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS), a controversial hypothesis proposing a link between Group A streptococcal infection in children and some rapid-onset cases of obsessive-compulsive disorder (OCD) or tic disorders such as Tourette syndrome. Swedo retired from the NIH in 2019, and serves on the PANDAS Physician Network.
Several factors complicate the diagnosis of Asperger syndrome (AS), an autism spectrum disorder (ASD). Like other ASD forms, Asperger syndrome is characterized by impairment in social interaction accompanied by restricted and repetitive interests and behavior; it differs from the other ASDs by having no general delay in language or cognitive development. Problems in diagnosis include disagreement among diagnostic criteria, the controversy over the distinction between AS and other ASD forms or even whether AS exists as a separate syndrome, and over- and under-diagnosis for non-technical reasons. As with other ASD forms, early diagnosis is important, and differential diagnosis must consider several other conditions.
Autism, formally called autism spectrum disorder (ASD) or autism spectrum condition (ASC), is a neurodevelopmental disorder marked by deficits in reciprocal social communication and the presence of restricted and repetitive patterns of behavior. Other common signs include difficulties with social interaction, verbal and nonverbal communication, along with perseverative interests, stereotypic body movements, rigid routines, and hyper- or hyporeactivity to sensory input. Autism is clinically regarded as a spectrum disorder, meaning that it can manifest very differently in each person. For example, some are nonspeaking, while others have proficient spoken language. Because of this, there is wide variation in the support needs of people across the autism spectrum.
The imprinted brain hypothesis is an unsubstantiated hypothesis in evolutionary psychology regarding the causes of autism spectrum and schizophrenia spectrum disorders, first presented by Bernard Crespi and Christopher Badcock in 2008. It claims that certain autistic and schizotypal traits are opposites, and that this implies the etiology of the two conditions must be at odds.
Autism spectrum disorder (ASD) refers to a variety of conditions typically identified by challenges with social skills, communication, speech, and repetitive sensory-motor behaviors. The 11th International Classification of Diseases (ICD-11), released in January 2021, characterizes ASD by the associated deficits in the ability to initiate and sustain two-way social communication and restricted or repetitive behavior unusual for the individual's age or situation. Although linked with early childhood, the symptoms can appear later as well. Symptoms can be detected before the age of two and experienced practitioners can give a reliable diagnosis by that age. However, official diagnosis may not occur until much older, even well into adulthood. There is a large degree of variation in how much support a person with ASD needs in day-to-day life. This can be classified by a further diagnosis of ASD level 1, level 2, or level 3. Of these, ASD level 3 describes people requiring very substantial support and who experience more severe symptoms. ASD-related deficits in nonverbal and verbal social skills can result in impediments in personal, family, social, educational, and occupational situations. This disorder tends to have a strong correlation with genetics along with other factors. More research is identifying ways in which epigenetics is linked to autism. Epigenetics generally refers to the ways in which chromatin structure is altered to affect gene expression. Mechanisms such as cytosine regulation and post-translational modifications of histones. Of the 215 genes contributing, to some extent in ASD, 42 have been found to be involved in epigenetic modification of gene expression. Some examples of ASD signs are specific or repeated behaviors, enhanced sensitivity to materials, being upset by changes in routine, appearing to show reduced interest in others, avoiding eye contact and limitations in social situations, as well as verbal communication. When social interaction becomes more important, some whose condition might have been overlooked suffer social and other exclusion and are more likely to have coexisting mental and physical conditions. Long-term problems include difficulties in daily living such as managing schedules, hypersensitivities, initiating and sustaining relationships, and maintaining jobs.
The history of autism spans over a century; autism has been subject to varying treatments, being pathologized or being viewed as a beneficial part of human neurodiversity. The understanding of autism has been shaped by cultural, scientific, and societal factors, and its perception and treatment change over time as scientific understanding of autism develops.