Papers by Dagmara Dimitriou
Link to publication record in Explore Bristol Research PDF-document This is the author accepted m... more Link to publication record in Explore Bristol Research PDF-document This is the author accepted manuscript (AAM). The final published version (version of record) is available via Routledge . Please refer to any applicable terms of use of the publisher.
International Journal of Inclusive Education, Apr 6, 2018
Dressing is a fundamental independent living skill (ILS). Vision is an integrative sense which af... more Dressing is a fundamental independent living skill (ILS). Vision is an integrative sense which affords learning via sighted observation. Visual impairment (VI) denies/restricts access to learning via sight. As a result, children with VI and conditions where VI may be a component (e.g. Down syndrome (DS)) require structured, systematic support to develop ILS. The current study used a repeatedmeasures-intervention approach to examine the development of the ILS of dressing (ILSD) with novel intervention materials in young children. Participants (N=27: age range 5;05-10;02 years) were drawn from three groups: VI (n=9; age range 5;05-10;02 years); DS (n=9; age range 5;05-10;00 years) and Typically Developing (TD) (n=9; age range 6;05-8;00 years). The effectiveness of the intervention materials was measured over a period of 10 weeks. Clear and systematic verbal instruction combined with motor activities were useful in supporting ILSD. The assessment of the longer term effectiveness was carried out at 1 and 3 months post-intervention. This paper reported that the novel intervention materials supported the development of ILSD in all three groups. The findings could form a model for future work regarding the development of ILS in other skill areas and generalised to other developmental disorders.
Journal of pediatric neuropsychology, May 31, 2023
The coronavirus pandemic identified a clinical need for pediatric tele-neuropsychology (TeleNP) a... more The coronavirus pandemic identified a clinical need for pediatric tele-neuropsychology (TeleNP) assessment. However, due to limited research, clinicians have had little information to develop, adapt, or select reliable pediatric assessments for TeleNP. This preliminary systematic review aimed to examine the feasibility of pediatric TeleNP assessment alongside (1) patient/family acceptability, (2) reliability, and (3) the quality of the literature. Between May 2021 and November 2022, manual searches of PubMed, PsycINFO, and Google Scholar were conducted using terms related to "pediatric" and "teleneuropsychology." After extracting relevant papers with samples aged 0-22 years, predefined exclusion criteria were applied. Quality assessment was completed using the AXIS appraisal tool (91% rater-agreement). Twenty-one studies were included in the review, with reported qualitative and quantitative data on the feasibility, reliability, and acceptability extracted. Across included studies, TeleNP was completed via telephone/video conference with participants either at home, in a local setting accompanied by an assistant, or in a different room but in the same building as the assessor. Pediatric TeleNP was generally reported to be feasible (e.g., minimal behavioral differences) and acceptable (e.g., positive feedback). Nineteen studies conducted some statistical analyses to assess reliability. Most observed no significant difference between in-person and TeleNP for most cognitive domains (i.e., IQ), with a minority finding variable reliability for some tests (e.g., attention, speech, visuospatial). Limited reporting of sex-assigned birth, racialized identity, and ethnicity reduced the quality and generalizability of the literature. To aid clinical interpretations, studies should assess underexamined cognitive domains (e.g., processing speed) with larger, more inclusive samples.
Brain Sciences, Mar 26, 2021
Sleep is crucial for development across cognitive, physical, and social-emotional domains. Sleep ... more Sleep is crucial for development across cognitive, physical, and social-emotional domains. Sleep quality and quantity impact domains of daytime functioning, attainment, and global development. Previous work has explored sleep profiles in typically developing children and children with developmental disorders such as Down syndrome and Williams Syndrome, yet there is a complete absence of published work regarding the sleep profiles of children with vision impairment aged 4-11 years. This is the first known study that examines the sleep profiles in children with vision impairment (n = 58) in comparison to 58 typically developing children (aged 4-11 years) in the UK. Sleep was measured using the Childhood Sleep Habits Questionnaire (CSHQ; parental report), actigraphy and sleep diaries. Results showed group differences in subjective CSHQ scores but not objective actigraphy measures. Surprisingly, the findings revealed disordered sleep (namely, poor sleep quantity) in both groups. Discordance between CSHQ and actigraphy measures could represent heightened awareness of sleeping problems in parents/caregivers of children with vision impairment. The implications of this study extend beyond group comparison, examining disordered sleep in 'typically developing' children, exploring the potential role of light perception and the importance of sleep quality and quantity in both groups.
International Journal of Orientation & Mobility, 2019
The purpose of this commentary is to identify the key differences between the term Habilitation a... more The purpose of this commentary is to identify the key differences between the term Habilitation and Rehabilitation. Using historical and contemporary understandings, this commentary aims to disentangle these two terms from a developmental perspective. It is argued that these two concepts are distinct and should be appropriately reflected in international literature and practice.
Frontiers in Neurology, Jul 25, 2023
Study objectives: Compared to typically developing children and young adults (CYA-TD), those livi... more Study objectives: Compared to typically developing children and young adults (CYA-TD), those living with Sickle Cell Disease (CYA-SCD) experience more cognitive difficulties, particularly with executive function. Few studies have examined the relative importance of silent cerebral infarction (SCI), haemoglobin and arterial oxygen content on age-related cognitive changes using crosssectional or longitudinal (developmental trajectory) data. This study presents cohort data from a single timepoint to inform studies with multiple timepoints. Methods: We compared cross-sectional raw and scaled scores as age-related changes in cognition (trajectories) in CYA-SCD and age-and ethnicity-matched CYA-TD. We also compared cross-sectional age-related changes in cognition (trajectories) in CYA-SCD with and without SCI to CYA-TD. General cognitive abilities were assessed using Wechsler Intelligence Scales, including the Verbal Comprehension Index (VCI) and Perceptual Reasoning Index (PRI) underpinning IQ. Executive function was evaluated using the Delis-Kaplan Executive Function System (D-KEFS) Tower subtest and the Behaviour Rating Inventory of Executive Function (BRIEF) questionnaire. SCI were identified from contemporaneous 3 T MRI; participants with overt stroke were excluded. Recent haemoglobin was available and oxygen saturation (SpO 2 ) was measured on the day of the MRI. Results: Data were available for 120 CYA-SCD [62 male; age = 16.78 ± 4.79 years; 42 (35%) with SCI] and 53 CYA-TD (23 male; age = 17.36 ± 5.16). Compared with CYA-TD, CYA-SCD experienced a delayed onset in VCI and slower rate of development for BRIEF Global Executive Composite, Metacognition Index (MI), and Behaviour Regulation Index. The rate of executive function development for the BRIEF MI differed significantly between CYA-TD and CYA-SCD, with those with SCI showing a 26% delay compared with CYA-TD. For CYA-SCD with SCI, arterial oxygen content explained 22% of the variance in VCI and 37% in PRI, while haemoglobin explained 29% of the variance in PRI. Age-related cognitive trajectories of CYA-SCD may not be impaired but may progress more slowly. Longitudinal studies are required, using tests unaffected by practice. In addition to initiation of medical treatment, including measures to improve arterial oxygen content, early cognitive intervention, educational support, and delivery of extracurricular activities could support cognitive development for CYA-SCD.
Healthcare, Jul 21, 2023
Sleep and diet are essential for maintaining physical and mental health. These two factors are cl... more Sleep and diet are essential for maintaining physical and mental health. These two factors are closely intertwined and affect each other in both timing and quality. Eating disorders, including anorexia nervosa and bulimia nervosa, are often accompanied by different sleep problems. In modern society, an increasing number of studies are being conducted on the relationship between eating disorders and sleep. To gain a more comprehensive understanding of this field and highlight influential papers as well as the main research domains in this area, a scientometric approach was used to review 727 publications from 1971 to 2023. All documents were retrieved from Scopus through the following string "TITLE-ABS (("sleep" OR "insomnia") AND ("anorexia nervosa" OR "bulimia nervosa" OR "binge eating" OR "eating disorder*") AND NOT "obes*") AND (LIMIT-TO (LANGUAGE, "English"))". A document co-citation analysis was applied to map the relationship between relevant articles and their cited references as well as the gaps in the literature. Nine publications on sleep and eating disorders were frequently cited, with an article by Vetrugno and colleagues on nocturnal eating being the most impactful in the network. The results also indicated a total of seven major thematic research clusters. The qualitative inspection of clusters strongly highlights the reciprocal influence of disordered eating and sleeping patterns. Researchers have modelled this reciprocal influence by taking into account the role played by pharmacological (e.g., zolpidem, topiramate), hormonal (e.g., ghrelin), and psychological (e.g., anxiety, depression) factors, pharmacological triggers, and treatments for eating disorders and sleep problems. The use of scientometric perspectives provides valuable insights into the field related to sleep and eating disorders, which can guide future research directions and foster a more comprehensive understanding of this important area.
International Journal of Environmental Research and Public Health, Sep 19, 2021
Autistic adults have a high prevalence of sleep problems and psychiatric conditions. In the gener... more Autistic adults have a high prevalence of sleep problems and psychiatric conditions. In the general population sleep problems have been associated with a range of demographic and lifestyle factors. Whether the same factors contribute to different types of disturbed sleep experienced by autistic adults is unknown and served as the main aim of this study. An online survey was conducted with 493 autistic adults. Demographic information (e.g., age, gender), about lifestyle (e.g., napping), and information about comorbid conditions was collected. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality and the Epworth Sleepiness Scale (ESS) was used to assess daytime somnolence. Stepwise multiple regression analyses were used to examine predictors of each subscale score on the PSQI, as well as PSQI and ESS total scores. Results indicated that individuals who reported having a diagnosis of anxiety and insomnia were more likely to have poorer sleep quality outcomes overall. Furthermore, individuals who reported habitually napping had higher daytime dysfunction, increased sleep disturbances, and increased daytime sleepiness. These results provide novel insights into the demographic and lifestyle factors that influence sleep quality and daytime somnolence in autistic adults and can be used for targeted sleep interventions.
Sleep Medicine, Dec 1, 2017
International Journal of Environmental Research and Public Health, Jan 16, 2021
Background: Children with intellectual and developmental difficulties often experience sleep prob... more Background: Children with intellectual and developmental difficulties often experience sleep problems, which in turn may impact parental sleep patterns. This study explored the role of parental sleep knowledge as a moderator on the relationship between child sleep and parental sleep impairment. Methods: 582 parents or caregivers (92.6% mothers) of children with different developmental disabilities (Age M = 9.34, 29.5% females) such as Down's syndrome, participated in an online survey. Multiple regression analysis was conducted. Results: Parental sleep knowledge of child sleep was a moderating variable in the relationship between child sleep nocturnal duration and parental sleep impairment. Although overall, sleep knowledge was high in this sample, two specific knowledge gaps were identified namely child sleep duration requirements, and the recognition of signs of a well-rested child. Conclusion: This study has provided evidence that increased parental sleep knowledge can positively impact both child and parental sleep outcomes.
Sleep Medicine, Dec 1, 2022
Sleep Medicine, Dec 1, 2019
Digital health, 2022
Background Chronic pain conditions affect up to one third of the adult population in the United K... more Background Chronic pain conditions affect up to one third of the adult population in the United Kingdom. Sleep problems are prevalent and negatively impact quality of life. Lack of standardised tools for routine screening and assessment of sleep changes have been a barrier for sleep management. Novel sleep wearables offer an exciting and accessible way to measure sleep but have not been tested outside of the consumer-led landscape and are not commonly used in research and clinical settings. Aims The study aimed to explore the feasibility and acceptability of a sleep monitoring headband (Dreem 2) utilising EEG technology and accompanying smartphone application among a cohort of adults with chronic pain. Results Twenty-one adults (81% women) completed a one-week home sleep study using a sleep headband and accompanying app. Ninety per cent of participants met the pre-defined requirement of two-night's sleep recording. All participants recorded one night of sleep data via the sleep headband. The majority (76%) of participants were satisfied with the sleep study, and 86% of participants were willing to wear the headband longer than the 2-night minimum requirement. Finally, 76% reported the headband as ‘somewhat’ or ‘extremely’ comfortable whist awake; 57% rated the headband as comfortable during sleep. Conclusion The Dreem 2 headband appears to be a feasible and acceptable means of collecting sleep measurements among individuals with chronic pain, despite common sleep disturbances. These devices may have utility for screening, assessment and monitoring in research and practice. Further research is needed to provide guidelines and training for integration.
Frontiers in Psychology, May 7, 2021
Individuals with chronic pain often experience co-existing sleep problems and depression-related ... more Individuals with chronic pain often experience co-existing sleep problems and depression-related states. Chronic pain, sleep problems, and depression interrelate, and have been shown to exacerbate one another, which negatively impacts quality of life. This study explored the relationships between pain severity, pain interference, sleep quality, and depression among individuals with chronic pain. Secondly, we tested whether sleep quality may moderate the relationship between pain and depression. A cross-sectional survey was completed by 1,059 adults with non-malignant chronic pain conditions (M age 43 years, 88% identified as women) and collected measures related to pain severity, pain interference, sleep quality, and depression. Multiple regression analyses found that pain severity, pain interference, and sleep quality are all significantly associated with depression. Secondly, moderated regression analyses revealed that sleep quality moderates the relationship between pain interference and depression among individuals with chronic pain such that good sleep quality attenuates the effect of pain interference on depression, and poor sleep quality amplifies the effect of pain interference on depression. These findings suggest that sleep quality may be a relevant therapeutic target for individuals with chronic pain and co-existing depression.
Frontiers in Psychology, Jul 1, 2021
Purpose: Sleep is essential for optimal learning across the developmental pathways. This study ai... more Purpose: Sleep is essential for optimal learning across the developmental pathways. This study aimed to (1) explore whether school start and end times and screen time influenced sleep disturbances in adolescents during the lockdown in China and (2) investigate if sleep disturbances at night and sleep-related impairment (daytime fatigue) influenced adolescents' academic performance and anxiety levels. Methods: Ninety-nine adolescents aged 15-17 years old were recruited from two public schools in Baishan City Jilin Province, China. An online questionnaire was distributed including questions on adolescents' demographics, screen time habits, academic performance, anxiety level, sleep disturbances, and sleep-related impairment. Results: Adolescents who started school earlier and ended school later had a greater severity of sleep disturbances and sleep-related impairment compared with students who started school later and finished earlier. Adolescents who engaged in screen time at bedtime were more likely to have a greater severity of sleep-related impairment than students who reported no screen time use at bedtime. Adolescents who had a greater severity of sleep disturbances had higher anxiety and higher academic achievements than adolescents with less sleep disturbances. Finally, 79.7% of adolescents reported their total sleep duration as <8 h. Conclusions: Adolescents are experiencing sleep disturbances to manage academic demands during COVID-19, which in turn is having a wider impact on their mental health. Many schools internationally have continued to provide online education to students, longitudinal studies on how COVID-19 has influenced adolescents sleep and mental health would be beneficial in understanding the impact of the pandemic.
Behavioral Sleep Medicine, Nov 14, 2017
Background: Sleep problems are commonly reported in attention deficit/hyperactivity disorder (ADH... more Background: Sleep problems are commonly reported in attention deficit/hyperactivity disorder (ADHD), and are also a familiar characteristic of typical development (TD). We sought to elucidate the relationship between sleep, ADHD-trait behaviours and cognitive inattention, and how it manifests between ADHD and TD children. Participants: 18 children diagnosed with ADHD and 20 age-matched TD controls aged 5-11-year-old participated in the study. Methods: Sleep profiles were assessed using Children's Sleep Habits Questionnaire and actigraphy measures. Behavioural functioning was examined using Conners' Parent Report Scale and attention using the computerised Conners' Continuous Performance Task. Results: We found evidence of 1) poorer sleep quality in the ADHD group, despite no difference in actual sleep time; 2) poor sleep quality in TD children predicted increased ADHD-trait behaviours, despite no association with attention; 3) a consistent trend for poor sleep quality predicting reduced attentional control in ADHD children, despite no association with behaviour. Conclusions: Poor sleep quality affects developmental sub-groups in different ways. For ADHD children poor sleep worsens their predisposed attentional deficit, whilst for TD children it mimics ADHD behaviours. These findings have important implications for the debate on over-diagnosis of childhood ADHD, and the use of sleep-based interventions. Above all, they highlight the importance of promoting good sleep hygiene in all children.
Frontiers in Psychology, Dec 1, 2015
Background: Modern life, with its many distractions, is seeing sleep quantity and quality decline... more Background: Modern life, with its many distractions, is seeing sleep quantity and quality decline during adolescence. This is a concern as research persuasively demonstrates the negative impact of reduced sleep on academic achievement, both in terms of learning and behavior. Aims: This study examined the relationship between sleep and school functioning in adolescence, with a focus on environmental factors that might mediate this relationship. Sample and Method: Forty-seven adolescents took part. Sleep was measured using the School Sleep Habits Survey (SSHS) and a sleep diary. School records of year grade point averages provided a measure of academic achievement. Raven's Standard Progressive Matrices gave a measure of general cognitive processing. Environmental sleep factors falling into three groups, namely, stimulant consumption, media use and exercise, were measured using a self-report questionnaire. Results: An average of 7.08 h of sleep was reported. Correlations revealed that Total sleep time (TST) and bedtimes on weekdays were strongly associated with academic achievement. Morning/eveningness and sleep/wake behavior problems had a strong relationship with performance on the Ravens. Stimulant consumption and media use before bed revealed strong relationships with TST and bedtimes on weekdays. Crucially, mediation analyses confirmed that both caffeine consumption and electronic media use before bedtime were negatively associated with academic performance, via the mediating pathway by affecting sleep. Exercise was not associated with any of the sleep variables, but was associated with better academic performance. The current findings highlight that, now more than ever, parents, schools and policy makers must be aware of the negative effects of caffeinated substances marketed to students, and electronic media use on their sleep habits. Our findings suggest that targeting caffeine consumption and electronic media use before bed may represent effective routes in alleviating modern teenage sleep debt, and in turn enhancing academic performance.
Research in Developmental Disabilities, Apr 1, 2013
Metaphor and metonymy are two types of figurative expressions in which an expression normally ass... more Metaphor and metonymy are two types of figurative expressions in which an expression normally associated with one concept (target) is used to communicate something about another concept (vehicle), without expressing an explicit link between the two concepts. In a metaphor, the target and vehicle belong to two different conceptual domains and a common ground (or link) is established through comparison or analogy (Warren, 1992). For example, in the metaphor ''John is a lion.'', John (target) is being compared to a lion (vehicle), as both are strong. In contrast, in a metonym, one salient aspect is used to refer to the whole or some other aspect of that entity (Frisson & Pickering, 1999), and thus the target and vehicle belong to the same conceptual or experiential domain (Barcelona, 2003). For example, in the metonym ''The palace gave a speech.'', the term palace (vehicle) is used to refer to the people within the palace (target). Metaphors and metonyms provide a way to understand and organise new ideas (Glucksberg, 2001; Ortony, 1975), and thus occur frequently as a tool within education to
Research in Developmental Disabilities, Oct 1, 2015
The current study explored the looking behaviours of young children with Autism Spectrum Disorder... more The current study explored the looking behaviours of young children with Autism Spectrum Disorders (ASD), Williams syndrome (WS), and typically developing (TD) children while they were administered a low-verbal Theory of Mind (ToM) task. Although ToM performance in both clinical groups was impaired, only participants with WS showed small differences in looking behaviour at the start of the video. Furthermore, while TD children who passed the ToM task looked longer at the original hiding place there was no such contrast in the clinical groups. This shows that looking behaviour in ASD and WS is not necessarily atypical when saliency aspects such as language, background, and colour are removed and that differences in looking behaviour cannot explain ToM performance.
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Papers by Dagmara Dimitriou