ORCID Profile
0000-0001-6506-4767
Current Organisations
Griffith University
,
University of Melbourne
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In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Rehabilitation And Therapy: Hearing And Speech | Community Child Health | Clinical Sciences | Public Health and Health Services | English As A Second Language | Other Medical and Health Sciences | Other Education | Paediatrics | Biological Psychology (Neuropsychology, Psychopharmacology, | Health Promotion | Epidemiology | Health And Community Services | Neurology And Neuromuscular Diseases | Medical And Health Sciences Not Elsewhere Classified
Child health | Hearing, vision, speech and their disorders | "Occupational, speech and physiotherapy" | Ethnicity and multiculturalism |
Publisher: Oxford University Press
Date: 23-08-2018
DOI: 10.1093/OXFORDHB/9780198786825.013.35
Abstract: This chapter describes the history of research in Language Disorders (LD) outlining changes in terminology and methodology and focuses on three newer research methodologies: population studies, the characterization of longitudinal change, and neuroimaging. Population studies have identified a clear social gradient in language ability, challenged assumptions about the role of non-verbal skills, and highlighted vulnerabilities in associated developmental domains. The fluidity of pre-school language development and increasing stability in the middle school years has become apparent in longitudinal population analyses and the importance of social disadvantage and the home-learning environment underlined. Neurobiological “differences” between those with and without LD are recognized, however little is known about the developmental pathways or the role of biological and environmental mechanisms in shaping them. Fully describing and understanding the ontogony of LD remains elusive. How environmental, genetic, epigenetic, and neurobiological effects interact and unfold over developmental time and across population s les remain priorities for research.
Publisher: Wiley
Date: 05-10-2004
DOI: 10.1111/J.1440-1754.2004.00483.X
Abstract: To explore the beliefs and practices of Australian surgeons regarding surgical intervention to release tongue-tie and to determine the main referral sources. In addition, we aimed to ascertain if there were differences in beliefs and practices according to surgical specialty. Four hundred surgeons in three different surgical specialties were surveyed via questionnaire. Multiple choice response questions and open ended questions were used to explore beliefs and practices surrounding tongue-tie assessment, management and follow up. The questionnaires were distributed by email (where available), followed by fax and mail. A response rate of 80.8% (n = 323) was obtained. Of these, 236 (73%) reported they practised surgery to release tongue-tie 46% were oral and maxillofacial surgeons, 37% were plastic surgeons and 17% were paediatric general surgeons. Indications for surgical management and follow up varied according to surgical specialty. There was no clear consensus regarding clinical indicators for surgery or functional outcomes following surgery. It appears that until a prospective study designed to address some of the controversial issues outlined is undertaken, we will remain ignorant about the need for surgery to release tongue-tie in children.
Publisher: Wiley
Date: 23-02-2018
DOI: 10.1111/CDEV.12727
Abstract: Oral language development is a key outcome of elementary school, and it is important to identify factors that predict it most effectively. Commonly researchers use ordinary least squares regression with conclusions restricted to average performance conditional on relevant covariates. Quantile regression offers a more sophisticated alternative. Using data of 17,687 children from the United Kingdom's Millennium Cohort Study, we compared ordinary least squares and quantile models with language development (verbal similarities) at 11 years as the outcome. Gender had more of an effect at the top of the distribution, whereas poverty, early language, and reading to the child had a greater effect at the bottom. The picture for TV watching was more mixed. The results are discussed in terms of the provision of universal and targeted interventions.
Publisher: Wiley
Date: 11-07-2023
Abstract: One of the most significant developmental accomplishments is the emergence of language in early childhood. Whilst this process is effortless for most children, others can face significant hurdles. Identifying, in the early years, which children will go on to have developmental language disorder is, however, fraught with several well‐documented challenges. In the preceding paper we described and linked new research evidence about factors that influence language development in the early years, noting that exposure to some may be time sensitive and that these influences cluster together and can accumulate over time. We demonstrated that risk profiles were associated with and characterised low language trajectories, and we considered how this information could be integrated into a concept that moves beyond screening at single time points in the early years. We argue that this evidence might be used to build an improved early years framework for language thereby creating a more equitable surveillance system that does not leave children living in less advantageous circumstances behind. Underpinning this thinking was a bioecological framework that incorporates the social, environmental and family factors in the child's ecosystem known to influence language development in the early years. To develop a proposal for the design and implementation of an early language public health framework based on current best evidence We synthesised the findings from the companion paper (Reilly & McKean 2023) regarding early language trajectories, inequalities and clustering of risks with key public health concepts, relevant intervention evidence and implementation theories to develop a new framework for language surveillance and preventative interventions in the early years. An evidence informed early language public health framework is presented. Describing in turn (1) essential components (2) relevant interventions (3) essential qualities for implementation ((i) probabilistic, (ii) proportionate, (iii) developmental and sustained and (iv) codesigned) (4) system‐level structures and (5) processes required to adopt and embed an early language public health framework in an existing Local Government Area's child health surveillance and early prevention‐intervention systems. Children's language development influences their life chances across the life course and language difficulties are unfairly distributed across society. Current evidence points to the need for whole systems approaches to early child language and enables a blueprint for such a framework to be described. Early child language development sets the stage for a child's life chances and language difficulties can have profound long‐term consequences. Such difficulties are unfairly distributed across society and the reach of preventative services is not universal or equitable. Several effective primary and secondary preventative interventions exist but their successful implementation is not straightforward. An early language public health framework of surveillance and intervention is described to provide equitable and effective early interventions to children from 0–4 years. We detail the essential components, interventions and qualities of that framework and describe system‐level structures and processes required to adopt and embed an early language public health framework in a given locality. A whole systems approach to early child language is required and should be co‐designed through local collaboration with family, community and children's services stakeholders. A public health speech and language therapist role could catalyse the implementation of such approaches and support continuous improvement.
Publisher: SAGE Publications
Date: 03-2017
Abstract: THE QUALITY AND ACCURACY OF research findings relies on the use of appropriate and sensitive research methods. To date, few studies have directly compared quantitative measurement methods in the early childhood field and the extent to which parent-reported and directly-measured behaviours agree is unclear. Existing studies are h ered by small s le sizes and the use of statistical techniques which quantify the magnitude of association between measures (e.g. correlations), but not agreement. Here we review the limitations of existing method comparisons and suggest how alternative statistical approaches such as the Bland-Altman Method and ordinary least products regression can be readily applied in the early childhood context. Understanding agreement (and disagreement) between measurement methods has potential to reduce research costs and improve data quality, with important implications for researchers, clinicians and policy-makers.
Publisher: SAGE Publications
Date: 06-07-2011
Abstract: Prospective questionnaire data from a longitudinal population s le on children with autism spectrum disorders (ASD), developmental delay, specific language impairment, or typical development (TD), were collected at ages eight, 12 and 24 months, via the Communication and Symbolic Behavior Scale Developmental Profile (CSBS) – Infant Toddler Checklist, and the Actions and Gesture section of the MacArthur-Bates Communicative Development Inventory (CDI):Words and Gestures. The four groups were compared at four years of age to identify whether any early behaviours differentiated the groups. While children with ASD differed from TD children on most social communicative measures by 12 months of age, the only social communication characteristic which could differentiate the children with ASD from the other groups were gesture scores on the CDI at 12 months and the CSBS at 24 months. Significant markers of ASD were identifiable in this community s le at an early age, although discrimination between clinical groups was rarely evident.
Publisher: Routledge
Date: 05-09-2013
Publisher: American Speech Language Hearing Association
Date: 14-04-2017
DOI: 10.1044/2016_JSLHR-S-15-0196
Abstract: The purpose of this study was to ascertain if there is an association between stuttering severity and behaviors and the expression of temperament characteristics, including precursors of anxiety. We studied temperament characteristics of a prospectively recruited community cohort of children who stutter ( N = 173) at ages 3, 4, and 6 years using the Short Temperament Scale STS (Prior, Sanson, Smart & Oberklaid, 2000). Six of 131 statistical tests of association between stuttering severity and behaviors and temperament traits were statistically significant at the 5% level, which was no more than expected by chance alone. On the basis of parent responses to the STS, preschoolers who exhibited different levels of stuttering severity and behaviors did not generally express temperament traits differently from one another. Stuttering severity and stuttering behaviors were not associated with the precursors of anxiety. Overall, taking multiple tests into consideration, results show little evidence of association between stuttering severity and temperament up to 4 years of age or between stuttering behaviors and temperament up to 6 years of age.
Publisher: SAGE Publications
Date: 09-2012
DOI: 10.1597/11-001
Abstract: To establish normative nasalance scores for a set of newly developed stimuli in Malay. Cross-sectional study. Participants were 150 native speakers of Malay aged 6 years to 12 years. All consented participants were initially screened to identify any overt difficulties relating to hearing, voice quality, resonance, or speech and language skills. Participants who passed the screen read or repeated each stimulus, and nasalance scores were recorded. The mean nasalance score for the Oral passage was 13.86% (SD = 5.11, 95% Cl = 13.04 to 14.68), 60.28% (SD = 6.99, 95% CI = 59.15 to 61.41) for the Nasal Passage, and 27.72% (SD = 4.74, 95% CI = 26.96 to 28.49) for the Set of Sentences. Despite small variations, the overall mean nasalance scores in Malay are consistent with published norms in other languages. Age and sex differences were observed but clinically not relevant.
Publisher: Wiley
Date: 02-1999
DOI: 10.1017/S0012162299000225
Abstract: Forty-seven children with non-organic failure to thrive (NOFT) were identified from a whole-population survey of children's growth and development. A significant proportion (N=17) of these 47 children were found to have oral-motor dysfunction (OMD) identified using a previously validated assessment tool. NOFT children with OMD and those with normal oral-motor function (N=30) were compared in order to ascertain whether there were any neurodevelopmental differences which might explain this finding. We hypothesized that children with OMD might have a subtle neurodevelopmental disorder. Few psychosocial variables discriminated the two groups. However, cognitive stimulation within the home and cognitive-growth fostering during mealtimes was much poorer for children with OMD. Some evidence has suggested that NOFT children with OMD may be 'biologically' more vulnerable from birth. We suggest that the continued use of the term 'non-organic' to describe failure to thrive in such children is questionable and requires redefining.
Publisher: BMJ
Date: 22-05-2015
DOI: 10.1136/BMJ.H2851
Publisher: Wiley
Date: 11-2002
DOI: 10.1046/J.1365-2788.2002.00442.X
Abstract: Despite considerable interest in the genetic, physical and neurological aspects of Rett syndrome (RS), there have been few studies of associated behavioural and emotional features. Furthermore, few case studies or surveys have included adult women with RS. The main aim of the present study was to compare behaviour problems in a s le of women with RS against data from normative s les. The primary carers of 50 women with RS completed the community version of the Aberrant Behavior Checklist. Women with RS were rated as having lower levels of irritability, hyperactivity and inappropriate speech behaviours than normative s les of adults with intellectual disability. A number of factors may affect the presentation of behaviour problems in women with RS (e.g. cognitive impairments or physical disabilities). Therefore, more research is needed in order to generate information about the behavioural phenotype of RS. The implications of the present data for future research are also discussed.
Publisher: Wiley
Date: 22-03-2013
DOI: 10.1111/CCH.12032
Abstract: Pre-school communication problems are common, with implications for school readiness and educational achievement. Help is available from a variety of community healthcare providers. This study examined the extent to which help is received, and the predictors of service receipt. Prospective community study, in Melbourne, Victoria. At age 4 years, we assessed the speech, receptive and expressive language and fluency of 1607 children and gave feedback to their parents. At age 5 years, 983 families provided data on service use for communication problems between and 4 and 5 years. We compared service use between participants with and without impairment, and used logistic regression to estimate the strength of association between potential predictors (gender, socio-economic status, maternal education, English-speaking background status, family history of speech and language problems and parent concern) and service use (binary outcome). Data were available for both communication status and service use for 753 children. Only 44.9% of the 196 children with communication impairment received help from a professional. Furthermore, 7% of the 557 that did not meet criteria for communication impairment nevertheless received help from a professional. Parent concern was the strongest predictor of service use (adjusted odds ratio = 9.0 95% CI: 5.6-14.8). Both over- and under-servicing for communication problems were evident. This study shows that accessing help for communication problems requires more than simply informing parents about the problem and having services available there is a need for systematic support to get the right children to services.
Publisher: Springer Science and Business Media LLC
Date: 2001
Abstract: Dysphagia is common in children with severe developmental disabilities. The nature of these difficulties can predispose them to foreign body ingestion. This article presents a case that highlights the need for vigilance in diagnosing dysphagia in children with multiple and complex developmental disabilities where severe cognitive impairment and an inability to communicate may mask the presence of underlying problems.
Publisher: American Academy of Pediatrics (AAP)
Date: 12-2010
Abstract: To quantify the contributions of child, family, and environmental predictors to language ability at 4 years. A longitudinal study was performed with a s le of 1910 infants recruited at 8 months in Melbourne, Australia. Predictors were child gender, prematurity, birth weight and order, multiple birth, socioeconomic status, maternal mental health, vocabulary, education, and age at child's birth, non–English-speaking background, and family history of speech/language difficulties. Outcomes were Clinical Evaluation of Language Fundamentals-Preschool, language scores, low language status (scores & .25 SDs below the mean), and specific language impairment (SLI) (scores & .25 SDs below the mean for children with normal nonverbal performance). A total of 1596 children provided outcome data. Twelve baseline predictors explained 18.9% and 20.9% of the variation in receptive and expressive scores, respectively, increasing to 23.6% and 30.4% with the addition of late talking status at age 2. A total of 20.6% of children (324 of 1573 children) met the criteria for low language status and 17.2% (251 of 1462 children) for SLI. Family history of speech/language problems and low maternal education levels and socioeconomic status predicted adverse language outcomes. The combined predictors discriminated only moderately between children with and without low language levels or SLIs (area under the curve: 0.72–0.76) this improved with the addition of late talking status (area under the curve: 0.78–0.84). Measures of social disadvantage helped explain more variation in outcomes at 4 years than at 2 years, but ability to predict low language status and SLI status remained limited.
Publisher: Wiley
Date: 18-02-2018
Abstract: The inaccurate estimation of language difficulties by teachers suggests the benefit of a short-language measure that could be used to support their decisions about who requires referral to a speech-language therapist. While the literature indicates the potential for the development of a short-language measure, evidence is lacking about which combination of language tasks it should include. To understand the number and nature of components/language tasks that should be included in a short-language measure for children in the early school years. Eight language tasks were administered to participants of the Early Language in Victoria Study (ELVS) at ages 5 (n = 995) and 7 (n = 1217). These included six language tasks measured by an omnibus language measure (which comprised a direction-following, morphological-completion, sentence-recall, sentence-formation, syntactic-understanding and word-association task) and a non-word repetition and a receptive vocabulary task, measured by two task-specific language measures. Scores were analyzed using principal component analysis (PCA), the Bland and Altman method, and receiver operating characteristic (ROC) curve analysis. PCA revealed one main component of language that was assessed by all language tasks. The most effective combination of two tasks that measured this component was a direction-following and a sentence-recall task. It showed the greatest agreement with an omnibus language measure and exceeded the criterion for good discriminant accuracy (sensitivity = 94%, specificity = 91%, accuracy = 91%, at 1 SD (standard deviation) below the mean). Findings support the combination of a direction-following and a sentence-recall task to assess language ability effectively in the early school years. The results could justify the future production of a novel short-language measure comprising a direction-following and a sentence-recall task to use as a screening tool in schools and to assess language ability in research participants.
Publisher: Wiley
Date: 03-1994
DOI: 10.1111/J.1469-7610.1994.TB01738.X
Abstract: For many years it has been suspected that severely impaired somatic growth during early postnatal life can be associated with the subsequent impairment of mental abilities. This study aimed to test that hypothesis on the basis of data gathered from a prospective whole population survey of infant development in south London. A year's birth cohort of 1558 full-term singletons was monitored 47 otherwise healthy cases with serious growth faltering in the first year were recruited. Mental and psychomotor abilities were assessed at 15 months. Potentially confounding psychosocial variables, including cognitive stimulation received at home, were measured contemporaneously. A statistical model was constructed that enabled the timing, duration and severity of growth faltering to be used as predictors of mental functioning. Up to 37% of the variance in cognitive and psychomotor outcome at 15 months can be explained by the model. The first few postnatal months appear to constitute a "sensitive period" for the relationship between growth and mental development.
Publisher: Wiley
Date: 09-11-2006
DOI: 10.1111/J.1440-1754.2006.00974.X
Abstract: To describe changes in infant prelinguistic communication skills between 8 and 12 months, and identify factors associated with those skills. Parent questionnaire data for a prospective population-based cohort of infants in metropolitan Melbourne, Australia. 1911 infants born November 2002-August 2003. Infant communication (Communication and Symbolic Behaviour Scales (CSBS)) at 8 and 12 months. Potential risk factors: sex prematurity multiple birth sociodemographic indicators maternal mental health, vocabulary and education non-English speaking background and family history of speech-language difficulties. Linear regression models were fitted to total standardised CSBS scores at 8 and 12 months. Social communication, especially the use of gesture, developed rapidly from 8 to 12 months. Female sex, twin birth, and family history were strongly associated with CSBS scores. The combined model accounted for 5% and 6% of the total variation at 8 and 12 months, respectively. CSBS score at 8 months strongly predicted CSBS score at 12 months (coefficient = 0.56, partial R(2) = 37.0). There is a dramatic increase in communication skills between 8 and 12 months, particularly the development of gesture, which (as in previous studies) predates and predicts future language development. Risk factors explained little variation in early communication trajectories and therefore, based on our findings, this developmental course is more likely to be biologically predetermined. Rather than focusing on risk factors, we suggest that language promotion activities in otherwise healthy young infants should either be universal or, if targeted, be based on the level of communication skills displayed.
Publisher: SAGE Publications
Date: 2022
DOI: 10.1177/1759720X221084848
Abstract: Achondroplasia is the most common short-limbed skeletal dysplasia resulting from gain-of-function pathogenic variants in fibroblast growth factor receptor 3 ( FGFR3) gene, a negative regulator of endochondral bone formation. Most treatment options are symptomatic, targeting medical complications. Infigratinib is an orally bioavailable, FGFR1–3 selective tyrosine kinase inhibitor being investigated as a direct therapeutic strategy to counteract FGFR3 overactivity in achondroplasia. The main objective of PROPEL is to collect baseline data of children with achondroplasia being considered for future enrollment in interventional studies sponsored by QED Therapeutics. The objectives of PROPEL 2 are to obtain preliminary evidence of safety and efficacy of oral infigratinib in children with achondroplasia, to identify the infigratinib dose to be explored in future studies, and to characterize the pharmacokinetic (PK) profile of infigratinib and major metabolites. PROPEL (NCT04035811) is a prospective, noninterventional clinical study designed to characterize the natural history and collect baseline data of children with achondroplasia over 6−24 months. PROPEL 2 (NCT04265651), a prospective, phase II, open-label study of infigratinib in children with achondroplasia, consists of a dose-escalation, dose-finding, and dose-expansion phase to confirm the selected dose, and a PK substudy. Children aged 3−11 years with achondroplasia who completed ⩾6 months in PROPEL are eligible for PROPEL 2. Primary endpoints include treatment-emergent adverse events and change from baseline in annualized height velocity. Four cohorts at ascending dose levels are planned for dose escalation. The selected dose will be confirmed in the dose-expansion phase. PROPEL and PROPEL 2 are being conducted in accordance with the International Conference on Harmonization Good Clinical Practice guidelines, principles of the Declaration of Helsinki, and relevant human clinical research and data privacy regulations. Protocols have been approved by local health authorities, ethics committees, and institutions as applicable. Parents/legally authorized representatives are required to provide signed informed consent signed informed assent by the child is also required, where applicable. PROPEL and PROPEL 2 will provide preliminary evidence of the safety and efficacy of infigratinib as precision treatment of children with achondroplasia and will inform the design of future studies of FGFR-targeted agents in achondroplasia. ClinicalTrials.gov: NCT04035811 NCT04265651.
Publisher: Elsevier BV
Date: 02-2020
DOI: 10.1016/J.NEUROPSYCHOLOGIA.2019.107312
Abstract: Developmental language disorder (DLD) and developmental speech disorder (DSD) are highly prevalent childhood conditions. An impaired ability to repeat nonsense words ("nonword repetition"), is claimed to be a robust behavioural marker for these conditions. Yet how brain function is altered during this task remains poorly understood. Previous research suggests that DLD or DSD may be associated with reduced brain activation in the inferior frontal and posterior temporal regions when compared to controls. However, this research is limited by within and between group variability in age, speech/language phenotype, and comorbidities. Here, we used functional MRI to examine brain activation during nonword repetition. As anticipated, behavioural findings confirmed that the DLD and DSD groups had poorer nonword repetition performance compared to typical controls. In contrast, fMRI revealed no statistically significant differences in brain activation, despite the groups appearing to engage slightly different regions when compared at identical thresholds. Therefore, whilst nonword repetition is a sensitive clinical marker for DLD and DSD, the findings from this study suggest that this task is not a sensitive brain MRI marker for children with these disorders, unlike for in iduals with single gene mutations like FOXP2 mutations.
Publisher: SAGE Publications
Date: 03-2017
Abstract: THE FIELD OF EARLY CHILDHOOD education and care (ECEC) in Australia is a highly dynamic one. Increased government interest and funding during the years of the Labor Governments from 2008–2012 strengthened the sector in terms of increased funding, policy development, level of staff qualification and measures of quality. While this support resulted in increased numbers of children enrolled in ECEC settings and greater numbers of students enrolled in early childhood teacher education degrees, it also contributed to increased workforce pressures and a shortage of qualified early childhood teachers. In this paper we report on a quantitative study that investigated the nature of student experience in a combined Bachelor of Education Early Childhood and Primary degree, and student perceptions of value. The results of the study indicate positive responses to the inclusion of both early childhood and primary content and professional experience undertaken in both prior to school and school settings.
Publisher: Mary Ann Liebert Inc
Date: 08-2013
Publisher: Cambridge University Press (CUP)
Date: 06-1986
DOI: 10.1017/S0022172400066365
Abstract: An outbreak of keratoconjunctivitis is described which involved at least 186 people adenovirus type 8 was identified in 50 of the cases. Topical human fibroblast interferon was assessed in a double-blind, placebo-controlled study in which 34 patients participated. Seventeen of the 34 trial patients yielded adenovirus type 8 three were infected with adenovirus type 7. The outbreak was curtailed by control of infection measures: principally careful hand-washing by medical personnel between cases and by discouraging attendance of new cases at the Eye Infirmary. Consequently the trial numbers are small. In addition there was a wide interpatient variation in the severity of infection. Therefore it was not possible to make any statistically valid conclusions concerning the recovery rate of patients receiving interferon or placebo.
Publisher: Wiley
Date: 11-07-2023
Abstract: The emergence of language in the early years is a major developmental accomplishment that underpins learning, enables social interaction and, later, is an indicator of well‐being. Learning language is an effortless process for most, but can be challenging for others. There is a need to act early. First, because there are several social, environmental and family factors known to influence how language develops during the critical early years. Second, there is a robust association between a child's socio‐economic circumstances and language outcomes. Put simply, children living in less advantaged circumstance have poorer language outcomes, which are apparent very early and persist across the lifespan. Third, children with demonstrated weaknesses in language learning in early childhood have poorer educational, employment, mental health and quality‐of‐life outcomes across the lifespan. Acting early to counter these impacts is important however, there are several well‐documented challenges in accurately identifying in the early years children who are at later risk of developmental language disorder (DLD) and to deliver prevention and intervention programmes to scale. This is critical because many services do not currently reach those who need them most as many as 50% of children in need may not be receiving support. To determine whether an improved surveillance system, based on best evidence, could be developed for the early years. We summarised findings from longitudinal, population or community studies that: (1) adopted bioecological models, (2) repeatedly measured language (including the early years) and (3) adopted similar methodologies, to identify factors that influence language outcomes. The evidence confirmed that language development is not always stable but is characterized by distinct trajectories and each has distinguishing social, environmental features. Children in the change or fluctuating groups tend to live in less advantageous circumstances that may not always support and enable language development. Risk factors tend to cluster and accumulate across the early years and beyond, thereby markedly increasing the likelihood of poorer language outcomes later in life. In this the first of two papers, designed to be read together, we integrate research on the social determinants of child language and propose they be embedded into surveillance models. This has the potential to reach more children and those living in disadvantaged circumstances. In the accompanying paper we combine this information with evidence‐informed early prevention/intervention approaches and propose the design and implementation of an early language public health framework. There are several well‐documented challenges in accurately identifying in the early years children who are at later risk of DLD and reaching those most in need of language support. A combination of child, family and environmental determinants, collectively and cumulatively, play out over time and dramatically increase the risk of later language problems, in particular those children living in disadvantaged circumstances. We propose an improved surveillance system that incorporates these determinants be developed and that this be part of a whole of system approach to child language in the early years. Clinicians intuitively act to prioritize children with multiple features or risks however, they can only do so for those who present or are identified to be at risk. Given many children with language problems are not being reached by many early language services, it is reasonable to ask if this knowledge can be integrated to improve reach. Or is a different surveillance model required?
Publisher: Informa UK Limited
Date: 03-2004
Publisher: Informa UK Limited
Date: 03-07-2018
DOI: 10.1080/02699206.2018.1488994
Abstract: Children's speech difficulties can be motor (phone misarticulation) or linguistic (impaired knowledge of phonological contrasts and constraints). These two difficulties sometimes co-occur. This paper reports longitudinal data from the Early Language in Victoria Study (ELVS) at 4 and 7 years of age. Of 1494 participants, 93 made non-age appropriate speech errors on standardised assessments at 4 years, and were able to be reassessed at 7 years. At 4 years, 85% of these children only made phonological errors, 14% made both articulation and phonological errors and one child only made articulation errors (a lateral lisp). In total, 8 of 13 children making both articulation and phonological errors at 4 years had resolved by 7 years. Unexpectedly, eight children who had demonstrated articulation of fricatives at 4 years, acquired distorted production of ≥ 50% of occurrences of/s, z/ by 7 years. In total, then, 22 children (24% of children with speech difficulties) made articulatory errors at one or both assessments. Case data for all children are presented. Theoretical and clinical implications are considered.
Publisher: Informa UK Limited
Date: 09-06-2014
DOI: 10.3109/17549507.2014.917439
Abstract: The present study used a population-based s le of children with cerebral palsy (CP) to estimate the prevalence of motor speech impairment and its association with activity and participation. A s le of 79 Victorian children aged 4 years 11 months to 6 years 5 months was recruited through the Victorian CP Register. The presence of motor speech impairment was recorded using the Viking Speech Scale (VSS). Activity and participation outcomes included speech intelligibility (the National Technical Institute for the Deaf rating scale, NTID), the Functional Communication Classification System (FCCS) and Communication Function Classification System (CFCS). A parent completed rating scale was used to examine the association between motor speech impairment and participation. Ninety per cent (71/79) of children demonstrated a motor speech impairment. Strong associations were found between the VSS and NTID (< .001), CFCS (< .001), and FCCS levels (<.001). VSS levels III-IV were significantly associated with restrictions in home, school, and community-based participation as perceived by parents. Although some ersity in activity and participation outcomes was observed within specific VSS levels, the results of this study suggested that children with mild motor speech impairments are more likely to demonstrate superior activity and participation outcomes compared to children with moderate or severe deficits.
Publisher: American Medical Association (AMA)
Date: 11-2012
DOI: 10.1001/ARCHPEDIATRICS.2012.1099
Abstract: To determine the emergent literacy and language effects of a low-intensity literacy promotion program (Let's Read) provided via universal well-child services to parents during the first 4 years of their child's life. Population-based, cluster randomized controlled trial performed between March 1, 2006, and December 10, 2010. Maternal and child health centers (clusters) in 5 relatively disadvantaged local government areas in Melbourne, Australia. All parents attending their 4-week well-child appointments in participating centers were invited to take part in the study. The Let's Read program was delivered at 4, 12, 18, and 42 months during universal well-child care visits. Child emergent literacy skills (intrasyllabic, phonemic, and sound/letter knowledge) and language (core, receptive, and expressive), measured at 4 years of age. A total of 630 parents participated, with 365 children in 32 intervention clusters and 265 children in 33 control clusters 563 children (89.4%) were retained in the study to 4 years of age. The adjusted mean differences (intervention minus control) for emergent literacy was 0.2 (95% CI, -0.2 to 0.6 P = .29) for intrasyllabic units, 0.05 (95% CI, -0.4 to 0.5 P = .85) for phonemic awareness, and 0.1 (95% CI, -1.5 to 1.6 P = .92) for letter knowledge. For language, the differences were 1.6 (95% CI, -1.1 to 4.3 P = .25) for core, 0.8 (95% CI, -2.0 to 3.7 P = .56) for receptive, and 1.4 (95% CI, -1.4 to 4.2 P = .32) for expressive scores. This population-wide primary care literacy promotion and book distribution program provided neither the anticipated benefits to literacy and language nor enhanced uptake of literacy activities at 4 years of age, even when targeted to relatively disadvantaged areas. isrctn.org Identifier: ISRCTN04602902.
Publisher: Elsevier BV
Date: 04-2008
DOI: 10.1016/J.INFBEH.2007.11.001
Abstract: Within a longitudinal study using a large representative, community s le of infants recruited at mean age 8 months, we examined influences on infant communication development at 24 months, including child gender, shy temperament, behavioural and emotional problems, and several variables relating to maternal psychosocial health. On most developmental measures girls were in advance of boys and they also showed shyer temperament. Child gender, shy temperament and maternal psychosocial indices were associated with both vocabulary development as measured by the MacArthur-Bates Communicative Development Inventory (CDI), and communication and symbolic development assessed via the Communication and Symbolic Behaviour Scales-Developmental Profile (CSBS) at 24 months. No prediction was found using scores at 8 or 12 months, although moderate stability between measures between 12 and 24 months was evident. Predictors of 24 month outcomes were all concurrently measured variables, and included temperamental shyness, but very little variance in communication outcomes was explained. Children whose mothers were experiencing clinical levels of depression and life difficulties reported more child behavioural problems.
Publisher: Elsevier BV
Date: 2020
Publisher: Wiley
Date: 25-03-2018
Abstract: Developmental language disorder (DLD) is common in children, but little is known about its association with quality of life (QoL) in middle childhood. QoL is a complex construct, aligning with an in idual's sense of well-being and is related to functional limitations associated with DLD. Biopsychosocial models of disability account for both the extent and functional limitations of the impairment however, the DLD literature rarely reports on both aspects. Studies are required that detail QoL in children with and without DLD. To investigate the association between DLD, identified at 4 years and persisting at 7 years, and QoL over 4, 7 and 9 years to compare QoL for children whose DLD was mild to moderate and severe at 7 years and to investigate how variables known to impact on language development (e.g., maternal vocabulary), as well as social-emotional behaviours at 4 and 7 years contribute to QoL at 9 years. The analyses included 872 children who participated in the 4-, 7- and 9-year data collection of the Early Language in Victoria Study (ELVS). We compared the parent-reported QoL profiles at 4, 7 and 9 years for children with and without DLD, and those with mild to moderate and severe DLD using the Pediatric Quality of Life Inventory (PedsQL). We conducted regression analyses to estimate how child, family and environmental factors predicted QoL at 9 years, including social-emotional behaviours measured using the Strengths & Difficulties Questionnaire (SDQ) at 4 and 7 years. Children with DLD (n = 70) had lower parent-reported QoL at 9 years than typically developing children (n = 802), with mean scores of 74.9 and 83.9 respectively. There was no evidence of differences in QoL between those with severe (n = 14) or mild to moderate (n = 56) DLD. In contrast to their peers, children with DLD had a profile of declining QoL between 4 and 9 years. For all children, language skills at 7 years predicted QoL at 9 years. For children with DLD, emotional symptoms and peer problems at 4 years plus SDQ Total Difficulties at 7 years were predictive of lower QoL at 9 years. Children with DLD had a lower QoL than their typical peers at 9 years and, contrary to previous studies, differences in QoL were not observed with DLD severity. Co-occurring social-emotional problems appear to play an important role in contributing to the lower QoL experienced by children with DLD. Consideration of associated functional limitations is required to support the communication and social development of all young children with DLD.
Publisher: American Academy of Pediatrics (AAP)
Date: 03-2019
Abstract: To examine profiles of infant regulatory behaviors and associated family characteristics in a community s le of 12-month-old infants and mental health difficulties at 5 and 11 years of age. Items relating to demographic characteristics, maternal distress, and infant regulation were completed by 1759 mothers when their infants were 8 to 12 months old. The Strengths and Difficulties Questionnaire was completed by mothers at child ages 5 (n = 1002) and 11 (n = 871) years. Analyses revealed 5 profiles ranging from the most settled infants (36.8%) to those with mainly sleep problems (25.4%), isolated mild-to-moderate tantrums (21.3%), complex regulatory difficulties (13.2%), and complex and severe regulatory difficulties (3.4%). Compared with those in the settled profile, children in the moderately unsettled profile were more likely to score in the clinical range for total difficulties at 11 years of age (odds ratio [OR] 2.85 95% confidence interval [CI]: 1.28 to 6.36 P & .01), and children in the severely unsettled profile were more likely to score in the clinical range at 5 (OR 9.35 95% CI: 2.49 to 35.11 P & .01) and 11 years of age (OR 10.37 95% CI: 3.74 to 28.70 P & .01). Infants with multiple moderate-to-severe regulatory problems experience substantially heightened odds of clinically significant mental health concerns during childhood, and these symptoms appear to worsen over time. Clinicians must inquire about the extent, complexity, and severity of infant regulatory problems to identify those in the most urgent need of intervention and support.
Publisher: Wiley
Date: 23-10-2008
DOI: 10.1111/J.1365-2214.2008.00846.X
Abstract: A significant proportion of children with cerebral palsy have some degree of feeding impairment, which not only affects their ability to obtain adequate nourishment, but may also impinge on their ability to interact with their mothers during mealtimes. The quality of the maternal-child interaction may also be affected by the mealtime being prolonged and/or stressful. Patterns of interaction between mothers and their children with cerebral palsy have typically been described in play situations. There is limited information about interaction during mealtimes. The purpose of this study therefore, was to observe and describe the characteristics of mealtime interaction between mothers and their young children with cerebral palsy, and to determine whether feeding impairment and other s le characteristics were related to interaction patterns. The participants were 20 mothers and their children with cerebral palsy. Physical, cognitive, and feeding abilities varied. Video recordings of each mother-child dyad interacting during a typical mealtime were analysed in order to describe the structure of the interaction, the communicative functions used, and what method the children used to communicate. The characteristics of the interaction were summarized and compared and the relationship between feeding ability and other child factors and interaction patterns were explored. Results revealed that interactions were maternally dominated. Mothers produced most of the communicative behaviour during the mealtime and used more directive functions than their children. The severity of feeding impairment was related to child patterns of interaction, but not to maternal interaction patterns. Language delay was also related to interaction patterns. The results of this study highlight the importance for professionals to consider mealtime interactions for children with cerebral palsy and their mothers as an integral part of feeding investigations and ongoing interventions, as feeding impairment does seem to have a bearing on aspects of interaction.
Publisher: Project MUSE
Date: 2017
Publisher: SAGE Publications
Date: 11-03-2020
Abstract: Building or acquiring research data management (RDM) capacity is a major challenge for health and medical researchers and academic institutes alike. Considering that RDM practices influence the integrity and longevity of data, targeting RDM services and support in recognition of needs is especially valuable in health and medical research. This project sought to examine the current RDM practices of health and medical researchers from an academic institution in Australia. A cross-sectional survey was used to collect information from a convenience s le of 81 members of a research institute (68 academic staff and 13 postgraduate students). A survey was constructed to assess selected data management tasks associated with the earlier stages of the research data life cycle. Our study indicates that RDM tasks associated with creating, processing and analysis of data vary greatly among researchers and are likely influenced by their level of research experience and RDM practices within their immediate teams. Evaluating the data management practices of health and medical researchers, contextualised by tasks associated with the research data life cycle, is an effective way of shaping RDM services and support in this group. This study recognises that institutional strategies targeted at tasks associated with the creation, processing and analysis of data will strengthen researcher capacity, instil good research practice and, over time, improve health informatics and research data quality.
Publisher: Wiley
Date: 09-04-2003
DOI: 10.1017/S0012162203000616
Abstract: Systematic data from a multidisciplinary clinical assessment of a large series of females with Rett syndrome (RS n=87) is presented. Participants' ages ranged from 2 years 1 month to 44 years 10 months. Areas assessed included oromotor skills, feeding problems, growth, breathing abnormalities, mobility, postural abnormalities and joint deformities, epilepsy, hand use and stereotypies, self-care, and cognitive and communication skills. Many previously reported trends in the presentation of RS over time were confirmed, notably the increasingly poor growth and near pervasiveness of fixed joint deformities and scoliosis in adulthood. In contrast, there was a slight trend towards improved autonomic function in adulthood, whereas feeding difficulties increased into middle childhood and then reached a plateau. Improvements in mobility into adolescence were followed by a decline in those skills in adulthood. Levels of dependency were high, confirming findings from previous studies. Despite the presence of repetitive hand movements, a range of hand-use skills was seen in in iduals of all ages. Cognitive and communication skills were limited, but there was little evidence of deterioration of these abilities with age. These findings confirm that RS is not a degenerative condition and indicate that intervention and support to maintain and increase motor skills, daily living skills, and cognitive and communicative functioning are appropriate targets for in iduals with RS.
Publisher: Wiley
Date: 13-02-2009
Publisher: Wiley
Date: 24-03-2012
DOI: 10.1111/J.1365-2214.2011.01234.X
Abstract: Pre-school language impairment is common and greatly reduces educational performance. Population attempts to identify children who would benefit from appropriately timed intervention might be improved by greater knowledge about the typical profiles of language development. Specifically, this could be used to help with the early identification of children who will be impaired on school entry. This study applied longitudinal latent class analysis to assessments at 8, 12, 24, 36 and 48 months on 1113 children from a population-based study, in order to identify classes exhibiting distinct communicative developmental profiles. Five substantive classes were identified: Typical, i.e. development in the typical range at each age Precocious (late), i.e. typical development in infancy followed by high probabilities of precocity from 24 months onwards Impaired (early), i.e. high probabilities of impairment up to 12 months followed by typical language development thereafter Impaired (late), i.e. typical development in infancy but impairment from 24 months onwards Precocious (early), i.e. high probabilities of precocity in early life followed by typical language by 48 months. The entropy statistic (0.84) suggested classes were fairly well defined, although there was a non-trivial degree of uncertainty in classification of children. That half of the Impaired (late) class was expected to have typical language at 4 years and 6% of the numerically large Typical class was expected to be impaired at 4 years illustrates this. Characteristics indicative of social advantage were more commonly found in the classes with improving profiles. Developmental profiles show that some pre-schoolers' language is characterized by periods of accelerated development, slow development and catch-up growth. Given the uncertainty in classifying children into these profiles, use of this knowledge for identifying children who will be impaired on school entry is not straightforward. The findings do, however, indicate greater need for language enrichment programmes among disadvantaged children.
Publisher: Wiley
Date: 10-08-2023
Abstract: Epidemiological studies have provided invaluable insight into the origin and impact of low language skills in childhood and adolescence. However, changing terminology and diagnostic guidelines have contributed to variable estimations of the prevalence of developmental language difficulties. The aim of this review was to profile the extent and variability of low language prevalence estimates through a systematic review of epidemiological literature. A systematic review of the empirical research (August 2022) was undertaken to identify studies that aimed to estimate the prevalence of low language skills in children ( years). A total of 19 studies published between 1980–2022 met inclusion criteria for review. Studies reported prevalence estimates of low language skills in children between 1 and 16 years. Estimated rates varied from 0.4% to 25.2%. More stable estimations were observed in studies of children aged 5 years and older and those that applied updated diagnostic criteria to performance on standardised assessments of receptive and expressive language. The estimated prevalence of low language skills in childhood varies considerably in the literature. Application of updated diagnostic criteria, including the assessment of functional impact, is critical to inform advocacy efforts and govern social, health and educational policies. Epidemiological research has informed our understanding of the origin and impact of low language capacity in childhood. Childhood language disorder is met with a rich history of evolving terminology and diagnostic guidelines to identify children with low language skills. Inconsistent definitions of and methods to identify low language in children have resulted in variable prevalence estimates in population‐based studies. Variability in prevalence estimates impacts advocacy efforts to inform social, health and educational policy for child language disorder. A total of 19 studies published at the time of this review aimed to provide estimates of the proportion of children who experience low language skills. Prevalence estimates varied between 0.4% and 25.2%, with more stable estimates reported in studies of older school‐age children and those which utilised standardised assessments of both expressive and receptive language. Few studies utilised assessments of functional impact of language difficulties, which is misaligned with updated diagnostic criteria for child language disorder. This review reports substantial variability in estimates of the proportion of children and adolescents who live with low language skills. This variability underscores the importance of applying updated diagnostic criteria to identify the prevalence low language in childhood. Efforts to estimate the prevalence of low language must include measures of functional impact of low language skills. This aligns with clinical recommendations, which call for routine assessment of functional outcomes. To this end, we require a unified understanding of the term ‘functional impact’ in the context of low language, including the development and evaluation of measures that assess impact across emotional, social and academic domains.
Publisher: Cambridge University Press
Date: 31-07-2022
Publisher: Informa UK Limited
Date: 07-12-2013
Publisher: Cambridge University Press
Date: 31-07-2022
Publisher: Cambridge University Press
Date: 31-07-2022
Publisher: SAGE Publications
Date: 05-05-2023
Abstract: Data sharing presents new opportunities across the spectrum of research and is vital for science that is open, where data are easily discoverable, accessible, intelligible, reproducible, replicable and verifiable. Despite this, it is yet to become common practice. Global efforts to develop practical guidance for data sharing and open access initiatives are underway, however evidence-based studies to inform the development and implementation of effective strategies are lacking. This study sought to determine the barriers and facilitators to data sharing among health researchers and to identify the target behaviours for designing a behaviour change intervention strategy. Data were drawn from a cross-sectional survey of data management practices among health researchers from one Australian research institute. Determinants of behaviour were theoretically derived using well-established behavioural models. Data sharing practices have been described for 77 researchers, and 6 barriers and 4 facilitators identified. The primary barriers to data sharing included perceived negative consequences and lack of competency to share data. The primary facilitators to data sharing included trust in others using the data and social influence related to public benefit. Intervention functions likely to be most effective at changing target behaviours were also identified. Results of this study provide a theoretical and evidence-based process to understand the behavioural barriers and facilitators of data sharing among health researchers. Designing interventions that specifically address target behaviours to promote data sharing are important for open researcher practices.
Publisher: Oxford University Press (OUP)
Date: 14-06-2017
DOI: 10.1093/IJE/DYX079
Publisher: Wiley
Date: 02-06-2020
DOI: 10.1111/JCPP.13277
Abstract: Low language abilities are known to be associated with significant adverse long-term outcomes. However, associations between low language and health-related quality of life (HRQoL) are unclear. We aimed to (a) examine the association between low language and HRQoL from 4 to 13 years and (b) classify the children's trajectories of HRQoL and language and examine the association between language and HRQoL trajectories. Data were from an Australian community-based cohort of children. HRQoL was measured at ages 4-13 years using the parent-reported Pediatric Quality of Life Inventory 4.0. Language was assessed using the Clinical Evaluation of Language Fundamentals (CELF)-Preschool 2nd edition at 4 years and the CELF-4th edition at 5, 7 and 11 years. Multivariable linear regression and mixed effect modelling were used to estimate cross-sectional and longitudinal associations between low language and HRQoL from 4 to 13 years. A joint group-based trajectory model was used to characterize associations between HRQoL and language trajectories over childhood. Children with low language had substantially lower HRQoL than children with typical language from 4 to 13 years. Higher language scores were associated with better HRQoL, particularly in social and school functioning. Three HRQoL trajectories were identified: stable-high (51% of children), reduced with slow decline (40%) and low with rapid decline (9%). Children with low language were less likely to follow a stable-high HRQoL trajectory (40%) while 26% and 34% followed the reduced with slow decline and low with rapid decline trajectories, respectively. Children with low language experienced reduced HRQoL from 4 to 13 years. More than half had declining trajectories in HRQoL highlighting the need to monitor these children over time. Interventions should not only aim to improve children's language ability but also address the wider functional impacts of low language.
Publisher: Wiley
Date: 26-02-2013
DOI: 10.1111/JPC.12126
Abstract: To explore the link between pre-school children's general home computer use and their letter knowledge. As part of the Early Language in Victoria Study, a community cohort of 1539 four-year-old children was tested on letter knowledge as well as on non-verbal intelligence, oral language, articulation and phonological awareness. Performance on these measures was examined in relation to parent-questionnaire responses exploring home literacy environment and the amount of time children spent using the computer. A positive correlation between computer use and letter knowledge was found, and this association was still evident after controlling for other cognitive and environmental factors known to predict the development of letter knowledge in young children. Greater computer use in pre-school children appears to have a positive association with emerging literacy development. Future research needs to examine the nature of that association.
Publisher: Wiley
Date: 24-05-2011
DOI: 10.1111/J.1460-6984.2011.00003.X
Abstract: Relationships between child language development and temperament have been little studied in young children, although it is known that children with language impairment are at risk in a number of domains of psychosocial development involving temperamental influences. To investigate the relationships between temperament and language development, along with child behavioural adjustment and maternal psychosocial factors. A s le of 4-year-old children with language impairment was compared with typically developing children, from a large community cohort in a longitudinal study, on three temperament dimensions, behavioural and emotional problems, and maternal factors. Participants were part of a large community cohort involved in a longitudinal study. While the groups did not differ significantly on temperamental shyness/sociability, children with language impairment showed more negative dispositions on the persistence/self-regulation factor, and on overall temperamental difficultness. Behavioural problems were elevated in the language impairment group and were associated with temperament in both groups. Maternal measures of education level, reading and vocabulary skills were significantly lower in the language impairment group. Generally the language impairment group showed a constellation of developmental disadvantages which add to the existing developmental vulnerability conferred by the presence of language impairment. Poorer child temperament self-regulation and behavioural adjustment are strong risk factors for school learning, while lower mother education and literacy contribute further disadvantage. Clinicians managing language impairment in children need to be aware of the whole package of risk factors which are common in this population.
Publisher: Elsevier BV
Date: 07-2018
DOI: 10.1016/J.JPEDS.2018.02.043
Abstract: To characterize the organization of speech- and language-related white matter tracts in children with developmental speech and/or language disorders. We collected magnetic resonance diffusion-weighted imaging data from 41 children, ages 9-11 years, with developmental speech and/or language disorders, and compared them with 45 typically developing controls with the same age range. We used probabilistic tractography of diffusion-weighted imaging to map language (3 segments of arcuate fasciculus, extreme capsule system) and speech motor (corticobulbar) tracts bilaterally. The corticospinal and callosal tracts were used as control regions. We compared the mean fractional anisotropy and diffusivity values between atypical and control groups, covarying for nonverbal IQ. We then examined differences between atypical subgroups: developmental speech disorder (DSD), developmental language disorder, and co-occurring developmental speech and language disorder. Fractional anisotropy in the left corticobulbar tract was lower in the DSD than in the control group. Radial and mean diffusivity were higher in the DSD than the developmental language disorder, co-occurring developmental speech and language disorder, or control groups. There were no group differences for any metrics in the language or control tracts. Atypical development of the left corticobulbar tract may be a neural marker for DSD. This finding is in line with reports of speech disorder after left corticobulbar damage in children and adults with brain injury. By contrast, we found no association between diffusion metrics in language-related tracts in developmental language disorder, and changes for language disorders are likely more complex.
Publisher: Elsevier BV
Date: 07-2019
DOI: 10.1016/J.JBI.2019.103222
Abstract: Personal health information is a valuable resource to the advancement of research. In order to achieve a comprehensive reform of data infrastructure in Australia, both public engagement and building social trust is vital. In light of this, we conducted a study to explore the opinions, perceived risks and trustworthiness regarding the use of personal health information for research, in a s le of the public attending a tertiary healthcare facility. The Consumer Opinions of Research Data Sharing (CORDS) study was a questionnaire-based design with 249 participants who were attending a public tertiary healthcare facility located on the Gold Coast, Australia. The questionnaire was designed to explore opinions and evaluate trust and perceived risk in research that uses personal health information. Concept analysis was used to identify key dimensions of perceived risk. Overall participants were supportive of research, highly likely to participate and mostly willing to share their personal health information. However, where the perceived risk of data misuse was high and trust in others was low, participants expressed hesitation to share particular types of information. Performance, physical and privacy risks were identified as key dimensions of perceived risk. This study highlights that while participant views on the use of personal health information in research is mostly positive, where there is perceived risk in an environment of low trust, support for research decreases. The three key findings of this research are that willingness to share data is contingent upon: (i) data type (ii) risk perception and (iii) trust in who is accessing the data. Understanding which factors play a key role in a person's decision to share their personal health information for research is vital to securing a social license.
Publisher: Springer Science and Business Media LLC
Date: 28-04-2018
DOI: 10.1007/S10803-018-3565-2
Abstract: This study used a prospective community-based s le to describe patterns and predictors of language development from 4 to 7 years in verbal children (IQ ≥ 70) with autism spectrum disorder (ASD n = 26-27). Children with typical language (TD n = 858-861) and language impairment (LI n = 119) were used for comparison. Children with ASD and LI had similar mean language scores that were lower on average than children with TD. Similar proportions across all groups had declining, increasing and stable patterns. Language progressed at a similar rate for all groups, with progress influenced by IQ and language ability at 4 years rather than social communication skills or diagnosis of ASD. These findings inform advice for parents about language prognosis in ASD.
Publisher: Informa UK Limited
Date: 2001
DOI: 10.1080/09638280150504207
Abstract: There is increasing agreement that many genetic disorders have characteristic behavioural phenotypes that is genetic anomalies have specific effects on behaviour. In this paper the existing literature is reviewed with an aim to identify behavioural and emotional features that are candidates for Rett syndrome (RS) specific behaviours. A number of behavioural and emotional features have been reported to be common in in iduals with RS. These behaviours may constitute an RS-specific profile of behaviour or behavioural phenotype. Alternatively, these behaviours may simply reflect the multiple disabilities found in in iduals with severe or profound cognitive impairment. The diagnostic criteria for Rett syndrome include a number of the behavioural features, such as hand stereotypies and breathing difficulties, although other behavioural features are not included.
Publisher: Elsevier BV
Date: 12-2018
Publisher: Wiley
Date: 29-01-2015
Abstract: Early identification of Autism Spectrum Disorder (ASD) is currently limited by the absence of reliable biological markers for the disorder, as well as the reliability of screening and assessment tools for children aged between 6 and 18 months. Ongoing research has demonstrated the importance of early social communication skills in differentiating children later diagnosed with ASD from their typically developing (TD) peers, but researchers have not yet investigated whether these differences can be detected using community-ascertained systematic observation data as early as 12 months. To investigate whether differences in early social communication skills can be detected at 12 months of age, comparing children later diagnosed with ASD, and TD peers and to determine whether differences remain when groupings are based on age of subsequent ASD diagnosis. From a prospective community-ascertained s le, we collected data on children in early life, then conducted retrospective analyses for those children who were later diagnosed with ASD by the age of 7 years, compared with matched TD peers. We analysed standardized observational data of early communication skills, collected using the Communication and Symbolic Behavior Scales-Developmental Profile (CSBS-DP) Behavior S le, when participants were 12 months of age. Children in the ASD group exhibited significantly lower social communication skills than the TD group, including on the Total score and Social and Symbolic Composite scores of the CSBS-DP Behavior S le. Differences on the Total score and Social Composite were also detected for both early and late ASD diagnosis groups when compared with the TD group. These findings give further support for the importance of social communication in assessing children at risk of ASD as early as 12 months of age. Future research could evaluate the sensitivity and specificity of direct observation of these early communication skills as diagnostic indicators for ASD at 12 months, and investigate whether it is possible to distinguish between ASD and other high-risk groups (e.g. developmental delay) at this age.
Publisher: Elsevier BV
Date: 10-2001
Publisher: Cambridge University Press
Date: 31-07-2022
Publisher: American Speech Language Hearing Association
Date: 24-05-2017
DOI: 10.1044/2016_JSLHR-S-16-0035
Abstract: To examine if a community s le of 11-year-old children with persistent stuttering have higher anxiety than children who have recovered from stuttering and nonstuttering controls. Participants in a community cohort study were categorized into 3 groups: (a) those with persistent stuttering, (b) those with recovered stuttering, and (c) nonstuttering controls. Linear regression modeling compared outcomes on measures of child anxiety and emotional and behavioral functioning for the 3 groups. Without adjustment for covariates (unadjusted analyses), the group with persistent stuttering showed significantly increased anxiety compared with the recovered stuttering group and nonstuttering controls. The group with persistent stuttering had a higher number of children with autism spectrum disorder and/or learning difficulties. Once these variables were included as covariates in subsequent analysis, there was no difference in anxiety, emotional and behavioral functioning, or temperament among groups. Although recognized to be associated with stuttering in clinical s les, anxiety was not higher in school-age children who stutter in a community cohort. It may be that anxiety develops later or is less marked in community cohorts compared with clinical s les. We did, however, observe higher anxiety scores in those children who stuttered and had autism spectrum disorder or learning difficulties. Implications and recommendations for research are discussed.
Publisher: Oxford University Press (OUP)
Date: 10-2000
DOI: 10.1093/BRAIN/123.10.2160
Abstract: A retrospective case-note analysis was undertaken of 47 children with a congenital upper motor neurone bulbar palsy (excluding pure speech dyspraxia) to clarify the phenotype of Worster-Drought syndrome (WDS) and to record its associated features and complications. The results revealed that the study children had significant bulbar problems (with 80% still needing a modified diet and a similar number using augmentative communication methods at last review). There were also high rates of predictable bulbar complications (86% had dribbling, 60% had glue ear, gastro-oesophageal reflux in 40%, history of poor nutrition in 40% and aspiration in 40%). Most of the children had additional complex impairments (91% had mild pyramidal tetraplegia, 81% learning difficulties, 60% congenital defects, 41% neuropsychiatric problems and 28% epilepsy). Over half of the children had significant medical problems in the first year, but mean age at diagnosis was 6 years. There were no obvious causes in pregnancy or birth. Six children had a family history of WDS and 32% (12/37) had abnormal neuroimaging including five with bilateral perisylvian polymicrogyria. In our experience, WDS is not uncommon, is relatively easily diagnosed and is crucial not to miss as the management of these children's multiple impairments is complex and requires a careful team approach. WDS falls clearly within the cerebral palsies as a syndrome that includes motor impairment arising from static damage to the brain in early life. The common presence of cognitive, behavioural and seizure impairments strongly supports the cerebral cortical (presumably perisylvian) localization. Its core elements are a suprabulbar paresis, a mild spastic tetraplegia and a significant excess of cognitive and behavioural impairments and epilepsy. The complete overlap in phenotype between WDS and the bilateral perisylvian syndrome leads us to propose that they are the same condition. WDS is startlingly absent from epidemiological studies of the cerebral palsies and rarely diagnosed, presumably because of lack of clinical awareness of the condition and lack of major gross motor impairments.
Publisher: Springer Science and Business Media LLC
Date: 2003
Abstract: It has long been recognized that there is phenotypic overlap between Rett syndrome (RS) and autism. Advances in our clinical and genetic understanding of RS over the past decade have made clear that the cause and course of RS and autism are distinct (except perhaps in a few cases). Despite this, further delineation of the phenotypic overlap between RS and autism is warranted to enhance clinical decision-making and to further understanding of neuropathological development in both disorders. The present study measured autistic symptoms using the Autism Behavior Checklist (ABC) in a s le of girls with RS and a comparison group of girls with severe and profound mental retardation (SMR). Controlling for developmental level and motor ability, girls with RS scored more highly than those with SMR on the Sensory and Relating subscales. In contrast, there were no group differences on the Body and Object use, Language and Social and Self-help subscales. Further work on the characterisation of the behavioral phenotype of genetic disorders such as RS and autism may aid in identifying the neuropathogenic processes that lead from gene-to-brain-to-behavior.
Publisher: Springer Science and Business Media LLC
Date: 14-01-2021
DOI: 10.1186/S13023-021-01678-8
Abstract: Recognition and appropriate management of the craniofacial manifestations of patients with skeletal dysplasia are challenging, due to the rarity of these conditions, and dearth of literature to support evidence-based clinical decision making. Using the Delphi method, an international, multi-disciplinary group of in iduals, with significant experience in the care of patients with skeletal dysplasia, convened to develop multi-disciplinary, best practice guidelines in the management of craniofacial aspects of these patients. After a comprehensive literature review, 23 initial statements were generated and critically discussed, with subsequent development of a list of 22 best practice guidelines after a second round voting. The guidelines are presented and discussed to provide context and assistance for clinicians in their decision making in this important and challenging component of care for patients with skeletal dysplasia, in order standardize care and improve outcomes.
Publisher: American Speech Language Hearing Association
Date: 26-10-2018
Publisher: Elsevier BV
Date: 06-2021
Publisher: Wiley
Date: 10-2018
DOI: 10.1111/JSR.39_12765
Publisher: Cambridge University Press (CUP)
Date: 27-06-2008
DOI: 10.1017/S0305000908008726
Abstract: The Macarthur-Bates Communicative Development Inventories (CDI) have been used widely to document early communicative development. The paper reports on a large community s le of 1,447 children recruited from low, middle and high socioeconomic (SES) areas across metropolitan Melbourne, Australia. Regression analyses were conducted to determine the extent to which communicative behaviours reported at 0 8 and 1 0 predicted vocabulary development at 1 0 and 2 0. In support of previous findings with smaller, often less representative s les, gesture and object use at 1 0 were better predictors of 2 0 vocabulary than were gesture and object use at 0 8. At 1 0, children from the lower SES groups were reported to understand more words than children from the higher SES groups, but there were no SES differences for words produced at 1 0 or 2 0. The findings add to our understanding of the variability in the development of early communicative behaviours.
Publisher: Wiley
Date: 02-2023
Abstract: A wealth of evidence supports the important role high‐quality parent–child interactions play in children's early language acquisition. However, the impact on later language outcomes remains unclear. To examine the associations between responsive parental behaviours across the early years and child language outcomes at age 7 years with families from an Australian longitudinal cohort study ( N = 1148, 50% female). At child ages 12, 24 and 36 months, parents completed a self‐report measure of responsive parental behaviours. Child language was directly assessed at age 7 using the Clinical Evaluation of Language Fundamentals, 4th edition (CELF‐4), Australian Standardisation. Linear regression was used to examine associations between responsive parental behaviours from 12 to 36 months (consistently high, inconsistent and consistently low responsive parental behaviours at the three time points) and language scores at age 7 years. Adjusted models were run, including the following potential confounders: child sex birth weight birth order maternal education socio‐economic disadvantage non‐English‐speaking background family history of speech–language problems mother's vocabulary score maternal mental health score and mother's age at birth of child. A final adjusted model was run, including the potential confounder variables as well as adjusting for children's earlier language skills. Linear regression results showed children with parents who rated high on responsive parental behaviours at all three time points had higher mean language scores at age 7 than children whose parents reported low responsive parental behaviours across early childhood. This association attenuated after adjusting for earlier child language skills. Findings support the consistent use of responsive parental behaviours across the very early years of childhood to support long‐term language outcomes. Findings also suggest that models of surveillance and support which monitor and assist families at multiple time‐points over the early years are likely to be most effective for preventing ongoing language difficulties. There is extensive evidence consistently demonstrating the important contribution of aspects of parent–child interaction, specifically responsive parental behaviours, to children's language development. Understanding the cumulative benefit of responsive parent–child interactions across the very early years may help to inform preventive interventions and service delivery models for supporting young children's language development. This study demonstrates in a large, population‐based cohort the contribution of consistency of responsive parental behaviours during infancy and toddlerhood to school‐age language outcomes, accounting for other child, family and environmental factors. Capturing regular parent behaviours via self‐report during the early years may be a more efficient and less costly method than parent–child interaction observations to monitor the home language‐learning environment during routine developmental checks. Findings support the need for surveillance of children and families in the early years, ensuring that intervention occurs when families need it most, that is, support is responsive to changing needs and that nuanced advice and support strategies are provided to activate positive developmental cascades. Capturing both parent behaviours and child language may assist clinicians to identify those families who may benefit from parent–child interaction intervention.
Publisher: Springer Science and Business Media LLC
Date: 21-05-2021
DOI: 10.1186/S12887-021-02712-1
Abstract: The idea of the ‘30 million word gap’ suggests families from more socioeconomically advantaged backgrounds engage in more verbal interactions with their child than disadvantaged families. Initial findings from the Language in Little Ones (LiLO) study up to 12 months showed no word gap between maternal education groups. Families with either high or low maternal education were purposively recruited into a five-year prospective study. We report results from the first three waves of LiLO when children were 6, 12 and 18 months old. Day-long audio recordings, obtained using the Language Environment Analysis software, provided counts of adult words spoken to the child, child vocalizations and conversational turns. By the time children were 18 months old all three measures of talk were 0.5 to 0.7 SD higher among families with more education, but with large variation within education groups. Changes in talk from 6 to 18 months highlighted that families from low educated backgrounds were decreasing the amount they spoke to their children (− 4219.54, 95% CI -6054.13, − 2384.95), compared to families from high educated backgrounds who remained relatively stable across this age period (− 369.13, 95% CI − 2344.57, 1606.30). The socioeconomic word gap emerges between 12 and 18 months of age. Interventions to enhance maternal communication, child vocalisations and vocabulary development should begin prior to 18 months.
Publisher: Springer Science and Business Media LLC
Date: 03-02-2020
DOI: 10.1186/S12887-020-1946-0
Abstract: There is evidence that parents from more socioeconomically disadvantaged backgrounds engage in fewer verbal interactions with their child than more advantaged parents. This leads to the so-called, ‘30 million-word gap’. This study aims to investigate the number of words children hear and the number of vocalizations children produce in their first year of life and examines whether these aspects of the early language home environment differ by maternal education. Mothers were recruited into a five-year prospective cohort study and categorized into either high or low maternal education groups. Data was derived from the first two waves of the study, when the children were six and twelve months old. At both waves, children were involved in day-long audio recordings using the Language Environment Analysis software that provided automatic counts of adult words spoken to the child, child vocalizations and conversational turns. Descriptive results are presented by maternal education groups. There was large variation within each maternal education group, with the number of adult words spoken to the child ranging from 2958 to 39,583 at six months and 4389 to 45,849 at twelve months. There were no meaningful differences between adult words, child vocalizations or conversational turns across maternal education groups at either wave of data collection. These results show that a word gap related to maternal education is not apparent up to twelve months of age. The large variability among both maternal education groups suggests that universal interventions that encourage all parents to talk more to their child may be more appropriate than interventions targeted towards disadvantaged families during the first year of life.
Publisher: Elsevier BV
Date: 03-2021
Publisher: Springer Science and Business Media LLC
Date: 16-12-2007
DOI: 10.1007/S10803-006-0293-9
Abstract: This paper describes the development of a video-based evaluation tool for use in Rett syndrome (RTT). Components include a parent-report checklist, and video filming and coding protocols that contain items on eating, drinking, communication, hand function and movements, personal care and mobility. Ninety-seven of the 169 families who initially agreed to participate returned a videotape within 8 months of the first request. Subjects whose videos were returned had a similar age profile to those who did not provide a video but were more likely to have classical than atypical RTT. Evidence of the content and social validity and inter-rater reliability on 11 videos is provided. Video may provide detailed, objective assessment of function and behaviour in RTT.
Publisher: Springer Science and Business Media LLC
Date: 29-11-2022
DOI: 10.1038/S41398-022-02250-Z
Abstract: Reading Disability (RD) is often characterized by difficulties in the phonology of the language. While the molecular mechanisms underlying it are largely undetermined, loci are being revealed by genome-wide association studies (GWAS). In a previous GWAS for word reading (Price, 2020), we observed that top single-nucleotide polymorphisms (SNPs) were located near to or in genes involved in neuronal migration/axon guidance (NM/AG) or loci implicated in autism spectrum disorder (ASD). A prominent theory of RD etiology posits that it involves disturbed neuronal migration, while potential links between RD-ASD have not been extensively investigated. To improve power to identify associated loci, we up-weighted variants involved in NM/AG or ASD, separately, and performed a new Hypothesis-Driven (HD)–GWAS. The approach was applied to a Toronto RD s le and a meta-analysis of the GenLang Consortium. For the Toronto s le ( n = 624), no SNPs reached significance however, by gene-set analysis, the joint contribution of ASD-related genes passed the threshold ( p ~1.45 × 10 –2 , threshold = 2.5 × 10 –2 ). For the GenLang Cohort ( n = 26,558), SNPs in DOCK7 and CDH4 showed significant association for the NM/AG hypothesis (sFDR q = 1.02 × 10 –2 ). To make the GenLang dataset more similar to Toronto, we repeated the analysis restricting to s les selected for reading/language deficits ( n = 4152). In this GenLang selected subset, we found significant association for a locus intergenic between BTG3 - C21orf91 for both hypotheses (sFDR q 9.00 × 10 –4 ). This study contributes candidate loci to the genetics of word reading. Data also suggest that, although different variants may be involved, alleles implicated in ASD risk may be found in the same genes as those implicated in word reading. This finding is limited to the Toronto s le suggesting that ascertainment influences genetic associations.
Publisher: Cambridge University Press (CUP)
Date: 26-10-2022
DOI: 10.1017/BEC.2022.23
Abstract: Young mothers are more likely to access healthcare for their children in emergent care settings and less likely to use preventive care. This study examines the healthcare-seeking behaviours of young mothers to inform the design of tailored interventions. Semi-structured interviews with nine young mothers (aged ≤ 25 years) who were attending a supported playgroup in Brisbane, Australia were conducted and explored using the Capability, Opportunity and Motivation and Behaviour (COM-B) model and the Theoretical Domains Framework (TDF). Five behavioural themes were identified (navigating the system, complex referral pathways, delays and long wait times, understanding child development, and connecting to services) and the role of the supported playgroup in shaping young mothers’ understanding of child development and connecting them to services was highlighted. Recommended strategies to address these factors include opportunities for young mothers to learn about child developmental milestones, improving young mothers’ health literacy, increasing young mothers’ skills and/or the availability of support to help them navigate health services, and providing more accessible entry points for child assessments, referrals, or early intervention programs.
Publisher: Springer Science and Business Media LLC
Date: 15-11-2017
Publisher: SAGE Publications
Date: 11-2006
DOI: 10.1597/05-172
Abstract: To examine the natural history of feeding skills in babies with clefts and identify risk factors and predictors of poor feeding. Sixty-two babies with clefts were examined at 2 weeks, 3 months, and 14 months of age. Feeding ability, oral motor function, and feeding efficiency were assessed. Univariate analyses were used to determine whether oral motor function and sequelae varied according to feeding ability or cleft condition. Multivariable logistic regressions were used to determine risk factors for poor feeding. Poor feeding skills were detected in one third of newborns. The prevalence of poor feeding reduced to 19% at 3 months of age and 15% at 14 months of age. Oral motor dysfunction and sequelae (particularly nasal regurgitation) were more commonly observed in babies with poor feeding skills irrespective of comorbidity. The main risk factor for poor feeding was a diagnosis of syndrome or Pierre Robin sequence (PRS). At 2 weeks of age, babies with syndrome or PRS were 15 times more likely to have poor feeding skills than their nonsyndromic counterparts. When syndrome or PRS was controlled for, babies with cleft palate and cleft lip and palate were equally likely to have poor feeding skills. Parental report of feeding efficiency was predictive of poor feeding in young babies. Poor feeding skills are relatively common in newborns with cleft palate and cleft lip and palate. Treatment for feeding problems may be needed beyond the first year of life, especially for babies born with PRS or a syndrome.
Publisher: SAGE Publications
Date: 05-2007
DOI: 10.1597/05-173
Abstract: To describe the sucking performance of bottle-fed babies with cleft conditions. Forty 2-week-old-babies with cleft lip (CL n = 8), cleft palate (CP n = 22), and cleft lip and palate (CLP n = 10) were examined. Suction, compression, and other sucking parameters were measured during bottle-feeding and compared to determine if they varied with cleft condition or feeding ability. All babies with CL and one with CLP demonstrated suction. Thirteen of 22 babies with CP demonstrated suction but only three maintained regular pressure changes over time. Between-group differences in the litude of suction and compression were associated with cleft condition. Cleft lip participants demonstrated the greatest litude of suction followed by those with CP and CLP. Cleft lip and CP participants generated similar litudes of compression. This was greater than their counterparts with CLP. Good feeders (n = 15) generated high levels of suction, while satisfactory (n = 15) and poor feeders (n = 10) did not generate any during bottle-feeding. Between-group differences in intra-oral pressures were confirmed when babies were examined by cleft condition. Babies with smaller clefts (i.e., CL or minor soft palate clefts) were more likely to generate normal levels of suction and compression compared to their counterparts with larger clefts. Since good feeders were more likely to have smaller clefts it was not surprising that they demonstrated higher suction pressures than babies with satisfactory or poor feeding ability. Compression values were not significantly different across the feeding ability groups. These data may inform feeding management strategies.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 28-04-2020
DOI: 10.1212/WNL.0000000000009441
Abstract: Determining the genetic basis of speech disorders provides insight into the neurobiology of human communication. Despite intensive investigation over the past 2 decades, the etiology of most speech disorders in children remains unexplained. To test the hypothesis that speech disorders have a genetic etiology, we performed genetic analysis of children with severe speech disorder, specifically childhood apraxia of speech (CAS). Precise phenotyping together with research genome or exome analysis were performed on children referred with a primary diagnosis of CAS. Gene coexpression and gene set enrichment analyses were conducted on high-confidence gene candidates. Thirty-four probands ascertained for CAS were studied. In 11/34 (32%) probands, we identified highly plausible pathogenic single nucleotide (n = 10 CDK13 , EBF3 , GNAO1 , GNB1 , DDX3X , MEIS2 , POGZ , SETBP1 , UPF2 , ZNF142 ) or copy number (n = 1 5q14.3q21.1 locus) variants in novel genes or loci for CAS. Testing of parental DNA was available for 9 probands and confirmed that the variants had arisen de novo. Eight genes encode proteins critical for regulation of gene transcription, and analyses of transcriptomic data found CAS-implicated genes were highly coexpressed in the developing human brain. We identify the likely genetic etiology in 11 patients with CAS and implicate 9 genes for the first time. We find that CAS is often a sporadic monogenic disorder, and highly genetically heterogeneous. Highly penetrant variants implicate shared pathways in broad transcriptional regulation, highlighting the key role of transcriptional regulation in normal speech development. CAS is a distinctive, socially debilitating clinical disorder, and understanding its molecular basis is the first step towards identifying precision medicine approaches.
Publisher: Springer Science and Business Media LLC
Date: 16-07-2021
Publisher: Elsevier BV
Date: 11-1991
Publisher: Wiley
Date: 07-12-2022
DOI: 10.1111/JCPP.13733
Abstract: Language is foundational for neurodevelopment and quality of life, but an estimated 10% of children have a language disorder at age 5. Many children shift between classifications of typical and low language if assessed at multiple times in the early years, making it difficult to identify which children will have persisting difficulties and benefit most from support. This study aims to identify a parsimonious set of preschool indicators that predict language outcomes in late childhood, using data from the population‐based Early Language in Victoria Study ( n = 839). Parents completed surveys about their children at ages 8, 12, 24, and 36 months. At 11 years, children were assessed using the Clinical Evaluation of Language Fundamentals 4th Edition (CELF‐4). We used random forests to identify which of the 1990 parent‐reported questions best predict children's 11‐year language outcome (CELF‐4 score ≤81 representing low language) and used SuperLearner to estimate the accuracy of the constrained sets of questions. At 24 months, seven predictors relating to vocabulary, symbolic play, pragmatics and behavior yielded 73% sensitivity (95% CI: 57, 85) and 77% specificity (95% CI: 74, 80) for predicting low language at 11 years. [Corrections made on 5 May 2023, after first online publication: In the preceding sentence ‘motor skills’ has been corrected to ‘behavior’ in this version.] At 36 months, 7 predictors relating to morphosyntax, vocabulary, parent–child interactions, and parental stress yielded 75% sensitivity (95% CI: 58, 88) and 85% specificity (95% CI: 81, 87). Measures at 8 and 12 months yielded unsatisfactory accuracy. We identified two short sets of questions that predict language outcomes at age 11 with fair accuracy. Future research should seek to replicate results in a separate cohort.
Publisher: BMJ
Date: 21-04-2021
DOI: 10.1136/ARCHDISCHILD-2020-320321
Abstract: Assess the mental health, physical health, cognitive and language development of 10-year old children in families where mothers have reported intimate partner violence (IPV) compared with children with no reported IPV exposure. Prospective pregnancy cohort. Maternal report of IPV (Composite Abuse Scale) at 1, 4 and 10 years. Maternal and direct assessment of child mental health (probable psychiatric diagnosis, anxiety and emotional/behavioural difficulties), cognition (IQ and executive function), language (general, pragmatic and receptive) and physical health at 10 years. A subs le of 615 mother–child dyads drawn from a pregnancy cohort of 1507 nulliparous women recruited from six public hospitals in Melbourne, Australia. Any IPV exposure from infancy to age 10 was associated with poorer child outcomes at age 10. Specifically, twice the odds of a probable psychiatric diagnosis, emotional/behavioural difficulties, impaired language skills (general and pragmatic), and having consulted a health professional about asthma or sleep problems. IPV exposure at age 10 associated with two to three times higher odds of all mental health outcomes, elevated blood pressure and sleep problems. Early life exposure alone (at 1 and/or 4 years) associated with three times higher odds of a general language problem and asthma at age 10. The high prevalence of IPV and increased risk of poorer health and development among children exposed highlights the burden of ill health carried by children in families experiencing IPV. Fewer difficulties where exposure was limited to the early years builds the case for better identification, understanding and resourcing of effective early intervention.
Publisher: Wiley
Date: 27-08-2018
DOI: 10.1111/DMCN.13993
Abstract: Dodd's Model for Differential Diagnosis is one of the available clinical diagnostic classification systems of childhood speech sound disorders. Yet we do not understand the validity of this system beyond clinical s les, precluding its application in epidemiological or population-based research. This study aimed to determine the prevalence of subgroups of speech sound disorders in a community s le, relative to past clinical s les, in children speaking standard Australian English. We examined speech development in a community-ascertained s le of children at 4 years (n=1607). Inclusion for speech sound disorder was a score of less than or equal to 1 standard deviation on a standardized speech test, and/or research assistant concern, and/or three or more speech errors on sounds typically acquired by 4 years. Dodd's model was then applied to 126 children. Data revealed proportions of children across Dodd's diagnostic subgroups as follows: suspected atypical speech motor control (10%) inconsistent phonological disorder (15%) consistent atypical phonological disorder (20%) phonological delay (55%) and articulation disorder alone (0%). The findings are in line with known prevalence of these subgroups in clinical populations. Our findings provide additional support for speech-language pathologists to use this system in clinical practice for differential diagnosis and targeted intervention of speech sound disorders in children. Dodd's Model for Differential Diagnosis is the first classification system of speech sound disorders to be applicable to both clinical and community cohorts.
Publisher: Springer Science and Business Media LLC
Date: 09-1994
DOI: 10.1007/BF03075900
Publisher: Research Square Platform LLC
Date: 05-01-2021
DOI: 10.21203/RS.3.RS-61766/V2
Abstract: Background: Recognition and appropriate management of the craniofacial manifestations of patients with skeletal dysplasia are challenging, due to the rarity of these conditions, and dearth of literature to support evidence-based clinical decision making. Methods: Using the Delphi method, an international, multi-disciplinary group of in iduals, with significant experience in the care of patients with skeletal dysplasia, convened to develop multi-disciplinary, best practice guidelines in the management of craniofacial aspects of these patients. Results: After a comprehensive literature review, 23 initial statements were generated and critically discussed, with subsequent development of a list of 22 best practice guidelines after a second round voting. Conclusions: The guidelines are presented and discussed to provide context and assistance for clinicians in their decision making in this important and challenging component of care for patients with skeletal dysplasia, in order standardize care and improve outcomes.
Publisher: Wiley
Date: 23-09-2016
DOI: 10.1111/JPC.13318
Abstract: An inability or difficulty communicating can have a profound impact on a child's future ability to participate in society as a productive adult. Over the past few years the number of interventions for children with speech and language problems has almost doubled the majority are targeted interventions delivered by speech pathologists. In this paper we examine the distribution of speech pathology services in metropolitan Melbourne and how these are aligned with need as defined by vulnerability in language and social disadvantage. We identified three times as many private sector services compared to public services for the 0-5 year age group. Overall there was poorer availability of services in some of the most vulnerable areas. The profound and long-term impact of impoverished childhood language, coupled with the considerable limitations on public spending, provide a strong impetus to deliver more equitably distributed speech pathology services.
Publisher: Informa UK Limited
Date: 04-10-2020
DOI: 10.1080/09297049.2019.1674799
Abstract: Despite the widespread use of nonword repetition in child neuropsychological research and clinical practice, the specific cognitive, linguistic and motor processes that contribute to variability in performance are unclear. The aim of this work was to determine the role of phonological memory, word reading, oromotor sequencing, and oromotor control on nonword repetition performance in the context of children's speech and language abilities. Ninety one children between the ages of 9 and 11 years, with a broad range of speech and language abilities participated in the study. Hierarchical regression was used to a) evaluate the contribution of phonological memory, word reading, oromotor sequencing and oromotor control to nonword repetition and b) determine whether speech and/or language ability moderated the relationship between these specific skills and nonword repetition performance. Results showed all four predictor variables were related to nonword repetition performance, accounting for 59% of variance. The variable with the strongest association with nonword repetition was phonological memory, followed by oromotor sequencing ability, word reading, and oromotor control. Contrary to expectations, neither speech nor language ability were significantly associated with the degree to which these specific skills were drawn upon to perform the nonword repetition task. These findings underline the multidimensional nature of the nonword repetition task and provide further evidence of the major contributions made by phonological memory, word reading, speech sequencing and control to performance on this task. Further, findings suggest that speech and language ability, as measured here, do not significantly influence the skills employed for nonword repetition performance.
Publisher: Informa UK Limited
Date: 14-07-2014
DOI: 10.3109/17549507.2014.923511
Abstract: To investigate the feasibility of adopting automated interactive voice response (IVR) technology for remotely capturing standardized speech s les from stuttering children. Participants were 10 6-year-old stuttering children. Their parents called a toll-free number from their homes and were prompted to elicit speech from their children using a standard protocol involving conversation, picture description and games. The automated IVR system was implemented using an off-the-shelf telephony software program and delivered by a standard desktop computer. The software infrastructure utilizes voice over internet protocol. Speech s les were automatically recorded during the calls. Video recordings were simultaneously acquired in the home at the time of the call to evaluate the fidelity of the telephone collected s les. Key outcome measures included syllables spoken, percentage of syllables stuttered and an overall rating of stuttering severity using a 10-point scale. Data revealed a high level of relative reliability in terms of intra-class correlation between the video and telephone acquired s les on all outcome measures during the conversation task. Findings were less consistent for speech s les during picture description and games. Results suggest that IVR technology can be used successfully to automate remote capture of child speech s les.
Publisher: Oxford University Press (OUP)
Date: 06-1997
DOI: 10.1093/OXFORDJOURNALS.PUBMED.A024611
Abstract: The aim of the study was to prevent the occurrence of serious, overwhelming infection following splenectomy, by a district based initiative. Subjects were residents of Plymouth and Torbay District Health Authority (DHA) who had undergone splenectomy in the past and general practitioners (GPs) within the District. District guidelines on the prevention of post splenectomy sepsis were developed and disseminated among local GPs and hospital doctors. Patients who had undergone operative splenectomy were actively traced through GP and hospital information systems so that they could be offered sepsis preventive measures in accordance with the guidelines. Data capture-recapture was used as an ascertainment adjustment method to estimate the district prevalence of alive patients who have had an operative splenectomy. A postal questionnaire of district GPs was undertaken after one year to determine their awareness and use of the guidelines. Eight-eight alive patients who had undergone splenectomy were not previously identified be their GP as being asplenic. They were traced so that they could be offered sepsis preventive measures in line with the local guidelines. The estimated district prevalence of in iduals who had had an operative splenectomy after ascertainment adjustment using data capture-recapture is p = 9.75 per 10,000 population [95 per cent confidence interval (CI) (7.87, 11.64) per 10,000]. Out of 367 district GPs, 201 used the local guidelines after one year. Effective prevention of overwhelming infection following splenectomy requires an active population based approach.
Publisher: MDPI AG
Date: 03-03-2018
DOI: 10.3390/EN11030545
Publisher: Elsevier BV
Date: 06-2017
DOI: 10.1016/J.JPEDS.2017.02.059
Abstract: To examine predictors of speech disorder resolution versus persistence at age 7 years in children with speech errors at age 4 years. Participants were drawn from a longitudinal, community cohort. Assessment at age 4 years (N?=?1494) identified children with speech errors. Reassessment at age 7 years allowed categorization into resolved or persistent categories. Logistic regression examined predictors of speech outcome, including family history, sex, socioeconomic status, nonverbal intelligence, and speech error type (delay vs disorder). At age 7 years, persistent errors were seen in over 40% of children who had errors at age 4 years. Speech symptomatology was the only significant predictor of outcome (P?=?.02). Children with disordered errors at age 4 years were twice as likely to have poor speech outcomes at age 7 years compared with those with delayed errors. Children with speech delay at age 4 years seem more likely to resolve, and this might justify a "watch and wait" approach. In contrast, those with speech disorder at age 4 years appear to be at greater risk for persistent difficulties, and could be prioritized for therapy to offset long-term impacts.
Publisher: Informa UK Limited
Date: 11-07-2014
DOI: 10.3109/17549507.2014.923512
Abstract: This study aims to determine whether the communication and language skills of children who have a history of stuttering are different from children who do not have a history of stuttering at ages 2-5 years. This study utilizes data from the Early Language in Victoria Study (ELVS), a longitudinal study with a community s le of 1910 children recruited in Melbourne, Australia, as well as a concurrent study examining the onset and progression of stuttering. Participants with a history of stuttering (n = 181) and a control group without a history of stuttering (n = 1438) were identified according to the established protocol of these two existing studies. The stuttering group scored higher than the non-stuttering group on all of the communication and language outcomes measured. The group differences were statistically significant on four of the seven measures and these findings were maintained when potentially confounding factors were controlled for. Importantly, the children with a history of stuttering, as a group, and the control group without a history of stuttering demonstrated developmentally-appropriate early communication and language skills.
Publisher: Elsevier BV
Date: 12-2021
DOI: 10.1016/J.JFLUDIS.2021.105843
Abstract: This systematic review critically appraises and maps the evidence for stuttering interventions in childhood and adolescence. We examine the effectiveness of speech-focused treatments, the efficacy of alternative treatment delivery methods and identify gaps in the research evidence. Nine electronic databases and three clinical trial registries were searched for systematic reviews, randomised controlled trials (RCTs) and studies that applied an intervention with children (2-18 years) who stutter. Pharmacological interventions were excluded. Primary outcomes were a measure of stuttering severity and quality assessments were conducted on all included studies. Eight RCTs met inclusion criteria and were analysed. Intervention approaches included direct (i.e. Lidcombe Program LP) and indirect treatments (e.g. Demands and Capacities Model DCM). All studies had moderate risk of bias. Treatment delivery methods included in idual face-to-face, telehealth and group-based therapy. Both LP and DCM approaches were effective in reducing stuttering in preschool aged children. LP had the highest level of evidence (pooled effect size=-3.8, CI -7.3 to -0.3 for LP). There was no high-level evidence for interventions with school-aged children or adolescents. Alternative methods of delivery were as effective as in idual face-to-face intervention. The findings of this systematic review and evidence mapping are useful for clinicians, researchers and service providers seeking to understand the existing research to support the advancement of interventions for children and adolescence who stutter. Findings could be used to inform further research and support clinical decision-making.
Publisher: Wiley
Date: 10-09-2010
DOI: 10.3109/13682820903277944
Abstract: Parent report instruments are frequently used for the identification of both 'at-risk' children and to support the diagnosis of communication delay. Whilst the evidence is strong for the accuracy of parent report of vocabulary between 2 and 3 years, there are fewer studies that have considered the ability of parents to report on early communication behaviours in 12-month-old infants. To investigate the validity of the underlying structure of the Communication and Symbolic Behaviour Scales-Developmental Profile (CSBS-DP) for each of the direct observation and parent reports of communication behaviour in infants at 12 months of age. Participants were 1725 infants, already participating in a longitudinal study of language development, whose parents completed the Infant-Toddler Checklist from the CSBS-DP. Seven hundred and twenty-eight (728) of these infants also completed the Behaviour S le from the CSBS-DP. The structure of the CSBS-DP was examined using confirmatory factor analyses (CFA) of the Behaviour S le and the Infant-Toddler Checklist. Correlations between the Infant-Toddler Checklist and the Behaviour S le on the total, composite, and subscale scores were also calculated. Confirmatory factor analysis of the CSBS-DP Behaviour S le replicated previous work conducted during the development of the instrument, but on a larger and younger cohort of Australian infants. The data provided support for at least three factors, broadly representing Social, Speech, and Symbolic communication skills, with some evidence that the speech factor could be further split into sub-factors representing Sounds and Words. There was support for a three-factor structure for the Infant-Toddler Checklist. Moderate correlations were found between results from the Behaviour S le and the Infant-Toddler Checklist. As measures of early communication skill for young infants, the CSBS-DP Behaviour S le and the Infant-Toddler Checklist are valid clinical tools for measuring constructs broadly representing Social, Speech, and Symbolic communication skills. The Speech composite in particular emerged as a strong factor under the Behaviour S le.
Publisher: Wiley
Date: 04-1992
DOI: 10.1111/J.1469-8749.1992.TB14980.X
Abstract: The oral-motor function of 10 infants with Turner syndrome and their age- and sex-matched controls were assessed during feeding. In addition to well-recognised dysmorphic features, including oral anomalies and high-arched palates, index infants had marked hypotonia of the cheeks and lips, dysfunctional tongue movements and poorly developed chewing skills. Their meal-times were significantly shorter than those of the controls and they weighed significantly less at six, 12 and 15 months. All mothers of infants with Turner syndrome complained of difficulties feeding their children and these problems often had been present since birth.
Publisher: Oxford University Press (OUP)
Date: 19-03-2018
DOI: 10.1093/IJE/DYY034
Publisher: American Speech Language Hearing Association
Date: 12-2009
DOI: 10.1044/1092-4388(2009/08-0161)
Abstract: This study aimed to compare 2 quantitative acoustic measures of nasality in children with cleft lip and palate (CLP) and healthy controls using formalized perceptual assessment as a guide. Fifty participants (23 children with CLP and 27 age- and gender-matched healthy controls) aged between 4 and 12 years produced a variety of high and low vowels that allowed perceptual ratings of nasal resonance severity as well as acoustic analysis of spectral changes. Two objective measures of nasality were used: 1/3 octave spectra analysis and the voice low tone high tone ratio. Each respective technique has been evaluated in previous research, and their potential as an effective means of detecting changes in nasal resonance has been demonstrated. Only 1/3 octave spectra analysis differentiated between participants with hypernasal speech and those perceived to have normal nasal resonance. Significant differences were also observed between varying levels of perceived severity on vowels within nonnasalized phonemic environments ( i t/, /t i p/). Perceptual judgment remains the primary means of evaluating levels of nasality in children with CLP. However, the development and validation of easy-to-use objective techniques remains an important goal for effective clinical and empirical practice.
Publisher: Springer Science and Business Media LLC
Date: 02-05-2018
Publisher: Elsevier BV
Date: 12-2022
Publisher: Proceedings of the National Academy of Sciences
Date: 23-08-2022
Abstract: The use of spoken and written language is a fundamental human capacity. In idual differences in reading- and language-related skills are influenced by genetic variation, with twin-based heritability estimates of 30 to 80% depending on the trait. The genetic architecture is complex, heterogeneous, and multifactorial, but investigations of contributions of single-nucleotide polymorphisms (SNPs) were thus far underpowered. We present a multicohort genome-wide association study (GWAS) of five traits assessed in idually using psychometric measures (word reading, nonword reading, spelling, phoneme awareness, and nonword repetition) in s les of 13,633 to 33,959 participants aged 5 to 26 y. We identified genome-wide significant association with word reading (rs11208009, P = 1.098 × 10 −8 ) at a locus that has not been associated with intelligence or educational attainment. All five reading-/language-related traits showed robust SNP heritability, accounting for 13 to 26% of trait variability. Genomic structural equation modeling revealed a shared genetic factor explaining most of the variation in word/nonword reading, spelling, and phoneme awareness, which only partially overlapped with genetic variation contributing to nonword repetition, intelligence, and educational attainment. A multivariate GWAS of word/nonword reading, spelling, and phoneme awareness maximized power for follow-up investigation. Genetic correlation analysis with neuroimaging traits identified an association with the surface area of the banks of the left superior temporal sulcus, a brain region linked to the processing of spoken and written language. Heritability was enriched for genomic elements regulating gene expression in the fetal brain and in chromosomal regions that are depleted of Neanderthal variants. Together, these results provide avenues for deciphering the biological underpinnings of uniquely human traits.
Publisher: Elsevier BV
Date: 06-2023
Publisher: Wiley
Date: 09-2017
DOI: 10.1111/JCPP.12790
Abstract: Little is known about the nature, range and prevalence of different subgroups in language trajectories extant in a population from 4 to 11 years. This hinders strategic targeting and design of interventions, particularly targeting those whose difficulties will likely persist. Children's language abilities from 4 to 11 years were investigated in a specialist language longitudinal community cohort (N = 1,910). Longitudinal trajectory latent class modelling was used to characterise trajectories and identify subgroups. Multinomial logistic regression was used to identify predictors associated with the language trajectories children followed. Three language trajectory groups were identified: 'stable' (94% of participants), 'low-decreasing' (4%) and 'low-improving' (2%). A range of child and family factors were identified that were associated with following either the low-improving or low-increasing language trajectory many of them shared. The low-improving group was associated with mostly environmental risks: non-English-speaking background, social disadvantage and few children's books in the home. The low-decreasing group was associated with mainly biological risks: low birth weight, socioemotional problems, lower family literacy and learning disability. By 4 years, services can be confident that most children with low language will remain low to 11 years. Using rigid cut-points in language ability to target interventions is not recommended due to continued in idual variability in language development. Service delivery models should incorporate monitoring over time, targeting according to language abilities and associated risks and delivery of a continuum of interventions across the continuum of need.
Publisher: Informa UK Limited
Date: 03-2009
Publisher: AMPCo
Date: 09-2011
DOI: 10.5694/MJA11.10254
Publisher: Informa UK Limited
Date: 06-2004
Publisher: Cambridge University Press (CUP)
Date: 21-06-2018
DOI: 10.1017/S030500091800017X
Abstract: We explored whether supported (SJE) or coordinated joint engagement (CJE) between mothers recruited from the community and their 24-month-old children who were slow-to-talk at 18 months old were associated with child language scores at ages 24, 36, and 48 months ( n = 197). We further explored whether SJE or CJE modified the concurrent positive associations between maternal responsive behaviours and language scores. Previous research has shown that SJE, maternal expansions, imitations, and responsive questions were associated with better language scores. Our main finding was that SJE but not CJE was consistently positively associated with 24- and 36-month-old expressive and receptive language scores, but not with 48-month-old language scores. SJE modified how expansions and imitations, but not responsive questions, were associated with language scores the associations were evident in all but the highest levels of SJE. Further research is necessary to test these findings in other s les before clinical recommendations can be made.
Publisher: BMJ
Date: 21-04-2021
DOI: 10.1136/ARCHDISCHILD-2020-320321
Abstract: Assess the mental health, physical health, cognitive and language development of 10-year old children in families where mothers have reported intimate partner violence (IPV) compared with children with no reported IPV exposure. Prospective pregnancy cohort. Maternal report of IPV (Composite Abuse Scale) at 1, 4 and 10 years. Maternal and direct assessment of child mental health (probable psychiatric diagnosis, anxiety and emotional/behavioural difficulties), cognition (IQ and executive function), language (general, pragmatic and receptive) and physical health at 10 years. A subs le of 615 mother–child dyads drawn from a pregnancy cohort of 1507 nulliparous women recruited from six public hospitals in Melbourne, Australia. Any IPV exposure from infancy to age 10 was associated with poorer child outcomes at age 10. Specifically, twice the odds of a probable psychiatric diagnosis, emotional/behavioural difficulties, impaired language skills (general and pragmatic), and having consulted a health professional about asthma or sleep problems. IPV exposure at age 10 associated with two to three times higher odds of all mental health outcomes, elevated blood pressure and sleep problems. Early life exposure alone (at 1 and/or 4 years) associated with three times higher odds of a general language problem and asthma at age 10. The high prevalence of IPV and increased risk of poorer health and development among children exposed highlights the burden of ill health carried by children in families experiencing IPV. Fewer difficulties where exposure was limited to the early years builds the case for better identification, understanding and resourcing of effective early intervention.
Publisher: Informa UK Limited
Date: 2006
Publisher: Cambridge University Press (CUP)
Date: 04-2017
DOI: 10.1016/J.EURPSY.2017.01.1020
Abstract: Developmental language disorder (DLD) is common, yet the neurobiology of DLD is poorly understood. A key hypothesis suggests atypical functional lateralization of language, which might be accompanied structurally by a deficit in inter-hemispheric connectivity of language-related regions. Indeed, aberrations of the corpus callosum have been associated with language deficits in children with frank neurological lesions and/or born pre-term. In contrast, studies examining the corpus callosum in children with DLD remain elusive. We aimed to expand this largely understudied field by comparing callosal morphology between 17 children with DLD and 17 typically developing children carefully matched for sex and age. We analyzed high-resolution structural magnetic resonance imaging data applying a well-validated computational approach, which captures the thickness of the corpus callosum with a high regional specificity at 100 equidistant points. As shown in Fig. 1, we observed a significantly thinner corpus callosum, particularly in the splenium, in children with DLD compared to typically developing controls (DLD CTL). These findings indicating pronounced aberrations in the brain's largest whiter matter tract make an important contribution to an understudied field of research and support the theory that DLD is accompanied by atypical lateralization of language function. The authors have not supplied their declaration of competing interest.
Publisher: Wiley
Date: 06-1989
DOI: 10.1111/J.1469-8749.1989.TB03998.X
Abstract: Non-organic failure to thrive among socio-economically deprived inner-city infants may be associated with abnormal oral-motor functioning and aspects of social adversity, such as disorganised meal-times. A Feeding Assessment Schedule was devised to rate oral-motor behaviour objectively and was used to test nine pairs of case and comparison children while they were being fed at home. Video-recordings were made for later analysis. The case infants had immature and abnormal oral-motor development that made them less able to be fed successfully. Temperamentally they were more 'difficult' than the comparison infants, and they were less adept at signalling their needs during meal-times. The case infants also were fed in inappropriate positions for their age, with more distractions and less suitable utensils.
Publisher: Wiley
Date: 11-2013
Abstract: Language impairment (LI) in the preschool years is known to vary over time. Stability in the diagnosis of LI may be influenced by children’s in idual variability, the measurement error of commonly used assessment instruments and the cut-points used to define impairment. To investigate the agreement between two different age-based versions of a language assessment instrument and the stability of the classification of LI using the two measures over a 12-month period. A total of 945 participants completed the Clinical Evaluation of Language Fundamentals(CELF—Preschool 2 or 4th Edn) at 4 and 5 years of age. Agreement and stability were analysed using Bland–Altman plots, correlation and odds ratios. Sensitivity and specificity were calculated for two thresholds of the CELF-P2 using the diagnostic category on the child’s subsequent CELF-4. For all CELF scores, mean differences for the cohort between 4 and 5 years were within 1.5 scale score units. In contrast, at the in idual level variability was found across the range of scores and was of a greater magnitude than previously reported. Stability in LI classification was low, with 36% of 5-year-olds with LI (defined as a standard score below –1.25) classified as typical at 4 years, even though odds ratios calculated from classifications at the two time points suggested that 4-year-olds with LI had 23 times greater odds than their typical peers to receive a diagnosis of LI at 5 years. The CELF-P2 did not demonstrate adequate levels of diagnostic accuracy for LI at 5 years: sensitivity of 64% and specificity of 92.9%. Substantial variability across the entire range of possible CELF scores was observed in this community cohort between the ages of 4 and 5 years. The stability of LI classification was lower than that reported in previous research conducted primarily on smaller clinical cohorts. The current study’s results suggest that the variability observed in developmental language pathways is the result of a combination of limitations in measurement instruments, in idual children’s abilities and the arbitrary nature of the boundaries defining LI.
Publisher: American Association on Intellectual and Developmental Disabilities (AAIDD)
Date: 2003
Publisher: Informa UK Limited
Date: 2001
DOI: 10.1080/09638280150504199
Abstract: In this paper we review the existing literature on factors that contribute to growth failure in Rett syndrome (RS) with particular emphasis on the extent and nature of the feeding difficulties that arise. Data on growth and feeding related problems, collected over four years in a specialized clinic for females with Rett syndrome are presented and management protocols developed in the clinic discussed. Feeding related problems and growth failure occur commonly in Rett syndrome yet our understanding of the mechanisms causing growth failure are poorly understood. Both nutritional and non-nutritional factors are thought to contribute and it has not been possible to develop efficacious intervention strategies. Consequently, clinical management of growth failure in Rett syndrome is not evidence based.
Publisher: Frontiers Media SA
Date: 11-11-2016
Publisher: American Academy of Pediatrics (AAP)
Date: 10-2015
Abstract: We have previously shown short-term benefits to phonology, letter knowledge, and possibly expressive language from systematically ascertaining language delay at age 4 years followed by the Language for Learning intervention. Here, we report the trial’s definitive 6-year outcomes. Randomized trial nested in a population-based ascertainment. Children with language scores & .25 SD below the mean at age 4 were randomized, with intervention children receiving 18 1-hour home-based therapy sessions. Primary outcome was receptive/expressive language. Secondary outcomes were phonological, receptive vocabulary, literacy, and narrative skills parent-reported pragmatic language, behavior, and health-related quality of life costs of intervention and health service use. For intention-to-treat analyses, trial arms were compared using linear regression models. Of 1464 children assessed at age 4, 266 were eligible and 200 randomized 90% and 82% of intervention and control children were retained respectively. By age 6, mean language scores had normalized, but there was little evidence of a treatment effect for receptive (adjusted mean difference 2.3 95% confidence interval [CI] –1.2 to 5.7 P = .20) or expressive (0.8 95% CI –1.6 to 3.2 P = .49) language. Of the secondary outcomes, only phonological awareness skills (effect size 0.36 95% CI 0.08–0.65 P = .01) showed benefit. Costs were higher for intervention families (mean difference AU$4276 95% CI: $3424 to $5128). Population-based intervention targeting 4-year-old language delay was feasible but did not have lasting impacts on language, possibly reflecting resolution in both groups. Long-term literacy benefits remain possible but must be weighed against its cost.
Publisher: American Academy of Pediatrics (AAP)
Date: 03-2017
Abstract: To examine at 7 years the language abilities of children, the salience of early life factors and language scores as predictors of language outcome, and co-occurring difficulties A longitudinal cohort study of 1910 infants recruited at age 8 to 10 months. Exposures included early life factors (sex, prematurity, birth weight/order, twin birth, socioeconomic status, non–English speaking background,family history of speech/language difficulties) maternal factors (mental health, vocabulary, education, and age) and child language ability at 2 and 4 years. Outcomes were 7-year standardized receptive or expressive language scores (low language: ≥1.25 SD below the mean), and co-occurring difficulties (autism, literacy, social, emotional, and behavioral adjustment, and health-related quality of life). Almost 19% of children (22/1204 .9%) met criteria for low language at 7 years. Early life factors explained 9-13% of variation in language scores, increasing to 39-58% when child language scores at ages 2 and 4 were included. Early life factors moderately discriminated between children with and without low language (area under the curve: 0.68–0.72), strengthening to good discrimination with language scores at ages 2 and 4 (area under the curve: 0.85–0.94). Low language at age 7 was associated with concurrent difficulties in literacy, social-emotional and behavioral difficulties, and limitations in school and psychosocial functioning. Child language ability at 4 years more accurately predicted low language at 7 than a range of early child, family, and environmental factors. Low language at 7 years was associated with a higher prevalence of co-occurring difficulties.
Publisher: Elsevier BV
Date: 03-2020
Publisher: BMJ Publishing Group Ltd
Date: 09-2021
Publisher: Elsevier BV
Date: 06-2020
Publisher: Informa UK Limited
Date: 06-2004
Publisher: Springer Science and Business Media LLC
Date: 08-02-2020
Publisher: BMJ
Date: 12-2002
Publisher: Oxford University Press (OUP)
Date: 05-02-2021
Abstract: Compared to national averages, the Gold Coast, Australia, has a proportionately higher number of children entering their first year of primary school with ‘at risk’ or ‘vulnerable’ language skills. This paper investigates the distribution of paediatric speech-language pathology (SLP) services on the Gold Coast, relative to children’s language and cognitive skills, and socioeconomic status (SES). SLP service locations were identified through national association data and a manual search and mapped against SES and Australian Early Development Census data, for language and cognitive skills. Data for 7595 children was included, with 943 (12.4%) at risk and 780 (12.6%) vulnerable for language and cognitive skills. A total of 75 SLPs were identified (85.3% private, 14.6% public), which is 1 SLP to every 23 children who might have current or impending speech, language and communication needs. Fewer services were available in areas where vulnerable children were located and most were private providers, leading to further potential barriers to service access. The number of SLP services located on the Gold Coast is inadequate to meet the needs of children with language and cognitive skill vulnerabilities. Consideration of how services might be distributed is explored and warrants further consideration.
Publisher: Elsevier BV
Date: 06-2021
Publisher: Informa UK Limited
Date: 28-07-2016
DOI: 10.1080/17549507.2016.1209559
Abstract: To examine (1) the patterns of service use and costs associated with language impairment in a community cohort of children from ages 4-9 years and (2) the relationship between language impairment and health service utilisation. Participants were children and caregivers of six local government areas in Melbourne participating in the community-based Early Language in Victoria Study (ELVS). Health service use was reported by parents. Costs were valued in Australian dollars in 2014, from the government and family perspectives. Depending on age, the Australian adapted Clinical Evaluation of Language Fundamentals - Pre-school, 2nd Edition (CELF-P2) or the CELF, 4th Edition (CELF4) was used to assess expressive and receptive language. At 5, 7 and 9 years respectively 21%, 11% and 8% of families reported using services for speech and/or language concerns. The annual costs associated with using services averaged A$612 (A$255 to government, A$357 to family) at 5 years and A$992 (A$317 to government, A$675 to family) at 7 years. Children with persistent language impairment had significantly higher service costs than those with typical language. Language impairment in 4-9-year-old children is associated with higher use of services and costs to both families and government compared to typical language.
Publisher: Wiley
Date: 11-02-2020
Publisher: Wiley
Date: 05-2005
Publisher: Mary Ann Liebert Inc
Date: 09-2019
Publisher: Wiley
Date: 18-11-2014
DOI: 10.1111/DMCN.12635
Abstract: The epidemiology of preschool speech sound disorder is poorly understood. Our aims were to determine: the prevalence of idiopathic speech sound disorder the comorbidity of speech sound disorder with language and pre-literacy difficulties and the factors contributing to speech outcome at 4 years. One thousand four hundred and ninety-four participants from an Australian longitudinal cohort completed speech, language, and pre-literacy assessments at 4 years. Prevalence of speech sound disorder (SSD) was defined by standard score performance of ≤79 on a speech assessment. Logistic regression examined predictors of SSD within four domains: child and family parent-reported speech cognitive-linguistic and parent-reported motor skills. At 4 years the prevalence of speech disorder in an Australian cohort was 3.4%. Comorbidity with SSD was 40.8% for language disorder and 20.8% for poor pre-literacy skills. Sex, maternal vocabulary, socio-economic status, and family history of speech and language difficulties predicted SSD, as did 2-year speech, language, and motor skills. Together these variables provided good discrimination of SSD (area under the curve=0.78). This is the first epidemiological study to demonstrate prevalence of SSD at 4 years of age that was consistent with previous clinical studies. Early detection of SSD at 4 years should focus on family variables and speech, language, and motor skills measured at 2 years.
Publisher: Wiley
Date: 05-08-2013
DOI: 10.1002/AJMG.A.36055
Abstract: Relatively little is known about the neurobiological basis of speech disorders although genetic determinants are increasingly recognized. The first gene for primary speech disorder was FOXP2, identified in a large, informative family with verbal and oral dyspraxia. Subsequently, many de novo and familial cases with a severe speech disorder associated with FOXP2 mutations have been reported. These mutations include sequencing alterations, translocations, uniparental disomy, and genomic copy number variants. We studied eight probands with speech disorder and their families. Family members were phenotyped using a comprehensive assessment of speech, oral motor function, language, literacy skills, and cognition. Coding regions of FOXP2 were screened to identify novel variants. Segregation of the variant was determined in the probands' families. Variants were identified in two probands. One child with severe motor speech disorder had a small de novo intragenic FOXP2 deletion. His phenotype included features of childhood apraxia of speech and dysarthria, oral motor dyspraxia, receptive and expressive language disorder, and literacy difficulties. The other variant was found in a family in two of three family members with stuttering, and also in the mother with oral motor impairment. This variant was considered a benign polymorphism as it was predicted to be non-pathogenic with in silico tools and found in database controls. This is the first report of a small intragenic deletion of FOXP2 that is likely to be the cause of severe motor speech disorder associated with language and literacy problems.
Publisher: Wiley
Date: 03-07-2018
Abstract: Research investigating language skills in school-aged children with non-syndromic cleft lip and/or palate is sparse. Past studies focus on younger populations, lack key comparisons to demographically matched control cohorts or explore language as a component of broader academic skills. Trends of existing studies suggest that affected children may perform at a lower level compared with typically developing peers. To examine the receptive and expressive language skills of middle-school-aged children with non-syndromic cleft lip and palate (CLP) and cleft palate only (CP). Additionally, to explore the language skills of children with clefts compared with a non-cleft control group. Thirty-seven participants with orofacial clefts (aged 7 -14 years) participated in the study: 19 with CLP (10 males 9 females) and 18 with CP (8 males 10 females). A non-cleft comparison group consisted of 129 in iduals matched on age, sex and maternal education level. Participants completed formal language (Clinical Evaluation of Language Fundamentals, Fourth Edition) and non-verbal intellectual measurements (Wechsler Abbreviated Scale of Intelligence-WASI). Demographic and developmental information was obtained via parental interview. Further clinical details (e.g., surgery hearing status) were extracted from patient medical files. Cleft and non-cleft language and non-verbal IQ outcomes were reported separately. Language outcomes were then compared between groups. Participants with clefts achieved core (mean = 103.31, standard deviation (SD) = 10.31), receptive (mean = 102.51, SD = 11.60) and expressive (mean = 102.89, SD = 12.17) language index scores within the normative average range. A total of 14.1% and 17.8% of the cleft and non-cleft groups respectively had impairment (i.e., ≥ 1.25 SD below the mean) in one or more language domains. No significant differences were found in the three language index scores between cleft and non-cleft groups. This study is the first formally to examine language skills alongside non-verbal IQ in school-aged children with clefts compared with a large matched non-cleft population. Results suggest that health professionals should evaluate each child as they present and not assume that a child with non-syndromic CLP or CP will also have co-occurring language difficulties. Where language falls in the average range, these skills can be harnessed to support areas of difficulty often associated with orofacial clefting, such as speech.
Publisher: Wiley
Date: 28-10-2002
Abstract: Although physical features, including loss of hand skills, deceleration of head growth, spasticity and scoliosis, are cardinal features of Rett syndrome (RS), a number of behavioural features are also associated with the disorder, including hand stereotypies, hyperventilation and breath holding. No study has tested the specificity of these behavioural features to in iduals with RS, compared to in iduals with severe to profound mental retardation (SMR). A novel checklist of characteristic RS behavioural and emotional features, the Rett Syndrome Behaviour Questionnaire (RSBQ), was developed to test the type and specificity of behavioural features of RS against those found in girls with SMR. After controlling for the effects of RS-related physical disabilities, the RSBQ discriminated between the groups. Some aspects of the behaviours found to be specific to RS are included in the necessary or supportive RS diagnostic criteria, notably hand behaviours and breathing problems. Additional behavioural features were also more frequently reported in the RS than the SMR group, including mood fluctuations and signs of fear/anxiety, inconsolable crying and screaming at night, and repetitive mouth and tongue movements and grimacing. Full validation of the scale requires confirmation of its discriminatory power and reliability with independent s les of in iduals with RS and SMR. Further delineation of the specific profile of behaviours seen in RS may help in identification of the function of the MECP2 gene and in improved differential diagnosis and management of in iduals with RS.
Publisher: BMJ
Date: 02-05-2008
Abstract: Malnutrition and growth deficiency are common in neurologically impaired children. Gastrostomy placement has been shown to result in significant catch-up growth, improved health of the child and reduction in family stress its cost-effectiveness has not been investigated. Costs related to gastrostomy placement are estimated here from a prospective controlled study of children referred to a tertiary paediatric centre in the UK. Costs of inpatient stay, medication, tests, general practitioner consultations, community healthcare, equipment, and parents' indirect costs were estimated at baseline and follow-up. Costs of the different types of gastrostomy surgery are given. Results for both time periods were available for 54 of the 76 children recruited to the study. Five-day food diaries were kept at baseline and follow-up. Costs of food increased slightly but not significantly post surgery from pound sterling 33 to pound sterling 40 (Euro 44 to Euro 54, US$65 to US$78) per week. Variation in cost between cases was considerable but the mean net cost difference of pound sterling 20.80 (CI - pound sterling 43.79 to pound sterling 85.35) (Euro 28 (CI Euro-59 to Euro 115), US$41 (CI US$-86 to US$167)) per week per child including for food and surgery, was also not significant. Community service costs were significantly lower post surgery. Few parents reported personal costs at either time point, although many had reduced or stopped paid work to care for the child. As gastrostomy placement for these children resulted in significant clinical benefit at no significant extra cost, it is concluded that the procedure is cost-effective.
Publisher: Elsevier BV
Date: 02-2022
Publisher: Elsevier BV
Date: 09-2019
Publisher: Springer Science and Business Media LLC
Date: 21-09-2016
Publisher: Elsevier BV
Date: 09-2022
Publisher: Wiley
Date: 08-07-2008
Publisher: Springer Science and Business Media LLC
Date: 1995
DOI: 10.1007/BF00260975
Publisher: Springer Science and Business Media LLC
Date: 1995
DOI: 10.1007/BF00260976
Publisher: Wiley
Date: 08-07-2020
DOI: 10.1111/CCH.12792
Publisher: Wiley
Date: 21-03-2022
DOI: 10.1111/DMCN.15211
Abstract: To examine the phenomenology of stuttering across the lifespan in the largest prospective cohort to date. Participants aged 7 years and older with a history of developmental stuttering were recruited. Self‐reported phenotypic data were collected online including stuttering symptomatology, co‐occurring phenotypes, genetic predisposition, factors associated with stuttering severity, and impact on anxiety, education, and employment. A total of 987 participants (852 adults: 590 males, 262 females, mean age 49 years [SD = 17 years 10 months range = 18–93 years] and 135 children: 97 males, 38 females, mean age 11 years 4 months [SD = 3 years range = 7–17 years]) were recruited. Stuttering onset occurred at age 3 to 6 years in 64.0%. Blocking (73.2%) was the most frequent phenotype 75.9% had sought stuttering therapy and 15.5% identified as having recovered. Half (49.9%) reported a family history. There was a significant negative correlation with age for both stuttering frequency and severity in adults. Most were anxious due to stuttering (90.4%) and perceived stuttering as a barrier to education and employment outcomes (80.7%). The frequent persistence of stuttering and the high proportion with a family history suggest that stuttering is a complex trait that does not often resolve, even with therapy. These data provide new insights into the phenotype and prognosis of stuttering, information that is critically needed to encourage the development of more effective speech therapies. Half of the study cohort had a family history of stuttering. While 75.9% of participants had sought stuttering therapy, only 15.5% identified as having recovered. There was a significant negative correlation between age and stuttering frequency and severity in adults.
Publisher: Informa UK Limited
Date: 21-09-2022
Publisher: Elsevier BV
Date: 04-2003
DOI: 10.1016/S0361-9230(03)00017-0
Abstract: This systematic review and meta-analysis aimed to identify the determinants for best practice and establish current benchmarks for recovery following reconstructive neurosurgery for people with Parkinson's disease. Eleven studies reporting results for 95 grafted patients were selected on the grounds of using optimal surgical techniques and the Core Assessment Program for Intracerebral Transplantation (CAPIT) protocol for data collection. Consistent trends demonstrating high levels of recovery were identified on most outcome measures. Determinants for best practice were identified as selecting younger patients using low dose immunosuppression bilateral grafting and employing strategies to ensure the quantity and viability of the grafted cells. Secondary analysis of data demonstrated a correlation of rho=0.666 (P<0.05) between increases in striatal dopaminergic activity and UPDRS Motor (off) scores. Overall effect size 'd' was found to be 1.129 UPDRS Motor (off) condition and 0.719 for UPDRS Total (off) condition. The design of the studies and the variable standards for reporting the data precluded the use of more powerful and accurate meta-analyses. It was recommended that the creation of a collaborative database would improve the extraction of data and allow for more powerful statistical analyses for evaluating the overall harm and benefits associated with reconstructive neurosurgery.
Publisher: Wiley
Date: 06-04-2011
DOI: 10.1111/J.1460-6984.2011.00006.X
Abstract: At least two-thirds of the world's children grow up in environments where more than one language is spoken. Despite the global predominance of multilingualism, much remains unknown regarding the language acquisition of children acquiring multiple languages compared with monolingual children. A greater understanding of multilingualism is crucial for speech-language pathologists given the increasing number of children being raised in linguistically erse environments. To investigate the expressive morphological abilities of multilingual children acquiring English, compared with monolingual children, at 3 years of age. Participants were 148 children (74 multilingual children 74 matched monolingual children mean age of 3 years 4 months) already participating in a larger prospective longitudinal cohort study of language development in Melbourne, Australia. Thirty-one languages in addition to English were represented within the embedded cohort. All participants completed a direct language assessment to measure their expressive abilities across a range of English morphemes. The parents of the multilingual participants completed an interview regarding the children's language backgrounds and experiences. The Multilingual Group typically performed below the Monolingual Group in terms of their accurate use and mastery of English morphemes at 3 years of age, although variable expressive abilities were indicated within each group. The same morphemes were shown to be mastered by relatively higher proportions of each group. Likewise, the same forms were mastered by relatively lower proportions of each group. The results indicated similarities between the children's acquisition of English morphology, regardless of whether they were acquiring English only or in combination with another language(s) at 3 years of age. This study found a range of similarities and differences between multilingual compared with monolingual children's acquisition of English morphology at 3 years of age. The findings have important implications for researchers and clinicians involved in the management of linguistically erse populations by advancing knowledge of early multilingual English morpheme acquisition and building awareness of acquisition patterns among multilingual and monolingual English-speaking children at 3 years of age.
Publisher: BMJ
Date: 14-05-2015
DOI: 10.1136/BMJ.H2318
Publisher: American Academy of Pediatrics (AAP)
Date: 02-2021
Abstract: To examine the contribution of early life factors and preschool- and school-aged language abilities to children’s 11-year language and academic outcomes. Participants (N = 839) were from a prospective community cohort study of 1910 infants recruited at 8 to 10 months of age. Early life factors included a combination of child (prematurity, birth weight), family (socioeconomic disadvantage, family history of language difficulties), and maternal factors (education, vocabulary, and age). Language (standardized assessment of receptive and expressive skills) and academic (national assessment) outcomes at 11 years were predicted by using a series of multivariable regression models. Early life factors explained 11% to 12% of variance in language scores at 11 years. The variance explained increased to 47% to 64% when language scores from 2 to 7 years were included. The largest increase in variance explained was with 4-year language scores. The same early life factors explained 13% to 14% of academic scores at 11 years, with increases to 43% to 54% when language scores from 2 to 11 years were included. Early life factors adequately discriminated between children with typical and low language scores but were much better discriminators of children with typical and low academic scores. When earlier language scores were added to models then the area under the curve increased to 0.9 and above. Children’s language outcomes at 11 years are accurately predicted by their 4-year language ability and their academic outcomes at 11 years are predicted by early family and home environment factors. Children with low language abilities at 11 years consistently performed more poorly on national assessments of literacy and numeracy.
Publisher: Wiley
Date: 06-05-2020
Publisher: Wiley
Date: 31-05-2001
Publisher: American Speech Language Hearing Association
Date: 21-05-2019
DOI: 10.1044/2019_JSLHR-S-17-0476
Abstract: The purpose of this letter is to respond to Marcotte's (2019) letter to the editor, “The Influence of Treatment on Children's Recovery from Stuttering: Comments on Kefalianos et al. (2017) and Leech et al. (2017),” published by the Journal of Speech, Language, and Hearing Research .
Publisher: SAGE Publications
Date: 30-10-2018
Abstract: Some children’s speech impairment resolves spontaneously. Others have persistent problems affecting academic and social development. Identifying early markers that reliably predict long-term outcome would allow better prioritization for preschool intervention. This article evaluates the significance of different types of speech errors, made by 93 four-year-olds in a longitudinal population cohort study, for performance at seven years. At four years, the non-age appropriate speech errors made on standardized assessments were categorized as: phonologically delayed (error patterns typical of younger children) or, some errors atypical of normal development, including consistent errors (e.g. word initial consonant deletion), inconsistent pronunciations of the same word, or lateral distortion of /s, z/). Delayed children, some with occasional interdental /s, z/ articulation errors, were more likely to resolve (67%) than those making atypical errors (35%) by seven years. Qualitative analyses indicated that children making few atypical errors were more likely to resolve, irrespective of total number of errors or whether they received intervention. The findings’ theoretical implications relate to deficits underlying phonological disorders. Clinical implications concern assessment measures and prioritization for intervention.
Publisher: Elsevier BV
Date: 02-2019
Publisher: Wiley
Date: 10-1995
Publisher: Springer Science and Business Media LLC
Date: 09-07-2012
Publisher: American Speech Language Hearing Association
Date: 17-10-2017
DOI: 10.1044/2017_JSLHR-S-16-0205
Abstract: For a community cohort of children confirmed to have stuttered by the age of 4 years, we report (a) the recovery rate from stuttering, (b) predictors of recovery, and (c) comorbidities at the age of 7 years. This study was nested in the Early Language in Victoria Study. Predictors of stuttering recovery included child, family, and environmental measures and first-degree relative history of stuttering. Comorbidities examined at 7 years included temperament, language, nonverbal cognition, and health-related quality of life. The recovery rate by the age of 7 years was 65%. Girls with stronger communication skills at the age of 2 years had higher odds of recovery (adjusted OR = 7.1, 95% CI [1.3, 37.9], p = .02), but similar effects were not evident for boys (adjusted OR = 0.5, 95% CI [0.3, 1.1], p = .10). At the age of 7 years, children who had recovered from stuttering were more likely to have stronger language skills than children whose stuttering persisted ( p = .05). No evident differences were identified on other outcomes including nonverbal cognition, temperament, and parent-reported quality of life. Overall, findings suggested that there may be associations between language ability and recovery from stuttering. Subsequent research is needed to explore the directionality of this relationship.
Publisher: Wiley
Date: 08-2008
Publisher: Springer Science and Business Media LLC
Date: 26-11-2022
DOI: 10.1038/S41574-021-00595-X
Abstract: Achondroplasia, the most common skeletal dysplasia, is characterized by a variety of medical, functional and psychosocial challenges across the lifespan. The condition is caused by a common, recurring, gain-of-function mutation in FGFR3, the gene that encodes fibroblast growth factor receptor 3. This mutation leads to impaired endochondral ossification of the human skeleton. The clinical and radiographic hallmarks of achondroplasia make accurate diagnosis possible in most patients. However, marked variability exists in the clinical care pathways and protocols practised by clinicians who manage children and adults with this condition. A group of 55 international experts from 16 countries and 5 continents have developed consensus statements and recommendations that aim to capture the key challenges and optimal management of achondroplasia across each major life stage and sub-specialty area, using a modified Delphi process. The primary purpose of this first International Consensus Statement is to facilitate the improvement and standardization of care for children and adults with achondroplasia worldwide in order to optimize their clinical outcomes and quality of life.
Publisher: American Academy of Pediatrics (AAP)
Date: 03-2011
Abstract: Early shared reading and literacy promotion benefits have stimulated international interest in the development of early-years literacy-promotion programs despite limited evidence of effectiveness at a broader population level. To determine whether a population-based primary care literacy promotion intervention during the first 2 years of life improves early markers of subsequent literacy by 2 years of age. This cluster randomized controlled trial took place in 5 relatively disadvantaged areas in Melbourne, Australia. Infants attending their maternal and child health centers were recruited at age 1–2 months. The intervention (4–8, 12, and 18 months) comprised maternal and child health nurses modelling shared reading activities to parents, supported by parent information and free books. Outcomes (at 2 years) included expressive vocabulary (MacArthur Bates Communicative Development Inventory), communication (Communication and Symbolic Behavior Scales), and home literacy environment (StimQ-Toddler). We analyzed the outcomes using random-effects (linear regression) models allowing for clustering. A total of 552 families (87.6% 324 intervention and 228 control families) of 630 recruited families (66.5% response) were retained to outcome. A total of 97.3% of intervention parents received some (93.7% to all) of the intervention. At 2 years, the trial arms had similar vocabulary (adjusted mean difference: −2.0 [95% confidence interval: −6.2 to 2.2] P = .36), communication (adjusted mean difference: 0.2 [95% confidence interval: −2.3 to 2.7] P = .87), and home literacy (adjusted mean difference: −0.4 [95% confidence interval: −1.0 to 0.2] P = .21). This universal literacy-promotion program was not beneficial in relatively disadvantaged communities by the age of 2 years and may be ineffective. Alternative interpretations may relate to program intensity, reach and/or sleeper effects. Definitive outcomes at 4 years are awaited.
Publisher: SAGE Publications
Date: 09-1995
DOI: 10.1177/096914139500200309
Abstract: To identify the relative importance of failure to thrive during infancy as a risk factor for later abuse or neglect. Whole population birth cohort (1 January to 31 December 1986) studied prospectively over a four year period. An inner city health district in London, England. 2609 births, of whom 47 were identified as having non-organic failure to thrive by first birthday. Registration on Child Protection Register, or subject to investigation of suspected abuse or neglect without registration. 2·5% (64) of birth cohort had been placed on the Child Protection Register during the period 1986–1990, and a further 1·2% (32) had been a cause for concern. The relative risk attributable to nonorganic failure to thrive was 4·3 (95% CI 1·65 to 11·94) and exceeded other measured risk factors, including birth weight g, 1·96 (95% CI 1·01 to 3·82) gestation weeks, 3·26 (95% CI 1·32 to 3·75) ordinal position , 1·53 (95% CI 0·72 to 3·23). A multiple logistic regression confirmed the independent contribution of non-organic failure to thrive to subsequent poor parenting warranting professional intervention. Early postnatal non-organic failure to thrive is a risk factor for later serious parenting deficiencies, but previous research has overstated its importance. Within the community studied the nature of subsequent risk was (non-nutritional) neglect, rather than non-accidental injury. More than eight out of 10 cases do not give further cause for concern.
Publisher: Wiley
Date: 26-06-2020
DOI: 10.1111/DMCN.14592
Publisher: Public Library of Science (PLoS)
Date: 08-07-2016
Publisher: Cambridge University Press (CUP)
Date: 30-10-2009
DOI: 10.1017/S030500090999016X
Abstract: This study examines potential predictors of ‘precocious talking’ (expressive language ⩾90th percentile) at one and two years of age, and of ‘stability’ in precocious talking across both time periods, drawing on data from a prospective community cohort comprising over 1,800 children. Logistic regression was used to examine the relationship between precocious talking and the following potential predictors: gender, birth order, birth weight, non-English speaking background, socioeconomic status, maternal age, maternal mental health scores, and vocabulary and educational attainment of parents. The strongest predictors of precocity (being female and having a younger mother) warrant further exploration. Overall, however, it appears that precocity in early vocabulary development is not strongly influenced by the variables examined, which together explained just 2·6% and 1% of the variation at 1 0 and 2 0 respectively.
Publisher: Springer Science and Business Media LLC
Date: 03-08-2005
Abstract: We aimed to improve the understanding of genotype-phenotype correlations in Rett syndrome (RS) by adopting a novel approach to categorising phenotypic dimensions - separating typicality of presentation, outcome severity and age of onset - and by classifying MECP2 mutations strictly by predicted functional attributes. MECP2 mutation screening results were available on 190 patients with a clinical diagnosis of RS (140 cases with classic RS, 50 with atypical RS). 135 cases had identified mutations. Of the 140 patients, 116 with classic RS (82.9%) had an identified mutation compared with 19 of 50 patients (38%) with an atypical presentation. Cases with early onset of regression and seizures, and those with clinical features that might indicate alternative aetiologies, were less likely to have mutations. In iduals with late truncating mutations had a less typical presentation than cases with missense and early truncating mutations, presumably reflecting greater residual function of MECP2 protein. In iduals with early truncating mutations had a more severe outcome than cases with missense and late truncating mutations. These findings held when restricting the analysis to cases over 15 years of age and classic cases only. Previous findings of variation in severity among the common mutations were confirmed. The approach to phenotypic and genotypic classification adopted here allowed us to identify genotype-phenotype associations in RS that may aid our understanding of pathogenesis and also contribute to clinical knowledge on the impact of different types of mutations.
Publisher: Mary Ann Liebert Inc
Date: 12-2007
Publisher: BMJ
Date: 08-2023
DOI: 10.1136/BMJOPEN-2022-071004
Abstract: Australian practices for diagnosing fetal alcohol spectrum disorder (FASD) are lengthy and require specialist expertise. Specialist teams are based in urban locations they are expensive and have prolonged waitlists. Innovative, flexible solutions are needed to ensure First Nations children living in rural/remote communities have culturally appropriate and equitable access to timely diagnosis and support. This study compares the accuracy of rapid assessments (index tests) that can be administered by a range of primary healthcare practitioners to specialist standardised FASD assessments (reference tests). The cost-efficiency of index tests will be compared with reference tests. At least 200 children aged 6–16 years at-risk of FASD will be recruited across at least seven study sites. Following standards for reporting diagnostic accuracy study (STARD) guidelines, all children will complete index and reference tests. Diagnostic accuracy statistics (including receiver operating curves, sensitivity, specificity, positive and negative predictive values and likelihood ratios) will identify whether rapid assessments can accurately identify: (1) the presence of an FASD diagnosis and (2) impairment in each neurodevelopmental domain, compared to comprehensive assessments. Direct and indirect healthcare costs for index tests compared to reference tests will be collected in primary healthcare and specialist settings. Children’s Health Queensland Hospital and Health Service Human Research Ethics Committee (HREC/20/QCHQ/63173) Griffith University Human Research Ethics Committee (2020/743). Results will assist in validating the use of index tests as part of a tiered neurodevelopmental assessment process that was co-designed with First Nations community and primary healthcare practitioners. Outcomes will be summarised and provided to participating practitioners and sites, and disseminated to community health services and consumers. Findings will be presented at national and international conferences and published in peer-reviewed journals. ACTRN12622000498796.
Publisher: BMJ
Date: 12-10-1985
Publisher: American Speech Language Hearing Association
Date: 2007
DOI: 10.1044/0161-1461(2007/002)
Abstract: The aims of this study were threefold: to report teachers' estimates of the prevalence of speech disorders (specifically, stuttering, voice, and speech-sound disorders) to consider correspondence between the prevalence of speech disorders and gender, grade level, and socioeconomic status and to describe the level of support provided to schoolchildren with speech disorders. Students with speech disorders were identified from 10,425 students in Australia using a 4-stage process: training in the data collection process, teacher identification, confirmation by a speech-language pathologist, and consultation with district special needs advisors. The prevalence of students with speech disorders was estimated specifically, 0.33% of students were identified as stuttering, 0.12% as having a voice disorder, and 1.06% as having a speech-sound disorder. There was a higher prevalence of speech disorders in males than in females. As grade level increased, the prevalence of speech disorders decreased. There was no significant difference in the pattern of prevalence across the three speech disorders and four socioeconomic groups however, students who were identified with a speech disorder were more likely to be in the higher socioeconomic groups. Finally, there was a difference between the perceived and actual level of support that was provided to these students. These prevalence figures are lower than those using initial identification by speech-language pathologists and similar to those using parent report.
Publisher: Informa UK Limited
Date: 2009
Publisher: Elsevier BV
Date: 06-2014
DOI: 10.1016/J.JFLUDIS.2014.01.003
Abstract: Adults who stutter have heightened rates of anxiety disorders, particularly social anxiety disorder, compared with non-stuttering controls. However, the timing of anxiety onset and its development in relation to stuttering is poorly understood. Identifying the typical age of anxiety onset in stuttering has significant clinical implications and is crucial for the management of both disorders across the lifespan. The present review aims to determine the scope of the research pertaining to this topic, identify trends in findings, and delineate timing of anxiety onset in stuttering. We examine putative risk factors of anxiety present for children and adolescents who stutter, and provide a review of the research evidence relating to anxiety for this population. Young people who stutter can experience negative social consequences and negative attitudes towards communication, which is hypothesised to place them at increased risk of developing anxiety. The prevalence of anxiety of young people who stutter, and the timing of anxiety onset in stuttering could not be determined. This was due to methodological limitations in the reviewed research such as small participant numbers, and the use of measures that lack sensitivity to identify anxiety in the targeted population. In sum, the evidence suggests that anxiety in stuttering might increase over time until it exceeds normal limits in adolescence and adulthood. The clinical implications of these findings, and recommendations for future research, are discussed. The reader will be able to: (a) discuss contemporary thinking on the role of anxiety in stuttering and reasons for this view (b) describe risk factors for the development of anxiety in stuttering, experienced by children and adolescents who stutter (c) outline trends in current research on anxiety and children and adolescents with stuttering and (d) summarise rationales behind recommendations for future research in this area.
Publisher: Wiley
Date: 06-2010
DOI: 10.1111/J.1365-2214.2010.01093.X
Abstract: Children's access to services for communication disorders is often determined by parental decisions to seek help or advice. The factors that predict whether parents seek help/advice about their child's communication development were explored in this study. Parents of children in a large, community cohort of children (the Early Language in Victoria Study) were asked whether they had sought help or advice about speech and language development at 1, 2, 3 and 4 years. Child, family and environmental variables, as well as parental concern and children's communication status, were used to predict help/advice seeking. The communication abilities of those in the help-seeking group were also evaluated. Gender, age, children's communication status and parental concern were consistent predictors of help/advice seeking. Significant over and under-identification was evident, and there was preliminary evidence that children with overt communication difficulties (such as unintelligible speech) were more likely to receive help. Parental support and education, as well as education of professionals who regularly have contact with young children, is necessary to support appropriate early identification of communication problems. Further research into service level factors such as availability and accessibility which may support or inhibit help/advice seeking is also indicated.
Publisher: CAIRN
Date: 09-2013
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2007
Publisher: BMJ
Date: 18-08-2011
DOI: 10.1136/BMJ.D4741
Publisher: Informa UK Limited
Date: 02-01-2015
Publisher: Informa UK Limited
Date: 28-02-2021
Publisher: American Academy of Pediatrics (AAP)
Date: 12-2016
Abstract: Tube feedings are commonly prescribed to infants with swallowing abnormalities detected by videofluoroscopic swallow study (VFSS), but there are no studies demonstrating efficacy of these interventions to reduce risk of acute respiratory illness (ARI). We sought to measure the association between swallowing interventions and future ARI, among VFSS-tested infants. Retrospective cohort of all infants (& months) tested with VFSS at a children’s hospital between January 1, 2010, and January 1, 2012. Hospital ARI encounters (emergency, observation, or inpatient status) in a 22-hospital integrated health care delivery system, between the first VFSS and age 3 years, were measured. VFSS results were grouped by normal, intermediate, and oropharyngeal aspiration (OPA), with OPA further sub ided by silent versus cough and thin versus thick liquid OPA. Cox regression modeled the association between swallowing interventions (thickened or nasal tube feedings) and ARI, accounting for changes in swallowing and interventions over time. 576 infants were tested with a VFSS in their first year of life, receiving a total of 1051 VFSSs in their first 3 years of life. More than 60% of infants received a measured feeding intervention. With the exception of infants with silent OPA who received thickened feedings, neither thickening nor nasal tube feedings, compared with no intervention, were associated with a decreased risk of subsequent ARI. Swallowing interventions and repeated testing are common among VFSS-tested infants. However, the importance of diagnosing and intervening on VFSS-detected swallowing abnormalities for the majority of tested infants remains unclear.
Publisher: Wiley
Date: 1999
DOI: 10.1046/J.1365-2214.1999.00085.X
Abstract: Children with multiple disabilities present complex management problems, both for their families and for the professionals involved in their care. For any one child, the list of functional and medical problems that need to be addressed is frequently reflected in an even longer list of involved professionals, leading to conflicting advice and problems in co-ordination of care. A hierarchical model for assessment and management is proposed, which highlights the interdependency of apparently different areas of functioning. The model aims to assist both parents and professionals in determining priorities, to improve interdisciplinary working, and to underpin staff training. Illustrative case studies indicate the importance of resolving issues in areas such as visual functioning, positioning and nutrition before integrated functions such as communication skills can be addressed successfully.
Publisher: American Speech Language Hearing Association
Date: 08-2014
DOI: 10.1044/2014_JSLHR-S-13-0069
Abstract: The purpose of this study was to ascertain whether and when temperament differences, including precursors of anxiety, emerge before onset and during stuttering development. The authors prospectively studied temperament characteristics of a community cohort of children who stutter ( N = 183) and children in the control group ( N = 1,261). No significant differences were found at ages 2, 3, or 4 years between children who stutter and control children for approach or at ages 3 or 4 years for easy/difficult temperament. Both of these measures are precursors of anxiety. Significant differences were found for reactivity and persistence at age 3 years. Children who stutter were less reactive to environmental stimuli and had a reduced ability to attend to a task until completion. There was no evidence of this difference for persistence at age 4 years. Reactivity was not measured at age 4 years. On the basis of parents' responses to the Short Temperament Scale, preschoolers who stutter did not have innately different temperaments from control children on those temperament traits measured from ages 2 to 4 years. They showed no signs of temperament precursors of anxiety before stuttering onset or shortly after. Results suggest, at most, that temperament is influenced somehow during the period after stuttering onset but with a waning developmental influence subsequently.
Publisher: Wiley
Date: 14-11-2016
DOI: 10.1111/DMCN.12957
Abstract: To examine the frequency, range, and features of language impairment in a community s le of children with cerebral palsy (CP) aged 5 to 6 years. Children with CP born between 2005 and 2007 were identified through the Victorian Cerebral Palsy Register. Eighty-four participants were recruited, representing 48% of the contacted families. The recruited s le was representative of non-participants. Participants completed standardized measures of receptive and expressive language, and non-verbal cognition. Language impairment was identified in 61% (51/84) of participants. Twenty-four per cent (20/84) were non-verbal. Co-occurring receptive and expressive language impairment was common (37/84, 44%). Isolated receptive (6/84, 7%) and expressive (4/84, 5%) impairments occurred relatively infrequently. At a group level, verbal and non-verbal participants demonstrated deficits across language subdomains (i.e. semantics, syntax, morphology), rather than in single domains. Cognitive impairment and Gross Motor Function Classification System levels IV and V were associated with higher rates of language impairment (odds ratio [OR] 15.2, 95% confidence interval [CI] 3.2-71.8 and OR 8.5, 95% CI 1.8-40.3 respectively). Only cognition was independently associated with language impairment when both of these factors were considered within a multivariable model. Language impairment was common in 5-year-old and 6-year-old children with CP, affecting three out of five children. Participants were impaired across linguistic subdomains indicating a generalized language deficit. Findings suggest most children would benefit from a clinical language assessment. To target services effectively, subgroups of in iduals with CP at greatest risk for language impairment need to be identified.
Publisher: Cold Spring Harbor Laboratory
Date: 04-11-2021
DOI: 10.1101/2021.11.04.466897
Abstract: The use of spoken and written language is a capacity that is unique to humans. In idual differences in reading- and language-related skills are influenced by genetic variation, with twin-based heritability estimates of 30-80%, depending on the trait. The relevant genetic architecture is complex, heterogeneous, and multifactorial, and yet to be investigated with well-powered studies. Here, we present a multicohort genome-wide association study (GWAS) of five traits assessed in idually using psychometric measures: word reading, nonword reading, spelling, phoneme awareness, and nonword repetition, with total s le sizes ranging from 13,633 to 33,959 participants aged 5-26 years (12,411 to 27,180 for those with European ancestry, defined by principal component analyses). We identified a genome-wide significant association with word reading (rs11208009, p=1.098 × 10 −8 ) independent of known loci associated with intelligence or educational attainment. All five reading-/language-related traits had robust SNP-heritability estimates (0.13–0.26), and genetic correlations between them were modest to high. Using genomic structural equation modelling, we found evidence for a shared genetic factor explaining the majority of variation in word and nonword reading, spelling, and phoneme awareness, which only partially overlapped with genetic variation contributing to nonword repetition, intelligence and educational attainment. A multivariate GWAS was performed to jointly analyse word and nonword reading, spelling, and phoneme awareness, maximizing power for follow-up investigation. Genetic correlation analysis of multivariate GWAS results with neuroimaging traits identified association with cortical surface area of the banks of the left superior temporal sulcus, a brain region with known links to processing of spoken and written language. Analysis of evolutionary annotations on the lineage that led to modern humans showed enriched heritability in regions depleted of Neanderthal variants. Together, these results provide new avenues for deciphering the biological underpinnings of these uniquely human traits.
Publisher: Wiley
Date: 05-2006
Publisher: Elsevier BV
Date: 10-1993
Publisher: Oxford University Press (OUP)
Date: 10-05-2022
DOI: 10.1093/IJE/DYAC086
Publisher: Nova Southeastern University
Date: 2021
DOI: 10.46743/1540-580X/2021.2041
Abstract: Purpose: With COVID-19 social distancing measures requiring a shift in how healthcare is delivered, telehealth service provision allows patients to receive care remotely while adhering to relevant safety regulations. This study investigated the perceptions and experiences of allied health practitioners and their patients at a multidisciplinary allied health clinic that rapidly transitioned to telehealth service delivery. Method: Allied health practitioners (both qualified and student) and patients were recruited during the transition to telehealth across a large healthcare facility located on the Gold Coast, Australia. Participants were surveyed after each telehealth session rating their satisfaction and experience across four areas (technical, administrative and operational, privacy, communication). Descriptive statistics were used to express categorical variables and a chi-square test of independence was applied to determine the presence of any associations. Results: Surveys (n=197) were collected from allied health practitioners (n = 31) and their patients (n = 70). Overall, high levels of satisfaction and experience with telehealth among patients and a consensus in satisfaction and experience among exercise physiology, physiotherapy and psychology practitioners were reported. Speech pathology student practitioners rated their satisfaction and telehealth experience significantly (p 0.001) lower than other disciplines. A significant relationship [χ2 (2, n = 127) = 7.49, p = .02] between student practitioners and the impact of telehealth on achieving session goals and outcomes was also identified. Conclusions: This study highlights complexities related to the acceptability and adoption of telehealth, technical aspects, and user functionality which contribute to the growing body of evidence supporting digital health technologies in the delivery and access to allied health services. In a multidisciplinary context, this study advocates for the consideration of discipline-specific issues when designing and implementing digital health services.
Publisher: Wiley
Date: 09-06-2014
DOI: 10.1111/JPC.12614
Abstract: The aim of this study is to identify social communication skills in infancy which predict autism spectrum disorder (ASD) diagnosis by 7 years as compared with children with other developmental difficulties or typical development from within a population s le. Children with an ASD (n = 41), developmental delay (n = 28), language impairment (n = 47) and typical development (n = 41) were drawn from a large, longitudinal community s le following children from 8 months to 7 years of age, the Early Language in Victoria Study. At 7 years of age, early social communication skills at 8, 12 and 24 months from the Communication and Symbolic Behavior Scales Infant-Toddler Checklist and the MacArthur-Bates Communicative Development Inventory: Words and Gestures were compared between groups and used to predict ASD diagnosis. Significant predictors of ASD diagnosis were found from 8 months, predominantly focused on gesture use and communicative behaviours, such as requesting and joint attention. While comparisons between children with ASD and children with language impairment and typical development revealed differences from 8 months of age, the developmental delay group did not differ significantly from ASD on any measure until 24 months of age. At 24 months, children with ASD had lower Communication and Symbolic Behavior Scales Use of Communication scores as compared with all other groups. The capacity to identify early markers of ASD should facilitate awareness of the risk of an ASD as compared with other developmental problems and point to the need for further developmental assessment, monitoring and provision of early intervention if indicated.
Publisher: Informa UK Limited
Date: 03-08-2020
DOI: 10.1080/09638288.2020.1788179
Abstract: To explore the characteristics and associated factors of oromotor dysfunction in minimally verbal children with cerebral palsy (CP) aged five to six years, recruited from a population-based registry. Twenty children with CP who were minimally verbal completed a standardised, observational oromotor assessment. Linear regression analyses examined the relationship between oromotor dysfunction and potential associated factors (e.g., fine and gross motor function, communication, and feeding). Oromotor dysfunction affected every participant and was identified in all structures examined (i.e., face, jaw, lips, and tongue). Oromotor movements showed little dissociation among jaw, lip, and tongue movements. Oromotor dysfunction was univariately associated with the Manual Ability Classification System levels IV-V ( Oromotor dysfunction was highly prevalent in our s le of minimally verbal children with CP, having significant functional impacts on feeding and communication. Findings suggest that fine motor function (i.e., Manual Ability Classification System levels IV-V) is a stronger predictor than gross motor function for identifying children with CP who are minimally verbal and at risk of oromotor dysfunction. IMPLICATIONS FOR REHABILITATIONOromotor dysfunction was highly prevalent in our s le of minimally verbal children with cerebral palsy.Severe fine motor impairment strongly predicted oromotor dysfunction, indicating that fine motor function may provide an early indicator of impaired oromotor function for this clinical population.Robust, standardised measures of motor speech-related oromotor development suitable for children with cerebral palsy who are minimally verbal are lacking.Until such a measure is developed, formal evaluation may be achieved via oral motor assessments standardised for typically developing children, with the caveat one must interpret the results with caution.
Publisher: Wiley
Date: 29-01-2019
DOI: 10.1111/CDEV.13219
Abstract: This study investigates associations between trajectories of children's vocabulary development and subsequent behavioral and emotional difficulties via two potential mediating mechanisms literacy and peer problems. Nationally representative data from 4,983 Australian children were used to examine trajectories of receptive vocabulary (4-5, 6-7, and 8-9 years) and hyperactivity-inattention, conduct problems and emotional symptoms (8-9, 10-11, 12-13, 14-15 years), and literacy and peer problems (8-9 years). Lower growth in vocabulary was related to trajectories of hyperactivity-inattention, conduct problems, and emotional symptoms. Literacy was a key mediator explaining these associations. Results were consistent for children below the 50th percentile for vocabulary at 4-5 years compared to the full s le. These findings suggest that early literacy-based interventions may alleviate declining academic, emotional and behavioral functioning in adolescence.
Publisher: Wiley
Date: 08-06-2017
Abstract: Evidence suggests that language and social, emotional and behavioural (SEB) difficulties are associated in children and adolescents. When these associations emerge and whether they differ by language or SEB difficulty profile is unclear. This knowledge is crucial to guide prevention and intervention programmes for children with language and SEB difficulties. To determine whether receptive and expressive language skills are associated with internalizing and externalizing behaviours in slow-to-talk toddlers. In a community-based prospective study of 200 slow-to-talk children, language was measured at 24 and 36 months using Preschool Language Scale 4th Edition and at 48 months using Clinical Evaluation of Language Fundamentals-Preschool 2nd Edition. Internalizing and externalizing behaviours were measured by parent report at each age. Longitudinal data were analysed using repeated-measures regression, with up to three observations per child. Robust standard errors were used to account for non-independence of measures within participants. The shape of the associations were examined by fitting quadratic and cubic terms. The effects of confounders on the associations were examined. Receptive language had a negative linear association with internalizing behaviours after adjusting for confounders (β = -0.16, 95% [CI = -0.26, -0.07], p = .001) and a negative curved association with externalizing behaviours after adjusting for biological confounders (β In 24-48-month-old slow-to-talk children, lower receptive language scores were associated with higher internalizing behaviours. The magnitude of the association was small. For children with very poor receptive language scores, lower receptive language skills were associated with higher externalizing behaviours. Young children with low receptive language abilities may be at risk of internalizing difficulties those with very low receptive language skills may be at particular risk of externalizing difficulties. This has clinical implications for interventions for young children with receptive language difficulties.
Publisher: American Academy of Pediatrics (AAP)
Date: 09-2013
Abstract: To document the natural history of stuttering by age 4 years, including (1) cumulative incidence of onset, (2) 12-month recovery status, (3) predictors of stuttering onset and recovery, and (4) potential comorbidities. The study cohort was a prospective community-ascertained cohort (the Early Language in Victoria Study) from Melbourne, Australia, of 4-year-old children (n = 1619 recruited at age 8 months) and their mothers. Outcome was stuttering onset by age 4 years and recovery within 12 months of onset, defined using concurrent monthly parent and speech pathologist ratings. Potential predictors: child gender, birth weight, birth order, prematurity, and twinning maternal mental health and education socioeconomic status and family history of stuttering. Potential comorbidities: preonset and concurrent temperament, language, nonverbal cognition, and health-related quality of life. By age 4 years, the cumulative incidence of stuttering onset was 11.2% (95% confidence interval [CI]: 9.7% to 12.8%). Higher maternal education (P = .004), male gender (P = .02), and twinning (P = .005) predicted stuttering onset. At outcome, stuttering children had stronger language (mean [SD]: 105.0 [13.0] vs 99.6 [14.6] mean difference 5.5, 95% CI: 3.1 to 7.8 P & .001) and nonverbal cognition (mean [SD]: 106.5 [11.4] vs 103.9 [13.7], mean difference 2.6, 95% CI: 0.4 to 4.8 P = .02) and better health-related quality of life but were otherwise similar to their nonstuttering peers. Only 9 of 142 children (6.3% 95% CI: 2.9% to 11.7%) recovered within 12 months of onset. Although stuttering onset is common in preschoolers, adverse affects are not the norm in the first year after onset.
Publisher: Wiley
Date: 14-10-2001
Publisher: Elsevier BV
Date: 12-2017
Publisher: Wiley
Date: 08-1996
DOI: 10.1111/J.1469-8749.1996.TB12138.X
Abstract: Detailed examination of several aspects of feeding was carried out on a representative s le of a defined geographical population of children with Down syndrome. The examination included standardised assessments both of oral-motor function and of parent-child interaction. The findings suggest that the development of oral-motor function in children with Down syndrome not only lags behind intellectual development, but also follows an aberrant pathway. In particular, specific aspects of tongue and jaw function were impaired together with problems initiating and maintaining a smooth sequence of feeding actions. Also, parent-child interactions, as in studies on play, tended to be more controlling. Parents of children with Down syndrome do not spontaneously report the extent of their child's feeding problems unless specific enquiry is made, preferably accompanied by observation of feeding.
Publisher: Wiley
Date: 18-02-2015
DOI: 10.1111/DMCN.12714
Abstract: The neurobiological contributions of childhood language disorder are not well understood. Yet there is increasing evidence that language disorder is associated with differences in brain structure and/or function in core language regions. A key hypothesis has been that children with language disorder do not show the same degree of leftward asymmetry of these regions as observed in typically developing children. We aimed to systematically review structural and functional magnetic resonance imaging (fMRI) studies to examine brain commonalities and differences between children with language disorder and typically developing controls and differences in leftward asymmetry between these groups. A systematic review was conducted using MeSH terms synonymous with childhood language disorder and brain MRI methods. The search identified 1443 papers, and 18 articles met the criteria and were appraised for level and quality of evidence. Atypical brain structure and function was reported within traditionally recognized language regions across studies, including the inferior frontal gyrus, posterior superior temporal gyrus, and caudate nucleus. The direction of difference (e.g. increased/decreased) was variable, however, likely because of differences in language disorder groups examined and magnetic resonance data acquisition and analysis approaches. As regards asymmetry, there was some evidence of reduction of the anticipated structural and functional leftward asymmetry in frontal language regions in language disorder groups. Mounting evidence suggests that children with language disorder have atypical brain structure and function within neural regions integral to language. There is limited support for the hypothesis that children with language disorder show a reduction of leftward structural and/or functional asymmetry in frontal language regions. Interpretation is limited, however, by a high degree of variability in language disorder assessment and phenotype, and in magnetic resonance methodologies. A large-scale magnetic resonance study of brain structure and function is required in a well-defined language disorder population cohort, with replication, to provide confirmatory data on the neural correlates of childhood language disorder.
Publisher: Wiley
Date: 13-08-2018
DOI: 10.1002/DEV.21762
Abstract: Developmental language disorder (DLD) and speech sound disorder (SSD) are common, and although scientific evidence for structural and functional alterations in DLD/SSD is accumulating, current neuroimaging studies provide an incongruent picture. Here, we hypothesized that children affected by DLD and SSD present with gray matter (or gray matter asymmetry) aberrations in brain areas associated with language processing compared to typically developing (TD) children. To assess this hypothesis, we enhanced MRI-based information with microscopically defined cytoarchitectonic probabilities of Broca's area (BA 45, BA 44) as well as an auditory area (TE 3.0). We detected a larger rightward gray matter asymmetry in BA 45 in children with DLD (n = 13) and with SSD (n = 18) compared to TD children (n = 18), albeit only on a trend level. Interestingly though, we observed significantly larger gray matter volumes in right BA 45 in DLD compared to SSD children (and also compared to TD children).
Publisher: MDPI AG
Date: 26-06-2018
DOI: 10.3390/EN11071667
Publisher: Elsevier BV
Date: 09-2019
DOI: 10.1016/J.JFLUDIS.2019.105708
Abstract: To compare two experimental Westmead Program treatments with a control Lidcombe Program treatment for early stuttering. The design was a three-arm randomized controlled trial with blinded outcome assessments 9 months post-randomization. Participants were 91 pre-school children. There was no evidence of difference in percentage syllables stuttered at 9 months among groups. Dropout rates were substantive and may have been connected with novel aspects of the trial design: the use of community clinicians, no exclusion criteria, and randomization of children younger than 3 years of age. The substantive dropout rate for all three arms in this trial means that any conclusions about the 9-month stuttering outcomes must be regarded as tentative. However, continued development of the Westmead Program is warranted, and we are currently constructing an internet version.
Publisher: Informa UK Limited
Date: 06-2004
Publisher: Wiley
Date: 03-02-2010
DOI: 10.1111/J.1365-2214.2009.00997.X
Abstract: Functional magnetic resonance imaging (fMRI) is increasingly applied in paediatric research. Parents typically provide research consent for their children yet, no study has examined the rates of consent, nor factors influencing parental decision making for consent. The present study aimed to determine the proportion of parents that would consent to their child undergoing an fMRI study, and to elicit the reasons, motivators and detractors affecting their decision. Ninety parents of children aged 6 years were invited to participate in a postal survey study. Fifty-three parents (59%) responded and one-third (34%, 18/53) reported that they would consent. The main reason for consent was that participation could benefit children in the future (89%, 16/18). Common reasons for not consenting included that fMRI may be anxiety-provoking (54%), or was an unnecessary medical procedure (23%). Our preliminary data suggest that researchers may have to approach three times the number of participants required in order to recruit a suitable number of healthy children to fMRI studies. Further research examining the influence of recruitment approaches (e.g. phone vs. postal) and the various factors influencing decision making regarding consent is required. For ex le, careful examination of the language used in describing the procedure could facilitate parental understanding about fMRI and alleviate anxiety associated with the procedure. This is an important consideration for recruitment to future fMRI studies given that anxiety was a key factor influencing parental non-consent.
Publisher: Elsevier
Date: 2022
Publisher: Springer Science and Business Media LLC
Date: 21-06-2017
Publisher: Wiley
Date: 1995
DOI: 10.3109/13682829509031324
Abstract: Three twin births occurring within 18 months in Oxfordshire, in which a girl with Down's syndrome was twin to an unaffected boy, provided an opportunity for a closely matched comparison of ratings on the Schedule for Oral Motor Assessment, which examines oral-motor function in a systematic and reliable way. A detailed description of the video-recording of one twin pair is included. This illustrates abnormalities of oral-motor function which may occur generally in Down's syndrome, as suggested further by a numerical tabulation of the differences found between the twins.
Publisher: Wiley
Date: 05-2008
DOI: 10.1111/J.1469-8749.2008.02051.X
Abstract: The aim of this study was to investigate the participation of children with cerebral palsy (CP) in activities outside school and to compare their participation with a large representative s le of children. A population-based survey was conducted of children with CP born in Victoria, Australia in 1994 and 1995. Of 219 living children identified, 114 (52.1%) returned completed surveys. The children (65 males, 49 females) were aged between 10 years 9 months and 12 years 9 months (mean age 11y 9mo, SD 6mo). Thirty-eight per cent had hemiplegia, 23% diplegia, 4% triplegia, 34% quadriplegia, and 1% was of unknown topography. Distribution according to the Gross Motor Function Classification System (GMFCS) was 22.8% Level I, 36% Level II, 10.5% Level III, 8.8% Level IV, and 21.9% Level V. Distribution according to the Manual Ability Classification System (MACS) was: 19.3% Level I, 38.6% Level II, 14.0% Level III, 8.8% Level IV, and 19.3% Level V. Participation was measured using the Children's Assessment of Participation and Enjoyment. Participation in selected sport, cultural, and quiet leisure activities was compared with population-based data for 11-year-olds from the Australian Bureau of Statistics. Children with CP undertook a median of 26.5 activities (interquartile range 10) in 4 months which were commonly informal rather than formal. Intensity of participation was low. Diversity and intensity of participation was similar for children in each level of the MACS and the GMFCS, except for participants in Level V. More children with CP participated in organized sports (p<0.001) compared with other Australian children, although with lower frequency (p<0.001). Participation ersity and level of intensity of Australian children with CP were similar to those reported in a Canadian study.
Publisher: S. Karger AG
Date: 2014
DOI: 10.1159/000368227
Abstract: b i Background: /i /b Large-scale multi-site experimental and clinical speech protocols require high-fidelity, easy-to-use speech recording technologies. However, little is known about the reliability and comparability of affordable, portable and commonly used technologies with traditional well-validated devices (e.g., a hard disc recorder with a high-quality microphone). b i Objective: /i /b To examine the comparability of speech and voice s les acquired from protocols involving high- and low-quality devices. b i Methods: /i /b Speech s les were acquired simultaneously from 15 healthy adults using four devices and analyzed acoustically for measures of timing and voice quality. For the purpose of making initial comparisons, methods were deemed comparable if the resultant acoustic data yielded root mean squared error values ≤10% and statistically significant Spearman's correlation coefficients. b i Results: /i /b The data suggest that there is significant and widespread variability in the quality and reliability between different acquisition methods for voice and speech recording. Not one method provided statistically similar data to the protocol using the benchmark device (i.e., a high-quality recorder coupled with a condenser microphone). Acoustic analysis cannot be assumed to be comparable if different recording methods are used to record speech. b i Conclusions: /i /b Findings have implications for researchers and clinicians hoping to make comparisons between labs or, where lower-quality devices are suggested, to offer equal fidelity.
Publisher: Wiley
Date: 05-1992
DOI: 10.1111/J.1469-8749.1992.TB11449.X
Abstract: The nature and extent of feeding difficulties associated with cerebral palsy was assessed in 12 infants with moderate to severe oral-motor dysfunction, compared with a control group. Data were gathered at the infants' homes by interview and by direct observation of mealtimes. The results revealed a range of long-standing problems, for which little management advice had been given. Most case infants were poorly positioned specially designed seats were not used. The mean duration of mealtimes for case and comparison infants did not differ significantly. Case infants ate and were offered less food than the control infants. Feeding problems usually had persisted since birth and were associated with marked failure to thrive. Multidisciplinary assessments of the severe feeding difficulties of these children are indicated.
Publisher: Springer Science and Business Media LLC
Date: 15-11-2019
DOI: 10.1007/S00429-019-01978-7
Abstract: Developmental language disorder (DLD) and developmental speech disorder (DSD) are common, yet their etiologies are not well understood. Atypical volume of the inferior and posterior language regions and striatum have been reported in DLD however, variability in both methodology and study findings limits interpretations. Imaging research within DSD, on the other hand, is scarce. The present study compared grey matter volume in children with DLD, DSD, and typically developing speech and language. Compared to typically developing controls, children with DLD had larger volume in the right cerebellum, possibly associated with the procedural learning deficits that have been proposed in DLD. Children with DSD showed larger volume in the left inferior occipital lobe compared to controls, which may indicate a compensatory role of the visual processing regions due to sub-optimal auditory-perceptual processes. Overall, these findings suggest that different neural systems may be involved in the specific deficits related to DLD and DSD.
Publisher: MDPI AG
Date: 14-07-2023
Abstract: Through a cross-sectional community study of 2044 children aged 2 years, we (1) examine the impact of hearing loss on early spoken expressive vocabulary outcomes and (2) investigate how early intervention-related factors impact expressive vocabulary outcomes in children with hearing loss predominantly identified through universal newborn hearing screening. We used validated parent/caregiver-reported checklists from two longitudinal cohorts (302 children with unilateral or bilateral hearing loss, 1742 children without hearing loss) representing the same population in Victoria, Australia. The impact of hearing loss and lification-related factors on vocabulary was estimated using g-computation and multivariable linear regression. Children with versus without hearing loss had poorer expressive vocabulary scores, with mean scores for bilateral loss 0.5 (mild loss) to 0.9 (profound loss) standard deviations lower and for unilateral loss marginally (0.1 to 0.3 standard deviations) lower. For children with hearing loss, early intervention and lification by 3 months, rather than by 6 months or older, resulted in higher expressive vocabulary scores. Children with hearing loss demonstrated delayed spoken expressive vocabulary despite whole-state systems of early detection and intervention. Our findings align with calls to achieve a 1-2-3 month timeline for early hearing detection and intervention benchmarks for screening, identification, and intervention.
Publisher: Wiley
Date: 16-02-2011
Publisher: American Academy of Pediatrics (AAP)
Date: 2009
Abstract: OBJECTIVES. Our goals were to document (1) the onset of stuttering and (2) whether specific child, family, or environmental factors predict stuttering onset in children aged up to 3 years. METHODS. Participants included a community-ascertained cohort of 1619 2-year-old Australian children recruited at 8 months of age to study the longitudinal development of early language. The main outcome measure was parental telephone report of stuttering onset, verified by face-to-face expert diagnosis. Preonset continuous measures of the child's temperament (approach/withdrawal) and language development were available. Information on a range of predictor measures hypothesized to be associated with stuttering onset was obtained (maternal mental health and education levels, gender, premature birth status, birth weight, birth order, twinning, socioeconomic status, family history of stuttering). RESULTS. By 3 years of age, the cumulative incidence of stuttering onset was 8.5%. Onset often occurred suddenly over 1 to 3 days (49.6%) and involved the use of word combinations (97.1%). Children who stuttered were not more shy or withdrawn. Male gender, twin birth status, higher vocabulary scores at 2 years of age, and high maternal education were associated with stuttering onset. The multivariable model, however, had low predictive strength just 3.7% of the total variation in stuttering onset was accounted for. CONCLUSIONS. The cumulative incidence of stuttering onset was much higher than reported previously. The hypothesized risk factors for stuttering onset together explained little of the variation in stuttering onset up to 3 years of age. Early onset was not associated with language delay, social and environmental factors, or preonset shyness/withdrawal. Health professionals can reassure parents that onset is not unusual up to 3 years of age and seems to be associated with rapid growth in language development.
Publisher: John Wiley & Sons, Ltd
Date: 19-07-2004
Publisher: Springer Science and Business Media LLC
Date: 17-06-2021
Publisher: Elsevier BV
Date: 08-2002
DOI: 10.1016/S0387-7604(02)00058-X
Abstract: Data on features of regression and pre-regression developmental history in a case series of 53 girls and women with Rett syndrome are presented. Consistent with the diagnostic criteria, hand skills and verbal or non-verbal communication skills were the most common skills lost during regression. Play and motor skills were also lost in half the cases. Regression most commonly occurred between 12 and 18 months of age but was noted in a few cases before 6 months or after 36 months. Pre-regression developmental delays or abnormalities were noted in over two-thirds of cases, increasing to 85% of the youngest cases where parental reporting was likely to be more accurate. Age at regression was not associated with severity of physical and growth symptoms, and thus did not appear to be an index of neurological severity. There is a continuing need to further elucidate the pre- and post-regression features of Rett syndrome in order to aid early identification, diagnosis and referral for genotype mutation analysis.
Publisher: Elsevier BV
Date: 03-2017
DOI: 10.1016/J.JFLUDIS.2016.12.001
Abstract: To describe the language development in a s le of young children who stutter during the first 12 months after stuttering onset was reported. Language production was analysed in a s le of 66 children who stuttered (aged 2-4 years). The s le were identified from a pre-existing prospective, community based longitudinal cohort. Data were collected at three time points within the first year after stuttering onset. Stuttering severity was measured, and global indicators of expressive language proficiency (length of utterances and grammatical complexity) were derived from the s les and summarised. Language production abilities of the children who stutter were contrasted with normative data. The majority of children's stuttering was rated as mild in severity, with more than 83% of participants demonstrating very mild or mild stuttering at each of the time points studied. The participants demonstrated developmentally appropriate spoken language skills comparable with available normative data. In the first year following the report of stuttering onset, the language skills of the children who were stuttering progressed in a manner that is consistent with developmental expectations.
Publisher: BMJ
Date: 08-01-1994
Publisher: Elsevier BV
Date: 12-1993
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 2019
Publisher: American Academy of Pediatrics (AAP)
Date: 2016
Abstract: Universal newborn hearing screening was implemented worldwide largely on modeled, not measured, long-term benefits. Comparative quantification of population benefits would justify its high cost. Natural experiment comparing 3 population approaches to detecting bilateral congenital hearing loss (& dB, better ear) in Australian states with similar demographics and services: (1) universal newborn hearing screening, New South Wales 2003–2005, n = 69 (2) Risk factor screening (neonatal intensive care screening + universal risk factor referral), Victoria 2003–2005, n = 65 and (3) largely opportunistic detection, Victoria 1991–1993, n = 86. Children in (1) and (2) were followed at age 5 to 6 years and in (3) at 7 to 8 years. Outcomes were compared between states using adjusted linear regression. Children were diagnosed younger with universal than risk factor screening (adjusted mean difference –8.0 months, 95% confidence interval –12.3 to –3.7). For children without intellectual disability, moving from opportunistic to risk factor to universal screening incrementally improved age of diagnosis (22.5 vs 16.2 vs 8.1 months, P & .001), receptive (81.8 vs 83.0 vs 88.9, P = .05) and expressive (74.9 vs 80.7 vs 89.3, P & .001) language and receptive vocabulary (79.4 vs 83.8 vs 91.5, P & .001) these nonetheless remained well short of cognition (mean 103.4, SD 15.2). Behavior and health-related quality of life were unaffected. With new randomized trials unlikely, this may represent the most definitive population-based evidence supporting universal newborn hearing screening. Although outperforming risk factor screening, school entry language still lagged cognitive abilities by nearly a SD. Prompt intervention and efficacy research are needed for children to reach their potential.
Publisher: Wiley
Date: 07-2014
Publisher: Wiley
Date: 19-08-2018
DOI: 10.1111/CCH.12615
Abstract: There is growing evidence that specific styles of parent-child interaction benefit child development, particularly child language development. Direct observational techniques help clarify the behaviours and styles within parent-child interactions that may influence child language outcomes however, these techniques tend to be labour-intensive and costly. We report on the development of a replicable, low-burden mechanism for observing and coding specific maternal linguistic behaviours in a population-based cohort of 2-year-olds. The coding scheme was developed as part of a prospective, longitudinal study examining the associations between maternal responsive behaviours and child language outcomes in slow-to-talk toddlers. In the first phase of the study, three coding systems were tested by coding five s le parent-toddler interactions and then comparing them based on (a) the ease of method and thus likely intrarater and interrater reliability and (b) the number of data points. The second phase was to demonstrate how the chosen method could be used in practice with a large at-risk group of toddlers. Of the three coding systems explored, the Observer® XT software was selected for ease of use and because detailed coding of free-play videos could be achieved in close to real time. Intrarater and interrater reliability were established in 251 mother-child free-play videos, producing high intraclass correlation coefficients of 0.95 to 0.99 for the six behaviours. The study provides evidence that numerous parent-child interactions can be rigourously yet efficiently coded without substantial information loss. The observational mechanism in the current study has been fully developed and is shown to be feasible for research purposes focusing on parent-toddler interactions. However, further testing of the observational mechanism is required to examine whether the same results could be produced if coding was conducted "live" and for shorter duration thereby making it readily useable for clinicians.
Publisher: American Speech Language Hearing Association
Date: 22-01-2018
Publisher: Public Library of Science (PLoS)
Date: 11-04-2016
Publisher: Informa UK Limited
Date: 03-2008
Publisher: Elsevier BV
Date: 12-1996
DOI: 10.1016/S0022-3476(96)70032-X
Abstract: To determine the prevalence and nature of feeding difficulties and oral motor dysfunction among a representative s le of 49 children with cerebral palsy (12 to 72 months of age). A population survey was undertaken by means of a combination of interview and home observational measures. Sucking (57%) and swallowing (38%) problems in the first 12 months of life were common, and 80% had been fed nonorally on at least one occasion. More than 90% had clinically significant oral motor dysfunction. One in three (36.2%) was severely impaired and therefore at high risk of chronic undernourishment. There was a substantial discrepancy between the lengthy duration of mealtimes reported by mothers and those actually observed in the home (mean, 19 minutes 21 seconds range, 5 minutes 21 seconds to 41 minutes 39 seconds). In 60% of the children, severe feeding problems preceded the diagnosis of cerebral palsy. Using a standardized assessment of oral motor function, we found the majority of children to have clinically significant oral motor dysfunction. Contrary to maternal report, mealtimes were relatively brief, and this, combined with the severity of oral motor dysfunction, made it difficult for some children to achieve a satisfactory nutritional intake. The study illustrates the importance of observing feeding, preferably in the home.
Publisher: American Psychological Association (APA)
Date: 02-2021
DOI: 10.1037/FAM0000804
Abstract: Intimate partner violence (IPV) between parents is associated with poorer child language development. This study aimed to examine pathways from IPV and maternal depressive symptoms in children's 1st year to language skills at 10 years. Pathways were examined via IPV, maternal depressive symptoms, and maternal involvement in home learning activities (e.g., reading, storytelling) at age 4. A secondary aim was to examine whether these pathways differed by child gender. Data were drawn from 1,507 mothers and their firstborn children participating in a community-based prospective longitudinal study. At child age 1 and 4 years, mothers reported IPV using the Composite Abuse Scale (CAS) and completed a depression scale. At child age 10 years, mothers completed the Children's Communication Checklist (2nd edition) Short Form and 4 pragmatic subscales, and children completed a receptive vocabulary test. Results provided some evidence that maternal depressive symptoms at 4 years postpartum may be an important mechanism by which exposure to IPV and maternal depressive symptoms in the child's 1st year is associated with poorer language at age 10. These pathways remained evident after accounting for social disadvantage, number of siblings, and concurrent IPV exposure at 10 years. There was little evidence that the pathways were mediated by maternal involvement or differed by gender. Implications for speech pathology, health, and education professionals concern identifying and supporting the language needs of children in family contexts where IPV is present. Intervention strategies for families affected by IPV such as supporting maternal mental health and the mother-child relationship could be extended to support child language development. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Publisher: Elsevier BV
Date: 12-2018
DOI: 10.1016/J.JFLUDIS.2018.10.002
Abstract: The Consolidated Standards of Reporting Trials (CONSORT) statement strongly suggests one primary outcome for clinical trials, yet the outcomes of stuttering treatments span numerous behavioral and psychosocial domains. That presents a roadblock to eventual meta-analysis of clinical trials for adults who stutter. We propose a simple and convenient outcome measure for clinical trials of stuttering treatment for adults that spans whatever behavioral and psychosocial factors might impel clients to seek treatment: a nine-point scale of Satisfaction with Communication in Everyday Speaking Situations (SCESS). The scale consists of one question which is simple, brief, easy to administer, cost-free, and translatable into many languages. The present report develops the SCESS scale by determining its reliability, content validity, and construct validity. Reliability, content validity, and construct validity of the SCESS were confirmed with statistically significant and substantive correlations with speech-related and anxiety-related measures. However, the SCESS did not correlate well with percentage syllables stuttered. Three behavioral and psychosocial measures had the highest correlation with the SCESS: total Overall Assessment of the Speaker's Experience of Stuttering, self-reported stuttering severity, and Unhelpful Thoughts and Beliefs about Stuttering. The SCESS measure has potential to be applied as an overarching clinical trial outcome measure of stuttering treatment effect. This study provides some preliminary evidence for including it as a primary or secondary outcome in clinical trials of adult stuttering treatments. However, further studies are needed to establish the SCESS responsiveness to different stuttering treatments.
Publisher: American Academy of Pediatrics (AAP)
Date: 12-2007
Abstract: OBJECTIVE. This article responds to evidence gaps regarding language impairment identified by the US Preventive Services Task Force in 2006. We examine the contributions of putative child, family, and environmental risk factors to language outcomes at 24 months of age. METHODS. A community-ascertained s le of 1720 infants who were recruited at 8 months of age were followed at ages 12 and 24 months in a prospective, longitudinal study in metropolitan Melbourne, Australia. Outcomes at 24 months were parent-reported infant communication (Communication and Symbolic Behavior Scales and MacArthur-Bates Communicative Development Inventories vocabulary production score). Putative risk factors were gender, preterm birth, birth weight, multiple birth, birth order, socioeconomic status, maternal mental health, maternal vocabulary and education, maternal age at birth of child, non–English-speaking background, and family history of speech-language difficulties. Linear regression models were fitted to total standardized Communication and Symbolic Behavior Scales and Communicative Development Inventories vocabulary production scores a logistic regression model was fitted to late-talking status at 24 months. RESULTS. The regression models accounted for 4.3% and 7.0% of the variation in the 24-month Communication and Symbolic Behavior Scales and Communicative Development Inventories scores, respectively. Male gender and family history were strongly associated with poorer outcomes on both instruments. Lower Communication and Symbolic Behavior Scales scores were also associated with lower maternal vocabulary and older maternal age. Lower vocabulary production scores were associated with birth order and non–English-speaking background. When the 12-month Communication and Symbolic Behavior Scales Total score was added as a covariate in the linear regression of 24-month Communication and Symbolic Behavior Scales Total score, it was by far the strongest predictor. CONCLUSIONS. These early risk factors explained no more than 7% of the variation in language at 24 months. They seem unlikely to be helpful in screening for early language delay.
Publisher: BMJ
Date: 18-07-1992
Abstract: To measure the effect of parenteral antibiotics given before admission to hospital on mortality and on bacteriological investigations in meningococcal disease. Retrospective review of hospital notes and laboratory and public health medicine department records. Three health districts in south west England. Patients with meningococcal disease in Gloucester district presenting between 1 January 1982 and 31 December 1991 (n = 190) patients with meningococcal disease in Plymouth (n = 118) and Bath (n = 73) districts presenting between 1 January 1988 and 31 December 1991 (total = 381). Number of deaths from meningococcal disease. Parenteral antibiotic given by general practitioners was associated with a substantial reduction in mortality (from 9% to 5% relative risk 0.6, 95% confidence interval 0.2 to 1.5) patients with a rash were more likely to be given parenteral antibiotics, and mortality was further reduced (from 12% to 5% 0.5, 0.2 to 1.4). In a district where such treatment was regularly encouraged its use increased from 5% to 40% of cases over 10 years (p = 0.00001). Treatment with parenteral antibiotics before admission made isolation of meningococci from blood and cerebrospinal fluid less likely but did not affect nasopharyngeal cultures. General practitioners should carry benzylpenicillin in their emergency bags at all times and should administer it promptly, preferably intravenously, whenever meningococcal disease is suspected, unless the patient has had an anaphylactic reaction to penicillin. Specimens for culture should include a nasopharyngeal swab.
Publisher: Frontiers Media SA
Date: 04-02-2022
Abstract: Screening and surveillance of development are integral to ensuring effective early identification and intervention strategies for children with vulnerabilities. However, not all developmental skills have reliable screening processes, such as early language ability. We describe how a set of early life factors used in a large, prospective community cohort from Australia are associated with language abilities across the preschool years, and determine if either an accumulation of risk factors or a clustering of risk factors provide a feasible approach to surveillance of language development in preschool children. There were 1,208 children with a 7-year language outcome. The accumulation of early life factors increased the likelihood of children having low language skills at 7-years. Over a third of children with typical language skills (36.6%) had ≤ two risks and half of the children with low language (50%) had six or more risks. As the number of factors increases the risk of having low language at 7-years increases, for ex le, children with six or more risks had 17 times greater risk, compared to those with ≤ two risks. Data collected from 1,910 children at 8- to 12-months were used in the latent class modeling. Four profile classes (or groups) were identified. The largest group was developmentally enabled with a supportive home learning environment (56.2%, n = 1,073). The second group was vulnerable, both developmentally and in their home learning environment (31.2%, n = 596) the third group was socially disadvantaged with a vulnerable home learning environment (7.4%, n = 142) the final group featured maternal mental health problems and vulnerable child socio-emotional adjustment (5.2%, n = 99). Compared to developmentally enabled children, the risk of low language at 7-years was greater for children in the three other groups. The cumulative and cluster risk analyses demonstrate the potential to use developmental surveillance to identify children within the first years of life who are at risk of language difficulties. Importantly, parent-child interaction and the home learning environment emerged as a consistent cluster. We recommend they be adopted as the common focus for early intervention and universal language promotion programs.
Publisher: Informa UK Limited
Date: 2009
DOI: 10.3109/09638280902971406
Abstract: To investigate the extent to which selected in idual, family and environmental variables were associated with participation of children who have cerebral palsy in activities outside school. Data were gathered through a population-based survey of 114 children born in 1994 or 1995 in Victoria, Australia. Participation was measured using the Children's Assessment of Participation and Enjoyment. Selected independent variables were classified as related to the child, family or environment. Linear regression analysis was used to identify variables associated with participation in informal (activities that require little planning) and formal (those with structure and leaders) activities. Participation in informal activities tended to be greater in children who preferred informal activities and who had higher manual ability (adjusted R(2) = 36.3%). Girls and those with better gross motor function also tended to participate in more activities. The explanatory power of the regression model for participation in formal activities was limited (adjusted R(2) = 4.2%). Knowing a child's activity preferences is critical to intervention planning. Being exposed to a range of activities within supportive environments may provide the opportunity to develop preferences, especially in activities where children with cerebral palsy have reduced participation, such as in physical activities.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2014
Publisher: Wiley
Date: 02-05-2019
Abstract: Submucous cleft palate (SMCP) has a heterogeneous presentation and is often identified late or misdiagnosed. Diagnosis is prompted by speech, resonance or feeding symptoms associated with velopharyngeal insufficiency. However, the broader impacts of SMCP on communication have rarely been examined and therefore are poorly understood. To describe the communicative profile of in iduals with non-syndromic SMCP by examining speech, language and pragmatics (social language). Fifteen participants with SMCP aged 5 -12 , without a genetic diagnosis, participated in the study. Participants completed standardized assessments examining language, resonance, speech and non-verbal intellect. Parents also completed the Children's Communication Checklist (CCC-2), which provided a measure of overall communicative ability, including pragmatic skills. Formal language outcomes were compared with two cohorts: 36 in iduals with overt non-syndromic clefts and 129 in iduals with no history of clefting. Speech intelligibility was reduced secondary to hypernasality, disordered articulation and/or impaired phonology (n = 7) in children with SMCP. Poorer overall language outcomes were observed for children with SMCP compared with both those with overt clefts and no history of clefting (p < 0.001). Language scores for children with SMCP ranged from impaired (n = 6) to above the standardized mean (n = 4). Receptive and expressive language performance were independently correlated with non-verbal IQ (p < 0.01). Those with severe language impairment (n = 4) also had borderline or impaired non-verbal IQ. Parents reported that speech and semantics were the most affected sub-domains of communication, while scores were the highest for the initiation domain. Speech and language skills were correlated strongly with pragmatics (r = 0.877, p < 0.01). Overall, performance was variable within the SMCP group across speech, language and pragmatic assessments. In addition to well-documented speech difficulties, children with SMCP may have language or pragmatic impairments, suggesting that further neurodevelopmental influences may be at play. As such, for in iduals with SMCP, additional clinical screening of language and pragmatic abilities may be required to ensure accurate diagnosis and guide both cleft and non-cleft related therapy programmes.
Publisher: Wiley
Date: 07-2014
Publisher: Wiley
Date: 07-12-2018
Abstract: Identifying risk and protective factors for language development informs interventions for children with developmental language disorder (DLD). Maternal responsive and intrusive communicative behaviours are associated with language development. Mother-child interaction quality may influence how children use these behaviours in language learning. To identify (1) communicative behaviours and interaction quality associated with language outcomes (2) whether the association between a maternal intrusive behaviour (directive) and child language scores changed alongside a maternal responsive behaviour (expansion) and (3) whether interaction quality modified these associations. Language skills were assessed at 24, 36 and 48 months in 197 community-recruited children who were slow to talk at 18 months. Mothers and 24-month-olds were video-recorded playing at home. Maternal praise, missed opportunities, and successful and unsuccessful directives (i.e., whether followed by the child) were coded during a 10-min segment. Interaction quality was rated using a seven-point fluency and connectedness (FC) scale, during a 5-min segment. Linear regressions examined associations between these behaviours/rating and language scores. Interaction analysis and simple slopes explored effect modification by FC. There was no evidence that missed opportunities or praise were associated with language scores. Higher rates of successful directives in the unadjusted model and unsuccessful directives in the adjusted model were associated with lower 24-month-old receptive language scores (e.g., unsuccessful directives effect size (ES) = -0.41). The association between unsuccessful directives and receptive language was weaker when adjusting for co-occurring expansions (ES = -0.34). Both types of directives were associated with poorer receptive and expressive language scores in adjusted models at 36 and 48 months (e.g., unsuccessful directive and 48-month receptive language, ES = -0.66). FC was positively associated with 24-, 36- and 48-month language scores in adjusted models (e.g., receptive language at 24 months, ES = 0.21, at 48 months, ES = 0.18). Interaction analysis showed the negative association between successful directives and 24-month receptive language existed primarily in poorly connected dyads with low FC levels. These findings illustrate the effects of the combined interaction between different maternal communicative behaviours and features of the interaction itself on child language development, and the need to consider both in research and practice. Whilst more intrusive directives were associated with poorer language scores, this association attenuated when adjusting for co-occurring responsive expansions, and the association was strongest for children in lower quality interactions. This work may inform clinical practice by helping clinicians target the most appropriate communicative behaviours for specific mother-child dyads.
Publisher: SAGE Publications
Date: 08-07-2016
Abstract: We compared loss and gain in communication from 1 to 2 years in children later diagnosed with autism spectrum disorder (n = 41), language impairment (n = 110) and in children with typical language development at 7 years (n = 831). Participants were selected from a prospective population cohort study of child language (the Early Language in Victoria Study). Parent-completed communication tools were used. As a group, children with autism spectrum disorder demonstrated slower median skill gain, with an increasing gap between trajectories compared to children with typical development and language impairment. A proportion from all groups lost skills in at least one domain (autism spectrum disorder (41%), language impairment (30%), typical development (26%)), with more children with autism spectrum disorder losing skills in more than one domain (autism spectrum disorder (47%), language impairment (15%, p = 0.0003), typical development (16%, p 0.001)). Loss was most common for all groups in the domain of ‘emotion and eye gaze’ but with a higher proportion for children with autism spectrum disorder (27% language impairment (12%, p = 0.03), typical development (14%, p = 0.03)). A higher proportion of children with autism spectrum disorder also lost skills in gesture (p = 0.01), sounds (p = 0.009) and understanding (p = 0.004) compared to children with typical development but not with language impairment. These findings add to our understanding of early communication development and highlight that loss is not unique to autism spectrum disorder.
Publisher: BMJ
Date: 11-01-1992
Abstract: Exposure to whole cigarette smoke from reference cigarettes results in the prompt (peak activity is 6 hrs), but fairly weak (similar to 2 fold), induction of murine pulmonary microsomal monooxygenase activity. This activity can be detected by using as substrates either benzo(a)pyrene or ethoxyresorufin, and can be inhibited by treatment with cycloheximide or actinomycin D. Unlike the induction of pulmonary monooxygenases following intratracheal administration of 3-methylcholanthrene, these cigarette smoke-induced increases were not unequivocally linked to the Ah locus. Whole smoke condensate and fractions derived from these condensates can a) induce pulmonary monooxygenase activity, b) inhibit benzo(a)pyrene metabolism in vitro, c) be metabolized to forms mutagenic to Salmonella typhimurium tester strains TA153, or TA98, d) transform C3H 10T1/2 cells in vitro, and e) enhance the carcinogenicity of benzo(a)pyrene in murine pulmonary tissue. A potentially important observation is that whereas hepatic tissue is capable of activating whole cigarette smoke condensate to mutagenic forms in vitro, murine pulmonary tissue does not seem capable of such activation. Although these pulmonary-derived tissue homogenates have significant AHH activity and can metabolize Aflatoxin B1, 2-aminofluorene and 7, 8-dihydro-7,8-dihydroxybenzo(a)pyrene to mutagenic forms, these homogenates fail to activate both cigarette smoke condensate and the pro-mutagen, 6-aminochrysene. These results are discussed with reference to the concept that whole cigarette smoke may be both a potential "initiator" and "promotor" of lung cancer in mice, and that this latter property may be the most important in determining cancer risk.
Publisher: American Academy of Pediatrics (AAP)
Date: 10-2013
Abstract: Population approaches to lessen the adverse impacts of preschool language delay remain elusive. We aimed to determine whether systematic ascertainment of language delay at age 4 years, followed by a 10-month, 1-on-1 intervention, improves language and related outcomes at age 5 years. A randomized trial nested within a cross-sectional ascertainment of language delay. Children with expressive and/or receptive language scores more than 1.25 SD below the mean at age 4 years entered the trial. Children randomly allocated to the intervention received 18 1-hour home-based therapy sessions. The primary outcomes were receptive and expressive language (Clinical Evaluation of Language Fundamentals – Preschool, 2nd Edition) and secondary outcomes were child phonological skills, letter awareness, pragmatic skills, behavior, and quality of life. A total of 1464 children were assessed for language delay at age 4 years. Of 266 eligible children, 200 (13.6%) entered the trial, with 91 intervention (92% of 99) and 88 control (87% of 101) children retained at age 5 years. At age 5 years, there was weak evidence of benefit to expressive (adjusted mean difference, intervention − control, 2.0 95% confidence interval [CI] −0.5 to 4.4 P = .12) but not receptive (0.6 95% CI −2.5 to 3.8 P = .69) language. The intervention improved phonological awareness skills (5.0 95% CI 2.2 to 7.8 P & .001) and letter knowledge (2.4 95% CI 0.3 to 4.5 P = .03), but not other secondary outcomes. A standardized yet flexible 18-session language intervention was successfully delivered by non-specialist staff, found to be acceptable and feasible, and has the potential to improve long-term consequences of early language delay within a public health framework.
Publisher: Informa UK Limited
Date: 14-01-2015
DOI: 10.3109/09638288.2014.999164
Abstract: To explore parents' views of the activities and participation of children with cerebral palsy (CP) with a range of communicative abilities and the factors (personal and environmental) that influenced these. Thirteen parents of children with CP aged 4-9 years participated in semi-structured in idual interviews. Interviews were recorded, transcribed and analysed thematically. Identified codes and themes were mapped to the domains of the International Classification of Functioning, Disability and Health - Children and Youth Version (ICF-CY). Parents' responses reflected all ICF-CY domains comprising activity, participation and environmental factors. Codes were primarily mapped to the domains learning and applying knowledge, communication, mobility and interpersonal interactions and relationships. Key barriers identified included aspects of parents' own interactions with their child (e.g. not offering choices), unfamiliar people and settings, negative attitudes of others and children's frustration. Facilitators included support received from the child's family and school, being amongst children, having a familiar routine and the child's positive disposition. Despite the barriers experienced, children participated in a range of activities. Parents placed importance on communication and its influence on children's independence, behaviour and relationships. Barriers and facilitators identified highlight aspects of the environment that could be modified through intervention to enhance communication and participation. Children's activities and participation were largely related to early learning tasks (e.g. literacy), communication, mobility and interactions. Intervention aimed at improving activities and participation may address the various child, impairment, social and environment factors identified here as impacting on activities and participation (e.g. the child's personal characteristics, communication and physical impairments, the support and attitudes of others and the familiarity of the environment). Therapists will need to consider (and manage) the potential negative impact communication deficits may have on children's behaviour, independence and social skills which may in turn detrimentally impact on activity and participation.
Publisher: John Wiley & Sons, Ltd
Date: 23-07-2001
Publisher: MDPI AG
Date: 04-12-2017
DOI: 10.3390/EN10122050
Publisher: Informa UK Limited
Date: 06-05-2014
DOI: 10.3109/17549507.2014.898095
Abstract: This study aimed to quantify the non-hospital healthcare costs associated with language difficulties within two nationally representative s les of children. Data were from three biennial waves (2004-2008) of the Longitudinal Study of Australian Children (B cohort: 0-5 years K cohort: 4-9 years). Language difficulties were defined as scores ≤ 1.25 SD below the mean on measures of parent-reported communication (0-3 years) and directly assessed vocabulary (4-9 years). Participant data were linked to administrative data on non-hospital healthcare attendances and prescription medications from the universal Australian Medicare subsidized healthcare scheme. It was found that healthcare costs over each 2-year age band were higher for children with than without language difficulties at 0-1, 2-3, and 4-5 years, notably 36% higher (mean difference = $AU206, 95% CI = $90, $321) at 4-5 years (B cohort). The slightly higher 2-year healthcare costs for children with language difficulties at 6-7 and 8-9 years were not statistically different from those without language difficulties. Modelled to the corresponding Australian child population, 2-year government costs ranged from $AU1.2-$AU12.1 million (depending on age examined). Six-year healthcare costs increased with the persistence of language difficulties in the K cohort, with total Medicare costs increasing by $192 (95% CI = $74, $311 p = .002) for each additional wave of language difficulties. Language difficulties (whether transient or persistent) were associated with substantial excess population healthcare costs in childhood, which are in addition to the known broader costs incurred through the education system. It is unclear whether healthcare costs were specifically due to the assessment and/or treatment of language difficulties, as opposed to conditions that may be co-morbid with or may cause language difficulties.
Publisher: Elsevier BV
Date: 12-2021
Publisher: Wiley
Date: 23-02-2021
Publisher: Wiley
Date: 24-07-2018
DOI: 10.1111/CCH.12600
Abstract: In a community s le of slow-to-talk toddlers, we aimed to (a) quantify how well maternal responsive behaviors at age 2 years predict language ability at age 4 and (b) examine whether maternal responsive behaviors more accurately predict low language status at age 4 than does expressive vocabulary measured at age 2 years. Prospective community-based longitudinal study. At child age 18 months, 1,138 parents completed a 100-word expressive vocabulary checklist within a population survey 251 (22.1%) children scored ≤20th percentile and were eligible for the current study. Potential predictors at 2 years were (a) responsive language behaviors derived from videotaped parent-child free-play s les and (b) late-talker status. Outcomes were (a) Clinical Evaluation of Language Fundamentals-Preschool Second Edition receptive and expressive language standard score at 4 years and (b) low language status (standard score > 1.25 standard deviations below the mean on expressive or receptive language). Two hundred eight (82.9% of 251) participants were retained to age 4. In adjusted linear regression analyses, maternal expansions predicted higher receptive (p < 0.001, partial R A combination of short measures of different dimensions, such as parent responsive behaviors, in addition to a child's earlier language skills increases the ability to predict language outcomes at age 4 to a precision that is approaching clinical value. Research to further enhance predictive values should be a priority, enabling health professionals to identify which slow-to-talk toddlers most likely will or will not experience later poorer language.
Publisher: Public Library of Science (PLoS)
Date: 04-08-2015
Publisher: Elsevier BV
Date: 09-2012
DOI: 10.1016/J.JFLUDIS.2012.03.002
Abstract: The topic of temperament and early stuttering and the extent to which it involves anxiety is theoretically and clinically relevant. The topic can contribute to theory development and clinical practices with early stuttering. We present a review of the empirical literature for this area with a view to determining which of two hypotheses might be true. The first is that, for the population of those who stutter, unusual temperament is a causal factor for the development of the disorder and its later association with anxiety. The second hypothesis is that for the population of those who stutter the developmental manifestation of anxiety is an effect of stuttering. Both hypotheses attempt to account for the well-known association of anxiety with chronic stuttering. A firm conclusion about the matter would be premature at present because the literature involved is limited and contains some inconsistencies. We suggest some quantitative and qualitative directions for future research. We argue also that the only way to resolve the matter is with longitudinal studies of cohorts ascertained prior to stuttering onset. Conclusive findings about the matter can only emerge when research extends beyond its modest scope of 10 interpretable publications. The reader will be able to: (a) describe temperament and the role it plays during anxiety development, (b) explain two alternative hypotheses which implicate temperament in early childhood stuttering (c) describe current knowledge regarding temperament similarities and differences between stuttering and control children, and (d) discuss the theoretical and clinical implications of understand the relationship between temperament, anxiety and early stuttering.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Start Date: 2011
End Date: 2013
Funder: Deutsche Forschungsgemeinschaft
View Funded ActivityStart Date: 2005
End Date: 2010
Funder: Australian Research Council
View Funded ActivityStart Date: 2016
End Date: 2021
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2019
End Date: 2022
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2005
End Date: 2007
Funder: Australian Research Council
View Funded ActivityStart Date: 2016
End Date: 2020
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2005
End Date: 2008
Funder: Australian Research Council
View Funded ActivityStart Date: 2009
End Date: 2011
Funder: Australian Research Council
View Funded ActivityStart Date: 2008
End Date: 2010
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2014
End Date: 2017
Funder: Economic and Social Research Council
View Funded ActivityStart Date: 2013
End Date: 2017
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2003
End Date: 2007
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2007
End Date: 2009
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2010
End Date: 2013
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2007
End Date: 2011
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2005
End Date: 2005
Funder: British Academy
View Funded ActivityStart Date: 2014
End Date: 2019
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2012
End Date: 2017
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2007
End Date: 2010
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2015
End Date: 2019
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2014
End Date: 2018
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2005
End Date: 2007
Funder: Friedreich's Ataxia Research Alliance
View Funded ActivityStart Date: 2017
End Date: 2021
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2016
End Date: 2020
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 04-2005
End Date: 02-2009
Amount: $260,000.00
Funder: Australian Research Council
View Funded ActivityStart Date: 03-2005
End Date: 03-2006
Amount: $71,901.00
Funder: Australian Research Council
View Funded ActivityStart Date: 01-2006
End Date: 12-2009
Amount: $160,000.00
Funder: Australian Research Council
View Funded ActivityStart Date: 2009
End Date: 12-2012
Amount: $334,000.00
Funder: Australian Research Council
View Funded ActivityStart Date: 07-2005
End Date: 06-2011
Amount: $272,000.00
Funder: Australian Research Council
View Funded Activity