Many speech-language pathologists (SLPs) are underprepared to serve children with autism spectrum disorders (ASDs), despite a growing need and increased expectation for ASD expertise. To understand ...this practice gap, 60 SLPs and 26 parents of children with ASDs were surveyed regarding SLP knowledge and competency. Of concern was that only about 50% of SLPs correctly identified ASD defining criteria. Respondents rated eight SLP practices as Important to Very Important, but SLPs reported being only Somewhat Competent to Competent. The parents’ rating of SLP competency was significantly lower than parental ratings of importance for one educational practice, use of nonstandardized assessment and observational methods. Also, parents rated the development of the Individualized Education Program significantly higher in importance than SLPs rated it. Findings varied for ASD specialty subgroups. Results support socially valid improvements in preparation for SLPs on the frontlines of assessment, treatment, and development of health and educational systems for children with ASDs.
Full text
Available for:
NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
Forty-eight toddlers participated in a word-learning task to assess gesture input on mapping nonce words to unfamiliar objects. Receptive fast mapping and expressive naming for target object-word ...pairs were tested in three conditions - with a point, with a shape gesture, and in a no-gesture, word-only condition. No statistically significant effect of gesture for receptive fast-mapping was found but age was a factor. Two year olds outperformed one year olds for both measures. Only one girl in the one-year-old group correctly named any items. There was a significant interaction between gesture and gender for expressive naming. Two-year-old girls were six times more likely than two-year-old boys to correctly name items given point and shape gestures; whereas, boys named more items taught with the word only than with a point or shape gesture. The role of gesture input remains unclear, particularly for children under two years and for toddler boys.
The need for effective services for persons with autism spectrum disorders (ASD) is driving efforts to better prepare teams of allied health professionals. To address this need, an interprofessional ...graduate course was piloted with students from three allied health professions: physical
therapy, occupational therapy, and speech-language pathology. The course aims were to address knowledge and competency in the field of ASD and to promote interprofessional abilities during entry-level preparation. Nine graduate students participated in weekly on-line education and attended
a day-long autism conference with local practitioners from seven different professions. Attitude changes toward interprofessional practice were assessed with two pre- to post-test Likert scales. Results revealed statistically significant increases in favorable ratings towards other disciplines
as well as for two interprofessional competency domains, interprofessional communication and teams and teamwork. A two-part measure yielding quantitative (Likert scales) and qualitative data (open-ended written responses) revealed a significant increase in ratings from pre- to post-test for
basic knowledge of ASD and increased specificity and confidence in the open-ended written responses. This course is one component of a broader initiative across campus, in the region, and statewide to better serve individuals with ASD.
Full text
Available for:
BFBNIB, NMLJ, NUK, PNG, UL, UM, UPUK
Acute respiratory distress syndrome (ARDS) is a severe, life-threatening form of respiratory failure characterized by pulmonary edema, inflammation, and hypoxemia due to reduced alveolar fluid ...clearance (AFC). Alveolar fluid clearance is required for recovery and effective gas exchange, and higher rates of AFC are associated with reduced mortality. Thyroid hormones play multiple roles in lung function, and L-3,5,3'-triiodothyronine (T3) has multiple effects on lung alveolar type II cells. T3 enhances AFC in normal adult rat lungs when administered intramuscularly and in normal or hypoxia-injured lungs when given intratracheally. The safety of a commercially available formulation of liothyronine sodium (synthetic T3) administered intratracheally was assessed in an Investigational New Drug Application-enabling toxicology study in healthy rats. Instillation of the commercial formulation of T3 without modification rapidly caused tracheal injury and often mortality. Intratracheal instillation of T3 that was reformulated and brought to a neutral pH at the maximum feasible dose of 2.73 µg T3 in 300 µl for 5 consecutive days had no clinically relevant T3-related adverse clinical, histopathologic, or clinical pathology findings. There were no unscheduled deaths that could be attributed to the reformulated T3 or control articles, no differences in the lung weights, and no macroscopic or microscopic findings considered to be related to treatment with T3. This preclinical safety study has paved the way for a phase I/II study to determine the safety and tolerability of a T3 formulation delivered into the lungs of patients with ARDS, including coronavirus disease 2019-associated ARDS, and to measure the effect on extravascular lung water in these patients. SIGNIFICANCE STATEMENT: There is growing interest in treating lung disease with thyroid hormone triiodothyronine (T3) in pulmonary edema and acute respiratory distress syndrome (ARDS). However, there is not any published experience on the impact of direct administration of T3 into the lung. An essential step is to determine the safety of multiple doses of T3 administered in a relevant animal species. This study enabled Food and Drug Administration approval of a phase I/II clinical trial of T3 instillation in patients with ARDS, including coronavirus disease 2019-associated ARDS (T3-ARDS ClinicalTrials.gov Identifier NCT04115514).
Identification of language disorders in children younger than 3 years remains challenging despite agreement that early intervention improves outcomes. This study of twin language and gesture ...development substantiated the twinning effect, an unexplained lag in expressive and receptive language seen in twins, for a group of 88, 16- to 18-month-old twins who did not present with extreme perinatal risk. A valid, parent-report measure revealed word production of 10th percentile and less for 15 twins. Pregnancy complications, but not a positive family history of speech, language, or learning disorders or other case history factors, significantly increased the odds of this early expressive delay. The twinning effect was more pronounced for gesture than for spoken vocabulary: 29 twins fell below gesture norms. This was unexpected. Because gesture signals early communicative intentionality, twins with early expressive delay who present with limited gestures, with or without additional risk factors, warrant priority consideration for early intervention.
Purpose: Effects of clicks and tonebursts on early and late auditory middle latency response (AMLR) components were evaluated in young and older cigarette smokers and nonsmokers. Method: Participants ...( n = 49) were categorized by smoking and age into 4 groups: (a) older smokers, (b) older nonsmokers, (c) young smokers, and (d) young nonsmokers. Monaural, 2-channel AMLRs were acquired from Fz and Cz electrodes with 3 stimuli (clicks, 500 Hz, and 3000 Hz). Results: Group differences included significantly higher V-Na amplitude in young adults and shorter Pb latency in older nonsmokers. Young smokers had a significantly higher Nb-Pb amplitude and shorter Nb latency than other groups. Toneburst stimuli yielded significantly longer V, Na, and Pa latencies compared to clicks. Pb latency was shorter at Fz than at Cz. Relative amplitudes were significantly higher at Fz than at Cz overall; Pa-Nb and Nb-Pb were significantly lower for 3000 Hz than for 500 Hz and clicks. Conclusions: Responses from young smokers revealed a higher amplitude and shorter latency for later AMLR waves, reflecting an arousal effect of smoking in cortical and subcortical generators. AMLR differences in older adults may be due to age-related neurochemical changes in the central nervous system. Stimulus and electrode differences plus smoking and aging effects can guide neurodiagnostic AMLR protocols, especially in young adult smokers.
Full text
Available for:
DOBA, IZUM, KILJ, NUK, ODKLJ, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Background
SNPs associated with C‐reactive protein (CRP) and plasma lipids have been investigated for polygenic overlap with Alzheimer’s disease (AD) risk SNPs. Previously, we reported pleiotropic ...effects between SNPs associated with cognitive impairment (CI) and SNPs associated with systemic inflammation as measured by CRP and plasma lipids in the Health and Retirement Study (HRS). We sought to replicate our results in the Women’s Health Initiative Memory Study (WHIMS).
Method
Analysis of SNP pleiotropic effects was completed using data from 6,078 non‐Hispanic White women (aged 71.4 SD 7.4 at baseline) for whom genetic, cognitive, and/or biomarker data were available. We identified CI using WHIMS adjudicated case status (normal vs. mild cognitive impairment or probable dementia). Secondary phenotypes included baseline CRP and plasma lipid levels (HDL, LDL, and total cholesterol TC). Genome‐wide association analyses were conducted for all phenotypes. A conditional false discovery rate framework defined genetic pleiotropy. Genetic pleiotropy was identified if SNPs were associated with CI conditional on association with secondary phenotypes (CRP, HDL, LDL, TC) at an FDR < 0.05. Functional genomic bioinformatics analysis and comparison with prior findings were conducted.
Result
Genetic pleiotropy was observed for CI conditional on association with the secondary phenotypes of plasma CRP, HDL, LDL, and TC. These results replicate associations for SNPs in the APOE, APOC1, PVRL2/NECTIN2 loci reported in the prior HRS study for CRP, LDL, TC. The odds ratios for the association of these SNPs with CI ranged from 0.5 to 4.0, consistent with moderate effect sizes for the APOE ε2 or ε4 alleles. For WHIMS, FDR significant results were observed in both directions for several of the traits (CRP, lipids), further supporting evidence of genetic pleiotropy. Moreover, we observed associations for SNPs in the APOE, APOC1, PVRL2/NECTIN2 loci for CI conditional on HDL.
Conclusion
We identified polygenic overlap between CI and CRP, LDL, HDL, and TC phenotypes in WHIMS, largely replicating prior results in the HRS. The variants and associated genes identified are involved in pathological processes including metabolic, cardiovascular, and immune response and are potentially important for AD risk prediction and development of therapeutic approaches based on anti‐inflammatory mechanisms.
Full text
Available for:
FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
The GeneXpert Dx system (Cepheid, Sunnyvale, CA) is a fully integrated and automated nucleic acid sample preparation, amplification, and real-time detection system. It consists of an instrument, a ...personal computer, and disposable fluidic cartridges. The analytical sensitivity and specificity of the GeneXpert enterovirus assay (GXEA) were determined with a panel of 63 different enterovirus serotypes and 24 other microorganisms, respectively. The potential for blood, hemoglobin, white blood cells, and excess protein to interfere with the assay was also assessed. The performance parameters of the GXEA were determined at three sites with 102 cerebrospinal fluid (CSF) samples obtained from patients with suspected meningitis. All samples were tested for enterovirus RNA with locally developed reverse transcription-PCR (RT-PCR) assays at the trial sites and with a seminested RT-PCR and an analyte-specific reagent (Cepheid) at a reference laboratory. The 5' nontranslated region was the target for all of the PCR assays except the seminested RT-PCR, which amplified a VP1 sequence. The VP1 amplicon was sequenced to identify the enterovirus types. Consensus reference laboratory RT-PCR results were used to classify cases of enteroviral meningitis. The GXEA detected all of the enterovirus serotypes and none of the other microorganisms tested except rhinovirus 16. The assay was unaffected by moderate amounts of blood or blood components. Thirty-six (35%) of the CSF samples tested had at least one positive PCR result. Eleven different enterovirus serotypes were identified in the positive samples. The GXEA had a sensitivity of 97.1% (95% confidence interval CI, 84.7 to 99.9%) and a specificity of 100% (95% CI, 94.6 to 100%) for the diagnosis of enteroviral meningitis.
Fast mapping weaknesses in children with specific language impairment (SLI) may be explained by differences in disambiguation, mapping an unknown word to an unnamed object. The impact of language ...ability and linguistic stimulus on disambiguation was investigated. Sixteen children with SLI (8 preschool, 8 school-age) and sixteen typically developing age-matched children selected referents given familiar and unfamiliar object pairs in three ambiguous conditions: phonologically distinct word (PD), phonologically similar word (PS), no word (NW). Preschoolers with SLI did not disambiguate, unlike typically developing age-matched participants, who consistently selected unfamiliar objects given PD. School-age children with SLI disambiguated given PD. Delays in disambiguation for young children with SLI suggest limitations in processes that facilitate word learning for typically developing children. School-age children with SLI consistently selected familiar objects for PS, unlike typically developing children, suggesting differences in phonological activation for word learning.
Teena M. McGuinness
University of Alabama, Birmingham
Debra J. Blanton
Bureau of Indian Affairs/Bureau of Indian Education, Crownpoint, NM
Contact author: Brenda L. Beverly, University of South ...Alabama, Speech Pathology and Audiology, 2000 University Commons, Mobile, AL 36688-0002. E-mail: bbeverly{at}usouthal.edu .
Purpose: This was a Time II survey of outcomes for children, now ages 9 to 13 years, who were almost 4 years old on average when they were adopted from the former Soviet Union.
Method: As part of a larger study (see T. McGuinness, R. Ryan, & C. Broadus Robinson, 2005), parents of 55 children ( M age = 11 years) were surveyed regarding their children's speech-language, behavior, and eligibility for special education. The children's mean length of institutionalization was 36 months.
Results: A total of 45, or 82%, of the children had at least one special education label. The most frequent was communication disorder, which was reported for 34 children, or 62%. The frequency of attention deficit hyperactivity disorder (ADHD) was high, 42%. The ratio of boys to girls for communication disorders and ADHD was 1.5:1. Girls who were adopted after 36 months of age were 4 times more likely than girls who were adopted before 36 months to be labeled ADHD, and children with low birth weight exhibited learning disabilities twice as often as children with normal birth weight.
Conclusion: Speech-language, learning, and attention deficits for late-adopted, early adolescent children were higher than expected. These children from the former Soviet Union experienced substantial preadoption adversity associated with lengthy orphanage stays and poor care. Gender and low birth weight were also factors.
KEY WORDS: international adoption, school-age children, language disorders, ADHD
CiteULike Connotea Del.icio.us Digg Facebook Reddit Technorati Twitter What's this?
Full text
Available for:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
PDF
