Inferential comprehension of 3-6 year olds within the context of story grammar: a scoping review.

BACKGROUND: The ability to make inferences plays a crucial role in reading comprehension and the educational success of school-aged children. However, it starts to unfold much earlier than school entry and literacy. Given that it is likely to be targeted in speech language therapy, it would be useful for clinicians to have access to information about a developmental sequence of inferential comprehension. Yet, at this time, there is no clear proposition of the way in which this ability develops in young children prior to school entry. AIMS: To reduce the knowledge gap with regards to inferential comprehension in young children by conducting a scoping review of the literature. The two objectives of this research are: (1) to describe typically developing children's comprehension of causal inferences targeting elements of story grammar, with the goal of proposing milestones in the development of this ability; and (2) to highlight key elements of the methodology used to gather this information in a paediatric population. METHODS & PROCEDURES: A total of 16 studies from six databases that met the inclusion criteria were qualitatively analysed in the context of a scoping review. This methodological approach was used to identify common themes and gaps in the knowledge base to achieve the intended objectives. MAIN CONTRIBUTION: Results permit the description of key elements in the development of six types of causal inference targeting elements of story grammar in children between 3 and 6 years old. Results also demonstrate the various methods used to assess this ability in young children and highlight particularly interesting procedures for use with this younger population. CONCLUSIONS: These findings point to the need for additional studies to understand this ability better and to develop strategies to stimulate an evidence-based developmental sequence in children from an early age.

Inferential Comprehension Abilities in French-Speaking Preschoolers Exposed to Neglect in the Early Longitudinal Language and Neglect Study.

PURPOSE: Using a longitudinal design, this study aimed to describe inferential comprehension abilities of neglected French-speaking preschool children from 42 to 66 months of age in comparison to non-neglected peers, to examine the association with receptive vocabulary, and to determine whether rates of change in inferential abilities over time was stable between the two group conditions. METHOD: An inferential comprehension task and the French version of the Peabody Picture Vocabulary Test-Fourth Edition were administered to a group of neglected children (n = 37-40) and to a group of same-age non-neglected children (n = 71-91) at 42, 54, and 66 months old, as part of the Early Longitudinal Language and Neglect study. RESULTS: Results show that children exposed to neglect obtain significantly lower scores compared to their same-age peers on inferential comprehension and receptive vocabulary measures at all three time points (p < .001) with large to very large effect sizes and indicate moderate to strong correlations between the two variables. Children from the neglected group present difficulties in inferencing compared to same-age non-neglected peers, a disadvantage that remains stable over time. CONCLUSIONS: This study demonstrates the significant gap in inferential comprehension abilities between neglected and non-neglected preschool children. These results reiterate the importance of early detection of language comprehension difficulties in young children coming from vulnerable environments.

Relationship between COVID-19 pandemic-related experienced stress and lifestyle habits among university students from Québec, Canada.

Whether COVID-19-related experienced stress influenced lifestyle habits remains to be thoroughly evaluated among university students. This study examined the relationship between COVID-19-related experienced stress and subsequent lifestyle habits among undergraduate students. This cross-sectional study included 708 undergraduate students from Université Laval (Québec, Canada) participating in the Expériences Pandémiques (ExPan) cohort. Data on COVID-19-related experienced stress and lifestyle were self-reported using a questionnaire completed between February and April of 2022. A stress index (SI) was computed by summing scores associated with 31 situational statements related to the pandemic (e.g., not being able to see friends, dealing with job loss). A healthy lifestyle score (HLS) ranging from zero to seven was calculated based on seven lifestyle habits: moderate-to-vigorous physical activity, sleep quality, fruit and vegetable intake, tobacco and electronic cigarette use, alcohol consumption, cannabis use, and hard or sedative-hypnotic drugs use. In multivariable-adjusted models, a negative association between the SI and the HLS was found (ß10% increment SI = -0.23, 95% CI = -0.30, -0.16 HLS point; P < 0.0001). The SI was also negatively associated with sleep quality, and fruit and vegetable consumption, while being positively associated with at-risk alcohol consumption, cannabis use, and hard or sedative-hypnotic drug use. Subgroup analyses suggested a negative relationship between the SI and HLS among participants who did not receive academic accommodations (e.g., additional time for evaluations, personal notetaker), but not those who received such accommodations. This study suggests that COVID-19-related experienced stress was negatively associated with healthy lifestyle habits in this cohort of undergraduate students.

Intervention for improving comprehension in 4-6 year old children with specific language impairment: practicing inferencing is a good thing.

Few studies report on therapy to improve language comprehension in children with specific language impairment (SLI). We address this gap by measuring the effect of a systematic intervention to improve inferential comprehension using dialogic reading tasks in conjunction with pre-determined questions and cues. Sixteen children with a diagnosis of SLI aged 4-6 participated in 10 weekly treatment sessions carried out by their regular therapists. Baseline and maintenance periods were also tabulated. Two experimental measures and a standardized test revealed that children's total scores and the quality of their responses post-treatment were better than those obtained pre-treatment. However, perhaps due to the use of non-equivalent probes, this change could not be interpreted solely as a significant effect of intervention. These results nevertheless suggest that a systematically designed intervention focusing on the comprehension of specific types of questions requiring inferencing and using a carefully scaffolded cueing strategy can be beneficial.

Inclusion of autistic students: promising modalities for supporting a school team.

PURPOSE: School staff who work with autistic students are at a high risk of exhaustion. More training and guidance are needed to enable them to respond to these students' needs. The purpose of this study was to design and evaluate a professional development program offered by an occupational therapist to help a team of school staff facilitate the participation of autistic students and their peers. METHODS: A design-based research approach guided the development and evaluation of the modalities of the program. A case study was conducted in a school with nine school staff members using individual interviews, questionnaires, and a logbook. RESULTS: The program comprised five modalities: regular presence of the occupational therapist, a needs analysis, content focused on the features of an inclusive school, individual coaching, and team coaching. The following elements emerged as particularly helpful for the participants: frequent interactions with the occupational therapist, opportunities to collaborate, personalized support, experimentation of new practices with the occupational therapist, and concrete training content that can benefit all students. CONCLUSION: The modalities of the program appear promising to help a school team facilitate the participation of all students, including those who are autistic.Implications for rehabilitationOccupational therapists can help school teams to facilitate the participation of autistic students and their peers.A combination of individual and team coaching sessions appears promising in helping school staff adopt practice changes to make their school more inclusive.Using a multi-tiered approach can help therapists collaborate with school staff members to first find solutions that will be applicable with all of their students.

Design of Instructional Videos for People with Autism Who Want to Learn About Grocery Store Work: A Community, Business, Educational and Health Partnership.

To facilitate the integration of people with autism into the food industry labour market, this cross sectoral project aimed to design, validate and test instructional videos to concretely demonstrate various tasks in the grocery store, and to probe interest and assess knowledge about these tasks. Results are the delivery of 21 instructional videos validated for individuals with autism and 21 for mentors in grocery.

Young Adults With Developmental Language Disorder: A Systematic Review of Education, Employment, and Independent Living Outcomes.

Purpose Research on developmental language disorder (DLD) in adulthood has increased rapidly in recent years. However, to date, there has been no systematic literature review on this topic, thereby limiting the possibility to have a comprehensive overview of publications in this field. Method Following Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines, we conducted a systematic literature review. A literature search was undertaken in four databases, from 2005 to 2018. We selected articles with original data related to life outcomes of young adults with and without DLD, all aged between 18 and 34 years, in three life areas: education, employment, and independent living. Methodological characteristics of the studies were analyzed. Results Fifteen articles were selected with longitudinal designs. In every life area, young adults with DLD were compared to their typically developing peers to identify their strengths and weaknesses. The predictive role of language abilities was also examined. Conclusions Outcomes within each life area are heterogeneous. Nevertheless, similarly to young children and adolescents, young adults with DLD face numerous challenges. Although language abilities partly predict some of these outcomes, much of the variance remains unaccounted for and some outcomes are unrelated to this predictor. This systematic literature review has implications for researchers and practitioners to identify promising avenues for research, interventions, and policy development. Supplemental Material https://doi.org/10.23641/asha.13022552.

Autism spectrum disorder: How can occupational therapists support schools?

BACKGROUND.: Children with autism spectrum disorder (ASD) face multiple occupational challenges in their school, and school staff need additional support to increase their participation. PURPOSE.: The aim of this study is to identify how Response to Intervention (RTI) could be used by occupational therapists to support school personnel who work with children with ASD. METHOD.: In a descriptive qualitative study, three discussion groups were undertaken with occupational therapists and school staff members in Quebec, Canada, to identify the main concerns regarding the participation of children with ASD in school activities as well as the actions to consider when attempting to increase school-related abilities. FINDINGS.: School staff members are primarily concerned with frequent outbursts and limited autonomy, along with low motivation and anxiety in children with ASD in diverse school activities and contexts. The actions identified provide guidelines for school and occupational therapist selection, the process to follow, collaborative practices, and support required. IMPLICATIONS.: A practice model is presented for occupational therapists who seek to develop school capacity to support the participation of children with ASD.

Availability and Quality of Web Resources for Parents of Children With Disability: Content Analysis and Usability Study.

BACKGROUND: The internet is a valuable resource for parents of typical children, who are looking for information about their children's growth and development and how to boost them. However, for parents of children with special needs, especially for non-English-speaking parents, there are anecdotal reports stating that specific and accurate information is not available on the internet. OBJECTIVE: This study aims to describe the type of information available on the internet for French-speaking parents of children with disability as well as assess the quality of the information collected. METHODS: We carried out a search of the existing relevant websites targeted at parents of children with disability. We used a validated instrument to extract structural, textual, and visual characteristics of these websites and evaluate their usability. RESULTS: In all, 42 websites were analyzed; of these, the information had been validated by a trustworthy source in only 18 (43%) websites. Networking opportunities for parents were available in only 7 (17%) websites. Most websites provided information related to autism spectrum disorder (20/42, 42%) and learning disabilities (19/42, 45%), and only a few websites discussed other disability types such as behavorial disorders and developmental language disorders (4/42, 10% each). Community, social, and civic life (9/42, 22%); domestic life (12/42, 29%); and mobility (15/42, 36%) were the less frequently covered topics. With regard to the usability evaluation, 22 of the 42 (52%) websites received a global score <70%, whereas 20 (48%) scored ≥70. CONCLUSIONS: Although the internet is an infinite source of information, it is not necessarily actionable for parents of children with disability. Some information remains difficult to find online, and networking opportunities with other parents dealing with similar challenges are scarce.

Prediction of the outcome of children who had a language delay at age 2 when they are aged 4: Still a challenge.

PURPOSE: This study investigated the role that variables related to children and their environment play in the prediction of outcomes at 4 years of age for children with a language delay at 2 years. METHOD: A longitudinal study was undertaken where 64 children (45 boys, 19 girls; mean age = 53.3 months; SD = 4.4) with language delay at age 2 years were re-evaluated at age 4 years. Three developmental trajectories were analysed. RESULT: The early stages of grammar, as estimated by mean length of utterance at 3.5 years, are an important prognosis factor of subsequent language impairment (LI). Children who are exposed to several risk factors simultaneously are more likely to have a language delay (LD) or a LI, but the profile of LD children is more akin to that of the typically developing (TD) children. Children with LI tend to have profiles with a greater number of risk factors. CONCLUSION: The results of this study encourage different intervention approaches depending on the child's language profile at 2 years, due to differing language prognosis. The results also point to the need to assess the child's environment. Future studies with large diverse population samples may give more precise information on potential risk factors and their cumulative effect.

Comprehension of Inferences in a Narrative in 3- to 6-Year-Old Children.

Purpose: This study aimed to describe the development of inferential abilities of children age 3 to 6 years in a narrative using a dialogic reading task on an iPad. Method: Participants were 121 typically developing children, divided into 3 groups according to age range (3-4 years old, 4-5 years old, 5-6 years old). Total score of inferential comprehension, subscores by causal inference type targeting elements of the story grammar, and quality of response were examined across groups. Results: Inferential comprehension emerged early, from 3 to 4 years old, with considerable interindividual variability. Inferential comprehension scores increased significantly in relation to age, leading to developmental steps with regards to the type of causal inferences. The ability to infer the problem of the story, the internal response of a character, and predictions were easier starting at age 4 years. Then, the 5- to 6-year-olds were better able to infer the goal, the attempt to solve the problem, and the resolution. Last, between the ages of 3 and 6 years, children improved in terms of the quality of response they provided. Conclusion: This study addresses important gaps in our knowledge of inferential comprehension in young children and has implications for planning of early education in this realm.

An examination of clinicians' experiences of collaborative culturally competent service delivery to immigrant families raising a child with a physical disability.

PURPOSE: Although collaborative, culturally competent care has been shown to increase positive health outcomes and client satisfaction with services, little is known about the ways that clinicians implement service delivery models with immigrant families having a child with a disability. The purpose of this study is to examine the experiences of clinicians working with immigrant families raising a child with a physical disability and to examine the views and experiences of clinicians providing collaborative, culturally competent care to immigrant families raising a child with a physical disability. METHOD: This study draws on in-depth interviews with 43 clinicians within two pediatric centers in Toronto and Quebec. RESULTS: Our findings show that clinicians remove or create barriers for immigrant families in different ways, which affect their ability to provide culturally competent care for immigrant families raising a child with a physical disability. CONCLUSIONS: Our findings suggest that there is a need for more institutional support for collaborative, culturally competent care to immigrant families raising a child with a physical disability. There is a lack of formal processes in place to develop collaborative treatment plans and approaches that would benefit immigrant families. Implications for Rehabilitation Clinicians need greater institutional support and resources to spend more time with families and to provide more rehabilitative care in families' homes. Building rapport with families includes listening to and respecting families' views and experiences. Facilitate collaboration and culturally competent care by having team meetings with parents to formulate treatment plans.

The roles of effective communication and client engagement in delivering culturally sensitive care to immigrant parents of children with disabilities.

PURPOSE: Delivering pediatric rehabilitation services to immigrant parents of children with disabilities requires the practice of culturally sensitive care. Few studies have examined the specific nature of culturally sensitive care in pediatric rehabilitation, especially the notions of effective communication and client engagement. METHOD: Interviews were held with 42 therapists (10 social workers, 16 occupational therapists and 16 speech language pathologists) from two locations in Canada (Toronto and Quebec City). Data were analyzed using an inductive content analysis approach. RESULTS: Study themes included the importance and nature of effective communication and client engagement in service delivery involving immigrant parents. Participants discussed using four main types of strategies to engage immigrant parents, including understanding the family situation, building a collaborative relationship, tailoring practice to the client's situation and ensuring parents' understanding of therapy procedures. CONCLUSIONS: The findings illuminate the importance of effective, two-way communication in providing the mutual understanding needed by therapists to engage parents in the intervention process. The findings also richly describe the engagement strategies used by therapists. Clinical implications include recommendations for strategies for therapists to employ to engage this group of parents. Furthermore, the findings are applicable to service provision in general, as engaging families in a collaborative relationship through attention to their specific situation is a general principle of good quality, family-centered care. Implications for Rehabilitation Effective communication permeates the delivery of culturally sensitive care and provides mutual understanding, which is fundamental to client engagement. The findings illuminate the nature of "partnership" by indicating the role of collaborative therapist strategies in facilitating engagement. Four main strategies facilitate effective communication and client engagement, including understanding the family situation, building a collaborative relationship, tailoring practice to the client's situation and ensuring parents' understanding of therapy procedures. Engaging families in a collaborative relationship through attention to their specific situation is a general principle of good quality, family-centered care.

Sentence comprehension in postinstitutionalized school-age children.

PURPOSE: In this study, the authors investigated sentence comprehension and spatial working memory abilities in a sample of internationally adopted, postinstitutionalized (PI) children. The authors compared the performance of these PI children with that of an age-matched group of children living with their birth families. They hypothesized that PI children would perform below clinical threshold on tasks of sentence comprehension and that poor sentence comprehension would be associated with poor performance in working memory. METHOD: Twenty-three PI children and 36 comparison children were administered sentence comprehension and spatial memory tasks from standardized assessments. RESULTS: Some oral sentence comprehension skills and the spatial working memory skills were weaker in the school-age PI children than in the age-matched comparison children. A mediational analysis demonstrated that poor spatial working memory performance partially explains the sentence comprehension differences between the 2 groups. CONCLUSION: These findings provide valuable information to better plan early intervention and special education for PI children.

Three profiles of language abilities in toddlers with an expressive vocabulary delay: variations on a theme.

PURPOSE: The presence of an expressive vocabulary delay (EVD) in the context of otherwise harmonious development has been the main criterion used to define language delay in 2-year-olds. To better understand the communicative functioning of these children, other variables must be considered. In this study, the aim was to delineate and characterize clusters of 2-year-olds with EVD by measuring other language variables in these children. METHOD: Language and related variables were measured in 68 francophone children with EVD. RESULTS: In a cluster analysis, 2 language variables--(a) language expression and engagement in communication and (b) language comprehension--yielded 3 clusters ranging from weak language ability to high scores on both variables. Further differences were found between these clusters with regard to 2 correlates of lexical acquisition--namely, size of the expressive vocabulary and cognitive development. CONCLUSION: These results shed new light on the notion of heterogeneity in toddlers who present with an EVD by proposing subgroups among them. A follow-up investigation of these participants is ongoing.

Systematic review of the literature on characteristics of late-talking toddlers.

BACKGROUND: Research has investigated late-talking toddlers because they are at great risk of continuing to experience language-learning difficulties once they enter school and hence are candidates for early intervention. It is also important to consider this group of children with regards to the immediate characteristics which are detrimental to their development and for which early intervention has become increasingly available. AIMS: To review the literature on late-talking toddlers in order to identify the characteristics of this population whose importance has been clearly demonstrated, identify sources of incongruence in findings, and to underscore aspects of language delay at 2 years of age and characteristics about which additional knowledge is needed. MAIN CONTRIBUTION: The review highlights the need to define the language difficulties found in late-talking toddlers based on clinical profiles that go beyond the criterion of an expressive vocabulary delay. It also underscores the association between vocabulary delay and characteristics of the child such as social-emotional development and characteristics of the socio-familial environment such as language stimulation. CONCLUSIONS: Future research should take into account the lack of homogeneity observed within the population of children with a vocabulary delay at 2 years of age and attempt to identify subgroups within late-talking toddlers. It should also consider a multifactorial perspective of child development to further the understanding of this phenomenon.