Eye tracking as an objective measure of hyperphagia in children with Prader-Willi syndrome.

This study examined sensitivity of eye tracking measures to hyperphagia severity in Prader-Willi syndrome (PWS). Gaze data were collected in 57 children with PWS, age 3-11 years, and 47 typically developing peers at two study sites during free visual exploration of complex stimulus arrays that included images of food, animals, and household objects. Analysis of the number and duration of fixations as well as gaze perseverations revealed that food items are not exceptionally salient for children with PWS. Instead, increased attention to food in the context of other high-interest items (e.g., animals) was associated with caregiver reports of more severe hyperphagia and more advanced nutritional phase. The study also provided preliminary evidence of possible genetic subtype and sex differences as well as demonstrated that multiple investigators in a wide range of settings can effectively implement the eye tracking protocol. The results indicate that gaze characteristics derived from eye tracking may be a promising objective marker of hyperphagia in PWS for use in research and clinical trials.

Validation of the Vanderbilt Responses to Your Child's Speech Rating Scale for Parents of Young Children Who Stutter.

PURPOSE: This study reports the development, refinement, and exploration of the psychometric properties of the Vanderbilt Responses to Your Child's Speech (VRYCS) rating scale, a novel measure designed to assess parents' self-perceived responses to the speech of their children who stutter (CWS). METHOD: Parents of 214 young (ages 2;4[years;months]-5;11) CWS completed the original 40-item version of the VRYCS. Content analyses and an exploratory factor analysis determined the scale's factors and identified specific items corresponding to each. Items that did not load onto the factors were removed and internal consistency was assessed. RESULTS: The final 18-item VRYCS rating scale includes five factors relating to parents' responses to the speech of their CWS including (a) Requesting Change, (b) Speaking for the Child, (c) Supporting Communication, (d) Slowing and Simplifying, and (e) Responding Emotionally. Reliability was demonstrated, responses by parents of CWS were described, and a revised scoring form developed. CONCLUSIONS: The VRYCS is a valid and reliable tool for assessing and exploring parents' perceptions of their own responses to the speech of their CWS for clinical and research purposes. Clinical applications of the VRYCS for assessment and treatment of childhood stuttering are discussed.

Visual food cue processing in children with Prader-Willi Syndrome.

Hyperphagia and the associated interest in food is a characteristic feature of Prader-Willi syndrome (PWS) that emerges during childhood and remains a life-long concern. This study examined neural responses reflecting food cue salience in children with PWS and typical controls, age 3-12 years. Visual event-related potentials were recorded while participants in satiated state passively viewed photographs of high- and low-calorie foods, animals, and neutral objects. Contrary to the prediction, children with PWS did not demonstrate greater than typical neural responses to food, suggesting that it is not an exceptionally motivationally salient stimulus in PWS. Caregiver reports of greater hyperphagia were associated with neural responses to low-calorie foods suggesting accelerated and more fine-grained visual stimulus categorization in terms of edibility and caloric content. Overall, the findings align more closely with the altered satiety rather than increased food reward models of hyperphagia in PWS.

Sympathetic arousal as a marker of chronicity in childhood stuttering.

PURPOSE: This study investigated whether sympathetic activity during a stressful speaking task was an early marker for stuttering chronicity. METHOD: Participants were 9 children with persisting stuttering, 23 children who recovered, and 17 children who do not stutter. Participants performed a stress-inducing picture-naming task and skin conductance was measured across three time points. RESULTS: Findings indicated that at the initial time point, children with persisting stuttering exhibited higher sympathetic arousal during the stressful speaking task than children whose stuttering recovered. CONCLUSIONS: Findings are taken to suggest that sympathetic activity may be an early marker of heightened risk for chronic stuttering.

Cortical associates of emotional reactivity and regulation in childhood stuttering.

PURPOSE: This study sought to determine the cortical associates of emotional reactivity and emotion regulation (as indexed by the amplitude of evoked response potentials [ERP]) in young children who do and do not stutter during passive viewing of pleasant, unpleasant and neutral pictures. METHOD: Participants were 17 young children who stutter and 22 young children who do not stutter (between 4 years 0 months to 6 years 11 months). The dependent measures were (1) mean amplitude of late positive potential (LPP, an ERP sensitive to emotional stimuli) during passive (i.e., no response required) picture viewing and directed reappraisal tasks and (2) emotional reactivity and regulation related scores on caregiver reports of young children's temperament (Children's Behavior Questionnaire, CBQ). RESULTS: Young CWS, when compared to CWNS, exhibited significantly greater LPP amplitudes when viewing unpleasant pictures, but no significant between-group difference when viewing pleasant pictures and during the emotion regulation condition. There were, however, for CWS, but not CWNS, significant correlations between temperament-related measures of emotion and cortical measures of emotional reactivity and regulation. CONCLUSIONS: Findings provide further empirical support for the notion that emotional processes are associated with childhood stuttering, and that CWS's inherent temperamental proclivities need to be taken into account when empirically studying or theorizing about this association.

Sympathetic arousal of young children who stutter during a stressful picture naming task.

PURPOSE: The purpose of the current study was to investigate sympathetic arousal of young children who do and do not stutter during a stressful picture-naming task under instructions to name pictures as rapidly as possible. METHOD: Thirty-seven young children who stutter (CWS) and 39 young children who do not stutter (CWNS) served as participants. Dependent measures consisted of tonic skin conductance during a pretask baseline, a stress-inducing rapid picture-naming task, and post-picture-naming task condition. RESULTS: Findings indicated that, when chronological age was not taken into account, there was no between-group difference in tonic skin conductance level. When age was taken into account, however, there was a significant talker group×age group interaction, with follow-up analyses indicating that 3-year-old CWS exhibited significantly higher sympathetic arousal than their CWNS peers, and their 4-year-old CWNS peers. CONCLUSIONS: Findings were taken to be consistent with non-physiological results indicating an association between emotional processes and childhood stuttering. This association, at least for this cross-sectional study of tonic skin conductance level (SCL) during a picture-naming task, was moderated by children's chronological age. Such developmental differences may be associated with various processes, for example, attention, cognition, or physiology, or some combination of two or more of these processes. Future empirical study of these processes in young CWS and CWNS may profit from longitudinal measurement of converging lines of evidence from behavioral, parent and psychophysiological indexes of emotional reactivity and regulation. EDUCATIONAL OBJECTIVES: After reading this article, the reader will be able to: (a) discuss salient findings in the literature regarding the association between emotional processes and childhood stuttering; (b) discuss sympathetic arousal, and how skin conductance is used to measure it; and (c) discuss the role of chronological age in the association between emotion and stuttering in young children.

Corpus callosum morphology in children who stutter.

UNLABELLED: Multiple studies have reported both functional and neuroanatomical differences between adults who stutter and their normally fluent peers. However, the reasons for these differences remain unclear although some developmental data suggest that structural brain differences may be present in school-age children who stutter. In the present study, the corpus callosum of children with persistent stuttering, children who recovered from stuttering and typically developing children between 9 and 12 years of age was compared to test if the presence of aberrant callosal morphology is implicated in this disorder. The total corpus callosum midsagittal area and area of each subsection consisting of the rostrum, anterior midbody, posterior midbody and splenium were measured using MIPAV (Medical Image Processing, Analysis, and Visualization). Voxel-based morphometry (VBM) was also used to compare white matter volume. No differences were detected in the corpus callosum area or white matter volume between children with persistent stuttering, children who recovered from stuttering and typically developing children. These results agree with dichotic listening studies that indicate children who stutter show the typical right ear advantage. Therefore, the neural reorganization across the midline shown in adults who stutter may be the result of long-term adaptations to persistent stuttering. EDUCATIONAL OBJECTIVES: After reading this article, the reader will be able to: (1) summarize research findings on corpus callosum development; and (2) discuss the characteristics of corpus callosum anatomy in stuttering.