Longitudinal associations between parental mathematics anxiety and attitudes and young children's mathematics attainment.

The associations between parental mathematics anxiety and attitudes and children's mathematics attainment in early primary school were explored. Initially, parents of preschool children (Mage = 3;11 [years;months]) completed a questionnaire indexing parental mathematics anxiety and attitudes and the frequency of preschool home number experiences. The children completed mathematics assessments in their first year (n = 231, Mage = 5;2) and second year (n = 119, Mage = 6;3) of schooling and a mathematics anxiety questionnaire in their third year of schooling (n = 119, Mage = 6;7). A questionnaire indexing the frequency of primary school home number experiences was completed by 119 of the parents in their children's second year of schooling (Mage = 6;0). All indices of parental mathematics anxiety and attitudes predicted children's mathematics attainment in their first school year. These associations were independent of parental mathematics attainment and were not mediated by the frequency of preschool home number experiences. Furthermore, the positive association between preschool home number experiences and children's mathematics attainment was not weaker in the context of high parental mathematics anxiety or negative parental mathematics attitudes. One index of parental mathematics attitudes predicted children's mathematics attainment in their second school year, but this association was not significant when prior attainment was controlled. There was a stronger association between maternal mathematics anxiety and girls' attainment versus boys' attainment. Parental mathematics anxiety did not predict children's mathematics anxiety. The findings suggest that children whose parents have high mathematics anxiety or negative mathematics attitudes are more likely to have lower mathematics attainment in their first year of school. However, the mechanism underpinning this association is not yet established.

Ventilation in Extremely Preterm Infants and Respiratory Function at 8 Years.

BACKGROUND: Assisted ventilation for extremely preterm infants (<28 weeks of gestation) has become less invasive, but it is unclear whether such developments in care are associated with improvements in short-term or long-term lung function. We compared changes over time in the use of assisted ventilation and oxygen therapy during the newborn period and in lung function at 8 years of age in children whose birth was extremely premature. METHODS: We conducted longitudinal follow-up of all survivors of extremely preterm birth who were born in Victoria, Australia, in three periods - the years 1991 and 1992 (225 infants), 1997 (151 infants), and 2005 (170 infants). Perinatal data were collected prospectively, including data on the duration and type of assisted ventilation provided, the duration of oxygen therapy, and oxygen requirements at 36 weeks of age. Expiratory airflow was measured at 8 years of age, and values were converted to z scores for age, height, ethnic group, and sex. RESULTS: The duration of assisted ventilation rose substantially over time, with a large increase in the duration of nasal continuous positive airway pressure. Despite the increase in the use of less invasive ventilation over time, the duration of oxygen therapy and the rate of oxygen dependence at 36 weeks rose, and airflows at 8 years of age were worse in 2005 than in earlier periods. For instance, for 2005 versus 1991-1992, the mean difference in the z scores for the ratio of forced expiratory volume in 1 second to forced vital capacity was -0.75 (95% confidence interval [CI], -1.07 to -0.44; P<0.001), and for 2005 versus 1997 the mean difference was -0.53 (95% CI, -0.86 to -0.19; P=0.002). CONCLUSIONS: Despite substantial increases in the use of less invasive ventilation after birth, there was no significant decline in oxygen dependence at 36 weeks and no significant improvement in lung function in childhood over time. (Funded by the National Health and Medical Research Council of Australia and the Victorian Government's Operational Infrastructure Support Program.).

How to interpret polysomnography.

A 5-year-old child presents to a paediatric clinic with their parents because of concerns about snoring, which is loud, every night and associated with respiratory pauses. This has been present for 6 months. Can clinical evaluation diagnose sleep-disordered breathing in children or are further investigations required? Should further investigations include oximetry or polysomnography? If a polysomnogram is performed, how are the results interpreted? In this paper we describe the indications for polysomnography, outline the parameters measured and decode a clinical polysomnography report.

Increasing airway obstruction from 8 to 18†years in extremely preterm/low-birthweight survivors born in the surfactant era.

BACKGROUND: The evolution of airway obstruction into late adolescence of extremely preterm (gestational age <28 weeks) or extremely low-birthweight (birth weight <1000 g) survivors in the era after surfactant was introduced is unclear. OBJECTIVE: To compare changes in spirometry from 8 to 18 years of age of a geographical cohort of preterm survivors with normal birth weight controls, and to determine higher risk groups within the preterm cohort. METHODS: Of 297 extremely preterm/low-birthweight survivors born in 1991-1992 in the state of Victoria, Australia, 81% and 70% had spirometry at 8 and 18 years of age, respectively. Corresponding rates among 260 normal birth weight controls were 80% and 58%, respectively. Data were analysed using linear mixed models. RESULTS: The preterm group had substantial impairments in airflow at both ages compared with controls (eg, mean differences in z-score for FEV1; 8 years -1.02, 95% CI -1.21 to -0.82; 18 years -0.92, 95% CI -1.14 to -0.71). The preterm group had a greater increase in small airway obstruction between 8 and 18 years compared with controls. Within the preterm group, those who had bronchopulmonary dysplasia in the newborn period and those who were smokers at 18 years had airway obstruction that increased over time compared with those who did not. CONCLUSIONS: Preterm survivors born in the surfactant era had significant impairments in airflow through childhood into late adolescence that increased over time compared with controls. At-risk preterm participants include those who had bronchopulmonary dysplasia, and smokers at 18 years.

Lung Clearance Index and Structural Lung Disease on Computed Tomography in Early Cystic Fibrosis.

RATIONALE: The lung clearance index is a measure of ventilation distribution derived from the multiple-breath washout technique. It has been suggested as a surrogate for chest computed tomography to detect structural lung abnormalities in individuals with cystic fibrosis (CF); however, the associations between lung clearance index and early structural lung disease are unclear. OBJECTIVES: We assessed the ability of the lung clearance index to reflect structural lung disease on the basis of chest computed tomography across the entire pediatric age range. METHODS: Lung clearance index was assessed in 42 infants (ages 0-2 yr), 39 preschool children (ages 3-6 yr), and 38 school-age children (7-16 yr) with CF before chest computed tomography and in 72 healthy control subjects. Scans were evaluated for CF-related structural lung disease using the Perth-Rotterdam Annotated Grid Morphometric Analysis for Cystic Fibrosis quantitative outcome measure. MEASUREMENTS AND MAIN RESULTS: In infants with CF, lung clearance index is insensitive to structural disease (κ = -0.03 [95% confidence interval, -0.05 to 0.16]). In preschool children with CF, lung clearance index correlates with total disease extent. In school-age children, lung clearance index correlates with extent of total disease, bronchiectasis, and air trapping. In preschool and school-age children, lung clearance index has a good positive predictive value (83-86%) but a poor negative predictive value (50-55%) to detect the presence of bronchiectasis. CONCLUSIONS: These data suggest that lung clearance index may be a useful surveillance tool to monitor structural lung disease in preschool and school-age children with CF. However, lung clearance index cannot replace chest computed tomography to screen for bronchiectasis in this population.

Early respiratory infection is associated with reduced spirometry in children with cystic fibrosis.

RATIONALE: Pulmonary inflammation, infection, and structural lung disease occur early in life in children with cystic fibrosis. OBJECTIVES: We hypothesized that the presence of these markers of cystic fibrosis lung disease in the first 2 years of life would be associated with reduced lung function in childhood. METHODS: Lung function (forced expiratory volume in the first three-quarters of a second [FEV0.75], FVC) was assessed in individuals with cystic fibrosis diagnosed after newborn screening and healthy subjects during infancy (0-2 yr) and again at early school age (4-8 yr). Individuals with cystic fibrosis underwent annual bronchoalveolar lavage fluid examination, and chest computed tomography. We examined which clinical outcomes (pulmonary inflammation, infection, structural lung disease, respiratory hospitalizations, antibiotic prophylaxis) measured in the first 2 years of life were associated with reduced lung function in infants and young children with cystic fibrosis, using a mixed effects model. MEASUREMENTS AND MAIN RESULTS: Children with cystic fibrosis (n = 56) had 8.3% (95% confidence interval [CI], -15.9 to -6.6; P = 0.04) lower FEV0.75 compared with healthy subjects (n = 18). Detection of proinflammatory bacterial pathogens (Pseudomonas aeruginosa, Staphylococcus aureus, Haemophilus influenzae, Aspergillus species, Streptococcus pneumoniae) in bronchoalveolar lavage fluid was associated with clinically significant reductions in FEV0.75 (ranging between 11.3 and 15.6%). CONCLUSIONS: The onset of lung disease in infancy, specifically the occurrence of lower respiratory tract infection, is associated with low lung function in young children with cystic fibrosis. Deficits in lung function measured in infancy persist into childhood, emphasizing the need for targeted therapeutic interventions in infancy to maximize functional outcomes later in life.

Identifying the cognitive predictors of early counting and calculation skills: Evidence from a longitudinal study.

The extent to which phonological, visual-spatial short-term memory (STM), and nonsymbolic quantitative skills support the development of counting and calculation skills was examined in this 14-month longitudinal study of 125 children. Initial assessments were made when the children were 4 years 8 months old. Phonological awareness, visual-spatial STM, and nonsymbolic approximate discrimination predicted growth in early calculation skills.These results suggest that both the approximate number system and domain-general phonological and visual-spatial skills support early calculation. In contrast, only performance on a small nonsymbolic quantity discrimination task (where the presented quantities were always within the subitizing range) predicted growth in cardinal counting skills. These results suggest that the development of counting and the development of calculation are supported by different cognitive abilities.

The impact of the development of verbal recoding on children's early writing skills.

BACKGROUND: The spontaneous recoding of visual stimuli into a phonological code to aid short-term retention has been associated with progress in learning to read (Palmer, 2000b). AIM: This study examined whether there was a comparable association with the development of writing skills. SAMPLE: One hundred eight children (64 males) in the second year of the UK educational system (mean age 5:8 years, SD = 4 months) were recruited to the study. METHODS: The children participated in tasks to assess their general cognitive abilities, reading skills, and their predominant short-term memory (STM) strategy for retaining visually presented stimuli. On the basis of their memory profile, children were classified as either engaging in verbal recoding of the stimuli (N = 31) or not (N = 77). Writing performance was indexed as alphabet transcription, spelling, and early text production skills. RESULTS: Children classified as verbal recoders demonstrated better spelling performance and produced more individual letters, words, and T-units in their texts than did children who persisted with a visual memory strategy. In contrast, the alphabet transcription abilities of the groups did not differ. Hierarchical regression analyses revealed that variance in text production skills was associated with STM capacity and that moreover, significant independent variance in the number of words and T-units in the children's texts was predicted by individual differences in verbal recoding abilities. CONCLUSION: The results suggest that the development of verbal recoding skills in STM may play a role in children's early progress in writing, particularly their text generation skills.

Different components of working memory have different relationships with different mathematical skills.

A comprehensive working memory battery and tests of mathematical skills were administered to 90 children-41 in Year 1 (5-6 years of age) and 49 in Year 3 (7-8 years of age). Working memory could explain statistically significant variance in number writing, magnitude judgment, and single-digit arithmetic, but the different components of working memory had different relationships with the different skills. Visual-spatial sketchpad (VSSP) functioning predicted unique variance in magnitude judgments and number writing. Central executive functioning explained unique variance in the addition accuracy of Year 1 children. The unique variance explained in Year 3 multiplication explained by phonological loop functioning just missed conventional levels of significance (p=.06). The results are consistent with the VSSP having a role in the development of number writing and magnitude judgments but a lesser role in early arithmetic.

Telehealth-supported level 2 pediatric home polysomnography.

STUDY OBJECTIVES: The gold standard for diagnosis of pediatric obstructive sleep apnea (OSA) is level 1 polysomnography (PSG). At our centre, some children are selected for unattended level 2 home sleep apnea testing (HSAT) with telehealth support, and we sought to review this home service. METHODS: A retrospective audit was conducted from 2013 to 2020. All level 2 HSAT reports in children aged 5-18 years referred for suspected OSA were analyzed. American Academy of Sleep Medicine-compliant portable PSG acquisition equipment with electroencephalogram was used. The primary outcome was the proportion of technically successful tests achieved, and of these, the percentage with potential underestimation of diagnostic category. Secondary outcomes included sleep quality and parental acceptance by nonvalidated service-specific questionnaire. Data were analyzed using descriptive and inferential statistics. χ2 tests were used for categorical variables. RESULTS: There were 233 (139 male, 59.6%) patients studied between 2013 and 2020 (7 years). The mean age was 10.8 (standard deviation 3.6) years. Sixty-seven patients (28.8%) had comorbidities. Technically successful studies were obtained in almost 90% (209/233) and failed studies occurred in just over 10% (24/233). One failed study still achieved a diagnosis. There was no significant difference between failed studies set up by hospital-in-the-home nurses compared with sleep scientists (P = .2). Overall, an accurate diagnosis was made in 80% (167/209) of patients, with potential for underestimation in 20% (42/209). Six hours or more of sleep was obtained in 89.5%. Parental questionnaires revealed 89.3% perceived high-level care, 91% perceived increased convenience, and 76% perceived good/excellent telehealth support. CONCLUSIONS: Telehealth-supported pediatric HSAT achieves technical success in almost 90% of patients investigated for OSA, with 89.5% achieving ≥ 6 hours sleep duration and excellent family acceptability. CITATION: Griffiths A, Mukushi A, Adams A-M. Telehealth-supported level 2 pediatric home polysomnography. J Clin Sleep Med. 2022;18(7):1815-1821.

Shallow or deep? The impact of orthographic depth on visual processing impairments in developmental dyslexia.

The extent to which impaired visual and phonological mechanisms may contribute to the manifestation of developmental dyslexia across orthographies of varying depth has yet to be fully established. By adopting a cross-linguistic approach, the current study aimed to explore the nature of visual and phonological processing in developmental dyslexic readers of shallow (Italian) and deep (English) orthographies, and specifically the characterisation of visual processing deficits in relation to orthographic depth. To achieve this aim, we administered a battery of non-reading visual and phonological tasks. Developmental dyslexics performed worse than typically developing readers on all visual and phonological tasks. Critically, readers of the shallow orthography were disproportionately impaired on visual processing tasks. Our results suggest that the impaired reading and associated deficits observed in developmental dyslexia are anchored by dual impairments to visual and phonological mechanisms that underpin reading, with the magnitude of the visual deficit varying according to orthographic depth.

Double Trouble: Visual and Phonological Impairments in English Dyslexic Readers.

Developmental dyslexia is a reading disorder characterized by problems in accurate or fluent reading. A deficiency in phonological processing is thought to underpin the reading difficulties of individuals with developmental dyslexia and a variety of explanations have been proposed including deficits in phonological awareness and verbal memory. Recent investigations have begun to suggest that developmental deficits in the acquisition of reading may also co-occur with visual processing deficits, which are particularly salient for visually complex stimuli, yet these deficits have received relatively little attention from researchers. To further explore the nature of phonological and visual processing in developmental dyslexia, we administered a series of non-reading tasks tapping both domains. Unsurprisingly, individuals with developmental dyslexia performed worse than typically developing readers in phonological tasks. More intriguingly, they also struggled with visual tasks, specifically when discriminating between novel visual patterns, and in visuo-spatial working memory, which requires greater attentional control. These findings highlight that individuals with developmental dyslexia present not only with phonological impairments but also difficulties in processing visual materials. This aspect has received limited attention in previous literature and represents an aspect of novelty of this study. The dual phonological and visual impairments suggest that developmental dyslexia is a complex disorder characterized by deficits in different cognitive mechanisms that underpin reading.

Working memory in children with reading disabilities.

This study investigated associations between working memory (measured by complex memory tasks) and both reading and mathematics abilities, as well as the possible mediating factors of fluid intelligence, verbal abilities, short-term memory (STM), and phonological awareness, in a sample of 46 6- to 11-year-olds with reading disabilities. As a whole, the sample was characterized by deficits in complex memory and visuospatial STM and by low IQ scores; language, phonological STM, and phonological awareness abilities fell in the low average range. Severity of reading difficulties within the sample was significantly associated with complex memory, language, and phonological awareness abilities, whereas poor mathematics abilities were linked with complex memory, phonological STM, and phonological awareness scores. These findings suggest that working memory skills indexed by complex memory tasks represent an important constraint on the acquisition of skill and knowledge in reading and mathematics. Possible mechanisms for the contribution of working memory to learning, and the implications for educational practice, are considered.

A structural analysis of working memory and related cognitive skills in young children.

The aim of this study was to investigate the functional organisation of working memory and related cognitive abilities in young children. A sample of 633 children aged between 4 and 6 years were tested on measures of verbal short-term memory, complex memory span, sentence repetition, phonological awareness, and nonverbal ability. The measurement model that provided the best fit of the data incorporates constructs that correspond to the central executive, phonological loop, and episodic buffer subcomponents of working memory, plus distinct but associated constructs associated with phonological awareness and nonverbal ability.