Exploring early syntactic generalisation: evidence from a growth curve analysis of Spanish "se" constructions.

Children's early grammatical constructions, e.g., SVO, exhibit a learning curve with cumulative verb types (CVT) increasing exponentially. According to Ninio (2006), the fact that learning curves, though nonlinear, can be modelled by a continuous regression suggests instant generalisation. Moreover, differences in initial verbs across children indicate minimal involvement of semantics. This study tested these claims on the Spanish "se" constructions (SSCs) in two children, Juan and Lucía (Aguado-Orea & Pine, 2015). Ninio's findings were replicated. Nonetheless, exploratory analyses indicated that curves are driven by the temporal distribution of tokens (instances of the SSC irrespective of verb type) and therefore may reflect non-productivity-related mechanisms, e.g., retrieval-based learning. Furthermore, hapax verbs were relatively late to emerge in the children's data, suggesting emergent generalisation. Analyses of raw lexical frequencies indicated relative semantic homogeneity across the two children's verb types, suggesting a semantic prototype. Nonetheless, ecological factors may also explain these lexical similarities.

Evaluation of a Depression Intervention in People With HIV and/or TB in Eswatini Primary Care Facilities: Implications for Southern Africa.

INTRODUCTION: Depression associated with chronic illnesses is common in Southern Africa, yet there are major treatment gaps. This study assesses the feasibility and acceptability of the Healthy Activity Program intervention for depression among people with HIV and/or TB. The intervention involves training nonspecialist nurses in depression, including identification, counseling based on behavioral activation theory, and structured referral. METHODS: This is a mixed methods evaluation of a pilot counseling service integrated within routine HIV and TB care from 2018 to 2019. Participants included people living with HIV and/or patients with TB in rural Eswatini. RESULTS: A total of 324 people living with HIV and/or TB were screened for depression, with 19% (62/324) screening positive. The median number of sessions attended was 3 (interquartile range: 1-5), with 16/60 (26%) attending the minimum 5 sessions. Qualitative results indicated acceptability, but there were concerns about feasibility. CONCLUSIONS: The Healthy Activity Program is a promising option to manage the treatment gap for depression in people with HIV and/or TB. However, task-shifting to nonspecialist health care professionals without increasing staff capacity is a barrier to implementation. Realistic and pragmatic assessments of capacity and workforce are essential.

The development and roll-out of a new hydrocoele surgery facility assessment tool for the elimination of lymphatic filariasis.

A hydrocoele surgery facility assessment tool (HSFAT) was developed to assess the readiness of hydrocoele surgery services in health facilities prior to implementation of hydrocoele surgical campaigns for the elimination of lymphatic filariasis (LF). A first version of the tool was piloted in Bangladesh, Malawi and Nepal in 2019, then, following feedback from country programme managers, a second version of the tool was rolled out across countries implementing hydrocoele surgery in the Accelerating the Control of Neglected Tropical Diseases (Ascend) West and Central Africa Programme, including Benin, Burkina Faso, Ghana, Guinea, Niger and Nigeria. The HSFAT assessed facilities across 10 domains: background information, essential amenities, emergency patient transfer, laboratory capacity, surgical procedures and trained staff, infection prevention, non-disposable basic equipment, disposable basic equipment, essential medicines and current hydrocoele practices. The HSFAT results highlight key areas for improvement in different countries and can be used to develop a quality improvement plan, which may include actions with agreed deadlines to improve the readiness and quality of hydrocoele surgery services provided by the health facility, prior to implementation of surgical campaigns and assist country programmes to achieve the dossier requirements set out by the World Health Organization for the elimination of LF.

Collocational knowledge in children: a comparison of English-speaking monolingual children, and children acquiring English as an Additional Language.

Collocations, e.g., apples and pears, hard worker, constitute an important avenue of linguistic enquiry straddling both grammar and the lexicon. They are sensitive to language experience, with adult L2 learners and children learning English as an Additional Language (EAL) exhibiting poor collocational knowledge. The current study piloted a novel collocational assessment with children (mean age 6;3, 40 monolingual, 32 EAL). It investigated (1) the feasibility of a collocational assessment at this age, (2) whether collocational knowledge is associated with other language domains (receptive grammar and vocabulary), and (3) whether collocational knowledge is more affected than other domains. The assessment demonstrated good psychometric properties and was highly correlated with performance in other domains, indicating shared psycholinguistic mechanisms. Unlike adult counterparts, the EAL children performed equally poorly across domains. Given the role played by collocations in vocabulary development and reading, a focus on this domain may be beneficial for EAL children.

Decentralising NCD management in rural southern Africa: evaluation of a pilot implementation study.

BACKGROUND: The prevalence of non-communicable diseases, and associated morbidity and mortality, is increasing rapidly in low and middle-income countries where health systems often have limited access and lower quality of care. The intervention was to decentralise uncomplicated non-communicable disease (NCD) care from a hospital to nurse practitioners in health centres in a poor rural district in Eswatini, southern Africa. The objective of this study was to assess the feasibility and impact of decentralised care for NCDs within nurse-led clinics in order improve access and inform healthcare planning in Eswatini and similar settings. METHODS: In collaboration with the Eswatini Ministry of Health, we developed and implemented a package of interventions to support nurse-led delivery of care, including: clinical desk-guide for hypertension and diabetes, training modules, treatment cards and registries and patient leaflets. Ten community clinics in the Lubombo Region of Eswatini were randomly selected to be trained to deliver NCD care for a period of 18 months. Observational data on follow-up rates, blood pressure (BP), glucose etc. were recorded and evaluated. We compared blood pressure and blood glucose measurements between the first and fourth visits and fitted a linear mixed effects model. RESULTS: One thousand one hundred twenty-five patients were recruited to the study. Of these patients, 573 attended for at least 4 appointments. There was a significant reduction in mean BP among hypertensive patients after four visits of 9.9 mmHg systolic and 4.7 mmHg diastolic (p = 0.01), and a non-significant reduction in fasting blood glucose among diabetic patients of 1.2 mmol/l (p = 0.2). Key components of NCD care were completed consistently by nurses throughout the intervention period, including a trend towards patients progressing from monotherapy to dual therapy in accordance with prescribing guidelines. CONCLUSIONS: The findings suggest that management of diabetes and hypertension care in a rural district setting can be safely delivered by nurses in community clinics according to a shared care protocol. Improved access is likely to lead to improved patient compliance with treatment.

Complex sentence profiles in children with Specific Language Impairment: Are they really atypical?

Children with Specific Language Impairment (SLI) have language difficulties of unknown origin. Syntactic profiles are atypical, with poor performance on non-canonical structures, e.g. object relatives, suggesting a localized deficit. However, existing analyses using ANOVAs are problematic because they do not systematically address unequal variance, or fully model random effects. Consequently, a Generalised Linear Model (GLM) was used to analyze data from a Sentence Repetition (SR) task involving relative clauses. seventeen children with SLI (mean age 6;7), twenty-one Language Matched (LM) children (mean age 4;8), and seventeen Age Matched (AM) children (mean age 6;5) repeated 100 canonical and non-canonical sentences. ANOVAs found a significant Group by Canonicity interaction for the SLI versus AM contrast only. However, the GLM found no significant interaction. Consequently, arguments for a localized deficit may depend on statistical methods which are prone to exaggerate profile differences. Nonetheless, a subgroup of SLI exhibited particularly severe structural language difficulties.

Past tense -ed omissions by children with specific language impairment: The role of sonority and phonotactics.

Children with Specific Language Impairment (SLI) frequently omit past tense -ed. Omission rates are subject to phonological context. Two phonological characteristics were manipulated; the sonority profile of the stem-final phoneme plus affix, and the phonotactic probability of the word-final phonemes (/i:pt/ in beeped). Seventeen children with SLI (mean age 6;7) and 21 language-matched children (mean age 4;8) repeated sentences containing regularly inflected verbs according to a 2 (sonority) by 2 (phonotactic legality) design. Affix omissions were analysed. There was a significant effect of sonority only, characterised by a difficulty with level-sonority clusters, and no interaction. Syllabic affixes, e.g. head-ed, were produced relatively accurately. It is argued that -ed omissions in SLI may reflect a low-level speech or articulation difficulty which surfaces in uniquely challenging clusters. This is not an alternative to morphosyntactic accounts; rather past tense omissions are best explained according to complexity in multiple domains; syntactic, morpho-syntactic and phonological.

Two languages, two minds: flexible cognitive processing driven by language of operation.

People make sense of objects and events around them by classifying them into identifiable categories. The extent to which language affects this process has been the focus of a long-standing debate: Do different languages cause their speakers to behave differently? Here, we show that fluent German-English bilinguals categorize motion events according to the grammatical constraints of the language in which they operate. First, as predicted from cross-linguistic differences in motion encoding, bilingual participants functioning in a German testing context prefer to match events on the basis of motion completion to a greater extent than do bilingual participants in an English context. Second, when bilingual participants experience verbal interference in English, their categorization behavior is congruent with that predicted for German; when bilingual participants experience verbal interference in German, their categorization becomes congruent with that predicted for English. These findings show that language effects on cognition are context-bound and transient, revealing unprecedented levels of malleability in human cognition.

Sentence repetition in children with specific language impairment: an investigation of underlying mechanisms.

BACKGROUND: Sentence repetition (SR) is a reliable clinical marker of specific language impairment (SLI). However, little is known about cognitive processes underpinning SR, or areas of breakdown in children with SLI. AIMS: The study investigated which cognitive mechanisms were most closely involved in SR performance: syntactic knowledge, phonological short-term memory (STM) and working memory (WM). METHODS & PROCEDURES: Twenty-three children with SLI (mean age = 6;7), 18 age-matched (mean age = 6;5) and 21 language-matched children (mean age = 4;8) repeated 180 sentences of varying length and complexity. Total words omitted, added or substituted were counted. Assessments of syntactic knowledge using a structural priming task, and assessments of WM, and phonological STM, were conducted. Twenty sentences were presented in a delayed repetition condition to investigate the role of phonological STM. OUTCOMES & RESULTS: The children with SLI made more SR errors than controls and found delayed repetition especially difficult. Their SR errors were qualitatively similar to errors on other production tasks. In the SLI group, all assessments were good predictors, though the priming task was the strongest. In the control groups WM tasks were the best predictors, but the phonological STM task was a poor predictor. CONCLUSIONS & IMPLICATIONS: The data support a multifaceted view of SR with a role for syntactic knowledge, WM and STM. 'Redintegration', whereby long-term memory representations are used to maintain information in short-term memory, is likely to be a key process. Specific errors in the SLI group are likely to reflect difficulties with underlying syntactic representations. Children with SLI may be more dependent on phonological STM than typically developing children.

Interpretation of compound nouns by adolescents with specific language impairment and autism spectrum disorders: an investigation of phenotypic overlap.

The study aimed to investigate (i) whether adolescents with Specific Language Impairment (SLI) and Autism plus Language Impairment (ALI) experience word-formation difficulties, and (ii) whether these two groups present with a similar language phenotype. The study investigated four groups using a 2 (language status) ×2 (autism status) design; adolescents with SLI (n = 14), ALI (n = 16), Autism Language-Typical (ALT; n = 14), and language matched controls (n = 17), with all groups presenting with typical non-verbal skills. Mean age was 14;10. Comprehension of conventional Noun-Noun lexical compounds (e.g., snowman), synthetic compounds (SCs, e.g., cat chaser), and novel root compounds (RCs, e.g., sheep socks), was assessed using a forced-choice picture selection task. The SLI and ALI participants frequently mis-parsed the SCs, interpreting the first noun as the agent. Those with poorer vocabularies and non-word repetition had greater difficulties. Reaction time (RT) profiles were flatter in the ASD groups, with similar RTs across different compounds. Language difficulties in the SLI and ALI groups extend to word-formation processes; for example, comprehension of SCs. This may reflect difficulties making analogies with stored lexical items. Overall the results support the hypothesis of a phenotypic overlap between SLI and ALI.

Speech perception and phonological short-term memory capacity in language impairment: preliminary evidence from adolescents with specific language impairment (SLI) and autism spectrum disorders (ASD).

BACKGROUND: The cognitive bases of language impairment in specific language impairment (SLI) and autism spectrum disorders (ASD) were investigated in a novel non-word comparison task which manipulated phonological short-term memory (PSTM) and speech perception, both implicated in poor non-word repetition. AIMS: This study aimed to investigate the contributions of PSTM and speech perception in non-word processing and whether individuals with SLI and ASD plus language impairment (ALI) show similar or different patterns of deficit in these cognitive processes. METHOD & PROCEDURES: Three groups of adolescents (aged 14-17 years), 14 with SLI, 16 with ALI, and 17 age and non-verbal IQ matched typically developing (TD) controls, made speeded discriminations between non-word pairs. Stimuli varied in PSTM load (two- or four-syllables) and speech perception load (mismatches on a word-initial or word-medial segment). OUTCOMES & RESULTS: Reaction times showed effects of both non-word length and mismatch position and these factors interacted: four-syllable and word-initial mismatch stimuli resulted in the slowest decisions. Individuals with language impairment showed the same pattern of performance as those with typical development in the reaction time data. A marginal interaction between group and item length was driven by the SLI and ALI groups being less accurate with long items than short ones, a difference not found in the TD group. CONCLUSIONS & IMPLICATIONS: Non-word discrimination suggests that there are similarities and differences between adolescents with SLI and ALI and their TD peers. Reaction times appear to be affected by increasing PSTM and speech perception loads in a similar way. However, there was some, albeit weaker, evidence that adolescents with SLI and ALI are less accurate than TD individuals, with both showing an effect of PSTM load. This may indicate, at some level, the processing substrate supporting both PSTM and speech perception is intact in adolescents with SLI and ALI, but also in both there may be impaired access to PSTM resources.