Psychometric Validation of a Hearing Screening Questionnaire for Preschoolers based on language development evaluation by caregivers.

INTRODUCTION: This study aimed to validate three age-adjusted versions of a Hearing Screening Questionnaire for Preschoolers, in Brazilian Portuguese, based on parents' perception of their children's hearing and oral language. METHODS: Psychometric validation was conducted on three questionnaires, each comprising nine items with Yes/No responses. Three items focused on hearing screening at birth, and six assessed hearing and oral language. The study included 152 parents and their children, who attended day care centers in Belo Horizonte, Brazil. The children were categorized into three age bands: 12 to 18 months, 19 to 35 months, and 36 to 48 months. Audiological assessments, including tympanometry, transient-evoked otoacoustic emissions (TOAE) and pure-tone audiometry (when applicable), were performed on the children. In case of abnormal findings in the previous exams, auditory brainstem response (ABR) testing was conducted. Descriptive data, false alarm, and false-negative analyses were carried out. RESULTS: Considering any type of hearing loss, whether unilateral or bilateral, the questionnaires showed a false-negative rate of 41.17% (7/17 children). However, when considering only bilateral hearing loss, the questionnaire showed a false alarm rate of 31.69% (45/142) and a false-negative rate of 30.0% (3/10). When focusing exclusively on sensorineural hearing loss, the questionnaire identified two children (1.31%), with a false-negative rate of 0% but a false-positive rate of 33.33%. CONCLUSION: Language-development oriented questionnaires allowed quick screening of potential hearing loss in preschoolers. This study found a robust hit rate with these questionnaires. Their validation signifies a promising and cost-effective tool for conducting hearing screenings in preschool children, especially in nations lacking a comprehensive school screening policy.The validated questionnaire affords an easy-to-apply, low-cost and effective instrument for preschool hearing screening.

Autism and Down syndrome: early identification and diagnosis.

BACKGROUND: The diagnosis of autism spectrum disorder (ASD) in Down syndrome (DS) is underestimated because it is necessary to understand which aspects of the behavioral phenotype are related to DS and which are related to ASD. Objective: To conduct a systematic review of the literature on early identification and diagnosis of ASD in patients with DS. Data source: The VHL, MEDLINE, Cochrane, CINAHL, Scopus, Web of Science and Embase databases were searched and data were evaluated using PRISMA. Data synthesis: Out of 1,729 articles evaluated, 15 were selected. Although well studied, identification of ASD in DS can be difficult because of the need to understand which aspects of the behavioral phenotype are related to Down syndrome and which to autism. In this review, the prevalence of ASD was found to range from 12% to 41%. Early identification of autism risk in individuals with Down syndrome is still poorly studied, even though there are screening instruments for infants. Several instruments for diagnosing autism in individuals with Down syndrome were found, but a developmental approach is fundamental for making a clear diagnosis. Conclusions: Screening procedures are important for detecting early signs of autism risk in the first year of life. Careful evaluation methods are needed to establish the diagnosis, which include choosing appropriate tools for evaluation of development and cognition, and analysis of qualitative aspects of social interaction, among others. It has been indicated in the literature that early detection and timely accurate diagnosis, in association with an intervention, may benefit development, quality of life and social inclusion.

Autism and Down syndrome: early identification and diagnosis / Autismo e síndrome de Down: identificação precoce e diagnóstico

ABSTRACT Background: The diagnosis of autism spectrum disorder (ASD) in Down syndrome (DS) is underestimated because it is necessary to understand which aspects of the behavioral phenotype are related to DS and which are related to ASD. Objective: To conduct a systematic review of the literature on early identification and diagnosis of ASD in patients with DS. Data source: The VHL, MEDLINE, Cochrane, CINAHL, Scopus, Web of Science and Embase databases were searched and data were evaluated using PRISMA. Data synthesis: Out of 1,729 articles evaluated, 15 were selected. Although well studied, identification of ASD in DS can be difficult because of the need to understand which aspects of the behavioral phenotype are related to Down syndrome and which to autism. In this review, the prevalence of ASD was found to range from 12% to 41%. Early identification of autism risk in individuals with Down syndrome is still poorly studied, even though there are screening instruments for infants. Several instruments for diagnosing autism in individuals with Down syndrome were found, but a developmental approach is fundamental for making a clear diagnosis. Conclusions: Screening procedures are important for detecting early signs of autism risk in the first year of life. Careful evaluation methods are needed to establish the diagnosis, which include choosing appropriate tools for evaluation of development and cognition, and analysis of qualitative aspects of social interaction, among others. It has been indicated in the literature that early detection and timely accurate diagnosis, in association with an intervention, may benefit development, quality of life and social inclusion.

RESUMO Antecedentes: O diagnóstico de autismo na síndrome de Down é subestimado, sendo necessário entender quais aspectos do fenótipo comportamental estão relacionados à síndrome de Down e quais são do autismo. Objetivo: Revisão Sistemática da Literatura sobre identificação precoce e diagnóstico do Transtorno do Espectro Autista em pacientes com síndrome de Down. Fonte de dados: Busca nas bases BVS, MEDLINE, Cochrane, CINAHL, Scopus, Web of Science e Embase e avaliação pelo PRISMA. Síntese dos dados : De 1.729 artigos avaliados, foram selecionados 15. Apesar de ser bastante estudada, a identificação do transtorno do espectro do autismo na síndrome de Down pode ser difícil devido a compreensão de quais aspectos do fenótipo comportamental estão relacionados à síndrome de Down e quais são do autismo. Nessa revisão foi encontrada variação na prevalência de 12% a 41%. A identificação precoce de risco de autismo na síndrome de Down é pouco estudada mesmo existindo instrumentos de triagem para lactentes. Sobre o diagnóstico do autismo na síndrome de Down foram encontrados diversos instrumentos, mas é necessária abordagem desenvolvimental para um diagnóstico apurado. Conclusões: É destacada a importância de procedimentos de triagem de sinais precoces de risco de autismo ainda no primeiro ano de vida. São para estabelecimento do diagnóstico a escolha de instrumentos para a avaliação do desenvolvimento e cognição, análise dos aspectos qualitativos da interação social, dentre outros. A detecção precoce e o diagnóstico preciso no tempo correto e uma intervenção poderão beneficiar o desenvolvimento, a qualidade de vida e inclusão social.

The Effects of Prenatal Diagnosis on the Interaction of the Mother-Infant Dyad: A Longitudinal Study of Prenatal Care in the First Year of Life.

Introduction: Mother-child interactions during the first years of life have a significant impact on the emotional and cognitive development of the child. In this work, we study how a prenatal diagnosis of malformation may affect maternal representations and the quality of these early interactions. To this end, we conducted a longitudinal observational study of mother-child interactions from the gestational stage until the baby completed 12 months of age. Participants and Methods: We recruited 250 pregnant women from a local university hospital. Among them, 50 mother-infant dyads participated in all stages of the study. The study group consisted of 25 pregnant women with fetuses with some structural alteration and the control group consisted of 25 pregnant women with fetuses without structural anomalies. We collected obstetric and socio demographic data and pregnancy outcomes. Anxiety and depressive state data were collected using the COVI and Raskin Scales. We video-recorded the mother-infant interactions during several stages, including when the child was a newborn and when the child was 2, 4, 6, 9, and 12 months of age. The quality of the mother infant interactions were measured using the Coding Interactive Behavior (CIB). The interactive moments recorded on video was composed of three different activities, each one lasting appoximately 3 min, which included (1) Free Interaction, where the mother was instructed to interact "as usual" without any toy, (2) Toy Interaction, where the mother and baby played with a puppv, and (3) Song Interaction, where the mother and baby interacted while the mother sang the "Happy Birthday" song. Results: In the gestational phase, there was a significant difference between the groups with respect to anxiety and depression scores, which were significantly higher for the study group. In the postnatal phase, we found significant differences between the groups with respect to CIB scales after the child completed 6 months of age: the study group presented significantly higher values of Maternal Sensitivity at 6 months of age, of Baby Involvement at 9 and 12 months of age, and of Dyadic Reciprocity at 6, 9, and 12 months of age, while the control group presented significantly higher values of Withdrawal of the Baby at 6 months of age, and of Dyadic Negative States at 6 and 9 months of age. Conclusion: The support offered by the study favored the mother-infant bond and had a positive effect on the quality of interaction during the first year of life, despite the presence of prenatal diagnosis.

"Motherese" Prosody in Fetal-Directed Speech: An Exploratory Study Using Automatic Social Signal Processing.

Introduction: Motherese, or emotional infant directed speech (IDS), is the specific form of speech used by parents to address their infants. The prosody of IDS has affective properties, expresses caregiver involvement, is a marker of caregiver-infant interaction quality. IDS prosodic characteristics can be detected with automatic analysis. We aimed to explore whether pregnant women "speak" to their unborn baby, whether they use motherese while speaking and whether anxio-depressive or obstetrical status impacts speaking to the fetus. Participants and Methods: We conducted an observational study of pregnant women with gestational ages from 26 to 38 weeks. Women were recruited in a university hospital department of obstetrics. Thirty-five women agreed to participate in the study, and 26 audio records were exploitable. We collected obstetrical and sociodemographic data, pregnancy outcomes, anxiety and depressive status using the Covy and Raskin Scales, and life events using the Sensations During Pregnancy and Life Event Questionnaire. Each participant was left alone with an audio recorder with a recommendation to feel free to speak to her fetus as she would have done at home. The recording was stopped after 3 min. Audio recordings were analyzed by two methods: psycholinguist experts' annotation and computational objective automatic analyses. Results: Most mothers (89%) reported speaking to their fetuses. We found a correlation between maternal first perceptions of fetal movements and the start of mother's speaking to fetus. Motherese prosody was detected with both annotation and automatic analysis with a significant correlation between the two methods. In this exploratory study, motherese use was not associated with maternal anxiodepressive or obstetrical status. However, the more future mothers were depressed, the less they spoke with their fetuses during the recording. Conclusion: Fetal directed speech (FDS) can be detected during pregnancy, and it contains a period of prosody that shares the same characteristics of motherese that can be described as prenatal motherese or emotional fetal-directed speech (e-FDS). This means that pregnant women start using motherese much earlier than expected. FDS seems to be correlated with maternal first perceptions of fetal movements and depression scores. However, more research is needed to confirm these exploratory results.

Estratégias de percepção da língua materna: do nascimento até um ano de vida / Strategies for perception of mother tongue: from born to one year old

RESUMO Bebês muito jovens demonstram habilidades linguísticas bastante refinadas, sendo capazes de perceber várias características na fala do adulto. A percepção da língua materna é, pois, imprescindível para a aquisição da linguagem. Esta revisão de literatura trata das habilidades de percepção de fala dos bebês a partir do nascimento até um ano de idade. Para tanto, foi realizada a busca bibliográfica em 7 bases de dados, nos idiomas inglês, francês, português e espanhol, no período de 2007 a 2014. Com esse levantamento bibliográfico foi possível reconhecer como a aquisição da linguagem ocorre de forma rápida e que bebês bem jovens são capazes de utilizar estratégias elaboradas para iniciar tal aquisição.

ABSTRACT Very young babies show very refined language skills being able to perceive many features in adult speech. The perception of the mother tongue is therefore essential to language acquisition. This literature review deals with speech perception skills of children less than one year of age. Therefore, a literature search was performed in 7 databases, in English, French, Portuguese and Spanish, in the period of 2003-2014. From this bibliographic research it was possible to recognize how language acquisition occurs quickly, and that very young infants are able to use elaborate strategies to initiate such acquisition.

Early development of turn-taking in vocal interaction between mothers and infants.

Infants are known to engage in conversation-like exchanges from the end of the second month after birth. These 'protoconversations' involve both turn-taking and overlapping vocalization. Previous research has shown that the temporal organization of adult-infant turn-taking sequences is similar to that of adult verbal conversation. It has also been shown that young infants adjust the quality of their vocalization in response to the quality and timing of adult vocalization. We present new evidence of turn-taking interaction in infants aged between 8 and 21 weeks based on the analysis of 176 samples of naturalistic face-to-face interactions from 51 dyads. We found high levels of latched turns as well as frequent initiation of turn-taking by infants at these ages. Our data do not support the hypothesis that turn-taking ability increases with age between 2 and 5 months but do suggest that infants are active participants in turn-taking from the earliest age and that mothers adjust turn-taking formats to infants.

Investigação do reconhecimento do próprio nome em bebês de 4 a 5 meses: estudo piloto / Investigation of the recognition of own name in babies from 4 to 5 months: pilot study

OBJETIVO: verificar se as crianças na faixa etária entre quatro e cinco meses reconhecem o próprio nome. MÉTODO: estudo transversal, realizado com 16 bebês com idade entre quatro e cinco meses, avaliados pelo programa Estadual de Triagem Auditiva Neonatal Universal (TANU) no Ambulatório de Fonoaudiologia do Hospital das Clínicas da Universidade Federal de Minas Gerais (HC-UFMG). Foram realizadas avaliações auditiva e de linguagem, além do teste de reconhecimento do próprio nome. Realizou-se análise descritiva das variáveis utilizadas no estudo e análise estatística. As variáveis contínuas foram comparadas por meio do teste T pareado e considerou-se nível de significância de 5% e coeficiente de confiança de 95%. RESULTADOS: verificou-se predominância das respostas dos bebês à evocação do próprio nome, na maioria dos bebês avaliados. CONCLUSÕES: com base nos critérios utilizados neste estudo, entre quatro e cinco meses as crianças já são capazes de reconhecer seu próprio nome.

PURPOSE: to verify that children aged between four and five months recognize their own names. METHOD: it is a cross-sectional study with 16 infants aged between four and five months, assessed by the Newborn Hearing Screening State Program (NHSP) in the Speech and Language Therapy Clinic of Hospital das Clínicas of Universidade Federal de Minas Gerais (HC - UFMG). In addition to the recognition test of the name, it was realized hearing and language assessment. A descriptive analysis of the variables of the study was held and the statistical analysis. Continuous variables were compared using the paired T test and it was considered a significance level of 5% and confidence coefficient of 95%. RESULTS: it was verified a predominance of responses to recall the name itself, in most infants evaluated. CONCLUSIONS: on the basis of the criteria set out in this study, infants aged between four and five months are capable of recognize their own names.

Plasticity of illusory vowel perception in Brazilian-Japanese bilinguals.

Previous research shows that monolingual Japanese and Brazilian Portuguese listeners perceive illusory vowels (/u/ and /i/, respectively) within illegal sequences of consonants. Here, several populations of Japanese-Brazilian bilinguals are tested, using an explicit vowel identification task (experiment 1), and an implicit categorization and sequence recall task (experiment 2). Overall, second-generation immigrants, who first acquired Japanese at home and Brazilian during childhood (after age 4) showed a typical Brazilian pattern of result (and so did simultaneous bilinguals, who were exposed to both languages from birth on). In contrast, late bilinguals, who acquired their second language in adulthood, exhibited a pattern corresponding to their native language. In addition, an influence of the second language was observed in the explicit task of Exp. 1, but not in the implicit task used in Exp. 2, suggesting that second language experience affects mostly explicit or metalinguistic skills. These results are compared to other studies of phonological representations in adopted children or immigrants, and discussed in relation to the role of age of acquisition and sociolinguistic factors.