Early language processing efficiency and pre-literacy outcomes in children born full term and preterm.

Language processing efficiency-that is, the skill at processing language in real time-assessed in toddlerhood is associated with later language outcomes in children born full term (FT) and preterm (PT) during school age. No studies to date have assessed patterns of relations between early language processing efficiency and pre-literacy skills, such as print knowledge and phonological awareness, and whether relations are similar in FT and PT children. In this study, participants (N = 94, 49 FT and 45PT) were assessed in the looking-while-listening (LWL) task at 18 months of age (corrected for degree of prematurity), deriving measures of processing speed and accuracy. At 4½ years of age, children were assessed on standardized tests of print knowledge, phonological awareness, and expressive language. Processing speed and accuracy predicted both pre-literacy outcomes (r2 change = 7.8%-19.5%, p < .01); birth group did not moderate these effects. Relations were significantly reduced when controlling for expressive language. Thus, early language processing efficiency supports later expressive language abilities, which in turn supports developing pre-literacy skills. Processing speed and phonological awareness were also directly related, indicating an independent role for processing speed in literacy development. Mediation effects were not moderated by birth group, suggesting a similar developmental pathway in FT and PT children.

Using a multidimensional model of attention to predict low-income preschoolers' early academic skills across time.

The current study examines the organization of attention skills across the preschool year before kindergarten, and tests how distinct attention subcomponents predict early academic skills in a sample of low-income children (n = 99). Children completed well-validated attention tasks in fall at 4.5 years old and spring at 5 years old, capturing the abilities to selectively focus, sustain attention, and employ executive control. Exploratory factor analyses at both time points support a 2-factor model differentiating selective and sustained attention from attention processing speed and executive attention, suggesting that attention in low-income preschoolers may have a simpler organization than the 3-factor structure found in adulthood. Multiple regression models find children's ability to selectively focus and sustain attention serves as a robust concurrent and longitudinal predictor of academic skills. These results highlight the role of selective and sustained attention processes in supporting school readiness for economically vulnerable children.

Self-Directed Telehealth Parent-Mediated Intervention for Children With Autism Spectrum Disorder: Examination of the Potential Reach and Utilization in Community Settings.

BACKGROUND: There is a significant need for strategies to increase access to evidence-based interventions for children with autism spectrum disorder (ASD). One novel approach is to train parents to use evidence-based interventions for their child with ASD via telehealth. Pilot work examining the efficacy of one such program, ImPACT Online, demonstrated a high rate of parent program engagement, low attrition, and associated gains in parent learning and child social communication. OBJECTIVE: The objective of this study was to conduct an open trial of ImPACT Online to better understand its dissemination potential. METHODS: We examined the reach and representativeness of families who registered (n=36) compared to families who were referred (n=139) to the open trial for one referral site. We then compared the demographics of all families who enrolled in the open trial (n=112) to families who enrolled in one of two controlled trials of the same program (n=50). We also examined metrics of program engagement for the open and controlled trials, the relationship between program engagement and changes in parents' intervention knowledge, and program evaluation for the participants in the open trial. RESULTS: In total, 25.8% (36/139) of the parents who were given information about the program at their child's diagnostic feedback session registered with the program. The parents who enrolled in the open (OT) and controlled trials (CT), respectively, were similar in gender (OT: 84.8% (95/112); CT: 88% (44/50), female), marital status (OT: 80.4% (90/112) ; CT: 69.6% (32/46), married), education (OT: 58.0% (65/112); CT: 54.0% (27/50), college degree or higher), and employment status (OT: 58.0% (65/112); CT: 65.3% (32/49), employed outside the home). The child participants were similar in terms of gender (OT: 83.0% (93/112); CT: 76.0% (38/50), male) and race and ethnicity (OT: 38.4% (43/112); CT: 24.0% (12/50), minority). However, the mean chronological age of the child participants in the open trial group was significantly higher (Mean=60.0 months) than in the controlled trial group (Mean=43.0 months), with t160=5.22, P<.001. Parents in the open trial engaged with the program at a significantly lower rate than the controlled trial, F3,81=21.14, P<.001. Program engagement was significantly associated with gains in parent intervention knowledge across both the groups, beta=.41, t=2.43, P=.02. Participants in the open access trial evaluated the program highly, but several barriers were noted. CONCLUSIONS: These data suggest that additional strategies may need to be developed to support families in using telehealth-based parent-mediated intervention in community settings.

An interprofessional education program's impact on attitudes toward and desire to work with older adults.

BACKGROUND: Insufficient numbers of health professions students aspire to work with the increasing numbers of the elderly. Although programs exist to promote interest in serving this population, inadequate numbers of health professionals remain an issue. METHODS: This study sample consisted of medical (n = 75) and health profession students (n = 210) enrolled in a semester-long interprofessional clinical education program designed to enhance interprofessional teamwork and provide positive exposure to elderly in the community. Each team of three visited an assigned elder three times during the semester. Students were acquainted with their elder and also administered a comprehensive geriatric physical and socioemotional battery of assessments. After each visit, the teams met and held a debriefing with faculty. Attitudes toward older adults and the desire to work with older adults were assessed using the Carolina Opinion of Care of Older Adults. The survey was administered twice: before initiating the semester-long program and immediately after program completion. RESULTS: Total score and subscale scores were compared pre- and post-experience. Scores on the subscale "Early Interest in Geriatrics" were significantly higher postexperience compared to pre-experience. Scores on the remaining subscales and the total score remained unchanged. DISCUSSION: Results indicate that exposure to elderly adults may increase the interest in working with this population and does not diminish attitudes toward the elderly. Longer exposure may be needed to invoke attitudinal changes across additional subtests.

Evaluating the lifestyles of physicians and PAs in orthopedics.

OBJECTIVE: Limited current research is available comparing job satisfaction and lifestyles of physicians and physician assistants (PAs). Given the professional similarities and the upward trend in employment for both professions, this research is important in educating future professionals and employers. This study examined job contentment among orthopedic physicians and PAs. METHODS: A cross-sectional survey was designed to assess career and lifestyle satisfaction. The survey was e-mailed to orthopedic clinics across the United States. RESULTS: 27 PAs and 50 physicians completed the survey. Compared with physicians, PAs were more likely to recommend their career and to desire to switch specialties. Physicians reported a higher level of agreement that the professional schedule overshadows personal life, and that the stress and demand of the profession impair personal health. CONCLUSION: PAs in orthopedics self-reported a higher lifestyle satisfaction than physicians. One specialty was examined and larger, more diverse studies should be conducted.

The promise and pitfalls of a strength-based approach to child poverty and neurocognitive development: Implications for policy.

There has been significant progress in understanding the effects of childhood poverty on neurocognitive development. This progress has captured the attention of policymakers and promoted progressive policy reform. However, the prevailing emphasis on the harms associated with childhood poverty may have inadvertently perpetuated a deficit-based narrative, focused on the presumed shortcomings of children and families in poverty. This focus can have unintended consequences for policy (e.g., overlooking strengths) as well as public discourse (e.g., focusing on individual rather than systemic factors). Here, we join scientists across disciplines in arguing for a more well-rounded, "strength-based" approach, which incorporates the positive and/or adaptive developmental responses to experiences of social disadvantage. Specifically, we first show the value of this approach in understanding normative brain development across diverse human environments. We then highlight its application to educational and social policy, explore pitfalls and ethical considerations, and offer practical solutions to conducting strength-based research responsibly. Our paper re-ignites old and recent calls for a strength-based paradigm shift, with a focus on its application to developmental cognitive neuroscience. We also offer a unique perspective from a new generation of early-career researchers engaged in this work, several of whom themselves have grown up in conditions of poverty. Ultimately, we argue that a balanced strength-based scientific approach will be essential to building more effective policies.

Associations between early efficiency in language processing and language and cognitive outcomes in children born full term and preterm: similarities and differences.

Associations between children's early language processing efficiency and later verbal and non-verbal outcomes shed light on the extent to which early information processing skills support later learning across different domains of function. Examining whether the strengths of associations are similar in typically developing and at-risk populations provides an additional lens into the varying routes to learning that children may take across development. In this follow-up study, children born full-term (FT, n = 49) and preterm (PT, n = 45, ≤32 weeks gestational age, birth weight <1800 g) were assessed in the Looking While Listening (LWL) task at 18 months (corrected for degree of prematurity in PT group). This eye-tracking task assesses efficiency of real-time spoken language comprehension as accuracy and speed (RT) of processing. At 4 ½ years, children were assessed on standardized tests of receptive vocabulary, expressive language, and non-verbal IQ. Language processing efficiency was associated with both language outcomes (r2-change: 7.0-19.7%, p < 0.01), after covariates. Birth group did not moderate these effects, suggesting similar mechanisms of learning in these domains for PT and FT children. However, birth group moderated the association between speed and non-verbal IQ (r2-change: 4.5%, p < 0.05), such that an association was found in the PT but not the FT group. This finding suggests that information processing skills reflected in efficiency of real-time language processing may be recruited to support learning in a broader range of verbal and non-verbal domains in the PT compared to the FT group.

iCatcher+: Robust and Automated Annotation of Infants' and Young Children's Gaze Behavior From Videos Collected in Laboratory, Field, and Online Studies.

Technological advances in psychological research have enabled large-scale studies of human behavior and streamlined pipelines for automatic processing of data. However, studies of infants and children have not fully reaped these benefits because the behaviors of interest, such as gaze duration and direction, still have to be extracted from video through a laborious process of manual annotation, even when these data are collected online. Recent advances in computer vision raise the possibility of automated annotation of these video data. In this article, we built on a system for automatic gaze annotation in young children, iCatcher, by engineering improvements and then training and testing the system (referred to hereafter as iCatcher+) on three data sets with substantial video and participant variability (214 videos collected in U.S. lab and field sites, 143 videos collected in Senegal field sites, and 265 videos collected via webcams in homes; participant age range = 4 months-3.5 years). When trained on each of these data sets, iCatcher+ performed with near human-level accuracy on held-out videos on distinguishing "LEFT" versus "RIGHT" and "ON" versus "OFF" looking behavior across all data sets. This high performance was achieved at the level of individual frames, experimental trials, and study videos; held across participant demographics (e.g., age, race/ethnicity), participant behavior (e.g., movement, head position), and video characteristics (e.g., luminance); and generalized to a fourth, entirely held-out online data set. We close by discussing next steps required to fully automate the life cycle of online infant and child behavioral studies, representing a key step toward enabling robust and high-throughput developmental research.

Neuroanatomical correlates of heterotypic comorbidity in externalizing male adolescents.

Children and adolescents with externalizing behavior disorders including attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) often present with symptoms of comorbid internalizing psychopathology. However, few studies have examined central nervous system correlates of such comorbidity. We evaluated interactions between externalizing and internalizing symptoms in predicting mesolimbic, septo-hippocampal, and anterior cingulate volumes among 12- to 16-year-old boys with either ADHD, ADHD and CD, or no psychiatric condition (n = 35). These regions were chosen given established links to trait impulsivity, trait anxiety, and behavior regulation, respectively. Collapsed across groups, Externalizing × Internalizing symptom interactions accounted for individual differences in gray matter densities in each region. Externalizing youth with comorbid internalizing symptoms showed smaller reductions in gray matter than individuals with externalizing psychopathology alone. These results suggest that internalizing symptoms are associated with less severe structural compromises in brain regions subserving motivation and behavior regulation among externalizing boys.

The value of lesser-impact-factor surgical journals as a source of negative and inconclusive outcomes reporting.

OBJECTIVES: (1) Examine the tendency of peer-reviewed surgical journals to publish positive reports or negative and inconclusive outcome articles as a function of the journals' impact factor (IF). (2) Examine the frequency with which surgical journal editors/publishers adhere to the International Committee of Medical Journal Editors statement on sources of funding and/or conflicts of interest (COI). BACKGROUND: Evidence-based medicine is often used as a template for measuring quality of medical care. Clinicians put their faith in peer-reviewed articles as quality-assured and reliable information. However, peer-reviewed literature does not provide balanced access to positive, negative, and inconclusive reports. Funding may also influence the decision to publish certain articles and can thus add to the reported bias in the literature. METHODS: Articles from 15 surgical journals comprising 3 separate journal groups based upon 2006 impact factor (IF) rankings were reviewed. All were published in 2007. Manuscripts were classified by 5 independent reviewers as having positive, negative, or inconclusive primary and secondary outcomes and for statements on funding/COI. Positive reports were defined as P < 0.05, null hypothesis rejected; negative reports defined as P < 0.05, null hypothesis accepted; and inconclusive reports defined as P > 0.05. Inter-observer consistency was affirmed. Separate analysis of randomized controlled trials (RCT) was performed to assess for the quality of published positive and negative trials. RESULTS: We evaluated 2457 published articles. Positive primary outcomes were reported in 67% to 100% of studied articles in selected journals. Negative and inconclusive primary outcomes were less likely to be reported, except for one journal that reported a high of 33% negative articles. Higher-ranked journals published fewer negative and inconclusive studies (5%-7%) than both medium- and lowly-ranked journals (P < 0.0001). The proportion of RCTs published varied, constituting 18% to 21% of articles in the 5 high-ranked journals compared to 6% to 14% in the 5 more lowly ranked journals (P < 0.0001). Reporting of COIs and funding were more frequent in high-IF compared to low-IF journals (P < 0.0001). CONCLUSIONS: Quality rather than outcome should be the measure on which a publication decision is made; commercial bias may further complicate this balance. Lower IF-rated journals may serve a decidedly useful purpose by publishing more negative and inconclusive outcome studies. The practice of focusing disproportionately on the positive outcomes of most studies may result in unbalanced evidence.

Neurobiological adaptations to violence across development.

Developmental adaptations to violent environments involve a multitude of cascading effects spanning many levels of analysis from genes to behavior. In this review, we (a) examine the potentiating effects of violence on genetic vulnerabilities and the functioning of neurotransmitter systems in producing both internalizing and externalizing psychopathology; (b) describe implications of violence exposure for brain development, particularly within the hippocampus and prefrontal cortex; and (c) consider the effects of violence on developing human stress and startle responses. This review integrates literatures on the developmental effects of violence among rodents, nonhuman primates, and humans. Many neurobiological changes that are adaptive for survival in violent contexts become maladaptive in other environments, conferring life-long risk for psychopathology.

Neurological correlates of reward responding in adolescents with and without externalizing behavior disorders.

Opposing theories of striatal hyper- and hypodopaminergic functioning have been suggested in the pathophysiology of externalizing behavior disorders. To test these competing theories, the authors used functional MRI to evaluate neural activity during a simple reward task in 12- to 16-year-old boys with attention-deficit/hyperactivity disorder and/or conduct disorder (n = 19) and in controls with no psychiatric condition (n = 11). The task proceeded in blocks during which participants received either (a) monetary incentives for correct responses or (b) no rewards for correct responses. Controls exhibited striatal activation only during reward, shifting to anterior cingulate activation during nonreward. In contrast, externalizing adolescents exhibited striatal activation during both reward and nonreward. Externalizing psychopathology appears to be characterized by deficits in processing the omission of predicted reward, which may render behaviors that are acquired through environmental contingencies difficult to extinguish when those contingencies change.

Familial and temperamental predictors of resilience in children at risk for conduct disorder and depression.

In this study, we evaluated predictors of resilience among 8- to 12-year-old children recruited from primarily low socioeconomic status neighborhoods, 117 of whom suffered from clinical levels of conduct problems and/or depression, and 63 of whom suffered from no significant symptoms. Tests of interactions were conducted between (a) paternal antisocial behavior and maternal depression and (b) several physiological indices of child temperament and emotionality in predicting (c) children's conduct problems and depression. Both internalizing and externalizing outcomes among children were associated specifically with maternal melancholic depression, and not with nonmelancholic depression. In addition, low levels of respiratory sinus arrhythmia (RSA) among children conferred significant risk for depression, regardless of maternal melancholia, whereas high RSA offered partial protection. Furthermore, high levels of maternal melancholia conferred significant risk for child depression, regardless of paternal antisocial behavior, whereas low levels of maternal melancholia offered partial protection. Finally, low levels of electrodermal responding (EDR) conferred significant risk for conduct problems, regardless of paternal antisocial behavior, whereas high EDR offered partial protection. None of the identified protective factors offered complete immunity from psychopathology. These findings underscore the complexity of resilience and resilience-related processes, and suggest several potential avenues for future longitudinal research.