HPV Vaccination Champions: Evaluating a Technology-Mediated Intervention for Parents.

Human papillomavirus (HPV) vaccination prevents 6 HPV-related cancers in men and women. Yet, rates of HPV vaccination among adolescents in the United States lag behind other developed nations, revealing a significant public health issue. This feasibility study tested a collaborative online learning environment to cultivate HPV vaccination champions. A 3-month training program recruited parents to serve as proponents and social media influencers to identify solutions to overcome barriers to HPV vaccination. A mixed methods study design included a pretest survey, three online asynchronous focus groups, a posttest survey, as well as a longitudinal follow-up survey at 6 months. Participants included 22 parents who self-identified as female (95.4%) and white (90.9%). Overall, there was a statistically significant difference in knowledge of HPV and HPV vaccination between pretest and posttest (p = 0.0042). This technology-mediated intervention increased parents' confidence and motivated them to speak more freely about HPV vaccination in-person and online with others in their social networks. Participants identified prevalent misinformation about HPV vaccination and learned how to effectively craft messages to address concerns related to safety and side effects, gender, understanding of risk, and sexual activity. Objective measures and qualitative open-ended assessment showed high intervention engagement and treatment satisfaction. All participants (100%) indicated that they enjoyed participating in the intervention. The effectiveness of this feasibility study suggests that social media is an appropriate platform to empower parents to counter vaccine hesitancy and misinformation through HPV vaccination information that is simple and shareable in-person and online.

Biological changes in auditory function following training in children with autism spectrum disorders.

BACKGROUND: Children with pervasive developmental disorders (PDD), such as children with autism spectrum disorders (ASD), often show auditory processing deficits related to their overarching language impairment. Auditory training programs such as Fast ForWord Language may potentially alleviate these deficits through training-induced improvements in auditory processing. METHODS: To assess the impact of auditory training on auditory function in children with ASD, brainstem and cortical responses to speech sounds presented in quiet and noise were collected from five children with ASD who completed Fast ForWord training. RESULTS: Relative to six control children with ASD who did not complete Fast ForWord, training-related changes were found in brainstem response timing (three children) and pitch-tracking (one child), and cortical response timing (all five children) after Fast ForWord use. CONCLUSIONS: These results provide an objective indication of the benefit of training on auditory function for some children with ASD.

Age-related differences in vocal responses to pitch feedback perturbations: a preliminary study.

The present study tested the effect of age on voice fundamental frequency (F(0)) responses to pitch-shifted feedback. Pitch-shift stimuli (-100 cents, 200 ms duration) were presented to 30 native-English speakers: 10 children (7-12 yrs), 10 younger adults (19-21 yrs), and 10 older adults (60-73 yrs). Significantly larger response magnitudes were found in the older group compared to the children and young adult groups, while the longest latencies were associated with the children group as compared to the two adult groups. These findings provide preliminary evidence of an age effect on the modulation of vocal responses to pitch-shifted feedback.

Brainstem transcription of speech is disrupted in children with autism spectrum disorders.

Language impairment is a hallmark of autism spectrum disorders (ASD). The origin of the deficit is poorly understood although deficiencies in auditory processing have been detected in both perception and cortical encoding of speech sounds. Little is known about the processing and transcription of speech sounds at earlier (brainstem) levels or about how background noise may impact this transcription process. Unlike cortical encoding of sounds, brainstem representation preserves stimulus features with a degree of fidelity that enables a direct link between acoustic components of the speech syllable (e.g. onsets) to specific aspects of neural encoding (e.g. waves V and A). We measured brainstem responses to the syllable /da/, in quiet and background noise, in children with and without ASD. Children with ASD exhibited deficits in both the neural synchrony (timing) and phase locking (frequency encoding) of speech sounds, despite normal click-evoked brainstem responses. They also exhibited reduced magnitude and fidelity of speech-evoked responses and inordinate degradation of responses by background noise in comparison to typically developing controls. Neural synchrony in noise was significantly related to measures of core and receptive language ability. These data support the idea that abnormalities in the brainstem processing of speech contribute to the language impairment in ASD. Because it is both passively elicited and malleable, the speech-evoked brainstem response may serve as a clinical tool to assess auditory processing as well as the effects of auditory training in the ASD population.

Effects of background noise on cortical encoding of speech in autism spectrum disorders.

This study provides new evidence of deficient auditory cortical processing of speech in noise in autism spectrum disorders (ASD). Speech-evoked responses (approximately 100-300 ms) in quiet and background noise were evaluated in typically-developing (TD) children and children with ASD. ASD responses showed delayed timing (both conditions) and reduced amplitudes (quiet) compared to TD responses. As expected, TD responses in noise were delayed and reduced compared to quiet responses. However, minimal quiet-to-noise response differences were found in children with ASD, presumably because quiet responses were already severely degraded. Moreover, ASD quiet responses resembled TD noise responses, implying that children with ASD process speech in quiet only as well as TD children do in background noise.

Social-emotional learning skill, self-regulation, and social competence in typically developing and clinic-referred children.

Social-emotional learning (SEL) skill includes the ability to encode, interpret, and reason about social and emotional information. In two related studies, we examined the relationship between children's SEL skill, their ability to regulate their own behavior, and the competence of their social interactions. Study 1 included 158 typically developing children ages 4 to 14 years. Study 2 included 126 clinic-referred children ages 5 to 17 years. Findings from both studies supported the conclusion that SEL skill includes three broad factors: awareness of nonverbal cues; the ability to interpret social meaning through theory of mind, empathy, and pragmatic language; and the ability to reason about social problems. Furthermore, the better children perform on measures of SEL skill and the more their parents and teachers report that children can regulate their behavior, the more competent their social interactions.

Audio-vocal system regulation in children with autism spectrum disorders.

Do children with autism spectrum disorders (ASD) respond similarly to perturbations in auditory feedback as typically developing (TD) children? Presentation of pitch-shifted voice auditory feedback to vocalizing participants reveals a close coupling between the processing of auditory feedback and vocal motor control. This paradigm was used to test the hypothesis that abnormalities in the audio-vocal system would negatively impact ASD compensatory responses to perturbed auditory feedback. Voice fundamental frequency (F(0)) was measured while children produced an /a/ sound into a microphone. The voice signal was fed back to the subjects in real time through headphones. During production, the feedback was pitch shifted (-100 cents, 200 ms) at random intervals for 80 trials. Averaged voice F(0) responses to pitch-shifted stimuli were calculated and correlated with both mental and language abilities as tested via standardized tests. A subset of children with ASD produced larger responses to perturbed auditory feedback than TD children, while the other children with ASD produced significantly lower response magnitudes. Furthermore, robust relationships between language ability, response magnitude and time of peak magnitude were identified. Because auditory feedback helps to stabilize voice F(0) (a major acoustic cue of prosody) and individuals with ASD have problems with prosody, this study identified potential mechanisms of dysfunction in the audio-vocal system for voice pitch regulation in some children with ASD. Objectively quantifying this deficit may inform both the assessment of a subgroup of ASD children with prosody deficits, as well as remediation strategies that incorporate pitch training.

Isolation of Streptomycin-Resistant Isolates of Erwinia amylovora in New York.

Streptomycin is currently the only antibiotic registered for the control of fire blight, a devastating disease of apple (Malus), pear (Pyrus), and other rosaceous plants caused by the bacterium Erwinia amylovora. Resistance of E. amylovora to streptomycin was first identified in California pear orchards in 1971 and is currently endemic in many parts of the United States. The Northeast remains the only major U.S. apple-growing region without streptomycin-resistant isolates of E. amylovora. In 2002, during a routine survey for streptomycin resistance, isolates from two neighboring orchards in Wayne County, NY were found to be highly resistant to streptomycin at a concentration of 100 µg/ml. This constitutes the first authenticated report of streptomycin resistance in New York State. Infected trees were shipped at the same time from a single nursery in Michigan. Resistance was caused by the acquisition of the strA-strB gene pair, inserted into the ubiquitous nontransmissible E. amylovora plasmid pEA29. Previously, streptomycin-resistant E. amylovora populations from Michigan were described with a similar mechanism of resistance, although the strA-strB genes are not unique to Michigan. These findings illustrate how unintentional movement of nursery material could undermine efforts to prevent the spread of antibiotic-resistant E. amylovora.

Fire Blight Resistance of Budagovsky 9 Apple Rootstock.

Erwinia amylovora, the causal agent of fire blight, can cause a fatal infection of apple rootstocks known as rootstock blight. Budagovsky 9 (B.9) apple rootstock is reported to be highly susceptible when inoculated with E. amylovora, although results from multiple trials showed that B.9 is resistant to rootstock blight infection in field plantings. Conflicting results could stem from genetic variation in the B.9 population, appearing as phenotypic differences in rootstock material. However, genetic testing, using 23 microsatellite loci, confirmed the clonal uniformity of B.9 in commerce. Variation in growth habit between B.9 rootstocks originating from two nurseries also has been discounted as a source of disease resistance. Instead, results indicate a possible novel resistance phenotype in B.9 rootstock. B.9 rootstock was susceptible to leaf inoculation by E. amylovora, statistically similar to the susceptible rootstock Malling 9 (M.9). Conversely, inoculation assays targeting woody 4- to 5-year-old tissue revealed a high level of resistance in B.9, whereas M.9 remained susceptible. Although the mechanism by which B.9 gains resistance to E. amylovora is unknown, it is reminiscent of age-related resistance, due to an observed gain of resistance in woody rootstock tissue over succulent shoot tissue. Durable fire blight resistance correlated with tissue development could be a valuable tool for rootstock breeders.

Musical experience shapes human brainstem encoding of linguistic pitch patterns.

Music and speech are very cognitively demanding auditory phenomena generally attributed to cortical rather than subcortical circuitry. We examined brainstem encoding of linguistic pitch and found that musicians show more robust and faithful encoding compared with nonmusicians. These results not only implicate a common subcortical manifestation for two presumed cortical functions, but also a possible reciprocity of corticofugal speech and music tuning, providing neurophysiological explanations for musicians' higher language-learning ability.

Auditory training improves neural timing in the human brainstem.

The auditory brainstem response reflects neural encoding of the acoustic characteristic of a speech syllable with remarkable precision. Some children with learning impairments demonstrate abnormalities in this preconscious measure of neural encoding especially in background noise. This study investigated whether auditory training targeted to remediate perceptually-based learning problems would alter the neural brainstem encoding of the acoustic sound structure of speech in such children. Nine subjects, clinically diagnosed with a language-based learning problem (e.g., dyslexia), worked with auditory perceptual training software. Prior to beginning and within three months after completing the training program, brainstem responses to the syllable /da/ were recorded in quiet and background noise. Subjects underwent additional auditory neurophysiological, perceptual, and cognitive testing. Ten control subjects, who did not participate in any remediation program, underwent the same battery of tests at time intervals equivalent to the trained subjects. Transient and sustained (frequency-following response) components of the brainstem response were evaluated. The primary pathway afferent volley -- neural events occurring earlier than 11 ms after stimulus onset -- did not demonstrate plasticity. However, quiet-to-noise inter-response correlations of the sustained response ( approximately 11-50 ms) increased significantly in the trained children, reflecting improved stimulus encoding precision, whereas control subjects did not exhibit this change. Thus, auditory training can alter the preconscious neural encoding of complex sounds by improving neural synchrony in the auditory brainstem. Additionally, several measures of brainstem response timing were related to changes in cortical physiology, as well as perceptual, academic, and cognitive measures from pre- to post-training.

Brainstem responses to speech syllables.

OBJECTIVE: To establish reliable procedures and normative values to quantify brainstem encoding of speech sounds. METHODS: Auditory brainstem responses to speech syllables presented in quiet and in background noise were obtained from 38 normal children. Brainstem responses consist of transient and sustained, periodic components-much like the speech signal itself. Transient peak responses were analyzed with measures of latency, amplitude, area, and slope. Magnitude of sustained, periodic frequency-following responses was assessed with root mean square, fundamental frequency, and first formant amplitudes; timing was assessed by stimulus-to-response and quiet-to-noise inter-response correlations. RESULTS: Measures of transient and sustained components of the brainstem response to speech syllables were reliably obtained with high test-retest stability and low variability across subjects. All components of the brainstem response were robust in quiet. Background noise disrupted the transient responses whereas the sustained response was more resistant to the deleterious effects of noise. CONCLUSIONS: The speech-evoked brainstem response faithfully reflects many acoustic properties of the speech signal. Procedures to quantitatively describe it have been developed. SIGNIFICANCE: Accurate and precise manifestation of stimulus timing at the auditory brainstem is a hallmark of the normal perceptual system. The brainstem response to speech sounds provides a mechanism for understanding the neural bases of normal and deficient attention-independent auditory function.