A systematic review on experimental studies about patient adherence to treatment.

A better understanding of patients' adherence to treatment is a prerequisite to maximize the benefit of healthcare provision for patients, reduce treatment costs, and is a key factor in a variety of subsequent health outcomes. We aim to understand the state of the art of scientific evidence about which factors influence patients' adherence to treatment. A systematic literature review was conducted using PRISMA guidelines in five separate electronic databases of scientific publications: PubMed, PsycINFO (ProQuest), Cochrane library (Ovid), Google Scholar, and Web of Science. The search focused on literature reporting the significance of factors in adherence to treatment between 2011 and 2021, including only experimental studies (e.g., randomized controlled trials [RCT], clinical trials, etc.). We included 47 experimental studies. The results of the systematic review (SR) are grouped according to predetermined categories of the World Health Organization (WHO): socioeconomic, treatment, condition, personal, and healthcare-related factors. This review gives an actual overview of evidence-based studies on adherence and analyzed the significance of factors defined by the WHO classification. By showing the strength of certain factors in several independent studies and concomitantly uncovering gaps in research, these insights could serve as a basis for the design of future adherence studies and models.

The Assessment of Chinese Children's English Vocabulary-A Culturally Appropriate Receptive Vocabulary Test for Young Chinese Learners of English.

Millions of Chinese children learn English at increasingly younger ages. Yet when it comes to measuring proficiency, educators, and researchers rely on assessments that have been developed for L1 learners and/or for different cultural contexts, or on non-validated, individually designed tests. We developed the Assessment of Chinese Children's English Vocabulary test (ACCE-V) to address the need for a validated, culturally appropriate receptive vocabulary test, designed specifically for young Chinese learners. The items are drawn from current teaching materials used in China, and the depictions of people and objects are culturally appropriate. We evaluated the instrument's reliability and validity in two field tests with a combined sample size of 1,092 children (181 children for the first field test and 911 children for the second field test, age range from 3.1 to 7.7, mean age: 5.2. Item Response Theory (IRT) analyses show that the ACCE-V is sufficiently sensitive to capture different proficiency levels and that it has good psychometric properties. ACCE-V scores were correlated with Peabody Picture Vocabulary Test scores, indicating concurrent validity. We found that children's age and English learning experience can significantly predict the scores of ACCE-V, but the effect of English learning experience is greater. The ACCE-V thus offers an alternative to existing vocabulary tests. We argue that culturally appropriate assessments like the ACCE-V are fairer to learners and help promote an English learning and teaching environment that is less dominated by Western cultures and native speaker norms.

Input effects in the acquisition of verb inflection: Evidence from Emirati Arabic.

This study investigates the acquisition of the Imperfective verb inflection paradigm in Emirati Arabic (EA), to determine whether the learning process is sensitive to the phonological and typological properties of the input. We collected data from 48 participants aged 2;7 to 5;9 years, using an elicited production paradigm. Input frequencies of inflectional contexts, verb types and tokens were obtained from corpora of child-directed and adult EA. Children's accuracy was inversely related to the input frequency of inflectional contexts, but not related to type and token frequency or phonological neighborhood density. Token frequency interacted with age, such that younger children performed considerably worse on low-frequency tokens, but older children performed equally well on high- and low-frequency tokens. We conclude that learning is input-driven, but that a sufficiently regular paradigm allows children to eventually generalise across all items earlier than in previously studied European languages.

Structural and interactional aspects of adverbial sentences in English mother-child interactions: an analysis of two dense corpora.

We analysed both structural and functional aspects of sentences containing the four adverbials "after", "before", "because", and "if" in two dense corpora of parent-child interactions from two British English-acquiring children (2;00-4;07). In comparing mothers' and children's usage we separate out the effects of frequency, cognitive complexity and pragmatics in explaining the course of acquisition of adverbial sentences. We also compare these usage patterns to stimuli used in a range of experimental studies and show how differences may account for some of the difficulties that children have shown in experiments. In addition, we report descriptive data on various aspects of adverbial sentences that have not yet been studied as a resource for future investigations.

Interactions between givenness and clause order in children's processing of complex sentences.

Understanding complex sentences that contain multiple clauses referring to events in the world and the relations between them is an important development in children's language learning. A number of theoretical positions have suggested that factors like syntactic structure (clause order), iconicity (whether the order of clauses reflects the order of events), and givenness (whether information is shared between speakers) affect ease of comprehension. We tested these accounts by investigating how these factors interact in British English-speaking children's comprehension of complex sentences with adverbial clauses (after, before, because, if), while controlling for language level, working memory and inhibitory control. 92 children in three age groups (4, 5 and 8 years) and 17 adults completed a picture selection task. Participants heard an initial context sentence, followed by a two-clause sentence which varied in: (1) the order of the main and subordinate clause; (2) the order of given and new information; and (3) whether the given information occurred in the main or subordinate clause. Accuracy and response times were measured. Our results showed that given-before-new improves comprehension for four- and five-year-olds, but only when the given information is in the initial subordinate clause (e.g., "Sue crawls on the floor. Before she crawls on the floor, she hops up and down"). Temporal adverbials (after, before) were processed faster than causal adverbials (because, if). These effects were not found for the eight-year-olds, whose performance was more similar to that of the adults. Providing a context sentence also improved performance compared to presenting the test sentences in isolation. We conclude that existing accounts based on either ease of processing or information structure cannot fully account for these findings, and suggest a more integrated explanation which reflects children's developing language and literacy skills.

Iconicity affects children's comprehension of complex sentences: The role of semantics, clause order, input and individual differences.

Complex sentences involving adverbial clauses appear in children's speech at about three years of age yet children have difficulty comprehending these sentences well into the school years. To date, the reasons for these difficulties are unclear, largely because previous studies have tended to focus on only sub-types of adverbial clauses, or have tested only limited theoretical models. In this paper, we provide the most comprehensive experimental study to date. We tested four-year-olds, five-year-olds and adults on four different adverbial clauses (before, after, because, if) to evaluate four different theoretical models (semantic, syntactic, frequency-based and capacity-constrained). 71 children and 10 adults (as controls) completed a forced-choice, picture-selection comprehension test, providing accuracy and response time data. Children also completed a battery of tests to assess their linguistic and general cognitive abilities. We found that children's comprehension was strongly influenced by semantic factors - the iconicity of the event-to-language mappings - and that their response times were influenced by the type of relation expressed by the connective (temporal vs. causal). Neither input frequency (frequency-based account), nor clause order (syntax account) or working memory (capacity-constrained account) provided a good fit to the data. Our findings thus contribute to the development of more sophisticated models of sentence processing. We conclude that such models must also take into account how children's emerging linguistic understanding interacts with developments in other cognitive domains such as their ability to construct mental models and reason flexibly about them.

Don't shoot the giant whose shoulders we are standing on.

Structural priming is a sufficient but not a necessary condition for proving the existence of representations. Absence of evidence is not evidence of absence. Cognitive science relies on the legitimacy of positing representations and processes without "proving" every component. Also, psycholinguistics relies on other methods, including acceptability judgments, to find the materials for priming experiments in the first place.

How German children use intonation to signal information status in narrative discourse.

Recent research on adult German suggests that speakers use particular pitch accent types to signal the information status of discourse referents. This study investigates to what extent German five- and seven-year-olds have acquired this mapping. Semi-natural speech data was obtained from a picture-elicited narration task in which the information status was systematically varied. Surprisingly, data from an adult control group were inconsistent with the claim of a clear status-accent mapping, and demonstrated that adult scripted speech cannot be taken as a target model. However, compared with adults' unscripted speech productions, children were indeed adult-like in their information status marking. Both child groups accented new referents, but tended to deaccent given referents. Accessible referents (whose first mentions were less recent) were mostly realized like new referents. Differences between adults and children emerged in the use of intonation to structure narrations, suggesting that some functions of intonation may be acquired only later.

Polynomial modeling of child and adult intonation in German spontaneous speech.

In a data set of 291 spontaneous utterances from German 5-year-olds, 7-year-olds and adults, nuclear pitch contours were labeled manually using the GToBI annotation system.Ten different contour types were identified.The fundamental frequency (F0) of these contours was modeled using third-order orthogonal polynomials, following an approach similar to the one Grabe, Kochanski, and Coleman (2007) used for English. Statistical analyses showed that all but one contour pair differed significantly from each other in at least one of the four coefficients.This demonstrates that polynomial modeling can provide quantitative empirical support for phonological labels in unscripted speech, and for languages other than English. Furthermore, polynomial expressions can be used to derive the alignment of tonal targets relative to the syllable structure, making polynomial modeling more accessible to the phonological research community. Finally, within-contour comparisons of the three age groups showed that for children, the magnitude of the higher coefficients is lower, suggesting that they are not yet able to modulate their pitch as fast as adults.