The effect of cognitive intervention program on intelligence scores in preschool.

Dynamic assessment is an approach that aims to improve student performance through interventions. One of the important application areas of dynamic assessment is the assessment of intelligence. Within the scope of the study, after a Cognitive intervention program (CIP) was developed, its effects on intelligence scores were examined with a quasi-experimental research method. The CIP was prepared by adopting a dynamic assessment approach to improve the performance of students with expert support. This improvement would be provided by the clues and feedback given during the intervention within the scope of the CIP. The sample of the study included 173 students in the 5-6 age group (83 experimental group, 90 control group). The CIP developed by the researcher consisted of 54 worksheets and was applied to the experimental group for 9 weeks. The implementation of the worksheets was supervised by classroom teachers. The digital application of the Anadolu-Sak Intelligence Scale (d-ASIS) and Raven's colored progressive matrices (RCPM) were applied to both the experimental and control groups as pretests and posttests. The increases in the intelligence scores of the experimental and control groups were analyzed by MANOVA. The analysis showed that the intelligence levels of the experimental group increased significantly more than the control group in terms of both d-ASIS and RCPM total gain scores (posttest to pretest). This result indicated that the CIP, which was developed by adopting a dynamic assessment approach, supported cognitive development.

Screens and Preschools: The Bilingual English Language Learner Assessment as a Curriculum-Compliant Digital Application.

BACKGROUND/OBJECTIVES: The increase in digital tools in early childhood education highlights the need for evidence-based assessments that support cognitive development and align with educational requirements and technological advances. This study contributes to the evaluation of the Bilingual English Language Learner Assessment (BELLA), designed to enhance early learning through curriculum-aligned tasks in preschool-aged children. METHODS: Data were collected from 17 schools, including 506 preschool children, using a mixed-model approach to assess BELLA's capacity to appraise early numeracy, literacy, science, and social/emotional development. Analyses included a three-way ANOVA to examine the effects of sex, age, and sub-domain on pass rates and mixed-effects models to evaluate interactions between age and domain. RESULTS: The results indicated a significant effect of age on performance across all domains, with older children demonstrating higher pass rates (p < 0.0001). No significant gender bias was detected. The interaction between age and domain was also significant (p < 0.0001), suggesting domain-specific age-related performance trends, which aligns with internal validity requirements. CONCLUSION: These findings position BELLA within the growing body of literature on digital media use in early childhood assessment and education, highlighting its potential as a curriculum-compliant digital assessment tool that evaluates and supports cognitive development without a gender bias. This study contributes to the field by providing empirical evidence of BELLA's effectiveness and suggesting future research directions, including the exploration of its bilingual (and potentially multilingual) applications and external validation against existing evidence-based assessments.

Dynamic assessment of phonological awareness in monolingual and bilingual French-speaking children.

Dynamic assessment (DA) is a tool used to assess children's learning potential. Research on English-speaking children indicates that DA effectively diagnoses language disorders in monolingual and bilingual children. However, few DAs have been developed for French-speaking children. This study aimed to examine the validity of a dynamic phonological awareness task for differentiating French-speaking monolingual and bilingual children with and without developmental language disorder (DLD). Thirty-eight monolingual and bilingual children, aged 4-8 years, 23 with typical development (TD) and 15 with DLD, participated in the study. They performed a dynamic phoneme segmentation task, in which graduated cues were provided. Children were also administered a nonword repetition (NWR) task, and a modifiability scale, in which the examiner rated the child's responsivity during the task. Statistical analyses examined what factors influenced dynamic task performance, and calculated the sensitivity and specificity of the tests. Results indicated that four factors emerged as significant in a mixed-effects logistic regression model: age, diagnostic group (TD vs. DLD), modifiability, and the number of phonemes in the target word. Older children who had TD and higher modifiability scores had better segmentation skills than other children. Words with fewer phonemes were also easier to segment than words with greater numbers of phonemes. The dynamic task had good sensitivity in the identification of DLD but less good specificity. Our findings indicate that a dynamic task of phonological awareness has the potential to be used as a diagnostic tool to differentiate TD and DLD.

When to start renal replacement therapy in acute kidney injury: What are we waiting for?

Acute kidney injury remains a serious condition with a high mortality risk. In the absence of any new drugs, renal replacement therapy (RRT) is the most important treatment option. Randomized controlled trials have concluded that in critically ill patients without an emergency indication for RRT, a watchful waiting strategy is safe; however, further delays in RRT did not seem to confer any benefit, rather was associated with potential harm. During this process, balancing the risks of complications due to an unnecessary intervention with the risk of not correcting a potentially life-threatening complication remains a challenge. Dynamic renal function assessment, especially dynamic assessment of renal demand-capacity matching, combined with renal biomarkers such as neutrophil gelatinase-associated lipocalin and furosemide stress test, is helpful to identify which patients and when the patients may benefit from RRT.

Complete elimination of hyperleukocytosis risk in AML through early high-quality disease remission.

Background: Acute myeloid leukemia (AML) with hyperleukocytosis (HL) is a severe medical emergency associated with high mortality rates and poor prognosis. Prompt and urgent treatment is crucial to address this medical emergency. This study aims to elucidate appropriate diagnostic thresholds for HL and investigate underlying mechanisms and potential targeted therapies. Methods: X-tile software was employed to analyze white blood cell (WBC) count thresholds in AML patients using data from TCGA and TARGET AML databases. METASCAPE and Gene Set Enrichment Analysis (GSEA) were conducted to explore the molecular mechanisms underlying HL in AML. Potential molecular targeted drugs were identified using the CELLMINER platform. Results: Analysis revealed that a WBC count threshold of 75×109/L, rather than the conventional 100×109/L, is more appropriate for diagnosing HL in adult AML patients. This revised threshold could aid clinicians in identifying a greater number of patients requiring immediate intervention. Significant correlations were observed between HL and specific mutations, including NPM1, FLT3, and DNMT3A. For pediatric AML patients, the HL threshold was determined to be 165×109/L. Achieving complete remission (CR) or deeper levels of remission significantly reduces the risks associated with HL. The reduction in risk can lead to survival outcomes for HL patients that are comparable to those of non-hyperleukocytosis patients. Differential gene expression analysis indicated that downregulation of cell adhesion molecules is implicated in HL pathogenesis. Potential targeted therapies for AML with HL include Bcl2 inhibitors and histone deacetylase inhibitors. Clinical observations demonstrated that the addition of Bcl2 inhibitors, such as Venetoclax, to standard therapy results in a rapid reduction in WBC counts, thereby reducing tumor burden and providing prompt symptom relief. Combining these targeted drugs with conventional therapies appears promising in mitigating risks associated with HL. Conclusions: Lower diagnostic thresholds for HL in AML, identifies critical genetic correlations, and highlights effective molecular targeted therapies. Proactive early treatment is crucial for achieving deep remission and reducing HL risk. Future therapeutic strategies should consider integrating molecular targeted drugs with conventional therapies to improve outcomes for patients facing this high-risk hematological emergency.

Dynamic assessment of community resilience in China: empirical surveys from three provinces.

Background: Strengthening the construction of community resilience and reducing disaster impacts are on the agenda of the Chinese government. The COVID-19 pandemic could alter the existing community resilience. This study aims to explore the dynamic change trends of community resilience in China and analyze the primary influencing factors of community resilience in the context of COVID-19, as well as construct Community Resilience Governance System Framework in China. Methods: A community advancing resilience toolkit (CART) was used to conduct surveys in Guangdong, Sichuan, and Heilongjiang provinces in China in 2015 and 2022, with community resilience data and information on disaster risk awareness and disaster risk reduction behaviors of residents collected. The qualitative (in-depth interview) data from staffs of government agencies and communities (n = 15) were pooled to explore Community Resilience Governance System Framework in China. Descriptive statistics analysis and t-tests were used to investigate the dynamic development of community resilience in China. Hierarchical regression analysis was performed to explore the main influencing factors of residential community resilience with such socio-demographic characteristics as gender and age being controlled. Results: The results indicate that community resilience in China has improved significantly, presenting differences with statistical significance (p < 0.05). In 2015, connection and caring achieved the highest score, while disaster management achieved the highest score in 2022, with resources and transformative potential ranking the lowest in their scores in both years. Generally, residents presented a high awareness of disaster risks. However, only a small proportion of residents that were surveyed had participated in any "community-organized epidemic prevention and control voluntary services" (34.9%). Analysis shows that core influencing factors of community resilience include: High sensitivity towards major epidemic-related information, particular attention to various kinds of epidemic prevention and control warning messages, participation in epidemic prevention and control voluntary services, and formulation of epidemic response plans. In this study, we have constructed Community Resilience Governance System Framework in China, which included community resilience risk awareness, community resilience governance bodies, community resilience mechanisms and systems. Conclusion: During the pandemic, community resilience in China underwent significant changes. However, community capital was, is, and will be a weak link to community resilience. It is suggested that multi-stages assessments of dynamic change trends of community resilience should be further performed to analyze acting points and core influencing factors of community resilience establishment at different stages.

Dynamic impact assessment of urban floods on the compound spatial network of buildings-roads-emergency service facilities.

There are complex interactions among urban spatial elements in rainstorm scenarios. Road interruptions may cause isolation between partially submerged buildings and emergency service facilities, thereby affecting the recovery capability of flooded buildings and the accessibility of emergency service facilities. This study constructed a compound spatial network of urban buildings-roads-emergency service facilities, and analyzed the complex dynamic impacts of time-varying dynamic floods on building risk, road risk, and emergency service accessibility. Firstly, a refined flood risk assessment at the building scale was carried out in combination with flood inundation, building vulnerability, population, vulnerable areas, underground buildings, and life facilities. Secondly, betweenness centrality indicator in complex networks was used to calculate road traffic capacity and collapse threshold, and the accessibility of emergency service facilities is calculated based on road traffic capacity. Finally, the interaction and feedback relationships between the compound spatial network were analyzed. The results show that: (1) Flooded building comprehensive risk analysis reveals that floods have a significant impact on residential and commercial land use, and high-risk flood areas are mainly concentrated in the central region of study area. (2) The road network has a collapse threshold, and the fluctuating state of emergency service accessibility is significantly influenced by road traffic capacity. (3) Roads act as "bridges" connecting buildings and emergency service facilities, leading to the redistribution of building flood comprehensive risk and emergency service accessibility, presenting complex dynamic changes over time. Additionally, submerged roads also affect the accessibility of emergency service facilities around flooded buildings, reducing the recovery capacity of flooded buildings, and exhibiting significant heterogeneity characteristics. Future research should consider the complex impacts of floods on urban elements in order to better manage dynamic flood risk.

Unraveling individual differences in learning potential: A dynamic framework for the case of reading development.

Children show an enormous capacity to learn during development, but with large individual differences in the time course and trajectory of learning and the achieved skill level. Recent progress in developmental sciences has shown the contribution of a multitude of factors including genetic variation, brain plasticity, socio-cultural context and learning experiences to individual development. These factors interact in a complex manner, producing children's idiosyncratic and heterogeneous learning paths. Despite an increasing recognition of these intricate dynamics, current research on the development of culturally acquired skills such as reading still has a typical focus on snapshots of children's performance at discrete points in time. Here we argue that this 'static' approach is often insufficient and limits advancements in the prediction and mechanistic understanding of individual differences in learning capacity. We present a dynamic framework which highlights the importance of capturing short-term trajectories during learning across multiple stages and processes as a proxy for long-term development on the example of reading. This framework will help explain relevant variability in children's learning paths and outcomes and fosters new perspectives and approaches to study how children develop and learn.

Dynamic cerebral blood flow assessment based on electromagnetic coupling sensing and image feature analysis.

Dynamic assessment of cerebral blood flow (CBF) is crucial for guiding personalized management and treatment strategies, and improving the prognosis of stroke. However, a safe, reliable, and effective method for dynamic CBF evaluation is currently lacking in clinical practice. In this study, we developed a CBF monitoring system utilizing electromagnetic coupling sensing (ECS). This system detects variations in brain conductivity and dielectric constant by identifying the resonant frequency (RF) in an equivalent circuit containing both magnetic induction and electrical coupling. We evaluated the performance of the system using a self-made physical model of blood vessel pulsation to test pulsatile CBF. Additionally, we recruited 29 healthy volunteers to monitor cerebral oxygen (CO), cerebral blood flow velocity (CBFV) data and RF data before and after caffeine consumption. We analyzed RF and CBFV trends during immediate responses to abnormal intracranial blood supply, induced by changes in vascular stiffness, and compared them with CO data. Furthermore, we explored a method of dynamically assessing the overall level of CBF by leveraging image feature analysis. Experimental testing substantiates that this system provides a detection range and depth enhanced by three to four times compared to conventional electromagnetic detection techniques, thereby comprehensively covering the principal intracranial blood supply areas. And the system effectively captures CBF responses under different intravascular pressure stimulations. In healthy volunteers, as cerebral vascular stiffness increases and CO decreases due to caffeine intake, the RF pulsation amplitude diminishes progressively. Upon extraction and selection of image features, widely used machine learning algorithms exhibit commendable performance in classifying overall CBF levels. These results highlight that our proposed methodology, predicated on ECS and image feature analysis, enables the capture of immediate responses of abnormal intracranial blood supply triggered by alterations in vascular stiffness. Moreover, it provides an accurate diagnosis of the overall CBF level under varying physiological conditions.

Analogical thinking modifiability and math processing strategy.

A sample of 48 children in Grade 2 was randomly assigned to an experimental (n = 24) and a control group (n = 24). Both groups were administered the Analogical Modifiability Puzzle Test (AMPT) and Math Accuracy and Processing Strategy (MAPS) test before and after a teaching phase of the AMPT. The MAPS test includes scores for Accuracy, Processing Strategy, and a Math-Total. The findings reveal significant treatment x time interactions for AMPT (near-transfer) and MAPS (far-transfer) scores. Hierarchical regression analysis showed that AMPT post-teaching score added significantly to Math Total. The findings indicate that Math Accuracy and Math Processing Strategies are affected by mediation for analogical thinking and that modifiability of analogical thinking significantly predicts Math-Total.

Diaphragmatic ultrasonography as a predictor of respiratory muscle fatigue in myasthenia gravis.

INTRODUCTION/AIMS: Easy fatigability, the clinical hallmark of generalized myasthenia gravis (GMG), cannot be detected in a dynamic way. The aim of this study was to assess respiratory function dynamically through diaphragmatic ultrasonography (DUS) in GMG patients. METHODS: GMG patients and controls were recruited in a 1:1 ratio. DUS was performed during one quiet breath and 15 consecutive deep breaths. The diaphragm thicknesses were measured at different positions. Diaphragm thickening fraction (TFdi) and the maximal change in diaphragm thickness (Tmax) during 15 consecutive deep breaths were calculated and transformed to normality, named N-TFdi and N-Tmax, respectively. The percentages of changes in TFdi and Tmax compared with baseline were named ΔTFdi and ΔTmax, respectively. The diagnostic parameter for respiratory muscle fatigue was chosen from ΔTFdi and ΔTmax at different deep breath times according to their ability to distinguish GMG patients from controls and the interrater reliability of TFdi and Tmax. RESULTS: Thirty-four GMG patients and 30 healthy controls were enrolled. N-TFdi and N-Tmax significantly changed as the number of deep breaths increased (p < .001) in GMG patients, but not in controls. ΔTmax of the 15th deep breath (ΔTmax15) was selected as the diagnostic parameter for respiratory muscle fatigue. There were no significant differences in percentage of predicted values of forced vital capacity and arterial partial pressure of carbon dioxide between patients with normal and abnormal ΔTmax15. DISCUSSION: DUS could identify diaphragm fatiguability in GMG patients, which may be more reliable and sensitive in assessment of diaphragm fatigue than conventional methods.

Utilizing MSK Ultrasound for Comprehensive Assessment of the Femoral Trochlea: A Game Changer in Sports Medicine.

Musculoskeletal (MSK) ultrasound has emerged as a valuable tool for sports physical therapists in the assessment and treatment of various knee pathologies. Its ability to provide high-resolution images of soft tissue and superficial bone surfaces makes it especially useful for sports physical therapists and orthopedic clinicians. Specifically, MSK-ultrasound is increasingly recognized as a potent tool for the assessment of the femoral trochlea. Its non-invasive nature and dynamic imaging capabilities make it particularly suited for visualizing the femoral trochlea, a critical component in knee function and biomechanics. The use of MSK ultrasound in the evaluating the femoral trochlea provides sports medicine professionals with a dynamic, non-invasive, and cost-effective means to diagnose, and monitor knee-related injuries. This article delves into the utility of MSK ultrasound in the anatomical and functional assessment of the femoral trochlea, elucidating its benefits, limitations, and clinical implications for athletes.

Kinematic analysis of damaged capsulolabral structure in patients with anterior shoulder instability using cine-magnetic resonance imaging.

Background: We assessed damaged anterior capsulolabral motion during axial shoulder rotation in patients with anterior shoulder instability. Methods: Twenty-nine shoulders of 28 patients with anterior shoulder instability who underwent cine-magnetic resonance imaging during axial rotation of the adducted arm were included. The motion was captured after an intra-articular injection of saline solution (10-20 mL). During imaging, the shoulder was rotated passively from maximum internal rotation to maximum external rotation in the first 10 s and then back to maximum internal rotation in the subsequent 10 s. We assessed the rotational angles of the damaged labrum during compressing and pulling the humeral head against the glenoid. Evaluation of the rotational angles was performed on a series of axial images through the humeral head center. Results: The mean angles that damaged labrum compressed and pulled off against the glenoid were 12.0 ± 19.1° and 2.8 ± 21.2°, respectively. Additionally, seven of the 29 shoulders showed that the damaged labrum compressed on the glenoid rim before the rotational angle exceeded 0° during external rotation. In 13 shoulders, the damaged labrum could remain repositioned on the glenoid rim over the neutral position during internal rotation. In two shoulders, the damaged labrum was not compressed against the glenoid at the maximum external rotation. The injected saline moved from the posterior to the anterior side of the glenohumeral joint during internal rotation in each shoulder. Conclusion: The damaged labrum could be positioned on the glenoid when the arm was in a traditional internal immobilization.

Dynamic assessment of the effectiveness of digital game-based literacy training in beginning readers: a cluster randomised controlled trial.

In this article, we report on a study evaluating the effectiveness of a digital game-based learning (DGBL) tool for beginning readers of Dutch, employing active (math game) and passive (no game) control conditions. This classroom-level randomized controlled trial included 247 first graders from 16 classrooms in the Netherlands and the Dutch-speaking part of Belgium. The intervention consisted of 10 to 15 min of daily playing during school time for a period of up to 7 weeks. Our outcome measures included reading fluency, phonological skills, as well as purpose built in-game proficiency levels to measure written lexical decision and letter speech sound association. After an average of 28 playing sessions, the literacy game improved letter knowledge at a scale generalizable for all children in the classroom compared to the two control conditions. In addition to a small classroom wide benefit in terms of reading fluency, we furthermore discovered that children who scored high on phonological awareness prior to training were more fluent readers after extensive exposure to the reading game. This study is among the first to exploit game generated data for the evaluation of DGBL for literacy interventions.

Risk Prediction Models and Novel Prognostic Factors for Heart Failure with Preserved Ejection Fraction: A Systematic and Comprehensive Review.

BACKGROUND: Patients with heart failure with preserved ejection fraction (HFpEF) have large individual differences, unclear risk stratification, and imperfect treatment plans. Risk prediction models are helpful for the dynamic assessment of patients' prognostic risk and early intensive therapy of high-risk patients. The purpose of this study is to systematically summarize the existing risk prediction models and novel prognostic factors for HFpEF, to provide a reference for the construction of convenient and efficient HFpEF risk prediction models. METHODS: Studies on risk prediction models and prognostic factors for HFpEF were systematically searched in relevant databases including PubMed and Embase. The retrieval time was from inception to February 1, 2023. The Quality in Prognosis Studies (QUIPS) tool was used to assess the risk of bias in included studies. The predictive value of risk prediction models for end outcomes was evaluated by sensitivity, specificity, the area under the curve, C-statistic, C-index, etc. In the literature screening process, potential novel prognostic factors with high value were explored. RESULTS: A total of 21 eligible HFpEF risk prediction models and 22 relevant studies were included. Except for 2 studies with a high risk of bias and 2 studies with a moderate risk of bias, other studies that proposed risk prediction models had a low risk of bias overall. Potential novel prognostic factors for HFpEF were classified and described in terms of demographic characteristics (age, sex, and race), lifestyle (physical activity, body mass index, weight change, and smoking history), laboratory tests (biomarkers), physical inspection (blood pressure, electrocardiogram, imaging examination), and comorbidities. CONCLUSION: It is of great significance to explore the potential novel prognostic factors of HFpEF and build a more convenient and efficient risk prediction model for improving the overall prognosis of patients. This review can provide a substantial reference for further research.

Erratum: A new dynamic word learning task to diagnose language disorder in French-speaking monolingual and bilingual children.

[This corrects the article DOI: 10.3389/fresc.2022.1095023.].

Effects of Group-Dynamic Assessment and Process-Based Instruction on EFL Learners' Metacognitive Awareness and Listening Comprehension: A Mixed-Methods Inquiry.

Although a range of studies has explored the effectiveness of group-dynamic assessment (G-DA) and process-based instruction (PBI) in second language (L2) learning, no study has compared the effects of G-DA and PBI on EFL learners' metacognitive awareness (MA) and listening comprehension (LC). Thus, this study aimed to explore the effects of G-DA and PBI on fostering EFL learners' metacognitive awareness (MA) and listening comprehension (LC) in Iran. For this purpose, a total of one hundred and sixty intermediate EFL learners were selected through a convenience sampling method at Iran Language Institute (ILI) and were homogenized using the Key English Test (KET). The EFL learners whose scores fell around the mean score were chosen and randomly allocated as G-DA group (n = 30), PBI group (n = 30), and control group (n = 30). Afterward, they went through a pre-test, interventions (lasting 16 one-hour sessions held twice a week) and a post-test. The interactions in the classes were also meticulously recorded. The collected data were analyzed using a one-way ANOVA and a microgenetic development approach. Findings evidenced that the G-DA group and PBI group outperformed the control group concerning the gains in MA and LC. However, the findings evidenced that G-DA was more effective than PBI to foster the EFL learners' MA and LC. Additionally, the complementary qualitative results documented that the proper feedback offered in line with the principles and procedures of G-DA and PBI contributed to developing the participants' MA and LC. The study ends by offering some implications for the relevant stakeholders.

Scaffolding via Group-dynamic Assessment to Positively Affect Motivation, Learning Anxiety, and Willingness to Communicate: A Case Study of High School Students.

Although a mass of studies has demonstrated the effectiveness of scaffolding through group-dynamic assessment (G-DA) in fostering English as a foreign language (EFL) learners' language skills and components, its contributions to developing psychological constructs, such as motivation, learning anxiety (LA), and willingness to communicate (WTC) have remained largely unexplored in the context of Iranian high schools. Thus, this study purported to disclose the contributions of G-DA to Iranian high school students' motivation, LA, and WTC. For these purposes, 124 grade 11 students were chosen through a random sampling method at Shahed High School in Borujerd City, Iran, homogenized through the Oxford Quick Placement test (OQPT), and randomly allocated as a control group (CG) (n = 23) and an experimental group (EG) (n = 23). Afterward, a pre-test, interventions (for 16 one-hour sessions held two times a week as an extra-curricular program), and a post-test were implemented. The results of the independent samples t-tests evidenced that EG's motivation significantly improved compared to CG after the interventions. Additionally, the findings revealed that the G-DA-based instruction significantly contributed to relieving EG's LA. Further, the results uncovered that a statistically significant difference existed between EG and CG concerning the gains in WTC. The findings gained in this study are anticipated to contribute significantly to the various EFL settings, as well as they offer a variety of recommendations and implications for relevant stakeholders.

Dynamic Assessment of AAC Action Verb Symbols for Children with ASD.

Objectives: The purpose of this study was to determine whether children with autism spectrum disorder (ASD) make progress in learning to use action verb symbols on augmentative and alternative communication (AAC) applications across different communicative functions (requesting, labeling) and instructional formats (embedded instruction, discrete trial teaching). Methods: Four preschool-aged children completed graduated prompting dynamic assessment sessions in which they were provided with varying levels of support (e.g., models, gestures) across three instructional conditions: (a) requesting actions embedded in play, (b) labeling actions embedded in play, and (c) labeling actions presented via video during discrete trial teaching. An adapted multielement single-case design was used to compare participants' abilities to use symbols with different levels of support across the instructional conditions and a control. Results: Differences between instructional and control conditions were established for three participants. Three participants also reduced the levels of support they needed to use symbols in at least two instructional conditions. Although participants initially required lower levels of support (i.e., less restrictive prompts) in the requesting condition compared to labeling conditions, these differences only maintained for one participant. Across participants, differences between labeling conditions were minimal. Conclusions: Although children with ASD can use verb symbols with low levels of support during DA, additional intervention may be needed to increase independent responding. Individual characteristics may influence success across communicative functions.

4D dynamic system for visual-motor integration analysis.

It is very important to evaluate visual-motor integration (VMI), as it is used as an index to evaluate cognitive abilities. However, it is difficult to use the existing paper-based tests to evaluate the dynamic process, including spatial and depth perception abilities. Therefore, this study aims to extract kinematic and dynamic features for dynamic assessment for VMI. We propose a 4D dynamic analysis system that implements a VMI test in a virtual space using Leap motion controller and Unity3D and acquires the time-series data of hand joints and traces. We selected three categories of features: postural control ability, spatial and depth perception ability, and 4D analysis. The degree and patterns of postural maintenance differed between subjects in the VMI and MC tests. In addition, the personal patterns were identified with dynamic features, including their fluency and hesitation in relation to the task figures of the VMI test tool. As such, this system enables dynamic feature extraction and analysis which were previously impossible and presents performance results for healthy adults.