Survey of clinical staff knowledge on the long-term outcomes of very preterm infants delivered in a tertiary referral hospital.

AIM: To assess knowledge of our neonatal intensive care unit clinical staff regarding preterm neurodevelopmental outcomes using the 33-item Preterm Birth Knowledge Scale (PB-KS). METHODS: An anonymous convenience sampling survey of clinical staff in the Neonatal Directorate was conducted between July and December 2019. PB-KS, demographic information and prior staff education on long-term outcomes in very preterm infants were collected. RESULTS: There were 56 responses (five neonatologists, eight paediatric trainees, 41 neonatal nurses and two allied health staff). Responses were scored as correct or incorrect. The mean score on the PB-KS was 19.5 (range: 4-29 out of 40) with 50% correct answers. Accuracy was highest (96%) for rates of cerebral palsy and lowest (11%) for estimation of quality of life among preterm survivors. Staff reported training in long-term outcomes of preterm infants through attending a conference/seminar (20%) or a combination of formal training and seminars (41.1%). Over half of our clinical staff reported a lack of formal training. Formally trained clinical staff scored significantly better in this survey. Didactic seminars were indicated as preferred choice for staff education. CONCLUSIONS: Results of our survey will assist in developing a customised educational programme to address identified gaps in the knowledge of clinical staff as our survey also showed significantly better scores among staff who were formally trained about long-term outcomes in very preterm infants. Staff responses indicated that knowledge on long-term outcomes was variable but more accurate with regard to more severe disabilities and shorter-term developmental outcomes.

Self-regulatory speech during planning and problem-solving in children with SLI and their typically developing peers.

BACKGROUND: Past research with children with specific language impairment (SLI) has shown them to have poorer planning and problem-solving ability, and delayed self-regulatory speech (SRS) relative to their typically developing (TD) peers. However, the studies are few in number and are restricted in terms of the number and age range of participants, which limits our understanding of the nature and extent of any delays. Moreover, no study has examined the performance of a significant subset of children with SLI, those who have hyperactive and inattentive behaviours. AIMS: This cross-sectional study aimed to compare the performance of young children with SLI (aged 4-7 years) with that of their TD peers on a planning and problem-solving task and to examine the use of SRS while performing the task. Within each language group, the performance of children with and without hyperactive and inattentive behaviours was further examined. METHODS & PROCEDURES: Children with SLI (n = 91) and TD children (n = 81), with and without hyperactive and inattentive behaviours across the three earliest school years (Kindergarten, Preprimary and Year 1) were video-taped while they completed the Tower of London (TOL), a planning and problem-solving task. Their recorded speech was coded and analysed to look at differences in SRS and its relation to TOL performance across the groups. MAIN CONTRIBUTION: Children with SLI scored lower on the TOL than TD children. Additionally, children with hyperactive and inattentive behaviours performed worse than those without hyperactive and inattentive behaviours, but only in the SLI group. This suggests that children with SLI with hyperactive and inattentive behaviours experience a double deficit. Children with SLI produced less inaudible muttering than TD children, and showed no reduction in social speech across the first three years of school. Finally, for children with SLI, a higher percentage performed better on the TOL when they used SRS than when they did not. CONCLUSIONS & IMPLICATIONS: The results point towards a significant delay in the development and internalization of SRS in the SLI group, which should be taken into account when considering the planning and problem-solving of young children with SLI.

The Effectiveness of Self-regulatory Speech Training for Planning and Problem Solving in Children with Specific Language Impairment.

Self-regulatory speech has been shown to be important for the planning and problem solving of children. Our intervention study, including comparisons to both wait-list and typically developing controls, examined the effectiveness of a training programme designed to improve self-regulatory speech, and consequently, the planning and problem solving performance of 87 (60 males, 27 females) children aged 4-7 years with Specific Language Impairment (SLI) who were delayed in their self-regulatory speech development. The self-regulatory speech and Tower of London (TOL) performance of children with SLI who received the intervention initially or after a waiting period was compared with that of 80 (48 male, 32 female) typically developing children who did not receive any intervention. Children were tested at three time points: Time 1- prior to intervention; Time 2 - after the first SLI group had received training and the second SLI group provided a wait-list control; and Time 3 - when the second SLI group had received training. At Time 1 children with SLI produced less self-regulatory speech and were impaired on the TOL relative to the typically developing children. At Time 2, the TOL performance of children with SLI in the first training group improved significantly, whereas there was no improvement for the second training group (the wait-list group). At Time 3, the second training group improved their TOL performance and the first group maintained their performance. No significant differences in TOL performance were evident between typically developing children and those with SLI at Time 3. Moreover, decreases in social speech and increases in inaudible muttering following self-regulatory speech training were associated with improvements in TOL performance. Together, the results show that self-regulatory speech training was effective in increasing self-regulatory speech and in improving planning and problem solving performance in children with SLI.