What do justice-involved youth want from integrated youth services? A conjoint analysis.

Background: Many youth in the criminal justice system are affected by mental health and/or substance use (MHS) challenges, yet only a minority receive treatment. One way to increase access to MHS care is integrated youth services (IYS), a community-based model of service delivery where youth can access evidence-based treatment for their MHS problems and other wellbeing needs, in one location. However, it is unknown what IYS services justice-involved youth prioritize. Objective: This study explored what components of IYS justice-involved youth deem to be the most important in meeting their MHS service needs, in comparison with non-justice-involved youth, by conducting a secondary analysis of data gathered from a larger Ontario-wide study. Method: Using a conjoint analysis, n = 55 justice-involved youth, and n = 188 non-justice-involved youth, completed thirteen choice tasks representing different combinations of IYS. Results: Both justice-involved and non-justice-involved youth exhibited preferences for a broad range of core health services, including mental health services, substance misuse counseling, medication management, and physical or sexual health services. They also preferred a broad range of additional support services, in addition to fast access to care in a community setting that specializes in mental health services, with the incorporation of e-health services. Justice-involved youth prioritized working with a trained peer support worker to learn life skills and help them with the services they need. The importance of youth playing a leadership role in making decisions within IYS organizations was also a distinguishing preference among justice-involved youth. Conclusions: Tailoring IYS to meet the service preferences of justice-involved youth may enhance service utilization, potentially leading to better outcomes for justice-involved youth and their communities.

Contexte: Nombre de jeunes dans le système de justice pénale sont affectés de problèmes de santé mentale et/ou d'utilisation de substances (SMS), pourtant seule une minorité reçoit un traitement. Une façon d'élargir l'accès aux soins SMS consiste dans les services intégrés à la jeunesse (SIJ), un modèle communautaire de prestation de service dans lequel les jeunes peuvent avoir accès à un traitement fondé sur les données probantes pour leurs problèmes de SMS et autres besoins de bien-être en un seul lieu. Cependant, on ne sait pas à quels SIJ les jeunes impliqués dans la justice accordent la priorité. Objectif: La présente étude a exploré quelles composantes des SIJ sont jugées les plus importantes par les jeunes impliqués dans la justice pour répondre à leurs besoins de service de SMS, en comparaison avec les jeunes non impliqués dans la justice, au moyen d'une analyse secondaire des données recueillies d'une étude plus vaste à l'échelle de l'Ontario. Méthode: À l'aide d'une analyse conjointe, n = 55 jeunes impliqués dans la justice, et n = 188 jeunes non impliqués dans la justice ont répondu à treize tâches à choix représentant différentes combinaisons de SIJ. Résultats: Tant les jeunes impliqués dans la justice que les jeunes non impliqués ont affiché des préférences pour une large gamme de services de santé de base, notamment les services de santé mentale, la consultation pour abus de substances, la gestion des médicaments, et les services de santé physique ou sexuelle. Ils préféraient également une large gamme de services de soutien additionnels, en plus d'un accès rapide aux soins dans un milieu communautaire qui se spécialise en services de santé mentale, avec l'incorporation de services de santé en ligne. Les jeunes impliqués dans la justice accordaient la priorité au travail avec un pair aidant formé pour apprendre les compétences de la vie et les aider dans les services dont ils ont besoin. L'importance pour les jeunes de jouer un rôle de leadership dans la prise de décisions au sein des organisations de SIJ était également une préférence distincte chez les jeunes impliqués dans la justice. Conclusions: Adapter les SIJ pour répondre aux préférences de services des jeunes impliqués dans la justice peut améliorer l'utilisation des services, et mener potentiellement à de meilleurs résultats pour les jeunes impliqués dans la justice et leurs communautés.

Integrated Youth Service Preferences of Caregivers of Justice-Involved Youth: A Discrete Choice Conjoint Experiment.

Introduction: Mental health and/or substance use (MHS) challenges affect approximately 95% of youth in the criminal justice system, with only three in ten justice-involved youth receiving treatment. Caregivers of justice-involved youth have identified fragmented care as a barrier to youth accessing MHS services. One suggested solution to this problem is the implementation of integrated youth services (IYS). However, it is unknown which IYS components caregivers of justice-involved youth prioritize. Methods: Using a discrete choice conjoint experiment (DCE), n = 46 caregivers of justice-involved youth, and n = 204 caregivers of non-justice-involved, completed thirteen choice tasks representing different combinations of IYS. Results: Both caregiver groups exhibited preferences for involvement and access to information regarding their youth's treatment, and fast access to broad range of core health and additional services, in a community setting, with the incorporation of e-health services. Caregivers of justice-involved youth showed a unique preference for involvement in family counseling with their youth. The incorporation of this service feature may help to engage caregivers of justice-involved youth in their youths' MHS treatment 3-fold. Conclusion: Data gleaned from this analysis provides an understanding of what components of IYS models may help to engage caregivers of justice-involved youth.

Associations over the COVID-19 pandemic period and the mental health and substance use of youth not in employment, education or training in Ontario, Canada: a longitudinal, cohort study.

BACKGROUND: The economic shutdown and school closures associated with the COVID-19 pandemic have negatively influenced many young people's educational and training opportunities, leading to an increase in youth not in education, employment, or training (NEET) globally and in Canada. NEET youth have a greater vulnerability to mental health and substance use problems, compared to their counterparts who are in school and/or employed. There is limited evidence on the association between COVID-19 and NEET youth. The objectives of this exploratory study included investigating: longitudinal associations between the COVID-19 pandemic and the mental health and substance use (MHSU) of NEET youth; and MHSU among subgroups of NEET and non-NEET youth. METHODS: 618 youth (14-28 years old) participated in this longitudinal, cohort study. Youth were recruited from four pre-existing studies at the Centre for Addiction and Mental Health. Data on MHSU were collected across 11 time points during the COVID-19 pandemic (April 2020-August 2022). MHSU were measured using the CoRonavIruS Health Impact Survey Youth Self-Report, the Global Appraisal of Individual Needs Short Screener, and the PTSD Checklist for DSM-5. Linear Mixed Models and Generalized Estimating Equations were used to analyze associations of NEET status and time on mental health and substance use. Exploratory analyses were conducted to investigate interactions between sociodemographic characteristics and NEET status and time. RESULTS: At baseline, NEET youth were significantly more likely to screen positive for an internalizing disorder compared to non-NEET youth (OR = 1.92; 95%CI=[1.26-2.91] p = 0.002). No significant differences were found between youth with, and without, NEET in MHSU symptoms across the study time frame. Youth who had significantly higher odds of screening positive for an internalizing disorder included younger youth (OR = 1.06, 95%CI=[1.00-1.11]); youth who identify as Trans, non-binary or gender diverse (OR = 8.33, 95%CI=[4.17-16.17]); and those living in urban areas (OR = 1.35, 95%CI=[1.03-1.76]), compared to their counterparts. Youth who identify as White had significantly higher odds of screening positive for substance use problems (OR = 2.38, 95%CI=[1.72-3.23]) compared to racialized youth. CONCLUSIONS: Our findings indicate that sociodemographic factors such as age, gender identity, ethnicity and area of residence impacted youth MHSU symptoms over the course of the study and during the pandemic. Overall, NEET status was not consistently associated with MHSU symptoms over and above these factors. The study contributes to evidence on MHSU symptoms of NEET youth.

"A peer support worker can really be there supporting the youth throughout the whole process": a qualitative study exploring the role of peer support in providing substance use services to youth.

BACKGROUND: Youth (ages 12-24) rarely access services and supports to address substance use concerns. Peer support can facilitate service engagement and has been associated with positive substance use recovery outcomes in adults, yet few studies have examined this role among youth specifically. As such, this qualitative study explored the role of peer support in providing substance use services to youth in British Columbia and how best to support them in their role. METHODS: Participatory action research methods were used by partnering with youth who had lived/living experience of substance use, including peer support workers, to co-design the research protocol and materials. An initial focus group and subsequent interviews were held with 18 peer support workers who provide services to youth (ages 12-24) based on their own lived experience with mental health and/or substance use. The discussions were audio-recorded, transcribed verbatim, and analysed thematically using an inductive approach. RESULTS: Peer support workers' core experiences providing substance use services to youth centred around supporting youth throughout the whole process. This was accomplished by meeting youth where they are at, providing individualized care, and bridging the gap between other services and supports. However, participants experienced multiple organizational barriers hindering their ability to support youth and stressed the importance of having an employer who understands the work you are doing. This involved having someone advocating for the peer support role to promote collaboration, empowering peers to set boundaries and define their own role, and providing adequate training and mentorship. Finally, peer support workers described how their lived experience bridges connection and de-stigmatization at the individual, organizational, and community level, which was unique to their role. CONCLUSIONS: Peer support plays a unique role in youths' substance use journeys, given their own lived experience and flexibility within their role. However, their position is often misunderstood by employers and other service providers, leaving peers with inadequate support, training, and mentorship to do their job. The findings from this study call for improved integration of peer support into service environments, as well as standardized training that is in-depth and continuous.

Youth cannabis use in Canada post-legalization: service providers' perceptions, practices, and recommendations.

BACKGROUND: In 2018, Canada legalized recreational cannabis use with the purpose of protecting youth and restricting access. However, concerns have been raised that this objective has not been met as rates of cannabis use among youth aged 16-24 have not declined. Youth cannabis use is associated with various adverse effects including psychosis, anxiety, depression, suicidality, respiratory distress, cannabinoid hyperemesis syndrome, and intoxications. Service providers play a crucial role in addressing youth cannabis use. This study aimed to understand Ontario service providers' perceptions, practices, and recommendations on youth cannabis use. METHODS: This mixed method study included a survey and two focus groups. The survey was distributed to mental health service providers serving youth aged 16-24 across Ontario who were given the option to participate in a focus group. The survey included closed and open-ended questions regarding perceptions, practices, and recommendations, while the focus groups explored these categories in greater depth. Descriptive statistics were used to analyze close-ended questions and interpretative content analysis was applied for open-ended questions. Focus group data were analyzed using thematic analysis. RESULTS: The survey was completed by 160 service providers and 12 participated in two focus groups. Regarding perceptions, 60% of survey participants agreed with legalization, 26% had a strong understanding of medical versus recreational cannabis, 84% believed that cannabis has physical and mental health risks, and 49% perceived stigmatization. Less than half of the survey participants reported screening or assessing cannabis use, 16% stated they are highly familiar with treating cannabis use, and 67% reported that they rarely work with families. Subthemes identified in the focus groups under perceptions included normalization and stigmatization, harms for youth, and stigma, racism, and discrimination. Subthemes under practice included cannabis not being the primary focus, challenges with screening, assessment, and intervention, and referral to specialized services. Both the survey and focus group participants recommended increasing public education, enhancing service provider training, improving regulation and policies, reducing stigma and minimization, improving service access, and providing more culturally responsive services. CONCLUSION: Youth cannabis use in Canada remains a significant public health concern, necessitating a more comprehensive plan to protect Ontario youth and reduce associated harms.

Youth engagement in child maltreatment research: Gaps, barriers, and approaches.

Youth engagement in research, which involves meaningfully collaborating with youth as full partners in the research process, has contributed to improved research collaborations, enhanced youth participation, and increased motivation for researchers to address scientific questions relevant to youth. Engaging youth as partners in the research process is especially needed in the field of child maltreatment due to the high prevalence of maltreatment, its poor association with health outcomes, and the disempowerment that can occur following exposure to child maltreatment. Although evidence-based approaches for youth engagement in research have been established and applied in other areas such as mental health services, youth engagement in child maltreatment research has been limited. This is particularly disadvantageous to youth exposed to maltreatment as their voices remain absent from research priorities, which contributes to a discrepancy between the research topics that are relevant to youth and those that are pursued by the research community. Using a narrative review approach, we provide an overview of the potential for youth engagement within the field of child maltreatment research, identify barriers to youth engagement, provide trauma-informed strategies for engaging youth in the context of research, and review existing trauma-informed models for youth engagement. This discussion paper suggests that youth engagement in research can contribute to improvements in the design and delivery of mental health care services for youth exposed to traumatic experiences and should be prioritized in future research endeavors. Moreover, it is essential for youth who have historically experienced systemic violence to be engaged and have a voice in research that has the potential to impact policy and practice.

Navigating Supported Employment and Education Services for Youths During COVID-19 and Severe Weather Events.

In 2021, the British Columbia (BC) Interior experienced a series of unprecedented disasters, ranging from extreme heat and wildfires to catastrophic flooding and evacuations. Along with these severe weather events, BC was affected by COVID-19 outbreaks and public health restrictions. Despite these challenges, communities worked to ensure that youths who are at risk for increased mental health challenges continued to have access to services that promote well-being, such as individual placement and support programs for supported employment and education. This Open Forum presents program considerations and adaptations in Foundry Penticton, one of 12 province-wide integrated youth hubs, to ensure service delivery during acute and chronic disasters.

Barriers and Facilitators to the Implementation of an Integrated Youth Services Network in Ontario.

Introduction: In response to the challenges of the traditional mental health system for youth both in Canada and abroad, models of integrated youth services (IYS) that span the integration of mental health, health, substance use, eucation, employment, peer support, and navigation into 'one-stop shops' are being established nationally and internationally. IYS models, however, need to be better described and evaluated to inform the replicability of this approach in other jurisdictions. Description: This paper describes the implementation of an IYS in a small urban city and rural county in Ontario, Canada, including insights from key informants into barriers, facilitators, and lessons learned. Discussion: This evaluation identified a number of barriers and facilitators to the implementation of the IYS model in this specific context. Implementation facilitators included youth and family engagement, network partner collaboration, leadership, governance structure, community enthusiasm and support, and collaborative funding models. Barriers to implementation included the COVID-19 pandemic and related public health restrictions, the diverse needs of youth, change management, sustainable funding, and transportation. Lessons learned: By establishing a shared vision of delivering youth services across the integrated network, and engaging youth early in the process of model development, IYS have the potential to transform the service system for youth and their families. Meeting the diverse needs and challenges of youth who live in rural or small urban communities will enhance service delivery and experience for young people.

Sex-specific associations of maternal prenatal testosterone levels with birth weight and weight gain in infancy.

Associations between maternal salivary testosterone at 36 weeks' gestation with birth weight and infant weight gain through 6 months of age were examined in a group of 49 healthy, pregnant women and their offspring. The diurnal decline of maternal testosterone was conserved in late pregnancy, and levels showed significant day-to-day stability. Elevated maternal morning testosterone level was associated with lower birth weight Z-scores adjusted for gestational age and sex, and greater infant weight gain between birth and 6 months. Although maternal testosterone levels did not differ by fetal sex, relations were sex-specific such that maternal testosterone had a significant impact on weight for male infants; among female infants associations were nonsignificant. Results highlight the opposing influence of maternal androgens during pregnancy on decreased growth in utero and accelerated postnatal weight gain.

Characteristics and management practices associated with milk production in dairy herds in Ohio enrolled in official Dairy Herd Improvement Association programs.

OBJECTIVE: To determine herd characteristics and management practices associated with milk production in dairy herds enrolled in official Dairy Herd Improvement Association (DHIA) programs in Ohio. SAMPLE POPULATION: 186 dairy farms in Ohio. PROCEDURE: All herds in official DHIA programs in 9 counties were invited to participate. Information regarding herd characteristics and management practices was obtained, using a standardized questionnaire. Bulk-tank milk samples were obtained for bacteriologic culture. Official DHIA test-day records were obtained, and associations were identified, using multivariable ANOVA procedures. RESULTS: Of 479 eligible producers, 186 (39%) participated, and consecutive bulk-tank milk samples were available for culture from 172 (36%). Streptococcus agalactiae and Mycoplasma spp were not recovered from bulk-tank milk samples, but Staphylococcus aureus was recovered from 64 (37%) herds. Mean (+/- SD) number of lactating cows in participating herds was 97+/-66, with 123 (66%) herds milking < 100 cows. The RHA was significantly associated with number of cows in milk, estimated percentage of herd detected in estrus, reported annual percentage of heifer calves born alive that died before 8 weeks old, percentage days in milk, use of bovine somatotropin during the preceding 2 years, and sex of the person completing the questionnaire. CONCLUSIONS AND CLINICAL RELEVANCE: In this study, the strongest indicator of milk production was number of cows in milk. However, merely adding cows to a herd should not be considered to guarantee increased milk production, because other management traits could be confounded with increased number of cows in a herd.

Variables affecting the competency maintenance behaviors of occupational therapists.

OBJECTIVE: The purpose of this study was to examine the relationship between work environment and the competency maintenance activities of occupational therapists. METHOD: A survey of 121 occupational therapists in three states and interviews with 8 occupational therapists in Ohio were used. RESULTS: Analysis of survey data indicated that workplace support and the degree of competency monitoring are significant determinants of competency maintenance behavior. State continuing education requirements had no impact on reported levels of competency maintenance. Personal motivation of the therapist emerged as a potentially important moderator of the relationship between environment and competency maintenance. CONCLUSIONS: Although environmental factors enhance competency maintenance activities, active participation in competency maintenance is also related to the personal commitment of the individual therapist. Strategies that reduce barriers to effective competency maintenance and promote a culture of continuing competency in the profession merit further investigation.

Herd characteristics and management practices associated with bulk-tank somatic cell counts in herds in official Dairy Herd Improvement Association programs in Ohio.

OBJECTIVE: To identify herd characteristics and management practices associated with bulk-tank somatic cell counts (BTSCC) in dairy herds in Ohio enrolled in official Dairy Herd Improvement Association (DHIA) programs. SAMPLE POPULATION: 186 dairies in Ohio. PROCEDURE: All herds in official DHIA programs in 9 counties were asked to participate. Extensive information regarding herd characteristics and management practices was obtained, using a standardized questionnaire. Bulk-tank milk samples were requested from all participating herds for bacterial culture. Official DHIA test-day records for January 1997 were obtained from all herds enrolled in official DHIA programs in the 9 counties. Potential associations were identified, using multivariable ANOVA. RESULTS: Participation was 186 of 479 (39%) herds. Streptococcus agalactiae and Mycoplasma spp were not isolated from bulk-tank milk samples. Staphylococcus aureus was isolated from 64 of 172 (37%) of the herds. The BTSCC were inversely associated with peak daily milk production, postmilking teat disinfection, percentage of eligible cows in the herd detected in estrus, and directly related to the extent to which BTSCC was perceived as a herd problem during the preceding 2 years. Type of housing for nonlactating cows and product used for treatment of nonlactating cows also were significantly associated with BTSCC. CONCLUSIONS AND CLINICAL RELEVANCE: Consideration of herd characteristics and implementation of management practices associated with BTSCC could result in increased milk yield and production of milk with lower BTSCC.

Face lift: the anatomic basis for a safe, long-lasting procedure.

This article summarizes our current face lift technique and its evolution over the last 20 years. Our goal has been to provide excellent results with as little risk as possible. Changes in technique have been motivated primarily by improved understanding of facial anatomy. In this article we discuss the anatomic concepts we have found most useful in developing a safe, precise procedure, and we present our current preferred techniques.

Bolus maternal cocaine administration does not produce a large increase in fetal sheep cerebral cortical glutamate concentration.

Human cocaine use during pregnancy may result in postnatal neurologic dysfunction and abnormal behavior. L-Glutamate, the major excitatory neurotransmitter in the brain, plays an important role in cerebral cortical development. An optimal level of glutamate is required for normal neuronal development. We tested whether acute cocaine exposure produces large increases in glutamate release in the intact cerebral cortex of the near-term fetal sheep. Cocaine 3.0 mg kg(-1) IV bolus produced the expected increase in maternal and fetal mean arterial pressure, increase in fetal heart rate, decrease in uterine blood flow, and decrease in fetal arterial blood pO2 (N = 5). The percentage increases in extracellular glutamate concentration in the fetal cerebral cortex measured by in utero microdialysis were 7%, 15%, 17%, 17%, and 43% in each fetus (upper 95% confidence bound for the median = 43%). We conclude that if cocaine increases glutamate concentration in the developing cerebral cortex, the increase in magnitude is small relative to the changes produced by other interventions such as ethanol or umbilical cord occlusion. Mechanisms other than increases in cerebral cortical glutamate concentration probably contribute to the neurologic injury associated with prenatal cocaine exposure.

Chronic hypoxemia causes extracellular glutamate concentration to increase in the cerebral cortex of the near-term fetal sheep.

Fetal hypoxia is an important cause of neurologic morbidity and mortality. Hypoxia-induced increase in extracellular glutamate concentration can lead to excitotoxic neuronal death in adults. The objective of this study was to test whether chronic fetal hypoxemia increases extracellular glutamate concentration in the unanesthetized intact cerebral cortex of the near-term fetal sheep. Microdialysis probes were implanted into the parasagittal parietal cortex and periventricular white matter of near-term fetal sheep. At 124 +/- 1 days of gestation, extracellular glutamate concentration was determined before and during 24 h of fetal hypoxemia. Chronic hypoxemia was produced by tightening a vascular occluder placed around the maternal common iliac artery. Larger decreases in fetal arterial oxygen content were associated with larger increases in extracellular glutamate concentration in the parietal cortex (Kendall's tau = 0.81, N = 7, p = 0.005). No such relationship was detected in the periventricular white matter. Chronic hypoxemia increases extracellular glutamate concentration in the intact cerebral cortex of the unanesthetized near-term fetal sheep.

Management of a parturient with an uncorrected atrioventricular canal defect.

A 24-year-old woman at 37 weeks gestation, with an uncorrected atrioventricular canal defect and incipient congestive heart failure is presented. This rare defect is part of the larger group of endocardial cushion defects. The peripartum anesthetic management of this condition has not been described. Our patient had a large atrial septal defect, a common regurgitant atrioventricular valve, a large left-to-right shunt and a small ventricular septal defect. Her pregnancy was maintained until she developed symptoms of congestive heart failure. We discuss her peripartum management, monitoring and anesthetic choices.

Ethanol-induced changes in prostaglandin E concentration in the intact cerebral cortex of preterm and near-term fetal sheep.

Ethanol-induced changes in fetal prostaglandin E (PGE) concentration may play a role in the toxic effects of prenatal ethanol exposure. Using the novel technique of in utero microdialysis, the present study tested the hypothesis that acute ethanol exposure changes PGE concentration in the intact cerebral cortex of preterm (93 +/- 1 days of gestation) and near-term (124 +/- 1 days of gestation; term, approximately 147 days) fetal sheep. Fetal sheep were surgically instrumented with a microdialysis probe placed in the parasagittal parietal cortex. Three days later, the effects of maternal infusion of 1 g of ethanol/kg maternal body weight on preterm (n = 6) and near-term (n = 7) fetal cerebral cortical and plasma PGE concentrations were determined. In the preterm fetal cerebral cortex, PGE concentration was increased after ethanol infusion in all six animals studied. The median peak increase was 160% with a 95% confidence interval of 115 to 784%. There was considerable variation in the time of occurrence, magnitude, and duration of this increase. In the near-term fetal cerebral cortex, an increase in PGE concentration was observed after ethanol infusion in 5 of the 7 animals studied, whereas a decrease in PGE concentration was observed in the other two animals. Overall, ethanol did not increase significantly near-term fetal cerebral cortical PGE concentration. For both age groups, ethanol infusion had no effect on fetal plasma PGE concentration. These data indicate that ethanol can affect PGE production in the fetal cerebral cortex and that this effect seems to be gestational-age-dependent.

Mothers' and fathers' singing to infants.

Mothers and fathers sang a song of their choice, once to their infant and once as if to their infant (simulated). The pitch of songs was higher and the tempo slower for infant-directed than for simulated versions. Listeners varying in child-care experience, musical background, and cultural origin reliably identified which of the two versions was infant-directed (Experiment 1). Identification accuracy was enhanced by musical training, knowledge of the singers' language and culture, and by greater pitch and tempo differences between versions. Other adult listeners who rated the singer's emotional engagement assigned significantly higher ratings to infant-directed than to simulated versions (Experiment 2). Differences in pitch and tempo between both versions predicted emotional engagement ratings. Finally, rating differences between infant-directed and simulated versions were highly correlated with identification accuracy.

Temporal resolution in infancy and subsequent language development.

The MacArthur Communicative Development Inventory, a parent-report measure of vocabulary and syntax, was administered to 103 children (M = 23 months) who had participated in a study of temporal resolution when they were 6 months (n = 55) or 12 months (n = 48) of age. Children who performed above the median on the temporal resolution task in infancy were subsequently reported to have larger productive vocabularies, greater numbers of irregular word forms, and longer and more complex sentences than those who had performed below the median. Whether these findings reflect specific links between temporal resolution and language or whether they reflect general developmental factors remains to be determined.

Gap detection in infants, children, and adults.

Listeners who were 6.5 months, 12 months, 5 years, and 21 years of age were required to discriminate a pair of 500-Hz, Gaussian-enveloped tone pips from a short 500-Hz tone of the same duration and total energy. Groups of 6.5-month-old infants were tested on a single gap duration: 8, 12, 16, 20, 28, or 40 ms. Groups of 12-month-olds were also tested on a single gap duration: 8, 12, 16, or 20 ms. The 5-year-old children and adults were tested on gap durations of 8, 12, and 16 ms. The mean performance of 6.5-month-olds significantly exceeded chance levels on all gap durations except 8 ms, and that of 12-month-olds was above chance levels on all gap durations. For 5-year-old children and adults, mean performance also exceeded chance levels for all gap durations tested. Adults performed significantly better than 5-year-old children on gap durations of 12 and 16 ms. Gap-detection thresholds, defined by a performance criterion of d' = 0.5, were estimated at 11, 5.6, and 5.2 ms for infants, children, and adults, respectively. It is likely that smaller adult-infant differences in the present study compared to those reported in previous research stem from our use of Gaussian-enveloped tone pips and the consequent minimization of adaptation effects.