Speech-language pathologists' treatment goals for preschool language disorders: An ICF analysis.

Purpose: The World Health Organization's International Classification of Functioning, Disability and Health (ICF) provides a comprehensive framework to conceptualise clinical services. This study explored how speech-language pathologists (SLPs) conceptualised therapy goals for preschoolers with language difficulties and disorders within the ICF framework.Method: An online survey was distributed to SLPs practising in a publicly funded Preschool Speech and Language program in Ontario, Canada. SLPs rated their familiarity with the ICF framework, and then reported all therapy goals for one child with language difficulty/disorder on their caseload. For each reported goal, SLPs indicated the ICF component(s) they felt the goal addressed. Researchers then independently categorised SLPs' reported goals into the ICF components.Result: Ninety-three SLPs completed the survey, and 81% reported they were at least "somewhat" familiar with the ICF framework. On average, SLPs reported three therapy goals per child, and felt the Activities and Participation components were most frequently targeted (73% and 72% of all reported goals, respectively). Researchers categorised SLPs' reported goals differently, and identified 57% of goals addressing the Activities component, and 21% the Participation component.Conclusion: There is a need to better understand how SLPs and researchers conceptualise the ICF framework, particularly the Participation component.

Effectiveness of a parent-implemented language intervention for late-to-talk children: a real-world retrospective clinical chart review.

Purpose: This study aimed to: (1) evaluate the effectiveness of Target WordTM - The Hanen Program®for Parents of Children Who are Late Talkers for improving the real-world communicative participation skills of children who are late-to-talk, and (2) explore predictors of change in children's communicative participation skills.Method: We conducted a retrospective clinical chart review for 76 families who participated in the Target Word programme at a publicly-funded clinic. Families completed the Focus on the Outcomes of Communication Under Six (FOCUS) at pre-intervention, post-intervention, and after a 3-month consolidation period and scores were compared across the three assessment points. Regression analysis was then used to explore the relation between changes in children's communicative participation skills and potential predictors of change identified by 25 Target Word certified speech-language pathologists.Result: At the end of intervention, 75% of children had made a clinically significant change in communicative participation skills. Clinicians proposed verbal imitation, language development stagnation and parent interaction style as the top predictors of change in communicative participation skills. Of these, only verbal imitation at pre-intervention predicted change in communicative participation following the intervention.Conclusion: The Target Word programme can facilitate the development of communicative participation skills in late-to-talk children. Modifications to the intervention may be needed in order to maximise outcomes for children with limited verbal imitation.

Dynamics of spontaneous alpha activity correlate with language ability in young children.

Early childhood is a period of tremendous growth in both language ability and brain maturation. To understand the dynamic interplay between neural activity and spoken language development, we used resting-state EEG recordings to explore the relation between alpha oscillations (7-10 Hz) and oral language ability in 4- to 6-year-old children with typical development (N = 41). Three properties of alpha oscillations were investigated: a) alpha power using spectral analysis, b) flexibility of the alpha frequency quantified via the oscillation's moment-to-moment fluctuations, and c) scaling behavior of the alpha oscillator investigated via the long-range temporal correlation in the alpha-amplitude time course. All three properties of the alpha oscillator correlated with children's oral language abilities. Higher language scores were correlated with lower alpha power, greater flexibility of the alpha frequency, and longer temporal correlations in the alpha-amplitude time course. Our findings demonstrate a cognitive role of several properties of the alpha oscillator that has largely been overlooked in the literature.

Immature Auditory Evoked Potentials in Children With Moderate-Severe Developmental Language Disorder.

Purpose: Immature auditory processing has been proposed to underlie language impairments in children with developmental language disorder (DLD; also known as specific language impairment). Using newly available normative auditory evoked potential (AEP) waveforms, we estimated AEP maturity in individual children with DLD and explored whether this maturational index was related to their language abilities. Method: AEPs were elicited by 225 trials of a 490-Hz pure tone. Using intraclass correlation and our previously established normative AEP waveforms of 7- to 10-year-old children with typical development, we estimated the age equivalent of the AEPs (AEP-age) from 21 children with DLD. The relation between AEP maturity and language was explored through regression analysis. Results: AEP-age predicted 31% of the variance in the language abilities of children with DLD. The AEP-age of children with mild DLD was similar to their chronological age, whereas children with moderate-severe DLD showed, on average, a 1.3-year delay in their neural responses. AEP-age predicted receptive, but not expressive, language performance. Conclusion: Maturation in auditory neural responses is a significant predictor of language ability, particularly in children with moderate-severe DLD.

Maturation in auditory event-related potentials explains variation in language ability in children.

Processing of auditory information in the cortex continues to develop into later childhood and adolescence. Recent research has indicated that intraclass correlation (ICC) is the best method for capturing maturation in auditory event-related potentials (AEPs) of school-age children. However, the sensitivity of the ICC approach in discerning AEP changes in children has not been consistently demonstrated and positive results have not been replicated. We attempted this replication and further explored whether AEP maturation estimated using the ICC approach predicts cognitive and linguistic abilities in addition to chronological age. We measured AEPs in response to simple tones in groups of 7-, 8-, 9- and 10-year olds with typical development (N = 67) and used ICC to estimate the age equivalent of each child's AEP (AEP-age). Results indicated that ICC differentiated 7- to 8-year-old children from 9- to 10-year-old children and that AEP-age predicted both chronological age and significant, unique variance in language ability, but not in nonverbal IQ. Our findings support the view that auditory organization in children reflects both general developmental maturation and more specific development of language skills, and support the future use of AEP-age to identify and understand individual differences in brain maturation in typically developing and clinical populations.

A retrospective study of 51,781 adult oral and maxillofacial biopsies.

BACKGROUND: Few studies have compared patient and anatomic characteristics across the broad scope of oral and maxillofacial disease seen in dental clinics. The authors conducted a study to make these comparisons by surveying a large sample of histologically diagnosed oral and maxillofacial lesions in a US adult population. METHODS: A total of 51,781 specimens biopsied from 51,781 adult patients were received by an oral pathology service over 13 years (2001-2015) and analyzed. A description of patients' sex and age at diagnosis, as well as the anatomic site of biopsy was given for diagnoses of 10 oral disease types, including malignant neoplasm, benign neoplasm, infectious, reactive, potentially malignant, developmental, healthy tissue, immune dysfunction, physical trauma, and other. RESULTS: The authors reported reactive lesions were the most prevalent disease type found in the sample (74.9%). Malignant diagnoses comprised 1.97% of all biopsies. The 3 most prevalent diagnoses in this study included benign keratosis, chronic apical periodontitis, and radicular cyst. Different anatomic sites, patient age groups, and sexes show different distributions of disease. CONCLUSIONS: Certain disease types and diagnoses were found to have a higher prevalence by sex, among particular age groups, and in certain anatomic sites. PRACTICAL IMPLICATIONS: This information provides clinicians with a detailed and broad scope of the variety of oral and maxillofacial lesions processed at an oral pathology service and may assist practitioners in forming clinical impressions and differential diagnoses.

Pediatric Oral Pathology: A Retrospective Survey of 4,554 Biopsies.

PURPOSE: The purposes of this study were to: (1) report patient age, gender, and anatomical information on a large number of pediatric oral biopsies in the United States; and (2) highlight differences in recent pediatric oral lesions compared to past pediatric studies and an adult population. METHODS: A total of 4,554 pediatric biopsies received over the past 13 years (2001-2015) were surveyed. Patient's age, gender, anatomical site of biopsy, and diagnosis were described under 10 diagnostic categories: (1) malignant neoplasm; (2) benign neoplasm; (3) infectious; (4) reactive; (5) precancerous; (6) developmental; (7) healthy tissue; (8) immune dysfunction; (9) physical trauma; and (10) other. RESULTS: A gradual increase in the number of biopsies with age was noted. The most common diagnosis observed was mucocele, consisting of 28 percent of all biopsies. Biopsies across pathological categories were most commonly obtained from the mandible. CONCLUSIONS: Biopsies received from a pediatric population are largely reactive in nature. Compared to an adult population, the pediatric population has a significantly lower rate of malignant and precancerous lesions but a higher rate of developmental diagnosis. A diverse array of pathoses was seen in the gingiva and mandible, whereas palatal mucosa and the floor of the mouth exhibited more variation.