Assessment of early auditory development of very young Finnish children with LittlEARS(®) Auditory Questionnaire and McArthur Communicative Developmental Inventories.

OBJECTIVES: We analysed the Finnish version of the LittlEARS(®) Auditory Questionnaire as a method for assessing very young children's early auditory, pre-verbal and emerging verbal development. We also examined whether any background factors exist that influence the results and thus the usability of this method. To determine its potential in assessment, the Finnish version of the LittlEARS(®) Auditory Questionnaire was analysed in relation to the Finnish McArthur Communicative Developmental Inventories. The latter is currently the method most commonly used together with parental interviews. However, this method is neither designed for infants younger than 8 months nor is its main emphasis on auditory development. Thus, we investigated whether the Finnish version of LittlEARS(®) Auditory Questionnaire could supplement the Finnish McArthur Communicative Developmental Inventories and thereby help in detecting children with hearing impairments. METHODS: Normative data were collected for Finnish children with normal hearing (N=318) using the LittlEARS(®) Auditory Questionnaire and an abridged version of the Finnish McArthur Communicative Developmental Inventories. In addition, background information was collected with a questionnaire designed for this study. The results of these questionnaires were analysed in relation to each other. RESULTS: Statistical analysis showed that the results gained with the Finnish version of LittlEARS(®) Auditory Questionnaire and the abridged version of the Finnish McArthur Communicative Developmental Inventories are closely related. However, the LittlEARS(®) Auditory Questionnaire manages to capture the earlier and subtler changes that occur in infancy, therefore making a good continuum with McArthur Communicative Developmental Inventories. Also, most background factors, such as parents' educational level, did not affect the results significantly, rendering the LittlEARS(®) Auditory Questionnaire a valuable method for assessment of early auditory development in very young children. CONCLUSIONS: The Finnish version of the LittlEARS(®) Auditory Questionnaire is a reliable assessment tool with no confounding background factors. It enables evaluation of the early auditory development in even the youngest of children.

Brain atrophy accelerates cognitive decline in cerebral small vessel disease: the LADIS study.

OBJECTIVE: To examine the independent contributions and combined interactions of medial temporal lobe atrophy (MTA), cortical and subcortical atrophy, and white matter lesion (WML) volume in longitudinal cognitive performance. METHODS: A total of 477 subjects with age-related WML were evaluated with brain MRI and annual neuropsychological examinations in 3-year follow-up. Baseline MRI determinants of cognitive decline were analyzed with linear mixed models controlling for multiple confounders. RESULTS: MTA and subcortical atrophy predicted significantly steeper rate of decline in global cognitive measures as well as compound scores for psychomotor speed, executive functions, and memory after adjusting for age, gender, education, lacunes/infarcts, and WML volume. Cortical atrophy independently predicted decline in psychomotor speed. WML volume remained significantly associated with cognitive decline even after controlling for the atrophy scores. Moreover, significant synergistic interactions were found between WML and atrophy measures in overall cognitive performance across time and the rate of cognitive decline. Synergistic effects were also observed between baseline lacunar infarcts and all atrophy measures on change in psychomotor speed. The main results remained robust after exclusion of subjects with clinical stroke or incident dementia, and after additional adjustments for progression of WML and lacunes. CONCLUSIONS: Brain atrophy and WML are independently related to longitudinal cognitive decline in small vessel disease. MTA, subcortical, and cortical atrophy seem to potentiate the effect of WML and lacunes on cognitive decline.

Predictors of distress in cancer patients and their partners: the role of optimism in the sense of coherence construct.

AIM: The aim of this study was to clarify the associations between sense of coherence (SOC), dispositional optimism and distress (i.e., anxiety and depression) in cancer patients and their partners. METHODS: The associations between SOC, dispositional optimism (Life Orientation Test-Revised, LOT-R), depression (Beck Depression Inventory-14, BDI-14) and anxiety (Endler Multidimensional Anxiety Scales, EMAS-State) were studied in 147 cancer couples. The data were collected with self-report questionnaires at the time of diagnosis (2 months) and after 6 months. Path analysis was used to analyse the predictors of follow-up distress and crossover effects in the longitudinal data. RESULTS: Optimistic patients and patients with strong SOC as well as their partners reported fewer symptoms of depression and anxiety than less optimistic subjects and subjects with weaker SOC. Optimism partially explained the effect of SOC on distress and SOC seemed to be an independent factor in predicting distress. Patient and partner distress at baseline and at 8-month follow-up correlated positively. In addition, high partner optimism at baseline seemed to predict low patient anxiety at follow-up. CONCLUSIONS: The beneficial effects of SOC seem to include also other elements beyond optimism. In clinical practice, enhancing optimistic expectations of the future and promoting SOC could be expected to reduce distress in cancer patients and their partners.