Pearls & Oy-sters: Pivoting Treatment Regimens of Pediatric Atypical Teratoid Rhabdoid Tumors to Optimize Care in Adult ATRT: A Case Report.

Atypical teratoid rhabdoid tumor (ATRT) is a highly malignant embryonal tumor of the CNS, largely affecting pediatric patients, with exceedingly rare cases in adults at an estimated annual incidence of 1/1,000,000. We report a unique case of ATRT in a 43-year-old female patient who first presented with progressive focal headaches. Imaging revealed a sellar mass with suprasellar extensions, which was partially removed via a transsphenoidal resection. The tumor aggressively recurred just 1 month postoperatively. Her care team pursued a novel treatment plan by using a slightly modified COG ACNS 0332 regimen, which involved radiation, followed by 4 cycles of monthly chemotherapy including vincristine, cyclophosphamide, and cisplatin. Hematopoietic stem cells were collected between radiation and chemotherapy in the event that the patient required stem cell salvage therapy postadjuvant chemotherapy. The MRIs taken at 2 and 4 months postrecurrence indicated a substantial decrease in tumor volume, with corresponding clinical improvements to cranial nerve deficits. Given the scarcity of literature on adult cases of ATRT and the lack of a standard of care for these cases, discussing the efficacy of our patient's treatment plan may aid clinical decision making for adult ATRT cases.

Making Race Visible in the Speech, Language, and Hearing Sciences: A Critical Discourse Analysis.

PURPOSE: The purpose of this critical discourse analytic study is to identify how two key professional standards documents in the Speech, Language and Hearing Sciences field-the Standards for Certification document and the Essential Functions rubric-contribute to the discursive construction of the ideal speech-language pathologist and audiologist, and to examine whether the experiences and needs of people of color are taken into consideration in these documents. METHOD: Critical discourse analysis was used as both a conceptual and methodological lens for the systematic analysis of the targeted text. RESULTS: The findings show that considerations of race and racism were almost entirely absent from both documents and thus reflected a discourse of race neutrality that is ideologically consistent with color-blind racism. The enactment of racially coded expectations within a construct of race-neutral discourse maintains racial inequities in the speech, language, and hearing sciences professions. CONCLUSIONS: The findings highlight the need for the open acknowledgment of racism in our institutional policies and discourses and official and ongoing commitments to concrete and measurable antiracist actions to counteract systemic racism. Recommendations for and examples of antiracist measures are offered.

Language Use and Development in Third-Person Singular Contexts: Assessment Implications.

Purpose The purpose of this assessment-focused clinical focus article is to increase familiarity with African American English (AAE)-speaking children's pattern of language use in third-person singular contexts and to discuss implications for speech-language assessments of developing AAE-speaking children. Method The clinical focus draws on descriptive case study data from four typically developing child speakers of AAE who are between the ages of 3 and 5 years. The children's data from three different sources-sentence imitation, story retell, and play-based language samples-were subjected to linguistic analyses. Results The three sources of linguistic data offered different insights into the children's production of -s and other linguistic patterns in third-person singular contexts. Conclusions This study underscores the importance of exploring developing child AAE from a descriptive approach to reveal different types of information about patterns of morphological marking in different linguistic contexts, which is crucial in assessing developing AAE. Implications for language assessment are discussed.

Curriculum-Based Language Assessment With Culturally and Linguistically Diverse Students in the Context of Mathematics.

Purpose: The purpose of this tutorial is to discuss the use of curriculum-based language assessment (CBLA) with students who are English language learners and students who speak nonmainstream varieties of English, such as African American English. Method: The article begins with a discussion of the discourse of mathematics and the role of the speech-language pathologist (SLP), followed by a review of studies that includes those that examined the performance of English language learner and nonmainstream dialect-speaking students on word-based math items. Results: The literature review highlights the linguistic and content biases associated with word-based math problems. Useful strategies that SLPs and educators can incorporate in culturally and linguistically appropriate assessments are discussed. The tutorial ends with a discussion of CBLA as a viable assessment approach to use with culturally and linguistically diverse students. Conclusions: Tests used at national, state, and school levels to assess students' math abilities have associated linguistic bias and content bias often leading to an inaccurate depiction of culturally and linguistically diverse students' math skills. CBLA as an assessment method can be used by school-based SLPs to gather valid and useful information about culturally and linguistically diverse students' language for learning math. By using CBLA, SLPs can help modify curricular tasks in broader contexts in an effort to make math, including high-level math, "accessible and achievable for all" students (American Speech-Language-Hearing Association, 2017).

Development of Auxiliaries in Young Children Learning African American English.

PURPOSE: We examined language samples of young children learning African American English (AAE) to determine if and when their use of auxiliaries shows dialect-universal and dialect-specific effects. METHOD: The data were longitudinal language samples obtained from two children, ages 18 to 36 months, and three children, ages 33 to 51 months. Dialect-universal analyses examined age of first form and early uses of BE, DO, and modal auxiliaries. Dialect-specific analyses focused on rates of overt marking by auxiliary type and syntactic construction and for BE by surface form and succeeding element. RESULTS: Initial production of auxiliaries occurred between 19 and 24 months. The children's forms were initially restricted and produced in syntactically simple constructions. Over time, they were expanded in ways that showed their rates of marking to vary by auxiliary type, their rates of BE and DO marking to vary by syntactic construction, and their rates of BE marking to vary by surface form and succeeding element. CONCLUSIONS: Development of auxiliaries by young children learning AAE shows both dialect-universal and dialect-specific effects. The findings are presented within a development chart to guide clinicians in the assessment of children learning AAE and in the treatment of AAE-speaking children with language impairment.

Comparison of African American Children's Performances on a Minimal Competence Core for Morphosyntax and the Index of Productive Syntax.

PURPOSE: This study is a response to the need for evidence-based measures of spontaneous oral language to assess African American children under the age of 4 years. We determined if pass/fail status on a minimal competence core for morphosyntax (MCC-MS) was more highly related to scores on the Index of Productive Syntax (IPSyn)-the measure of convergent criterion validity-than to scores on 3 measures of divergent validity: number of different words (Watkins, Kelly, Harbers, & Hollis, 1995), Percentage of Consonants Correct-Revised (Shriberg, Austin, Lewis, McSweeney, & Wilson, 1997), and the Leiter International Performance Scale-Revised (Roid & Miller, 1997). METHOD: Archival language samples for 68 African American 3-year-olds were analyzed to determine MCC-MS pass/fail status and the scores on measures of convergent and divergent validity. RESULTS: Higher IPSyn scores were observed for 60 children who passed the MCC-MS than for 8 children who did not. A significant positive correlation, rpb = .73, between MCC-MS pass/fail status and IPSyn scores was observed. This coefficient was higher than MCC-MS correlations with measures of divergent validity: rpb = .13 (Leiter International Performance Scale-Revised), rpb = .42 (number of different words in 100 utterances), and rpb = .46 (Percentage of Consonants Correct-Revised). CONCLUSION: The MCC-MS has convergent criterion validity with the IPSyn. Although more research is warranted, both measures can be potentially used in oral language assessments of African American 3-year-olds.

BE, DO, and modal auxiliaries of 3-year-old African American English speakers.

PURPOSE: This study examined African American English-speaking children's use of BE, DO, and modal auxiliaries. METHOD: The data were based on language samples obtained from 48 three-year-olds. Analyses examined rates of marking by auxiliary type, auxiliary surface form, succeeding element, and syntactic construction and by a number of child variables. RESULTS: The children produced 3 different types of marking (mainstream overt, nonmainstream overt, zero) for auxiliaries, and the distribution of these markings varied by auxiliary type. The children's nonmainstream dialect densities were related to their marking of BE and DO but not modals. Marking of BE was influenced by its surface form and the succeeding verbal element, and marking of BE and DO was influenced by syntactic construction. CONCLUSIONS: Results extend previous studies by showing dialect-specific effects for children's use of auxiliaries and by showing these effects to vary by auxiliary type and children's nonmainstream dialect densities. Some aspects of the children's auxiliary systems (i.e., pattern of marking across auxiliaries and effects of syntactic construction) were also consistent with what has been documented for children who speak other dialects of English. These findings show dialect-specific and dialect-universal aspects of African American English to be present early in children's acquisition of auxiliaries.