Oral language enrichment in preschool improves children's language skills: a cluster randomised controlled trial.

BACKGROUND: Oral language skills provide the foundation for formal education, yet many children enter school with language weaknesses. This study evaluated the efficacy of a new language enrichment programme, the Nuffield Early Language Intervention-Preschool (NELI Preschool), delivered to children in the year before they enter formal education. METHODS: We conducted a preregistered cluster randomised controlled trial in 65 nursery schools in England (https://doi.org/10.1186/ISRCTN29838552). NELI Preschool consists of a 20-week whole-class language enrichment programme delivered by a teacher each day for 20 min. In addition, children with the weakest language skills in each class are allocated to receive additional targeted support delivered by classroom assistants (whole-class + targeted). The language skills of all children (n = 1,586) in participating classrooms were assessed using the LanguageScreen automated app (https://oxedandassessment.com/languagescreen/). Settings were then randomly allocated to an intervention or control group. The children with the weakest language in each class (whole-class + targeted children n = 438), along with four randomly selected children in each class allocated to the whole-class only programme (n = 288) were individually tested on a range of language measures. RESULTS: Children receiving NELI Preschool made larger gains than children in the control group on an oral language latent variable (whole-class children d = .26; whole-class + targeted children d = .16). CONCLUSIONS: This study provides good evidence that whole-class intervention delivered in preschool can produce educationally significant improvements in children's language skills. The intervention is scaleable and relatively low cost. These findings have important implications for educational and social policy.

A network model of referent identification by toddlers in a visual world task.

We present a neural network model of referent identification in a visual world task. Inputs are visual representations of item pairs unfolding with sequences of phonemes identifying the target item. The model is trained to output the semantic representation of the target and to suppress the distractor. The training set uses a 200-word lexicon typically known by toddlers. The phonological, visual, and semantic representations are derived from real corpora. Successful performance requires correct association between labels and visual and semantic representations, as well as correct location identification. The model reproduces experimental evidence that phonological, perceptual, and categorical relationships modulate item preferences. The model provides an account of how language can drive visual attention in the inter-modal preferential looking task.

Early language intervention improves behavioral adjustment in school: Evidence from a cluster randomized trial.

Oral language skills are critical for psychosocial development and children with language difficulties are more likely than peers to experience behavioral problems. This study investigated the effects of an oral language intervention on behavioral adjustment. We collected teacher ratings of behavioral adjustment for 1173 children taking part in a cluster randomized trial of the Nuffield Early Language Intervention (NELI) program in 193 primary schools. Ratings were collected before and immediately after the 20-week intervention. Children receiving the language program showed significantly greater improvements than the untreated control group on a latent variable reflecting behavioral adjustment (d = 0.23). However, the improvements in behavioral adjustment for children receiving language intervention were not mediated by improvements in language. We suggest that the improvements in behavioral adjustment are a consequence of the small group and individual teaching sessions in the language intervention program, which emphasizes the need to pay attention and regulate behavior. This emphasis appears to produce generalized improvements in children's behavior regulation outside of the targeted language teaching sessions.

The Oxford digital multiple errands test (OxMET): Validation of a simplified computer tablet based multiple errands test.

Impairments in executive functioning are common following Acquired Brain Injury, though there are few screening tools which present a time efficient and ecologically valid approach to assessing the consequences of executive impairments. We present the Oxford Digital Multiple Errands Test (OxMET), a novel and simplified computer-tablet version of a Multiple Errands Test. We recruited 124 neurologically healthy controls and 105 stroke survivors to complete the OxMET task. Normative data and internal consistency were established from the healthy control data. Convergent and divergent validation was assessed in a mixed subset of 158 participants who completed the OxMET and OCS-Plus. Test-retest reliability was examined across a mixed subset of 39 participants. Finally, we investigated the known-group discriminability of the OxMET. The OxMET demonstrated very high internal consistency, and stable group level test-retest performance as well as good convergent and divergent validity. The OxMET demonstrated high sensitivity and good specificity in overall differentiation of stroke survivors from controls. The Oxford Digital Multiple Errands Test is a brief, easy to administer tool, designed to quickly screen for potential consequences of executive impairments in a virtual environment shopping task on a computer tablet. Initial normative data and validation within a chronic stroke cohort is presented.

A Neural Network Model of Lexical-Semantic Competition During Spoken Word Recognition.

Visual world studies show that upon hearing a word in a target-absent visual context containing related and unrelated items, toddlers and adults briefly direct their gaze toward phonologically related items, before shifting toward semantically and visually related ones. We present a neural network model that processes dynamic unfolding phonological representations of words and maps them to static internal lexical, semantic, and visual representations. The model, trained on representations derived from real corpora, simulates this early phonological over semantic/visual preference. Our results support the hypothesis that incremental unfolding of a spoken word is in itself sufficient to account for the transient preference for phonological competitors over both unrelated and semantically and visually related ones. Phonological representations mapped dynamically in a bottom-up fashion to semantic-visual representations capture the early phonological preference effects reported in visual world tasks. The semantic visual preference typically observed later in such a task does not require top-down feedback from a semantic or visual system.

Validation of an automated scoring program for a digital complex figure copy task within healthy aging and stroke.

OBJECTIVE: Complex Figure Copy Tasks are one of the most commonly employed neuropsychological tests. However, manual scoring of this test is time-consuming, requires training, and can then still be inconsistent between different examiners. We aimed to develop and evaluate a novel, automated method for scoring a tablet-based Figure Copy Task. METHOD: A cohort of 261 healthy adults and 203 stroke survivors completed the digital Oxford Cognitive Screen-Plus (OCS-Plus) Figure Copy Task. Responses were independently scored by two trained human raters and by a novel automated scoring program. RESULTS: Overall, the Automated Scoring Program was able to reliably extract and identify the separate figure elements (average sensitivity and specificity of 92.10% and 90.20%, respectively) and assigned total scores which agreed well with manual scores (intraclass correlation coefficient [ICC] = .83). Receiver Operating Curve analysis demonstrated that, compared to overall impairment categorizations based on manual scores, the Automated Scoring Program had an overall sensitivity and specificity of 80% and 93.40%, respectively (Area Under the Curve; AUC = 86.70%). Automated total scores also reliably distinguished between different clinical impairment groups with subacute stroke survivors scoring significantly worse than longer-term survivors, which in turn scored worse than neurologically healthy adults. CONCLUSIONS: These results demonstrate that the novel Automated Scoring Program was able to reliably extract and accurately score Figure Copy Task data, even in cases where drawings were highly distorted due to comorbid fine-motor deficits. This represents a significant advancement as this novel technology can be employed to produce immediate, unbiased, and reproducible scores for Figure Copy Task responses in clinical and research environments. Key Points-Question: We aimed to develop and evaluate a novel, automated method for scoring a tablet-based Figure Copy Task. FINDINGS: The novel Automated Scoring Program was able to reliably extract and accurately score Figure Copy Task data, even in cases where drawings were highly distorted due to comorbid fine-motor deficits. IMPORTANCE: This represents a significant advancement as this novel technology can be employed to produce immediate, unbiased, and reproducible scores for Figure Copy Task responses in clinical and research environments. Next Steps: Trialing the Automated Scoring Program in clinical environments. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Validation of Oxford Cognitive Screen: Executive Function (OCS-EF), a tablet-based executive function assessment tool amongst adolescent females in rural South Africa.

Short, reliable, easily administered executive function (EF) assessment tools are needed to measure EF in low- and middle-income countries, particularly in sub-Saharan Africa given the prevalence of human immunodeficiency virus (HIV)-associated neurocognitive disorder. We administered Oxford Cognitive Screen-Executive Function (OCS-EF) to 932 rural South African females (mean age 19.7 years). OCS-EF includes seven tasks: two hot inhibition tasks (a modified Iowa Gambling Task, emotional go/no-go) and five cool EF tasks, two switching tasks (visuospatial rule-finding, geometric trails) and three working memory tasks (digit recall, selection and figure drawing). We performed confirmatory factor analysis testing whether a three-factor, two-factor hot-cool, two-factor working memory and inhibition/switching, or one-factor EF model fitted the data better. The three-factor (switching, inhibition and working memory) model had the best local and global fit (χ2 (11) 24.21, p = 0.012; RMSEA 0.036; CFI 0.920; CD 0.617). We demonstrated the feasibility of OCS-EF administration by trained laypeople, the tripartite structure of EF amongst adolescent females and the factorial validity of OCS-EF in this population and context. OCS-EF tablet-based cognitive assessment tool can be administered by trained laypeople and is a valid tool for assessing cognition at scale amongst adolescents in rural South Africa and similar environments.

Introducing the tablet-based Oxford Cognitive Screen-Plus (OCS-Plus) as an assessment tool for subtle cognitive impairments.

Here, we present the Oxford Cognitive Screen-Plus, a computerised tablet-based screen designed to briefly assess domain-general cognition and provide more fine-grained measures of memory and executive function. The OCS-Plus was designed to sensitively screen for cognitive impairments and provide a differentiation between memory and executive deficits. The OCS-Plus contains 10 subtasks and requires on average 24 min to complete. In this study, 320 neurologically healthy ageing participants (age M = 62.66, SD = 13.75) from three sites completed the OCS-Plus. The convergent validity of this assessment was established in comparison to the ACE-R, CERAD and Rey-Osterrieth. Divergent validity was established through comparison with the BDI and tests measuring divergent cognitive domains. Internal consistency of each subtask was evaluated, and test-retest reliability was determined. We established the normative impairment cut-offs for each of the subtasks. Predicted convergent and divergent validity was found, high internal consistency for most measures was also found with the exception of restricted range tasks, as well as strong test-retest reliability, which provided evidence of test stability. Further research demonstrating the use and validity of the OCS-Plus in various clinical populations is required. The OCS-Plus is presented as a standardised cognitive assessment tool, normed and validated in a sample of neurologically healthy participants. The OCS-Plus will be available as an Android App and provides an automated report of domain-general cognitive impairments in executive attention and memory.

Early language screening and intervention can be delivered successfully at scale: evidence from a cluster randomized controlled trial.

BACKGROUND: It is well established that oral language skills provide a critical foundation for formal education. This study evaluated the effectiveness of the Nuffield Early Language Intervention (NELI) programme in ameliorating language difficulties in the first year of school when delivered at scale. METHODS: We conducted a cluster randomized controlled trial (RCT) in 193 primary schools (containing 238 Reception classrooms). Schools were randomly allocated to either a 20-week oral language intervention or a business-as-usual control group. All classes (N = 5,879 children) in participating schools were screened by school staff using an automated App to assess children's oral language skills. Screening identified 1,173 children as eligible for language intervention: schools containing 571 of these children were allocated to the control group and 569 to the intervention group. RESULTS: Children receiving the NELI programme made significantly larger gains than the business-as-usual control group on a latent variable reflecting standardized measures of language ability (d = .26) and on the school-administered automated assessment of receptive and expressive language skills (d = .32). The effects of intervention did not vary as a function of home language background or gender. CONCLUSIONS: This study provides strong evidence for the effectiveness of a school-based language intervention programme (NELI) delivered at scale. These findings demonstrate that language difficulties can be identified by school-based testing and ameliorated by a TA delivered intervention; this has important implications for educational and social policy.

The relationship between executive function, risky behaviour and HIV in young women from the HPTN 068 study in rural South Africa.

Executive function (EF) may predict sexual risk-taking and HIV risk in young women in rural South Africa. We tested associations between EF and seven risky behavioural outcomes: binge drinking, illicit substance use, unprotected vaginal sex, concurrent sexual relationships, transactional sex, herpes simplex virus type 2 (HSV-2) infection, and HIV infection. We compared EF in young women with HIV to matched controls. 1080 young women underwent cognitive assessments. Better verbal short-term memory was associated with a lower risk of HSV-2 (OR 0.77; 95% CI 0.69, 0.86; p < 0.001). Uncorrected trends (p < 0.05) were better verbal working memory being associated with a lower risk of concurrency, better planning with a lower risk of illicit drug use, and better affective inhibition with a lower risk of transactional sex. 78 participants with sexually acquired HIV were matched with 153 HIV-negative controls and had poorer verbal working memory than controls (Hedge's g = -0.38; 95% CI -0.66, -0.10; p = 0.0076), but this was non-significant after adjustment. EF's contribution to young women's risky behaviour in this context does not hold when stringent statistical corrections are applied, with only verbal short term memory reaching statistical significance as predictor. Replication in other samples is recommended.

Understanding attention, memory and social biases in fragile X syndrome: Going below the surface with a multi-method approach.

Fragile X syndrome (FXS) is characterised by atypical social behaviours, such as gaze aversion. However, it remains unclear whether, or if so how, these behaviours affect cognitive processing and influence memory. We asked children with FXS (N = 16) and typically developing children (TD; N = 46) to explore naturalistic scenes containing social and non-social salient items unrelated to their task at hand (searching for a simple target object). We also assessed children's memory for target locations. We complemented behavioural responses with eye-tracking data for the subset of participants who managed to comply with calibration and the demands of the experimental testing session (6 children with FXS and 43 TD children). Children with FXS performed well at the experimental task, and showed similar accuracy and speed in locating targets in natural scenes to children of equivalent verbal abilities. They also learned target locations over blocks, but their memory of target locations was not as precise as that of comparison children. In addition, children with FXS initially directed few first looks to salient social items within the scenes, but these looks increased over blocks. Like TD children, children with FXS also dwelled gaze upon social items while recalling target locations from memory. Individual differences in everyday social characteristics also related to gaze and behavioural measures. In conclusion, experimental approaches can highlight cognitive underpinnings of atypical social behaviour in FXS, pinpointing both similarities and differences to TD individuals.

Neural dynamics underlying coherent motion perception in children and adults.

Motion sensitivity increases during childhood, but little is known about the neural correlates. Most studies investigating children's evoked responses have not dissociated direction-specific and non-direction-specific responses. To isolate direction-specific responses, we presented coherently moving dot stimuli preceded by incoherent motion, to 6- to 7-year-olds (n = 34), 8- to 10-year-olds (n = 34), 10- to 12-year-olds (n = 34) and adults (n = 20). Participants reported the coherent motion direction while high-density EEG was recorded. Using a data-driven approach, we identified two stimulus-locked EEG components with distinct topographies: an early component with an occipital topography likely reflecting sensory encoding and a later, sustained positive component over centro-parietal electrodes that we attribute to decision-related processes. The component waveforms showed clear age-related differences. In the early, occipital component, all groups showed a negativity peaking at ˜300 ms, like the previously reported coherent-motion N2. However, the children, unlike adults, showed an additional positive peak at ˜200 ms, suggesting differential stimulus encoding. The later positivity in the centro-parietal component rose more steeply for adults than for the youngest children, likely reflecting age-related speeding of decision-making. We conclude that children's protracted development of coherent motion sensitivity is associated with maturation of both early sensory and later decision-related processes.

Factors Influencing Manipulation of a Familiar Object in Patients With Limb Apraxia After Stroke.

Previous studies have shown that hand actions to visual objects are affected both by perceptual factors and by action goals. Our aim was to study how these processes affected hand actions in chronic stroke patients, based on whether they had limb apraxia. Twenty-two left hemisphere, chronic stroke patients were measured on neuropsychological tasks of limb apraxia, which was identified in a subgroup of 10 patients. All patients underwent testing on a separate task of making simple reach and grasp actions to a cup. Their performance was compared to a group of 18 healthy age-matched volunteers. Participants were instructed to grasp the top or bottom of a cup to either lift or turn it over so as to end with a hand position that was either comfortable or uncomfortable. This task tested the influence of the compatibility of hand-cup orientation, as well as goals driven by the end-state comfort of the hand, on action selection for object manipulation. Participants' performance was measured in terms of error rates, and speed of initiation and reaching (movement time) to the object. The patients' performance was significantly delayed, and error rates increased when reaching to grasp a cup under conditions of poor compatibility and end-state comfort. The subgroup of patients with apraxia showed a decreased influence of compatibility of hand interaction with the cup, with increased error rates and delayed response times, compared to patients with no apraxia and healthy volunteers. This is despite the fact they did not display significant deficits on neuropsychological tasks of real object use. The study shows that patients with apraxia have difficulties in selecting elements of object-directed actions, pertaining to both habitual and goal-directed factors.

Subclinically Anxious Adolescents Do Not Display Attention Biases When Processing Emotional Faces - An Eye-Tracking Study.

Recent research suggests that early difficulties with emotion regulation go along with an increased risk for developing psychiatric disorders, such as anxiety disorders for example. Adolescent anxiety is often referred to as a gateway disorder, due to its high predictability for lifelong persistent mental health problems. It has been shown that clinically anxious adolescents exhibit attention biases toward negative stimuli, yet whether these biases can also be found in the subclinical range of subclinically anxious adolescents is currently unclear. In this study, we set out to investigate this question by combining an emotional Go-Nogo task with eye-tracking techniques to assess attention biases for emotional faces in a subclinical sample of 23 subclinically anxious adolescent girls. This combined approach allowed us to look at both, behavioral and covert attention biases. Using both traditional and Bayesian hypothesis testing, we found no evidence for a bias toward negative, threat-relevant stimuli in the behavioral level or eye-tracking data. We believe that the results can help close a gap in the current literature by showing that like low-anxious adolescents, subclinically anxious adolescents do not exhibit attention biases when viewing de-contextualized emotional stimuli in the Overlap task. Together with previous research findings in clinically anxious participants which have reported high levels of attention biases, our results seem to suggest that attention biases do no increase linearly as a function of individual anxiety level. Future research is now needed to explore the contribution of additional factors, such as depression for example.

"17" is odd and "seventeen" is even: Meaning and physical form in stimulus-parity synaesthesia.

For individuals with stimulus-parity synaesthesia, eliciting stimuli (e.g., shapes, numbers, letters, colours) trigger a compelling feeling of oddness or evenness. Given that (a) many inducers are conceptual and (b) parity is itself a conceptual property, one questions whether stimulus-parity synaesthesia will be a categorically higher subtype, such that the conceptual properties of stimuli will be crucial in determining parity. We explore this question as it applies to Synaesthete R, one of only two stimulus-parity synaesthetes known to the contemporary literature. In Experiments 1 and 2, we examine whether parity is tied to concepts or percepts, asking, for example, whether a rectangle is even regardless of whether it is presented as an image or a word. Our results indicate that the parity of shapes (words and images), numbers (words, digits, and Roman numerals), and letters (lowercase and uppercase) differs according to the stimulus format, supporting a perceptual explanation. In Experiment 3, we examine the parity of colour stimuli, showing a systematic relationship between the measurable physical properties of hue, saturation, and lightness and synaesthetic parity. Despite the conceptual nature of inducers and concurrents, for Synaesthete R, stimulus-parity synaesthesia is a lower subtype; perceptual properties of stimuli determine parity.

Executive function associated with sexual risk in young South African women: Findings from the HPTN 068 cohort.

PURPOSE: Heightened sexual risk in adolescence and young adulthood may be partially explained by deficits in executive functioning, the set of cognitive processes used to make reasoned decisions. However, the association between executive function and sexual risk is understudied among adolescent girls and young women, particularly in low- and middle-income countries. METHODS: In a cohort of 853 young women age 18-25 in rural Mpumalanga province, South Africa, we evaluated executive function with three non-verbal cognitive tests: I. a rule-finding test, II. a trail-making test, and III. a figure drawing test. Using log-binomial regression models, we estimated the association between lower executive function test scores and indicators of sexual risk (unprotected sex acts, concurrent partnerships, transactional sex, and recent HSV-2 infection). RESULTS: In general, young women with lower executive function scores reported higher frequencies of sexual risk outcomes, though associations tended to be small with wide confidence intervals. Testing in the lowest quintile of Test I was associated with more unprotected sex [aPR (95% CI): 1.4 (1.0, 1.8)]. Testing in the lowest quintile of Test II was associated with more concurrent relationships and transactional sex [aPR (95% CI): 1.6 (1.1, 2.5) and 1.7 (1.3, 2.4), respectively], and testing in the lowest four quintiles of Test III was associated with more concurrent relationships [aPR (95% CI): 1.7 (1.0, 2.7)]. CONCLUSIONS: These results demonstrate an association between low executive function and sexual risk in South African young women. Future work should seek to understand the nature of this association and whether there is promise in developing interventions to enhance executive function to reduce sexual risk.

Online incidental statistical learning of audiovisual word sequences in adults: a registered report.

Statistical learning has been proposed as a key mechanism in language learning. Our main goal was to examine whether adults are capable of simultaneously extracting statistical dependencies in a task where stimuli include a range of structures amenable to statistical learning within a single paradigm. We devised an online statistical learning task using real word auditory-picture sequences that vary in two dimensions: (i) predictability and (ii) adjacency of dependent elements. This task was followed by an offline recall task to probe learning of each sequence type. We registered three hypotheses with specific predictions. First, adults would extract regular patterns from continuous stream (effect of grammaticality). Second, within grammatical conditions, they would show differential speeding up for each condition as a factor of statistical complexity of the condition and exposure. Third, our novel approach to measure online statistical learning would be reliable in showing individual differences in statistical learning ability. Further, we explored the relation between statistical learning and a measure of verbal short-term memory (STM). Forty-two participants were tested and retested after an interval of at least 3 days on our novel statistical learning task. We analysed the reaction time data using a novel regression discontinuity approach. Consistent with prediction, participants showed a grammaticality effect, agreeing with the predicted order of difficulty for learning different statistical structures. Furthermore, a learning index from the task showed acceptable test-retest reliability (r = 0.67). However, STM did not correlate with statistical learning. We discuss the findings noting the benefits of online measures in tracking the learning process.

In-group biases and oculomotor responses: beyond simple approach motivation.

An in-group bias describes an individual's bias towards a group that they belong to. Previous studies suggest that in-group bias facilitates approach motor responses, but disrupts avoidance ones. Such motor biases are shown to be more robust when the out-group is threatening. We investigated whether, under controlled visual familiarity and complexity, in-group biases still promote pro-saccade and hinder anti-saccades oculomotor responses. Participants first learned to associate an in-group or out-group label with an arbitrary shape. They were then instructed to listen to the group-relevant auditory cue (name of own and a rival university) followed by one of the shapes. Half of the participants were instructed to look towards the visual target if it matched the preceding group-relevant auditory cue and to look away from it if it did not match. The other half of the participants received reversed instructions. This design allowed us to orthogonally manipulate the effect of in-group bias and cognitive control demand on oculomotor responses. Both pro- and anti-saccades were faster and more accurate following the in-group auditory cue. Independently, pro-saccades were performed better than anti-saccades, and match judgements were faster and more accurate than non-match judgements. Our findings indicate that under higher cognitive control demands individuals' oculomotor responses improved following the motivationally salient cue (in-group). Our findings have important implications for learning and cognitive control in a social context. As we included rival groups, our results might to some extent reflect the effects of out-group threat. Future studies could extend our findings using non-threatening out-groups instead.

The understanding of complex syntax in children with Down syndrome.

Background: Down syndrome (DS) is associated with poor language skills that seem disproportionate to general nonverbal ability, but the nature and causes of this deficit are unclear. We assessed how individuals with DS understand complex linguistic constructions, and considered how cognitive ability and memory and impact the ability of those with DS to process these sentence types. Methods: There were three groups participating in the study: children with DS (n = 33) and two control groups composed of children with cognitive impairment of unknown aetiology (CI) (n = 32) and children with typical development (n = 33). The three groups did not differ on raw scores on a test of non-verbal cognitive ability. Using a newly devised animation task, we examined how well individuals with DS (n = 33) could understand relative clauses, complement clauses and adverbial clauses compared to children with CI and typically developing controls. Participants also completed the Test for the Reception of Grammar-2, three measures of memory (forward and backward digit recall, visuo-spatial memory) and a hearing screen. Results: Results indicated that (1) with the exception of intransitive subject relative clauses, children with DS performed at floor on all other complex sentences, (2) they performed at a significantly lower level than both control groups, and (3) DS status accounted for a significant proportion of the variance over and above memory skills. Conclusions: Our findings suggest that children with DS have a disproportionate difficulty understanding complex sentences compared to two control groups matched on mental age. Furthermore, their understanding of syntax is not completely explained by poor cognitive or memory skills, rather it appears to be a specific deficit that may distinguish children with DS from other neurodevelopmental disorders.