Atypical phonological processes in naming errors of children with language impairment.

The current study explored the characteristics of phonological errors of preschool children with DLD (Developmental Language Disorder), distinguishing between typical versus atypical phonological processes in segmental, syllabic and word levels. The analysis included 87 responses of words with phonological errors from a naming test, produced by 13 preschool children with DLD, aged 4;4-6;3 years. These responses included 166 phonological processes, which were classified into typical and atypical processes at the levels of: segments, syllables, and prosodic words. The findings revealed that 70% of the phonological processes were atypical. Furthermore, ten children produced more atypical processes, and there were more atypical than typical processes in segmental and word levels. It is suggested that some children with DLD represent phonological processes that are similar to those that children with speech and sound disorders produce. Therefore, clinically, the results emphasise the importance of analysing the typical and atypical characteristics of phonological errors as part of language assessment.

Content Words in Child-Directed Speech of Mothers Toward Children With Autism Spectrum Disorder.

Purpose Our study aimed to analyze the characteristics of content word usage in mother's child-directed speech ( CDS) toward children with autism spectrum disorder compared to mother's CDS toward typically developing children. Method We analyzed the lexical characteristics of CDS of mothers of children with autism (16 dyads) and compared them from a language developmental perspective to mothers of 20 typical children at the same level of expressive language development. Results Results suggest that mothers of children with autism use equal amounts of content words at the same language level, but the content consists of significantly more concrete nouns and active verbs and rarely the use of abstract nouns, stative verbs, adjectives, and adverbs. Conclusion This study suggests that professionals and parents of children with autism should be aware of the importance of varying their language use of content words.

Pediatric diabetes inpatient care: can medical staff knowledge be improved?

Background The purpose of this study was to assess the benefit of a short workshop addressing knowledge and confidence of inpatient caregivers (physicians and nurses) treating pediatric type 1 diabetes mellitus (T1DM) patients. Methods Questionnaires to determine familiarity with T1DM management and confidence in care were distributed at three university-affiliated medical centers. A 5-h practical-skills workshop was conducted at one center. Same questionnaires were filled out immediately after the workshop and 3 months later. Evaluation of knowledge was based on 16 multiple-choice questions, and confidence based on 10 categorical questions. Results Nurses and physicians (total 135, 106 women, 85 nurses) completed the questionnaires. The median knowledge score was 53.33 (40-66) and 46.7 (26.7-66.7) for nurses and physicians, respectively (p = 0.76). The confidence scores were 1.44 (1.1-1.9) and 1.56 (1.2-1.8), respectively (p = 0.7). More experience among nurses (>10 years) was associated with higher confidence scores (p = 0.04). Twenty-one physicians and 52 nurses, 66 women, attended the workshop. The median knowledge grade improved from 60 (47-67) to 81 (69-81), p < 0.001, immediately after, and to 69 (63-81), p < 0.001, 3 months post-workshop. The median confidence score improved from 1.8 (1.6-2) to 2.4 (2.1-2.6), p < 0.001, and to 2.2 (2-2.6), p < 0.001, respectively. There was no association with profession or seniority. Conclusions Knowledge and confidence in care of medical staff treating inpatient T1DM pediatric patients are lacking. Both improved significantly after the workshop, independent of seniority or profession.

Speech Acts During Friends' and Non-friends' Spontaneous Conversations in Preschool Dyads with High-Functioning Autism Spectrum Disorder versus Typical Development.

In this study, we videotaped two 10-min. free-play interactions and coded speech acts (SAs) in peer talk of 51 preschoolers (21 ASD, 30 typical), interacting with friend versus non-friend partners. Groups were matched for maternal education, IQ (verbal/nonverbal), and CA. We compared SAs by group (ASD/typical), by partner's friendship status (friend/non-friend), and by partner's disability status. Main results yielded a higher amount and diversity of SAs in the typical than the ASD group (mainly in assertive acts, organizational devices, object-dubbing, and pretend-play); yet, those categories, among others, showed better performance with friends versus non-friends. Overall, a more nuanced perception of the pragmatic deficit in ASD should be adopted, highlighting friendship as an important context for children's development of SAs.

Intra-word inconsistency in apraxic Hebrew-speaking children.

Intra-word inconsistency in a child is perceived as an indicator of speech impairment. Because the speech of typically developing children is highly variable, the extent and nature of the inconsistency must be defined when used as a diagnostic marker of speech impairment (McLeod, S., & Hewett, S. R. (2008). Variability in the production of words containing consonant clusters by typical 2- and 3-year-old children. Folia Phoniatrica et Logopaedica, 60(4), 163-172). In this paper, we study inconsistency with reference to the prosodic hierarchy (McCarthy, J. J., & Prince, A. S. (1996). Prosodic morphology 1986. Amherst, MA: University of Massachusetts. Retrieved April 15, 2010, from http://ruccs.rutgers.edu/pub/papers/pm86all.pdf), suggesting a new way to describe this phenomenon in childhood apraxia of speech (CAS). The prosodic hierarchy has been used in recent years to demonstrate the phonological development of typical and atypical populations. Sixteen children diagnosed with CAS (average age 3;11) participated in the study. The data, collected from each child in the course of eight weekly meetings, are drawn from naming single words. The results indicate that inconsistency is dominant for two prosodic levels, the segmental and the syllabic, while the prosodic word level was largely preserved.

Consonant-free words: evidence from Hebrew speaking children with cochlear implants.

This paper reports on a rare phenomenon in language development-the production of words without consonants, and thus syllables without an onset. Such words, which are referred as Consonant-free words (CFWs), appeared for a short period in the early speech of hearing impaired Hebrew-speaking children, who produced words consisting of one or two vowels (where the latter were disyllabic). The quantitative data are drawn from the speech of six monolingual hearing-impaired Hebrew-speaking children using a cochlear implant device. Their age ranged from 1;5-2;8 years at their first recording session. The elicitation procedure was based on spontaneous speech and picture naming. Findings indicate that cochlear implant users produce CFWs at the initial stage of the prosodic word development. This study claims the CFWs characterize a transitional period between babbling and speech, which varies between different types of populations. The transitional period is rather short in typically developing children, who hardly ever produce CFWs, greater in cochlear implant children, and the greatest in developmental speech disorders such as dyspraxia. Clinical implications of these findings are also discussed.

Pain in infants who are younger than 2 months during suprapubic aspiration and transurethral bladder catheterization: a randomized, controlled study.

OBJECTIVE: Proper diagnosis of urinary tract infections depends on obtaining an uncontaminated urine sample for culture. Suprapubic aspiration and transurethral catheterization are the 2 recommended procedures for obtaining specimens for urine culture from young infants. The objective of the current study was to compare the pain that is experienced during these 2 procedures when performed in young infants. METHODS: A prospective, single-blind, randomized, controlled study was conducted at a university-affiliated hospital in Israel. Institutional Research Ethics Board approved the study. Infants who were 0 to 2 months of age and presented to the emergency department with fever and therefore required urine collection for culture were randomly assigned evenly into 2 sample collection groups: suprapubic aspiration or transurethral catheterization. Patients were excluded when they were born prematurely or had had a previous sepsis workup or other painful procedures or an anomaly of the urogenital system or abdominal wall. Eutectic mixture of local anesthetic cream that contained lidocaine and prilocaine was applied 1 hour before the procedure. The urethra was catheterized using a 5-Fr latex-free feeding tube that was lubricated with sterile water-soluble jelly that contained 2% lidocaine hydrochloride. Pediatric residents who were experienced with the procedures performed both suprapubic aspiration and transurethral catheterization. The parents were instructed to use any comfort strategies that they wished, including verbal or physical comforting and pacifiers. Pain during collection was assessed on a 100-mm visual analog scale by a nurse and a parent. In addition, the infant's upper part of the body was videotaped during the procedure. An investigator, who was blinded to the procedure, assigned a point score according to the Douleur Aigue du Nouveaune neonatal acute pain scale. For ensuring a successful blinding process, the following steps were taken. First, camera recording started 30 seconds before the procedure to prevent the possibility of distinguishing between the procedures on the basis of their duration. Second, the physician and the nurse were asked not to speak during the procedure to avoid revealing the nature of the procedure. Third, the person who videotaped the procedure watched the tape before it was analyzed to ensure the impossibility of identifying the procedure from the tape. The Student's t test was used to compare the groups. The primary outcome was the mean Douleur Aigue du Nouveaune score. Secondary outcomes were the mean visual analogue scale for pain as estimated by the parents and by the nurse. We estimated that 25 patients would be needed in each group to detect a difference in the mean Douleur Aigue du Nouveaune score of at least 2 points with a power of 80% and alpha of .05. RESULTS: The study was conducted between April 1, 2004, and April 30, 2005. Fifty-eight infants were recruited; 29 were randomly assigned to suprapubic aspiration, and 29 were randomly assigned to transurethral catheterization. Seven infants were excluded because of consent withdrawal (3 patients), because of technical difficulties during videotaping (3 patients), or because the child voided during the procedure (1 patient). Twenty-seven infants in the suprapubic aspiration group and 24 in the transurethral catheterization group completed the study. All male infants were circumcised. An adequate urine sample was obtained in 18 (66%) of 27 patients in the suprapubic aspiration group and in 20 (83.3%) of 24 in the transurethral catheterization group. The mean Douleur Aigue du Nouveaune score was significantly higher in patients who were randomly assigned to suprapubic aspiration compared with patients who were randomly assigned to transurethral catheterization (7 and 4.5, respectively). The differences in Douleur Aigue du Nouveaune score also were significant in a subgroup analysis of boys and girls. Mean visual analogue scale scores by parents was higher in the suprapubic aspiration group compared with transurethral catheterization (63 +/- 27 mm vs 46 +/- 26, respectively). Similarly, mean visual analogue scale scores by nurses was higher in the suprapubic aspiration group compared with transurethral catheterization (3 +/- 18 mm vs 43 +/- 25 mm, respectively). CONCLUSIONS: In infants who are younger 2 months, suprapubic aspiration is more painful than transurethral catheterization. Health professionals should consider these differences when choosing a method for obtaining a urine sample from young infants.