The potential impact of literacy intervention on speech sound production in students with intellectual disability and communication difficulties.

A small body of research and reports from educational and clinical practice suggest that teaching literacy skills may facilitate the development of speech sound production in students with intellectual disabilities (ID). However, intervention research is needed to test the potential connection. This study aimed to investigate whether twelve weeks of systematic, digital literacy intervention enhanced speech sound production in students with ID and communication difficulties. A sample of 121 students with ID were assigned to four different groups: phonics-based, comprehension-based, a combination with both phonics- and comprehension-based intervention and a comparison group with teaching-as-usual. Speech sound production was assessed before and after the intervention. The results on the data without the imputed variable suggested a significant positive effect of systematic, digital literacy interventions on speech sound production. However, results from sensitivity analyses with imputed missing data was more ambiguous, with the effect only approaching significance (ps = .05-.07) for one of the interventions. Nonetheless, we tentatively suggest that systematic, digital literacy intervention could support speech development in students with ID and communication difficulties. Future research should be done to confirm and further elucidate the functional mechanisms of this link, so that we may have a better understanding and can improve instruction and the pivotal abilities of speech and reading.

Paediatric Acute-onset Neuropsychiatric Syndrome (PANS) and intravenous immunoglobulin (IVIG): comprehensive open-label trial in ten children.

BACKGROUND: Treatment with intravenous immunoglobulin (IVIG) in children with Paediatric Acute-onset Neuropsychiatric Syndrome (PANS) has for many years been used on clinical indications, but the research evidence for its efficacy is insufficient. METHODS: Open-label prospective in-depth trial including ten children (median age 10.3 years) with PANS, who received IVIG treatment 2 g/kg monthly for three months. Primary outcomes were changes in symptom severity and impairment from baseline to first and second follow-up visits one month after first and one month after third treatment, using three investigator-rated scales: Paediatric Acute Neuropsychiatric Symptom (PANS) scale, Clinical Global Impression - Severity and Improvement (CGI-S and CGI-I) scales. Secondary outcomes reported here were changes in Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) scores, and side effects. RESULTS: All ten children received three treatments at one-month intervals according to study plan. From baseline to second follow-up marked reductions were seen in mean total PANS scale scores (p = .005), and CGI-S scores (p = .004). CGI-I ratings showed much to very much global improvement (mean CGI-I 1.8). Nine children had clinical response defined as > 30% reduction in PANS Scale scores. Improvements were also noted for CY-BOCS scores (p = .005), and in school attendance. Three children suffered moderate to severe temporary side effects after the first treatment, and the remaining seven had mild to moderate side effects. Side effects were much less severe after second and third treatments. CONCLUSIONS: Considerable and pervasive improvements in symptoms and clinical impairments were seen in these ten children after three monthly IVIG treatments. Moderate to severe transient side effects occurred in three cases. TRIAL REGISTRATION: EudraCT no. 2019-004758-27, Clinicaltrials.gov no. NCT04609761, 05/10/2020.

Prevalence of Reading Difficulties in 9- to 10-Year Old Children in Sweden Born With Cleft Palate.

OBJECTIVE: To investigate the prevalence of reading difficulties in children born with cleft palate at ages 9 and 10 in Sweden. DESIGN: Using a cross-sectional design, a parental questionnaire assessing dyslexia-like reading difficulties (Short Dyslexia Scale, SDS) was administered together with separate questions regarding background data. PARTICIPANTS: Families with a child born with overt cleft palate with or without cleft lip in 4 regions of Sweden. A total of 245 families were approached of which 138 families responded. Data from 136 (56%) were complete with information on cleft type and could be analyzed. RESULTS: Twenty-two percent (95% CI, 15-30) of the whole study group displayed risk for dyslexic reading difficulties on the SDS corresponding to the 7th to 10th percentiles in the population. Children with cleft palate only had a significantly higher prevalence of reading difficulties (37%) compared to children with unilateral cleft palate (19%) and bilateral cleft palate (10%). The frequency of reading difficulties in participants with comorbidity was 32%. Among a subgroup with reported comorbidity in areas of attention, language, and learning problems, there was a 2.5 times higher risk of reading disability compared to participants without this reported comorbidity. CONCLUSION: The prevalence of reading difficulties in the cleft palate population was higher than in the general population. Results showed that co-occurring difficulties were common in the cleft group and that reading difficulties often appear together with other, co-occurring neurodevelopmental difficulties.

Effect of the number of presentations on listener transcriptions and reliability in the assessment of speech intelligibility in children.

BACKGROUND: The assessment of intelligibility is an essential part of establishing the severity of a speech disorder. The intelligibility of a speaker is affected by a number of different variables relating, inter alia, to the speech material, the listener and the listener task. AIMS: To explore the impact of the number of presentations of the utterances on assessments of intelligibility based on orthographic transcription of spontaneous speech, specifically the impact on intelligibility scores, reliability and intra-listener variability. METHODS & PROCEDURES: Speech from 12 children (aged 4:6-8:3 years; mean = 5:10 years) with percentage consonants correct (PCC) scores ranging from 49 to 81 was listened to by 18 students on the speech-language pathology (SLP) programme and by two recent graduates from that programme. Three conditions were examined during the transcription phase: (1) listening to each utterance once; (2) listening to each utterance a second time; and (3) listening to all utterances from a given child a third time after having heard all of its utterances twice. OUTCOMES & RESULTS: Statistically significant differences between intelligibility scores were found across the three conditions, i.e. the intelligibility score increased with the number of presentations while inter-judge reliability was unchanged. The results differed markedly across listeners, but each individual listener's results were very consistent across conditions. CONCLUSIONS & IMPLICATIONS: Information about the number of times an utterance is presented to the listener is important and should therefore always be included in reports of research involving intelligibility assessment. There is a need for further research and discussion on listener abilities and strategies.

Swedish Test of Intelligibility for Children (STI-CH)--validity and reliability of a computer-mediated single word intelligibility test for children.

The aim of this study was twofold: first, to describe a new Swedish intelligibility test (Swedish Test of Intelligibility for Children, STI-CH) and second to evaluate its validity and reliability. STI-CH is based on the repetition of single words. Ten children with a speech-sound disorder (4:6-8:3 years of age, mean = 6.0 years) and 10 children with typical speech and language development (4:8-7:4 years of age, mean = 5.9 years) were included. Twenty speech-language pathology students served as listeners. Intra-judge reliability was high (r > 0.92), as was the intra-class correlation of inter-judge reliability (0.97). In terms of validity, there was a significant difference in STI-CH scores between the two groups, and the scores correlated statistically significantly with the Percentage of Consonants Correct (r = 0.94) and with intelligibility in spontaneous speech (r = 0.85). To sum up, the results indicate that STI-CH could be an option for the assessment of intelligibility in Swedish-speaking children, and that the principles used in the development of the test could be of use in the design of intelligibility tests in languages other than Swedish.

Imitation (rather than core language) predicts pragmatic development in young children with ASD: a preliminary longitudinal study using CDI parental reports.

BACKGROUND: Research in the last decades has clearly pointed to the important role of language and communicative level when trying to understand developmental trajectories in children with autism spectrum disorders (ASD). AIMS: The purpose of this longitudinal study was to investigate whether (1) core language skills, measured as expressive vocabulary and grammar, and/or (2) pre-linguistic social-communicative skills, including gestures and imitation abilities, drive pragmatic language development in young children with ASD. METHODS & PROCEDURES: We examined correlates and longitudinal predictors of pragmatic growth in a sample of 34 children with Autism spectrum disorder (ASD), whose parents were given parts of two MacArthur Communicative Developmental Inventories (CDI: Words & Gestures and CDI: Words & Sentences) for completion at two time points (at time 1 the mean child age was 41 months, and at time 2 it was 54 months). A novel feature in this study is that the relevant parts from both CDI forms were included at both time points, allowing us to examine whether pre-linguistic social-communication skills (e.g. imitation and gesturing) and/or core language skills (i.e. grammar and vocabulary) predict pragmatic language growth. OUTCOMES & RESULTS: The results show that basically all pre-linguistic, linguistic and pragmatic skills were associated concurrently. When controlling for possible confounders and for the autoregressive effect, imitation skills predicted pragmatic growth over time, whereas core language did not. This could only have been shown by the use of both CDI forms. CONCLUSIONS & IMPLICATIONS: This preliminary study may be of both conceptual and methodological importance for research in the field of language and communication development in ASD. Imitation may play a pivotal role in the development of subsequent conversational pragmatic abilities in young children with ASD. Future research should be directed at unravelling the mechanisms underlying this association.

Narrative retelling in children with neurodevelopmental disorders: is there a role for nonverbal temporal-sequencing skills?

Oral narrative retelling is often problematic for children with communicative and neurodevelopmental disorders. However, beyond a suggested role of language level, little is known about the basis of narrative performance. In this study we examine whether oral narrative retelling might be associated not just with language level but also with skills related to nonverbal narrative temporal sequencing. A diagnostically heterogeneous sample of Swedish-speaking children with a full scale IQ >70 was included in the study (N = 55; age 6-9 years). Narrative retelling skills were measured using the three subscores from the bus story test (BST). Independent predictors included (1) temporal sequencing skills according to a picture arrangement test and (2) a language skills factor consisting of definitional vocabulary and receptive grammar. Regression analyses show that language skills predicted BST Sentence Length and Subordinate Clauses subscores, while both temporal sequencing and language were independently linked with the BST Information subscore. When subdividing the sample based on nonverbal temporal sequencing level, a significant subgroup difference was found only for BST Information. Finally, a principal component analysis shows that temporal sequencing and BST Information loaded on a common factor, separately from the language measures. It is concluded that language level is an important correlate of narrative performance more generally in this diagnostically heterogeneous sample, and that nonverbal temporal sequencing functions are important especially for conveying story information. Theoretical and clinical implications are discussed.

Sentence memory recall in adolescents: Effects of motor enactment, keyboarding, and handwriting during encoding.

BACKGROUND: Prior research has shown that memory for action sentences is stronger when stimuli are enacted during encoding than simply listened to: the so-called enactment effect. The goal of the present study was to explore how writing during encoding-through handwriting and through keyboarding-fares compared with enacting, in supporting memory recall. METHODS: One hundred Norwegian high school students (64 girls, 36 boys) aged 16-21 years (M = 17.1) participated in the study. Four lists of verb-noun sentences with 12 sentences in each list were presented in four encoding conditions: (i) motor enactment, (ii) verbal listening, (iii) handwriting, and (iv) keyboarding. RESULTS: Results revealed a significant main effect of encoding condition, with the best memory gained in the enactment condition. Regarding writing, results showed that handwriting and keyboarding during encoding produced the lowest recall in comparison with the enactment and verbal listening conditions. CONCLUSION: These results thus provide additional support for the enactment effect. While there has been much discussion on the relative benefits of handwriting versus keyboarding on student performance, both seemed to be equally poor strategies for the particular learning task explored here, potentially through increased cognitive load.

Following children with severe or profound intellectual and multiple disabilities and their mothers through a communication intervention: single-case mixed-methods findings.

There is limited research targeting communication interventions for children with severe/profound intellectual and multiple disabilities. This study addressed outcomes from a communication course for parents of children with severe/profound intellectual and multiple disabilities and follows up on a previous publication by Rensfeldt Flink et al. (2020). Potential observable changes in the children's and parents' communicative behavior were studied as well as the parents' experiences of the intervention process and the effect of the course on parent-child communication. A mixed-methods design with a case-study framework was used. Two mother-child dyads participated. Data were collected before, during, and after the course. Video-recorded repeated play interactions by the dyads were coded and analyzed for the mothers' responsivity and use of augmentative and alternative communication and the children's interactive engagement. Longitudinal interview data from the mothers were analyzed thematically. No clear signs of behavioral change were observed in the coded video data. However, thematic analyses showed that the mothers experienced changes to communicative behaviors. Moreover, the course affected both mothers' reasoning about communication with their child and their child's communicative needs. The mothers' narratives contributed insights into how reflective processes might guide action in parent-mediated communication interventions. The implications for research and clinical practice are discussed.

Machine learning for distinguishing saudi children with and without autism via eye-tracking data.

BACKGROUND: Despite the prevalence of Autism Spectrum Disorder (ASD) globally, there's a knowledge gap pertaining to autism in Arabic nations. Recognizing the need for validated biomarkers for ASD, our study leverages eye-tracking technology to understand gaze patterns associated with ASD, focusing on joint attention (JA) and atypical gaze patterns during face perception. While previous studies typically evaluate a single eye-tracking metric, our research combines multiple metrics to capture the multidimensional nature of autism, focusing on dwell times on eyes, left facial side, and joint attention. METHODS: We recorded data from 104 participants (41 neurotypical, mean age: 8.21 ± 4.12 years; 63 with ASD, mean age 8 ± 3.89 years). The data collection consisted of a series of visual stimuli of cartoon faces of humans and animals, presented to the participants in a controlled environment. During each stimulus, the eye movements of the participants were recorded and analyzed, extracting metrics such as time to first fixation and dwell time. We then used these data to train a number of machine learning classification algorithms, to determine if these biomarkers can be used to diagnose ASD. RESULTS: We found no significant difference in eye-dwell time between autistic and control groups on human or animal eyes. However, autistic individuals focused less on the left side of both human and animal faces, indicating reduced left visual field (LVF) bias. They also showed slower response times and shorter dwell times on congruent objects during joint attention (JA) tasks, indicating diminished reflexive joint attention. No significant difference was found in time spent on incongruent objects during JA tasks. These results suggest potential eye-tracking biomarkers for autism. The best-performing algorithm was the random forest one, which achieved accuracy = 0.76 ± 0.08, precision = 0.78 ± 0.13, recall = 0.84 ± 0.07, and F1 = 0.80 ± 0.09. CONCLUSIONS: Although the autism group displayed notable differences in reflexive joint attention and left visual field bias, the dwell time on eyes was not significantly different. Nevertheless, the machine algorithm model trained on these data proved effective at diagnosing ASD, showing the potential of these biomarkers. Our study shows promising results and opens up potential for further exploration in this under-researched geographical context.

Data-driven analysis of gaze patterns in face perception: Methodological and clinical contributions.

Gaze patterns during face perception have been shown to relate to psychiatric symptoms. Standard analysis of gaze behavior includes calculating fixations within arbitrarily predetermined areas of interest. In contrast to this approach, we present an objective, data-driven method for the analysis of gaze patterns and their relation to diagnostic test scores. This method was applied to data acquired in an adult sample (N = 111) of psychiatry outpatients while they freely looked at images of human faces. Dimensional symptom scores of autism, attention deficit, and depression were collected. A linear regression model based on Principal Component Analysis coefficients computed for each participant was used to model symptom scores. We found that specific components of gaze patterns predicted autistic traits as well as depression symptoms. Gaze patterns shifted away from the eyes with increasing autism traits, a well-known effect. Additionally, the model revealed a lateralization component, with a reduction of the left visual field bias increasing with both autistic traits and depression symptoms independently. Taken together, our model provides a data-driven alternative for gaze data analysis, which can be applied to dimensionally-, rather than categorically-defined clinical subgroups within a variety of contexts. Methodological and clinical contribution of this approach are discussed.

The effect of constraining eye-contact during dynamic emotional face perception-an fMRI study.

Eye-contact modifies how we perceive emotions and modulates activity in the social brain network. Here, using fMRI, we demonstrate that adding a fixation cross in the eye region of dynamic facial emotional stimuli significantly increases activation in the social brain of healthy, neurotypical participants when compared with activation for the exact same stimuli observed in a free-viewing mode. In addition, using PPI analysis, we show that the degree of amygdala connectivity with the rest of the brain is enhanced for the constrained view for all emotions tested except for fear, and that anxiety and alexithymia modulate the strength of amygdala connectivity for each emotion differently. Finally, we show that autistic traits have opposite effects on amygdala connectivity for fearful and angry emotional expressions, suggesting that these emotions should be treated separately in studies investigating facial emotion processing.

Syllable Repetition vs. Finger Tapping: Aspects of Motor Timing in 100 Healthy Adults.

In this study we systematically compared syllable repetition and finger tapping in healthy adults, and explored possible impacts of tempi, metronome, musical experience, and age on motor timing ability. One hundred healthy adults used finger-tapping and syllable repetition to perform an isochronous pulse in three different tempi, with and without a metronome. Results showed that the motor timing was more accurate with finger tapping than with syllable repetition in the slowest tempo, and the motor timing ability was better with the metronome than without. Persons with musical experience showed better motor timing accuracy than persons without such experience, and the timing asynchrony increased with increasing age. The slowest tempo 90 bpm posed extra challenges to the participants. We speculate that this pattern reflects the fact that the slow tempo lies outside the 3-8 Hz syllable rate of natural speech, which in turn has been linked to theta-based oscillations in the brain.