Assessing Alzheimer's Disease Knowledge and Cognitive Risk Among a Rural Older Afro-Caribbean Cohort.

PURPOSE: Older, rural Afro-Caribbeans are a growing subset of the Black population who face increased risk for Alzheimer's disease and related dementias (ADRD), but research targeting ADRD is scarce in this group. The purpose of this study was to investigate dementia risk among older Afro-Caribbeans living in a rural area. We also examined age, sex, and years of education, and knowledge about Alzheimer's disease as potential predictors of dementia risk. DESIGN: A pre-post, correlational design was employed. METHODS: Cognitive screenings were conducted using Nasreddine's Mini-MoCA, with tests of language fluency/orientation/recall, and linear regression analysis. A basic knowledge of Alzheimer's disease survey (BKAD) was also administered. FINDINGS: A total of 55 Afro-Caribbean participants (67.0 +10.8y (M ± SD), 65.5% with 10y or less of education residing in a rural area within the last 20 years were included.Over 50% of the convenience sample scored in the cognitive risk range. Significant associations were found between Mini-MoCA Total and Language scores and education (p < 0.01). Further, there was a significant change from pretest to posttest in BKAD scores. BKAD pretest and posttest scores were also significantly higher for those without dementia risk based on the Mini-MoCA Total. CONCLUSION: While the Mini-MoCA showed good reliability in less-educated older Afro-Caribbeans, scores were strongly dependent on years of education. Offering a limited intervention resulted in increased BKAD scores in this Afro-Caribbean sample, and a low BKAD score was associated with a higher dementia risk category. CLINICAL EVIDENCE: This study contributes to the limited but growing body of research about Alzheimer's disease knowledge, cognitive risk, and dementia detection among Afro-Caribbeans. The use of language-neutral cognitive assessments is recommended among rural older immigrants.

Testing the 'Faith Moves Mountains model' to increase Alzheimer's disease awareness, detection, and diagnosis among rural, racially, and ethnically diverse older adults.

OBJECTIVES: Racially and ethnically diverse populations have recently contributed to the majority of rural and small-town growth. Consequently, the disproportionately high risk and prevalence of Alzheimer's disease and related dementias (ADRD) among rural and minoritized older residents will likely increase. To address this threat, we tested the hypotheses that (1) a faith-based, resident-led approach would increase basic ADRD knowledge and diagnosis, and (2) older age, female gender, lower educational levels, and more years lived rural would predict number of referrals, new dementia diagnoses, and treatment. METHODS: An adaptation of Schoenberg's Faith Moves Mountains model, previously successful in detection and management of other chronic illnesses in rural settings, guided this community-based participatory research. Local faith community members were trained as research assistants to recruit, administer surveys, conduct brief memory assessments, teach brain health strategies, and follow-up with residents. Outreaches were offered virtually during the pandemic, then in-person monthly at rotating church sites, and repeated ∼1 year later. RESULTS: This rural sample was racially and ethnically diverse (74.5% non-White), with 28% reporting eight or less years of formal education. Findings included that referrals and years lived rural were significant and positive predictors of new ADRD treatments [(b = 3.74, χ2(1, n = 235) = 13.01, p < 0.001); (b = 0.02, χ2(1, n = 235 = 3.93, p = 0.048)], respectively, regardless of participant characteristics. CONCLUSION: Resident-led action research in rural, diverse, faith communities is a successful approach to increasing ADRD disease knowledge, detection, diagnosis, and treatment.

Input Subject Diversity Accelerates the Growth of Tense and Agreement: Indirect Benefits From a Parent-Implemented Intervention.

Purpose: This follow-up study examined whether a parent intervention that increased the diversity of lexical noun phrase subjects in parent input and accelerated children's sentence diversity (Hadley et al., 2017) had indirect benefits on tense/agreement (T/A) morphemes in parent input and children's spontaneous speech. Method: Differences in input variables related to T/A marking were compared for parents who received toy talk instruction and a quasi-control group: input informativeness and full is declaratives. Language growth on tense agreement productivity (TAP) was modeled for 38 children from language samples obtained at 21, 24, 27, and 30 months. Parent input properties following instruction and children's growth in lexical diversity and sentence diversity were examined as predictors of TAP growth. Results: Instruction increased parent use of full is declaratives (ηp2 ≥ .25) but not input informativeness. Children's sentence diversity was also a significant time-varying predictor of TAP growth. Two input variables, lexical noun phrase subject diversity and full is declaratives, were also significant predictors, even after controlling for children's sentence diversity. Conclusions: These findings establish a link between children's sentence diversity and the development of T/A morphemes and provide evidence about characteristics of input that facilitate growth in this grammatical system.

Input Subject Diversity Enhances Early Grammatical Growth: Evidence from a Parent-Implemented Intervention.

PURPOSE: The current study used an intervention design to test the hypothesis that parent input sentences with diverse lexical noun phrase (NP) subjects would accelerate growth in children's sentence diversity. METHOD: Child growth in third person sentence diversity was modeled from 21 to 30 months (n = 38) in conversational language samples obtained at 21, 24, 27, and 30 months. Treatment parents (n = 19) received instruction on strategies designed to increase lexical NP subjects (e.g., The baby is sleeping.). Instruction consisted of one group education session and two individual coaching sessions which took place when children were approximately 22 to 23 months of age. RESULTS: Treatment substantially increased parents' lexical NP subject tokens and types (ηp2 ≥ .45) compared to controls. Children's number of different words was a significant predictor of sentence diversity in the analyses of group treatment effects and individual input effects. Treatment condition was not a significant predictor of treatment effects on children's sentence diversity, but parents' lexical NP subject types was a significant predictor of children's sentence diversity growth, even after controlling for children's number of different words over time. CONCLUSIONS: These findings establish a link between subject diversity in parent input and children's early grammatical growth, and the feasibility of using relatively simple strategies to alter this specific grammatical property of parent language input.

Growth of finiteness in the third year of life: replication and predictive validity.

PURPOSE: The authors of this study investigated the validity of tense and agreement productivity (TAP) scoring in diverse sentence frames obtained during conversational language sampling as an alternative measure of finiteness for use with young children. METHOD: Longitudinal language samples were used to model TAP growth from 21 to 30 months of age for 37 typically developing toddlers. Empirical Bayes (EB) linear and quadratic growth coefficients and child sex were then used to predict elicited grammar composite scores on the Test of Early Grammatical Impairment (TEGI; Rice & Wexler, 2001) at 36 months. RESULTS: A random-effects quadratic model with no intercept best characterized TAP growth, replicating the findings of Rispoli, Hadley, and Holt (2009). The combined regression model was significant, with the 3 variables accounting for 55.5% of the variance in the TEGI composite scores. CONCLUSION: These findings establish TAP growth as a valid metric of finiteness in the 3rd year of life. Developmental and theoretical implications are discussed.

Sequence and system in the acquisition of tense and agreement.

PURPOSE: The relatedness of tense morphemes in the language of children younger than 3 years of age is a matter of controversy. Generativist accounts predict that the morphemes will be related, whereas usage-based accounts predict the absence of relationships. This study focused on the increasing productivity of the 5 morphemes in the tense productivity score (copula BE, third-person singular present - 3s, past - ed, auxiliary DO, auxiliary BE; Hadley & Short, 2005) and their relationship to one another. METHOD: Twenty typically developing children were observed longitudinally from 21 to 33 months of age. One hour of naturalistic caregiver-child interaction sampled every 3 months was analyzed. RESULTS: Copula BE was more productive than all other morphemes from age 27 months onward. Auxiliary BE was significantly less productive than - 3s, - ed, and DO from age 27 months onward. Evaluation of third-person singular tense morphemes at age 33 months revealed that the productivity scores of copula is, - 3s, and does were all correlated. CONCLUSIONS: There is sequence and simultaneity in development that no prior framework has fully explained, as well as evidence of cross-morpheme relationships. In this article, the authors interpret these findings as support for the gradual morphosyntactic learning hypothesis ( Rispoli & Hadley, 2011; Rispoli, Hadley, & Holt, 2009).

The growth of tense productivity.

PURPOSE: This study tests empirical predictions of a maturational model for the growth of tense in children younger than 36 months using a type-based productivity measure. METHOD: Caregiver-child language samples were collected from 20 typically developing children every 3 months from 21 to 33 months of age. Growth in the productivity of tense morphemes, centered at 21 months, was examined using hierarchical linear modeling. The empirical Bayes residuals from 21- to 30-month productivity growth trajectories predicted children's accuracy of tense marking at 33 months. RESULTS: A random effects quadratic growth model with no intercept best characterized the growth of tense marking between 21 and 30 months. Average development was characterized by slow instantaneous linear growth of less than 1 morpheme per month at 21 months and acceleration overall. Significant variation around this trend was also evident. Children's linear and quadratic empirical Bayes residuals together predicted 33-month accuracy scores (r = .672, p = .008). CONCLUSIONS: Acceleration and variation about this trend are consistent with maturational models of language acquisition. With an empirically sound characterization of early variation in morphosyntactic growth rates, future investigations can more rigorously test hypotheses regarding biological, environmental, and developmental contributions to the acquisition of morphosyntax.

Individual differences in the onset of tense marking: a growth-curve analysis.

The purpose of this study was to explore individual differences in children's tense onset growth trajectories and to determine whether any within- or between-child predictors could account for these differences. Twenty-two children with expressive vocabulary abilities in the low-average to below-average range participated. Sixteen children were at risk for specific language impairment (SLI), and 6 children had low-average language abilities. Spontaneous language samples, obtained at 3-month intervals between 2;0 and 3;0, were analyzed to examine change in a cumulative productivity score for 5 tense morphemes: third person singular present, past tense, copula BE, auxiliary BE, and auxiliary DO. Hierarchical linear modeling was used to model intercept and linear growth at 30 months and quadratic growth overall. A growth model that included mean length of utterance (MLU) and MLU growth better explained within-child productivity score growth trajectories than a parallel model with vocabulary and vocabulary growth. Significant linear growth in productivity scores remained even after a control for MLU was in place. When between-child predictors were added in the final conditional model, only positive family history approached statistical significance, improving the overall estimation of the model's growth parameters. The findings support theoretical models of language acquisition that claim relative independence of tense marking from other more general aspects of vocabulary development and sentence length. The trends for family history are also consistent with proposals implicating faulty genetic mechanisms underlying developmental language disorders. Systematic use of familial risk data is recommended in future investigations examining the relationship between late-talking children and children at risk for SLI.

Comparison of linear weighting schemes for perfect match and mismatch gene expression levels from microarray data.

BACKGROUND: Data analytic approaches to Affymetrix microarray data include: (a) a covariate model, in which the observed signal is some estimated linear function of perfect match (PM) and mismatch (MM) signals; (b) a difference model [PM-MM]; and (c) a PM-only model, in which MM data is not utilized. METHODS: By decomposing the correlations among the variables in the statistical model and making certain assumptions, we theoretically derive the statistical model that reflects the actual gene expression level under a variety of conditions expected in microarray data. RESULTS AND CONCLUSION: When modeling non-systematic variation, the covariate model provides maximum flexibility and often reflects the actual gene expression levels better than the difference model. However, the PM-only model demonstrates superior power in an overwhelming majority of realistic situations, which provides theoretical support for the current trend to employ PM-only models in microarray data analyzes.

A comparative study of adults with and without self-reported learning disabilities in six English-speaking populations: what have we learned?

The purpose of this study was to compare adults with and without self-reported learning disabilities (SRLD and NSRLD) from six English-speaking populations including: English-speaking Canada, Great Britain, The Republic of Ireland, New Zealand, Northern Ireland, and the United States. These six populations were selected because they were all English-speaking populations, participated in the first administration of the International Adult Literacy Survey (IALS), and included the optional questions regarding the presence of a disability. In this study, we compared the groups on prevalence by population, percentage of each group by age and gender, awareness of learning disabilities and problems in school, document and quantitative literacy proficiency, educational attainment, reasons for dropping out of school, and employment, occupational and financial status. Findings were reported among these six populations within an historical perspective including differences in awareness and definition of learning disabilities, public policy, special education services, reading pedagogy, and teacher preparation. Recommendations are made for improving literacy and long-term outcomes for those with learning disabilities in all nations as well as future research directions.