Performance Monitoring and Cognitive Inhibition during a Speech-in-Noise Task in Older Listeners.

The goal of this study was to examine the effect of hearing loss on theta and alpha electroencephalography (EEG) frequency power measures of performance monitoring and cognitive inhibition, respectively, during a speech-in-noise task. It was hypothesized that hearing loss would be associated with an increase in the peak power of theta and alpha frequencies toward easier conditions compared to normal hearing adults. The shift would reflect how hearing loss modulates the recruitment of listening effort to easier listening conditions. Nine older adults with normal hearing (ONH) and 10 older adults with hearing loss (OHL) participated in this study. EEG data were collected from all participants while they completed the words-in-noise task. It hypothesized that hearing loss would also have an effect on theta and alpha power. The ONH group showed an inverted U -shape effect of signal-to-noise ratio (SNR), but there were limited effects of SNR on theta or alpha power in the OHL group. The results of the ONH group support the growing body of literature showing effects of listening conditions on alpha and theta power. The null results of listening condition in the OHL group add to a smaller body of literature, suggesting that listening effort research conditions should have near ceiling performance.

Impact of Effortful Word Recognition on Supportive Neural Systems Measured by Alpha and Theta Power.

OBJECTIVES: The goal of this study was to use theta and alpha electroencephalography (EEG) frequency power and self-report measures to examine performance monitoring, cognitive inhibition, and perceived effort required for speech understanding in noise. It was hypothesized that with a linear increase in word recognition task difficulty, there would be a linear increase in listening effort and word recognition performance would decrease in the challenging conditions. In addition, theta and alpha power would have an inverted U-shape across easy to challenging listening conditions. The inverted U-shape would reflect the neural underpinnings of listening effort that cannot be measured by task performance alone. DESIGN: EEG data were collected in 34 normal-hearing adults (18 to 33 years old) during the Words-In-Noise (WIN) test, which was presented in sound field. EEG frequency data were averaged and analyzed at three frontal channels for theta power (4 to 8 Hz), which is thought to reflect performance monitoring, and three parietal channels for alpha power (8 to 12 Hz), which is thought to reflect cognitive inhibition. A ten-point visual analog scale was administered after each WIN signal-to-noise ratio (SNR) condition to capture self-reported required and invested listening effort (RLE and ILE, respectively). The WIN SNR conditions were presented in descending and random order. RESULTS: The SNR presentation (descending or random SNR) had a null effect on word recognition performance; however, presentation did have an effect on theta power, alpha power, and ILE. When controlling for presentation, there were significant effects of SNR and presentation on both theta and alpha frequency power. Theta and alpha power had an inverted U-shape as a function of SNR from easy to challenging, with peak power in the moderate SNR conditions. RLE and ILE both significantly increased as task difficulty increased as expected; however, RLE showed a stronger relation to task performance than ILE. Alpha power was a significant predictor of RLE, ILE, and WIN performance when controlling for SNR. CONCLUSIONS: The elevated theta and alpha power in the easy to moderate SNRs and alpha power predicting self-reported listening effort suggest the activation of supportive neural systems during word recognition that could be considered a marker of listening effort. Moreover, the measures of neural support systems and listening effort were independent from task performance, which is a key element to further understanding the neural bases for listening effort. In the context of the broader literature, these results are consistent with (1) a parietal alpha role in supporting inhibitory control to suppress irrelevant information and (2) a frontal theta role in supporting performance monitoring in difficult listening conditions where speech recognition is feasible.

TRAQ Changes: Improving the Measurement of Transition Readiness by the Transition Readiness Assessment Questionnaire.

OBJECTIVE: The purpose of the current study was improving the measurement precision of the Transition Readiness Assessment Questionnaire (TRAQ 5.0-20 item) in order to gain better decimation of transition readiness skills across the 5 Stages of Change-from Precontemplation to Mastery. METHODS: In stage 1, starting with the TRAQ 5.0 20-item, 5 domain subscale questionnaire, we eliminated the five lowest discriminating items using Item response theory (IRT) in MPlus v7.4,which eliminated the domain subscale Managing Daily Activities, and we e added 15 more difficult and better discriminating items. We added items to both to the remaining 4 domain subscales and created a new domain subscale entitled Future Planning. The revised 30-item TRAQ was piloted among 386 youth between 16 and 24 years old (mean = 20 years; 54% female; 87% White). RESULTS: After examining the model fit, discrimination and difficulty coefficients, and modification indices, we eliminated 10 items and the new Future Planning domain subscale we eliminated. The resulting questionnaire has 4 domain subscales and 20 items. It exhibited good to excellent fit to the data, χ2(164) = 887.239, p < .001, CFI = 0.943, TLI = 0.93, RMSEA = 0.0942 (90% CI: 0.090, 0.114), WRMR = 1.111. All items have acceptable discrimination coefficients. Each of the 4 domain subscales have improved reliability as compared with the original TRAQ 5.0 20 item scale. CONCLUSIONS: The revised 20-itemTRAQ 6.0 has 4 domains subscales; Managing medications, keeping appointment, tracking health issues, and Talking with providers and has good construct validity as demonstrated by model fit. By adding more difficult items to the 4 resulting domain subscales, we have demonstrated improved item discrimination and difficulty, and therefore can better measure acquisition of transition readiness skills across the five stages of change from pre-contemplation to contemplation to initiation to action and finally to mastery.

Challenging the Link Between Early Childhood Television Exposure and Later Attention Problems: A Multiverse Approach.

In 2004, Christakis and colleagues published findings that he and others used to argue for a link between early childhood television exposure and later attention problems, a claim that continues to be frequently promoted by the popular media. Using the same National Longitudinal Survey of Youth 1979 data set (N = 2,108), we conducted two multiverse analyses to examine whether the finding reported by Christakis and colleagues was robust to different analytic choices. We evaluated 848 models, including logistic regression models, linear regression models, and two forms of propensity-score analysis. If the claim were true, we would expect most of the justifiable analyses to produce significant results in the predicted direction. However, only 166 models (19.6%) yielded a statistically significant relationship, and most of these employed questionable analytic choices. We concluded that these data do not provide compelling evidence of a harmful effect of TV exposure on attention.

The effects of rurality on substance use disorder diagnosis: A multiple-groups latent class analysis.

BACKGROUND: Rates of accidental overdose mortality from substance use disorder (SUD) have risen dramatically in the United States since 1990. Between 1999 and 2004 alone rates increased 62% nationwide, with rural overdose mortality increasing at a rate 3 times that seen in urban populations. Cultural differences between rural and urban populations (e.g., educational attainment, unemployment rates, social characteristics, etc.) affect the nature of SUD, leading to disparate risk of overdose across these communities. METHODS: Multiple-groups latent class analysis with covariates was applied to data from the 2011 and 2012 National Survey on Drug Use and Health (n=12.140) to examine potential differences in latent classifications of SUD between rural and urban adult (aged 18years and older) populations. Nine drug categories were used to identify latent classes of SUD defined by probability of diagnosis within these categories. Once the class structures were established for rural and urban samples, posterior membership probabilities were entered into a multinomial regression analysis of socio-demographic predictors' association with the likelihood of SUD latent class membership. RESULTS: Latent class structures differed across the sub-groups, with the rural sample fitting a 3-class structure (Bootstrap Likelihood Ratio Test P value=0.03) and the urban fitting a 6-class model (Bootstrap Likelihood Ratio Test P value<0.0001). Overall the rural class structure exhibited less diversity in class structure and lower prevalence of SUD in multiple drug categories (e.g. cocaine, hallucinogens, and stimulants). CONCLUSIONS: This result supports the hypothesis that different underlying elements exist in the two populations that affect SUD patterns, and thus can inform the development of surveillance instruments, clinical services, and prevention programming tailored to specific communities.

Validation of the Pictorial Infant Communication Scale for preschool-aged children with autism spectrum disorder.

Joint attention, or the shared focus of attention between objects or events and a social partner, is a crucial milestone in the development of social communication and a notable area of deficit in children with autism spectrum disorder. While valid parent-report screening measures of social communication are available, the majority of these measures are designed to assess a wide range of behaviors. Targeted assessment of joint attention and related skills is primarily limited to semi-structured, examiner-led interactions, which are time-consuming and laborious to score. The Pictorial Infant Communication Scale is an efficient parent-report measure of joint attention that can be used as a complement to structured assessments in fully characterizing early social communication development. This study examined the psychometric properties of the Pictorial Infant Communication Scale. Results revealed a high degree of internal consistency and strong intercorrelations between subscales. Additionally, confirmatory factor analysis supported a three-factor model of joint attention. Furthermore, significant correlations between the Pictorial Infant Communication Scale and direct clinical measures of child joint attention, language skills, and autism spectrum disorder symptom severity were suggestive of concurrent validity. Findings suggest that the Pictorial Infant Communication Scale is a promising tool for measuring joint attention skills in preschool-aged children with autism spectrum disorder.

How Are Child Restricted and Repetitive Behaviors Associated with Caregiver Stress Over Time? A Parallel Process Multilevel Growth Model.

The impact of raising a child with autism spectrum disorder (ASD) is frequently accompanied by elevated caregiver stress. Examining the variables that predict these elevated rates will help us understand how caregiver stress is impacted by and impacts child behaviors. This study explored how restricted and repetitive behaviors (RRBs) contributed concurrently and longitudinally to caregiver stress in a large sample of preschoolers with ASD using parallel process multilevel growth models. Results indicated that initial rates of and change in RRBs predicted fluctuations in caregiver stress over time. When caregivers reported increased child RRBs, this was mirrored by increases in caregiver stress. Our data support the importance of targeted treatments for RRBs as change in this domain may lead to improvements in caregiver wellbeing.

The effects of working memory on brain-computer interface performance.

OBJECTIVE: The purpose of the present study is to evaluate the relationship between working memory and BCI performance. METHODS: Participants took part in two separate sessions. The first session consisted of three computerized tasks. The List Sorting Working Memory Task was used to measure working memory, the Picture Vocabulary Test was used to measure general intelligence, and the Dimensional Change Card Sort Test was used to measure executive function, specifically cognitive flexibility. The second session consisted of a P300-based BCI copy-spelling task. RESULTS: The results indicate that both working memory and general intelligence are significant predictors of BCI performance. CONCLUSIONS: This suggests that working memory training could be used to improve performance on a BCI task. SIGNIFICANCE: Working memory training may help to reduce a portion of the individual differences that exist in BCI performance allowing for a wider range of users to successfully operate the BCI system as well as increase the BCI performance of current users.

Comparative efficacy of LEAP, TEACCH and non-model-specific special education programs for preschoolers with autism spectrum disorders.

LEAP and TEACCH represent two comprehensive treatment models (CTMs) that have been widely used across several decades to educate young children with autism spectrum disorders. The purpose of this quasi-experimental study was to compare high fidelity LEAP (n = 22) and TEACCH (n = 25) classrooms to each other and a control condition (n = 28), in which teachers in high quality special education programs used non-model-specific practices. A total of 198 children were included in data analysis. Across conditions, children's performances improved over time. This study raises issues of the replication of effects for CTMs, and whether having access to a high quality special education program is as beneficial as access to a specific CTM.

Brief report: concurrent validity of autism symptom severity measures.

The autism spectrum disorder (ASD) diagnostic classifications, according to the DSM-5, include a severity rating. Several screening and/or diagnostic measures, such as the autism diagnostic and observation schedule (ADOS), Childhood Autism Rating Scale (CARS) and social responsiveness scale (SRS) (teacher and parent versions), include an assessment of symptom severity. The purpose of this study was to examine whether symptom severity and/or diagnostic status of preschool-aged children with ASD (N = 201) were similarly categorized on these measures. For half of the sample, children were similarly classified across the four measures, and scores on most measures were correlated, with the exception of the ADOS and SRS-P. While the ADOS, CARS, and SRS are reliable and valid measures, there is some disagreement between measures with regard to child classification and the categorization of autism symptom severity.

Parent report of child's health-related quality of life after a primary-care-based weight management program.

BACKGROUND: Health-related quality of life (HRQoL) has been recognized as an important target and health outcome in obesity research. The current study aimed to examine HRQoL in overweight or obese children after a 10-week primary-care-based weight management program, Parent-Led Activity and Nutrition for Healthy Living, in southern Appalachia. METHODS: Sixty-seven children (ages 5-12 years) and their caregivers were recruited from four primary care clinics, two of which were randomized to receive the intervention. Caregivers in the intervention groups received two brief motivational interviewing visits and four group sessions led by providers as well as four phone follow-ups with research staff. Caregivers completed the PedsQL and demographic questionnaires at baseline and at 3, 6, and 12 months postintervention. Child height and weight were collected to determine standardized BMI. RESULTS: Caregivers of children receiving the weight control intervention reported no statistically significant improvements in child total HRQoL, as compared to the control group, across the course of treatment (ß=0.178; 95% confidence interval, -0.681, 1.037; p=0.687). Additionally, no statistically significant improvements were found across other HRQoL domains. CONCLUSIONS: Future studies examining HRQoL outcomes in primary care may consider treatment dose as well as methodological factors, such as utilization of multiple informants and different measures, when designing studies and interpreting outcomes.

Longitudinal comparison of early speech and language milestones in children with cleft palate: a comparison of US and Slovak children.

The purpose of this study was to compare early speech and language development of children with and without cleft lip and/or palate (CLP) in the US and Slovakia from 6 to 24 months of age. Thirty-two children from the US (eight with CLP and eight noncleft) and Slovakia (eight with CLP and eight noncleft) participated in this study. The children were videotaped at four time points for 30 minutes during mother-child interaction with play sets controlled for early-developing sounds in each language. Mean Babbling Level, consonant inventories, number of different words and mean length of utterance were calculated for 6- to 24-month samples. Results indicated that the US and Slovak groups showed similar performance across the ages. Cleft and noncleft groups showed significant differences in acquisition of all of the speech and language measures. High-pressure consonants, particularly alveolar place of articulation, were problematic for children with CLP.

A written language intervention for at-risk second grade students: a randomized controlled trial of the process assessment of the learner lesson plans in a tier 2 response-to-intervention (RtI) model.

In a randomized controlled trial, 205 students were followed from grades 1 to 3 with a focus on changes in their writing trajectories following an evidence-based intervention during the spring of second grade. Students were identified as being at-risk (n=138), and then randomized into treatment (n=68) versus business-as-usual conditions (n=70). A typical group also was included (n=67). The writing intervention comprised Lesson Sets 4 and 7 from the Process Assessment of the Learner (PAL), and was conducted via small groups (three to six students) twice a week for 12 weeks in accordance with a response-to-intervention Tier 2 model. The primary outcome was the Wechsler Individual Achievement Test-II Written Expression Scale. Results indicated modest support for the PAL lesson plans, with an accelerated rate of growth in writing skills following treatment. There were no significant moderator effects, although there was evidence that the most globally impaired students demonstrated a more rapid rate of growth following treatment. These findings suggest the need for ongoing examination of evidence-based treatments in writing for young elementary students.

Seasonal association of thrombotic thrombocytopenic purpura.

BACKGROUND: Thrombotic thrombocytopenic purpura (TTP), a thrombotic microangiopathy, is a clinical diagnosis, characterized by microangiopathic hemolytic anemia and thrombocytopenia without another likely explanation. Some initiators of the disease are well represented in the literature, such as certain drugs, malignancies, and viral illness; however, there are less objective factors still being investigated, with references to hormonal, stress, and seasonal variations considered anecdotally. A better insight of these factors would aid in understanding the pathophysiology of the disease. STUDY DESIGN AND METHODS: We performed a retrospective review of all idiopathic TTP cases treated with therapeutic plasma exchange at our institution from 1999 to 2008 to determine whether there was seasonal variation in TTP presentation. Seasons were defined as follows: winter = December to February; spring = March to May; summer = June to August; and fall = September to November. With the use of Poisson regression models, the incidence between seasons was compared. RESULTS: During this study period, a total of 97 cases were recorded. Summer had the highest occurrence of TTP (35%). This was significant compared to the fall (p = 0.012) and the winter (p = 0.019). There were more cases in the summer compared to the spring, but this was not significant. CONCLUSION: In our population, there was a significant difference in the number of TTP cases presenting in summer compared to fall and winter. This supports a possible environmental, infectious, or physiologic influence associated with the summer.

Canine and feline epileptic seizures and the lunar cycle: 2,507 seizures (2000-2008).

Epileptic seizures in 211 canine and feline patients diagnosed with idiopathic epilepsy were evaluated for temporal significance in relation to the lunar cycle. Seizure counts were compared among each of the eight individual lunar phases, among each of eight exact lunar phase dates, and by percent of lunar illumination using generalized estimating equations. No statistical significance was found in any of these comparisons excluding a relationship between the onset of epileptic seizures and the phases of the moon. Alteration in anticonvulsant treatment or monitoring of canine and feline patients with idiopathic epilepsy at large was not warranted based on the lunar cycle.

Relationships among Repetitive Behaviors, Sensory Features, and Executive Functions in High Functioning Autism.

This study examined the relationship between repetitive behaviors and sensory processing issues in school-aged children with high functioning autism (HFA). Children with HFA (N = 61) were compared to healthy, typical controls (N = 64) to determine the relationship between these behavioral classes and to examine whether executive dysfunction explained any relationship between the variables. Particular types of repetitive behavior (i.e., stereotypy and compulsions) were related to sensory features in autism; however, executive deficits were only correlated with repetitive behavior. This finding suggests that executive dysfunction is not the shared neurocognitive mechanism that accounts for the relationship between restricted, repetitive behaviors and aberrant sensory features in HFA. Group status, younger chronological age, presence of sensory processing issues, and difficulties with behavior regulation predicted the presence of repetitive behaviors in the HFA group.