Gestational choline supplementation ameliorates T-maze reversal learning deficits induced by first trimester binge alcohol exposure in weanling lambs.

In rodent models of fetal alcohol spectrum disorders (FASD), cognitive deficits are implicated in impaired T-maze spatial reversal learning. Rat studies have indicated supplemental administration of choline during the developmental period of alcohol exposure can ameliorate spatial reversal deficits. This study tested whether beneficial effects of prenatal choline supplementation could be confirmed in a sheep model of binge exposure in the first trimester equivalent. Two hypotheses were tested: 1) alcohol exposure would produce deficits in reversal of a T-maze position discrimination; and 2) gestational dietary supplementation of choline would ameliorate those deficits. Mated ewes were assigned to one of seven groups-a normal control (NC) group or one of six infusion treatment groups: saline control (SC; isotonic saline), saline control plus choline (SC-CH; isotonic saline plus choline, 10 mg/kg administered orally throughout each day of gestation), binge alcohol (BA; 1.75 g/kg alcohol per infusion day), binge alcohol plus choline (BA-CH; 1.75 g/kg/day alcohol plus choline), heavy binge alcohol (HBA; 2.5 g/kg/day alcohol), or heavy binge alcohol plus choline (HBA-CH; 2.5 g/kg/day alcohol plus choline). The alcohol infusions modeled a weekend binge drinking pattern over the first trimester-equivalent (gestational day 4-41). T-maze training began at 12 weeks of age, with daily sessions occurring 5 days/week. Lambs were given five days of habituation training, followed by five days of position discrimination training (3 trials per daily session, intertrial interval of 3 hours, reinforced side randomly assigned across subjects). Lambs were then given 10 days of training on the reversal task. There was no difference among groups during acquisition. Alcohol impaired reversal learning, and choline supplementation mitigated these deficits in the HBA-CH group. These results suggest that maternal dietary choline supplementation can ameliorate or prevent some impairments of executive function in a sheep model of FASD.

Part 3: adult basic life support and automated external defibrillation: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

This review comprises the most extensive literature search and evidence evaluation to date on the most important international BLS interventions, diagnostics, and prognostic factors for cardiac arrest victims. It reemphasizes that the critical lifesaving steps of BLS are (1) prevention, (2) immediate recognition and activation of the emergency response system, (3) early high-quality CPR, and (4) rapid defibrillation for shockable rhythms. Highlights in prevention indicate the rational and judicious deployment of search-and-rescue operations in drowning victims and the importance of education on opioid-associated emergencies. Other 2015 highlights in recognition and activation include the critical role of dispatcher recognition and dispatch-assisted chest compressions, which has been demonstrated in multiple international jurisdictions with consistent improvements in cardiac arrest survival. Similar to the 2010 ILCOR BLS treatment recommendations, the importance of high quality was reemphasized across all measures of CPR quality: rate, depth, recoil, and minimal chest compression pauses, with a universal understanding that we all should be providing chest compressions to all victims of cardiac arrest. This review continued to focus on the interface of BLS sequencing and ensuring high-quality CPR with other important BLS interventions, such as ventilation and defibrillation. In addition, this consensus statement highlights the importance of EMS systems, which employ bundles of care focusing on providing high-quality chest compressions while extricating the patient from the scene to the next level of care. Highlights in defibrillation indicate the global importance of increasing the number of sites with public-access defibrillation programs. Whereas the 2010 ILCOR Consensus on Science provided important direction for the "what" in resuscitation (ie, what to do), the 2015 consensus has begun with the GRADE methodology to provide direction for the quality of resuscitation. We hope that resuscitation councils and other stakeholders will be able to translate this body of knowledge of international consensus statements to build their own effective resuscitation guidelines.

The limitations of orthographic analogy in early reading development: performance on the clue-word task depends on phonological priming and elementary decoding skill, not the use of orthographic analogy.

Two experiments investigated the mechanisms underlying analogical transfer in the clue-word reading task developed by Goswami and her colleagues. Across both experiments, an equivalent number of "analogy" responses were made regardless of whether the clue word was seen or just heard. In addition, the number of "analogy" responses to words sharing both orthographic and phonological overlap with the clue words was no greater than that shown to words sharing only pronunciations. These results provide no evidence for the view that beginning readers make genuine orthographic-based analogies. Instead, the findings are interpreted within a framework in which phonological priming, in combination with the children's own partial decoding attempts based on limited orthographic knowledge, account for their performance on the clue-word task. It is concluded that the extent to which beginning readers make orthographic analogies is overestimated and as a consequence, theories that emphasize the importance of orthographic analogy as a mechanism driving the development of early reading skills need to be questioned.

Reading skills in hyperlexia: a developmental perspective.

Hyperlexia is characterized by advanced word-recognition skills in individuals who otherwise have pronounced cognitive, social, and linguistic handicaps. Language, word recognition, and reading-comprehension skills are reviewed to clarify the nature and core deficits associated with the disorder. It is concluded that hyperlexia should be viewed as part of the normal variation in reading skills, which are themselves associated with individual differences in phonological, orthographic, and semantic processing, short-term memory, and print exposure. A compulsive preoccupation with reading may also be crucial to the development of a hyperlexic reading profile. A theoretical framework, based on recent connectionist models of reading development, is described. This perspective provides a satisfactory account for how individual differences in a number of different skills can lead to a variety of manifestations of reading behavior, including hyperlexia.

Working memory deficits in poor comprehenders reflect underlying language impairments.

Three experiments assessed memory skills in good and poor comprehenders, matched for decoding skill. Experiments 1 and 2 investigated phonological and semantic contributions to short-term memory by comparing serial recall for words varying in length, lexicality, and concreteness. Poor comprehenders showed normal sensitivity to phonological manipulations (length and lexicality) but, consistent with their semantic weaknesses, their recall of abstract words was poor. Experiment 3 investigated verbal and spatial working memory. While poor comprehenders achieved normal spatial spans, their verbal spans were impaired. These results are discussed within a theoretical framework in which the memory difficulties associated with poor reading comprehension are specific to the verbal domain and are a concomitant of language impairment, rather than a cause of reading comprehension failure.

Developmental differences in sensitivity to semantic relations among good and poor comprehenders: evidence from semantic priming.

Semantic priming for category coordinates (e.g. CAT-DOG; AEROPLANE-TRAIN) and for pairs of words related through function (e.g. BROOM-FLOOR; SHAMPOO-HAIR) was assessed in children with good and poor reading comprehension, matched for decoding skill. Lexical association strength was also manipulated by comparing pairs of words that were highly associated with pairs that shared low association strength. Both groups of children showed priming for function-related words, but for the category co-ordinates, poor comprehenders only showed priming if the category pairs also shared high association strength. Good comprehenders showed priming for category-related targets, irrespective of the degree of prime-target association. These findings are related to models of language development in which category knowledge is gradually abstracted and refined from children's event-based knowledge and it is concluded that in the absence of explicit co-occurrence, poor comprehenders are less sensitive to abstract semantic relations than normal readers.

Individual differences in contextual facilitation: evidence from dyslexia and poor reading comprehension.

Ninety-two 7- to 10-year-old children read words presented in isolation or following a spoken sentence context. In absolute terms, poor readers showed more contextual facilitation than good readers. However, when the relative benefit of context was assessed, this was greater for children with better reading skills, and comprehension was a better predictor of contextual facilitation than decoding. Study 2 compared the performance of dyslexics with that of reading-age matched poor comprehenders and normal readers. The dyslexics showed greater contextual facilitation than the normal readers who, in turn, showed more priming than poor comprehenders. The results show that dyslexic children use context to compensate for poor decoding skills, whereas children with poor reading comprehension skills fail to benefit from context as much as normal readers.

Assessing reading difficulties: the validity and utility of current measures of reading skill.

BACKGROUND: Accurate assessment of reading difficulties is clearly important if appropriate support and remediation is to be provided. Many different reading tests are routinely used yet it is not clear to what extent different tests tap the same underlying skills. AIMS: The nature of the relationships between different tests of reading accuracy, reading comprehension and linguistic comprehension is investigated in this paper. SAMPLES, METHODS AND RESULTS: In study 1, 184 7-10 year old children completed a listening comprehension test, three tests of reading accuracy (reading of nonwords, single words and text) and two tests of reading comprehension (test comprehension and sentence completion). While sentence completion was well accounted for by individual differences in word recognition, text comprehension was more heavily dependent on listening comprehension. Study 2 compared the performance of children with poor comprehension skills with controls matched for age, nonverbal ability and decoding skill. The poor comprehenders had greatest difficulty with those tests most heavily dependent on linguistic comprehension and least difficulty on purer measures of decoding. CONCLUSIONS: These findings show that different reading tests measure different aspects of the reading process and that caution should be exercised when selecting tests for the assessment of reading difficulties.

A connectionist perspective on the development of reading skills in children.

The development of decoding skills has traditionally been viewed as a stage-like process during which children's reading strategies change as a consequence of the acquisition of phonological awareness. More explicit accounts of the mechanisms involved in learning to read are provided by recent connectionist models in which children learn mappings initially between orthography and phonology, and later between orthography, phonology and semantics. Evidence from studies of reading development suggests that learning to read is determined primarily by the status of a child's phonological representations and is therefore compromised in dyslexic children who have phonological deficits. Children who have language impairments encompassing deficits in semantic representations have qualitatively different reading problems centring on difficulties with reading comprehension and in learning to read exception words.

The Automatic Activation of Sound-Letter Knowledge: An Alternative Interpretation of Analogy and Priming Effects in Early Spelling Development

This paper presents two experiments investigating 6-year-old children's use of analogy in spelling. In Experiment 1, children make analogies between a visible clue word and a similar sounding target word. Analogies are made to the same extent regardless of whether the clue and target share a rime unit, a consonant vowel (CV) or a vowel but are not made when only common letters are shared. A second experiment investigates children's spelling by analogy when the clue word is not visible. Again, an equal number of analogies are made between words sharing a rime unit, a CV or a vowel. From the earliest stages of learning to spell, children benefit from drawing analogies (at the level of individual phonemes) with words that they know. These findings are related to recent connectionist models of the development of reading and spelling skills.