Beta Spectral Power during Passive Listening in Preschool Children with Specific Language Impairment.

INTRODUCTION: Children with specific language impairment (SLI) have difficulties in different speech and language domains. Electrophysiological studies have documented that auditory processing in children with SLI is atypical and probably caused by delayed and abnormal auditory maturation. During the resting state, or different auditory tasks, children with SLI show low or high beta spectral power, which could be a clinical correlate for investigating brain rhythms. METHODS: The aim of this study was to examine the electrophysiological cortical activity of the beta rhythm while listening to words and nonwords in children with SLI in comparison to typical development (TD) children. The participants were 50 children with SLI, aged 4 and 5 years, and 50 age matched TD children. The children were divided into two subgroups according to age: (1) children 4 years of age; (2) children 5 years of age. RESULTS: The older group differed from the younger group in beta auditory processing, with increased values of beta spectral power in the right frontal, temporal, and parietal regions. In addition, children with SLI have higher beta spectral power than TD children in the bilateral temporal regions. CONCLUSION: Complex beta auditory activation in TD and SLI children indicates the presence of early changes in functional brain connectivity.

Speech-language pathologists' professional stress level and factors affecting it in the Republic of Serbia.

BACKGROUND: In the Republic of Serbia, to our knowledge, there has been no research dedicated to the professional stress faced by speech-language pathologists (SLPs). Since speech therapy belongs to the helping professions, SLPs might experience professional stress. OBJECTIVE: To examine the levels of professional stress in SLPs concerning sociodemographic characteristics and terms of the workplace. METHODS: The research was conducted online, using a questionnaire designed to determine professional stress in speech-language pathologists - Speech-Language Pathologist Stress Inventory. The voluntary sample consisted of 185 employed SLPs from the Republic of Serbia. The stress level was observed concerning marital status, years of working experience, age, educational degree, caseload size, job sector, job setting, type of patients' diagnosis, and type of service which SLPs provide. RESULTS: The results showed that SLPs experience mild to moderate levels of professional stress and that there is a statistically significant difference in the stress level concerning years of working experience, age, job sector, and job setting. Applying Generalized Linear Mixed Model revealed that two-way interaction (Years of working experience * Marital status) and three-way interaction (Age * Job Setting * Type of patients' diagnosis) dominated on the model. CONCLUSION: Since it is noted that SLPs are experiencing mild to moderate levels of professional stress, it is important to emphasize the need for adaptation of existing work terms as well as to provide additional support to speech therapists in order to improve their mental health.

Resting-state EEG alpha rhythm spectral power in children with specific language impairment: a cross-sectional study.

PURPOSE: This study investigated EEG alpha rhythm spectral power in children with Specific Language Impairment (SLI) and compared it to typically developing children to better understand the electrophysiological characteristics of this disorder. Specifically, we explored resting-state EEG, because there are studies that point to it being linked to speech and language development. METHODS: EEG recordings of 30 children diagnosed with specific language impairment and 30 typically developing children, aged 4.0-6.11 years, were carried out under eyes closed and eyes open conditions. Differences in alpha rhythm spectral power in relation to brain topography and experimental conditions were calculated. RESULTS: In the eyes closed condition, alpha rhythm spectral power was statistically significantly lower in children with specific language impairment in the left temporal (T5) and occipital electrodes (O1, O2) than in typically developing children. In the eyes open condition, children with SLI showed significantly lower alpha rhythm spectral power in the left temporal (T3, T5), parietal (P3, Pz), and occipital electrodes (O1, O2). There were no statistically significant differences between the groups in relation to the relative change (the difference between average alpha rhythm spectral power during eyes closed condition and average alpha rhythm spectral power during eyes open condition divided by average alpha rhythm spectral power during eyes closed condition) in the alpha rhythm spectral power between the conditions. CONCLUSION: Lower alpha rhythm spectral power in the left temporal, left, midline parietal, and occipital brain regions could be a valuable electrophysiological marker in children with SLI. Further investigation is needed to examine the connection between EEG alpha spectral power and general processing and memory deficits in patients with SLI.

EEG Correlates of Cognitive Functions in a Child with ASD and White Matter Signal Abnormalities: A Case Report with Two-and-a-Half-Year Follow-Up.

This research aimed to examine the EEG correlates of different stimuli processing instances in a child with ASD and white matter signal abnormalities and to investigate their relationship to the results of behavioral tests. The prospective case study reports two and a half years of follow-up data from a child aged 38 to 66 months. Cognitive, speech-language, sensory, and EEG correlates of auditory-verbal and auditory-visual-verbal information processing were recorded during five test periods, and their mutual interrelation was analyzed. EEG findings revealed no functional theta frequency range redistribution in the frontal regions favoring the left hemisphere during speech processing. The results pointed to a positive linear trend in the relative theta frequency range and a negative linear trend in the relative alpha frequency range when listening to and watching the cartoon. There was a statistically significant correlation between EEG signals and behavioral test results. Based on the obtained results, it may be concluded that EEG signals and their association with the results of behavioral tests should be evaluated with certain restraints considering the characteristics of the stimuli during EEG recording.

Comparing Anxiety Levels during the COVID-19 Pandemic among Mothers of Children with and without Neurodevelopmental Disorders.

The COVID-19 pandemic undoubtedly burdened families, perhaps even more for parents of children with neurodevelopmental disabilities. This research aims to determine the anxiety levels in mothers of children with neurodevelopmental disorders (autism spectrum disorder and specific language impairment) and mothers of typically developed children. The cross-sectional study comprised 280 mothers from the period of the COVID-19 pandemic in Serbia. A confidential survey included main demographic data and the State-Trait Anxiety Inventory (STAI). Results revealed that the mean levels of STAI-S and STAI-T are elevated in the observed sample of mothers in the first pandemic wave; the STAI-S level is in the high category (STAI-S mean = 46.69), while STAI-T is in the intermediate category near the cut-off value for the high level (STAI-T mean = 43.04). A statistically significant strong positive correlation between STAI-S and STAI-T is seen (r = 0.802, p = 0.001). GLMM analysis revealed that interactions, rather than independent variables, significantly impact anxiety, implying a complex relationship between the observed variables and STAI. Compared with the results from the pre-pandemic study, our findings reveal that COVID-19 affects mothers of children with and without neurodevelopmental disorders in a complex manner, imposing a need for psychological support, which may positively affect mothers' mental health and the development of their offspring.

Importance of Early Intervention in Reducing Autistic Symptoms and Speech-Language Deficits in Children with Autism Spectrum Disorder.

The intervention focused on starting treatment at an early age to develop the child's full potential, which is known as early intervention. Given that autistic symptoms and language deficits occur at an early age and affect other areas of development in children with autistic spectrum disorder, we wanted to examine if early intervention is more effective in the reduction in autistic symptoms and language deficits in children aged 36−47 months old when compared to children 48−60 months old. The sample consisted of 29 children diagnosed with ASD who were admitted for integrative therapy. All participants were divided into two groups based on age: G1: 36−47 months old children, and G2: 48−60 months old children. To estimate the presence of autistic symptoms, we used the GARS-3, and for the assessment of speech−language abilities, we used the subscale Estimated Speech and Language Development (ESLD). Our results regarding the effect of the group on the difference in the scores at two time points showed that there was a statistically significant effect of the group on the reduction in autistic symptoms (p < 0.05) but no effect of the group on the differences in speech−language abilities between the two time points (p > 0.05). Our study highlights the importance of emphasizing the exact age when using the terms "early intervention" and "early development" in future studies and practice because it is necessary to determine and establish guidelines about which particular ages are crucial for starting treatment in certain developmental aspects.

Arterial Presumed Perinatal Ischemic Stroke: A Mini Review and Case Report of Cognitive and Speech-Language Profiles in a 5-Year-Old Girl.

Arterial presumed perinatal ischemic stroke is a type of perinatal stroke that emerges due to late or delayed diagnostics of perinatal or neonatal arterial ischemic stroke. It is usually recognized before one year of life due to hemiparesis. This injury may lead to cognitive, behavioral, or motor symptoms, and life-long neurodevelopmental disabilities. In this case report, we describe a five-year-old girl with a history of arterial presumed perinatal ischemic stroke in the left hemisphere, which adversely affected her cognitive and language outcomes. The girl's cognitive development has been uneven, ranging from below average to average, and she had specific language acquisition deficits in comprehension, vocabulary, morphology, use of complex syntax, and narrative structure. The obtained results point to the specificity of each child whose development is influenced not only by the timing of the brain lesion and the degree of damage, but also by the child's neurobiological capacity. In addition, we provide an updated review of the literature that includes information on epidemiology, risk factors, diagnostics, clinical manifestations, outcomes, and potential therapies. The present article highlights the importance of early intervention and systematic monitoring of children with perinatal stroke with the aim of improving the child's development.

Maternal Anxiety and Its Associated Factors During the First and Second Wave of COVID-19 Pandemic in Serbia: A Cross-Sectional Study.

Aim: The COVID 19-pandemic affects people differently, while pregnant women are among the most sensitive populations. The data about maternal mental health during the COVID-19 outbreak are in some ways consistent but also country-specific. Purpose: The study aims to explore the impact of the COVID-19 pandemic on pregnant women's anxiety and identify its associated factors. Patients and Methods: This cross-sectional study included a sample of 358 pregnant women during the first and second waves of the pandemic in Serbia. An anonymous survey included basic demographic questions, pregnancy-related background questions, the question of self-reported COVID-19-related fear, State-Trait Anxiety Inventory (STAI), and Multidimensional Scale of Perceived Social Support (MSPSS). Results: The study revealed no pregnant women with low anxiety levels measured by STAI-T and STAI-S, while the STAI-S and STAI-T scores indicated high anxiety in 32.4% and 42.7% of pregnant women, respectively. The obtained results pointed out the nonlinear dependence of state anxiety on observed associated factors and their complex interactions, including the data collecting period. Conclusion: Our findings reveal that COVID-19 affects pregnant women's mental health and makes it necessary for psychological monitoring and support for pregnant women, which may be reflected in their mental health but also the development of their offspring.

Maternal Distress during Pregnancy and the Postpartum Period: Underlying Mechanisms and Child's Developmental Outcomes-A Narrative Review.

Maternal mental health may be considered a determining factor influencing fetal and child development. An essential factor with potentially negative consequences for a child's psychophysiological development is the presence of maternal distress during pregnancy and the postpartum period. The review is organized and presented to explore and describe the effects of anxiety, stress, and depression in pregnancy and the postpartum period on adverse child developmental outcomes. The neurobiology of maternal distress and the transmission mechanisms at the molecular level to the fetus and child are noted. In addition, the paper discusses the findings of longitudinal studies in which early child development is monitored concerning the presence of maternal distress in pregnancy and the postpartum period. This topic gained importance in the COVID-19 pandemic context, during which a higher frequency of maternal psychological disorders was observed. The need for further interdisciplinary research on the relationship between maternal mental health and fetal/child development was highlighted, especially on the biological mechanisms underlying the transmission of maternal distress to the (unborn) child, to achieve positive developmental outcomes and improve maternal and child well-being.

Electroen cephalography correlates of word and non-word listening in children with specific language impairment: An observational study20F0.

Auditory processing in children diagnosed with speech and language impairment (SLI) is atypical and characterized by reduced brain activation compared to typically developing (TD) children. In typical speech and language development processes, frontal, temporal, and posterior regions are engaged during single-word listening, while for non-word listening, it is highly unlikely that perceiving or speaking them is not followed by frequent neurones' activation enough to form stable network connections. This study aimed to investigate the electrophysiological cortical activity of alpha rhythm while listening words and non-words in children with SLI compared to TD children. The participants were 50 children with SLI, aged 4 to 6, and 50 age-related TD children. Groups were divided into 2 subgroups: first subgroup - children aged 4.0 to 5.0 years old (E = 25, C = 25) and second subgroup - children aged 5.0 to 6.0 years old (E = 25, C = 25). The younger children's group did not show statistically significant differences in alpha spectral power in word or non-word listening. In contrast, in the older age group for word and non-word listening, differences were present in the prefrontal, temporal, and parieto-occipital regions bilaterally. Children with SLI showed a certain lack of alpha desynchronization in word and non-word listening compared with TD children. Non-word perception arouses more brain regions because of the unknown presence of the word stimuli. The lack of adequate alpha desynchronization is consistent with established difficulties in lexical and phonological processing at the behavioral level in children with SLI.

Can EEG Correlates Predict Treatment Efficacy in Children with Overlapping ASD and SLI Symptoms: A Case Report.

Evaluation of the rehabilitation efficacy may be an essential indicator of its further implementation and planning. The research aim is to examine whether the estimation of EEG correlates of auditory-verbal processing in a child with overlapping autism spectrum disorder (ASD) and specific language impairment (SLI) symptoms may be a predictor of the treatment efficacy in conditions when behavioral tests do not show improvement during the time course. The prospective case report reports follow-up results in a child aged 36 to 66 months. During continuous integrative therapy, autism risk index, cognitive, speech-language, sensory, and EEG correlates of auditory-verbal information processing are recorded in six test periods, and their mutual interrelation was analyzed. The obtained results show a high statistically significant correlation of all observed functions with EEG correlates related to the difference between the average mean values of theta rhythm in the left (F1, F3, F7) and right (F2, F4, F8) frontal region. The temporal dynamics of the examined processes point to the consistency of the evaluated functions increasing with time flow. These findings indicate that EEG correlates of auditory-verbal processing may be used to diagnose treatment efficacy in children with overlapping ASD and SLI.

The speech and language profile of a child with Turner Syndrome- a case study.

BACKGROUND: Turner syndrome is a genetic disorder that affects only females. It has specific cognitive characteristics, but speech and language data are scarce. METHODS AND PROCEDURES: Prospective case report; we report a girl aged seven's cognitive and speech and language profile. RESULTS: Cognitive assessment shows higher performance IQ (PIQ), and atypical cognitive profile for Turner syndrome. Speech and language assessment show a significant difference between receptive and expressive language levels. Although the girl did comprehend most of the language structure, there was a lack of it in spontaneous speech. She demonstrated inconsistency in the use of language morphology and complex linguistic structures, primarily because of significant inconsistency in her sound production. Although she produced the majority of phonemes correctly in isolation, her spontaneous speech production was incomprehensible. CONCLUSION: Case studies of speech and language development may reveal a specific characteristic in the cases with Turner syndrome to delineate genetic factors from individual developmental variabilities.

Neuroinflammation in Autism and Supplementation Based on Omega-3 Polyunsaturated Fatty Acids: A Narrative Review.

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder characterized by persistent deficits in social communication and social interaction across multiple contexts and restricted, repetitive patterns of behavior, interests and activities. The maternal status of polyunsaturated fatty acids (PUFA) regulates microglial activity and neuroinflammatory pathways during a child's brain development. In children with ASD, the metabolism of PUFA is thought to be deficient or abnormal, leading to increased production of proinflammatory cytokines, increased oxidative stress and an imbalance in the formation and action of neurotransmitters. In addition, nutritional deficits in omega-3 PUFA may affect gut microbiota and contribute to ASD by the gut-brain axis. The aim of this study was to review the possible role of neuroinflammation in ASD development and the effect of omega-3 PUFA supplementation in children with ASD. Due to a wide heterogeneity across RCTs, no definitive conclusion about omega-3 PUFA effects in ASD can be drawn. Supplementation with PUFA could be considered as one of the aspects in regulating the biological status of the organism and could provide added value to standard medical and psychological interventions for reducing behavioral deficits.

The Impact of Maternal Anxiety on Early Child Development During the COVID-19 Pandemic.

Background: Maternal prenatal anxiety is among important public health issues as it may affect child development. However, there are not enough studies to examine the impact of a mother's anxiety on the child's early development, especially up to 1 year. Objective: The present prospective cohort study aimed to examine whether maternal trait anxiety, perceived social support, and COVID-19 related fear impacted speech-language, sensory-motor, and socio-emotional development in 12 months old Serbian infants during the COVID-19 pandemic. Methods: This follow-up study included 142 pregnant women (Time 1) and their children at 12 months (Time 2). Antenatal maternal anxiety and children's development were examined. Maternal anxiety was assessed using the State-Trait Anxiety Inventory (STAI). Child speech-language, sensory-motor, and socio-emotional development were assessed using the developmental scale in the form of an online questionnaire that examined the early psychophysiological child development. Information on socioeconomic factors, child and maternal demographics, clinical factors, and perceived fear of COVID-19 viral infection were collected. Multivariable General Linear Model analysis was conducted, adjusted for demographic, clinical, and coronavirus prenatal experiences, maternal prenatal anxiety levels, perceived social support, speech-language, motor skills, and cognitive and socio-emotional development at the infants' age of 12 months. Results: The study revealed the influence of the COVID-19 pandemic on maternal trait anxiety. The association between selected independent factors and infants' development was found in a demographically unified sample except for employment and the number of children. There was a correlation between all observed developmental functions. Univariate General Linear model statistical analysis indicated that linear models with selected independent factors and covariates could account for 30.9% (Cognition) up to 40.6% (Speech-language) of variability in developmental functions. It turned out that two-way and three-way interactions had a dominant role on models, and STAI-T Level and COVID-19 related fear were present in all interaction terms. Conclusion: Our findings reveal important determinants of child developmental outcomes and underline the impact of maternal anxiety on early child development. These findings lay the groundwork for the following interdisciplinary research on pregnancy and child development to facilitate and achieve positive developmental outcomes and maternal mental health.

Fetal Middle Cerebral Artery Pulsatility Index in No-Risk Pregnancies: Effects of Auditory Stimulation and Pregnancy Order.

Pulsatility index (PI) values in a fetal middle cerebral artery (MCA) were compared in no-risk pregnancies to examine the differences related to auditory stimulation test and pregnancy order. The study included 196 women with no-risk pregnancies selected from the database of more than 1000 pregnant women divided into two groups. Group 1 consisted of 98 nulliparous women (C1 = 98) and Group 2 consisted of 98 parous women (C2 = 98). All pregnant women were of comparable age and fetal gestational age (GA) when MCA-PI values were recorded. Measurements of PI values in fetal MCA were obtained before and immediately after the application of fetal auditory stimulation test. The MCA-PI measuring was conducted in the period between the 36th and the 41st week of GA. The results showed that PI baseline values and PI values after defined auditory stimulation were significantly different when measured in nulliparous women compared to parous women (p = 0.001; p = 0.003, respectively), while no group differences were observed in relative PI value changes due to auditory stimulation. These findings suggest that hemodynamic changes in fetal MCA caused by defined auditory stimulation measured by PI value changes may be valuable in the assessment of fetal auditory perception functionality and its development.

Neurophysiological Approach to Examining Knowledge/Belief in the Prayer of an Untrained Person: A Case Study.

An adult female (22 years) of Christian orthodox religion was examined during the silent Lord's prayer, the most common, short prayer, with the aim of possible differentiation between belief and knowledge in her experience, analyzing the behavior of subgroups of theta and beta cerebral EEG rhythms, which occur through constant and occasional activation of cerebral regions. The participant was not trained in reading the prayer to herself or other people. EEG examination was performed by Nihon Kohden Corporation, EEG-1200-K Neurofax apparatus, in the monopolar longitudinal montage in the system of 10/20 electrodes aimed at determining the peak frequency value of each exploratory site. The method of result analysis was based on connecting cerebral regions into networks of 3 or more members according to identical peak frequency value, which was observed within subgroups of theta and beta frequencies and analyzed through a proximity index and continuity and discontinuity of activation during the observed period. Out of the definite observation sample of 3 s from each subperiods (beginning, middle and end), a window of 2 s was moving from the beginning till end of the period with 200-ms time lag. This resulted in six subsamples for each electrode and for each experimental situation (resting state, situation of prayer). Stable and unstable activity of the regions was assessed within subgroups via cartographic formulas equivalent to the states which subgroups of theta and beta imply in psychophysiological sense. The results indicated that through participant's inner dialogue-monologue there are elements of both knowledge and belief, and that this phenomenon is possible considering insufficiently specific circumstances of the experiment and the participant herself, such as her relatively young age and insufficient practice of praying. The paper discusses the types of connections between regions which imply knowledge and those related to belief according to our understanding and regarding findings in literature.

Differences in speech and language abilities between children with 22q11.2 deletion syndrome and children with phenotypic features of 22q11.2 deletion syndrome but without microdeletion.

BACKGROUND: 22q11.2DS is the most common microdeletion syndrome in humans, usually associated with speech and language delay (SLD). Approximately 75% of children with 22q11.2 microdeletion have congenital heart malformations (CHM) which after infant open-heart surgery might lead to SLD. AIMS: The purpose of this study was to determine whether factors associated with microdeletion contribute to SLD in children with 22q11.2DS. METHODS AND PROCEDURES: We compared speech and language abilities of two groups of school-aged children: those with 22q11.2 microdeletion (E1) and those with the phenotype resembling 22q11.2DS but without the microdeletion (E2). An age-matched group of typically developing children was also tested. OUTCOMES AND RESULTS: The obtained results revealed that children from group E1 have lower level of speech and language abilities compared to children from group E2 and control group. Additionally, mild to moderate SLD was detected in children from group E2 compared to children from the control group. CONCLUSIONS AND IMPLICATIONS: The obtained results imply that both CHM after infant open-heart surgery and other factors associated with 22q11.2 microdeletion, contribute to SLD in patients with 22q11.2 microdeletion. Based on this, we could postulate that there is/are some potential candidate gene(s), located in the 22q11.2 region, whose function could be important for speech and language development.

Cognitive and electrophysiological characteristics of children with specific language impairment and subclinical epileptiform electroencephalogram.

The current study is a preliminary examination of cognitive profiles and cortical distribution of the spectral power of different electroencephalogram (EEG) rhythms in children with specific language impairment and subclinical epileptiform discharges. Although a number of empirical studies point to higher incidence of abnormal EEGs in children with specific language impairment, only a few studies were found examining electrophysiological characteristics, such as locus of discharges and connections with cognitive functioning in this population of children. The sample included 12 children with specific language impairment (SLI) and abnormal EEG who underwent testing of cognitive functioning using the Wechsler Intelligence Scale for Children (WISC). The control sample included 13 children with specific language impairment and regular EEG. Results point to lower scores on several subtests of the performance scale for children with abnormal EEG than for the group with regular EEG. Detailed EEG analysis of cortical distribution of the spectral power of different EEG rhythms partially confirms the results of neuropsychological assessment, pointing to abnormal function of frontal and temporal regions. Higher values of spectral power of the delta brain rhythm in frontal regions are associated with lower results on the WISC performance scale. Results are discussed in the context of subgroups of the population of children with SLI.

Adaptive filter based two-probe noise suppression system for transient evoked otoacoustic emission detection.

Transient otoacoustic emission (TEOAE) is a method widely used in clinical practice for assessment of hearing quality. The main problem in TEOAE detection is its much lower level than the level of environmental and biological noise. While the environmental noise level can be controlled, the biological noise can be only reduced by appropriate signal processing. This paper presents a new two-probe preprocessing TEOAE system for suppression of the biological noise by adaptive filtering. The system records biological noises in both ears and applies a specific adaptive filtering approach for suppression of biological noise in the ear canal with TEOAE. The adaptive filtering approach includes robust sign error LMS algorithm, stimuli response summation according to the derived non-linear response (DNLR) technique, subtraction of the estimated TEOAE signal and residual noise suppression. The proposed TEOAE detection system is tested by three quality measures: signal-to-noise ratio (S/N), reproducibility of TEOAE, and measurement time. The maximal TEOAE detection improvement is dependent on the coherence function between biological noise in left and right ears. The experimental results show maximal improvement of 7 dB in S/N, improvement in reproducibility near 40% and reduction in duration of TEOAE measurement of over 30%.