Retrieval Practice and Word Learning by Children With Developmental Language Disorder: Does Expanding Retrieval Provide Additional Benefit?

PURPOSE: The word learning of preschool-age children with developmental language disorder (DLD) is improved when spaced retrieval practice is incorporated into the learning sessions. In this preregistered study, we compared two types of spacing-an expanding retrieval practice schedule and an equally spaced schedule-to determine if one of these approaches yields better word learning outcomes for the children. METHOD: Fourteen children with DLD aged 4-5 years and 14 same-age children with typical language development (TD) learned eight novel nouns over two sessions. Spacing for half of the novel words was expanded gradually during learning; for the remaining novel words, greater spacing remained at the same level throughout learning. Immediately after the second session and 1 week later, the children's recall of the words was tested. RESULTS: The children with TD recalled more novel words than the children with DLD, although this difference could be accounted for by differences in the children's standardized receptive vocabulary test scores. The two groups were similar in their ability to retain the words over 1 week. Initially, the shorter spacing in the expanding schedule resulted in greater retrieval success than the corresponding (longer spaced) retrieval trials in the equally spaced schedule. These early shorter spaced trials also seemed to benefit retrieval of the trials with greater spacing that immediately followed. However, as the learning period progressed, the accuracy levels for the two conditions converged and were likewise similar during final testing. CONCLUSION: We need a greater understanding of how and when short spacing can be helpful to children's word learning, with the recognition that early gains might give a misleading picture of the benefits that short spacing can provide to longer term retention. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25537696.

Long-term consequences of mothers' and fathers' wartime deployments: Protocol for a two-wave panel study.

Multiple adjustment difficulties have been associated with children's exposure to recent parental wartime military deployments, but long-term consequences have not yet been systematically studied. This investigation will assess direct and indirect relationships between exposures to parental deployments early in life and later youth adjustment. Parents' psychological health and family processes will be examined as mediators, and parents' and children's vulnerability and support will be examined as moderators. Archival data will be combined with new data gathered from two children and up to two parents in families where children will be aged 11 to 16 at the first data collection and will have experienced at least one parental deployment, for at least one child prior to age 6. Data are being gathered via telephone interviews and web-based surveys conducted twice one year apart. Outcomes are indicators of children's social-emotional development, behavior, and academic performance. Notable features of this study include oversampling of female service members, inclusion of siblings, and inclusion of families of both veterans and currently serving members. This study has potentially important implications for schools, community organizations and health care providers serving current and future cohorts of military and veteran families.

TelePriming sentence production in aphasia.

Background: The application of videoconferencing to the assessment and treatment of aphasia has been rapidly increasing; however, there is a need to develop treatments targeting sentence production in persons with aphasia (PWA) that can be delivered through videoconferencing. Structural priming has received recent attention as a potential training method for PWA. We investigated the feasibility and efficacy of a collaborative structural priming task delivered via the internet, TelePriming, in facilitating sentence production in PWA and healthy adults. Method: In Study 1, young adults (YA), older adults (OA), and PWA participated in a collaborative dialogue-like priming task through videoconferencing, taking turns with an interlocutor (experimenter) to describe transitive action pictures with the goal of finding matching pictures. We measured whether participants produced more passive sentences to describe their picture after hearing their interlocutor produce passive compared to active sentences (primes). In Study 2, we compared the data from the OA and PWA of Study 1 (TelePriming) to different groups of OA and PWA, who completed the same priming task in person. Results: All three groups showed robust priming effects in Study 1, producing more passive sentences to describe target pictures after hearing the experimenter produce passive versus active sentences. In Study 2, when controlling for demographic information (age, education) and aphasia severity, TelePriming resulted in larger priming effects for OA and PWA, compared to the in-person priming task. Survey results revealed that both OA and PWA experienced increased comfort and satisfaction with using technology following the task. Conclusion: Interactive message-structure alignment processes remain largely intact in PWA, and the positive effects of structural priming in a collaborative communicative task are not diminished by remote delivery. The findings demonstrate the feasibility and validity of TelePriming in OA and PWA, laying experimental groundwork for future use of TelePriming in the assessment and treatment of clinical populations with limited access to face-to-face sessions.

Long-term phonemic representations become audiovisual by mid-childhood.

In earlier work with adults, we showed that long-term phonemic representations are audiovisual, meaning that they contain information on typical mouth shape during articulation. Many aspects of audiovisual processing have a prolonged developmental course, often not reaching maturity until late adolescence. In this study, we examined the status of phonemic representations in two groups of children - 8-9-year-olds and 11-12-year-olds. We used the same audiovisual oddball paradigm as in the earlier study with adults (Kaganovich and Christ, 2021). On each trial, participants saw a face and heard one of two vowels. One vowel occurred frequently (standard), while another occurred rarely (deviant). In one condition (neutral), the face had a closed, non-articulating mouth. In the other condition (audiovisual violation), the mouth shape matched the frequent vowel. Although stimuli were audiovisual in both conditions, we hypothesized that identical auditory changes would be perceived differently by participants. Namely, in the neutral condition, deviants violated only the audiovisual pattern specific to each experimental block. By contrast, in the audiovisual violation condition, deviants additionally violated long-term representations for how a speaker's mouth looks during articulation. We compared the amplitude of MMN and P3 components elicited by deviants in the two conditions. In the 11-12-year-old group, the pattern of neural responses was similar to that in adults - namely, they had a larger MMN component in the audiovisual compared to neutral condition, with no major difference in the P3 amplitude. In contrast, in the 8-9-year-old group, we saw a posterior MMN in the neutral condition only and a larger P3 in the audiovisual violation compared to the neutral condition. The larger P3 in the audiovisual violation condition suggests that younger children did perceive deviants as being more attention-grabbing when they violated the typical combination of sound and mouth shape. Yet, at this age, the earlier, more automatic stages of phonemic processing indexed by the MMN component may not yet encode visual speech elements the same way they do in older children and adults. We conclude that phonemic representations do not become audiovisual until 11-12 years of age.

Exploring the Relationship Between Resilience and the Adverse Impact of Stuttering in Children.

PURPOSE: People who stutter often experience significant adverse impact related to stuttering. However, it is unclear how adverse impact develops in children who stutter (CWS) and whether there are protective factors that may mitigate its development. This study examined the relationship between resilience, a potentially protective factor, and stuttering's adverse impact in CWS. Resilience comprises external factors, such as family support and access to resources as well as personal attributes, making it a comprehensive protective factor to explore. METHOD: One hundred forty-eight CWS aged 5-18 years completed the age-appropriate version of the Child and Youth Resilience Measure (CYRM) and the Overall Assessment of the Speaker's Experience of Stuttering. Parents completed a caregiver version of the CYRM and a behavioral checklist for their child. The adverse impact of stuttering was modeled as a function of resilience (external, personal, and total), controlling for child age and behavioral checklist score. We also estimated correlations between child-report and parent-report CYRM measures to assess rater agreement. RESULTS: Children reporting greater external, personal, or total resilience were more likely to experience lower degrees of adverse impact related to their stuttering. We documented stronger correlations between younger child and parent ratings of resilience and weaker correlations between older child and parent ratings. CONCLUSIONS: These results yield valuable insight into the variability of adverse impact experienced by CWS and offer empirical support for strength-based speech therapy approaches. We discuss the factors that contribute to a child's resilience and provide practical suggestions for how clinicians can incorporate resilience-building strategies into intervention for children experiencing significant adverse impact from their stuttering. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.23582172.

Can Retrieval Practice Facilitate Verb Learning in Children With Developmental Language Disorder and Their Peers With Typical Language Development?

PURPOSE: Children with developmental language disorder (DLD) have well-documented verb learning difficulties. In this study, we asked whether the inclusion of retrieval practice during the learning period would facilitate these children's verb learning relative to a similar procedure that provided no retrieval opportunities. METHOD: Eleven children with DLD (M age = 60.09 months) and 12 children with typical language development (TD; M age = 59.92 months) learned four novel verbs in a repeated spaced retrieval (RSR) condition and four novel verbs in a repeated study (RS) condition. The words in the two conditions were heard an equal number of times, in the context of video-recorded actors performing novel actions. RESULTS: Recall testing immediately after the learning period and 1 week later revealed greater recall for novel verbs in the RSR condition than for novel verbs in the RS condition. This was true for both groups, and for immediate as well as 1-week testing. The RSR advantage remained when children had to recall the novel verbs while watching new actors perform the novel actions. However, when tested in contexts requiring the children to inflect the novel verbs with -ing for the first time, the children with DLD were much less likely to do so than their peers with TD. Even words in the RSR condition were only inconsistently inflected. CONCLUSIONS: Retrieval practice provides benefits to verb learning-an important finding given the challenges that verbs present to children with DLD. However, these benefits do not appear to automatically translate to the process of adding inflections to newly learned verbs but rather appear to be limited to the operations of learning the verbs' phonetic forms and mapping these forms onto associated actions.

Error Characteristics Lend Specificity to Nonword Repetition Performance in Children Who Stutter With and Without Concomitant Disorders.

PURPOSE: In our earlier study, we found that overall accuracy on nonword repetition (NWR) lacked the specificity to differentiate among groups of children who stutter (CWS) with and without concomitant speech sound and/or language disorders and children who do not stutter (CWNS). The aim of this study was to determine whether NWR error characteristics distinguish these groups of children with different speech sound production and language abilities yielding insight into the deficits underlying poorer performance. METHOD: Participants were 141 children (88 CWS, 53 CWNS). CWS were divided into subgroups based on the presence or absence of concomitant speech sound and language disorders. Children completed an NWR task composed of one- to four-syllable nonwords. Error types included omissions, substitutions, and migrations. Error location was documented across the syllables of the longest, four-syllable nonwords and within each syllable (onset, nucleus, and coda) for all nonwords. RESULTS: We found that error patterns characterized groups' NWR performance. Specifically, CWS groups made more errors on syllable onsets, more errors on the first and fourth syllable of the four-syllable nonwords, and more substitution errors than CWNS. CWS with concomitant speech sound and/or language disorders made more omission errors than CWNS and CWS with typical speech sound and language abilities. CWS with both a speech sound and language disorder made more migration errors than all other groups. CONCLUSIONS: Using a data-driven framework derived from prior empirical investigations of NWR errors, this study demonstrated that error characteristics enhance the specificity of NWR by distinguishing groups of CWS with and without concomitant speech sound and language deficits. These error patterns also provide a window into the processes underlying NWR performance in CWS.

Measuring Physical Activity Regulatory Styles and Identity Among Adults 55 Years or Older.

Objectives. The purpose of this study was to examine the psychometric properties of modified versions of the Behavioral Regulation in Exercise Questionnaire and Exercise Identity Scale for use with adults ages ≥55 years to measure regulatory styles and identity related to physical activity. Methods. Participants [Mage = 66.29 years (SD = 7.06)] answered an online questionnaire twice across a four-week timescale. We assessed measurement invariance and convergent and divergent validity based on relations between regulatory styles, identity, and physical activity. Results. Both measures were invariant across gender and time, and findings support the convergent and divergent validity of the scales. Notably, a two-factor model of identity representing role identity and physical activity beliefs provided the best fit, and physical activity beliefs was more strongly related to introjected regulation. Discussion. Taken together, there is evidence that these modified scales are suitable for use with adults ages ≥55 years.

Multi-type childhood maltreatment exposure and substance use development from adolescence to early adulthood: A GxE study.

BACKGROUND: Childhood maltreatment types can co-occur and are associated with increased substance use during adolescence and early adulthood. There is also a strong genetic basis for substance use which interacts with environmental factors (e.g., childhood maltreatment) to influence substance use phenotype. OBJECTIVE: This research aimed to identify childhood maltreatment sub-groups based on type and chronicity, and their association with substance use change from adolescence to early adulthood, while accounting for the influence of substance use polygenic risk (i.e., genetic risk based on the combined effects of multiple genes). PARTICIPANTS: We used a sample of unrelated European-origin Americans with genetic and childhood maltreatment data (n = 2,664) from the National Longitudinal Study of Adolescent to Adult Health. METHODS: Latent profile analysis was used for sub-group identification and direct and interaction effects were tested for longitudinal trajectories of substance use utilizing generalized estimating equations. RESULTS: Three sub-groups with co-occurring childhood maltreatment exposures were identified: a high sexual abuse sub-group, a high physical abuse sub-group, and a normative sub-group (with low maltreatment exposure). At high polygenic risk, the high physical abuse sub-group had faster increases in substance use over time. In comparison, the high sexual abuse sub-group had faster progression in substance use only at low and medium polygenic risk. CONCLUSIONS: Findings provide initial evidence for biological and environmental differences among maltreatment sub-groups on trajectories of substance use.

Coparenting Problems and Parenting Behavior as Mediating Links Between Interparental Conflict and Toddlers' Adjustment Difficulties in Germany.

Objective: Interparental conflict has long been acknowledged as a major risk factor for the well-being of children. Empirical studies reveal clear associations between children's maladjustment and frequent destructive conflicts between their parents (van Eldik et al., 2020). Existing research suggests that interparental conflict spills over from the couple to the coparental relationship, undermining parents' skills to cooperate and their parenting competencies. This study addresses the effects of interparental conflict on the behavioral and emotional problems of toddlers. Methods: The analyses were based on longitudinal data from the German Family Panel pairfam. The sample comprised information on N = 828 anchor participants (59.9 % female) and their 3- to 5-year-old children. Results: As expected, the effects of interparental conflict on children's behavioral and emotional problems were mediated by coparenting problems and in part also by negative parenting. Further analyses comparing mothers and fathers revealed a stronger direct path of interparental conflict on coparenting for mothers. Conclusions: The findings provide support for the significance of the interparental relationship and coparenting quality for child development, even in this young age group, and point to the importance of early prevention.

Trajectories of depression symptoms during the process of deployment in military couples.

Informed by life course theory, we estimated depression symptom trajectories for couples throughout a deployment cycle using data from a longitudinal study of National Guard couples (n= 339). One-third of couples served as a comparison group by participating in data collection after their deployments were canceled. We proposed that 1) service members and partners would display multiple trajectories of depression symptoms that differ as a function of role (i.e., service member or at-home partner) and exposure to deployment; 2) trajectory patterns would be associated with indicators of human capital; 3) service members' and partners' depression symptoms would be linked to each other. We found that depressive symptom trajectories varied by exposure to deployment and role, and that higher levels of human capital were mostly associated with lower depressive symptoms, although we did not find support for partner interdependence. Results were considered in the context of life course theory and emotional cycles of deployment.

Event-related potentials evidence for long-term audiovisual representations of phonemes in adults.

The presence of long-term auditory representations for phonemes has been well-established. However, since speech perception is typically audiovisual, we hypothesized that long-term phoneme representations may also contain information on speakers' mouth shape during articulation. We used an audiovisual oddball paradigm in which, on each trial, participants saw a face and heard one of two vowels. One vowel occurred frequently (standard), while another occurred rarely (deviant). In one condition (neutral), the face had a closed, non-articulating mouth. In the other condition (audiovisual violation), the mouth shape matched the frequent vowel. Although in both conditions stimuli were audiovisual, we hypothesized that identical auditory changes would be perceived differently by participants. Namely, in the neutral condition, deviants violated only the audiovisual pattern specific to each block. By contrast, in the audiovisual violation condition, deviants additionally violated long-term representations for how a speaker's mouth looks during articulation. We compared the amplitude of mismatch negativity (MMN) and P3 components elicited by deviants in the two conditions. The MMN extended posteriorly over temporal and occipital sites even though deviants contained no visual changes, suggesting that deviants were perceived as interruptions in audiovisual, rather than auditory only, sequences. As predicted, deviants elicited larger MMN and P3 in the audiovisual violation compared to the neutral condition. The results suggest that long-term representations of phonemes are indeed audiovisual.

Exploring Relationships Among Risk Factors for Persistence in Early Childhood Stuttering.

Purpose The purpose of this study is to investigate how epidemiological and clinical factors collectively predict whether a preschooler who is stuttering will persist or recover and to provide guidance on how clinicians can use these factors to evaluate a child's risk for stuttering persistence. Method We collected epidemiological and clinical measures from 52 preschoolers (M = 54.4 months, SD = 6.7 months; 38 boys and 14 girls) diagnosed as stuttering. We then followed these children longitudinally to document whether they eventually recovered or persisted in stuttering. Risk factors found to be significantly associated with stuttering persistence were used to build single and multiple variable predictive statistical models. Finally, we assessed each model's prediction capabilities by recording how accurate a model was in predicting a child's stuttering outcome-persisting or recovered. Results We found that a positive family history of stuttering, poorer performance on a standardized articulation/phonological assessment, higher frequency of stuttering-like disfluencies during spontaneous speech, and lower accuracy on a nonword repetition task were all significantly associated with an increased probability of persistence. The interaction between family history of stuttering and nonword repetition performance was also significant. The full multiple regression model incorporating all these risk factors resulted in the best fitting model with the highest predictive accuracy and lowest error rate. Conclusions For the first time, we show how multiple risk factors collectively predict the probability of stuttering persistence in 3- to 5-year-old preschool children who stutter. Using the full combination of risk factors to assess preschoolers who stutter yielded more accurate predictions of persistence compared to sparser models. A better understanding of the factors that underlie stuttering persistence will yield insight into the underpinnings of chronic stuttering and will help identify etiological targets for novel treatment approaches.

A multi-study examination of the role of repeated spaced retrieval in the word learning of children with developmental language disorder.

BACKGROUND: Many children with developmental language disorders (DLD) have well-documented weaknesses in vocabulary. In recent years, investigators have explored the nature of these weaknesses through the use of novel word learning paradigms. These studies have begun to uncover specific areas of difficulty and have provided hints about possible intervention strategies that might help these children learn words more accurately and efficiently. Among the studies of this type are those that incorporate repeated spaced retrieval activities in the learning procedures. METHODS: In this study, we examined the data from four of these studies that employed the same types of participants (4- and 5-year-old children with DLD and same-age children with typical language development), research design, and outcome measures. The studies differed primarily in the type of learning condition that was being compared to a spaced retrieval condition. A mixed-effects modeling framework was used, enabling the data from the four studies and different outcome measures to be aggregated. RESULTS: Across the studies, more words in the repeated spaced retrieval condition were recalled than those in the comparison conditions. This was true regardless of outcome measure. Children with typical language development recalled more words than the children with DLD. Both groups benefited from spaced retrieval, though effects were larger for the group with DLD. Children recalled words as accurately 1 week after learning as they did at the 5-min mark; the two groups were essentially identical in this respect. CONCLUSIONS: Overall, the findings support the continued refinement of these types of repeated spaced retrieval procedures, as they may have potential to serve as effective approaches to intervention.

Impaired Audiovisual Representation of Phonemes in Children with Developmental Language Disorder.

We examined whether children with developmental language disorder (DLD) differed from their peers with typical development (TD) in the degree to which they encode information about a talker's mouth shape into long-term phonemic representations. Children watched a talker's face and listened to rare changes from [i] to [u] or the reverse. In the neutral condition, the talker's face had a closed mouth throughout. In the audiovisual violation condition, the mouth shape always matched the frequent vowel, even when the rare vowel was played. We hypothesized that in the neutral condition no long-term audiovisual memory traces for speech sounds would be activated. Therefore, the neural response elicited by deviants would reflect only a violation of the observed audiovisual sequence. In contrast, we expected that in the audiovisual violation condition, a long-term memory trace for the speech sound/lip configuration typical for the frequent vowel would be activated. In this condition then, the neural response elicited by rare sound changes would reflect a violation of not only observed audiovisual patterns but also of a long-term memory representation for how a given vowel looks when articulated. Children pressed a response button whenever they saw a talker's face assume a silly expression. We found that in children with TD, rare auditory changes produced a significant mismatch negativity (MMN) event-related potential (ERP) component over the posterior scalp in the audiovisual violation condition but not in the neutral condition. In children with DLD, no MMN was present in either condition. Rare vowel changes elicited a significant P3 in both groups and conditions, indicating that all children noticed auditory changes. Our results suggest that children with TD, but not children with DLD, incorporate visual information into long-term phonemic representations and detect violations in audiovisual phonemic congruency even when they perform a task that is unrelated to phonemic processing.

Changes to gait speed when romantic partners walk together: Effect of age and obstructed pathway.

BACKGROUND: Walking at a brisk pace is widely recommended to promote health. When partners walk together, walking activity is increased and maintained due to enhanced social support and accountability, but at least one person must adjust their gait speed. Decreased gait speed could compromise health benefits, which may be especially relevant for the aging population. RESEARCH QUESTION: Do adults change gait speed when walking with their romantic partner, relative to walking alone, and is the change in speed affected by age or pathway conditions? METHODS: Participants were 141 individuals from 72 romantic couples; age range 25-79 years. The three couple conditions were walking alone, walking with their partner, and walking while holding hands with their partner. The two pathway conditions were clear pathway and pathway with obstacles. Gait speed was modeled as a function of the couple conditions, pathway conditions, and covariates (gender, age, relationship duration, and physical activity) using mixed-effects (3-level) regression. RESULTS: In both pathway conditions, both partners reduced speed when walking together (p < 0.001), and reduced speed further while holding hands (p < 0.001), when compared to walking alone. These effects were unchanged when covariates were included in the model. Further, speed was slower on the obstructed pathway for all participants, but the magnitude of slowing was greater with increasing age (p < 0.001) and in females (p=0.03). SIGNIFICANCE: Across the adult lifespan, when walking together, both partners decreased gait speed by a clinically meaningful amount (≥0.05 m/s). While walking with a partner may increase walking activity due to social support, reduced speed when walking together may unintentionally reduce health benefits and gait quality in both partners. Future research should identify how health is impacted by the trade-off between increased walking activity and reduced gait speed when romantic partners walk together.

Multimorbidity patterns and their relationship to mortality in the US older adult population.

BACKGROUND: Understanding patterns of multimorbidity in the US older adult population and their relationship with mortality is important for reducing healthcare utilization and improving health. Previous investigations measured multimorbidity as counts of conditions rather than specific combination of conditions. METHODS: This cross-sectional study with longitudinal mortality follow-up employed latent class analysis (LCA) to develop clinically meaningful subgroups of participants aged 50 and older with different combinations of 13 chronic conditions from the National Health Interview Survey 2002-2014. Mortality linkage with National Death Index was performed through December 2015 for 166,126 participants. Survival analyses were conducted to assess the relationships between LCA classes and all-cause mortality and cause specific mortalities. RESULTS: LCA identified five multimorbidity groups with primary characteristics: "healthy" (51.5%), "age-associated chronic conditions" (33.6%), "respiratory conditions" (7.3%), "cognitively impaired" (4.3%) and "complex cardiometabolic" (3.2%). Covariate-adjusted survival analysis indicated "complex cardiometabolic" class had the highest mortality with a Hazard Ratio (HR) of 5.30, 99.5% CI [4.52, 6.22]; followed by "cognitively impaired" class (3.34 [2.93, 3.81]); "respiratory condition" class (2.14 [1.87, 2.46]); and "age-associated chronic conditions" class (1.81 [1.66, 1.98]). Patterns of multimorbidity classes were strongly associated with the primary underlying cause of death. The "cognitively impaired" class reported similar number of conditions compared to the "respiratory condition" class but had significantly higher mortality (3.8 vs 3.7 conditions, HR = 1.56 [1.32, 1.85]). CONCLUSION: We demonstrated that LCA method is effective in classifying clinically meaningful multimorbidity subgroup. Specific combinations of conditions including cognitive impairment and depressive symptoms have a substantial detrimental impact on the mortality of older adults. The numbers of chronic conditions experienced by older adults is not always proportional to mortality risk. Our findings provide valuable information for identifying high risk older adults with multimorbidity to facilitate early intervention to treat chronic conditions and reduce mortality.

Questions to Measure Enjoyment of and Satisfaction With Physical Activity: Are They Appropriate for Use in an Older Population?

BACKGROUND AND OBJECTIVES: Enjoyment of and satisfaction with physical activity have been proposed as two actionable mechanisms to promote sustained engagement in physical activity. An accurate understanding of how, why, and for whom these two mechanisms work (or not) in response to a particular intervention strategy is contingent on having suitable measures for the population of interest. This study aims to determine whether the Physical Activity Enjoyment Scale-8 and a novel approach to the measurement of satisfaction with physical activity are suitable for use among older adults (M age = 66.25 years; range = 55-91 years). RESEARCH DESIGN AND METHODS: Participants answered an online questionnaire twice across 4 weeks. Measurement invariance was assessed within a structural equation modeling framework; convergent validity was assessed by correlating the latent variables enjoyment and satisfaction with each other and with physical activity behavior. RESULTS: Both measures were invariant between gender and across time. Enjoyment and satisfaction were related to each other (r = 0.72) and to physical activity (r = 0.48 and 0.64, respectively). DISCUSSION AND IMPLICATIONS: Results support the suitability of these measures as tools to assess enjoyment of and satisfaction with physical activity among older adults.

After Initial Retrieval Practice, More Retrieval Produces Better Retention Than More Study in the Word Learning of Children With Developmental Language Disorder.

Purpose Children with developmental language disorder (DLD) often have difficulty with word learning. Recent studies have shown that incorporating retrieval practice provides a significant benefit to this learning. However, we have not yet discovered the best balance between the amount of retrieval and the amount of study (hearing the word in the presence of the referent) that is provided. In this investigation, we compared a word learning procedure using more retrieval and less study with a procedure that used more study and less retrieval. Method Participants were 13 children with DLD and 13 same-age peers with typical language development (TD). Both groups ranged in age from 4 to 6 years. The children learned two sets of novel words, with each set taught in two sessions. During an initial criterion period, the children had the opportunity to retrieve all of the words. Following this period, the words were either retrieved without further study or studied without additional retrieval. Recall and recognition testing immediately followed the second learning session and was repeated 1 week later. Testing assessed the children's retention of both the word forms and their meanings. Results Better recall both immediately after learning and after 1 week was seen for the more retrieval/less study condition. This was seen for both groups of children for word form recall and for children with DLD for meaning. Group differences were not found. Conclusion This study served as a stringent test of the benefits of retrieval to children's word learning. Continued retrieval after initial retrieval practice appeared to be helpful even when further study was discontinued and when the comparison study condition had also provided retrieval practice in the initial stages. Further refinement of retrieval procedures might lead to the development of useful clinical tools to promote word learning.

Chronic condition patterns in the US population and their association with health related quality of life.

This study aims to identify chronic disease patterns and their relationship to health-related quality of life (HRQL) in the US population. This cross-sectional study used data from 86,745 participants aged 18 years and older of the Medical Expenditure Panel Survey (MEPS) 2010-2015, we employed latent class analysis (LCA) to identify subgroups of participants with different combinations of 23 chronic conditions which had medical utilization during the past 12 months. Derived chronic condition latent classes were used to predict the 12-Item Short Form Survey physical component score (PCS), mental component score (MCS) in addition to overall HRQL (SF-6D) while controlling for covariates. LCA identified five unique multi-morbidity groups: "healthy" (62.5%), "vascular risk" (18.9%), "anxiety" (12.2%), "heart disease" (2.9%), and "severely-impaired" (3.5%). Covariate-adjusted mean SF-6D scores varied significantly among classes: healthy (0.85), vascular risk (0.77), anxiety (0.67), heart disease group (0.65), and severely-impaired (0.56). The anxiety group, proportionately younger and female, had high PCS (46.3) but low MCS (41.9). The heart disease group, although older and in poor physical health (PCS = 33.2), had higher MCS scores (46.9). Our results demonstrate multi-morbidity significantly impacts HRQL. The relationship between physical and mental health functioning varied across different multi-morbidity groups, and the discordance was more pronounced in younger ages and females. Our research also identified an older age group that was mentally robust and maintained a strong HRQL. Findings can inform the development of targeted interventions to improve physical and mental health functioning in vulnerable populations.