Les pratiques de l'action intersectorielle locale pour l'équité en santé : étude du cas Quartier nourricier de la Corporation de développement communautaire Centre-Sud à Montréal.

INTRODUCTION: Afin d'agir sur les inégalités de santé et les ressources locales promotrices de santé, les praticiens et les décideurs doivent être outillés pour pratiquer l'action intersectorielle locale. Planifier et optimiser ces partenariats demeure pourtant un défi en raison du manque de connaissances sur les processus menant à l'atteinte de leurs objectifs - ce qu'ils font et comment. Cette étude documente empiriquement, à l'aide d'une étude de cas, les pratiques de conception de l'action intersectorielle locale dans la démarche Quartier nourricier (QN) à Montréal. MÉTHODES: Une analyse secondaire d'un sous-ensemble des données originales du programme de recherche Valeur de l'action intersectorielle locale a été effectuée. Les données qualitatives sont issues d'une collecte de données prospective ayant suivi l'évolution du système d'action complexe QN entre mars et novembre 2014. Les traces observables de l'action ont été relevées dans des notes d'observation, des documents et des entretiens téléphoniques, puis codifiées dans une matrice chronologique d'évènements critiques et une matrice ordonnée par rôle. L'analyse inductive des matrices a identifié les éléments significatifs pour expliquer le déroulement de l'action. RÉSULTATS: Trois opérations interdépendantes et concomitantes affectent à la fois la relation entre les partenaires et la conception du projet : (a) l'idéation sous contraintes, (b) la négociation de priorités, et (c) la représentation politique. Chaque opération présente un ensemble de pratiques qui font progresser l'action intersectorielle locale. CONCLUSION: Mettre en lumière les pratiques du terrain, en les ancrant dans trois opérations nécessaires pour effectuer des transformations dans les environnements locaux favorables à la santé, permet de guider la planification des stratégies et la conduite des actions pour mener des partenariats intersectoriels. MOTS CLÉS: Action communautaire, action intersectorielle locale, collaboration/partenariats, conception, développement des capacités (y compris les compétences), environnements favorables à la santé, étude de cas, promotion de la santé, réalisme critique, urbanisme/santé urbaine/milieu urbain.

Developmental trajectories of speech and language in neglected children aged 3 to 5 years: Results of the ELLAN study.

BACKGROUND: Neglected children are at high risk for significant difficulties in speech and language development. Because no longitudinal study has been conducted to date, the dynamic description of development during the preschool period is unknown. OBJECTIVES: Establish the developmental trajectories of speech sounds, receptive and expressive vocabulary, and morphosyntax among neglected children during the preschool years and compare them with those of non-neglected children. PARTICIPANTS AND SETTING: Participants are 69 neglected children and 99 same age non-neglected peers (37 and 46 males respectively) recruited at 36 months of age. Data were collected at home. METHODS: Data were collected at six-month intervals between the ages of 3 and 5.5 years using psychometrically robust tools. Neglected and control groups were compared according to age using repeated measures ANOVAs on all variables. A discrete mixture model for clustering longitudinal data was used for testing the heterogeneity of the language trajectories among neglected children. RESULTS: The language development of the neglected children as a whole group is lower than that of the control group for all variables. Two subgroups are identified within the neglected group: one with a developmental trajectory similar to that of the non-neglected children, and another whose trajectory is far below that of the control group. The effect sizes of these differences vary between 1.4 and 3 standard deviations under the mean. CONCLUSIONS: A large proportion of neglected children present significant speech and language difficulties from the age of 3, but some of them catch up and develop similarly to non-neglected children.

Spoken Communicative Intents Among 3- to 4.5-Year-Old French-Speaking Children: Procedure and Data From the Early Longitudinal Language and Neglect Study.

PURPOSE: This study aimed to (a) provide speech-language pathologists and researchers with a play-based procedure to measure the expression of spoken communicative intents by children aged 3 to 4.5 years and (b) present indicators of these children's capacity to produce these intents in this context. METHOD: A method inspired by TRIAGE (Technique de Recherche d'Informations par Animation d'un Group d'Experts) allowed an advisory group of 16 speech-language pathologists to select and agree on definitions of intents to include in this procedure, among a set of 13 preselected intents based on the scientific literature. A longitudinal design including four measuring times was used to verify the production of these intents by 99 French-speaking children (46 boys; M age = 36.09 months) at 36, 42, 48, and 54 months using the Neighborhood Game, a previously developed elicitation procedure of communicative intents conducted within the context of symbolic play. For each measurement time, the average percentage of children who had produced each intent at least 3 times was calculated with a 95% confidence interval. Nonparametric analysis of variance for longitudinal data was carried out to verify progression with age. RESULTS: A finalized list of eight communicative intents was selected along with their definition and a standardized script to elicit them during symbolic play. The production frequency of most intents showed significant progression between the first and the fourth measurement time. Arguing is the only intent that is still not produced by more than 90% of children at the age of 54 months. CONCLUSIONS: This study led to the development of an assessment procedure, which presents ecological validity and elicits the expression of eight communicative intents among 3- to 4.5-year-olds. This procedure can support the work of speech-language pathologists and researchers. The accompanying indicators of children's capacity to produce these intents at a given age in this kind of context are a notable addition to the knowledge on typical language development. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21844206.

We Need to Talk About Social Inequalities in Language Development.

PURPOSE: This article aims to raise speech-language pathologists' (SLPs') awareness about the extent of social inequalities in the language development of children, and their social determinants. METHOD: This article draws on empirical evidence and theoretical foundations from the field of public health to highlight the roots and distribution of social inequalities in the language development of children. The Total Environment Assessment Model for Early Child Development is presented as a means to understand the social determinants of early child development, and its relevance to the context of early language development is discussed. Informed by these theoretical notions, this article encourages SLPs to reflect on actions directed toward the social determinants of language. Drawing from health promotion approaches, a conceptualization of language interventions and intervention outcomes as "events in systems" is suggested. CONCLUSION: The public health-inspired approach to language interventions shared in this article invites institutions and SLPs to direct their gaze to the social determinants of language and broaden the scope of actions that are included in individual or group interventions aimed at supporting the language development of children.

Parental behaviors associated with the level of pragmatic language ability among 42-month-old neglected children.

BACKGROUND: Exposure to neglect can severely compromise children's pragmatic skills (social language use). The disruptions of parent-child interactions that typically occur in context of neglect may compromise several parental behaviors which are known to foster language skills such as pragmatics. OBJECTIVES: 1- Compare the behaviors of neglectful and non-neglectful parents in four domains which are of interest for pragmatic language development, namely, responsive, supportive, affective, and control behaviors, and 2- Identify parental behaviors associated with the levels of pragmatic ability of 42-month-old neglected children. PARTICIPANTS: Study sample consisted of 21 neglected children living in their biological family, recruited in four Youth Centers in the province of Québec (Canada) and 95 non-neglected children recruited in child-care centers. METHOD: Parental behaviors were video recorded in context of free-play with the child at the participants' homes between 2015 and 2017, and subsequently analyzed using the Coding Observations of Parent-Child Interactions (COPI), developed to observe ten parental behaviors associated with early language development. The level of pragmatic ability of children was established using the Language Use Inventory: French, a standardized questionnaire completed with parents of both groups. RESULTS: Parents in situation of neglect scored lower than parents in the control group on eight of the ten behaviors (p < .001). Parental reciprocity was associated with the level of pragmatic ability of 42-month-old neglected children (p = .04). CONCLUSIONS: The results of this exploratory study provide insight on the associations between parental behaviors and the level of pragmatic language skills of children experiencing neglect.

The Pragmatic Language Skills of Severely Neglected 42-Month-Old Children: Results of the ELLAN Study.

The goals of this study were twofold: (1) to compare the pragmatic language skills (i.e., social communication skills) of 42-month-old neglected children with those of same-aged non-neglected children and (2) to measure the prevalence of pragmatic difficulties among the neglected children. The study sample was composed of 45 neglected and 95 non-neglected 42-month-old French-speaking children. The Language Use Inventory: French (LUI-French) was completed with all parents. This measure, comprised of 159 scored items divided into 10 subscales, was used to assess the children's pragmatic skills. The 10th percentile on the LUI-French (95% confidence interval ) was used to identify children with pragmatic difficulties. The neglected children had lower scores than the non-neglected children on all 10 dimensions of pragmatics evaluated (p < .01), as well as lower LUI-French Total Scores (p < .001). The effect sizes of these differences varied between 0.84 and 2.78. Forty-four percent of the neglected children presented significant pragmatic difficulties compared to 4.2% of their non-neglected peers (p < .001). It can be concluded that exposure to neglect significantly compromises children's pragmatic skills. These results support the need for interventions geared toward neglected children and their families to support the early development of their pragmatic skills.