Enhancing social-emotional functioning in adolescents with developmental language disorder or deaf or hard of hearing through a Theory of Mind intervention.

BACKGROUND: This study examines the effect of a Theory of Mind (ToM) intervention on ToM abilities and social-emotional functioning in adolescents with developmental language disorder (DLD) or who are deaf/hard of hearing (D/HH). It emphasizes the importance of self-reflection and measurement for personal growth. The research design incorporates both subjective and objective measures to evaluate the intervention's efficacy. AIMS: To investigate the impact of the ToM intervention on ToM abilities and social-emotional functioning in adolescents with DLD or who are D/HH. It hypothesizes that participants in the intervention groups will show improved ToM and social-emotional functioning compared with those in the control groups. METHODS & PROCEDURES: Adolescents with DLD or who are D/HH were recruited through collaboration with educational institutions. The study utilized a pre-/post-test design, assigning participants to either the intervention or the control group. The ToM intervention involved targeted activities to enhance ToM abilities. ToM abilities and social-emotional functioning were assessed using standardized tests and self-report questionnaires. Statistical analyses compared outcomes between the intervention and no intervention groups. OUTCOMES & RESULTS: The findings reveal subjective improvements in social-emotional functioning among the D/HH intervention group. However, no significant effects on objective ToM measures were observed. These results highlight the need for further investigation and refinement of interventions in these areas. Future research should focus on improving intervention strategies and exploring additional objective measures to gain a comprehensive understanding of the intervention's impact on ToM and social-emotional functioning in this population. CONCLUSIONS & IMPLICATIONS: The ToM intervention shows subjective benefits in improving social-emotional functioning among D/HH adolescents. However, it does not yield significant effects on objective ToM measures. These findings emphasize the ongoing need to refine interventions targeting ToM abilities and social-emotional functioning in this population. Future studies should explore alternative strategies and incorporate additional objective measures to enhance understanding and outcomes. WHAT THIS PAPER ADDS: What is already known on this subject Before this study, it was known that ToM interventions have the potential to enhance ToM abilities. However, the specific effects of such interventions on subjective and objective measures for ToM and social-emotional functioning in adolescents with DLD or who are D/HH remained unclear, necessitating further research. What this paper adds to the existing knowledge This study adds to the existing knowledge by demonstrating subjective improvements in social-emotional functioning among adolescents who are D/HH and underwent a ToM intervention. However, no significant effects on objective ToM measures were observed. These findings highlight the need for refining interventions and exploring additional measures to better understand the intervention's impact. What are the potential or actual clinical implications of this work? The subjective improvements in social-emotional functioning observed in this study have important clinical implications. They suggest that ToM interventions can positively impact the social well-being of adolescents who are D/HH. However, the lack of significant effects on objective ToM measures emphasizes the need for further research and intervention refinement to address specific areas of improvement in this population.

The effect of audio-support on strategy, time, and performance on reading comprehension in secondary school students with dyslexia.

The use of adequate reading comprehension strategies is important to read efficiently. Students with dyslexia not only read slower and less accurately, they also use fewer reading comprehension strategies. To compensate for their decoding problems, they often receive audio-support (narration written text). However, audio-support linearly guides readers from beginning to end through texts, possibly hindering the use of reading comprehension strategies in expository texts and negatively impacting reading time and reading comprehension performance. We examined to what extent audio-support affects reading comprehension strategies, reading times, and reading comprehension performance in 21 secondary school students with dyslexia and 22 typically developing controls. Participants were provided with three types of assignments (summarizing, open-ended questions, statement questions) in each condition (written text with and without audio-support). SMI RED-500 eye tracker captured eye movements during reading. The standard deviation of the weighted fixation duration times on the three paragraphs was considered indicative of the disparity of readers' attention within the text. Following a discrimination based on experts' reading behavior and hand-coded validation, these scores visualized whether students used the intensive reading strategy (reading whole text) or selective reading strategy (focusing on part of the text). In open-ended assignments, students divided their attention more over the whole text instead of focusing on one specific part when audio was added. In addition, audio-support increased reading time in students with and without dyslexia in most tasks, while in neither of the tasks audio-support affected reading comprehension performance. Audio-support impacts reading comprehension strategy and reading time in all students.

Post-treatment reading development in children with dyslexia: the challenge remains.

The goal of this study was to examine the post-treatment development of word and pseudoword accuracy and fluency and its cognitive and linguistic predictors in Dutch children with dyslexia compared with typical readers in the upper primary grades. Word and pseudoword reading accuracy and fluency were assessed at the start and end of grade 5 and at the end of grade 6. Phonological awareness, rapid naming, verbal short-term memory, vocabulary, and visual attention span were assessed at the start of grade 5. Repeated measures ANOVAs revealed that children with dyslexia were less accurate than typical readers and showed very little improvements in accuracy over time. They were also less fluent and showed less growth in reading fluency than typical readers. The children with dyslexia did improve more in word reading fluency than in pseudoword reading fluency over time. Visual attention span and phonological awareness predicted reading accuracy development in typical readers, while rapid naming predicted individual differences in reading fluency in children with dyslexia. It can be concluded that in the upper grades, children with dyslexia not only struggled with fluent reading, but they also still struggled with accurate reading in a relatively transparent orthography like Dutch, even after they had received a reading intervention to remediate their reading difficulties.

Deficient Response to Altered Auditory Feedback in Dyslexia.

Although dyslexia is characterized by a deficit in phonological representations, the nature of this deficit is debated. Previously, it was shown that adults with dyslexia respond differently to online manipulations of auditory feedback. In the present study, we found that individual differences in reading and reading-related skills within a group of 30 children (10-13 years old) with dyslexia were associated with the response to altered feedback. The fractional anisotropy of the arcuate fasciculus/superior longitudinal fasciculus was not directly related to the response to altered feedback. This study corroborates that speech perception-production communication is important for phonological representations and reading.

Guideline versus non-guideline based management of rectal cancer in octogenarians.

PURPOSE: The number of octogenarians with rectal adenocarcinoma is growing. Current guidelines seem difficult to apply on octogenarians which may result in non-adherence. The aim of this retrospective cohort study is to give insight in occurrence of treatment-related complications, hospitalisations and survival among octogenarians treated according to guidelines versus octogenarians treated otherwise. METHODS: 108 octogenarians with rectal adenocarcinoma were identified by screening of medical records. 22 patients were excluded for treatment process analysis because of stage IV disease or unknown stage. Baseline characteristics, diagnostic process, received treatment, motivation for deviation from guidelines, complications, hospitalisations and date of death were documented. Patients were divided in two groups depending on adherence to treatment guidelines. Differences in baseline characteristics, treatment-related complications and survival between both groups were evaluated. RESULTS: Diagnosis and treatment according to guidelines occurred in 95 and 54% of the patients, respectively. When documented, patient's preference and comorbidities were major reasons to deviate from guidelines. 66% of patients who were treated according to guidelines experienced complications versus 34% of those treated otherwise (p = 0.02). After adjustment for differences in age and polypharmacy, this association was not significant. Patients treated according to the guideline had better survival 18 months after diagnosis (80 versus 56%, p = 0.02). CONCLUSIONS: Treating octogenarians with rectal cancer according to guidelines seem to lead to better overall survival, but may lead to a high risk of complications. This may jeopardise quality of life. More and prospective studies in octogenarians with rectal cancer are needed to customize guidelines for these patients.

Differential lexical predictors of reading comprehension in fourth graders.

The mental lexicon plays a central role in reading comprehension (Perfetti & Stafura, 2014). It encompasses the number of lexical entries in spoken and written language (vocabulary breadth), the semantic quality of these entries (vocabulary depth), and the connection strength between lexical representations (semantic relatedness); as such, it serves as an output for the decoding process and as an input for comprehension processes. Although different aspects of the lexicon can be distinguished, research on the role of the mental lexicon in reading comprehension often does not take these individual aspects of the lexicon into account. The current study used a multicomponent approach to examine whether measures of spoken and written vocabulary breadth, vocabulary depth, and semantic relatedness were differentially predictive of individual differences in reading comprehension skills in fourth-grade students. The results indicated that, in addition to nonverbal reasoning, short-term memory, and word decoding, the four measures of lexical quality substantially added (30 %) to the proportion of explained variance of reading comprehension (adding up to a total proportion of 65 %). Moreover, each individual measure of lexical quality added significantly to the prediction of reading comprehension after all other measures were taken into account, with written lexical breadth and lexical depth showing the greatest increase in explained variance. It can thus be concluded that multiple components of lexical quality play a role in children's reading comprehension.

The concurrent and predictive validity of the Dutch version of the Communicative Development Inventory in children with Down Syndrome for the assessment of expressive vocabulary in verbal and signed modalities.

The expressive vocabulary of children with Down Syndrome (DS) is generally measured with parental reports, such as the Communicative Development Inventory (CDI), given that standardized tests for assessing vocabulary levels may be too difficult for most young children with DS. The CDI provides important insight into the parents' perception of their child's vocabulary development. The CDI has proven to be a valid measurement of expressive vocabulary, spoken and gestural, in typical and atypical populations. The validity in children with DS is not well established and signed vocabulary is often not included. This longitudinal study examined the concurrent and predictive validity of the Dutch version of the CDI (N-CDI) in children with DS between 2;0 and 7;6 years old to assess spoken and signed vocabulary. N-CDI scores were assessed on strength of association with mental age, an expressive vocabulary test and spontaneous language analyses in a play setting with parents at T1 and T2 (1.5 years later), and a therapy setting with speech language pathologists at T1. The results of the present study show that the N-CDI is a valuable and valid measurement of expressive vocabulary in children with DS. Strengths and weaknesses of several assessment methods for expressive vocabulary are discussed.

Behavioural assessment of autism spectrum disorders in people with multiple disabilities.

BACKGROUND: It is difficult to diagnose autism spectrum disorder (ASD) in people with a combination of intellectual and sensory disabilities because of overlap in behaviour. The ASD typical behaviours of people with combined intellectual and sensory disabilities are often caused by their disabilities and not by ASD. Current diagnostic tools are inadequate to differentiate between people with and without ASD when they have these combined disabilities, because tools lack norms for this population or are subjective, indirect or unable to adapt to the variety of disabilities that these people may have. Because giving a correct diagnosis is necessary for treatment and support, a new observational tool was developed to diagnose ASD in people with multiple disabilities, observation of autism in people with sensory and intellectual disabilities (OASID). METHOD: Observation of autism in people with sensory and intellectual disabilities was tested on 18 participants with moderate to profound intellectual disabilities, one or dual sensory impairment, with and without ASD. Two independent experts diagnosed these participants as well in order to test the psychometric properties and differentiating abilities of OASID. RESULTS: Observation of autism in people with sensory and intellectual disabilities showed high inter-rater reliability, internal consistency of scales and content and construct validity. OASID could differentiate people with and without ASD without overlap. CONCLUSIONS: Observation of autism in people with sensory and intellectual disabilities could differentiate people with intellectual disabilities combined with sensory impairments, who clearly had or did not have signs of ASD. People with unclear signs of ADS scored in between those two groups with regard to their OASID scores. Psychometric properties of OASID are promising.

From numeracy to arithmetic: Precursors of arithmetic performance in children with cerebral palsy from 6 till 8 years of age.

Children with cerebral palsy (CP) are generally delayed in arithmetic compared to their peers. The development of early numeracy performance in children with CP is not yet evident, nor have the factors associated with change over time been identified. Therefore, we examined the development of numeracy in children with CP over a two year period and studied which cognitive factors were predictive of arithmetic performance. A longitudinal study with three measurement waves separated by one year was conducted. 56 children participated (37 boys, M=6.0 years, SD=.58). Standardized tasks were used to assess verbal- and visual-spatial working memory, executive functioning, fine motor skills and early numeracy performance. In addition, experimental tasks were developed to measure counting and arithmetic. The results showed that early numeracy performance of children with CP increased between 6 and 8 years of age. Structural equation modelling showed that early numeracy was strongly related to arithmetic performance at the consecutive year. Working memory, counting and fine motor skills were all positively related to early numeracy performance a year later. Furthermore, working memory and fine motor skills were precursors of the development of early numeracy. Considering the importance of numeracy and arithmetic in daily life and in academic and work success, children with CP could substantially benefit from intervention programs aimed at increasing working memory and early numeracy performance.

Cognitive precursors of arithmetic development in primary school children with cerebral palsy.

The aim of this study was to examine the development of arithmetic performance and its cognitive precursors in children with CP from 7 till 9 years of age. Previous research has shown that children with CP are generally delayed in arithmetic performance compared to their typically developing peers. In children with CP, the developmental trajectory of the ability to solve addition- and subtraction tasks has, however, rarely been studied, as well as the cognitive factors affecting this trajectory. Sixty children (M=7.2 years, SD=.23 months at study entry) with CP participated in this study. Standardized tests were administered to assess arithmetic performance, word decoding skills, non-verbal intelligence, and working memory. The results showed that the ability to solve addition- and subtraction tasks increased over a two year period. Word decoding skills were positively related to the initial status of arithmetic performance. In addition, non-verbal intelligence and working memory were associated with the initial status and growth rate of arithmetic performance from 7 till 9 years of age. The current study highlights the importance of non-verbal intelligence and working memory to the development of arithmetic performance of children with CP.

Monitoring in language perception in high-functioning adults with autism spectrum disorder: evidence from event-related potentials.

OBJECTIVES: Autism spectrum disorder (ASD) is characterized by impaired global language processing, whereas local language processing often appears intact. Recent psycholinguistic research suggests that the quality of language perception relies on monitoring, an aspect of executive control. The aim of the study was to examine monitoring in people with ASD of (a) local, orthographic violations, and (b) global, syntactic violations, when provided with single level versus dual level task instructions. METHODS: We recorded event-related potentials and compared P600 effects to the linguistic violations relative to correct words in 14 adults with ASD and 14 matched controls. RESULTS: In control participants, local errors elicited a monitoring response as tapped by the P600 effect in both conditions. For global errors, the P600 effect was present only at one centroposterior site in the single level condition, whereas in the dual level condition a broadly distributed effect was obtained. People with ASD, however, showed a monitoring response to local and global errors both in the single and dual level condition. CONCLUSIONS: The main ERP finding suggests that when instructed people with ASD monitor global aspects of language already under simple circumstances, whereas people without ASD mainly do so under more complex circumstances. SIGNIFICANCE: Results suggest that language problems in ASD should not be studied in terms of a linguistic dysfunction as such, but in light of the use of executive resources during language comprehension.

Neural evidence of allophonic perception in children at risk for dyslexia.

Learning to read is a complex process that develops normally in the majority of children and requires the mapping of graphemes to their corresponding phonemes. Problems with the mapping process nevertheless occur in about 5% of the population and are typically attributed to poor phonological representations, which are--in turn--attributed to underlying speech processing difficulties. We examined auditory discrimination of speech sounds in 6-year-old beginning readers with a familial risk of dyslexia (n=31) and no such risk (n=30) using the mismatch negativity (MMN). MMNs were recorded for stimuli belonging to either the same phoneme category (acoustic variants of /bə/) or different phoneme categories (/bə/ vs. /də/). Stimuli from different phoneme categories elicited MMNs in both the control and at-risk children, but the MMN amplitude was clearly lower in the at-risk children. In contrast, the stimuli from the same phoneme category elicited an MMN in only the children at risk for dyslexia. These results show children at risk for dyslexia to be sensitive to acoustic properties that are irrelevant in their language. Our findings thus suggest a possible cause of dyslexia in that they show 6-year-old beginning readers with at least one parent diagnosed with dyslexia to have a neural sensitivity to speech contrasts that are irrelevant in the ambient language. This sensitivity clearly hampers the development of stable phonological representations and thus leads to significant reading impairment later in life.

Allophonic mode of speech perception in Dutch children at risk for dyslexia: a longitudinal study.

There is ample evidence that individuals with dyslexia have a phonological deficit. A growing body of research also suggests that individuals with dyslexia have problems with categorical perception, as evidenced by weaker discrimination of between-category differences and better discrimination of within-category differences compared to average readers. Whether the categorical perception problems of individuals with dyslexia are a result of their reading problems or a cause has yet to be determined. Whether the observed perception deficit relates to a more general auditory deficit or is specific to speech also has yet to be determined. To shed more light on these issues, the categorical perception abilities of children at risk for dyslexia and chronological age controls were investigated before and after the onset of formal reading instruction in a longitudinal study. Both identification and discrimination data were collected using identical paradigms for speech and non-speech stimuli. Results showed the children at risk for dyslexia to shift from an allophonic mode of perception in kindergarten to a phonemic mode of perception in first grade, while the control group showed a phonemic mode already in kindergarten. The children at risk for dyslexia thus showed an allophonic perception deficit in kindergarten, which was later suppressed by phonemic perception as a result of formal reading instruction in first grade; allophonic perception in kindergarten can thus be treated as a clinical marker for the possibility of later reading problems.

Staff behavior toward children and adolescents in a residential facility: a self-report questionnaire.

The purpose of the present study was to examine psychometric properties of the Staff Behavior toward Clients questionnaire (SBC), a self-report measure for care staff working with children and adolescents with mild to borderline intellectual disabilities in residential care. Ninetynine care staff completed the SBC and the Strengths and Difficulties Questionnaire (SDQ) for 99 of their clients. Factor analysis revealed four factors (i.e. behavior regulation, client-directed care, teaching and empowerment). Results indicated excellent internal consistency of all factors and ability of the SBC to detect differences in client populations with respect to behavior problems. These data suggest that the SBC could provide a reliable and valid measure of staff behavior toward clients in residential facilities.

Semantic categorization and reading skill across Dutch primary grades: development yes, relationship no.

In the present study, the development of semantic categorization and its relationship with reading was investigated across Dutch primary grade students. Three Exemplar-level tasks (Experiment 1) and two Superordinate-level tasks (Experiment 2) with different types of distracters (phonological, semantic and perceptual) were administered to assess semantic categorization skills. Reading was measured with a standardized word-reading test. Results of both experiments demonstrated that children in the higher grades had shorter reaction times and fewer errors than children in the lower grades. Reading skill, however, was not related to semantic categorization performance. Moreover, neither grade level nor reading skill was related to the effect of distracter type on error percentages. Based on the results of this study, we suggest a substantial development of semantic categorization skills over time, and reject the notion that Dutch poor readers have less advanced semantic categorization skills than typical readers.

Home literacy environment of pre-school children with intellectual disabilities.

BACKGROUND: For pre-school children, the home literacy environment (HLE) plays an important role in the development of language and literacy skills. As there is little known about the HLE of children with intellectual disabilities (ID), the aim of the present study was to investigate the HLE of children with ID in comparison with children without disabilities. METHOD: Parent questionnaires concerning aspects of the HLE were used to investigate differences between 48 children with ID, 107 children without disabilities of the same chronological age and 36 children without disabilities of the same mental age (MA). Furthermore, for the children with ID, correlations were computed between aspects of the HLE and children's non-verbal intelligence, speech intelligibility, language and early literacy skills. RESULTS AND CONCLUSIONS: From the results of the multivariate analyses of variance it could be concluded that the HLE of children with ID differed from that of children in the chronological age group on almost all aspects. When compared with children in the MA group, differences in the HLE remained. However, differences mainly concerned child-initiated activities and not parent-initiated activities. Correlation analyses showed that children's activities with literacy materials were positively related with MA, productive syntax and vocabulary age, and book orientation skills. Also, children's involvement during storybook reading was related with their MA, receptive language age, productive syntax and vocabulary age, book orientation and rapid naming of pictures. The amount of literacy materials parents provided was related to a higher productive syntax age and level of book orientation of the children. Parent play activities were also positively related to children's speech intelligibility. The cognitive disabilities of the children were the main cause of the differences found in the HLE between children with ID and children without disabilities. Parents also adapt their level to the developmental level of their child, which may not always be the most stimulating for the children.

Foundations of phonological awareness in pre-school children with cerebral palsy: the impact of intellectual disability.

BACKGROUND: Children with cerebral palsy (CP) and accompanying disabilities are prone to reading difficulties. The aim of the present study was to examine the foundations of phonological awareness in pre-school children with CP in comparison with a normally developing control group. Rhyme perception was regarded as an early indicator of phonological awareness, whereas non-verbal reasoning, speech ability, auditory perception, auditory short-term memory and vocabulary were regarded as foundation measures. METHODS: A number of tasks were administrated to examine group differences in rhyme perception and its foundation measures. Correlations between the tasks were analysed for both groups followed by multiple regression analyses wherein rhyme perception was predicted by its foundation measures. RESULTS: Children with CP scored below their normally developing peers on emergent phonological awareness and its foundation measures. Regarding the prediction of phonological awareness, non-verbal reasoning followed by pseudoword articulation, were found to predict phonological awareness, i.e. rhyme perception, in the group of children with CP. In the control group, auditory perception was a significant predictor of emergent phonological awareness. The CP group was further split up into two groups according to the children's non-verbal reasoning skills, i.e. general IQ. The below-average IQ group scored below the average IQ group on phonological awareness and on most foundation measures. In addition, the average IQ group of the children with CP scored lower than the control group. CONCLUSION: The results of this study indicate that general intelligence and speech ability (i.e. pseudoword articulation) can be seen as important facilitators of emergent phonological awareness in children with CP. These findings support the role of intelligence in the emergence of phonological awareness in children with CP. Children with CP with intellectual disabilities seem to have a disadvantage in acquiring phonological awareness, especially when their speech abilities are also impaired. However, general intelligence is not enough to predict phonological awareness as other foundation measures are also important for phonological awareness independent of general intelligence.

Literacy achievement of children with intellectual disabilities and differing linguistic backgrounds.

BACKGROUND: The aim of the present study was to examine the literacy achievement of 10- to 12-year-old native and non-native children with intellectual disabilities (ID) living in the Netherlands. An intriguing question within this context was whether the second language learning non-native children with ID would show a double disadvantage when compared with their monolingual Dutch peers with no ID. METHODS: Dutch literacy scores in the domains of word decoding, vocabulary, syntax and text were therefore compared for: (1) intellectually disabled native Dutch children; (2) intellectually disabled non-native children; (3) normally developing native Dutch children; and (4) normally developing non-native children. The interrelations between literacy subskills were also compared for native vs. non-native children with ID. RESULTS: The native and non-native students diagnosed as intellectually disabled produced substantially lower literacy scores than their non-disabled peers. The differences between the native (L1) and non-native (L2) children in regular vs. special education were found to depend on the aspect of literacy considered. Word decoding and language skills turned out to significantly predict the children's reading comprehension, although some differences in the strength of relationships could also be evidenced. CONCLUSIONS: The literacy achievement of intellectually disabled children with differing linguistic backgrounds generally falls behind that of their non-disabled peers. For word decoding, the non-native children in regular and special education were generally able to keep up with their native peers. For higher-order literacy abilities closely related to the mental lexicon, sentence processing and text processing, however, significant differences in the performances of the native (L1) and non-native (L2) children in regular vs. special education were found, suggesting a double disadvantage for the non-native children in special education.

Relationship between myocardial tissue norepinephrine and coronary flow heterogeneity.

The purpose of this study was to investigate the hypothesis that heterogeneity of myocardial tissue norepinephrine content exists and is one of the controllers of flow heterogeneity in the canine myocardium. Tissue norepinephrine content was measured simultaneously with coronary blood flow in multiple sections of the left ventricle of eight anesthetized open-chest dogs. Radioactive microspheres were used for the measurement of blood flow during baseline and sympathetic stimulation. The left ventricle was cut into 15 subepicardial and 15 subendocardial sections. Norepinephrine levels of these same tissue sections were measured using high-pressure liquid chromatography. The average control coronary blood flow was 92.4 +/- 19.5 ml/min/100 g. Ansa subclavia stimulation (10-msec duration, 18-24 V, 10 impulses/sec) increased coronary blood flow to 127.9 +/- 21.9 ml/min/100 g. The average of the norepinephrine levels was 2480 +/- 573 ng/g wet wt and the biological variation was almost four times the method variation. The within-animal coefficient of variation was 32.9%. No significant regional differences were found in flow or norepinephrine content. Regression analysis between the percentage of mean norepinephrine (PNE) and the percentage of mean control flow (Pflow) produced the equation: Pflow = 0.29 (PNE) + 70.4 (r = 0.44, P less than .0001). The equation for PNE vs percentage of stimulated flow is Pflow = 0.24 (PNE) + 76.2 (r = 0.48, P less than .0001). Thus, significant heterogeneity of tissue norepinephrine levels exists in the heart. There also appears to be a direct linear relationship between tissue norepinephrine content and coronary blood flow distribution in the canine myocardium.