Blog Archives

Initiating and responding to joint attention bids in children with autism: A review of the literature

Joint attention is a skill that involves coordinating the attention of at least two individuals towards an object or event. Although it is seen as a critical skill in early child development, it is frequently absent in children with autism and has been linked to poorer language outcomes for those children. As a result, multiple interventions have been developed to teach children with autism to respond to, and initiate, bids for joint attention. These interventions, however, differ widely both in terms of procedures used and in whether they focus on teaching children to respond to, or initiate, bids for joint attention. This literature review was conducted to document research gaps and intervention similarities between joint attention intervention studies for children with autism. The specific intent of this review was to determine whether researchers teach responding and initiating separately or sequentially, describe the extent to which procedures differ among studies, and identify whether social or non-social consequences are used during joint attention training. Implications for the treatment of joint attention deficits are discussed and recommendations to both researchers and practitioners are provided.

from Research in Developmental Disabilities

Evaluation of the Efficacy of Communication-Based Treatments for Autism Spectrum Disorders

This literature review examines the present level of evidence in support of communication-based treatments for children with autism spectrum disorders. Reviews to date have reported on research published through 2002. The current article included 36 studies published between 2002 and 2007. Best available evidence is presented for seven treatment categories: applied behavior analysis, naturalistic behavioral, developmental, classroom-based, video modeling, social skills, and augmentative and alternative communication. Findings indicate that empirical support has been obtained for the efficacy of several methods, whereas other methods remain in an exploratory stage of investigation.

from Communications Disorders Quarterly

Dysphagia treatment post stroke: a systematic review of randomised controlled trials

from Age and Ageing

Background: dysphagia is common following stroke and is associated with the development of pneumonia. Many dysphagia treatment options are available, some still experimental and others already rooted in common practice. Previous reviews of these treatments were limited due to a dearth of available studies. Recently, more trials have been published warranting a re-examination of the evidence.

Objective: a systematic review of all randomised controlled trials (RCTs), updating previous work and evaluating a broader range of therapeutic interventions intended for use in adults recovering from stroke and dysphagia.

Methods: using multiple databases, we identified RCTs published between the years 1966 and August 2007 examining the efficacy of dysphagia therapies following stroke. Across studies, results of similar treatments and outcomes were compared and evaluated.

Results: fifteen articles were retrieved assessing a broad range of treatments that included texture-modified diets, general dysphagia therapy programmes, non-oral (enteral) feeding, medications, and physical and olfactory stimulation. Across the studies there was heterogeneity of the treatments evaluated and the outcomes assessed that precluded the use of pooled analyses. Descriptively these findings present emerging evidence that nasogastric tube feeding is not associated with a higher risk of death compared to percutaneous feeding tubes; and general dysphagia therapy programmes are associated with a reduced risk of pneumonia in the acute stage of stroke.

Conclusions: dysphagia is known to be a common and potentially serious complication of stroke. Despite the recent newly published RCTs, few utilise the same treatment and outcomes thereby limiting the evidence to support the medical effectiveness of common dysphagia treatments used for patients recovering from stroke.

Teaching students with intellectual or developmental disabilities to write: A review of the literature

from Research in Developmental Disabilities

The purpose of this review was to identify effective methods for teaching writing to students with intellectual disabilities. After criteria were established, database searches and hand searches of selected peer-reviewed journals were conducted. Findings revealed a relatively small number of studies that met the criteria for inclusion. Participants, settings, research designs, independent variables, dependent variables, and results are synthesized across studies. Writing instruction effects on various written expression outcomes were aggregated by averaging percentage of non-overlapping data (PND) across studies. Findings revealed that strategy instruction was investigated more frequently than other types of approaches. Strategy instruction was consistently found to be very effective for teaching writing skills to students with intellectual disabilities. Limitations, directions for future research, and implications for practice are discussed.

Sex-linked deafness

from Clinical Genetics

Many human syndromes associated with hearing loss are caused by disease genes located on the X chromosome, but few X-linked loci for non-syndromic hearing loss have been reported. Surprisingly, a Y-linked locus has been identified, representing one of the only disease loci on the Y chromosome. This study reviews the different sex-linked genes and loci on the X- and Y chromosome leading to syndromic and especially non-syndromic hearing loss.

Current State of Knowledge: Speech Recognition and Production in Children with Hearing Impairment

from Ear and Hearing

This review summarizes the prevalent literature covering speech recognition and production in children with mild to severe hearing impairment (HI). In general, the ability to recognize and produce speech improves as the child matures but decreases with greater severity of hearing loss. Performance scores on measures of phonetic contrast perception and word recognition are relatively high for children with mild to severe HI when compared to children with profound HI, but not as high as scores for children with normal hearing (NH). Babbling may develop at a slower rate for infants with mild to moderate HI when compared to that of infants with NH. Articulation is not severely affected by mild to severe HI and the most common errors are omissions and substitutions, particularly for fricatives and affricates. Children with mild to severe HI generally produce intelligible speech.

Current State of Knowledge: Psychosocial Development in Children with Hearing Impairment

from Ear and Hearing

The purpose of this review is to synthesize historical and recent evidence concerning psychosocial development in children with mild to severe hearing impairment. Included are studies of quality of life, social-emotional development, self-concept, and social access. Concerns are raised about sampling issues and limited consistency in measurement strategies used. Interdisciplinary perspectives on social-emotional learning and development are integrated in an effort to identify research gaps and suggest future research needs. The need for prospective studies involving a new generation of children with early access to amplification is stressed.

Current State of Knowledge: Perceptual Processing by Children with Hearing Impairment

from Ear and Hearing

Perception concerns the identification and interpretation of sensory stimuli in our external environment. The purpose of this review is to survey contemporary views about effects of mild to severe sensorineural hearing impairment (HI) in children on perceptual processing. The review is one of a series of papers resulting from a workshop on Outcomes Research in Children with Hearing Loss sponsored by The National Institute on Deafness and Other Communication Disorders/National Institutes of Health. Children with HI exhibit heterogeneous patterns of results. In general, however, perceptual processing of the

(a) auditory properties of nonspeech reveals some problems in processing spectral information, but not temporal information;

(b) auditory properties of speech reveals some problems in processing temporal sequences, variation in spatial location, and voice onset times, but not in processing talker-gender, weighting acoustic cues, or covertly orienting to the spatial location of sound;

(c) linguistic properties of speech reveals some problems in processing general linguistic content, semantic content, and phonological content.

The normalcy/abnormalcy of results varies as a function of degree of loss and task demands. As a general rule, children with severe HI have more abnormalities than children with mild to moderate HI. Auditory linguistic properties are also generally processed more abnormally than auditory nonverbal properties. This outcome implies that childhood HI has less effect on more physical, developmentally earlier properties that are characterized by less contingent processing. Some perceptual properties that are processed in a more automatic manner by normal listeners are processed in a more controlled manner by children with HI. This outcome implies that deliberate perceptual processing in the presence of childhood HI requires extra effort and more mental resources, thus limiting the availability of processing resources for other tasks.

Current State of Knowledge: Outcomes Research in Children with Mild to Severe Hearing Impairment-Approaches and Methodological Considerations

from Ear and Hearing

This paper will provide a backdrop to the others in this section on outcomes of children with mild to moderate sensorineural hearing loss. Our objective here is to provide an overview of the research approaches used to study the outcomes of these children to provide guidance for future studies of children with mild to severe sensorineural hearing impairment (HI). During the past 20 yr there has been a gradual coalescence of research practices concerned with examining outcomes. Those who have done this work have come from different disciplines and in many cases were motivated by different circumstances. As a result, terminology and perspectives on outcomes research often still bears the features of these different disciplines and objectives of this research. This paper is an effort to provide the reader with an overview of this research endeavor that will highlight the diversity of the work being conducted on outcomes but also emphasizes the common properties. This overview will emphasize the kinds of research questions that are asked in this area of research and the associated evidence obtained to address these research questions. After this initial section there will be a consideration of the methodological issues that need to be considered, particularly for outcome research in children with HI.

Biased to learn language

from Developmental Science

Some recent publications that explore the foundations of early language development are reviewed in this article. The review adopts the pivotal idea that infants’ advancements are helped by the existence of different types of biases. The infant’s discovery of the phonological properties of the language of the environment, as well as their learning of words, is assisted by different types of processing biases, ranging from perceptual to social factors.

Current State of Knowledge: Language and Literacy of Children with Hearing Impairment

from Ear and Hearing

The purpose of this paper is to provide a review of past and current research regarding language and literacy development in children with mild to severe hearing impairment. A related goal is to identify gaps in the empirical literature and suggest future research directions. Included in the language development review are studies of semantics (vocabulary, novel word learning, and conceptual categories), morphology, and syntax. The literacy section begins by considering dimensions of literacy and the ways in which hearing impairment may influence them. It is followed by a discussion of existing evidence on reading and writing, and highlights key constructs that need to be addressed for a comprehensive understanding of literacy in these children.

Acoustic Neuroma in a Private Neurotology Practice: Trends in Demographics and Practice Patterns

from Laryngoscope

Objectives/Hypothesis: To determine whether changes in demographics and management of patients with acoustic neuromas occurred between the years 1990 and 2005.

Study Design: Retrospective chart review.

Methods: Charts of all 614 patients with a diagnosis of acoustic neuroma, excluding neurofibromatosis-2, from 1990 through 2005 were reviewed. Age at diagnosis, tumor size, hearing, and initial therapy (observation, stereotactic radiation, or surgical excision) were obtained. Patients were grouped by time period (1990-1994, 1995-2000, 2001-2005).

Results: Mean age at diagnosis increased slightly from the middle period (53.4 yr) to the most recent (56.9 yr) (P <= .025). The proportion of patients 65 years or older increased from 21% to 29% to 32%, respectively, but the change was not significant. Average tumor size decreased from 1.7 cm initially to 1.4 cm most recently (P <= .039). There were no significant changes in hearing. Although surgical excision remains our most common treatment (58.5% in 2001-2005), it is becoming less frequent (>80% in earlier periods) (P <= .001). Observation with serial imaging was recommended in 37.3% in 2001 to 2005 as compared with 18.3% and 11.6% in the previous two time periods (P <= .001). These changes in initial treatment choices occurred for all age groups and primarily for small tumors. Use of radiation has increased only slightly, to 4.2% in the recent period.

Conclusion: Patients with acoustic neuroma are presenting with increased age and smaller tumors compared with 16 years ago. However, these changes cannot totally account for the large change in treatment trends. Technology and demographics are influential in these changes, but other difficult to measure forces, such aspatient influence and patient use of the Internet, are also factors.

Motor neuron disease associated with non-fluent rapidly progressive aphasia: case report and review of the literature

from the European Journal of Neurology

The superimposed clinical features of motor neuron disease (MND) and frontotemporal lobar degeneration (FTLD) comprise a rare neurological overlap syndrome that represents a diagnostic challenge to neurologists. Currently, FTLD-MND is considered a distinct entity and its clinicopathological basis has recently been reviewed. Our aim is to present a patient with MND and non-fluent rapidly progressive aphasia with clinical, imaging and histopathological correlation, as well as a brief review of the literature. We demonstrated the selective corticospinal tract (CST) and temporal lobe involvement using T1 spin-echo with an additional magnetization transfer contrast pulse on resonance (T1 SE/MTC) and FLAIR MR sequences in our patient, with further clinical and histopathological correlation. To the best of our knowledge, there is no description about the use of these particular MR sequences in the evaluation of FTLD-MND patients.