RESUMEN
Despite the high estimated prevalence of dysphagia in OSA, there is a paucity of evidence supporting behavioral interventions for treatment. The purpose of this study was to assess the impact of expiratory muscle strength training (EMST) on validated, standardized metrics of swallow and airway clearance capacity functions in moderate-to-severe OSA. 10 participants with OSA (mean age = 65.2 years) completed four weeks of EMST training employing a prospective single-arm, double-baseline interventional design. The Modified Barium Swallow Impairment Profile (MBSImP) Component and Composite (Oral Total [OT] and Pharyngeal Total [PT]) scores measured swallow physiology. Airway clearance capacity measures included maximum expiratory pressure (MEP) and peak cough flow (PCF). A historical normative database was used for OSA patient comparison of swallowing metrics. A total of 234 swallows were analyzed. At baseline, impairments in lingual control, oral residue and esophageal clearance were observed. However, no significant differences in the MBSImP Composite (OT/PT) scores were observed between the OSA and healthy referent group. After EMST intervention, there were no significant differences in pre- to post-intervention Composite (OT/PT) scores. However, large effect size was observed for MEP (p < 0.001, d = 3.0), and non-significant, but moderate effect size was observed in PCF (p = 0.19, d = 0.44). Study findings further quantify swallowing in moderate-to-severe OSA and provide preliminary evidence supporting the impact of EMST on airway clearance capacity.
RESUMEN
Forty-eight toddlers participated in a word-learning task to assess gesture input on mapping nonce words to unfamiliar objects. Receptive fast mapping and expressive naming for target object-word pairs were tested in three conditions - with a point, with a shape gesture, and in a no-gesture, word-only condition. No statistically significant effect of gesture for receptive fast-mapping was found but age was a factor. Two year olds outperformed one year olds for both measures. Only one girl in the one-year-old group correctly named any items. There was a significant interaction between gesture and gender for expressive naming. Two-year-old girls were six times more likely than two-year-old boys to correctly name items given point and shape gestures; whereas, boys named more items taught with the word only than with a point or shape gesture. The role of gesture input remains unclear, particularly for children under two years and for toddler boys.
RESUMEN
The need for effective services for persons with autism spectrum disorders (ASD) is driving efforts to better prepare teams of allied health professionals. To address this need, an interprofessional graduate course was piloted with students from three allied health professions: physical therapy, occupational therapy, and speech-language pathology. The course aims were to address knowledge and competency in the field of ASD and to promote interprofessional abilities during entry-level preparation. Nine graduate students participated in weekly on-line education and attended a day-long autism conference with local practitioners from seven different professions. Attitude changes toward interprofessional practice were assessed with two pre- to post-test Likert scales. Results revealed statistically significant increases in favorable ratings towards other disciplines as well as for two interprofessional competency domains, interprofessional communication and teams and teamwork. A two-part measure yielding quantitative (Likert scales) and qualitative data (open-ended written responses) revealed a significant increase in ratings from pre- to post-test for basic knowledge of ASD and increased specificity and confidence in the open-ended written responses. This course is one component of a broader initiative across campus, in the region, and statewide to better serve individuals with ASD.
Asunto(s)
Técnicos Medios en Salud/educación , Actitud del Personal de Salud , Trastorno del Espectro Autista/terapia , Educación de Postgrado/organización & administración , Relaciones Interprofesionales , Competencia Clínica , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Grupo de Atención al Paciente/organización & administración , AutoeficaciaRESUMEN
Fast mapping weaknesses in children with specific language impairment (SLI) may be explained by differences in disambiguation, mapping an unknown word to an unnamed object. The impact of language ability and linguistic stimulus on disambiguation was investigated. Sixteen children with SLI (8 preschool, 8 school-age) and sixteen typically developing age-matched children selected referents given familiar and unfamiliar object pairs in three ambiguous conditions: phonologically distinct word (PD), phonologically similar word (PS), no word (NW). Preschoolers with SLI did not disambiguate, unlike typically developing age-matched participants, who consistently selected unfamiliar objects given PD. School-age children with SLI disambiguated given PD. Delays in disambiguation for young children with SLI suggest limitations in processes that facilitate word learning for typically developing children. School-age children with SLI consistently selected familiar objects for PS, unlike typically developing children, suggesting differences in phonological activation for word learning.
Asunto(s)
Lenguaje Infantil , Comprensión , Trastornos del Desarrollo del Lenguaje/psicología , Fonética , Niño , Preescolar , Femenino , Humanos , Masculino , Psicolingüística , Percepción del HablaRESUMEN
PURPOSE: Effects of clicks and tonebursts on early and late auditory middle latency response (AMLR) components were evaluated in young and older cigarette smokers and nonsmokers. METHOD: Participants ( n = 49) were categorized by smoking and age into 4 groups: (a) older smokers, (b) older nonsmokers, (c) young smokers, and (d) young nonsmokers. Monaural, 2-channel AMLRs were acquired from Fz and Cz electrodes with 3 stimuli (clicks, 500 Hz, and 3000 Hz). RESULTS: Group differences included significantly higher V-Na amplitude in young adults and shorter Pb latency in older nonsmokers. Young smokers had a significantly higher Nb-Pb amplitude and shorter Nb latency than other groups. Toneburst stimuli yielded significantly longer V, Na, and Pa latencies compared to clicks. Pb latency was shorter at Fz than at Cz. Relative amplitudes were significantly higher at Fz than at Cz overall; Pa-Nb and Nb-Pb were significantly lower for 3000 Hz than for 500 Hz and clicks. CONCLUSIONS: Responses from young smokers revealed a higher amplitude and shorter latency for later AMLR waves, reflecting an arousal effect of smoking in cortical and subcortical generators. AMLR differences in older adults may be due to age-related neurochemical changes in the central nervous system. Stimulus and electrode differences plus smoking and aging effects can guide neurodiagnostic AMLR protocols, especially in young adult smokers.
Asunto(s)
Percepción Auditiva/fisiología , Trastornos de la Percepción Auditiva/etiología , Trastornos de la Percepción Auditiva/fisiopatología , Potenciales Evocados Auditivos/fisiología , Fumar/efectos adversos , Adulto , Factores de Edad , Anciano , Enfermedad Crónica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tiempo de Reacción/fisiología , Adulto JovenRESUMEN
PURPOSE: This was a Time II survey of outcomes for children, now ages 9 to 13 years, who were almost 4 years old on average when they were adopted from the former Soviet Union. METHOD: As part of a larger study (see T. McGuinness, R. Ryan, & C. Broadus Robinson, 2005), parents of 55 children (M age = 11 years) were surveyed regarding their children's speech-language, behavior, and eligibility for special education. The children's mean length of institutionalization was 36 months. RESULTS: A total of 45, or 82%, of the children had at least one special education label. The most frequent was communication disorder, which was reported for 34 children, or 62%. The frequency of attention deficit hyperactivity disorder (ADHD) was high, 42%. The ratio of boys to girls for communication disorders and ADHD was 1.5:1. Girls who were adopted after 36 months of age were 4 times more likely than girls who were adopted before 36 months to be labeled ADHD, and children with low birth weight exhibited learning disabilities twice as often as children with normal birth weight. CONCLUSION: Speech-language, learning, and attention deficits for late-adopted, early adolescent children were higher than expected. These children from the former Soviet Union experienced substantial preadoption adversity associated with lengthy orphanage stays and poor care. Gender and low birth weight were also factors.
Asunto(s)
Logro , Adopción/psicología , Trastornos de la Comunicación/diagnóstico , Emigrantes e Inmigrantes/psicología , Aculturación , Adolescente , Factores de Edad , Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/rehabilitación , Niño , Preescolar , Trastornos de la Comunicación/epidemiología , Trastornos de la Comunicación/rehabilitación , Comorbilidad , Educación Especial , Emigrantes e Inmigrantes/estadística & datos numéricos , Femenino , Estudios de Seguimiento , Humanos , Lactante , Recién Nacido de Bajo Peso , Recién Nacido , Masculino , Multilingüismo , Orfanatos , Factores de Riesgo , Razón de Masculinidad , U.R.S.S./etnología , Estados UnidosRESUMEN
8 preschoolers with specific language impairment (age range=44-58 mo.) and 8 language-matched, typically developing toddlers (22-29 mo.) participated in a verb comprehension task to investigate sensitivity to auxiliary is in four contexts --grammatical (Who is pushing?), omitted (Who pushing?), ungrammatical (Who in pushing?), and nonsense (Who id pushing?). Analysis yielded a significant interaction: children with specific language impairment had the lowest comprehension in the ungrammatical context and typically developing children had the highest. Perhaps children with specific language impairment, but not younger typically developing children, were sensitive to grammatical co-occurrences. One explanation is that knowledge of morphosyntax exceeded production for children with specific language impairment. Moreover, typically developing children may have ignored morpheme anomalies, perhaps benefitting from other input cues or flexible sentence processing.
Asunto(s)
Comprensión , Trastornos del Desarrollo del Lenguaje/diagnóstico , Semántica , Estimulación Acústica , Preescolar , Femenino , Humanos , Lactante , Masculino , Psicolingüística , Valores de Referencia , Acústica del Lenguaje , Percepción del HablaRESUMEN
A well-known characteristic of children with specific language impairment (SLI) is a significant deficit in grammatical morphology production compared with younger, language-matched, typically developing children. This is true for present tense be (am, is, are), as well as other inflectional morphemes. However, grammatical morpheme learning by children with SLI may vary depending on developmental stage. Participants were 8 boys with SLI (42 to 58 months old with mean length of utterances [MLUs] < or = 3.0 morphemes) and 14 MLU-matched controls (girls and boys; mean age of 27 months). These groups were younger and had lower MLUs than groups from oft-cited studies (e.g., Cleave and Rice, 1997; Leonard, Bortolini, Caselli, McGregor, and Sabbadini, 1992; Leonard, Eyer, Bedore, and Grela, 1997; Rice, Wexler, and Hershberger, 1998). The SLI group had a significantly higher percentage of be use in obligatory contexts (46%) than did the younger, typically developing children (27%). This pattern of better performance in grammatical morphology by SLI groups than controls has been reported. Ingram (1972) and Morehead and Ingram (1973) found similar results for children with language impairment in early-MLU stages. Although findings are presented with caution, they afford an opportunity to consider the nature of SLI. If SLI represents a general processing limitation, then that limitation might enable the language learner with SLI to acquire some initial morphological mappings with relative success. This apparent paradox, which also is evident in normal language acquisition, has been termed less is more by Newport (1990). Limited perception and memory force attention to smaller pieces of the input, and these constraints simplify the task for the language learner. SLI is compared with a chronically constrained system that initially assists the learner to achieve basic form-function mappings but ultimately hinders mastery of English morphology.