Behavioural outcomes and psychopathology during adolescence

Preterm birth is associated with a high risk of residual neurodevelopmental disability and cognitive impairment. These problems are closely associated with psychiatric disorders and thus it is unsurprising that preterm birth also confers high risk for poor long term mental health. The risk associated with preterm birth is not a general one, but appears to be specific to symptoms and disorders associated with anxiety, inattention and social and communication problems, and manifest in a significantly higher prevalence of emotional disorders, ADHD and Autism. Adolescence is a key period for mental health and studies have shown that problems evident in childhood persist over this time and are more stable amongst preterm individuals than term-born peers. There is also modest evidence for an increased prevalence of psychotic symptoms in preterm adolescents. The high prevalence of psychiatric disorders, present in around 25% of preterm adolescents, requires long term screening and intervention

Speech-Language and Cognitive Findings in Patients with HIV/AIDS

BACKGROUND: Few adult patients with HIV/AIDS are screened regularly for speech-language and cognitive disorders even though they may manifest communication difficulties. No comprehensive studies assessing the broad range of speech-language and cognitive disorders of adults with HIV/AIDS appear in the literature. As such, clinicians may be unfamiliar with the types of communication disorders that may be manifested. This study assessed the prevalence of speech-language and cognitive disorders in adults with HIV/AIDS using a broad inventory of speech, language, and cognitive skills. METHODS: A cross-sectional design was used to investigate communication disorders in a convenience sample of patients living with HIV/AIDS. Adult patients from a general internal medicine clinic in Wichita, Kansas were recruited as they presented for medical appointments. Each participant received a speech-language and cognitive test battery consisting of 10 assessments. RESULTS: The primary outcomes were: (1) presence of any speech-language or cognitive disorder, and (2) degree of communication disorder, as measured by the number of positive results. Eighty-two adults with HIV/AIDS were evaluated for communication disorders. Prevalence was 95%; 78 out of 82 participants manifested abnormal findings on at least one assessment in the test battery. Test results revealed a variety of cognitive and language issues, mostly related to integrating information on the picture description task (45%), timed word generation (44%), and memory-related story retelling (35%). Two participants revealed abnormal results on all ten assessments. CONCLUSION: Speech-language and cognition deficits are common in adult patients with HIV/AIDS. Every patient with HIV/AIDS should be assessed to determine the impact of these communication deficits on their daily living skills

Cybersafety: Educating individuals with aphasia or cognitive-communication disorders

The Internet poses risks, also known as cyberthreats. Everyone is vulnerable to cyberthreats, including individuals with aphasia (IwA) or cognitive-communication disorders (IwCCD). When speech-language pathologists introduce Internet into treatment plans for IwA or IwCCD the ASHA Code of Ethics dictates they “shall fully inform the persons they serve of the nature and possible effects of services rendered and products dispensed”. Yet safe-use products and protocols designed to inform or educate IwA and IwCCD about cybersafety are not reported in the literature. In this project we examine cyberthreats and cybersafety as they affect IwA and IwCCD by1) reviewing literature on cyberthreats; 2) reporting anecdotes from IwA and IwCCD who are Internet users; and 3) proposing strategies to support safer Internet use. We examine information and knowledge needed to create adaptations and scaffolds supporting safer Internet-use for people with language/cognitive-communication disabilities, and propose strategies for teaching cybersafety concepts. Issues drawn from the human-computer interaction (HCI) literature will facilitate discussion of privacy, accessibility, and universal design (Hochheister & Lazar, 2007)

Editorial. Clinical pragmatics: an emergentist perspective

[First Paragraph] Clinical pragmatics has been a major growth area in clinical linguistics and speech and language pathology over the past two decades. Its scope is vast: if we define pragmatics in broad terms, there are no communicative disorders which do not involve pragmatic impairment at least to some degree (Perkins, 2003). Early work in the area tended to focus on the application of pragmatic theory in the analysis of pragmatic impairment (e.g. speech act theory (Hirst, LeDoux, & Stein, 1984), conversational implicature (Damico, 1985) and, more recently, relevance theory (Leinonen & Kerbel, 1999)) and on the development of pragmatic assessments, tests and profiles which included a theoretically eclectic range of items drawn from both pragmatic theory and elsewhere (e.g. Bishop, 1998; Penn, 1985; Prutting & Kirchner, 1983). In more recent years there has been an increasing interest in the neurological and cognitive bases of pragmatic impairment (e.g. Paradis, 1998; Perkins, 2000; Stemmer, 1999) and in the use of interactional approaches such as conversation analysis (e.g. Goodwin, 2003). This special issue of Clinical Linguistics and Phonetics draws on all of these areas but focuses on a particular aspect of pragmatic impairment which has often been overlooked – namely, that the behaviours we describe as pragmatic impairments are in fact the outcome of very varied and highly complex processes. This neglect is partly due to a common tendency to see pragmatics as a separate ‘level’ or even ‘module’ of language, on a par with syntax and semantics. Influenced on the one hand by speech act theory, with its distinction between language structure and communicative acts, and on the other hand by clinical populations who were either able to communicate well despite being linguistically impaired or else were poor communicators despite having good linguistic ability, clinicians assumed there to be a clear dissociation between linguistic and pragmatic competence. Although there is still considerable neurological evidence for a broadly modular view in terms of the lateralisation of linguistic and pragmatic functions, there is also compelling evidence for seeing pragmatic impairment as a more complex, non-unitary phenomenon. Non-modular, or ‘interactional’, views of pragmatic impairment have been influenced by connectionist and functional models of linguistic and cognitive processing (e.g. Bates, Thal, & MacWhinney, 1991), by a growing awareness of the role played in pragmatics by cognitive capacities such as inference, theory of mind and executive function (Martin & McDonald, 2003), and by approaches such as Conversation Analysis (e.g. Damico, Oelschlaeger, & Simmons-Mackie, 1999) which focus on those features of pragmatics which can only be accounted for in terms of interpersonal, collaborative activity. All of these interactional approaches share a view of pragmatic impairment as ‘emergent’, or ‘epiphenomenal’ (Perkins, 1998), rather than as a stand-alone, monadic entity

Autism and Communication: A Phenomenology of Parents’ Perspectives

Autism spectrum disorders (ASD) are characterized by language impairments and are often treated with a variety of communication interventions. In addition to these interventions, the parents of autistic children have to learn how to care for and communicate with their children on a daily basis, especially when their children do not speak. This study made use of phenomenological investigation techniques to explore (1) what parents understand about communication with their nonspeaking autistic children and (2) what particular strategies they find to be effective. Six mothers of autistic children were interviewed, and resulting themes were divided according to parents’ understandings and the formal and informal strategies they use. Implications for practice and future research are given

EEG complexity as a biomarker for autism spectrum disorder risk

BACKGROUND: Complex neurodevelopmental disorders may be characterized by subtle brain function signatures early in life before behavioral symptoms are apparent. Such endophenotypes may be measurable biomarkers for later cognitive impairments. The nonlinear complexity of electroencephalography (EEG) signals is believed to contain information about the architecture of the neural networks in the brain on many scales. Early detection of abnormalities in EEG signals may be an early biomarker for developmental cognitive disorders. The goal of this paper is to demonstrate that the modified multiscale entropy (mMSE) computed on the basis of resting state EEG data can be used as a biomarker of normal brain development and distinguish typically developing children from a group of infants at high risk for autism spectrum disorder (ASD), defined on the basis of an older sibling with ASD. METHODS: Using mMSE as a feature vector, a multiclass support vector machine algorithm was used to classify typically developing and high-risk groups. Classification was computed separately within each age group from 6 to 24 months. RESULTS: Multiscale entropy appears to go through a different developmental trajectory in infants at high risk for autism (HRA) than it does in typically developing controls. Differences appear to be greatest at ages 9 to 12 months. Using several machine learning algorithms with mMSE as a feature vector, infants were classified with over 80% accuracy into control and HRA groups at age 9 months. Classification accuracy for boys was close to 100% at age 9 months and remains high (70% to 90%) at ages 12 and 18 months. For girls, classification accuracy was highest at age 6 months, but declines thereafter. CONCLUSIONS: This proof-of-principle study suggests that mMSE computed from resting state EEG signals may be a useful biomarker for early detection of risk for ASD and abnormalities in cognitive development in infants. To our knowledge, this is the first demonstration of an information theoretic analysis of EEG data for biomarkers in infants at risk for a complex neurodevelopmental disorder.This research was supported by a grant from Autism Speaks (to HTF), National Institute on Deafness and Other Communication Disorders (NIDCD) grant R21 DC08647 (to HTF), NIDCD grant R01 DC 10290 (to HTF and CAN) and a grant from the Simons Foundation (to CAN and WJB). We thank the following people for their help in data collection: Tara Augenstein, Leah Casner, Laura Kasparian, Nina Leezenbaum, Vanessa Vogel-Farley and Annemarie Zuluaga. We are especially grateful to the families who participated in this study. (Autism Speaks; R21 DC08647 - National Institute on Deafness and Other Communication Disorders (NIDCD); R01 DC 10290 - National Institute on Deafness and Other Communication Disorders (NIDCD); Simons Foundation

What does the intention to be a volunteer for a student with autism predict? the role of cognitive brain types and emotion and behavior characteristics

The study was designed to verify which cognitive brain types and behaviors in classroom predicted the intention to volunteer to become a peer buddy for a student with Autism Spectrum Disorder (ASD). Five hundred and sixteen adolescents attending the first grade of public high schools were enrolled. Gender-related differences were discussed according to the empathizing-systemizing theory. As expected, empathy and prosocial behavior predicted volunteering in ASD intervention. We conclude that the selection of peers as intervention agents should require more informative sources. Clinical and research implications are discussedEste estudio se diseñó para verificar qué tipos de cerebro cognitivo y comportamientos en el aula predecían la intención de ofrecerse voluntario a acompañar a un alumno con trastorno del espectro autista (TEA). Se apuntaron 516 adolescentes de primer curso de enseñanza secundaria. Se abordaron las diferencias relativas al género de acuerdo a la teoría empatía-sistematización. Según lo esperado, la empatía y el comportamiento prosocial predecían la voluntariedad para intervenir en el TEA. Se concluye que la elección de compañeros como agentes de intervención necesitaría de más fuentes de información. Se comentan las implicaciones clínicas y de investigació