Evidences of Factorial Structure and Precision of Phonemic Awareness Tasks (TCFe)

Para evaluar la conciencia fonológica, habilidad determinante para el aprendizaje de la lectura y escritura, es necesario proporcionar evidencias a cerca del constructo que un dicho instrumento se propone a medir a fin de tener parâmetros fiables para la investigación empírica y para el desarrollo de programas de intervención educativa y de rehabilitación. En Brasil, hasta el momento, no hay estudios de evidencia de la validez basada en la estructura interna para pruebas de conciencia fonológica. Este artículo presenta los resultados para la validez de uma prueba de conciencia fonológica constituída por tres sub-pruebas: dos de subtración Del fonema inicial y una de segmentación fonémica. El análisis factorial confirmatorio multidimensional fue aplicado a uma muestra de 176 estudiantes brasileños ( Medad= 9,3 años) de 1º a 5º año del enseñanza básica. Los resultados indicará nun modelo bien ajustado, con items de dificuldad mediana y cargas factoriales altas; corroborando la estructura interna y la concepción teórica adecuadas.To assess phonological awareness - a decisive skill for learning to read and write - it is necessary to provide evidence about an instrument construct to present trustworthy parameters for both empirical research and the development of educational intervention and rehabilitation programs. In Brazil, at this moment, there are no studies regarding the internal structure for tests of phonological awareness. This article shows the factorial validity of a test of phonological awareness composed by three sub-tests: two tasks of subtraction of initial phoneme and one of phonemic segmentation. The multidimensional confirmatory factorial analysis was applied to a sample of 176 Brazilian students ( Mage= 9.3 years) from the first to fifth grade of elementary school. Results indicated a well-adjusted model, with items of intermediate difficulty and high factor loadings; thus, this corroboratedthe internal structure and well-designed theoretical conception.Para avaliar a consciência fonológica, habilidade determinante para a aprendizagem da leitura e da escrita, é necessário prover evidências acerca do construto que um dado instrumento se propõe a mensurar de modo a fornecer parâmetros confiáveis tanto para a pesquisa empírica como para o desenvolvimento de programas de intervenção educacional e de reabilitação. No Brasil, até o momento, não há estudos de evidências de validade com base na estrutura interna para testes de consciência fonológica. Este artigo apresenta os resultados para a validade de um teste de consciência fonológica constituído por três sub-testes: duas tarefas de subtração do fonema inicial e uma de segmentação fonêmica. A análise fatorial confirmatória multidimensional foi aplicada a uma amostra de 176 estudantes brasileiros ( Midade= 9,3 anos) de 1º ao 5º ano do ensino fundamental. Resultados indicaram modelo bem ajustado, com itens de dificuldade mediana e cargas fatoriais altas; corroborando a estrutura interna e concepção teórica adequadas

Short report: COVID-19-related anxiety is associated with mental health problems among adults with rare disorders

Background For adults with rare disorders, COVID-19 can be more severe and deadlier. This may lead to anxiety about COVID-19 among adults with rare disorders, including worries about being infected. COVID-19 anxiety is linked with mental health problems in the general population. Aims To examine the levels of mental health problems and COVID-19 anxiety, and their association, among adults with rare disorders. Methods and procedures Adults with rare disorders (N = 58, Mage = 45.2 years, SD = 12.7, 69.0% females, 31.0% males) answered standardized mental health and COVID-19 anxiety questionnaires online. Their scores were compared with samples without rare disorders. Outcomes and results Mental health problems were higher than in a sample without rare disorders (effect size d = 1.14), as was COVID-19 anxiety (effect size d = 0.53). COVID-19 anxiety correlated significantly with mental health problems (r = .46). Controlling for age, gender, and work status, COVID-19 anxiety explained 16.1% of the variance in mental health problems (ΔR2 = .161, p = .001). Conclusions and implications COVID-19 anxiety is higher than norms and associated with mental health problems for adults with rare disorders. During the pandemic, clinicians are recommended to assess COVID-19 anxiety for patients with rare disorders.publishedVersio

Redefining effect size interpretations for psychotherapy RCTs in depression

Introduction: Effect sizes are often used to interpret the magnitude of a result and in power calculations when planning research studies. However, as effect size interpretations are context-dependent, Jacob Cohen’s suggested guidelines for what represents a small, medium, and large effect are unlikely to be suitable for a diverse range of research populations and interventions. Our objective here is to determine empirically-derived effect size thresholds associated with psychotherapy randomized controlled trials (RCTs) in depression by calculating the effect size distribution. Methods: We extracted effect sizes from 366 RCTs provided by the systematic review of Cuijpers and colleagues (2020) on psychotherapy for depressive disorders across all age groups. The 50th percentile effect size, as this represents a medium effect size, and the 25th (small) and 75th (large) percentile effect sizes were calculated to determine empirically-derived effect size thresholds. Results: After adjusting for publication bias, 0.27, 0.53, and 0.86 represent small, medium, and large effect sizes, respectively, for psychotherapy treatment for depressive disorders. Discussion: The effect size distribution for psychotherapy treatment of depression indicates that observed effect size thresholds are larger than Cohen’s suggested effect size thresholds (0.2, 0.5, and 0.8). These results have implications for the interpretation of study effects and the planning of future studies via power analyses, which often use effect size thresholds.publishedVersio

Reading intervention for students with intellectual disabilities without functional speech who require augmentative and alternative communication: a multiple single-case design with four randomized baselines

Background Literacy is one of the most important skills a students can achieve, as it provides access to information and communication. Unfortunately, literacy skills are not easily acquired, especially for students with intellectual disabilities who require augmentative and alternative communication (AAC). There are many barriers to literacy acquisition, some due to low expectations from parents and teachers and lack of evidence-based reading programs and reading materials adapted for AAC. Barriers as a result of extensive support needs is also a real factor. This trial aims to deliver reading instructions to 40 students with intellectual disabilities who require AAC and contribute in the debate on how to best support this population through reading instructions to maximizes their reading skills. Methodology Forty non-verbal or minimally verbal students (age 6–14) with intellectual disabilities who require AAC will be part of a reading intervention with a multiple single-case design with four randomized baselines. The intervention period will last for 18 months and will commence in March 2023. The students will receive the intervention in a one-to-one format, working systematically with a reading material that contains phonological awareness and decoding tasks based on the Accessible Literacy Learning (ALL) developed by Janice Light and David McNaughton. All the teachers will be trained to deliver the reading intervention. Discussion The reading material “Lesing for alle” (Reading for all) is based on and follow the strategies behind the research of ALL. The current trial will through a reading intervention contribute to move beyond only teaching sight words and combine several reading components such as sound blending, letter-sound correspondence, phoneme segmentation, shared reading, recognition of sight words, and decoding. The strategies and methods in use is built on the existing science of reading, especially what has been effective in teaching reading for students with intellectual disabilities who require AAC. There is limited generalizability of prior findings in reading-related phonological processing interventions to different populations of them who use AAC specially outside of the USA. More research is needed to understand how programs designed to improve reading skills across other settings understand the program’s long-term effects and to study the effectiveness when delivered by educators who are not speech language therapists or researchers.publishedVersio

Does #Tamojunto alter the dynamic between drug use and school violence among youth? Secondary analysis from a large cluster-randomized trial

The present study investigated how intervention might alter the relationship between perpetrating violence and later drug use. A cluster-randomized controlled trial design involving 72 schools (38 intervention, 34 control) and 6390 students attending grades 7 and 8 was employed in Brazil. Drug use and violence were assessed at three points. A random-intercept cross-lagged panel model examined the reciprocal association between drug use and school violence domains across the three data collection waves. For both groups, we found that the cross-lagged effect of perpetration on further drug use in adolescents was stronger than the reverse, but the interrelationship was not statistically significant between #Tamojunto and control schools. The carry-over effects of drug use and violence were also not significantly different between groups. There is a lack of evidence showing that #Tamojunto can modify the dynamics between drug use and school violence across the 21-month period. The direction of the causal effect (i.e., the more perpetration behavior, the more subsequent drug use behavior) is present, but weak in both groups. The trial registration protocol at the national Brazilian Register of Clinical Trials (REBEC) is #RBR-4mnv5g

Cardiovascular Risk Factors and Risk of Alzheimer Disease and Mortality: A Latent Class Approach

BackgroundCardiovascular risk factors co‐occur with one another, and little is known about the extent of their clustering and risk of Alzheimer disease (AD). We identify groups of cardiovascular risk factors in cognitively normal individuals and investigate between‐group differences in incident AD and death.Methods and ResultsCognitively normal individuals were recruited from the National Alzheimer's Coordinator Center. A latent class analysis was conducted with hypertension, hypercholesterolemia, heart condition, stroke, smoking history, diabetes, and high body mass index. Between‐group differences in the incidence of AD, mortality, and mortality‐adjusted AD were investigated. This study included 12 412 cognitively normal individuals (average follow‐up, 65 months). Three groups were identified: (1) low probabilities of cardiovascular risk factors (reference; N=5398 [43%]), (2) hypertension and hypercholesterolemia (vascular‐dominant; N=5721 [46%]), and (3) hypertension, hypercholesterolemia, diabetes, and high body mass index (vascular‐metabolic; N=1293 [10%]). Both vascular groups were significantly older, had more men, were slightly less educated, and were slightly more cognitively impaired than the reference group (all P<0.05). However, only the vascular‐metabolic group had a significantly younger age of death compared with the reference group (84.3 versus 88.7 years, P<0.001). Only the vascular‐dominant group had a greater incidence of AD (odds ratio [OR], 1.30; P<0.001) compared with the reference group. Mortality was greater in the vascular‐dominant (OR, 3.26; P<0.001) and vascular‐metabolic groups (OR, 1.84; P=0.02). Mortality‐adjusted AD was greater in the vascular‐dominant (OR, 1.54; P=0.02) and vascular‐metabolic groups (OR, 1.46; P=0.04).ConclusionsThree distinct cardiovascular risk factor groups were identified in cognitively normal elderly individuals. Only the vascular‐dominant group was associated with a greater incidence of AD. Selective mortality may contribute to the attenuated association between the vascular‐metabolic group and incident AD.publishedVersio