The home literacy environment of school-aged children with autism spectrum disorders

For typically developing (TD) children, the home literacy environment (HLE) impacts reading competence, yet few studies have explored the HLE of children with autism spectrum disorders (ASD). We collected information about the HLE of children aged 7–13 with ASD and their TD peers via a parental questionnaire and examined whether there were any differences in home literacy practices. Subtle group differences emerged. Children with ASD and concomitant language disorder (autism language disorder [ALD]) were engaged in shared reading and reading discussion more frequently than were TD children and children with ASD and age-appropriate language skills (autism language normal [ALN]). However, both ALN and ALD children engaged in shared reading for a shorter duration than their TD peers. Across groups, frequency and duration of independent reading were positively associated with reading ability and attitude. Thus, home literacy practices appear to reflect child characteristics, and parents are well placed to facilitate their children's literacy development through encouragement and scaffolding

Cognitive and environmental predictors of early literacy skills

Not all young children benefit from book exposure in preschool age. It is claimed that the ability to hold information in mind (short-term memory), to ignore distraction (inhibition), and to focus attention and stay focused (sustained attention) may have a moderating effect on children’s reactions to the home literacy environment. In a group of 228 junior kindergarten children with a native Dutch background, with a mean age of 54.29 months (SD = 2.12 months), we explored therefore the relationship between book exposure, cognitive control and early literacy skills. Parents filled in a HLE questionnaire (book sharing frequency and an author recognition checklist as indicator of parental leisure reading habits), and children completed several tests in individual sessions with the researcher (a book-cover recognition test, PPVT, letter knowledge test, the subtests categories and patterns of the SON, and cognitive control measures namely digit span of the KABC, a peg tapping task and sustained attention of the ANT). Main findings were: (1) Children’s storybook knowledge mediated the relationship between home literacy environment and literacy skills. (2) Both vocabulary and letter knowledge were predicted by book exposure. (3) Short-term memory predicted vocabulary over and above book exposure. (4) None of the cognitive control mechanisms moderated the beneficial effects of book exposure

Testing innovative strategies to reduce the social gradient in the uptake of bowel cancer screening: a programme of four qualitatively enhanced randomised controlled trial

Background: Bowel cancer screening reduces cancer-specific mortality. There is a socioeconomic gradient in the uptake of the English NHS Bowel Cancer Screening Programme (BCSP), which may lead to inequalities in cancer outcomes. Objective: To reduce socioeconomic inequalities in uptake of the NHS BCSP’s guaiac faecal occult blood test (gFOBt) without compromising uptake in any socioeconomic group. Design: Workstream 1 explored psychosocial determinants of non-uptake of gFOBt in focus groups and interviews. Workstream 2 developed and tested four theoretically based interventions: (1) ‘gist’ information, (2) a ‘narrative’ leaflet, (3) ‘general practice endorsement’ (GPE) and (4) an ‘enhanced reminder’ (ER). Workstream 3 comprised four national cluster randomised controlled trials (RCTs) of the cost-effectiveness of each intervention. Methods: Interventions were co-designed with user panels, user tested using interviews and focus groups, and piloted with postal questionnaires. RCTs compared ‘usual care’ (existing NHS BCSP invitations) with usual care plus each intervention. The four trials tested: (1) ‘gist’ leaflet (n = 163,525), (2) ‘narrative’ leaflet (n = 150,417), (3) GPE on the invitation letter (n = 265,434) and (4) ER (n = 168,480). Randomisation was based on day of mailing of the screening invitation. The Index of Multiple Deprivation (IMD) score associated with each individual’s home address was used as the marker of socioeconomic circumstances (SECs). Change in the socioeconomic gradient in uptake (interaction between treatment group and IMD quintile) was the primary outcome. Screening uptake was defined as the return of a gFOBt kit within 18 weeks of the invitation that led to a ‘definitive’ test result of either ‘normal’ (i.e. no further investigation required) or ‘abnormal’ (i.e. requiring referral for further testing). Difference in overall uptake was the secondary outcome. Results: The gist and narrative trials showed no effect on the SECs gradient or overall uptake (57.6% and 56.7%, respectively, compared with 57.3% and 58.5%, respectively, for usual care; all p-values > 0.05). GPE showed no effect on the gradient (p = 0.5) but increased overall uptake [58.2% vs. 57.5% in usual care, odds ratio (OR) = 1.07, 95% confidence interval (CI) 1.04 to 1.10; p < 0.0001]. ER showed a significant interaction with SECs (p = 0.005), with a stronger effect in the most deprived IMD quintile (14.1% vs. 13.3% in usual care, OR = 1.11, 95% CI 1.04 to 1.20; p = 0.003) than the least deprived (34.7% vs. 34.9% in usual care OR = 1.00, 95% CI 0.94 to 1.06; p = 0.98), and higher overall uptake (25.8% vs. 25.1% in usual care, OR = 1.07, 95% CI 1.03 to 1.11; p = 0.001). All interventions were inexpensive to provide. Limitations: In line with NHS policy, the gist and narrative leaflets supplemented rather than replaced existing NHS BCSP information. This may have undermined their effect. Conclusions: Enhanced reminder reduced the gradient and modestly increased overall uptake, whereas GPE increased overall uptake but did not reduce the gradient. Therefore, given their effectiveness and very low cost, the findings suggest that implementation of both by the NHS BCSP would be beneficial. The gist and narrative results highlight the challenge of achieving equitable delivery of the screening offer when all communication is written; the format is universal and informed decision-making mandates extensive medical information. Future work: Socioculturally tailored research to promote communication about screening with family and friends should be developed and evaluated. Trial registration: Current Controlled Trials ISRCTN74121020. Funding: This project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full in Programme Grants for Applied Research; Vol. 5, No. 8. See the NIHR Journals Library website for further project information

Vocabulary development at home:A multimedia elaborated picture supporting parent-toddler interaction

Some children enter elementary school with large vocabulary delays, which negatively influence their later school performance.A rich home language environment can support vocabulary development through frequent high-quality parent–toddler interaction. Elaborated picture home activities can support this rich home language environment. This study compares the effects of a multimedia versus a paper elaborated picture on the parent–toddler interaction and toddlers’ vocabulary development. In a within-subjects design, 20 toddlers (age 3–4) discussed a multimedia and a paper elaborated picture with a parent. Results showed that toddlers knew significantly more words (receptively and expressively) after both activities. Moreover, the improvement in receptive vocabulary knowledge was significantly larger with the multimedia elaborated picture compared with the paper-based picture. In addition, both parent and toddler engaged in a significant higher level of decontextualized language in response to multimedia. The present study shows that multimedia elaborated pictures can support parents at home to engage in a parent–toddler interaction that is richer and supports the development of receptive vocabulary more compared with traditional paper-based activities. In the future, multimedia-based home activities for toddlers’ vocabulary development, supporting parent–child interaction, can be offered relatively cheap and easily via internet

A Vygotskian perspective on parent-child talk during iPad story sharing

This study explores the themes in the talk of two mothers and daughters as they share a self-created story with an iPad app. Vygotsky's theory of learning is applied to inform a thematic analysis and help interpret the learning potential within the observed parent–child exchanges. A deductive–inductive thematic analysis identified three recurring themes in the parent–child talk: realistic fiction, scaffolding variations, and engaged players and objects of ‘play’. The themes suggested that Vygotsky's theory has particular relevance in exploring the learning processes facilitated by the iPad app. In addition, however, post-Vygotskian theoretical frameworks were helpful in capturing the dynamic co-construction of the authentic and multimedia stories parents and children shared