Natural History of Stuttering to 4 Years of Age: A Prospective Community-Based Study

These findings from a community-ascertained cohort refute long-held views suggesting that developmental stuttering is associated with a range of poorer outcomes. If anything, the reverse was true, with stuttering predicting subsequently better language,nonverbal skills, and psychosocial health-related quality of life at 4 years of age.Future research with this cohort will support a more complete longitudinal understanding of when and in whom recovery occurs. Current best practice recommends waiting for 12 monthsbefore commencing treatment, unlessthe child is distressed, there is parental concern, or the child becomes reluctant to communicate. It may be that for many children treatment could be deferred even longer. Treatment is efficacious15 but is both intensive (median of 15.4o ne-hour clinical sessions followedby 10 one-hour clinical maintenance sessions) and expensive; this "watchful waiting" recommendation would therefore help target allocation of scarce resources to the small number of children who do not resolve and experience adverse outcomes, secure in the knowledge that delaying treatment by a year or more has been shown not to compromise treatment efficac

Classroom promotion of oral language : Outcomes from a randomized controlled trial of a whole-of-classroom intervention to improve children’s reading achievement

Children need rich language learning experiences in school to build language and reading skills. Research suggests that various effective ways to support teacher provision of these experiences. The Classroom Promotion of Oral Language cluster randomized controlled trial (n = 1,360 students; 687 intervention, 673 control) examined whether a teacher professional learning intervention targeting oral language in the first years of school led to improved student outcomes compared to usual teaching practices. The intervention comprised face-to-face professional learning and ongoing support. The primary outcome was student reading ability at Grade 3; secondary outcomes included oral language, reading, and mental health at Grades 1 and 3. No differences were detected between the intervention and control arms. Implications of results and future directions are explored

Classroom promotion of oral language (CPOL): protocol for a cluster randomised controlled trial of a school-based intervention to improve children\u27s literacy outcomes at grade 3, oral language and mental health

Introduction Oral language and literacy competence are major influences on children’s developmental pathways and life success. Children who do not develop the necessary language and literacy skills in the early years of school then go on to face long-term difficulties. Improving teacher effectiveness may be a critical step in lifting oral language and literacy outcomes. The Classroom Promotion of Oral Language trial aims to determine whether a specifically designed teacher professional learning programme focusing on promoting oral language can lead to improved teacher knowledge and practice, and advance outcomes in oral language and literacy for early years school children, compared with usual practice.Methods and analysis This is a two-arm cluster multisite randomised controlled trial conducted within Catholic and Government primary schools across Victoria, Australia. The intervention comprises 4 days of face-to-face professional learning for teachers and ongoing implementation support via a specific worker. The primary outcome is reading ability of the students at grade 3, and the secondary outcomes are teacher knowledge and practice, student mental health, reading comprehension and language ability at grade 1; and literacy, writing and numeracy at grade 3. Economic evaluation will compare the incremental costs of the intervention to the measured primary and secondary outcomes

Mothers as First Teachers: Exploring the Features of Motherchild Interactions That Support Young Aboriginal Children’s Multilingual Learning at Playgroup

For many Indigenous children living in remote communities, the prerequisites to achieving strong language and learning outcomes include the maintenance of their first languages and progress in learning English as an additional language. This paper reports on data from a Linkage study conducted with families at two Families as First Teachers (FaFT) playgroups in two remote Northern Territory communities. The data highlight the ways parents and carers encouraged very young children to engage in home languages as a foundation on which to develop skills in English during play and book reading activities. Transcripts of mother-child book reading and play sessions and reflections of FaFT Family Liaison Officers are examined to explore the language interactions and the strategies used by mothers to support children’s multilingual learning. The data highlight the importance of early childhood teaching and learning that honours children’s linguistic and cultural resources and prioritises families’ aspirations for children’s multilingual language learning

Parent perceptions of a group telepractice communication intervention for autism

Background & Aims Estimates suggest that one in 59 children receive a diagnosis of autism and that early intervention can be effective if applied consistently and intensively. Parent implemented intervention can increase intervention consistency and intensity however, availability of providers, geographical factors, time constraints, and parental stress levels can all act as barriers to service access. Limitations in understanding elements that support family engagement can also impact participation in intervention. Telepractice can increase availability of intervention services and decrease the time and costs associated with face-to-face delivery. Research focused on children with autism has shown that telepractice is acceptable to parents. Despite positive findings for telepractice services with individual clients, limited research has been conducted on telepractice services for parent groups; parent perceptions and preferences regarding intervention; and service delivery methods. This research aimed to investigate parent perceptions of a group intervention programme for autism; the telepractice approach; parent and child outcomes; and parental stress. The purpose of the investigation was to build an understanding of parent's intervention preferences to inform future service offerings, increase choice, and support participation. Methods Eleven parents of preschool children with autism participated in a telepractice delivered group training programme called Hanen More Than Words (HMTW). The intervention is traditionally delivered face to face and teaches strategies to facilitate social-communication development in young children. Quantitative and qualitative measures were used to evaluate parent perceptions of the telepractice HMTW intervention. Data were collected via the Parenting Stress Index, HMTW programme evaluation forms, and online parent survey. Quantitative data was analysed using descriptive statistics. Pre- and post-intervention comparisons of parenting stress were conducted using paired T-Tests. Open comment field responses were analysed qualitatively using a directed content analysis. Results Parents reported high levels of satisfaction with telepractice delivered HMTW across intervention and post programme evaluations. Interactive learning opportunities, group participation, video coaching, individualisation of service, and programme facilitation were identified as key supports to learning. Parents perceived increased insight into the interaction, learning, and behaviour of themselves and their children. They reported positive changes in strategy implementation and confidence. Parents also perceived improvements in their children's communication, responsiveness, interaction, and play following intervention. Parental stress measurements from pre- to post intervention, were not significantly different. Conclusions Telepractice may reduce service barriers and improve access, particularly with the efficiency of a group delivery approach. Utilising technology to deliver group intervention was acceptable to parents and perceived to have positive outcomes for both parent and child. Further investigation into parent perceptions of intervention types and delivery approaches, could facilitate a broader understanding of family needs with respect to service access and engagement. Implications Expansion of telepractice offerings can increase efficiencies and service choice for families and providers. Limitations in service availability and barriers to service access and engagement, confirm the importance of pursuing ongoing service improvements and evaluating the preferences of service users. Development of standardised tools to measure and compare parent perceptions across intervention types and service delivery approaches would be beneficial

The production of complement clauses in children with language impairment

Purpose The purpose of this research was to provide a comprehensive description of complement-clause production in children with language impairment. Complement clauses were examined with respect to types of complement structure produced, verb use, and both semantic and syntactic accuracy. Method A group of 17 children with language impairment (mean age = 6;10 [years; months]) was compared with a group of 17 younger children with typical language development (mean age = 4;6). Examples of both nonfinite complements with different subjects and sentential complements involving a range of complement-taking verbs were collected using specially designed elicitation tasks. Results The children with language impairment were able to construct both types of complement clauses, had access to a range of verbs that are utilized within these constructions, and had knowledge of the grammatical constraints imposed by these verbs. However, they were more restricted in their production of sentential complements and produced significantly fewer semantically accurate complements (both finite and nonfinite) than the children with typical language development. Conclusion Children with language impairment evidenced deviant rather than merely delayed development in the area of complement-clause production. Complex sentences such as complement clauses need to be targeted in language intervention programs

Paths to language development in at risk children: a qualitative comparative analysis (QCA)

Abstract Background Childhood language development is related to long term educational, employment, health and social outcomes. Previous research identifies a complex range of risk and protective factors which result in good and poor language outcomes for children, however children at risk are an underrepresented group in these studies. Our aim is to investigate the combinations of factors (paths) that result in good and poor language outcomes for a group of 5 year old children of mothers experiencing adversity. Methods This mixed methods study utilised longitudinal data from a randomised control trial of sustained home visiting (MECSH) to determine the language outcomes in at risk children. Mothers were randomly assigned to a comparison group at entry to the study (prior to child’s birth). Their children who were retained at entry to school completed language assessments (n = 41) and were participants in this study. Influence of 13 key factors derived from the extant literature that impact language development were explored. Regression was used to determine the six key factors of influence and these were used in the Qualitative Comparative Analysis (QCA). QCA was employed to examine the necessary and sufficient conditions and paths affecting language development linked to good and poor language outcomes. A post hoc analysis of the risk and protective paths to good and poor language outcomes was also conducted. Results Thirteen distinct pathways led to good language outcomes and four paths to poor language outcomes in five year old at risk children. A variety of condition combinations resulted in these outcomes, with maternal responsivity, toddler development and number of children in the home being key. High and low maternal education influenced both good and poor language development. Conclusions The paths to good and poor language outcomes were different and complex. Most paths to a good language outcome involved protective factors, though not always. In addition, paths to poor language more often involved risk factors. The varied patterns of risk and protective factors point to the need for interventions across the first five years of life in both health and education for families which can respond to these risk and protective patterns. Trial registration The original RCT was retrospectively registered in the ANCTR: ACTRN12608000473369

Assessment of complement clauses : a comparison between elicitation tasks and language sample data

The aim of this study was to determine whether data from specifically designed elicitation tasks and commonly-used language sampling techniques provided the same information about children's production of complement clauses. It was predicted that elicitation tasks would yield more examples of complement clauses and children would use a wider range of verbs to form complement clauses in elicitation tasks than in language samples. A group of 20 pre-school children aged between 3;11-5;3 years were investigated. Each child completed two elicitation tasks, prompting the production of two of the major forms of complement clauses. A language sample of 100 utterances was also collected from each child. The results demonstrated that the two methods of data collection do not provide the same information about children's production of complement clauses. Significantly more examples of both types of complement clauses investigated were produced in the elicitation tasks. Similarly, children used a greater range of verbs in the elicitation tasks. Thus, language sample data under-estimate pre-school children's competency with complement clauses. Accurate and efficient methods of assessment of children's language structures are vital for speech-language pathologists to base their management decisions on. Elicitation tasks offer a viable alternative to language sampling.10 page(s

The human bite injury: a clinical audit and discussion regarding the management of this alcohol fuelled phenomenon

The aim of this study was to audit the management of these human bite wounds, with particular focus on infective complications and outcomes. Methods: A three year retrospective chart review was undertaken on all patients referred to the plastic surgery unit from 1 January 2003 through to 31 December 2005. A total of 92 patients with 96 human bite wounds were identified. The majority were male (92%). Alcohol consumption was documented in 86% of cases. The majority (70%) occurred over the weekend or on a public holiday. Facial injuries made up 70% of injuries with the remainder being to the upper limb. The ear was the most common target of all facial injuries (65%). Infection was documented in 18 cases (20%), with bite injuries to the upper limb and those presenting late (>12 h) having a higher incidence of infection