Pragmatic ability in children with early onset brain damage and children with pragmatic language impairnent

The general purpose was to study pragmatically related abilities in children with early-onset brain damage, i.e. children with cerebral palsy (CP) and children with spina bifida and hydrocephalus (SBH), and in a group of children with pragmatic language impairment (PLI). In study I and III children with CP, SBH and PLI were compared. In study I pragmatically related abilities were assessed. No significant differences between the CP group and the SBH group occurred, both groups having pragmatically related problems. The three groups all had problems with story comprehension and narrative ability. In study III literal and inferential understanding were analyzed. No significant differences occurred between the CP group and the SBH group. The PLI group made fewer inferences and had significantly less typical answers compared to the CP group. In study II, conversations during intervention between children with CP and their physiotherapists (PTs) and speech language therapists (SLTs) were studied. The PTs talked significantly more about topics not directly related to the intervention compared to the SLTs. In study IV narrative ability in children with CP was explored. The difficulties with story recall, compared to the norms of the test and the results of a group of TD children, could be related to problems with explicitness and causal conjunctions. In conclusion, the children with CP and the children with SBH represented in this thesis both have pragmatically related problems. The problems occur mainly in relation to higher-level language skills as narrative ability, and are mainly manifested at a textual level

Inferential ability in children with cerebral palsy, spina bifida and pragmatic language impairment.

The aim of the study was to investigate and compare the ability to make inferences in three groups of children ranging from 5;2 to 10;9 years: 10 children with cerebral palsy (CP), 10 children with spina bifida and hydrocephalus (SBH) and 10 children with pragmatic language impairment (PLI). The relationship between inferential and literal comprehension was investigated by analysing atypical responses. For this analysis an analytic framework was developed. The PLI group performed significantly worse on inferential questions than the CP group. It was only in the PLI group that problems with inferential questions exceeded the problems with literal questions, and the CP group even performed significantly better in this condition. Inferential comprehension was found to be related to language comprehension in the CP group, but was more related to the ability to predict future developments in the SBH- and PLI-groups. The PLI group relied more on world knowledge and associations than on text-related factors when delivering an atypical response compared to the CP group. The analysis of atypical responses proved to be a promising tool for the planning of an adequate intervention

Children with cerebral palsy, spina bifida and pragmatic language impairment: Differences and similarities in pragmatic ability.

Pragmatically related abilities were studied in three clinical groups of children from 5 to 11 years of age; children with cerebral palsy (CP; n=10), children with spina bifida and hydrocephalus (SBH; n=10) and children with pragmatic language impairment (PLI; n=10), in order to explore pragmatic abilities within each group. A range of pragmatic, linguistic and cognitive assessments were performed, and comparisons between the groups were made. In addition, connections between variables were studied. The most salient result was the many similarities and the lack of clear boundaries between the groups. The only significant differences found concerned short-term memory and inference ability, where all three groups experienced problems but to varying extent. Different patterns of variance were found in the groups, indicating that different underlying abilities such as reception of grammar, inferential comprehension and lexical comprehension seem to affect pragmatic ability in somewhat different ways. The results suggest that the children with CP and SBH in this study shared a number of pragmatically related traits, being more similar than would be expected according to earlier research. Finally, it is suggested that pragmatic assessment is further subdivided into a socially versus a linguistically related assessment

Interaction during intervention: conversations between professionals and children with cerebral palsy.

To develop interactional ability, conversation with both peers and adults is vital. However, for children with physical impairments, like cerebral palsy, interactions with adults often dominate. In this study, interaction between eight Swedish children with cerebral palsy, mean age 8.6 years, and their physiotherapists (PTs) and speech-language therapists (SLTs) was analysed during intervention across 16 dyads. The analysis of data focused on how quantitative, interactional and topical dominance was manifested by the PTs and the SLTs. In addition, mitigating strategies and use of feedback was investigated. Surprisingly, the only significant finding was in topic maintenance, where the PTs' conversations were more directed towards topics unrelated to the intervention context when compared to the conversations of the SLTs. Although not significant, the PTs tended to dominate by having a greater amount of talk, and the SLTs by asking many questions. It is discussed how the two professions may contribute to the development of interactional skills and pragmatic ability among children with cerebral palsy, given their professional training and focus of intervention

Narrative ability in children with cerebral palsy.

In a previous study a group of children with cerebral palsy (CP) were found to have considerable difficulties with narratives, performing several standard deviations below the criteria for the Information score of the Bus Story Test (BST). To examine in depth the performance of children with CP and a control group with typically developing (TD) children on a narrative task, in order to search for possible underlying causes to the problems in the CP group. The results of the BST for 10 children with CP, mean age 7;11 years, were investigated. The analysis of the BST was supplemented with the use of the Narrative Assessment Profile (NAP) and quantitative analyses of number of words, mazes, propositions, types of conjunctions and story elements. A significant relationship between the explicitness dimension on the Narrative Assessment Profile and the BST Information score in the CP group suggested that the problems could be derived to a limited use of cohesion and a scarcity of essential information. Compared to the CP group, the TD group used significantly more causal conjunctions. The results indicate a general problem with cohesion at the textual level in the CP group. A further finding was the occurrence of a positive correlation between the use of mazes and the BST Information score in the CP group. These results have implications for the design of a more specific intervention for children, where the NAP was found to be a valuable tool in combination with the BST or other assessment materials. Further, it is shown that mazes, mostly regarded as a behaviour that not enhances speech production, for some children can be used as a means to find necessary words and pieces of information

Comparing Model Projections with Reality: Experiences from Modelling Building Stock Energy Use in Norway

Projections of future energy use in buildings are a crucial tool in the tracking and attainment of political targets for energy efficiency and climate gas mitigation. In this article, a new methodology for projecting both the final energy use and the peak power demand for the Norwegian building stock is presented. The novelty of the methodology is to combine a set of existing, previously documented models in a novel way that integrates building stock models, hourly energy demand load profiles, and energy system modelling. The result is a coherent long-term projection of both annual and hourly energy use for different energy carriers, presented here with four scenarios of final energy use. The results show an expected decrease in total energy use for the Norwegian building stock between −2 and −12 TWh towards 2050, corresponding to a −3% to −14% of the energy use in 2020. Models for projecting future energy use are helpful both to evaluate the potential effects of current policies and to help reveal the need for new or updated policies. However, to have the desired effect, the projections must be as realistic as possible and reflect the actual development in energy use in the building stock. This necessitates a methodology for evaluating historical long-term annual energy use projections to understand why some models succeed in predicting energy use development while others fail. In this article, a set of indicators for evaluating the calibration of different models are presented. The indicators evaluate the initial difference and the divergence in the annualised trend for energy use projection models, compared to statistical data. The indicators are used to compare selected historical energy use projections for the Norwegian building stock against energy use from statistics from 2000 to 2020. The comparison shows large differences between the different projections, where calibrated scenarios show energy savings that tend to be more optimistic in the reference projection but more conservative in the best case potential.publishedVersio

Comparing Model Projections with Reality: Experiences from Modelling Building Stock Energy Use in Norway

Projections of future energy use in buildings are a crucial tool in the tracking and attainment of political targets for energy efficiency and climate gas mitigation. In this article, a new methodology for projecting both the final energy use and the peak power demand for the Norwegian building stock is presented. The novelty of the methodology is to combine a set of existing, previously documented models in a novel way that integrates building stock models, hourly energy demand load profiles, and energy system modelling. The result is a coherent long-term projection of both annual and hourly energy use for different energy carriers, presented here with four scenarios of final energy use. The results show an expected decrease in total energy use for the Norwegian building stock between −2 and −12 TWh towards 2050, corresponding to a −3% to −14% of the energy use in 2020. Models for projecting future energy use are helpful both to evaluate the potential effects of current policies and to help reveal the need for new or updated policies. However, to have the desired effect, the projections must be as realistic as possible and reflect the actual development in energy use in the building stock. This necessitates a methodology for evaluating historical long-term annual energy use projections to understand why some models succeed in predicting energy use development while others fail. In this article, a set of indicators for evaluating the calibration of different models are presented. The indicators evaluate the initial difference and the divergence in the annualised trend for energy use projection models, compared to statistical data. The indicators are used to compare selected historical energy use projections for the Norwegian building stock against energy use from statistics from 2000 to 2020. The comparison shows large differences between the different projections, where calibrated scenarios show energy savings that tend to be more optimistic in the reference projection but more conservative in the best case potential