A new EPG protocol for assessing DDK accuracy scores in children : a Down's syndrome study

Recent research has suggested that eliciting diadochokinetic (DDK) rate and accuracy in young children is difficult [1], with analysis being timeconsuming.This paper details a new protocol for assessing DDK in young children or children with intellectual impairment (Down's syndrome) and a method for calculating accuracy scores automatically. Accuracy scores were calculated from auditory and electropalatographic analyses and found to correlate in some instances. The children with Down's syndrome presented with similar DDK rates to typically-developing children but reduced accuracy.casl[1] Cohen, W., Waters, D., Hewlett, N., 1998, DDK rates in the paediatric clinic: a methodological minefield. International Journal of Language and Communication Disorders, 33, supplement, 428-433. [2] Dodd, B., Hua, Z., Crosbie, S., Holm, A., 2002, Diagnostic Evaluation of Articulation and Phonology. London: The Psychological Corporation. [3] Fletcher, S.G., 1978. The Fletcher time-by-count Test of Diadochokinetic Syllable Rate. Austin: PRO-ED. [4] Kumin, L., 2006. Speech intelligibility and childhood verbal apraxia in children with Down syndrome. Down Syndrome Research and Practice, 10, 10-22. [5] Robbins, J., Klee,T., 1987, Clinical Assessment of Oropharyngeal Motor Development in Young Children. Journal of Speech and Hearing Disorders, 52, 271-277. [6] Thoonen, G., Maassen, B., Wit, J., Gabreels, F., Schreuder, R., 1996, The integrated use of maximum performance tasks in differential diagnostic evaluations among children with motor speech disorders. Clinical Linguistics and Phonetics, 10, 311-336. [7] Williams, P. and Stackhouse, J., 2000. Rate, accuracy and consistency: diadochokinetic performance of young, normally developing children. Clinical Linguistics & Phonetics, 14, 267-293pub43pu

A model to assess the efficacy of vaccines for control of liver fluke infection

Fasciola hepatica, common liver fluke, infects cattle and sheep causing disease and production losses costing approximately $3billion annually. Current control relies on drugs designed to kill the parasite. However, resistance is evident worldwide and widespread in some areas. Work towards a vaccine has identified several antigens of F. hepatica that show partial efficacy in terms of reducing worm burden and egg output. A critical question is what level of efficacy is required for such a vaccine to be useful? We have created the first mathematical model to assess the effectiveness of liver fluke vaccines under simulated field conditions. The model describes development of fluke within a group of animals and includes heterogeneity in host susceptibility, seasonal exposure to metacercariae and seasonal changes in temperature affecting metacercarial survival. Our analysis suggests that the potential vaccine candidates could reduce total fluke burden and egg output by up to 43% and 99%, respectively, on average under field conditions. It also suggests that for a vaccine to be effective, it must protect at least 90% of animals for the whole season. In conclusion, novel, partial, vaccines could contribute substantially towards fasciolosis control, reducing usage of anthelmintics and thus delaying the spread of anthelmintic resistance

Variability in fricative production of young people with Down's syndrome : an EPG analysis

Speech production in Down's syndrome is highly variable, with particular problems arising from complex articulations such as fricatives. In this paper, EPG analysis is used to study the variation in the production of the fricatives /s/ and /sh/ in 6 young people with Down's syndrome. The variability of these productions is compared with information from the Robbins and Klee Oral/Speech Motor Control Protocol.casl[1] Bleile, K., Schwartz, I. 1984. Three perspectives on the speech of children with Down's syndrome. Journal of Communication Disorders 17, 2, 87-94. [2] Dodd, B., Thompson, L. 2001. Speech Disorder in children with Down's syndrome. Journal of Intellectual Disability Research 45, 4, 308-316. [3] Gibbon, F. 2004. Abnormal patterns of tongue-palate contact in the speech of individuals with cleft palate. Clinical Linguistics and Phonetics 18, 4-5, 285-311. [4] Gibbon, F., Hardcastle, W. 1987. Articulatory description and treatment of lateral /s/- using Electropalatography: a case study. British Journal of Disorders of Communication 22, 203-217. [5] Gibbon, F. E., McNeill, A. M., Wood, S. E., Watson, J. M. M. 2003. Changes in linguapalatal contact patterns during therapy for velar fronting in a 10-year-old with Down's syndrome. International Journal of Communication Disorder. 38, 47-64. [6] Hamilton, C. 1993. Investigation of the articulatory patterns of young adults with Down's syndrome using electropalatography. Down's Syndrome: Research and Practice, 1 (1), 15-28. [7] Hardcastle, W.J., Gibbon, F. 1997. Electropalatography and its clinical applications. In: Ball, M. J., Code, C. (eds), Instrumental Clinical Phonetics. London: Whurr publishers, 149-193. [8] Hoole, P., Zeigler, W., Hartmann, E., Hardcastle, W. 1989. Parallel electropalatographic and acoustic measures of fricatives. Clinical Linguistics and Phonetics 3, 59-69. [9] Kumin, L. 1996. Speech and Language Skills in Children with Down Syndrome. Mental Retardation and Developmental Disabilities 2, 109-115. [10] McLeod, S., Roberts, A. 2005. Templates of tongue/palate contact for speech sound intervention. In C. Heine & L. Brown (Eds). Proceed. Of Speech Pathology Australia National Conference Melbourne:Speech Pathology Australia, 104-112. [11] Mcleod, S., Roberts, A., Sita, J. 2006. Tongue/palate contact for the production of /s/ and /z/. Clinical Linguistics and Phonetics, 20, 1, 51-66. [12] Robbins, J., Klee, T. 1987. Clinical Assessment of Oropharyngeal Motor Development in Young Children. Journal of Speech and Hearing Disorders. 52, 271-277 [13] Spender, Q., 1995. Impaired oral-motor function in children with Down's syndrome: a study of three twin pairs. European Journal of Disorders of Communication. 30, 77-87. [14] Tabain, M. 2001. Variability in Fricative Production and Spectra: Implications for the Hyper- and Hypo- and Quantal Theories of Speech Production. Language and Speech 44, 1, 57-94. [15] Weismer, G. 1997. Motor Speech Disorders. In W. J. Hardcastle & J. Laver (Eds) The Handbook of Phonetic Sciences. Oxford: Blackwell, 191-220.pub41pu

Prosody and its relationship to language in school-aged children with high-functioning autism.

This series consists of unpublished working- papers. They are not final versions and may be superseded by publication in journal or book form, which should be cited in preference. All rights remain with the author(s) at this stage, and circulation of a work in progress in this series does not prejudice its later publication. Comments to authors are welcome. Subsequent publication & presentation details: Dec 2006, in press at International Journal of Language and Communication Disorders.Disordered expressive prosody is a widely reported characteristic of the speech of individuals with autism. Despite this, it has received little attention in the research literature and the few studies that have addressed it have not described its relationship to other aspects of communication. This study investigated the prosody and language skills of 31 children with high functioning autism. The children completed a battery of speech, language and nonverbal assessments and a procedure for assessing receptive and expressive prosody.Language skills varied, but the majority of children had deficits in at least one aspect of language with expressive language most severely impaired. All of the children had difficulty with at least one aspect of prosody and prosodic ability correlated highly with expressive and receptive language.caslunpub141unpu

The prosody-language relationship in children with high-functioning autism

Submitted for publication in Gomez, J., McGregor, E., Nunez, M. and Williams, K. (Eds.). Autism: An Integrated View. Oxford: Blackwell Publishing, due for publication 2007Abstract In Kanner's original description of autism he noted disordered prosody as a common feature. Despite this, the area has received very little attention in the literature and those studies that have addressed prosody in autism have not addressed its relationship to other aspects of communication. This chapter will give an overview of research in this area to date and summarise the findings of a study designed to investigate the prosody and language skills of 31 children with high functioning autism. Two case studies of children with autism will be used to illustrate the relationship between language and prosody and to emphasise the prosodic impairment present in many children with autism.caslunpub148unpu

The relationship between speech, oromotor, language and cognitive abilities in children with Down's syndrome.

This series consists of unpublished working- papers. They are not final versions and may be superseded by publication in journal or book form, which should be cited in preference. All rights remain with the author(s) at this stage, and circulation of a work in progress in this series does not prejudice its later publication. Comments to authors are welcome.Background: Children and young people with Down's syndrome (DS) present with deficits in expressive speech and language, accompanied by strengths in vocabulary comprehension compared to nonverbal mental age. Speech intelligibility is particularly impaired, but whether speech is delayed or disordered is a controversial topic. Most studies suggest a delay, but no studies explore the relationship between cognitive or language skills and intelligibility. This study sought to determine whether severity of speech disorder correlates with language and cognitive level and to describe the types of errors, developmental or non-developmental, that occur in the speech of children and adolescents with DS. Methods & Procedures: 15 children and adolescents with DS (aged 10 to 18) were recruited. Participants completed a battery of standardised speech, language and cognitive assessments. The phonology assessment was subject to process analyses. Results from each test were correlated to determine relationships. Outcome & Results: People with DS present with deficits in receptive and expressive language that is not wholly accounted for by their cognitive delay. Receptive vocabulary is a strength in comparison to language skills, but it was unclear whether it is more advanced compared to non-verbal cognitive skills. The majority of speech errors were developmental in nature but all of the children with DS showed at least one atypical or non-developmental speech error.Conclusions: Children with DS present with speech disorders characterised by (often unusual) atypical errors alongside many developmental errors. Lack of correlation between speech and cognition or language suggests that the speech disorder in Down's syndrome is not simply due to cognitive delay.caslpub155pubWP-1

Using Electropalatography (EPG) in the assessment and treatment of developmental motor speech disorders: Linking basic and applied research

This series consists of unpublished working- papers. They are not final versions and may be superseded by publication in journal or book form, which should be cited in preference. All rights remain with the author(s) at this stage, and circulation of a work in progress in this series does not prejudice its later publication. Comments to authors are welcome.Many children experience significant difficulties in developing key aspects of speech. For some, these communication difficulties are compounded by co-occurring intellectual disabilities. This paper presents two case studies from a larger on-going longitudinal study of the effectiveness of using electropalatography (EPG) to address the intelligibility problems experienced by many children and young people with Down's syndrome (DS). EPG, an innovative computer-based tool for assessing and treating speech motor difficulties, enables the speaker to see- the placement of his or her tongue during speech and to attempt to correct any lingual palatal errors. This visual supplementation of auditory feedback offers potential therapeutic benefits for children with intellectual disabilities, many of whom show relative strengths in visual versus auditory and simultaneous versus sequential processing (e.g. [1]). EPG also provides therapists with an objective measure of articulatory ability. Findings from these two case studies demonstrate the potential utility of EPG in both the assessment and treatment of speech motor disorders in DS.caslpub156pubWP-1

Site investigation for the effects of vegetation on ground stability

The procedure for geotechnical site investigation is well established but little attention is currently given to investigating the potential of vegetation to assist with ground stability. This paper describes how routine investigation procedures may be adapted to consider the effects of the vegetation. It is recommended that the major part of the vegetation investigation is carried out, at relatively low cost, during the preliminary (desk) study phase of the investigation when there is maximum flexibility to take account of findings in the proposed design and construction. The techniques available for investigation of the effects of vegetation are reviewed and references provided for further consideration. As for general geotechnical investigation work, it is important that a balance of effort is maintained in the vegetation investigation between (a) site characterisation (defining and identifying the existing and proposed vegetation to suit the site and ground conditions), (b) testing (in-situ and laboratory testing of the vegetation and root systems to provide design parameters) and (c) modelling (to analyse the vegetation effects)

Developmentally appropriate transitional care during the Covid-19 pandemic for young people with juvenile-onset rheumatic and musculoskeletal diseases: the rationale for a position statement

From Springer Nature via Jisc Publications RouterHistory: received 2021-03-26, accepted 2021-06-06, registration 2021-07-31, pub-electronic 2021-08-25, online 2021-08-25, collection 2021-12Publication status: PublishedAbstract: Background: The importance of developmentally appropriate transitional care in young people with juvenile-onset rheumatic and musculoskeletal disease is well recognised. The Paediatric Rheumatology European Society (PReS) / European League Against Rheumatism (EULAR) Taskforce has developed international recommendations and standards for transitional care and a growing evidence base supports the positive benefits of such care. However, there is also evidence that universal implementation has yet to be realised. In 2020, against this background the COVID-19 pandemic arrived with significant impact on all our lives, young and old, patient, public and professional alike. The unfortunate reality of the pandemic with potential for unfavourable outcomes on healthcare provision during transition was acknowledged by the PReS working groups in a position statement to support healthcare professionals, young people and their caregivers. Aim: The aim of this review is to present the literature which provides the rationale for the recommendations in the PReS Position Statement. Summary: The following areas are specifically addressed: the prime importance of care coordination; the impact of the pandemic on the various aspects of the transition process; the importance of ensuring continuity of medication supply; the pros and cons of telemedicine with young people; ensuring meaningful involvement of young people in service development and the importance of core adolescent health practices such as routine developmental assessment psychosocial screening and appropriate parental involvement during transitional care

Study protocol for a randomized controlled trial comparing the efficacy of a specialist and a generic parenting programme for the treatment of preschool ADHD

BACKGROUND: The New Forest Parenting Programme (NFPP) is a home-delivered, evidence-based parenting programme to target symptoms of attention-deficit/hyperactivity disorder (ADHD) in preschool children. It has been adapted for use with 'hard-to-reach' or 'difficult-to-treat' children. This trial will compare the adapted-NFPP with a generic parenting group-based programme, Incredible Years (IY), which has been recommended for children with preschool-type ADHD symptoms.METHODS/DESIGN: This multicentre randomized controlled trial comprises three arms: adapted-NFPP, IY and treatment as usual (TAU). A sample of 329 parents of preschool-aged children with a research diagnosis of ADHD enriched for hard-to-reach and potentially treatment-resistant children will be allocated to the arms in the ratio 3:3:1. Participants in the adapted-NFPP and IY arms receive an induction visit followed by 12 weekly parenting sessions of 1½ hours (adapted-NFPP) or 2½ hours (IY) over 2.5 years. Adapted-NFPP will be delivered as a one-to-one home-based intervention; IY, as a group-based intervention. TAU participants are offered a parenting programme at the end of the study. The primary objective is to test whether the adapted-NFPP produces beneficial effects in terms of core ADHD symptoms. Secondary objectives include examination of the treatment impact on secondary outcomes, a study of cost-effectiveness and examination of the mediating role of treatment-induced changes in parenting behaviour and neuropsychological function. The primary outcome is change in ADHD symptoms, as measured by the parent-completed version of the SNAP-IV questionnaire, adjusted for pretreatment SNAP-IV score. Secondary outcome measures are: a validated index of behaviour during child's solo play; teacher-reported SNAP-IV (ADHD scale); teacher and parent SNAP-IV (ODD) Scale; Eyberg Child Behaviour Inventory - Oppositional Defiant Disorder scale; Revised Client Service Receipt Inventory - Health Economics Costs measure and EuroQol (EQ5D) health-related quality-of-life measure. Follow-up measures will be collected 6 months after treatment for participants allocated to adapted-NFPP and IY.DISCUSSION: This trial will provide evidence as to whether the adapted-NFPP is more effective and cost-effective than the recommended treatment and TAU. It will also provide information about mediating factors (improved parenting and neuropsychological function) and moderating factors (parent and child genetic factors) in any increased benefit.TRIAL REGISTRATION: Current Controlled Trials, ISRCTN39288126.</p