The Effects of Typically Developing Peers on the Participation and Language of Children With Complex Communication Needs During Shared Storybook Reading

Storybook reading and peer models have proven to be effective intervention strategies for children with communication disorders, however, there is limited research to support the use of these strategies as a duel approach for children using augmentative and alternative communication (AAC). The purpose of this study was to examine the effects of peer intervention and the use of manipulatives on children with disabilities who have complex communication needs using AAC during storybook reading and related activities. An evidence-based practice review of the literature was conducted to assess the current trends in storybook reading and identify the most effective and efficient ways to measure the child’s participation and engagement. A child using an AAC device participated in six storybook reading sessions that followed an alternating treatment design, with sessions alternating between peer/no peer and manipulatives/no manipulatives. The investigators used objective and subjective ratings to assess the participant’s engagement, enjoyment, participation, and attentiveness. Previous research and the results of the current study found that multiple measures are needed to assess the participation and engagement of children during storybook reading and related activities. Additional results revealed that the participant’s verbalizations increased with the presence of the peer and the manipulatives. The participant’s use of the AAC device increased with repeated storybook readings and the removal of manipulatives. The presence of the peer had no effect on the participant’s focused attention, however, the participant focused on the manipulatives, when present, for the majority of time

Morphological and cellular changes in secondary epidermal laminae of horses with insulin-induced laminitis

Objective—To determine cellular changes associated with secondary epidermal laminae (SEL) in forefeet and hind feet of ponies with insulin-induced laminitis.<p></p> Animals—8 ponies.<p></p> Procedures—Laminitis was induced in 4 ponies by IV administration of insulin and glucose; 4 control ponies received saline (0.9% NaCl) solution IV. Laminar tissue samples obtained from the dorsal aspects of the hooves were histologically evaluated. Primary epidermal lamina (PEL) length and width and SEL length, width, and angle were determined. Numbers of epidermal cell nuclei per micrometer and per total length of SEL and numbers of apoptotic and proliferative cells in axial, middle, and abaxial laminar regions were determined.<p></p> Results—SEL in treatment group ponies were significantly longer, were significantly narrower, and had a smaller angle relative to PEL in all laminar regions versus control ponies. In treatment group ponies, the number of epidermal cell nuclei per SEL was typically higher and the number of cells per micrometer of SEL was lower in laminar regions, apoptotic cell numbers were higher in abaxial and middle regions in forefeet and hind feet, and proliferating cell numbers were higher in axial laminar regions in forefeet and all laminar regions in hind feet, versus control ponies.<p></p> Conclusions and Clinical Relevance—Results indicated SEL elongation, narrowing, and alteration in orientation developed in all feet of ponies with insulin-induced laminitis. This was primarily attributable to cell stretching that developed at the same time as an accelerated cell death–proliferation cycle; differences in cell cycle responses among laminar regions between forefeet and hind feet may have been attributable to differences in load bearing.<p></p&gt