Impact of Noise and Working Memory on Speech Processing in Adults With and Without ADHD

Auditory processing of speech is influenced by internal (i.e., attention, working memory) and external factors (i.e., background noise, visual information). This study examined the interplay among these factors in individuals with and without ADHD. All participants completed a listening in noise task, two working memory capacity tasks, and two short-term memory tasks. The listening in noise task had both an auditory and an audiovisual condition. Participants included 38 young adults between the ages of 18-35 without ADHD and 25 young adults between the ages of 18-35 with ADHD. Results indicated that diagnosis, modality, and signal-to-noise ratio all have a main effect on a person\u27s ability to process speech in noise. In addition, the interaction between the diagnosis of ADHD, the presence of visual cues, and the level of noise had an effect on a person\u27s ability to process speech in noise. In fact, young adults with ADHD benefit less from visual information during noise than young adults without ADHD, an effect influenced by working memory abilities. These speech processing results are discussed in relation to theoretical models of stochastic resonance and working memory capacity. Implications for speech-language pathologists and educators are also discussed

Gains, Losses, and Life Goals Identified by Caregivers of Individuals with Disabilities in the United States

It is often reported that caregivers of individuals with disabilities experience stress as they manage caregiving responsibilities while they make the effort to balance family and work. Thirty-one caregivers of individuals with an array of disabilities in the United States completed a qualitative survey in this pilot study that asked them to identify their gains and losses from providing care and to identify their life goals. The gains from caregiving were identified as enhanced empathy and compassion, and the losses as strained family relationships, and less personal time. The most commonly identified life goals were experiencing happiness and achieving financial stability. The implications of these results on professionals’ attempts to support caregivers and their families are discussed

Linking Executive Functions and Written Language Intervention for Students with Language Learning Disorders

Purpose: School based speech-language pathologists (SLPs) has an important role in the identification and intervention of problems in oral and written language. In collaboration with classroom teachers, they often are asked to develop intervention plans that include evidence-based practices for those students with language learning disabilities (LLD) who have language deficits. The purpose of this article is to bridge theory to practice by explaining an evidence-based instructional model, the self-regulated strategy development model (SRSD), for SLPs to consider as they deliver instruction to support the written language deficits of students with LLD. Method: The authors examine critically the relationship between executive functions (EFs) and written expression. They discuss the EFs researchers have identified as important to students’ development of written expression and the difficulties students with LLD encounter in completing written expression tasks. The authors outline a model of EFs in relationship to the Not-So-Simple view of writing model which provides a framework for viewing the multiple components of the writing system. Conclusion: Based on the review of the literature, the SRSD is an effective evidence-based teaching model for instructing students with LLD that integrates and scaffolds the EFs essential for developing written expression skills

Audiovisual Speech-In-Noise (SIN) Performance of Young Adults with ADHD

Adolescents with Attention-deficit/hyperactivity disorder (ADHD) have difficulty processing speech with background noise due to reduced inhibitory control and working memory capacity (WMC). This paper presents a pilot study of an audiovisual Speech-In-Noise (SIN) task for young adults with ADHD compared to age-matched controls using eye-tracking measures. The audiovisual SIN task consists of varying six levels of background babble, accompanied by visual cues. A significant difference between ADHD and neurotypical (NT) groups was observed at 15 dB signal-to-noise ratio (SNR). These results contribute to the literature of young adults with ADHD.Comment: To be published in Symposium on Eye Tracking Research and Applications (ETRA '20 Short Papers), 6 pages, 3 figures, 2 table

Developing Speech-Language Pathology Students’ Grammatical Identification Skills Through Gamification

Background: Speech-Language Pathologists (SLPs) are communication experts required to analyze and interpret a variety of language components (Schuele, 2010). Language sampling is a form of communication analysis and is used with adult and pediatric populations. SLPs collect and analyze language samples in an effort to make evidence-based diagnostic and intervention decisions. When analyzing a language sample, sentences must be deconstructed along a variety of parameters. At Old Dominion University (ODU), the undergraduate Communication Sciences and Disorders program requires students to identify broad and specific grammatical categories during language sample analysis in preparation for clinical experiences. This research involves the design and implementaiton of a gaming application using spaced retrieval practice and principles of gaming theory to facilitate grammatical identification skills in undergraduate and graduate SLP students. Purpose: The primary aim of this project is to generate pilot data determining the utility of a gaming application (designed by the course instructor) for teaching grammatical category identification. The gaming application has been developed with an ODU undergraduate student and Information Technology specialists, and it is in the prototyping phase. There are three planned phases of application design in the pursuit of creating a generalizable and individualized tool for instruction at the elementary level and for other SLP college programs. Research Questions: 1) Do students who use the gaming application more accurately identify auxiliary verbs, main verbs, secondary verbs, subjective pronouns, objective pronouns, personal pronouns, and conjunctions more accurately than students who did not use the gaming application? 2) Over time, do students who use the gaming application perform better on accurately identifying auxiliary verbs, main verbs, secondary verbs, subjective pronouns, objective pronouns, personal pronouns, and conjunctions than students who do not use the gaming application?https://digitalcommons.odu.edu/gradposters2020_education/1002/thumbnail.jp

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation