Dynamic assessment and informed intervention for children with language impairment

Although speech and language therapy practitioners commonly place great weight on standardised, static assessment, the procedures may not be fully representative, and reveal little about the child’s learning potential or the direction that intervention should take. Vygotsky’s theories, particularly his notion of the Zone of Proximal Development, underpin a range of approaches within the complementary assessment paradigm known as Dynamic Assessment (DA) (Vygotsky 1986). The term is used for assessments consisting of ‘active intervention by the examiners and assessment of examinees’ response to intervention” (Haywood and Lidz 2007 P1) The current project investigated the application of Dynamic Assessment to a population of children with previously identified Language Impairments. As in parallel studies of intelligence, both manifest skills of language, and underlying processes used in manipulating and constructing language as a tool, were elucidated. The contribution that such an assessment can make to extending the understanding of language impairment, and in devising intervention programmes was investigated. This thesis describes the development of a Dynamic Assessment task requiring implicit knowledge of syntactic structure. The construction of the procedure was a novel adaptation and combination of established DA methodologies that are described and evaluated in Chapter 1. The task, which is essentially a sentence anagram, comprised 12 items specifically selected to assess particular grammatical structures reported in Chapter 2 to be problematic in children with Specific Language Impairments (SLI). The details of the task construction are reported in Chapter 3. The measure was employed on 24 children aged 8-10, with identified language impairment, and the results are reported in Chapter 4. Inter-rater reliability of the test measure was 88%, and the sensitivity of the test to change over time was demonstrated. Information about participants’ ability to transfer learning between items, their ability to use less directive prompts, their strategy use, and their metalinguistic and metacognitive awareness was extracted, and reported to the speech and language therapists working with the children. Evaluation of the test is discussed in Chapter 5. The thesis also reports on an investigation of the role of the information derived from the DA in informing intervention programmes (Chapter 6). The same cohort of 24 children with SLI was randomly allocated to two groups. Reports from the DA were used to inform the ongoing language intervention of one of the groups of children. In Chapter 7 the outcomes of therapy from that group were compared to the outcomes of the group receiving regular intervention. Differences between groups were nonsignificant although the gains achieved by subgroups of children were predicted, and in particular children making little progress in their ongoing therapy were shown to derive most benefit from the modified intervention. The information was rated as useful by participating SLTs who altered the nature of their intervention strategies. Discussion of the results and identification of factors such as emotional and behavioural issues that affect progress in intervention are discussed in Chapter 8. Implications for further development of the DA paradigm are discussed, and conclusions are summarized in Chapter 9.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Dynamic assessment of children with language impairments: A pilot study

This article describes the construction of a procedure for dynamic assessment of the expressive grammar of children already identified with language impairments. Few instruments exist for the dynamic assessment of language, and those that have been developed have been largely used to successfully differentiate language impaired from culturally different or typically developing populations. The emphasis in this study was on eliciting clinically useful information that may be used to inform intervention for children with specific language impairment (SLI). The method was piloted on three children with specific language impairments.The test—train—retest format made use of standardized administration of the CELF-3 (UK) before and after a designated training protocol. The training procedure required the children to formulate sentences from randomly presented words, assisted by mediation from the assessor. Results showed that the task used was valuable and appropriate for use as a dynamic measure, and elicited differentiated amounts of change in the children in response to the mediated training phase. Pre-test—post-test results were inconclusive, however, and the frameworks for summarizing information could benefit from revision

Multiomics modeling of the immunome, transcriptome, microbiome, proteome and metabolome adaptations during human pregnancy.

MotivationMultiple biological clocks govern a healthy pregnancy. These biological mechanisms produce immunologic, metabolomic, proteomic, genomic and microbiomic adaptations during the course of pregnancy. Modeling the chronology of these adaptations during full-term pregnancy provides the frameworks for future studies examining deviations implicated in pregnancy-related pathologies including preterm birth and preeclampsia.ResultsWe performed a multiomics analysis of 51 samples from 17 pregnant women, delivering at term. The datasets included measurements from the immunome, transcriptome, microbiome, proteome and metabolome of samples obtained simultaneously from the same patients. Multivariate predictive modeling using the Elastic Net (EN) algorithm was used to measure the ability of each dataset to predict gestational age. Using stacked generalization, these datasets were combined into a single model. This model not only significantly increased predictive power by combining all datasets, but also revealed novel interactions between different biological modalities. Future work includes expansion of the cohort to preterm-enriched populations and in vivo analysis of immune-modulating interventions based on the mechanisms identified.Availability and implementationDatasets and scripts for reproduction of results are available through: https://nalab.stanford.edu/multiomics-pregnancy/.Supplementary informationSupplementary data are available at Bioinformatics online

Multiomics modeling of the immunome, transcriptome, microbiome, proteome and metabolome adaptations during human pregnancy

Motivation Multiple biological clocks govern a healthy pregnancy. These biological mechanisms produce immunologic, metabolomic, proteomic, genomic and microbiomic adaptations during the course of pregnancy. Modeling the chronology of these adaptations during full-term pregnancy provides the frameworks for future studies examining deviations implicated in pregnancy-related pathologies including preterm birth and preeclampsia. Results We performed a multiomics analysis of 51 samples from 17 pregnant women, delivering at term. The datasets included measurements from the immunome, transcriptome, microbiome, proteome and metabolome of samples obtained simultaneously from the same patients. Multivariate predictive modeling using the Elastic Net (EN) algorithm was used to measure the ability of each dataset to predict gestational age. Using stacked generalization, these datasets were combined into a single model. This model not only significantly increased predictive power by combining all datasets, but also revealed novel interactions between different biological modalities. Future work includes expansion of the cohort to preterm-enriched populations and in vivo analysis of immune-modulating interventions based on the mechanisms identified. Availability and implementation Datasets and scripts for reproduction of results are available through: Https://nalab.stanford.edu/multiomics-pregnancy/

The Role of the Neighborhood Social Environment in Physical Activity among Hispanic Children: Moderation by Cultural Factors and Mediation by Neighborhood Norms.

Little is known about how the neighborhood social environment (e.g., safety, crime, traffic) impacts child physical activity. We examine the mechanism by which the neighborhood social environment is associated with child physical activity, moderated by individual-level cultural factors (e.g., language at home, immigrant generation) and mediated by neighborhood physical activity-related social norms (e.g., seeing walkers in the neighborhood). Data included 2749 non-Hispanic White and Hispanic children from the Healthy Communities Study. Multilevel regression was performed. The neighborhood social environment was not associated with physical activity in the full sample. However, Hispanic children speaking both English and Spanish and first- or second-generation Hispanic children engaged in more physical activity when the quality of the neighborhood social environment was higher (b = 1.60, p < 0.001 for Hispanic children speaking English and Spanish; b = 2.03, p < 0.01 for first-generation Hispanic children; b = 1.29, p < 0.01 for second-generation Hispanic children). Neighborhood physical activity-related social norms mediated the association between the neighborhood social environment and physical activity among Hispanic children speaking English and Spanish (b = 0.33, p < 0.001) and second-generation Hispanic children (b = 0.40, p < 0.001). Findings suggest heterogeneity in how neighborhood social environments impact physical activity by cultural factors. Health promotion programs may need to enhance neighborhood social environments to increase Hispanic children's physical activity

The Role of the Neighborhood Social Environment in Physical Activity among Hispanic Children: Moderation by Cultural Factors and Mediation by Neighborhood Norms

Little is known about how the neighborhood social environment (e.g., safety, crime, traffic) impacts child physical activity. We examine the mechanism by which the neighborhood social environment is associated with child physical activity, moderated by individual-level cultural factors (e.g., language at home, immigrant generation) and mediated by neighborhood physical activity-related social norms (e.g., seeing walkers in the neighborhood). Data included 2749 non-Hispanic White and Hispanic children from the Healthy Communities Study. Multilevel regression was performed. The neighborhood social environment was not associated with physical activity in the full sample. However, Hispanic children speaking both English and Spanish and first- or second-generation Hispanic children engaged in more physical activity when the quality of the neighborhood social environment was higher (b = 1.60, p < 0.001 for Hispanic children speaking English and Spanish; b = 2.03, p < 0.01 for first-generation Hispanic children; b = 1.29, p < 0.01 for second-generation Hispanic children). Neighborhood physical activity-related social norms mediated the association between the neighborhood social environment and physical activity among Hispanic children speaking English and Spanish (b = 0.33, p < 0.001) and second-generation Hispanic children (b = 0.40, p < 0.001). Findings suggest heterogeneity in how neighborhood social environments impact physical activity by cultural factors. Health promotion programs may need to enhance neighborhood social environments to increase Hispanic children’s physical activity

The effects of interrupting prolonged sitting with intermittent activity on appetite sensations and subsequent food intake in preadolescent children

<div><p>Background</p><p>Short-term and long-term exposure to prolonged sitting is associated with excess food intake and weight gain in children. Interrupting prolonged sitting with low-intensity activity has been shown to not alter hunger, satiety, or food consumption in children, however it is unclear whether interrupting sitting with high-intensity activity will alter appetite regulation in children.</p><p>Purpose</p><p>The purpose of this study was to examine the acute effects of interrupting prolonged sitting with intermittent activity performed at varying intensities on hunger, satiety, prospective food consumption (PFC), and food intake in preadolescent children.</p><p>Methods</p><p>Thirty-nine children (ages 7–11 years, 54% female, 33% overweight/obese) completed four experimental conditions in random order: 8 hours of sitting interrupted with 20, 2-minute low-, moderate-, or high-intensity activity breaks or 20, 2-minute sedentary screen time breaks. Exercise intensity corresponded with 25%, 50% and 75% of heart rate reserve, respectively. Hunger, satiety, and PFC were assessed using the Visual Analog Scale, at five time points (pre- and post-breakfast, pre- and post-lunch, and pre-dinner) during each experimental condition. Dietary compensation was assessed as total caloric intake during a post-condition dinner standardized to provide 70% of estimated daily energy requirements.</p><p>Results</p><p>There was a significant effect of time on hunger, satiety, and PFC throughout each condition day (p< 0.001). There were no differences across conditions for hunger (sedentary: 4.9±0.3 cm, low: 5.0±0.3 cm, moderate: 5.1±0.3 cm, high: 5.1±0.3 cm, p>0.05), satiety (sedentary: 4.7±0.3 cm, low: 4.4±0.3 cm, moderate: 4.6±0.3 cm, high: 4.2±0.3 cm, p>0.05), and PFC (sedentary: 4.9±0.3 cm, low: 4.7±0.3 cm, moderate: 4.9±0.3 cm, high: 5.0±0.3 cm, p>0.05). There were no significant differences in post-activity food intake across conditions (sedentary: 1071.9±53.6 kcals; low: 1092.6±43.4kcals; moderate: 996.2±54.6kcals; high: 1138.7±62.8kcals, p>0.05). However, there was a significant effect of condition on energy balance (sedentary: +61.4±65.9 kcals, low: +74.9±57.6 kcals, moderate: -58.3±62.8 kcals, high: -391.2±77.9 kcals; p<0.001). There were no significant effects of weight status on hunger, satiety, PFC, post-activity food intake, and mean energy balance across conditions (all p’s>0.05).</p><p>Conclusions</p><p>Interrupting prolonged sitting with physical activity of any intensity does not alter appetite sensations and subsequent food consumption in children. These data suggest that interventions targeting prolonged sitting with high-intensity intermittent activity may be an effective strategy to increase physical activity energy expenditure without increasing food intake, allowing for a short-term energy deficit in both healthy weight and overweight/obese children. Future studies should examine the long-term effects of interrupting prolonged sitting with activity on food consumption and weight status in preadolescent children.</p></div