The Effects of Altered Auditory Feedback (AAF) on Fluency in Adults Who Stutter: A Systematic Review

Background and Objectives: Stuttering affects 70 million people worldwide, which is about 1% of the population. Altered auditory feedback (AAF) is a process by which an individual’s auditory speech signal is electronically changed to temporarily increase the fluency of a person who stutters. For the purpose of this systematic review, AAF includes delayed auditory feedback (DAF) and frequency-altered feedback (FAF). This systematic review examines fluency enhancement in adults who stutter when using AAF devices. Methods: A review of the literature was searched using PubMed, Ovid MEDLINE, PsycINFO, and CINAHL databases with key search terms related to stuttering and AAF. Inclusion criteria included: 1) adults ages ≥ 18 years old who stutter, 2) comparison of altered auditory feedback forms and/or no altered auditory feedback forms in the treatment of stuttering, 3) inclusion of DAF or FAF, 4) outcomes related to aspects of stuttering or people who stutter (e.g., fluency level, speech naturalness, speech rate), and 5) experimental research. Studies were quality assessed and rated by the authors. Results: A total of 16 articles were included in this review. Articles were of ‘moderate’ quality. Conclusions: AAF devices are generally effective in reducing stuttering frequency, with most notable fluency enhancement occurring during oral reading. The degree of fluency enhancement between individuals who stutter is variable and is influenced by factors such as stuttering severity. While research generally supports the use of AAF devices in reducing stuttering frequency, there are inconsistent findings regarding speech naturalness. AAF is likely most effective when used in conjunction with traditional speech therapy. Further research is needed to better understand the relationship between AAF and stuttering, particularly regarding unstructured speaking tasks and speech naturalness.https://scholarworks.uvm.edu/csdms/1004/thumbnail.jp

Noninvasive Metrics for Identification of Brain Injury Deficits in Piglets

Balance and bispectral index metrics were evaluated in piglets following focal and diffuse brain injury. A significant decrease in bispectral index existed at 24 hours after diffuse brain injury, but not after focal injury. Postural sway increased at 1–6 hours after both focal and diffuse injuries

Identification of Sensory Processing and Integration Symptom Clusters: A Preliminary Study

Rationale. This study explored subtypes of sensory processing disorder (SPD) by examining the clinical presentations of cluster groups that emerged from scores of children with SPD on the Sensory Processing 3-Dimension (SP-3D) Inventory. Method. A nonexperimental design was used involving data extraction from the records of 252 children with SPD. Exploratory cluster analyses were conducted with scores from the SP-3D Inventory which measures sensory overresponsivity (SOR), sensory underresponsivity (SUR), sensory craving (SC), postural disorder, dyspraxia, and sensory discrimination. Scores related to adaptive behavior, social-emotional functioning, and attention among children with different sensory modulation patterns were then examined and compared. Results. Three distinct cluster groups emerged from the data: High SOR only, High SUR with SOR, and High SC with SOR. All groups showed low performance within multiple domains of adaptive behavior. Atypical behaviors associated with social-emotional functioning and attention varied among the groups. Implications. The SP-3D Inventory shows promise as a tool for assisting in identifying patterns of sensory dysfunction and for guiding intervention. Better characterization can guide intervention precision and facilitate homogenous samples for research

Finite Element Model Predictions of Intracranial Hemorrhage From Non-impact, Rapid Head Rotations in the Piglet

Clinicians are charged with the significant task of distinguishing between accidental and inflicted head trauma. Oftentimes this distinction is straightforward, but many times probabilities of injuries from accidental scenarios are unknown making the differential diagnosis difficult. For example, it is unknown whether intracranial hemorrhage (IH) can occur at a location other than a focal contact site following a low height fall. To create a foundation for predicting regional IH in infants, we sought to identify the biomechanical response and injury threshold best able to predict IH in 3–5 day old piglets. First, finite element (FE) model simulations of in situ animal studies were performed to ascertain the optimal representation of the pia-arachnoid complex, cerebrospinal fluid and cortical vasculature (PCC) for predicting brain strain and brain/skull displacement. Second, rapid head rotations resulting in various degrees of IH were simulated (n = 24) to determine the biomechanical predictor and injury threshold most closely correlated with IH. FE models representing the PCC with either spring connectors or solid elements between the brain and skull resulted in peak brain strain and brain/skull displacement similar to measured values in situ. However, when predicting IH, the spring connector representation of the PCC had the best predictive capability for IH with a sensitivity of 80% and a specificity of 85% when ≥1% of all spring connectors had at least a peak strain of 0.31 mm/mm. These findings and reported methodology will be used in the development of a human infant FE model to simulate real-world falls and identify injury thresholds for predicting IH in infants

The role of early childhood psychological factors in determining risk for enuresis at school age in a UK cohort

There is evidence for a link between psychological factors and bedwetting, but the direction of this association is unclear. Using data on 8769 children from the Avon Longitudinal Study of Parents and Children, we examined whether difficult temperament (Toddler Temperament Scale at 24 months; Emotionality Activity Sociability Questionnaire at 38 months) and psychological problems (Revised Rutter Parent Scale for Preschool Children at 42 months) are linked to bedwetting at school age. We examined the association between these risk factors and different patterns of bedwetting from 4 to 9 years using multinomial regression. Difficult temperament and psychological problems in early childhood were associated with increased odds of bedwetting at 4–9 years. The strongest associations were most often found for the pattern of bedwetting that was both frequent (at least twice a week) and persistent (up to age 9) e.g. the temperament traits of ‘adaptability’ and ‘mood’ were associated with a 33 % increase (95 % confidence interval = 1.14–1.55) and a 27 % increase (1.10–1.47) respectively in the odds of persistent and frequent bedwetting per one standard deviation increase in risk score. Early behaviour problems (e.g. conduct problems [1.43 (1.25, 1.63)] and hyperactivity [1.29 (1.11, 1.50), p < 0.001]) were also associated with frequent and persistent bedwetting, but there was less evidence that early emotional difficulties were risk factors for bedwetting. Adjustment for confounders did not alter these conclusions. The presence of difficult temperament and behaviour problems in early childhood might help to identify children who will continue to experience bedwetting at school age. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00787-015-0756-7) contains supplementary material, which is available to authorized users

A longitudinal investigation of childhood communication ability and adolescent psychotic experiences in a community sample

Background: Some childhood speech and language impairments precede psychosis but it is not clear whether they also precede adolescent psychotic experiences and whether this association is specific to psychotic experiences. Methods: Pragmatic language and expressive speech and language (parent-assessed using the Children's Communication Checklist) at age 9 and psychotic experiences and depression at ages 12 and 18 were investigated in 7659 participants from the Avon Longitudinal Study of Parents and Children. Associations were investigated using multivariate modelling. Results: Poorer pragmatic language at 9 years was associated with psychotic experiences at both ages (12 years OR 1.22, 95% CI 1.11, 1.34; 18 years OR 1.25, 95% CI 1.10, 1.41) but only with depression at 18 years (OR 1.10, 95% CI 1.00, 1.22). Poorer expressive speech and language ability was not associated with psychotic experiences or depression at either age. There was evidence that pragmatic language was specifically associated with psychotic experiences at age 12 but no evidence that the strength of any of the associations changed over time. Conclusions: Deficits in pragmatic language precede early and late adolescent psychotic experiences and early adolescent depression. Interventions aimed at helping children improve pragmatic language skills may reduce the incidence of adolescent psychopathology and associated psychological disorder and dysfunction later in life

De Novo Occurrence of a Variant in ARL3 and Apparent Autosomal Dominant Transmission of Retinitis Pigmentosa.

BackgroundRetinitis pigmentosa is a phenotype with diverse genetic causes. Due to this genetic heterogeneity, genome-wide identification and analysis of protein-altering DNA variants by exome sequencing is a powerful tool for novel variant and disease gene discovery. In this study, exome sequencing analysis was used to search for potentially causal DNA variants in a two-generation pedigree with apparent dominant retinitis pigmentosa.MethodsVariant identification and analysis of three affected members (mother and two affected offspring) was performed via exome sequencing. Parental samples of the index case were used to establish inheritance. Follow-up testing of 94 additional retinitis pigmentosa pedigrees was performed via retrospective analysis or Sanger sequencing.Results and conclusionsA total of 136 high quality coding variants in 123 genes were identified which are consistent with autosomal dominant disease. Of these, one of the strongest genetic and functional candidates is a c.269A&gt;G (p.Tyr90Cys) variant in ARL3. Follow-up testing established that this variant occurred de novo in the index case. No additional putative causal variants in ARL3 were identified in the follow-up cohort, suggesting that if ARL3 variants can cause adRP it is an extremely rare phenomenon

Omega-3 and Omega-6 Fatty acids and risk of psychotic outcomes in the ALSPAC birth cohort

Background Long chain polyunsaturated fatty acid (PUFA) levels have been implicated in the pathology of psychotic disorders. We investigated the relationship between childhood PUFA levels and later psychotic experiences (PE's) in a large birth cohort. Methods Plasma levels of Ω-3 and Ω-6 fatty acids (FA's) were assayed at ages 7 and 16 years. PE's were assessed at ages 12 and 18 years using a semi-structured interview. Primary outcome was any PE's at 18 years; sensitivity analyses examined incident PE's between ages 12 and 18 years, persistent PE's (at 12 and 18) and psychotic disorder at 18 years. Genetic instruments for Ω-3 and Ω-6 were derived and used in a multivariable Mendelian Randomization analysis. Results Higher levels of Ω-6 FA's AA, OA and AdA at age 7 years were weakly associated with a reduced risk for PE's at 18 years, however, effect sizes were small and attenuated after adjusting for confounders (strongest evidence for OA; adjusted OR, 0.842; 95% CI, 0.711, 0.998; p, 0.048). Total Ω-6 levels at age 16 years were associated with an increased odds of psychotic disorder at age 18 years. However, there was no association between Ω-6/Ω-3 ratio and psychosis outcomes, nor with genetic instruments of total Ω-3 or Ω-6 levels. Conclusions There is no strong evidence that total plasma Ω-3 FA levels or Ω-6/Ω-3 ratios in childhood and mid-adolescence are associated with increased risk for PE's or psychotic disorder, but very marginal evidence that alterations in the Ω-6 pathway at developmental time points might influence risk2