Early lexical expression in typically developing Maltese children : implications for the identification of language delay

Limited word production may be the first indicator of impaired language development. The unavailability of normative data and standardized assessments for young Maltese children hinders the identification of early language delays. This study aimed to document Maltese children’s expressive vocabulary growth and accompanying range of variation, to assist identification of children at risk for language impairment. The expressive vocabularies of 44 typically developing children aged 12–30 months were measured through caregiver report. Mean scores at each age point were characterized by substantial individual variation. Gender was not related to mean growth in vocabulary production. Minimum scores were compared to clinical thresholds for English-speaking children. Results emphasized the assessment- and language-specific nature of identification criteria. Nevertheless, established thresholds may be referred to when normative data for particular languages/language pairs are limited. In such contexts, the consideration of other risk markers gains importance in supplementing findings on lexical expression.peer-reviewe

The development of the English-Maltese assessment of speed of handwriting test

This commentary discusses the development of the English-Maltese Assessment of Speed of Handwriting (EMASH), a novel bilingual (English and Maltese) writing speed diagnostic assessment battery. The EMASH is an adaptation of the Detailed Assessment of Speed of Handwriting (DASH), a previously standardized English assessment battery developed by Barnett, Henderson, Scheib & Schulz, 2007 with the aim of identifying handwriting difficulties. Given the lack of evaluation instruments that measure writing speed performance that are standardized on the local population, or are in the mother tongue, this study sets out to realize the translation and adaptation of the DASH for the Maltese population. The DASH is not scientifically appropriate to administer and score on Maltese children since it is standardized on a UK population.peer-reviewe

Identifying a protocol to assess literacy-related skills in Maltese children and adolescents with Down syndrome

Acquiring the ability to read is a complex process that involves a number of skills. Recent literature confirms that many individuals with Down syndrome (DS) can acquire useful levels of reading ability which can open new opportunities. In contrast with the typically-developing (TD) population, students with DS portray an uneven pattern of development of pre-reading and reading skills. This commentary explores the aspects that need to be considered when assessing the pre-literacy and literacy abilities of students with DS in the Maltese bilingual context. Its aim is to identify the components of an assessment protocol that could be used to evaluate the literacy-related abilities of students with DS.peer-reviewe

The association of sentence imitation with other language domains in bilingual children

The association of sentence imitation with other language domains has been of interest to researchers and clinicians for decades. Sentence imitation taps both working memory and linguistic competence. Working memory refers to the ability to recall and manipulate linguistic information making sentence imitation a clinical marker for language ability. Meanwhile, research on the application of sentence imitation with bilingual language pairs is still emerging. This paper reports a study on a large sample of Maltese children brought up in an early bilingual language acquisition context. It analyses correlations between a sentence imitation task, verbal comprehension, narrative (story re-telling), phonological awareness and two measures of a phonology test: percentage consonants correct (PCC) and the inconsistency score. Data were collected from a total of 241 children, aged 24-72 months, who were selected randomly from the Public Birth Register. The sub-tests administered were part of a test battery, namely the Maltese-English Speech Assessment (MESA) (Grech, Dodd and Franklin, 2011) and the Language Assessment for Maltese Children (LAMC) (Grech, Franklin and Dodd, 2011). Correlations were calculated for the sentence imitation scores with specific language sub-test scores; significant correlations were identified as well as with chronological age. Regression analysis indicated that the sentence imitation sub-test of LAMC is a predictor for verbal comprehension and even stronger predictor for phonological awareness. It was concluded that performance on a sentence imitation task is a valid and reliable indication of Maltese bilingual children’s language ability.peer-reviewe

Contentious issues related to auditory processing disorder

A number of children undergo audiometric evaluation due to suspected hearing difficulties. Yet for some, their hearing sensitivity is found to be normal (Iliadou et al., 2017; Sharma, Purdy, & Kelly, 2009). Often, these children are described by parents and teachers as having difficulties to follow several instructions or attend to a conversation, and getting distracted when background noise is present (Iliadou et al., 2017; Witton, 2010). There are also reports of these children either misunderstanding or taking longer to understand simple verbal directions, and demonstrating selective hearing (Johnson, Benson, & Seaton, 1997). These weaknesses often cause educational, vocational and social challenges (American Speech-Language-Hearing Association (ASHA), 2005; British Society of Audiology (BSA, 2007). Children exhibiting these problems could be diagnosed with Auditory Processing Disorder (APD) (American Academy of Audiology (AAA), 2010; ASHA, 2005; BSA, 2007; Iliadou et al., 2017).peer-reviewe

The impact of socioeconomic status on auditory processing skills in Maltese children

Auditory processing skills (APS) may affect the development of language. Understanding the impact that socioeconomic status (SES) has on APS can help to identify individuals at risk of poor auditory processing skills and in turn develop more focused intervention strategies to target these skills before serious repercussions emerge. This study explored the impact of SES on the auditory processing skills of 41 Maltese children aged between 7 and 9 years. A self-devised questionnaire was used to gather information relating to the SES of the children, using maternal education and occupation to categorise SES. Such information was compared with the children’s performance on an auditory processing test battery in order to analyse its effect. Results demonstrated a significant correlation between SES groups and performance on the Duration Patterns Test (DPT), an auditory processing subtest which presents tones of varying duration as a stimulus. In addition, overall higher mean scores on almost all the tests were observed for the mid and high-mid socioeconomic groups. This study provides the first preliminary indications that lower SES could be associated with poorer APS in Maltese children.peer-reviewe

Local experience of transcutaneous bilirubinometry : an accurate alternative to serum sampling?

Background: Babies are frequently referred to the Paediatric Emergency Department from the Breastfeeding Clinic and Community Discharge Liaison service with jaundice as indicated by high transcutaneous bilirubin (TCB) readings measured using transcutaneous bilirubinometry. Serum bilirubin (SEB) testing is then performed in the Emergency Department and the need for admission for phototherapy decided based upon on SEB. If there is strict correlation between these modes of bilirubin measurement, there would be no need to verify TCB with SEB levels in cases where bilirubin is clearly above cut – off, thus reducing hospital waiting time, costs and time to starting treatment. --- Objectives: To establish whether TCB is a reliable screening test for neonatal jaundice necessitating phototherapy based on the relationship between TCB and SEB in patients in Malta. --- Method: Neonates referred from the Breastfeeding Clinic to the Paediatric Emergency Department with raised TCB over five months (June-October 2017) were included. Data was obtained from the Breastfeeding Clinic, local delivery suite and iSOFT Clinical Database, and interpreted using in-built data analysis tools and custom-made data analysis spreadsheets on Microsoft Excel®. --- Results: There was a significant difference between the two groups, mean TCB being significantly greater than SEB (t=2.32, p=0.04). However, TCB occasionally also under-read bilirubin levels. --- Conclusions: These findings differ from results of similar studies conducted in other centres. Given the significant difference between TCB and SEB, it is recommended that, locally, baseline SEB levels continue to be repeated in the Emergency Department prior to establishing the need for phototherapy in neonatal jaundice.peer-reviewe

Conceptual Framework for Speech Language Pathologists to Work with Migrants: A Focus on Malta

Abstract The goal of this paper is to describe the current state, needs and values of migrants with a focus on relevant global issues and Malta as a case study. It also aims to review services offered to these migrants, identify aspects that require attention and draw up a framework that could be applied to enhance services to the culturally diverse populations, particularly speech therapy. The health care services offered to migrants are reviewed in the light of attitudes and expectations. Professional perceptions and competences to work with these populations are also discussed and perceptions of migrants about services offered to them are taken into consideration. Issues related to equitable professional practice and the training of health care professionals to address needs of the cultural diverse community are discussed. Strategies to implement the conceptual framework are suggested

Auditory and language processing skills in Maltese children : a comparative study

Auditory processing disorder is described as a mixture of unrefined listening skills which, despite normal hearing, causes poor speech perception. These difficulties have also been reported in children with a diagnosis of language impairment (LI), literacy difficulties (LD)1, and attention-deficit/hyperactivity disorder (ADHD). The purpose of this study is to describe and compare the listening performance of typically developing (TD) children with those diagnosed with LI, LD, and ADHD on an assessment battery of auditory processing (AP) and language processing (LP). One hundred and one TD children and 53 children with a clinical diagnosis were assessed using four subtests of AP presenting linguistic stimuli, three AP subtests with non-linguistic stimuli and an assessment of LP. Parents of all children were required to fill in a questionnaire related to their listening difficulties. Parental report for the TD group on average yielded the lowest score, indicating fewer difficulties with listening skills in the TD group. The listening difficulties exhibited in the Maltese participants diagnosed with LI, LD and ADHD were mainly specific to the AP subtests using linguistic stimuli. The LI and LD groups generally performed significantly worse than the TD group on all AP subtests using linguistic stimuli, while the ADHD group performed significantly worse than the TD group on some of these tests. The same pattern did not emerge for the subtests using non-linguistic stimuli. Few significant effects between groups were evident. The LI groups were found to perform the weakest in all tests of language processing.peer-reviewe

A comparison of threats, vulnerabilities and management approaches in global seagrass bioregions

Global seagrass habitats are threatened by multiple anthropogenic factors. Effective management of seagrasses requires information on the relative impacts of threats; however, this information is rarely available. Our goal was to use the knowledge of experts to assess the relative impacts of anthropogenic activities in six global seagrass bioregions. The activities that threaten seagrasses were identified at an international seagrass workshop and followed with a web-based survey to collect seagrass vulnerability information. There was a global consensus that urban/industrial runoff, urban/port infrastructure development, agricultural runoff and dredging had the greatest impact on seagrasses, though the order of relative impacts varied by bioregion. These activities are largely terrestrially based, highlighting the need for marine planning initiatives to be co-ordinated with adjacent watershed planning. Sea level rise and increases in the severity of cyclones were ranked highest relative to other climate change related activities, but overall the five climate change activities were ranked low and experts were uncertain of their effects on seagrasses. The experts' preferred mechanism of delivering management outcomes were processes such as policy development, planning and consultation rather than prescriptive management tools. Our approach to collecting expert opinion provides the required data to prioritize seagrass management actions at bioregional scales