Communication in Daily Life of Children With Developmental Language Disorder: Parents' and Teachers' Perspectives

Purpose: This study explores limitations in communication in daily life of children with developmental language disorder (DLD) from their parents' perspective as well as communicative abilities and social functioning in the classroom from their teacher's perspective. Furthermore, differences between children with mixed receptive–expressive disorder and children with expressive-only disorder in communication in daily life and social functioning are studied. Method: Data were collected through questionnaires completed by parents and teachers of children (5–6 years old) who attended schools for special education for DLD. Language test scores were retrieved from school records. Parents of 60 children answered open-ended questions about situations and circumstances in which their child was most troubled by language difficulties. Teachers of 83 children rated communicative abilities, social competence, and student–teacher relationship. Results: Parents reported communication with strangers as most troublesome and mentioned the influence of the mental state of their child. Parents considered limitations in expressing oneself and being understood and not being intelligible as core difficulties. Teachers rated the children's communicative abilities in the school context as inadequate, but their scores concerning social competence and the quality of teacher–child relationships fell within the normal range. Children with receptive–expressive disorder experienced limitations in communication in almost all situations, whereas those with expressive disorder faced limitations in specific situations. Children with receptive–expressive disorder were also significantly more limited in their communicative abilities and social competence at school than children with expressive disorder. No differences were found between the two groups in the quality of the teacher–child relationship. Conclusions: The results confirm that children with DLD face significant challenges in a variety of communicative situations. We found indications that children with receptive–expressive disorder experience more severe limitations than children with expressive disorder. The involvement of parents and teachers in evaluating a child's communicative ability provides valuable and clinically relevant information

First Steps Toward Positive Behavior Support in the Netherlands:A Pilot Study Exploring the Effectiveness of a Training for Staff

Despite the effectiveness of positive behavior support (PBS) in reducing challenging behaviors, the availability of PBS for individuals with intellectual disabilities is limited in many countries including the Netherlands. Training care staff supporting individuals with intellectual disabilities in PBS may be a way to improve the provision of PBS. We aimed to explore the preliminary effectiveness of a PBS training for staff in reducing challenging behaviors of individuals with intellectual disabilities. Using a one group, double pretest-posttest design, 24 staff members involved in the care of 11 adult individuals with intellectual disabilities and challenging behaviors participated. We assessed changes in challenging behaviors and quality of life of the individuals, in staff self-efficacy in dealing with challenging behaviors, and in the use of restraints, using staff rated questionnaires, structured interviews, and medical files. At posttest, we found significant reductions in challenging behaviors, improved quality of life, and increased staff self-efficacy, but no changes in the use of restraints. In contrast, no significant changes on any of the measures appeared between the two pretests. These findings suggest that a staff training in PBS may be effective for reducing challenging behaviors in individuals with intellectual disabilities

Exploring the association of staff characteristics with staff perceptions of quality of life of individuals with intellectual disabilities and challenging behaviours

Background This study aimed to examine the associations between individual staff and staff team characteristics and quality of life of individuals with intellectual disabilities and challenging behaviours. Method With multilevel analyses, we examined educational level, experience, attitudes and behaviours of 240 staff members, in relation to their perception of quality of life of 152 individuals with intellectual disabilities and challenging behaviours they cared for. Results Two individual staff characteristics were related to better quality of life: higher educational and self-reflection levels. Of the team characteristics, higher educational level, higher self-efficacy and more friendly behaviour were associated with better quality of life. Unexpectedly, higher staff-individual ratio was related to lower quality of life. Conclusions Both individual staff and staff team characteristics are associated with quality of life, indicating the need to take staff team characteristics into account when examining quality of life

Prenatally diagnosed submicroscopic familial aberrations at 18p11.32 without phenotypic effect

Background: Recent development of MLPA (Multiplex-Ligation-dependent Probe Amplification, MRC-Holland) and microarray technology allows detection of a wide range of new submicroscopic abnormalities. Publishing new cases and case reviews associated with both clinical abnormalities and a normal phenotype is of great value. Findings/results. We report on two phenotypically normal foetuses carrying a maternally-inherited interstitial submicroscopic abnormality of chromosome 18p11.32. Both abnormalities were found with the aneuploidy MLPA kit P095 during rapid aneuploidy detection, which was offered along with conventional karyotyping. Foetus 1 and its mother have a 1,7 Mb deletion and foetus 2 and its mother have a 1,9 Mb duplication. In both cases normal babies were born. We used the HumanCytoSNP-12 array of Illumina to visualize the CNVs and map the breakpoints. Conclusions: We suggest that a CNV at 18p11.32 (528,050-2,337,486) may represent a new benign euchromatic variant

Influence of wear and overwear on surface properties of etafilcon A contact lenses and adhesion of Pseudomonas aeruginosa

PURPOSE. To determine changes in physicochemical surface properties of contact tenses (CLs) during daily wear and effects of lens wear on adhesion of a Pseudomonas aeruginosa strain from a patient with CL-related keratitis.METHODS. Ten new CL wearers used ionic, etafilcon A lenses with 58% water on both eyes for approximately 10 hours each day during 10 and 50 days. All lenses were treated daily with an appropriate lens care solution. After the CLs were worn for 10 days (first pair of lenses) and 50 days (second pair, representing overwear), hydrophobicity by water contact angles, surface roughness by atomic force microscope, elemental surface composition by x-ray photoelectron spectroscopy (XPS), and adsorbed proteins by SDS-PAGE were determined on one lens. The lens from the contralateral eye was placed in a parallel plate flow chamber for bacterial adhesion after each time interval.RESULTS. Water contact angles on lenses changed from 45degrees on unused lenses to 61degrees +/- 25degrees after 10 days of wear and changed significantly (P &lt;0.05) to 27degrees +/- 14degrees after 50 days of wear. Surface roughness increased significantly (P &lt;0.05) from 4 +/- 2 nm (unused) to 10 +/- 7 nm after 50 days of wear. These changes were accompanied by adsorption of proteinaceous material, as evidenced by XPS and SDS-PAGE, demonstrating adsorption of lysozyme, tear lipocalin, and a 30-kDa protein. Initial bacterial adhesion to worn CLs was lower than to unworn CLs. Furthermore, detachment of adhering bacteria from worn lenses was easier than from unworn lenses. The changes observed in the physicochemical surface properties of the lenses after the CLs were worn for 50 days were accompanied by reports of discomfort by 6 of the 10 new CL wearers. Multiple regression analysis revealed that the most predictive variables for an effect on initial deposition after 10 days of wear were hydrophobicity, roughness, the presence of nitrogen-rich material, including the presence of a 30-kDa protein, and the presence of oxygen-rich material-that is, the type of oxygen adsorbed (O==C or O-C). After 50 days of wear, roughness and the presence of tear lipocalin were most predictive.CONCLUSIONS. This study demonstrates that the physicochemical surface properties changed after wear and overwear, whereas overwear of the lenses decreased initial adhesion of P. aeruginosa #3 under the present experimental conditions.</p

Bacterial transmission from contact lenses to porcine corneas:An ex vivo study

PURPOSE. To quantify the transmission to ex vivo porcine eyes of Staphylococcus aureus 835 and Pseudomonas aeruginosa 3 from three types of contact lenses - one daily wear and two extended wear - differing in hydrophobicity and roughness. METHODS. One daily wear lens (etafilcon) and two extended-wear lenses (one lotrafilcon A and one balafilcon A) were inoculated in a bacterial suspension for 30 minutes and then placed on ex vivo porcine eyes. After 16 hours of contact between lens and eye, confocal laser scanning microscopy was used to determine the number of bacteria on the lens and cornea for the calculation of transmission percentages. RESULTS. Transmission percentages were significantly different for both bacterial strains from an etafilcon A lens and balafilcon A lens (P = 0.006 and 0.04, respectively). Percentages varied from 51% to 68% for the hydrophobic P. aeruginosa and from 54% to 82% for the hydrophilic S. aureus strain, depending on the contact lens involved. Both strains were transferred the least from the most hydrophilic and roughest lens made of lotrafilcon A, although the difference was only statistically significant for S. aureus. CONCLUSIONS. Bacterial transmission to the porcine cornea differed in the various types of contact lenses and was least in the hydrophilic and rough lens type

Enlarged NT (≥3.5 mm) in the first trimester - Not all chromosome aberrations can be detected by NIPT

__Background:__ Since non-invasive prenatal testing (NIPT) in maternal blood became available, we evaluated which chromosome aberrations found in our cohort of fetuses with an enlarged NT in the first trimester of pregnancy (tested with SNP microarray) could be detected by NIPT as well. __Method:__ 362 fetuses were referred for cytogenetic testing due to an enlarged NT (≥3.5 mm). Chromosome aberrations were investigated using QF-PCR, karyotyping and whole genome SNP array. __Results:__ After invasive testing a chromosomal abnormality was detected in 137/362 (38 %) fetuses. 100/362 (28 %) cases concerned trisomy 21, 18 or 13, 25/362 (7 %) an aneuploidy of sex chromosomes and 3/362 (0.8 %) triploidy. In 6/362 (1.6 %) a pathogenic structural unbalanced chromosome aberration was seen and in 3/362 (0.8 %) a susceptibility locus for neurodevelopmental disorders was found. We estimated that in 2-10 % of fetuses with enlarged NT a chromosome aberration would be missed by current NIPT approaches. __Conclusion:__ Based on our cohort of fetuses with enlarged NT we may conclude that NIPT, depending on the approach, will miss chromosome aberrations in a significant percentage of pregnancies. Moreover all abnormal NIPT results require confirmatory studies with invasive testing, which will delay definitive diagnosis in ca. 30 % of patients. These figures are important for pretest counseling enabling pregnant women to make informed choices on the prenatal test. Larger cohorts of fetuses with an enlarged NT should be investigated to assess the additional diagnostic value of high resolution array testing for this indication

Bacterial adhesion to contact lenses

Worldwide 85 million people use contact lenses (CL's) as an alternative to spectacles,. However, this large population is at risk and makes the use of CL's an important health concern, as CL wear can induce microbial keratitis, which may result in permanent visual loss. Bacteria adhere to the lens surface and form an infectious biofilm, depending on the physico-chemical surface properties determined by the bacterial cell, the lens and the suspending liquid. Different episodes of usage cycle in wearing the contact lens affect the physico-chemical properties of the lens surface and therefore influence the adhesion of bacteria, as outlined in Chapter 1. ... Zie: Summary.