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Background: One of the most consistent findings reported in the paediatric cochlear implant (CI) literature is the heterogeneity of language performance observed more in grammatical morphology than in lexicon or pragmatics. As most of the corpus studies addressing these issues have been conducted in English, it is unclear whether their results can be generalized to other languages. In particular, little is known about languages known for their grammatical complexity, such as French. Aims: The aim of this corpus study was to compare the productive use of function words (FWs) and some agreement features (AGRs) in children with CIs and children with typical development (TD) matched for mean length of utterance in words (MLUwords), a general index of grammatical complexity, and auditory experience, as measured by hearing age (HA) and chronological age (CA), respectively. Methods & Procedures: Natural speech samples from 116 monolingual French‐speaking children, including 40 children with CIs followed longitudinally and 76 TD children, were collected. FWs and AGRs were analysed using a Part of Speech Tagger (POS‐T) from the Child Language Data Exchange System (CHILDES). Outcomes & Results: The two groups differed by 3 years for HA and CA. No effect of family socio‐economic status (SES) was found in the CI group. Stepwise regression analyses showed that the two groups did not share the same predictors of MLUwords: plurals and determiners predicted MLUwords in children with CIs, at 2 and 3 years of HA, whereas feminine markers and subject‐pronouns were found to best predict MLUwords in TD children at 2 and 3 years of CA. Structural equation models (SEMs), a combination of confirmatory factor analysis (CFA) and path analysis, yielded a different hierarchical structure of grammatical relations (GRs). Selective difficulties affecting verbal clitics and other pronominal forms were found specifically in the CI group (object‐pronouns, reflexive, relative and past participles). Dependency grammar analysis confirmed these contrasting developmental profiles in multiword utterances, such as preposition/nouns, subject/verbs, and verb/determiner/nouns. Conclusions & Implications: Atypical grammatical patterns in children with CIs reflect a specific architecture of syntactic dependencies of FWs underpinning morphological complexity and syntactic connectivity. Clinical implications are discussed for assessment and intervention planning. What This Paper Adds: What is already known on this subject: The productive use of FWs has been identified as a particular area of weakness in children with CIs compared with TD children. In addition, heterogenous grammatical performance has often been found after 1–3 years of CI use, regardless of demographic factors such as age at implantation, duration of deafness or SES. What this paper adds to existing knowledge: Assessing the early building of FWs and AGRs in children with CIs helps to understand the syntactic complexity and hierarchical structure of their language. Since most corpus studies on grammatical morphology have been conducted in English, it is not clear whether their difficulties can be generalized to other languages. The French language has a system of FWs and inflections that determine the morphophonological properties of nominal and verbal forms. Early grammar learning in children with CIs born with profound deafness were compared with the two groups of TD children matched both for duration of auditory experience (i.e., HA of CI children, CA of TD children) and for MLUwords. We found a similar profile between groups at 2 years but not at 3 years for HA and CA. The two groups do not share the same predictors of MLUwords: namely, plurals and determiners for CI children versus feminine markers and subject pronouns for TD children. They show a different syntactic organization of GRs. Children with CIs struggle with selective difficulties affecting verbal clitics and pronominal forms (object‐pronouns, reflexive, relative and past participles). Consistent with theories of morphophonological richness and syntactic connectivity, our results support the distributional learning hypothesis of language acquisition that infants and toddlers are sensitive to FWs and AGRs at an early age. Specific components of syntactic organization are disrupted in children with CIs. What are the potential or actual clinical implications of this work?: This work has potential clinical implications because it unravels the limitations of morphophonological processing in children with CIs. Its results highlight a specific difficulty in learning FWs and AGRs in a verbal inflectional morphology context. [ABSTRACT FROM AUTHOR]

Background: Digital game‐based learning is gaining increased attention from both researchers and educators for improving mathematics instruction. However, the evidence for game‐based learning is mixed and research with rigorous research design and analyses are limited. Objective: Here, in a pre‐registered randomized controlled study, we investigated whether a fraction game designed collaboratively by educational experts and professional game developers may serve as a useful tool to enhance students' fraction knowledge. Methods: We assigned French fifth graders to either an experimental group who used the game (n = 110) or a control group (n = 78) who received traditional instruction on fractions. Fraction knowledge was assessed pre‐ and post‐intervention. Results: Results show that students in the active control group had superior overall fraction performance than students in the experimental group at the end of intervention. However, the game had a positive effect on decimal learning. We also found a positive relation between game performance and overall fraction knowledge scores at post‐test. Contribution: The study highlights the importance of game metrics as indicators of personalized assessment tools. Given the increased usage of games in learning mathematics and the equivocal results on the effectiveness of these games, our study also highlights the importance of pre‐registration and randomized controlled studies. Lay Description: What is already known about this topic: Digital game‐based learning (DGBL) is gaining popularity in mathematics teaching.DGBL shows potential for teaching difficult abstract concepts such as fractions.However, research evaluating DGBL for fractions is limited. What this paper adds: The study examines a fraction game designed by education experts and game designers.Students fraction knowledge is assessed using paper‐based test.Challenges associated with DGBL in the classroom are discussed in the paper. Implications for practice: The results will guide educators in designing effective fraction instruction in classroom.The study highlights the critical role of instructional support in DGBL for fractions.Game based metrics can be used to individualize instruction in the classroom. [ABSTRACT FROM AUTHOR]

The objective of this paper is to describe gestational weight gain (GWG), to assess the applicability of the 2009 Institute of Medicine (IOM) guidelines, and to derive a GWG adequacy classification within a French cohort. We included twins from the national, prospective, population‐based JUmeaux MODe d'Accouchement (JUMODA) cohort study (2014–2015). Following the IOM approach, we selected a 'standard' population of term pregnancies with 'optimal' birthweight (≥2500 g; n = 2562). GWG adequacy (insufficient; adequate; excessive) was defined using IOM recommendations (normal body mass index [BMI]: 16.8–24.5 kg [also utilized for underweight BMI]; overweight: 14.1–22.7 kg; obese: 11.4–19.1 kg). Additionally, using the IOM approach, we determined the 25th and 75th percentiles of GWG in our standard population to create a JUMODA‐derived GWG adequacy classification. GWG and GWG adequacy were described, overall and by BMI and parity. In the JUMODA standard population of term twin livebirths with optimal birthweight, mean GWG was 16.1 kg (standard deviation 6.3). Using IOM recommendations, almost half (46.5%) of the women had insufficient and few (10.0%) had excessive GWG, with similar results regardless of BMI or parity. The 25th and 75th percentiles of GWG in the JUMODA standard population (underweight: 13–21 kg; normal weight: 13–20 kg; overweight: 11–19 kg; obese: 7–16 kg) were lower than the IOM recommendations. The IOM recommendations classified a relatively high percentage of French women as having insufficient and a low percentage as having excessive GWG. Additional research to evaluate recommendations in relation to adverse perinatal outcomes is needed to determine whether the IOM recommendations or the JUMODA‐derived classification is more appropriate for French twin gestations. Key messages: Using the 2009 Institute of Medicine (IOM) recommendations to define gestational weight gain (GWG) adequacy in our French cohort classified almost half of women as having insufficient GWG and a relatively low percentage as having excessive GWG.The USA‐derived IOM definition for adequate GWG may not apply in France or in other non‐USA, contemporary obstetric populations.Additional research in large, population‐based contemporary cohorts with prospective GWG ascertainment and assessment of GWG adequacy classifications in relation to adverse outcomes is needed to inform evidence‐based GWG recommendations for twin pregnancies. [ABSTRACT FROM AUTHOR]

Background: As educational digital technologies are increasingly being used in schools, past research left unanswered the question of these technologies' impact on the socioeconomic achievement gap even when equal access is guaranteed. Objectives: The objectives of the present study are to examine whether and how the socioeconomic achievement gap can be reduced through the use of computer‐assisted instruction (CAI). Methods: We addressed this issue experimentally by comparing CAI to conventional teacher‐led classroom instruction with more than 800 middle and high school students from disadvantaged and highly privileged socioeconomic backgrounds in a range of topics. Results and Conclusions: Both disadvantaged and highly privileged students taught with CAI outperformed those taught with conventional instruction, thus maintaining the socioeconomic achievement gap constant. However, we also found that disadvantaged students receiving CAI performed as well as highly privileged students receiving conventional teacher‐led instruction. Takeaways: The positive effects associated with CAI may therefore help compensate the difficulties of students with a disadvantaged background, a still neglected possibility. Lay Description: What is already known about this topic?: Socioeconomic status affects academic achievement especially in students from disadvantaged backgrounds.Inequal access to digital learning is a by‐product of socioeconomic status.Computer‐assisted instruction is known to yield positive effects on learning. What this paper adds?: It examines the effectiveness of computer‐assisted instruction on reducing the socioeconomic achievement gap when equal access to digital education is guaranteed at the school level.It shows that computer‐assisted instruction (relative to teacher‐led conventional instruction) benefited disadvantaged students and their highly privileged counterparts equally, shifting the socioeconomic achievement gap upward.However, disadvantaged students receiving CAI may reach similar performance level as their highly privileged counterparts receiving conventional instruction, thus compensating the socioeconomic achievement gap. Implications for practice and/or policy: This finding strengthens the importance of targeting teaching methods depending on students' socioeconomic characteristics to allow disadvantaged students to maximize their learning potential and chances to access to higher education. [ABSTRACT FROM AUTHOR]

Background: Articulatory excursion and vocal intensity are reduced in many children with dysarthria due to cerebral palsy (CP), contributing to the children's intelligibility deficits and negatively affecting their social participation. However, the effects of speech‐treatment strategies for improving intelligibility in this population are understudied, especially for children who speak languages other than English. In a cueing study on English‐speaking children with dysarthria, acoustic variables and intelligibility improved when the children were provided with cues aimed to increase articulatory excursion and vocal intensity. While French is among the top 20 most spoken languages in the world, dysarthria and its management in French‐speaking children are virtually unexplored areas of research. Information gleaned from such research is critical for providing an evidence base on which to provide treatment. Aims: To examine acoustic and perceptual changes in the speech of French‐speaking children with dysarthria, who are provided with speech cues targeting greater articulatory excursion (French translation of 'speak with your big mouth') and vocal intensity (French translation of 'speak with your strong voice'). This study investigated whether, in response to the cues, the children would make acoustic changes and listeners would perceive the children's speech as more intelligible. Methods & Procedures: Eleven children with dysarthria due to CP (six girls, five boys; ages 4;11–17;0 years; eight with spastic CP, three with dyskinetic CP) repeated pre‐recorded speech stimuli across three speaking conditions (habitual, 'big mouth' and 'strong voice'). Stimuli were sentences and contrastive words in phrases. Acoustic analyses were conducted. A total of 66 Belgian‐French listeners transcribed the children's utterances orthographically and rated their ease of understanding on a visual analogue scale at sentence and word levels. Outcomes & Results: Acoustic analyses revealed significantly longer duration in response to the big mouth cue at sentence level and in response to both the big mouth and strong voice cues at word level. Significantly higher vocal sound‐pressure levels were found following both cues at sentence and word levels. Both cues elicited significantly higher first‐formant vowel frequencies and listeners' greater ease‐of‐understanding ratings at word level. Increases in the percentage of words transcribed correctly and in sentence ease‐of‐understanding ratings, however, did not reach statistical significance. Considerable variability between children was observed. Conclusions & Implications: Speech cues targeting greater articulatory excursion and vocal intensity yield significant acoustic changes in French‐speaking children with dysarthria. However, the changes may only aid listeners' ease of understanding at word level. The significant findings and great inter‐speaker variability are generally consistent with studies on English‐speaking children with dysarthria, although changes appear more constrained in these French‐speaking children. What this paper addsWhat is already known on the subjectAccording to the only study comparing effects of speech‐cueing strategies on English‐speaking children with dysarthria, intelligibility increases when the children are provided with cues aimed to increase articulatory excursion and vocal intensity. Little is known about speech characteristics in French‐speaking children with dysarthria and no published research has explored effects of cueing strategies in this population.What this paper adds to existing knowledgeThis paper is the first study to examine the effects of speech cues on the acoustics and intelligibility of French‐speaking children with CP. It provides evidence that the children can make use of cues to modify their speech, although the changes may only aid listeners' ease of understanding at word level.What are the potential or actual clinical implications of this work?For clinicians, the findings suggest that speech cues emphasizing increasing articulatory excursion and vocal intensity show promise for improving the ease of understanding of words produced by francophone children with dysarthria, although improvements may be modest. The variability in the responses also suggests that this population may benefit from a combination of such cues to produce words that are easier to understand. [ABSTRACT FROM AUTHOR]

Policy PointsPrivate health insurance (PHI) in France has been facing critical changes over the past 30 years. A complementary and voluntary scheme, it has been historically dominated by nonprofit entities. However, the share of for‐profit insurance companies in the sector has significantly increased. Nonprofit firms also changed their strategies and mimicked some for‐profit behaviors.The present paper argues that this process is a result of the conflict‐provoking coevolution of the insurance and health care sectors. Trying to improve the regulation of the insurance industry as whole, two European directives first jeopardized the business model of nonprofit entities. Then, two national reforms designed to improve health coverage significantly increased competition among insurers, notably in the area of corporate‐level contracts.Decoupling the insurance and health care sectors has become a major source of policy feedback and unexpected outcomes of reforms affecting the very organization of PHI. Context: In France, private health insurance (PHI) has an exceptionally high level of coverage and accounts for 13.7% of health expenditures. A complementary and voluntary scheme, it has been historically dominated by nonprofit, mutual benefit societies. Over the past 20 years, however, the market share of for‐profit insurance companies has increased by 47%. Financialization of the field developed, and competition based on new risk management strategies also increased. The broad aim of this paper is to characterize and to elucidate the causes of this trend. More specifically, we are interested in how and to what extent a series of supranational and national policies contributed to this situation. Method: Our data come from three sources. We first reviewed documents published by health insurers, government reports, and newspaper articles. We then conducted two semistructured interview campaigns between September 2017 and May 2018. The first mostly covered private and public actors and their involvement in European Union (EU) policymaking (n = 21). The second series of interviews was conducted with another group of actors directly involved at the French level (n = 16). Findings: Our findings support preliminary observations. PHI in France, we argue, is indeed facing a development of competition and marketlike instruments. Four major policies (two EU directives and two national reforms) played a significant role in this outcome. Surprisingly, however, it has never been the purpose of legislators and policymakers: while EU directives created a regulatory framework for insurance activities within the Single Market, policies adopted at the national level initially aimed at improving health coverage. We show that it is the interactions and the noncoordination among all of these policies that explain their unexpected outcome. Conclusions: The trend described in this paper is twofold. The first is Europeanization, as PHI in France is increasingly affected by EU legislation. Since this framework tends to favor larger firms and for‐profit companies, a reduction in statutory coverage can no longer be considered a quasi‐neutral transfer from (publicly owned) social security to nonprofit providers. At the same time, PHI is shifting toward collectivization: as competition increases, complementary health coverage is becoming gradually standardized and based at the corporate level. Together, these changes are likely to reduce freedom of choice and individual welfare, an assumption supported by studies published on the most recent period. [ABSTRACT FROM AUTHOR]

Many studies have demonstrated the crucial role of vocabulary in predicting reading performance in general. More recent work has indicated that one particular facet of vocabulary (its depth) is more closely related to language comprehension, especially inferential comprehension. On this basis, we developed a training application to specifically improve vocabulary depth. The objective of this study was to test the effectiveness of a mobile application designed to improve vocabulary depth. The effectiveness of this training was examined on 3rd and 4th grade children's vocabulary (breadth and depth), decoding and comprehension performances. A randomized waiting‐list control paradigm was used in which an experimental group first received the intervention during the first 4 weeks (between pretest and post‐test1), thereafter, a waiting control group received the training for the next 4 weeks (between postest1 and posttest2). Results showed that the developed application led to significant improvements in terms of vocabulary depth performance, as well as a significant transfer effect to reading comprehension. However, we did not observe such a beneficial effect on either vocabulary breadth or written word identification. These results are discussed in terms of the links between vocabulary depth and comprehension, and the opportunities the app presents for remedying language comprehension deficits in children. Lay Description: What is already known about this topic:Vocabulary is a powerful predictor of both word identification and text comprehensionVocabulary depth rather than breadth is more closely related to language comprehensionDepth of vocabulary is particularly predictive of inferencing skills What this paper adds:We develop a new training application specifically targeting vocabulary depthThe training led to significant gain in children's knowledge for the taught wordsWe also observe a transfer effect with significant improvements in reading comprehension Implications for practice and/or policy:Vocabulary depth trainings represent a good way for remedying language comprehension deficits [ABSTRACT FROM AUTHOR]

Tumour genetics is currently turning into a massive clinical approach. This paper is an enquiry into its practices as they expand beyond expert and experimental contexts and become routinised in clinical hospital settings. Studying a French university hospital, we unpack the content and everyday organization of diagnostic labour in this context. Exploring the sociotechnical frictions that arise in the process, we describe the ways in which they are collectively controlled, and stabilized through organizational fictions, that are instrumental in making tumour genetics doable in the hospital, at a large scale. We further show that the new role of external regulations in the production of clinical values for mutations has a strong impact on diagnostic work, making it possible to be performed locally without resorting to expert bioclinical collectives, and outside the professional jurisdiction of clinical geneticists. This division of labour appears as a necessary condition for the rise in clinical productivity required by a new function assigned to genetics: to guide the prescription of drugs for common diseases. This turn in the way genetics is embedded in the clinic calls for a thorough reassessment of its impacts on clinical discourses, practices and decisions. [ABSTRACT FROM AUTHOR]

Information seeking (IS) has become a critical activity in video‐based environments. Up to now, the effects of support on information seeking (i.e., scaffolding) have seldom been assessed. The twofold aim of the current study was to (a) assess the effects of scaffolding on IS in videos and (b) determine the characteristics of the users' mental models after an IS activity with or without scaffolding. We divided 50 participants into two groups that either did or did not benefit from initial scaffolding during an IS task. Both groups then had to perform a localization task without any further access to scaffolding. Results showed that scaffolding the video by providing a table of contents and markers on a timeline helped students to engage in highly efficient IS, but they had less accurate mental representations of the video than those without scaffolding. The hypothesis that scaffolding provides a usable but external model was therefore supported. Lay Description: What is already known about this topic: Videos are increasingly used in learning.Searching for information in videos may be a complex activity.So far, very few studies have been conducted on the potential effect of scaffolding videos during an information‐seeking (IS) task. What this paper adds: In this study, we put in place the scaffolding of the video by adding a table of contents and markers on the timeline.Structuration and segmentation have positive effects on the performance in IS, in terms of response success, time spent on each search, relevance, and perceived difficulty.Scaffolding has a negative impact on the users' internal representations of the video. Implications for practice: Incorporating a table of contents and a structured timeline into a video facilitates the search activity.Without scaffolding, the search activity is longer and cognitively more costly.Paradoxically, users have a poorer representation of the video (i.e., poorer mental model) after the IS task when they were given scaffolding.Future studies should focus on the benefits of providing structuring and segmentation in learning tasks. [ABSTRACT FROM AUTHOR]

Aim: To analyse the health care usage of individuals with cerebral palsy (CP) as a function of age and ambulatory status.Method: In total, 970 self-administered questionnaires relating to health care usage were sent, via a clinical network of professionals and institutions, to children and adults with CP in Brittany, France. Frequency of use of different aspects of health care were analysed as a function of age and ambulatory status. Multivariate logistic regression evaluated differences in the frequency of each health care type with age; the transition from childhood to adulthood was specifically analysed.Results: The response rate was 53% (282 adults, 230 children). Use of medication (particularly psychotropic and analgesic) increased with age, while physical-types of health care (rehabilitation, physical medicine and rehabilitation follow-up, and equipment) decreased with age, independently of ambulatory status. Use of other treatments, such as botulinum toxin injections, was not influenced by age. The provision of rehabilitation was particularly affected by the period of transition.Interpretation: Although health care needs change naturally in adulthood, the large decrease in usage of specific types of rehabilitation after the transition to adulthood suggested individuals had difficulty accessing this type of health care after childhood. These results provide objectives for the development of patient-centred, transitional consultations, and longitudinal studies.What This Paper Adds: Use of medication, particularly psychotropic and analgesic drugs, increased with age in individuals with cerebral palsy. Use of orthoses, physical medicine and rehabilitation physician follow-up, and rehabilitation decreased with age. Transition from childhood to adulthood involved significant changes in health care usage. [ABSTRACT FROM AUTHOR]

Aim: Benign paroxysmal torticollis (BPT), benign paroxysmal vertigo (BPV), and benign tonic upward gaze (BTU) are characterized by transient and recurrent episodes of neurological manifestations. The purpose of this study was to analyse the clinical relationships between these syndromes, associated comorbidities, and genetic bases.Method: In this cross-sectional study, clinical data of patients with BPT, BPV, or BTU were collected with a focus on developmental achievements, learning abilities, and rehabilitation. Neuropsychological assessment and genetic testing were performed.Results: Fifty patients (median age at inclusion 6y) were enrolled. Psychomotor delay, abnormal neurological examination, and low or borderline IQ were found in 19%, 32%, and 26% of the patients respectively. Cognitive dysfunction was present in 27% of the patients. CACNA1A gene mutation was identified in eight families, and KCNA1 and FGF14 mutation in one family respectively. The identification of a CACNA1A mutation was significantly associated with BTU (p=0.03) and with cognitive dysfunction (p=0.01). Patients with BPV were less likely to have cognitive dysfunction.Interpretation: Children with BPT, BPV, or BTU are at high risk of impaired psychomotor and cognitive development. These syndromes should not be regarded as benign and should be considered as part of the spectrum of a neurodevelopmental disorder.What This Paper Adds Ok: Patients with benign paroxysmal torticollis (BPT), benign paroxysmal vertigo (BPV), and benign tonic upward gaze (BTU) have an increased risk of psychomotor delay. These patients also have an increased risk of abnormal neurological examination and cognitive dysfunction. Gene mutations, especially in CACNA1A, were identified in 21% of the families. BPT, BTU, and BPV should not be regarded as benign. BPT, BTU, and BPV should be considered as part of the spectrum of a neurodevelopmental disorder. [ABSTRACT FROM AUTHOR]

Breastfeeding is recommended until 6 months of age, but a wide range of infant formula is available for nonbreastfed or partially breastfed infants. Our aim was to describe infant formula selection and to examine social- and health-related factors associated with this selection. Analyses were based on 13,291 infants from the French national birth cohort Etude Longitudinale Française depuis l'Enfance. Infant diet was assessed at Month 2 by phone interview and monthly from Months 3 to 10 via internet/paper questionnaires. Infant formulas were categorized in 6 groups: extensively or partially hydrolysed, regular with or without prebiotics/probiotics, and thickened with or without prebiotics/probiotics. Associations between type of infant formula used at 2 months and family or infant characteristics were assessed by multinomial logistic regressions. At Month 2, 58.1% of formula-fed infants were fed with formula enriched in prebiotics/probiotics, 31.5% with thickened formula, and 1.4% with extensively hydrolysed formula. The proportion of formula-fed infants increased regularly, but the type of infant formula used was fairly stable between 2 and 10 months. At Month 2, extensively hydrolysed formulas were more likely to be used in infants with diarrhoea or regurgitation problems. Partially hydrolysed formulas were more often used in families with high income, with a history of allergy, or with infants with regurgitation issues. Thickened formulas were used more with boys, preterm infants, infants with regurgitation issues, or in cases of early maternal return to work. The main factors related to the selection of infant formula were family and infant health-related ones. [ABSTRACT FROM AUTHOR]

Recent research suggests that inducing fixed (rather than malleable) beliefs about groups leads to more negative attitudes toward out-groups. The present paper identifies the underlying mechanism of this effect. We show that individuals with a fixed belief about groups tend to construe intergroup settings as threatening situations that might reveal shortcomings of their in-group (perceived threat). In the present research, we measured (Study 1) and manipulated (Study 2) participants' lay theories about group malleability. We found that the extent to which individuals had an entity (versus an incremental) group theory influenced the level of threat they felt when interacting with out-group members, and that perceived threat in turn affected their level of ethnocentrism and prejudice. These findings shed new light on the role of lay theories in intergroup attitudes and suggest new ways to reduce prejudice. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]