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The present study investigated the relationship between lexicon and grammar in individuals who use graphic symbol-based aided augmentative and alternative communication (AAC). Data came from 60 transcripts of generalization sessions that were part of two previous intervention studies, aimed at improving the expressive vocabulary and grammar of 12 children and youth who used graphic symbol-based AAC. The specific aims of the current study were to (a) describe vocabulary composition across different levels of expressive vocabulary and (b) analyze the relationship between global measures of expressive vocabulary and the use of grammar in individuals who use aided AAC. A series of multiple linear mixed effect regression analyses showed a positive predictive association between overall vocabulary size and the use of closed-class words, and a positive relationship between the use of verbs and the use of closed-class words. Additionally, the use of verbs had a significant positive association with the use of inflectional morphology, while the use of nouns did not. Theoretical and practical implications of these findings are discussed.

Background: Recent evidence suggests that pre-school children with co-occurring phonological speech sound disorder (SSD) and expressive language difficulties are at a higher risk of ongoing communication and literacy needs in comparison with children with these difficulties in isolation. However, to date there has been no systematic or scoping review of the literature specific to interventions for children with this dual profile. Aims: To explore the evidence regarding interventions for pre-school children with co-occurring phonological SSD and expressive language difficulties, including the content/delivery of such interventions, areas of speech and language targeted, and a broad overview of study quality. Methods & Procedures: A scoping review methodology was used in accordance with the guidance from the Joanna Briggs Institute. Following a systematic search of Ovid Medline, Ovid Emcare, OVID Embase, CINAHL, Psychinfo and ERIC, 11 studies were included in the review. A researcher-developed data extraction form was used to extract specific information about each intervention, with the JBI appraisal tools used to provide a broad overview of the quality of each study. Main contribution: Included papers consisted of six randomized controlled trials (RCTs), two cohort studies, two case studies and one case series. Interventions fell into two main categories: (1) integrated interventions that combined content for both speech and language targets and/or explicitly used the same type of technique to improve both domains; and (2) single-domain interventions that explicitly included content to target speech or language only, but also aimed to improve the other domain indirectly. Study quality varied, with detail on the content, context and delivery of interventions often underspecified, hampering the replication and clinical applicability of findings. Conclusions & Implications: Early emerging evidence was identified to support both integrated speech and language interventions as well as single-domain interventions. However, caution should be exercised due to the variation in the quality and level of detail reported for the interventions. Future intervention studies may seek to address this by reporting in accordance with Template for Intervention Description and Replication (TIDieR) reporting guidelines. This approach would enable clinicians to consider the applicability of the intervention to individual children within differing settings.

Children with partially intelligible speech and language difficulties are often provided with speech-generating devices (SGDs) to support their spoken communication. However, little is known about how SGDs can be used best to facilitate language development. This study evaluated the effects of a conversation-based intervention using SGDs, on the rate of expressive clause production in children with speech that is partially intelligible (SPI). A multiple probe across participants design was used to evaluate intervention with four children aged 8 to 10 years. Following baseline monitoring, the children received language-focused intervention involving adult recasting, SGD modeling, and prompting to repair. Participants showed increases in their rate, complexity and length of clause use. Gains were sustained and generalized. Intervention using conversation, recasting, and SGD modeling can increase clause production and grammaticality of children with SPI.

Conversational repair has been found to play a fundamental role in the acquisition of language. This paper describes existing research on conversational repair and its relationship to language learning, whether a first language or a second language, as well as its relevance to augmentative and alternative communication (AAC). A case is made for incorporating prompts to repair in conversation-based language interventions with children learning to use AAC. We argue that interventions targeting linguistic complexity should encourage self-repair in conversation in order to develop linguistic and operational competency as well as increase automaticity when using AAC. Clinical implications and directions for future research are discussed.

The present study investigated the effects of different types of recasts and prompts on the rate of repair and spontaneous use of novel vocabulary by eight children with severe motor speech disabilities who used speech-generating technologies to communicate. Data came from 60 transcripts of clinical sessions that were part of a conversation-based intervention designed to teach them pronouns, verbs, and verb inflections. The results showed that, when presented alone, interrogative choice and declarative recasts led to the highest rates of child repair. The results also showed that when children were presented with recasts and prompts to repair, the rate of repair increased. Spontaneous use of linguistic targets was significantly and positively related to conversational sequences where the adult recast was followed by child repair. These findings suggest that using different recast types and prompts to repair may be beneficial for spontaneous use of linguistic targets in this population.

AbstractPurposeMethodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONResearch suggests that rates for autism may be higher in cerebral palsy than in the general population. For those with severe bilateral physical impairment (GMFCS level IV and V) and little or no speech, describing a profile of social communication skills has been difficult because there are currently no assessments for early social communication specifically tailored for these children. Our aim was to explore the assessment of aspects of joint attention and social reciprocity in this group of children with CP.We compared the performance of children with bilateral CP on carefully designed assessments of joint attention and social responsiveness with groups of children with Down syndrome and autism. All three groups were matched for chronological age and mental age.Approximately 30% of the children with bilateral CP had early social communication scores similar to the autistic children. The remaining 70% of children with CP had a range of early social communication scores similar to the children with Down syndrome.It is possible to assess key early social communication skills in non-speaking children with bilateral motor disability. This could provide insights to help clinicians and caregivers as they discuss abilities and explore potential areas for intervention.With carefully designed activities, which do not rely on motor skills or verbal exchanges, it was possible to assess joint attention and social responsiveness skills in a group of non-speaking children with bilateral motor disability.We were able to identify a subgroup of non-speaking children with severe motor disability (approximately 30% of our cohort) whose scores on our assessments were similar to a group of autistic children.The ability to describe key early social communication skills should provide insights to help clinicians and caregivers as they discuss abilities and explore potential areas for intervention.With carefully designed activities, which do not rely on motor skills or verbal exchanges, it was possible to assess joint attention and social responsiveness skills in a group of non-speaking children with bilateral motor disability.We were able to identify a subgroup of non-speaking children with severe motor disability (approximately 30% of our cohort) whose scores on our assessments were similar to a group of autistic children.The ability to describe key early social communication skills should provide insights to help clinicians and caregivers as they discuss abilities and explore potential areas for intervention. [ABSTRACT FROM AUTHOR]

Purpose: This study was conducted to evaluate the effects of a conversation-based intervention on the expressive vocabulary and grammatical skills of children with severe motor speech disorders and expressive language delay who use augmentative and alternative communication. Method: Eight children aged from 8 to 13 years participated in the study. After a baseline period, a conversation-based intervention was provided for each participant, in which they were supported to learn and use linguistic structures essential for the formation of clauses and the grammaticalization of their utterances, such as pronouns, verbs, and bound morphemes, in the context of personally meaningful and scaffolded conversations with trained clinicians. The conversations were videotaped, transcribed, and analyzed using the Systematic Analysis of Language Transcripts (SALT; Miller & Chapman, 1991). Results: Results indicate that participants showed improvements in their use of spontaneous clauses, and a greater use of pronouns, verbs, and bound morphemes. These improvements were sustained and generalized to conversations with familiar partners. Conclusion: The results demonstrate the positive effects of the conversation-based intervention for improving the expressive vocabulary and grammatical skills of children with severe motor speech disorders and expressive language delay who use augmentative and alternative communication. Clinical and theoretical implications of conversation-based interventions are discussed and future research needs are identified.

This paper explores whether a structured history-taking tool yields useful descriptions of children's looking skills. Parents of 32 children referred to a specialist communication clinic reported their child's looking skills using the Functional Vision for Communication Questionnaire (FVC-Q), providing descriptions of single object fixation, fixation shifts between objects and fixation shifts from object to person. Descriptions were compared with clinical assessment. 24/32 children were reported to have some limitation in fixation. Limitation was subsequently seen in 30/32 children. Parental report and assessment agreed fully in 23/32 (72%). The largest area of discrepancy was object-person fixation shifts, with five children not observed to show this behavior despite its being reported. Findings indicate a structured questionnaire yields description of fixations, which correspond well with clinical assessment. Descriptions supported discussion between parents and clinicians. It is proposed that the FVC-Q is a valuable tool in supporting clinicians in eliciting information about fixation skills. [ABSTRACT FROM AUTHOR]

Purpose: This study was conducted to evaluate the effects of a conversation-based intervention on the expressive vocabulary and grammatical skills of children with severe motor speech disorders and expressive language delay who use augmentative and alternative communication. Method: Eight children aged from 8 to 13 years participated in the study. After a baseline period, a conversation-based intervention was provided for each participant, in which they were supported to learn and use linguistic structures essential for the formation of clauses and the grammaticalization of their utterances, such as pronouns, verbs, and bound morphemes, in the context of personally meaningful and scaffolded conversations with trained clinicians. The conversations were videotaped, transcribed, and analyzed using the Systematic Analysis of Language Transcripts (SALT; Miller & Chapman, 1991). Results: Results indicate that participants showed improvements in their use of spontaneous clauses, and a greater use of pronouns, verbs, and bound morphemes. These improvements were sustained and generalized to conversations with familiar partners. Conclusion: The results demonstrate the positive effects of the conversation-based intervention for improving the expressive vocabulary and grammatical skills of children with severe motor speech disorders and expressive language delay who use augmentative and alternative communication. Clinical and theoretical implications of conversation-based interventions are discussed and future research needs are identified. Supplemental Materials: https://doi.org/10.23641/ asha.5150113, For children who have little or no intelligible speech as a consequence of severe motor speech disorders (MSDs), the use of augmentative and alternative communication (AAC) systems can prove invaluable [...]

Children with a clinical description of cerebral palsy (CP) commonly experience cognitive and sensory difficulties that co-occur with motor impairment, and for some children this can include impairments in social communication. While research has begun to examine theory of mind abilities in children with CP, relatively little is known about social communication difficulties in this population. Assessing theory of mind abilities in children with CP using traditional procedures such as the classic Sally-Anne task can be problematic if performance is affected by physical difficulties in signalling responses and/or by cognitive and language demands inherent to the task itself. The central aim of this study therefore was to examine the potential of using a new action anticipation task and eye-tracking technique to assess implicit true and false belief understanding in four developmentally young children with quadriplegic cerebral palsy who had little or no functional speech, and one language age matched child with Down syndrome who did not have severe motor impairment. All children in this study consistently demonstrated anticipatory gaze behaviours in the context of the true belief task. One child with CP and the child with Down syndrome demonstrated anticipatory gaze behaviours indicative of an ability to attribute false belief. The findings are discussed in relation to the application of action anticipation and eye-tracking paradigms in research and clinical practice. (Contains 2 figures and 3 tables.)

The electronic edition of Pediatrics celebrates its 10th birthday this year. This article describes the origins and evolution of the online edition of Pediatrics, which, after launching in 1997, featured the world's first online-only section of a medical journal. Over the proceeding 10 years the journal introduced numerous innovations, including e-mail alerts, postpublication peer review, video supplements, online classified advertisements, Web-based manuscript submission, early release, and the development of the e Journal Archive. This article also describes the use and reception of the electronic journal. Whether measured by article accesses, citation rates, or the number of manuscript submissions, the electronic edition of Pediatrics has proven to be a success. It has allowed the journal to publish a larger number of articles and reach a wider audience than would have been economically possible with a print-only publication. Yet, even as Pediatrics recreates itself online, it is clear that there is much more that can be done to fully realize the potential of the new medium to facilitate professional communication. Key Words electronicjournals, journalology, THE ELECTRONIC EDITION of Pediatrics celebrates its 10th birthday this year. At the time it was launched, this was a groundbreaking innovation. In today's world, in which everyone over the [...]

ABBREVIATIONS. STM, scientific, technical, and medical; PLoS, Public Library of Science; AAP, American Academy of Pediatrics., Over the past few years there has been a growing concern within the world's scientific communities about access to scientific, technical, and medical (STM) literature. This concern has given rise [...]

The aim of this study was to develop and test a new classification scale to describe looking behaviours (gaze fixations and gaze shifts) in relation to eye-pointing. The Eye-pointing Classification Scale (EpCS) was developed and tested following established procedures for the construction and evaluation of equivalent scales, and involved 2 phases: Drawing on research literature, Phase 1 involved initial drafting of the scale through a series of multi-disciplinary group discussions; evaluation of the scale through a survey procedure, and subsequent expert group evaluation. Phase 2, was an examination of scale reliability and relationships between child characteristics and level of EpCS classification. In Phase 1, an initial draft of the scale was developed and then evaluated by 52 participants in 10 countries, leading to its refinement. Subsequent expert evaluation of content, style and structure indicated that no further refinement was required. In Phase 2, the scale achieved excellent levels of reliability in clinical testing. A significant relationship was identified between level of child motor ability and EpCS classification, and level of child language understanding and EpCS classification. Non-speaking children with severe bilateral cerebral palsy who have limited upper limb movement may communicate by using controlled looking behaviours to point to objects and people, referred to as eye-pointing. However, there is little consensus as to which looking behaviours represent eye-pointing and which do not. The Eye-pointing Classification Scale (EpCS) was developed to describe looking behaviours related to eye-pointing in this population of children The EpCS provides a new robust tool for clinical management and research with children with cerebral palsy. [ABSTRACT FROM AUTHOR]

Children with partially intelligible speech and language difficulties are often provided with speech-generating devices (SGDs) to support their spoken communication. However, little is known about how SGDs can be used best to facilitate language development. This study evaluated the effects of a conversation-based intervention using SGDs, on the rate of expressive clause production in children with speech that is partially intelligible (SPI). A multiple probe across participants design was used to evaluate intervention with four children aged 8 to 10 years. Following baseline monitoring, the children received language-focused intervention involving adult recasting, SGD modeling, and prompting to repair. Participants showed increases in their rate, complexity and length of clause use. Gains were sustained and generalized. Intervention using conversation, recasting, and SGD modeling can increase clause production and grammaticality of children with SPI. [ABSTRACT FROM AUTHOR]

"Careful consideration and planning have been given to the form of Pediatrics. Medical publications follow an almost stereotyped standard from which there is little chance to vary; but every effort [...]

The present study investigated the effects of different types of recasts and prompts on the rate of repair and spontaneous use of novel vocabulary by eight children with severe motor speech disabilities who used speech-generating technologies to communicate. Data came from 60 transcripts of clinical sessions that were part of a conversation-based intervention designed to teach them pronouns, verbs, and verb inflections. The results showed that, when presented alone, interrogative choice and declarative recasts led to the highest rates of child repair. The results also showed that when children were presented with recasts and prompts to repair, the rate of repair increased. Spontaneous use of linguistic targets was significantly and positively related to conversational sequences where the adult recast was followed by child repair. These findings suggest that using different recast types and prompts to repair may be beneficial for spontaneous use of linguistic targets in this population. [ABSTRACT FROM AUTHOR]

ABBREVIATION. DOI, digital object identifier. Visitors to the Pediatrics Web site will notice a new feature: Early Release articles. Beginning this month, we will publish some articles online in advance [...]

For some time now, Pediatrics has been grappling with one of the problems that every journal loves to have: a steadily increasing volume of manuscript submissions. Since 1995 computer software [...]

Purpose: This study was conducted to evaluate the effects of a conversation-based intervention on the expressive vocabulary and grammatical skills of children with severe motor speech disorders and expressive language delay who use augmentative and alternative communication. Method: Eight children aged from 8 to 13 years participated in the study. After a baseline period, a conversation-based intervention was provided for each participant, in which they were supported to learn and use linguistic structures essential for the formation of clauses and the grammaticalization of their utterances, such as pronouns, verbs, and bound morphemes, in the context of personally meaningful and scaffolded conversations with trained clinicians. The conversations were videotaped, transcribed, and analyzed using the Systematic Analysis of Language Transcripts (SALT; Miller & Chapman, 1991). Results: Results indicate that participants showed improvements in their use of spontaneous clauses, and a greater use of pronouns, verbs, and bound morphemes. These improvements were sustained and generalized to conversations with familiar partners. Conclusion: The results demonstrate the positive effects of the conversation-based intervention for improving the expressive vocabulary and grammatical skills of children with severe motor speech disorders and expressive language delay who use augmentative and alternative communication. Clinical and theoretical implications of conversation-based interventions are discussed and future research needs are identified. [ABSTRACT FROM AUTHOR]

Purpose: To describe the journal reading patterns of pediatrician members of the American Academy of Pediatrics (AAP) and compare results to similar surveys of medical faculty and physicians. The research also explored factors that might influence changes in reading patterns in the future, such as adoption of PDA technology. Methodology: A random sample of 2,000 AAP members was drawn from the AAP membership list, with paper surveys distributed in mid-2004. Settings/Subjects: Six hundred sixty-six pediatrician AAP members participated in a survey of reading behavior, with a total of 1,351 members answering some questions about technology use. Results: The hypotheses that pediatricians read many journal articles each month, read each article on average quite quickly, read heavily from personal subscriptions, read from both print and electronic journals, and read for many purposes were all supported. Pediatricians read journal articles primarily for current awareness and most often rely on quick reading from print journals for current awareness. Reading for research, writing, and presentations are more likely from library-provided electronic journals. Discussion/Conclusion: Convenience and purpose of reading are key factors that explain reading patterns of pediatricians. Print personal subscriptions are convenient for current awareness reading, while electronic journals systems are convenient for reading for research because they provide access to a broader range of journals. Publishers and librarians must understand the purposes and patterns of reading to design appropriate journals and services. Pediatricians read many current articles very quickly and from many different locations. Pediatricians under the age of thirty-five are more likely to use PDAs, suggesting that articles delivered to a handheld device might be accepted as convenient in the future. [ABSTRACT FROM AUTHOR]

Background Many organisms that are responsible for low-grade infection after total hip replacement (THR) are not recognized by routine culture. Patients and methods We examined wound contamination during primary total hip replacement performed in standard and ultra-clean operating theaters. 20 THRs were performed in each type of theater. Paired tissue specimens taken at the beginning and end of surgery were analyzed by bacterial culture and for the presence of bacterial DNA by the polymerase chain reaction (PCR). In total, 160 specimens (80 for culture, 80 for PCR) from 40 THRs were tested. Results In standard theaters, none of the 20 specimens taken at the start of surgery were positive by culture, but 3 were positive by PCR (15%). Of the 20 specimens taken at the end of surgery, 2 were positive by enriched culture and 9 were positive by PCR. All specimens positive by culture were also positive by PCR. In ultra-clean theaters, none of the 20 specimens taken at the start of surgery were positive by culture, but 2 were positive by PCR. Of the 20 specimens taken at the end of surgery, none were positive by culture, but 6 were positive by PCR. All specimens that were positive by culture were positive by PCR. Interpretation Wound contamination of primary THR occurs frequently in both standard and ultra-clean operating theaters and contamination is greater at the end of surgery than at the beginning (p=0.04). In this small series, we found no differences in wound contamination between standard and ultra-clean theaters (p=0.1). [ABSTRACT FROM AUTHOR]

Vocational guidance services have been developing in Northern Ireland for about thirty years. Recently the careers service has been transferred from an education to a manpower services base, while the schools have been given greater opportunity, and responsibility, for the provision of careers education. The changes have given considerable impetus to careers teacher training, and to the appointment of schools' careers staffs. The possibility of further development of the partnership between careers officers and careers teachers is examined. [ABSTRACT FROM PUBLISHER]