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For educators, the content of the curriculum really is like oxygen: it is the necessary precondition for improving schools, closing the achievement gap, engaging parents, and preparing teachers. However, when educators take the content of the curriculum for granted, they lose opportunities to coordinate and collaborate. Good curriculum instruction should be carefully planned to introduce topics early, and then teachers can intentionally revisit, deepen, and extend learning on these topics in later grades. This article presents the "Core Knowledge Language Arts" (CKLA) program that begins with preschool through third grade reading models to assist teachers incorporate a curriculum that helps students get the mastery for fluent reading, writing, and language comprehension. The program contains seven units, each with a teacher guide. Students and teachers engage in activities that build and deepen background knowledge using teaching practices that are appropriate for young children and early educators. The CKLA domains are carefully organized to build on each other within and across grades, giving students opportunities to refine and expand their knowledge and vocabulary over time. Included with this article are two sidebars: (1) Content on the Cutting-Room Floor: A Brief History of the Elementary Curriculum (Ruth Wattenberg); and (2) Preschoolers to Presidents: CKLA Builds Knowledge Step by Step.

The present study examined the extent to which preschool classroom supports--relational support (RS) and instructional support (IS)--are associated with children's language development and whether these associations vary as a function of children's language ability. The language skills of 360 children within 95 classrooms were assessed using an expressive narrative task in the fall and spring of the preschool year, teachers rated RS in the fall, and observations of IS were collected across the year. Research Findings: Hierarchical linear models revealed main effects of IS, but not RS, on preschoolers' development of expressive language skills. In addition, the associations between RS and IS on children's expressive language development were moderated by children's fall language ability. Specifically, the association between IS and language development was stronger for children with stronger expressive language skills, and the association between RS and language development was stronger for children with weaker expressive language skills. Practice or Policy: These findings suggest that professional development for preschool teachers might focus on aligning classroom supports with the needs of children with weaker language skills who are at risk for difficulty acquiring literacy.

Purpose: In this study, the authors used sequential analysis to explore bidirectional and dynamic dependencies between mothers' question use and children's verbal participation during shared reading. Method: The sample was composed of mothers and their preschool-age children with specific language impairment (SLI; n = 14). Each mother and child extratextual utterance was transcribed and coded. Mother utterances were coded as "questions" or "other"; in turn, questions were coded for cognitive challenge and topic directiveness. Child utterances were coded as "verbal participation" (related to the book) or "other"; utterances designated as verbal participation were also coded for level of production (minimal, low, high) on the basis of their mean length of utterance. Results: Descriptive data show variability in mothers' question use and some variability in the level of children's verbal participation during shared reading. However, mothers' question use did not facilitate higher levels of verbal participation by children. Furthermore, the level of children's verbal participation did not influence the cognitive challenge and topic directiveness of mothers' question use. Conclusions: The findings were contrary to hypotheses and collectively suggest potentially unique and challenging verbal dynamics between mothers and their young children with SLI during shared-reading experiences. Future directions for research are discussed.

Purpose: Speech-language pathologists (SLPs) and reading professionals provide educational services to children who are at risk for reading difficulties, although these professions do not necessarily coordinate efforts. To date, there is limited evidence regarding the proportion of children who receive services from both professionals. The current study reports the prevalence and overlap of speech-language and reading services provided to kindergartners and first graders in Virginia. Method: This study analyzed a population-level database of reading screening scores from 74,730 kindergartners and 75,088 first graders. Information regarding the speech-language services received by these children was obtained. Prevalence rates of speech-language impairment, reading risk, and comorbidity were calculated. The distribution of children receiving speech-language services across categories of reading competence was examined. Results: Findings indicated that approximately 6% of the children received speech-language services and 11.1% of the kindergartners and 13.7% of the first graders received reading services. One-quarter of the children receiving speech-language services also received reading services. Furthermore, children receiving speech-language services received reading services at twice the rate of children who were not receiving speech-language services in both kindergarten (23.1% vs. 9.1%) and first grade (25.2% vs. 11.3%). Clinical Implications: This study provides empirical support for improving coordination between SLPs and reading professionals.

Analysis of children's spoken narratives represents a potentially informative approach to language assessment within early childhood settings. Yet, narrative assessment is not readily amenable to at-scale use given the time needed to collect, transcribe, and analyze a child's narrative sample and the lack of consensus regarding what aspects of narrative expression ought to be examined (e.g., language form, language content). The purpose of this study was to describe a direct assessment of children's language abilities within a narrative context, the Narrative Assessment Protocol (NAP), which examines five aspects of language: sentence structure, phrase structure, modifiers, nouns, and verbs. In this study, we present findings regarding internal consistency, test-retest reliability, construct validity, and the concurrent and predictive validity of the NAP. NAP scores from 262 3-5-year-old children participating in preschool programs were assessed for these purposes. Findings indicated that the NAP exhibits reasonable psychometric properties across the areas addressed, to include significant concurrent and predictive relations with a norm-referenced measure of general language ability. Although more research is needed, preliminary findings indicate that the NAP provides professionals with a valid and informative assessment approach for examining children's language skills within a narrative context; such information may be useful for establishing and monitoring children's language growth within preschool programs or language interventions. (Contains 3 tables.)

Background Little information is available on the types, causes, and treatment of pneumonia in intensive care unit patients in usual clinical practice. Objective To characterize treatment of patients with presumed [...]

The article focuses on the importance of curriculum content in several aspects, which include precondition for school improvement, closing achievement gap, and teacher preparation. Topic discussed include the perception of educators and policymakers in terms of the importance of curriculum, education policy, and factors that influence early education. Also mentioned are Common Core standards, teacher quality, and Core Knowledge Language Arts (CKLA) Preschool.

Calls for transformational change of our healthcare system are increasingly clear, persuasive and insistent. They resonate at all levels, with those who fund, deliver, provide and receive care, and they are rooted in a deep understanding that the system, as currently rigidly structured, most often lacks the necessary flexibility to comprehensively meet the needs of patients across the continuum of care. The St. Joseph's Health System (SJHS) Integrated Comprehensive Care (ICC) Program, which bundles care and funding across the hospital to home continuum, has reduced fragmentation of care, and it has delivered improved outcomes for patients, providers and the system. This case study explores the essential contribution of nursing leadership to this successful transformation of healthcare service delivery.