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Experimental research has shown the benefits of auditory white noise on cognitive performance in children with attention problems. However, little is currently known about individual differences in noise response amongst children with a clinical diagnosis of attention deficit hyperactivity disorder (ADHD). In addition, no research has so far tested the effects of visual white noise on children with ADHD.

Many individuals with autism report that eye contact makes them stressed or uncomfortable. Besides expressing their right to respect for neurodiverse ways of nonverbal communication, some autistic individuals also express the wish to improve their capacity to tolerate eye contact. In the current study, five autistic adults completed a 21- to 28-day computerized program that combines psychoeducation with graduated exposure to eye contact through photos. Interview data, questionnaires, gaze patterns, and psychophysiological measures indexing stress and arousal (pupillary and galvanic skin response levels) were collected to monitor and evaluate outcomes. At intake, discomfort resulting from eye contact in everyday life was described as overwhelming and multifaceted. Post-training data showed that observed increases in eye contact were not happening at the expense of heightened arousal. These results provide information about the (complex) nature of eye gaze discomfort in autism while pointing toward promising techniques to increase discomfort tolerance.

Background: Within cohorts of children with autism spectrum disorder (ASD) there is considerable variation in terms of language ability. In the past, it was believed that children with ASD either had delayed articulation and phonology skills or excelled in those areas compared to other language domains. Very little is known about speech sound ability in relation to language ability and non-verbal ability in Swedish preschool children with ASD., Aim: The current study aimed to describe language variation in a group of 4-6-year-old children with ASD, focusing on in-depth analyses of speech sound error patterns with and without non-phonological language disorder and concomitant non-verbal delays., Method & Procedures: We examined and analysed the speech sound skills (including consonant inventory, percentage of correct consonants and speech sound error patterns) in relation to receptive language skills in a sample of preschool children who had screened positive for ASD in a population-based screening at 2.5 years of age. Seventy-three children diagnosed with ASD participated and were divided into subgroups based on their receptive language (i.e., non-phonological language) and non-verbal abilities., Outcomes & Results: The subgroup division revealed that 29 children (40%) had language delay/disorder without concurrent non-verbal general cognitive delay (ALD), 27 children (37%) had language delay/disorder with non-verbal general cognitive delay (AGD), and 17 children (23%) had language and non-verbal abilities within the normal range (ALN). Results revealed that children with ALD and children with AGD both had atypical speech sound error patterns significantly more often than the children with ALN., Conclusions & Implications: This study showed that many children who had screened positive for ASD before age 3 years - with or without non-verbal general cognitive delays - had deficits in language as well as in speech sound ability. However, individual differences were considerable. Our results point to speech sound error patterns as a potential clinical marker for language problems (disorder/delay) in preschool children with ASD., What This Paper Adds: What is already known on the subject Children with autism spectrum disorder (ASD) have deficits in social communication, restricted interests and repetitive behaviour. They show very considerable variation in both receptive and expressive language abilities. Previously, articulation and phonology were viewed as either delayed in children with ASD or superior compared with other (non-phonological) language domains. What this paper adds to existing knowledge Children with ASD and language disorders also have problems with speech sound error patterns. What are the potential or actual clinical implications of this work? About 75% of children with ASD experience language delays/disorders, as well as speech sound problems, related to speech sound error patterns. Understanding/acknowledging these phonological patterns and their implications can help in the diagnosis and intervention of speech sound disorders in children with ASD. Direct intervention targeting phonology might lead to language gains, but more research is needed., (© 2024 The Author(s). International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.)

A small body of research and reports from educational and clinical practice suggest that teaching literacy skills may facilitate the development of speech sound production in students with intellectual disabilities (ID). However, intervention research is needed to test the potential connection. This study aimed to investigate whether twelve weeks of systematic, digital literacy intervention enhanced speech sound production in students with ID and communication difficulties. A sample of 121 students with ID were assigned to four different groups: phonics-based, comprehension-based, a combination with both phonics- and comprehension-based intervention and a comparison group with teaching-as-usual. Speech sound production was assessed before and after the intervention. The results on the data without the imputed variable suggested a significant positive effect of systematic, digital literacy interventions on speech sound production. However, results from sensitivity analyses with imputed missing data was more ambiguous, with the effect only approaching significance ( p s = .05-.07) for one of the interventions. Nonetheless, we tentatively suggest that systematic, digital literacy intervention could support speech development in students with ID and communication difficulties. Future research should be done to confirm and further elucidate the functional mechanisms of this link, so that we may have a better understanding and can improve instruction and the pivotal abilities of speech and reading.

More knowledge is needed about long-term ADHD medication and symptom, daily functioning, comorbidity, and tolerability outcomes. This "Long-term Medication for ADHD (LMA) trial" was a prospective observational 2-year trial in children and adolescents aged 6-18 years (extension of 1-year trial). Participants met criteria for DSM-5 ADHD (inattentive or combined), with complex comorbidities; autism spectrum disorder (31%), autistic traits (24%), oppositional symptoms (59%), anxiety (32%), dyslexia/language disorder (16%), borderline intellectual functioning (17%). Medication was individually tailored and followed-up at clinical visits (1, 2, 3, 6, 12, 18, 24 months). Primary outcome: Clinical Global Impression-Severity and Improvement scales (CGI-S, CGI-I). Secondary outcomes: Investigator-rated ADHD-Rating Scale, Weiss Functional Impairment Rating Scale-Parent report (WFIRS-P; Family, School Learning and Behavior, Life Skills, Self-Concept, Social Activities, and Risky Activities domains), comorbidity symptoms and adverse events (AEs). One hundred twenty-eight participants were enrolled (1-year trial only n = 27, LMA trial n = 101). Of these 29 (23%) discontinued, mainly due to AEs (n = 7), moving (n = 7), or no longer needing medication (n = 6). Main AEs were poor appetite, low mood, anxiety, irritability, fatigue. Improvements from baseline to 2 years were large in CGI-S (effect size (ES) 2.28), ADHD-RS (ES 2.06), and moderate to large in WFIRS-P (ES total 0.73, learning 0.4, family 0.67). Overall, the trial showed robust and sustained improvements in ADHD symptom severity and daily functioning over a period of 2 years of ADHD medication in children and adolescents with ADHD and complex comorbidities. Most AEs were mild. Comorbidity symptoms were improved after 1 year, particularly oppositional symptoms, depression, and anxiety., (© 2024. The Author(s).)

Background: Prior research has shown that memory for action sentences is stronger when stimuli are enacted during encoding than simply listened to: the so-called enactment effect. The goal of the present study was to explore how writing during encoding-through handwriting and through keyboarding-fares compared with enacting, in supporting memory recall., Methods: One hundred Norwegian high school students (64 girls, 36 boys) aged 16-21 years (M = 17.1) participated in the study. Four lists of verb-noun sentences with 12 sentences in each list were presented in four encoding conditions: (i) motor enactment, (ii) verbal listening, (iii) handwriting, and (iv) keyboarding., Results: Results revealed a significant main effect of encoding condition, with the best memory gained in the enactment condition. Regarding writing, results showed that handwriting and keyboarding during encoding produced the lowest recall in comparison with the enactment and verbal listening conditions., Conclusion: These results thus provide additional support for the enactment effect. While there has been much discussion on the relative benefits of handwriting versus keyboarding on student performance, both seemed to be equally poor strategies for the particular learning task explored here, potentially through increased cognitive load., (© 2023 The Authors. Brain and Behavior published by Wiley Periodicals LLC.)

Background: Despite the prevalence of Autism Spectrum Disorder (ASD) globally, there's a knowledge gap pertaining to autism in Arabic nations. Recognizing the need for validated biomarkers for ASD, our study leverages eye-tracking technology to understand gaze patterns associated with ASD, focusing on joint attention (JA) and atypical gaze patterns during face perception. While previous studies typically evaluate a single eye-tracking metric, our research combines multiple metrics to capture the multidimensional nature of autism, focusing on dwell times on eyes, left facial side, and joint attention., Methods: We recorded data from 104 participants (41 neurotypical, mean age: 8.21 ± 4.12 years; 63 with ASD, mean age 8 ± 3.89 years). The data collection consisted of a series of visual stimuli of cartoon faces of humans and animals, presented to the participants in a controlled environment. During each stimulus, the eye movements of the participants were recorded and analyzed, extracting metrics such as time to first fixation and dwell time. We then used these data to train a number of machine learning classification algorithms, to determine if these biomarkers can be used to diagnose ASD., Results: We found no significant difference in eye-dwell time between autistic and control groups on human or animal eyes. However, autistic individuals focused less on the left side of both human and animal faces, indicating reduced left visual field (LVF) bias. They also showed slower response times and shorter dwell times on congruent objects during joint attention (JA) tasks, indicating diminished reflexive joint attention. No significant difference was found in time spent on incongruent objects during JA tasks. These results suggest potential eye-tracking biomarkers for autism. The best-performing algorithm was the random forest one, which achieved accuracy = 0.76 ± 0.08, precision = 0.78 ± 0.13, recall = 0.84 ± 0.07, and F1 = 0.80 ± 0.09., Conclusions: Although the autism group displayed notable differences in reflexive joint attention and left visual field bias, the dwell time on eyes was not significantly different. Nevertheless, the machine algorithm model trained on these data proved effective at diagnosing ASD, showing the potential of these biomarkers. Our study shows promising results and opens up potential for further exploration in this under-researched geographical context., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: Treatment with intravenous immunoglobulin (IVIG) in children with Paediatric Acute-onset Neuropsychiatric Syndrome (PANS) has for many years been used on clinical indications, but the research evidence for its efficacy is insufficient., Methods: Open-label prospective in-depth trial including ten children (median age 10.3 years) with PANS, who received IVIG treatment 2 g/kg monthly for three months. Primary outcomes were changes in symptom severity and impairment from baseline to first and second follow-up visits one month after first and one month after third treatment, using three investigator-rated scales: Paediatric Acute Neuropsychiatric Symptom (PANS) scale, Clinical Global Impression - Severity and Improvement (CGI-S and CGI-I) scales. Secondary outcomes reported here were changes in Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) scores, and side effects., Results: All ten children received three treatments at one-month intervals according to study plan. From baseline to second follow-up marked reductions were seen in mean total PANS scale scores (p = .005), and CGI-S scores (p = .004). CGI-I ratings showed much to very much global improvement (mean CGI-I 1.8). Nine children had clinical response defined as > 30% reduction in PANS Scale scores. Improvements were also noted for CY-BOCS scores (p = .005), and in school attendance. Three children suffered moderate to severe temporary side effects after the first treatment, and the remaining seven had mild to moderate side effects. Side effects were much less severe after second and third treatments., Conclusions: Considerable and pervasive improvements in symptoms and clinical impairments were seen in these ten children after three monthly IVIG treatments. Moderate to severe transient side effects occurred in three cases., Trial Registration: EudraCT no. 2019-004758-27, Clinicaltrials.gov no. NCT04609761, 05/10/2020., (© 2022. The Author(s).)

Objective: To investigate the prevalence of reading difficulties in children born with cleft palate at ages 9 and 10 in Sweden., Design: Using a cross-sectional design, a parental questionnaire assessing dyslexia-like reading difficulties (Short Dyslexia Scale, SDS) was administered together with separate questions regarding background data., Participants: Families with a child born with overt cleft palate with or without cleft lip in 4 regions of Sweden. A total of 245 families were approached of which 138 families responded. Data from 136 (56%) were complete with information on cleft type and could be analyzed., Results: Twenty-two percent (95% CI, 15-30) of the whole study group displayed risk for dyslexic reading difficulties on the SDS corresponding to the 7th to 10th percentiles in the population. Children with cleft palate only had a significantly higher prevalence of reading difficulties (37%) compared to children with unilateral cleft palate (19%) and bilateral cleft palate (10%). The frequency of reading difficulties in participants with comorbidity was 32%. Among a subgroup with reported comorbidity in areas of attention, language, and learning problems, there was a 2.5 times higher risk of reading disability compared to participants without this reported comorbidity., Conclusion: The prevalence of reading difficulties in the cleft palate population was higher than in the general population. Results showed that co-occurring difficulties were common in the cleft group and that reading difficulties often appear together with other, co-occurring neurodevelopmental difficulties.

There is limited research targeting communication interventions for children with severe/profound intellectual and multiple disabilities. This study addressed outcomes from a communication course for parents of children with severe/profound intellectual and multiple disabilities and follows up on a previous publication by Rensfeldt Flink et al. (2020). Potential observable changes in the children's and parents' communicative behavior were studied as well as the parents' experiences of the intervention process and the effect of the course on parent-child communication. A mixed-methods design with a case-study framework was used. Two mother-child dyads participated. Data were collected before, during, and after the course. Video-recorded repeated play interactions by the dyads were coded and analyzed for the mothers' responsivity and use of augmentative and alternative communication and the children's interactive engagement. Longitudinal interview data from the mothers were analyzed thematically. No clear signs of behavioral change were observed in the coded video data. However, thematic analyses showed that the mothers experienced changes to communicative behaviors. Moreover, the course affected both mothers' reasoning about communication with their child and their child's communicative needs. The mothers' narratives contributed insights into how reflective processes might guide action in parent-mediated communication interventions. The implications for research and clinical practice are discussed., Competing Interests: The authors report no conflict of interest., (© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

Gaze patterns during face perception have been shown to relate to psychiatric symptoms. Standard analysis of gaze behavior includes calculating fixations within arbitrarily predetermined areas of interest. In contrast to this approach, we present an objective, data-driven method for the analysis of gaze patterns and their relation to diagnostic test scores. This method was applied to data acquired in an adult sample (N = 111) of psychiatry outpatients while they freely looked at images of human faces. Dimensional symptom scores of autism, attention deficit, and depression were collected. A linear regression model based on Principal Component Analysis coefficients computed for each participant was used to model symptom scores. We found that specific components of gaze patterns predicted autistic traits as well as depression symptoms. Gaze patterns shifted away from the eyes with increasing autism traits, a well-known effect. Additionally, the model revealed a lateralization component, with a reduction of the left visual field bias increasing with both autistic traits and depression symptoms independently. Taken together, our model provides a data-driven alternative for gaze data analysis, which can be applied to dimensionally-, rather than categorically-defined clinical subgroups within a variety of contexts. Methodological and clinical contribution of this approach are discussed., Competing Interests: Declaration of competing interest David Eberhard, Martyna Galazka, Jakob Åsberg Johnels, Christopher Gillberg, Eva Billstedt, Nouchine Hadjikhani, and Tobias S. Andersen declare that they have no conflict of interests. Paolo Masulli is employed by iMotions A/S., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Eye-contact modifies how we perceive emotions and modulates activity in the social brain network. Here, using fMRI, we demonstrate that adding a fixation cross in the eye region of dynamic facial emotional stimuli significantly increases activation in the social brain of healthy, neurotypical participants when compared with activation for the exact same stimuli observed in a free-viewing mode. In addition, using PPI analysis, we show that the degree of amygdala connectivity with the rest of the brain is enhanced for the constrained view for all emotions tested except for fear, and that anxiety and alexithymia modulate the strength of amygdala connectivity for each emotion differently. Finally, we show that autistic traits have opposite effects on amygdala connectivity for fearful and angry emotional expressions, suggesting that these emotions should be treated separately in studies investigating facial emotion processing., (© The Author (2017). Published by Oxford University Press.)

In this study we systematically compared syllable repetition and finger tapping in healthy adults, and explored possible impacts of tempi, metronome, musical experience, and age on motor timing ability. One hundred healthy adults used finger-tapping and syllable repetition to perform an isochronous pulse in three different tempi, with and without a metronome. Results showed that the motor timing was more accurate with finger tapping than with syllable repetition in the slowest tempo, and the motor timing ability was better with the metronome than without. Persons with musical experience showed better motor timing accuracy than persons without such experience, and the timing asynchrony increased with increasing age. The slowest tempo 90 bpm posed extra challenges to the participants. We speculate that this pattern reflects the fact that the slow tempo lies outside the 3-8 Hz syllable rate of natural speech, which in turn has been linked to theta-based oscillations in the brain.

Background: The assessment of intelligibility is an essential part of establishing the severity of a speech disorder. The intelligibility of a speaker is affected by a number of different variables relating, inter alia, to the speech material, the listener and the listener task., Aims: To explore the impact of the number of presentations of the utterances on assessments of intelligibility based on orthographic transcription of spontaneous speech, specifically the impact on intelligibility scores, reliability and intra-listener variability., Methods & Procedures: Speech from 12 children (aged 4:6-8:3 years; mean = 5:10 years) with percentage consonants correct (PCC) scores ranging from 49 to 81 was listened to by 18 students on the speech-language pathology (SLP) programme and by two recent graduates from that programme. Three conditions were examined during the transcription phase: (1) listening to each utterance once; (2) listening to each utterance a second time; and (3) listening to all utterances from a given child a third time after having heard all of its utterances twice., Outcomes & Results: Statistically significant differences between intelligibility scores were found across the three conditions, i.e. the intelligibility score increased with the number of presentations while inter-judge reliability was unchanged. The results differed markedly across listeners, but each individual listener's results were very consistent across conditions., Conclusions & Implications: Information about the number of times an utterance is presented to the listener is important and should therefore always be included in reports of research involving intelligibility assessment. There is a need for further research and discussion on listener abilities and strategies., (© 2015 Royal College of Speech and Language Therapists.)

The aim of this study was twofold: first, to describe a new Swedish intelligibility test (Swedish Test of Intelligibility for Children, STI-CH) and second to evaluate its validity and reliability. STI-CH is based on the repetition of single words. Ten children with a speech-sound disorder (4:6-8:3 years of age, mean = 6.0 years) and 10 children with typical speech and language development (4:8-7:4 years of age, mean = 5.9 years) were included. Twenty speech-language pathology students served as listeners. Intra-judge reliability was high (r > 0.92), as was the intra-class correlation of inter-judge reliability (0.97). In terms of validity, there was a significant difference in STI-CH scores between the two groups, and the scores correlated statistically significantly with the Percentage of Consonants Correct (r = 0.94) and with intelligibility in spontaneous speech (r = 0.85). To sum up, the results indicate that STI-CH could be an option for the assessment of intelligibility in Swedish-speaking children, and that the principles used in the development of the test could be of use in the design of intelligibility tests in languages other than Swedish.

Background: Research in the last decades has clearly pointed to the important role of language and communicative level when trying to understand developmental trajectories in children with autism spectrum disorders (ASD)., Aims: The purpose of this longitudinal study was to investigate whether (1) core language skills, measured as expressive vocabulary and grammar, and/or (2) pre-linguistic social-communicative skills, including gestures and imitation abilities, drive pragmatic language development in young children with ASD., Methods & Procedures: We examined correlates and longitudinal predictors of pragmatic growth in a sample of 34 children with Autism spectrum disorder (ASD), whose parents were given parts of two MacArthur Communicative Developmental Inventories (CDI: Words & Gestures and CDI: Words & Sentences) for completion at two time points (at time 1 the mean child age was 41 months, and at time 2 it was 54 months). A novel feature in this study is that the relevant parts from both CDI forms were included at both time points, allowing us to examine whether pre-linguistic social-communication skills (e.g. imitation and gesturing) and/or core language skills (i.e. grammar and vocabulary) predict pragmatic language growth., Outcomes & Results: The results show that basically all pre-linguistic, linguistic and pragmatic skills were associated concurrently. When controlling for possible confounders and for the autoregressive effect, imitation skills predicted pragmatic growth over time, whereas core language did not. This could only have been shown by the use of both CDI forms., Conclusions & Implications: This preliminary study may be of both conceptual and methodological importance for research in the field of language and communication development in ASD. Imitation may play a pivotal role in the development of subsequent conversational pragmatic abilities in young children with ASD. Future research should be directed at unravelling the mechanisms underlying this association., (© 2014 Royal College of Speech and Language Therapists.)

Oral narrative retelling is often problematic for children with communicative and neurodevelopmental disorders. However, beyond a suggested role of language level, little is known about the basis of narrative performance. In this study we examine whether oral narrative retelling might be associated not just with language level but also with skills related to nonverbal narrative temporal sequencing. A diagnostically heterogeneous sample of Swedish-speaking children with a full scale IQ >70 was included in the study (N = 55; age 6-9 years). Narrative retelling skills were measured using the three subscores from the bus story test (BST). Independent predictors included (1) temporal sequencing skills according to a picture arrangement test and (2) a language skills factor consisting of definitional vocabulary and receptive grammar. Regression analyses show that language skills predicted BST Sentence Length and Subordinate Clauses subscores, while both temporal sequencing and language were independently linked with the BST Information subscore. When subdividing the sample based on nonverbal temporal sequencing level, a significant subgroup difference was found only for BST Information. Finally, a principal component analysis shows that temporal sequencing and BST Information loaded on a common factor, separately from the language measures. It is concluded that language level is an important correlate of narrative performance more generally in this diagnostically heterogeneous sample, and that nonverbal temporal sequencing functions are important especially for conveying story information. Theoretical and clinical implications are discussed., (© 2013 The Scandinavian Psychological Associations.)