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BACKGROUND Adolescents and young adults (AYAs) diagnosed with cancer experience physical, cognitive, and psychosocial effects from cancer treatment that can negatively affect their ability to remain engaged in education or work through cancer treatment and in the long-term. Disengagement from education or work can have lasting implications for AYAs’ financial independence, psychosocial wellbeing, and quality of life. Australian AYAs with cancer lack access to adequate specialist supports for their education and work needs, and report preference for online support that they can access from anywhere, in their own time. However, it remains unclear what online resources exist that are tailored to support AYAs with cancer in reaching their educational or work goals. OBJECTIVE This study aimed to determine (1) what online resources exist for Australian AYAs with cancer, to support return to education or work, and (2) identify the degree to which existing resources are age-specific, cancer-specific, culturally inclusive, evidence-based, are co-designed with AYAs, use age-appropriate language, and are easy to find. METHODS We conducted an environmental scan by searching Google with English search terms in August 2022 to identify information resources about employment and education for AYAs ever diagnosed with cancer. Data extraction was conducted in Microsoft Excel and the following were assessed: understandability and actionability (using the Patient Education and Materials Tool; PEMAT), readability (using the Sydney Health Literacy Lab (SHeLL) editor), and whether the resource was easy to locate, evidence-based, co-designed with AYA, and culturally inclusive of Aboriginal and Torres Strait Islander peoples. The latter was assessed using seven criteria previously developed by members of the research team. RESULTS We identified 24 online resources comprised of 20 written text resources and 12 video resources. Most resources (87.5%) were published by non-government organisations (NGOs) in Australia, Canada, the USA, and the UK. Seven resources focused on education, eight focused on work, and nine focused on both education and work. Evaluation of resources demonstrated poor understandability and actionability. Resources were rarely evidence-based or co-designed by AYAs, were difficult to locate online, and were largely not inclusive of Aboriginal and Torres Strait Islander populations. CONCLUSIONS Although online resources for AYAs with cancer are often available through the websites of hospitals or NGOs, this environmental scan suggests they would benefit from more evidence-based and actionable resources that are available in multiple formats (e.g., text and audio-visual) and tailored to be age-appropriate and culturally inclusive.

Purpose: This study aimed to provide detailed descriptive information about the speech of a heterogeneous cohort of children with autism spectrum disorder (ASD) and to explore whether subgroups exist based on this detailed speech data. High rates of delayed and disordered speech in both low-verbal and high-functioning children with ASD have been reported. There is limited information regarding the speech abilities of young children across a range of functional levels. Method: Participants were 23 children aged 2;0–6;11 (years;months) with a diagnosis of ASD. Comprehensive speech and language assessments were administered. Independent and relational speech analyses were conducted from single-word naming tasks and spontaneous speech samples. Hierarchical clustering based on language, nonverbal communication, and spontaneous speech descriptive data was completed. Results: Independent and relational speech analyses are reported. These variables are used in the cluster analyses, which identified three distinct subgroups: (a) children with high language and high speech ability ( n = 10), (b) children with low expressive language and low speech ability but higher receptive language and use of gestures ( n = 3), and (c) children with low language and low speech development ( n = 10). Conclusions: This is the first study to provide detailed descriptive speech data of a heterogeneous cohort of children with ASD and use this information to statistically explore potential subgroups. Clustering suggests a small number of children present with low levels of speech and expressive language in the presence of better receptive language and gestures. This communication profile warrants further exploration. Replicating these findings with a larger cohort of children is needed. Supplemental Material https://doi.org/10.23641/asha.16906978

Purpose: Brain tumour and leukaemia represent the most common childhood cancers and can result in communication and swallowing difficulties. The purpose of this study was to survey health professionals and consumers regarding the management of communication and swallowing difficulties in children with brain tumour or leukaemia (CBTL).Method: In this study participants completed a survey focussing on (1) communication and swallowing assessment and intervention, (2) multidisciplinary team (MDT) practices and (3) risk factors. Quantitative data were reported using descriptive statistics. Qualitative data were analysed using NVivo12 Qualitative Data Analysis Software.Result: Twenty-four participants were included (22 health professionals; two consumers). Most participants (≥80%) agreed that comprehensive and regular communication and swallowing assessments improved outcomes. Communication and swallowing interventions were reported to improve outcomes by 96% of participants. MDT care was considered essential in improving outcomes. Speech-language pathologists were the primary health professional identified in communication management; additional multidisciplinary health professionals were highlighted in swallowing management. Risk factors were identified across three categories: cancer-related, treatment-related and child-factors.Conclusion: This study collates the expertise and experience of multidisciplinary health professionals and consumers which can be used to guide assessment and intervention for communication and swallowing in CBTL. It also provides perspectives on MDT care and consideration of patient values and risk factors.

The effect of childhood brain tumor and its treatments on the developing brain are recognized to cause late-occurring structural and functional changes, inclusive of neurocognitive and communication disturbances.The aim of the present study was to investigate changes in function in the prospective cognitive-communication and language abilities of two children surviving childhood brain tumor (CBT) over a 12-month period post-treatment.The comprehensive language and cognitive-communication abilities of two cases (male aged 7;8-8;8, female aged 10;9-11;9) were assessed at two timepoints over a 12-month period: six months and 18 months following completion of CBT cancer treatment.Findings revealed a sharp decline in problem solving abilities over a 12-month period in the early stages of recovery from CBT in both cases examined, despite no or mild-moderate deficits in cognitive-communication or language function at initial assessment. Pre-literacy skills were noted to deteriorate on one task for one child, despite intact abilities at first assessment.The findings of progressive deterioration of cognitive-communication skills in both children treated for CBT highlights a clear need for ongoing surveillance and full comprehensive assessment across development. The critical need for ongoing management after discharge and implementation of early intervention throughout development is highlighted.

Infant dysphagia is commonly managed using thickened formulas. Substantial research investigates thickening of a variety of beverages for adults and children, yet few studies address the unique considerations of thickened formula for infants. Understanding the consistency and behaviour of thickened formula will guide clinicians and parents to make informed decisions to minimise risk of aspiration. To investigate the effect of time and storage temperature on the flow properties of thickened formula, four formulas and two thickeners currently utilised at a major metropolitan children’s hospital in Australia were tested in combinations, at refrigerated and room temperatures. Their flow properties were measured at three time-points (baseline, 1 h, 24 h) using the International Dysphagia Diet Standardisation Initiative (IDDSI) Flow Test, the current clinical standard for classifying drinks based on flow properties. A combination of paired t tests, Wilcoxon Signed-Rank tests, repeated measures analysis of variance (ANOVA) and Cohen’s d was used to statistically compare flow properties and determine the significance of the observed data. At baseline, 98% (n = 48) of the thickened formula bottles were measured as thinner than the “mildly thick” IDDSI category to which they were prepared. Conversely, at 24 h, 17% were measured thicker than “mildly thick” whilst 10% measured too thin for the category “mildly thick”. Refrigerated samples increased in thickness more significantly over time compared to those stored at room temperature. Two of the formulas, when thickened, resulted in a foamy mixture non-compatible with IDDSI Flow Test measurement. As a result, these two formulas were not subjected to further testing. All the tested commercial products behaved differently to each other and were unstable over varying times and temperatures. This finding indicates the need for improved guidelines regarding preparation and storage of thickened fluids. Further investigation is recommended into the chemical processes underlying the observed deviations.

Subgroups of children with different speech profiles have been described however, little is known about the trajectories of speech development or stability of subgroups over time. This longitudinal study described both speech trajectories and subgroup stability of 22 autistic children, aged 2;0–6;11 years, over 12 months. Independent and relational speech analyses, vocabulary size and nonverbal communication were used in clustering. Results suggest varied speech trajectories, particularly for children with ‘low language and low speech’ at Time 1. Receptive vocabulary and consonant inventory at Time 1 may predict speech outcomes after 12 months. A small subgroup of children (n = 3) present with low expressive vocabulary and speech but higher receptive vocabulary and use of gestures. This unique profile remained stable.

Impaired swallowing in infants can impact upon the ability to feed orally, often resulting in dependency on supplementary feeding. Such difficulties can lead to an increased burden of care and associated costs. The primary aim of this study was to investigate the impact of vocal cord palsy (VCP), acquired intraoperatively during cardiac surgery, on the feeding outcomes of infants at a tertiary metropolitan children's hospital. An additional aim was to obtain preliminary information on the impact of feeding difficulties in this group on the quality of life of parents and families. A review of 48 patients who had been referred to the speech pathology service was undertaken. Participants presented with heterogeneous cardiac diagnoses, and had an initial Videofluoroscopic Swallow Study (VFSS) at a median corrected age of 3.6 weeks. Sixty percent of participants presented with silent aspiration on VFSS. Thirty percent of participants required supplementary tube feeding more than 6 months post-surgery. Six percent of participants with poor feeding progress and persistent aspiration required further surgical intervention to support nutrition. Findings revealed no significant relationship between participant factors and the presence of feeding difficulties, however, infants with concomitant genetic and syndromic conditions were found to be most at-risk for long-term feeding difficulties. Analysis of informal parent questionnaire responses indicated parents experienced stress and anxiety after their child's discharge. This was noted in regard to their child's feeding, which impacts quality of life across a number of domains. Findings of this study highlight the importance of communicating the potential feeding difficulties to parents of at-risk infants prior to cardiac surgery. This study further highlighted the importance of routine post-operative otorhinolaryngology examinations following high-risk surgeries, as well as speech pathology management for all infants and children identified with VCP. Post-operative input from appropriately trained Speech Pathologists is vital in assisting parents to support and mitigate their child's difficulties through the provision of early intervention for feeding difficulties.

The purpose of this systematic review was to appraise and synthesize evidence on communication and swallowing outcomes associated with childhood brain tumor or leukemia (CBTL). A comprehensive database and grey literature search was conducted. Studies included: (a) peer-reviewed research published between 1998 and 2019, (b) English language, (c) children aged 0-16 years diagnosed with CBTL, and (d) used outcome measures focused on communication and/or swallowing. Quality assessment was completed and certainty of evidence rated using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Fifty-seven studies met inclusion criteria: 46 examined communication, seven examined swallowing, and four considered both. Most studies were descriptive and prospective. Communication difficulties were frequently reported and apparent at one or more points from diagnosis to survivorship. Swallowing difficulties were frequently reported during oncology treatment. Despite quality assessment revealing methodological shortcomings, results have implications for clinical services and future research.

Infant dysphagia is commonly managed using thickened formulas. Substantial research investigates thickening of a variety of beverages for adults and children, yet few studies address the unique considerations of thickened formula for infants. Understanding the consistency and behaviour of thickened formula will guide clinicians and parents to make informed decisions to minimise risk of aspiration. To investigate the effect of time and storage temperature on the flow properties of thickened formula, four formulas and two thickeners currently utilised at a major metropolitan children's hospital in Australia were tested in combinations, at refrigerated and room temperatures. Their flow properties were measured at three time-points (baseline, 1 h, 24 h) using the International Dysphagia Diet Standardisation Initiative (IDDSI) Flow Test, the current clinical standard for classifying drinks based on flow properties. A combination of paired t tests, Wilcoxon Signed-Rank tests, repeated measures analysis of variance (ANOVA) and Cohen's d was used to statistically compare flow properties and determine the significance of the observed data. At baseline, 98% (n = 48) of the thickened formula bottles were measured as thinner than the "mildly thick" IDDSI category to which they were prepared. Conversely, at 24 h, 17% were measured thicker than "mildly thick" whilst 10% measured too thin for the category "mildly thick". Refrigerated samples increased in thickness more significantly over time compared to those stored at room temperature. Two of the formulas, when thickened, resulted in a foamy mixture non-compatible with IDDSI Flow Test measurement. As a result, these two formulas were not subjected to further testing. All the tested commercial products behaved differently to each other and were unstable over varying times and temperatures. This finding indicates the need for improved guidelines regarding preparation and storage of thickened fluids. Further investigation is recommended into the chemical processes underlying the observed deviations.

Verbal fluency tests are often used as part of an assessment battery to investigate children's lexical knowledge as well as executive function skills. To date, however, issues surrounding consistency of measurement cloud comparisons across studies, with the developmental performance of Australian-English speaking children also currently lacking. This study tracked verbal fluency development as measured by two semantic fluency tasks that included coding of fluency, clustering and switching type responses.Participants included 355 typically developing Australian-English speaking children (4-10 years) and 46 young adults. Total fluency was determined by the number of words produced for each category (Animals or Food), minus repetitions and rule violations. Semantic clusters (words generated within a subcategory) were coded while switches between single words or subcategories were differentiated and coded as either hard or cluster switches.Fluency showed consistent improvement over age. Cluster Switches and Hard Switches showed some evidence of a plateau in performance relative to fluency, but in opposite direction. Other measures showed no strong trends over age. Results were similar for both semantic categories.Our results highlight the rich information available within a semantic fluency task and the importance of differentiating hard and cluster switches in paediatric samples.

Introduction: Tumors of the cerebellum are the most common brain tumors in children. Modern treatment and aggressive surgery have improved the overall survival. Consequently, growing numbers of survivors are at high risk for developing adverse and long-term neurological deficits including deficits of cognition, behavior, speech, and language. Post-operative cerebellar mutism syndrome (pCMS) is a well-known and frequently occurring complication of cerebellar tumor surgery in children. In the acute stage, children with pCMS may show deterioration of cerebellar motor function as well as pyramidal and cranial neuropathies. Most debilitating is the mutism or the severe reduction of speech and a range of neurobehavioral symptoms that may occur. In the long term, children that recover from pCMS continue to have more motor, behavioral, and cognitive problems than children who did not develop pCMS after cerebellar tumor surgery. The severity of these long-term sequelae seems to be related to the length of the mute phase. Aim of this narrative review: The impact of pCMS on patients and families cannot be overstated. This contribution aims to discuss the present knowledge on the natural course, recovery, and rehabilitation of children with pCMS. We suggest future priorities in developing rehabilitation programs in order to improve the long-term quality of life and participation of children after cerebellar tumor surgery and after pCMS in particular., SCOPUS: re.j, info:eu-repo/semantics/published

The narrative skills of children with brain tumours were examined. Influence of tumour location, radiotherapy, time post-treatment and presence of hydrocephalus was also investigated, as well as associations between narrative and language abilities.Seventeen children (aged 5;6-14;11) treated for brain tumour and their matched controls completed a narrative assessment and comprehensive language testing. Audio recorded narratives were analysed for microstructure and macrostructure elements. Between-group comparisons were conducted. Narrative elements were explored in association with tumour and treatment-related variables. Correlation analysis examined relationships between narrative scores and language test performance.While significant differences were not found between two groups of children across narrative elements, sub-group comparisons revealed marginal differences in macrostructure related to tumour location and hydrocephalus. Children treated with methods other than radiotherapy showed a significant increase in number of mazes in their narratives compared to children who received radiotherapy. Strong positive correlations also existed between narrative elements and language performance.Preliminary findings highlight the importance of investigating narrative abilities as part of a comprehensive language assessment. Macrostructure should be routinely examined where children are diagnosed with either posterior fossa tumour or hydrocephalus or have undergone surgery and/or chemotherapy for brain tumour.

Psychosocial functioning is compromised following pediatric traumatic brain injury (TBI), with the past few decades witnessing a proliferation of research examining the effect of childhood brain insult on a range of psychosocial outcomes. This paper describes the systematic recommendation of outcome instruments to address psychosocial functioning following pediatric TBI. A total of 65 instruments across 11 psychosocial areas (i.e., Global Outcome, Communication, Social Cognition, Behavioural and Executive Function, Other Neuropsychological Functioning, Psychological Status, TBI-related Symptoms, Activities and Participation, Support and Relationships, Sense of Self, and Health-Related Quality of Life) were reviewed using various assessment methods, including working groups, literature searches, comparisons with selection guidelines, and international expert opinion. Each measure was reviewed for its usefulness across early recovery, intervention, and outcome related studies. 34 instruments were recommended and classified according to the World Health Organization's International Classification of Functioning, Disability and Health taxonomy and categorised by psychosocial area. This compilation provides a common framework to guide the activities of clinicians and researchers in psychosocial rehabilitation. It is anticipated that these will foster a multidisciplinary approach to psychosocial dysfunction to enhance the evaluation, prediction, and improvement of functional outcomes for those with pediatric TBI.

This study is about the role of elicited verbal imitation in toddler word learning. Forty-eight toddlers were taught eight nonwords linked to referents. During training, they were asked to imitate the nonwords. Naming of the referents was tested at three intervals (one minute later [uncued], five minutes, and 1–7 days later [cued]) and recognition at the last two intervals. Receptive vocabulary, nonword repetition, and expressive phonology were assessed. The accuracy of elicited imitation during training predicted naming at one and five minutes, but not 1–7 days later. Neither nonword repetition nor expressive phonology was associated with naming over time but extant vocabulary predicted performance at all time intervals. We hypothesize that elicited imitation facilitates word learning in its earliest stages by supporting encoding of the word form into memory and allowing practice of the articulatory-phonological plan. At later stages, vocabulary facilitates integration of the word form into the lexical network.

Children who survive brain tumour are a growing population, and are increasingly seen in clinical caseloads worldwide. However, cure often comes at a cost, with devastating neurocognitive and communicative sequelae commonly seen in children across the course of development. The impact of tumour and treatment-related variables on the development and acquisition of neurocognitive and communicative skills is considerable, and includes the direct effect of a tumour located in the supratentorial and infratentorial regions, raised intracranial pressure, treatment effects from surgical intervention, radiotherapy, and/or chemotherapy, and other risk factors. Pragmatic abilities and social competence are commonly disrupted in childhood brain tumour (CBT), with devastating effects on quality of life. This chapter addresses the key social skills and constructs of social ability associated with CBT in addition to the primary mechanisms underpinning pragmatic deficits in CBT. Management of pragmatic deficits associated with CBT requires an integrated approach to assessment, treatment, and long-term surveillance. It is also important that these children are not ‘lost’ to services considered essential to ensuring improvements in social functioning and pragmatic competence. These approaches to assessment and intervention are outlined.

Background/aim Children with attention deficit hyperactivity disorder (ADHD) often present with pragmatic language deficits and difficulties with peer–peer friendships. Parents and typically developing peers (TDPs) may be able to assist via parent and peer-mediated intervention approaches when adequately supported by trained adult facilitators. This study investigated whether a parent-delivered play-based intervention supported by occupational therapists and speech language pathologists was feasible and improved the pragmatic language skills of children with ADHD and their TDPs. Methods Nine children with ADHD paired with nine TDPs (mean age = 8.2 years) participated. The seven-week intervention was delivered by parents of children with ADHD at their home and consisted of weekly assigned home-based modules, supported play-dates between the pairs of children and supplemented by three clinic visits. Parent adherence to intervention activity was monitored on a weekly basis. Blinded ratings of observed peer–peer play interactions were used to detect changes in pragmatic language from pre–post intervention and one month follow-up using the Pragmatic Observation Measure (POM). Results All parents reported completing the seven weekly home-based modules and attended all clinic visits. Significant improvements in observed pragmatic language skills were found from pre-follow-up for both the ADHD and TDP children and pre–post for the ADHD children. Conclusion The preliminary findings suggest that using parents to facilitate their child's pragmatic language skills was a feasible intervention approach with parents acting as agents of change to improve the pragmatic language of their children. This exploratory study identifies the need for further large-scale research to address the pragmatic language skills of children with ADHD using parent-delivery in a play-based, peer–peer context.

Communication and play skills are important aspects of development yet are largely uncharted in children with attention deficit hyperactivity disorder (ADHD). This exploratory study examined whether changes in pragmatic skills and problem-solving skills were observed in children with ADHD pre- and post-participation in a play-based intervention conducted by occupational therapists and speech-language pathologists. The study also investigated whether the presence of language difficulties affected the children’s play outcomes. Fourteen children with ADHD (5;0–10;7 years) participated in a 7-week, pilot intervention to address play and social skill deficits. Pre- and post-intervention testing included: (a) the assessment of play and problem-solving skills via standardized testing, and (b) pragmatic skills via parent report. The children’s language skills were also screened and compared with their play scores. Play skills significantly improved post-intervention. No significant differences were observed for pragmatic skills while prediction skills, an aspect of problem-solving, significantly improved pre- and post-play-based intervention. Fifty percent of children failed the language screener, yet separate paired t-tests identified significant play improvements irrespective of the presence or absence of language difficulty. Two independent t-tests revealed significant differences in play scores between these groups at pre- but not post-intervention. While play and predicting skills significantly improved post-play-based intervention, other aspects of problem-solving and pragmatics did not. Reasons for the lack of change in these areas are discussed. The presence of language difficulties did not appear to affect the play outcomes of children with ADHD following a play-based intervention. A larger scale experimental trial investigating the play and language skills of children with ADHD is warranted, as is future collaborative research between occupational therapists and speech-language pathologists in the assessment and management of children with ADHD.

Purpose The purpose of this systematic review was to provide a summary and evaluation of speech assessments used with children with autism spectrum disorders (ASD). A subsequent narrative review was completed to ascertain the core components of an evidence-based pediatric speech assessment, which, together with the results of the systematic review, provide clinical and research guidelines for best practice. Method A systematic search of eight databases was used to find peer-reviewed research articles published between 1990 and 2014 assessing the speech of children with ASD. Eligible articles were categorized according to the assessment methods used and the speech characteristics described. Results The review identified 21 articles that met the inclusion criteria, search criteria, and confidence in ASD diagnosis. The speech of prelinguistic participants was assessed in seven articles. Speech assessments with verbal participants were completed in 15 articles with segmental and suprasegmental aspects of speech analyzed. Assessment methods included connected speech samples, single-word naming tasks, speech imitation tasks, and analysis of the production of words and sentences. Conclusions Clinical and research guidelines for speech assessment of children with ASD are outlined. Future comparisons will be facilitated by the use of consistent reporting methods in research focusing on children with ASD.

Children with Attention Deficit Hyperactivity Disorder (ADHD) commonly experience significant pragmatic language deficits which put them at risk of developing emotional and social difficulties. This study aimed to examine the pragmatic language exhibited in a peer-to-peer interaction between the children with ADHD and their playmates following a pilot play-based intervention. Participants were children (aged 5–11 years) diagnosed as having ADHD (n = 14) and their self-selected typically-developing playmate. Pragmatic language was measured using the Pragmatic Protocol (PP) and the Structured Multidimensional Assessment Profiles (S-MAPs). Children's structural language was also screened and compared against their pragmatic language skills pre–post play-based intervention. The pragmatic language of children with ADHD improved significantly from pre–post intervention as measured by both the PP and S-MAPs. Both children with and without structural language difficulties improved significantly from pre- to post-intervention using S-MAPs; only children with structural language difficulties improved significantly using PP. The findings support the notion that pragmatic skills may improve following a play-based intervention that is characterized by didactic social interaction. As pragmatic language is a complex construct, it is proposed that clinicians and researchers reconsider the working definition of pragmatic language and the operationalization thereof in assessments.

To investigate casual conversations with friends following severe traumatic brain injury (TBI).Nine participants with severe TBI were matched by age, gender and education to nine control participants. Each participant also invited a friend to partake in the study. Participants were recorded engaging in a brief casual conversation with a friend. The resulting discourse was analysed using Exchange Structure Analysis (ESA). Rates of information giving, information requesting and communication repair and negotiation were collated. Non-parametric statistical analyses were performed.Participants with and without TBI obtained similar rates of information giving and information requesting. The friends of the participants with TBI produced significantly lower rates of information giving measures when compared to the controls, but achieved comparable rates of information requesting and communication repair and negotiation measures. Participants with TBI were observed to produce tangential language and to have difficulties identifying communication breakdown, asking questions and engaging in conversational joking.People with TBI are able to engage in casual conversations with friends in a similar way to matched controls. Friends of people with TBI are often restricted in contributing information in conversations. Further research is needed to specify the facilitative and restrictive communication behaviours so that they may be translated to clinical practise.

Introduction: Many children with attention deficit hyperactivity disorder (ADHD) have serious social and peer difficulties that can lead to adverse outcomes in adolescence and adulthood. To date, psychosocial treatments have produced poor outcomes in reducing social impairments commonly associated with ADHD. This study aimed to examine the efficacy of a new intervention designed to improve the play and social skills of children with ADHD and their playmates within the natural context of play. Methods: Participants included children (aged 5–11 years) diagnosed with ADHD, age-matched typically developing playmates (n = 14/group) and parents of children with ADHD. The intervention involved seven weekly video-recorded free-play sessions; video feed-forward/feedback and therapist- and peer-modelling were used to promote social play. The Test of Playfulness was used as a pre-/post-test measure. Data were subjected to Rasch analysis to calculate measure scores on interval level; dependant sample t-test and Cohen-d calculations were used to measure effect. Results: A dependant samples t-test revealed that both children with ADHD (t = 8.1; d.f. = 13; P < 0.01) and their playmates (t = 6.9; d.f. = 13; P < 0.01) improved in their social play. Results demonstrated a large effect in improving the social play of children with ADHD (d = 1.5) and their playmates (d = 1.3). Discussion: Results support the use of play, video feed-forward/feedback techniques, therapist- and peer-modelling and parent involvement as an effective means to develop the social play skills of children with ADHD. Further larger-scale research is required.

Using cross-sectional and longitudinal approaches, the current research investigated the language skills of two boys following CNS-targeted chemotherapy-only treatment for acute lymphoblastic leukaemia. A single case-multiple comparison study of each boy's general language skills, as assessed by the Clinical Evaluation of Language Fundamentals-Fourth Edition, the Peabody Picture Vocabulary Test-Third Edition Form A, and the Hundred Pictures Naming Test, and each boy's high level language skills as assessed by the Test of Language Competence-Expanded Edition, and the Test of Problem Solving-Elementary, Revised or the Test of Problem Solving-3 was undertaken. Additionally, using test norms only for comparison, the boys' language skills were assessed three times over a two-year period. The findings suggest that the language skills of both boys were generally within one standard deviation of their respective control group's mean, although one boy was experiencing moderate difficulty with high-level la...

Background/Aims:Childhood-acquired cerebellar studies to date have appeared to present a concordant pattern of specific neuropsychological profiles depending on lesion site. The aim was to determine the impact of a cerebellar tumour specifically on language function in children by reporting both the general and high-level language abilities of 4 cases with differing sites of hemispheric and vermal involvement. Methods: The language abilities of 4 children (aged from 7 years 9 months to 13 years), treated with surgery and/or radiotherapy for cerebellar tumour 6 months to 3 years previously, were examined. A standardized battery of general and high-level language assessments was administered. Results: Analysis revealed intact abilities across all 4 cases on measures of general language, including receptive language, expressive language, receptive vocabulary and naming. While 2 of the 4 cases also demonstrated intact high-level language skills across all measures, the remaining 2 demonstrated specific deficits in linguistic problem solving at 6 months after treatment. Follow-up assessment of 1 case also demonstrated further decline in this area 12 months later. Conclusion: Findings of high-level language deficits in problem solving in 2 of the 4 cases examined supported previous reports of specific impairments in high-level language and in thinking flexibility and problem solving following cerebellar hemispheric damage in childhood.

While the occurrence and management of brainstem tumours in children would not traditionally indicate potential direct structural impact on classical language centres, recent theories have implicated some involvement of the brainstem in a functional language and cognitive neural loop between the cerebellum and the cerebral hemispheres. Thus, the present paper explored the impact of treatment for brainstem tumour on the general and high-level language abilities of six children treated for brainstem tumour, in addition to phonological awareness skills. Group analysis revealed that children treated for brainstem tumour demonstrated intact language and phonological awareness abilities in comparison to an age- and gender-matched control group. Individual analysis revealed only one of six children treated for brainstem tumour revealed evidence of language disturbances, with an additional child demonstrating an isolated mildly reduced score on one phonological awareness task. Language deficits identified in a child treated with a combination of both radiotherapy and chemotherapy were noted in the high-level language area of lexical generation. Findings highlighted that no overt language disturbances were evident in children treated for brainstem tumour. However, further analysis into higher-level language skills in the present study indicated that both general and high-level language abilities require long-term monitoring in this population.

Background: Recent research addressing evidence from functional neuroimaging studies, neurophysiological research, and new advances in neuropsychology together with traditional cerebellar lesion studies have recently implicated the cerebellum in adult language and cognitive functions. However, more limited information is currently available in describing the functional connectivity present in the paediatric population. Aims: It is the purpose of this paper to review recent clinical research pertaining to paediatric populations, outlining the impact of site of lesion and specific associated clinical changes in children with cerebellar disturbances. Main contribution: The specific contribution of the right cerebellar hemisphere to language function is identified to also exist in the paediatric population, highlighting the existence of functional connections between this region of the brain and left frontal cortical areas early in development. Conclusions: Implications for future research in paediatric populations are extensive, as a greater awareness and an understanding of the recently acknowledged involvement of the cerebellum in cognition and nonmotor linguistic function is anticipated to also add new dimension and direction to the analysis of childhood language outcomes associated with the cerebellum.

This study's objective was to examine the current assessment practices of SLPs working with adults with acquired cognitive communication impairments following a TBI.Two hundred and sixty-five SLPs from the UK, the US, Canada, Australia and New Zealand responded to the online survey stating the areas of communication frequently assessed and the assessment tools they use.SLPs reported that they routinely assessed functional communication (78.8%), whereas domains such as discourse were routinely assessed by less than half of the group (44.3%). Clinicians used aphasia and cognitive communication/high level language tools and tools assessing functional performance, discourse, pragmatic skills or informal assessments were used by less than 10% of the group. The country and setting of service delivery influenced choice of assessment tools used in clinical practice.These findings have implications for training of SLPs in a more diverse range of assessment tools for this clinical group. The findings raise questions regarding the statistical validity and reliability of assessments currently used in clinical practice. It highlights the need for further research into how SLPs can be supported in translating current evidence about the use of assessment tools into clinical practice.

Two female subjects aged between 10 and 12 years, 20 months post high-dose radiotherapy for a low-grade astrocytoma in the brainstem region, were found to have intact language abilities across a wide range of skills including higher-level language and literacy. Subjects were tested using a battery of standardised language assessments covering general receptive and expressive language abilities, confrontation naming, problem solving, complex reasoning, knowledge and use of word functions, higher-level language, and literacy. In these particular cases, radiotherapy as a treatment for paediatric brainstem tumour in the absence of surgery or chemotherapy did not impact on communication ability. While no effects on language may manifest one to two years following treatment, the need to monitor patients in the long term is highlighted, as is longitudinal research at greater intervals post treatment. By removing the potential impact of surgical intervention, and/or chemotherapy, these cases can provide a...

The aim of the present study was to examine the linguistic humour abilities of a group of adolescents with head injury on a case-by-case basis. Nine adolescents with head injury aged between 12 years 1 month and 15 years 4 months, and nine individually matched adolescents aged between 12 years 1 month and 16 years 1 month were administered a humour test, a standard language battery, the CELF-3, and the Self-Esteem Index. The test of humour abilities required each subject to recognize and select an explanation from a group of three, as to what made each item funny. Items were based on morphological, semantic and syntactic humour elements. Examination of the individual profiles of each subject with head injury illustrated the existence of variability between subjects representing three language abilities in the presence of mild head injury; and impaired humour ability with concurrent language skills that are within normal limits. This third pattern supports previous studies, which have documented the occurrence of high-level language impairment while language abilities are intact. The present study emphasized the importance of investigating the abilities of individuals who have had a head injury in childhood, within a developmental framework. This perspective serves to highlight the context of contributing aspects that impact on future language development and recovery of injury, such as the time that the injury occurred in a child's development, in addition to injury severity and main trends: reduced humour abilities together with below average language skills; intact humour and the time that has elapsed post-injury.

Upon fast mapping, children rarely retain new words even over intervals as short as five minutes. In this study, we asked whether the memory process of encoding or consolidation is the bottleneck to retention. Forty-nine children, mean age 33 months, were exposed to eight 2-or-3-syllable nonce neighbors of words in their existing lexicons. Didactic training consisted of six exposures to each word in the context of its referent, an unfamiliar toy. Productions were elicited four times: immediately following the examiner’s model, and at 1-minute-, 5-minute-, and multiday retention intervals. At the final two intervals, the examiner said the first syllable and provided a beat gesture highlighting target word length in syllables as a cue following any erred production. The children were highly accurate at immediate posttest. Accuracy fell sharply over the 1-minute retention interval and again after an additional 5 minutes. Performance then stabilized such that the 5-minute and multiday posttests yielded comparable performance. Given this time course, we conclude that it was not the post-encoding process of consolidation but the process of encoding itself that presented the primary bottleneck to retention. Patterns of errors and responses to cueing upon error suggested that word forms were particularly vulnerable to partial decay during the time course of encoding.

Many children with attention deficit hyperactivity disorder (ADHD) have serious social and peer difficulties that can lead to adverse outcomes in adolescence and adulthood. To date, psychosocial treatments have produced poor outcomes in reducing social impairments commonly associated with ADHD. This study aimed to examine the efficacy of a new intervention designed to improve the play and social skills of children with ADHD and their playmates within the natural context of play.Participants included children (aged 5-11 years) diagnosed with ADHD, age-matched typically developing playmates (n=14/group) and parents of children with ADHD. The intervention involved seven weekly video-recorded free-play sessions; video feed-forward/feedback and therapist- and peer-modelling were used to promote social play. The Test of Playfulness was used as a pre-/post-test measure. Data were subjected to Rasch analysis to calculate measure scores on interval level; dependant sample t-test and Cohen-d calculations were used to measure effect.A dependant samples t-test revealed that both children with ADHD (t=8.1; d.f.=13; P0.01) and their playmates (t=6.9; d.f.=13; P0.01) improved in their social play. Results demonstrated a large effect in improving the social play of children with ADHD (d=1.5) and their playmates (d=1.3).Results support the use of play, video feed-forward/feedback techniques, therapist- and peer-modelling and parent involvement as an effective means to develop the social play skills of children with ADHD. Further larger-scale research is required.

The aim of the present study was to determine the ability of adolescents with a head injury to interpret and comprehend linguistic humour. Nine adolescents with head injury aged between 12 years 1 month and 15 years 4 months, and nine individually matched adolescents aged between 12 years 1 month and 16 years 1 month were administered a humour test, a standard language battery, the CELF-3, and the Self-Esteem Index. The test of humour abilities required each subject to recognize and select an explanation from a group of three, as to what made each item funny. Items were based on morphological, semantic and syntactic humour elements. Comparison at a group level demonstrated that adolescents with head injury performed significantly poorer in the interpretation and comprehension of linguistic humour than a group of individually matched peers. Contrary to expectations, a relationship between the level of self-esteem and humour comprehension did not exist. The findings of the present study suggest that further research into the effects of head injury on linguistic humour in adolescents is warranted, particularly from a case-by-case perspective.