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Deixis -- a fundamental part of communication -- involves combinations of speech, gesture and eye-gaze, yet little is known about the temporal dynamics of this coordination. The authors analysed eye-gaze, pointing gestures and verbal productions in 514 deictic episodes during triadic, semi-naturalistic, book-reading sessions performed by Italian children (1;08--2;07) and their caregivers. Results show three new findings. First, deictic communication is overwhelmingly preceded and accompanied by shared attention (of consistent duration) on an object, and only sometimes by disjoint attention. Second, children are synchronously multimodal (conveying information via speech, pointing gesture and eye-gaze) in their deictic communications. Third, the form of deictic communication used is not related to the complexity of the linguistic structures of the sample. Deictic communication is remarkably consistent in children ranging from approximately 1;08 to 2;07 years of age.

Background: Developmental stuttering is associated with increased risk of psychological distress and mental health difficulties. Less is known about the impact of other developmental speech problems on psychological outcomes, or the impact of stuttering and speech problems once other predictors have been adjusted for. Aims: To determine the impact of parent-reported adolescent stuttering and other speech difficulties on psycho- logical distress and associated symptoms as measured by the Rutter Malaise Inventory. Method & Procedures: A British birth cohort dataset provided information about 217 cohort members who stuttered and 301 cohort members who had other kinds of speech problem at age 16 according to parental report, and 15,694 cohort members who had experienced neither stuttering nor other speech difficulties. The main analyses concerned associations between adolescent stuttering or speech difficulty and score on the Rutter Malaise Inventory at age 42. Other factors that had previously been shown to be associated with score on the Malaise Inventory were also included in the analyses. Outcomes & Results: In the adjusted analyses that controlled for other predictors, cohort members who were reported to stutter had higher malaise scores than controls overall, indicating a higher level of psychological distress, but they were not at significantly more likely to have malaise scores in the range indicating a risk of serious mental health difficulties. Cohort members who were reported to have other speech difficulties during adolescence had malaise scores that overall did not differ significantly from those of controls in the adjusted analyses, but they were at significantly greater risk of serious mental health difficulties. Conclusions & Implications: These findings support those of other studies that indicate an association between stuttering and psychological distress. This study is the first to have shown that adolescents who experience speech difficulties other than stuttering are more likely than controls to be at risk of poorer mental health in adulthood. The results suggest a need for therapeutic provision to address psychosocial issues for both stuttering and other developmental speech disorders in adulthood, as well as further research into the consequences in adulthood of stuttering and other developmental speech disorders. (Contains 4 tables and 1 figure.)

Aims and Objectives: This study explored the extent to which bilingual language exposure and practice might alter the way in which bilingual first-generation adult speakers use deictic demonstratives in their first language (Spanish) after immersion in a new language environment (Norwegian). Fully developed L1 systems are expected to be stable and less susceptible to change or restructuring than child systems. In addition, core domains of a language such as deictic demonstrative reference are hypothesized to be more robust. Design: Participants were tested with the Spanish version of the memory game. They completed an ethnolinguistic background questionnaire with questions targeting demographic data, experience with language, and daily routines in language use. Data and analyses: Demonstrative use was analysed using binomial multilevel modelling, allowing residual variance to be partitioned into a between-participant component and a within-participant component. Findings: Results demonstrate a shift in the demonstrative system of Spanish native speakers who have resided in Norway for a median of 6.5 years. This shift is reflected in extensive use of the semantically underspecified item ese at the expense of the form aquel. The latter form is less frequent and highly context-dependent in corpora of the modern language. It can be hypothesized that first-generation speakers are faster in converging on a simplified system of deictic reference than the native speaker group tested in Spain, but this development parallels tendencies observed in the monolingual variety of the language. This faster shift may well be influenced and catalysed by bilingual language practice. Originality: This article addresses a gap in research on deictic terms under conditions of language attrition. It documents a restructuring of the deictic system in first-generation speakers of Spanish residing in another country. The results suggest that marking peri-personal space is a core feature of deictic systems across languages, also preserved under deictic system shift. [ABSTRACT FROM AUTHOR]

Purpose: In interview and survey studies, people who stutter report the belief that stuttering has had a negative impact on their own education and employment. This population study sought objective evidence of such disadvantage for people who stutter as a group, compared with people who do not stutter. Method: A secondary analysis of a British birth cohort dataset was used in the study. At age 16, there were 217 cohort members who were reported by their parents to stutter, and 15,694 cohort members with no known history of stuttering or other speech problems. Data were analysed concerning factors associated with report of stuttering at 16, school leaving age, highest qualification, unemployment early in working life, pay at age 23 and 50, and social class of job at age 23 and 50. Results: Those who stuttered at 16 were statistically more likely than those who did not stutter to be male, to have poorer cognitive test scores, and to have been bullied. There were no significant effects of stuttering on educational outcomes. For employment outcomes, the only significant association with stuttering concerned socioeconomic status of occupation at 50, with those who had been reported to stutter having lower-status jobs. Discussion: These findings fail to support the belief that stuttering has a negative impact on education and employment. The higher likelihood of those who stutter working in lower-status positions may reflect their preference for avoiding occupations perceived to require good spoken communication abilities. Therapeutic implications are discussed. (Contains 10 tables and 1 figure.)

Objective: The objective of these analyses was to explore maternal antenatal decisions about baby walker use, factors associated with these decisions and the relationship between antenatal plans to use a walker and postnatal walker use. Design: Cross sectional study. Setting: Mothers-to-be (n = 1174) participating in a cluster randomised controlled trial of an educational package to reduce walker use in 64 general practices in the East Midlands of the United Kingdom. Method: Data on plans to use a walker, socio-demographic and economic characteristics, partner's views on walker use, knowledge of walker-related injury and attitudes towards walkers were collected at entry to the trial by means of a self-completion questionnaire. Data on post-natal walker use was collected by postal questionnaire nine months after delivery. Results: The majority of mothers-to-be (74 per cent) had already decided whether or not to use a walker prior to the birth of their baby and one-third were planning to do so. Several factors were identified which may be useful for identifying mothers-to-be who are undecided about walker use antenatally; these include partner's views on walkers, parity, housing tenure and attitudes towards walkers. Antenatal plans about walker use had high positive and negative predictive values for predicting postnatal walker use. Conclusion: Education regarding walker use will be an important method for reducing walker use until walkers are no longer available to purchase first or second hand. The results of this study will assist health professionals in identifying which mothers-to-be are likely to be undecided about walker use and this group may be more receptive to health education than those who have already made a decision. (Contains 5 tables and 1 figure.)

Objective. The Union of National European Pediatric Societies and Associations recognized the lack of information regarding demography of delivery of care and training for the doctors who care for children in Europe. Therefore, the Union of National European Pediatric Societies and Associations studied factors and explanations for the variation between countries regarding pediatric primary care (PPC) and community pediatrics (CP) as well as the extent of formal training provided for those who take care of children at the community level. Methods. An explanatory letter and a questionnaire with 12 questions regarding delivery of PPC and CP and training was mailed to the president of each of 41 national pediatric societies in Europe. Statistical data about population, country's income, and infant mortality rate (IMR) were also obtained from World Health Organization data. Statistical analysis using multivariate and linear regression was conducted to ascertain which variables were associated with IMR. Descriptive statistics regarding demography and training are also reported. Results. In 1999, a total of 167 444 pediatricians served a population of 158 million children who were younger than 15 years and living in the 34 reporting European countries. The median number of children per pediatrician was 2094; this varied from 401 to 15 150. A pediatric system for PPC existed in 12 countries; 6 countries had a general practitioner system, and a combined system was reported from 16 countries. Pediatricians did not work at the primary care level at all in 3 countries. In 14 of 34 countries, pediatricians worked in various aspects of community medicine, such as developmental pediatrics, well-infant care, school physicians, and so forth. IMR was lower in countries with a higher income per capita. In addition, a pediatric system of primary care had a protective effect when looking at IMR as the outcome. In 75% of the countries, some form of training in pediatric care for pediatricians was reported; the corresponding data for general practitioners was 60%. Community-based teaching programs were offered to pediatricians and general practitioners in a minority of countries only. Conclusions. At the end of the century, Europe showed a considerable variation in both delivery of PPC and training for doctors who care for children. This study identified 3 different health care delivery systems for PPC, as well as 2 types of pediatricians who work in community-based settings. Formal training in PPC or CP for both pediatricians and general practitioners varied from established curricula to no teaching at all. Economic and sociopolitical issues, professional power, and geographical and historical factors may explain the differences in pediatric care among European countries. Pediatrics 2002;109:788-796; primary care, ambulatory pediatrics, delivery of care, training in primary care, European pediatrics., The Union of National European Pediatric Societies and Associations (UNEPSA) held a symposium in 1997 in Warsaw, Poland, on pediatric primary care (PPC) and community pediatrics (CP). The presidents of [...]

Deixis – a fundamental part of communication – involves combinations of speech, gesture and eye-gaze, yet little is known about the temporal dynamics of this coordination. The authors analysed eye-gaze, pointing gestures and verbal productions in 514 deictic episodes during triadic, semi-naturalistic, book-reading sessions performed by Italian children (1;08–2;07) and their caregivers. Results show three new findings. First, deictic communication is overwhelmingly preceded and accompanied by shared attention (of consistent duration) on an object, and only sometimes by disjoint attention. Second, children are synchronously multimodal (conveying information via speech, pointing gesture and eye-gaze) in their deictic communications. Third, the form of deictic communication used is not related to the complexity of the linguistic structures of the sample. Deictic communication is remarkably consistent in children ranging from approximately 1;08 to 2;07 years of age. [ABSTRACT FROM AUTHOR]

Abstract Background Most studies report that being parents of a child with cancer is a stressful experience, but these have tended to focus on mothers and few have included both parents. Moreover, studies have focussed on families in Western countries and none have been published examining the psychological outcomes for parents living in an Arabic country. This research explores the stress levels of Jordanian parents caring for a child with cancer in order to identify the psychological needs of parents in this environment and to explore how mothers and fathers stress levels might differ. Methods The study was carried out in Jordan using the Perceived Stress Scale 10-items (PSS10). The questionnaire was completed by 300 couples with a child who has cancer and a comparison group of 528 couples where the children do not have any serious illness. Multivariate backward regression analysis was carried out. Results Analysis adjusting for spousal stress and sociodemographic predictors revealed that stress levels of mothers with a child who had cancer remained significantly higher than mothers whose children did not have any serious illness (p Parental stress was analysed for those with a child who has cancer and in models which included spouse’s stress scores, sociodemographic and cancer-related predictors 64 % of the variance was explained for mothers (adjusted R2 = 0.64, p 2 = 0.64, p Conclusions This is the first study into the psychological outcomes for parents living in an Arabic country who care for a child with cancer. Both mothers and fathers with a child diagnosed with cancer reported higher stress levels than those from the normal Jordanian parent population. Mothers and fathers of children with cancer reported significantly different levels of stress to each other but models reveal significant contributions of the stress score of fathers upon mothers, and vice versa. The findings provide evidence of the need for psychological support to be developed for families caring for a child with cancer in Jordan.