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Purpose: Our purpose was to start examining clinical swallowing and motor speech skills of school-age children with unilateral cerebral palsy (UCP) compared to typically developing children (TDC), how these skills relate to each other, and whether they are predicted by clinical/demographic data (age, birth history, lesion type, etc.). Method: Seventeen children with UCP and 17 TDC (7-12 years old) participated in this cross-sectional study. Feeding/swallowing skills were evaluated using the Dysphagia Disorder Survey (DDS) and a normalized measure of mealtime efficiency (normalized mealtime duration, i.e., nMD). Motor speech was assessed via speech intelligibility and speech rate measures using the Test of Children's Speech Plus. Analyses included nonparametric bootstrapping, correlation analysis, and multiple regression. Results: Children with UCP exhibited more severe (higher) DDS scores (p = 0.0096, Part 1; p = 0.0132, Part 2) and reduced speech rate than TDC (p = 0.0120). Furthermore, in children with UCP, total DDS scores were moderately negatively correlated with speech intelligibility (words: r = -0.6162, p = 0.0086; sentences: r = -0.60792, p = 0.0096). Expressive language scores were the only significant predictor of feeding and swallowing performance, and receptive language scores were the only significant predictor of motor speech skills. Conclusions: Swallowing and motor speech skills can be affected in school-age children with UCP, with wide variability of performance also noted. Preliminary cross-system interactions between swallowing, speech, and language are observed and might support the complex relationships between these domains. Further understanding these relationships in this population could have prognostic and/or therapeutic value and warrants further study.

Background: Chronic and complex medical issues, including traumatic brain injuries (TBIs), have significant educational implications. The purpose of this study was to identify and summarize the literature on care coordination strategies among health care professionals, educators, and caregivers for children with special health care needs (CSHCN). Clarifying factors that influence care coordination for CSHCN can inform future studies on care coordination for students with TBI. Improved understanding of these factors may lead to better communication, reduction of unmet needs, more efficient service access, and improved long-term outcomes for children. Methods: A scoping review was conducted, guided by PRISMA-ScR methodology. Five databases (CINAHL, PSYCINFO, EMBASE, ERIC, PubMed) were searched to identify relevant studies that focused on care coordination and educational settings. Results: Twelve articles met inclusion criteria. Care coordination interventions for CSHCN used in educational settings focused on relationship-building strategies, clear procedures and roles, and education of members of the school community. Conclusions: Findings highlight strategies to coordinate care for CSHCN and factors that may moderate effects of these interventions. Key stakeholders should now study these strategies specifically in children with TBI.

Purpose: Our purpose was to start examining clinical swallowing and motor speech skills of school-age children with unilateral cerebral palsy (UCP) compared to typically developing children (TDC), how these skills relate to each other, and whether they are predicted by clinical/demographic data (age, birth history, lesion type, etc.). Method: Seventeen children with UCP and 17 TDC (7-12 years old) participated in this cross-sectional study. Feeding/swallowing skills were evaluated using the Dysphagia Disorder Survey (DDS) and a normalized measure of mealtime efficiency (normalized mealtime duration, i.e., nMD). Motor speech was assessed via speech intelligibility and speech rate measures using the Test of Children's Speech Plus. Analyses included nonparametric bootstrapping, correlation analysis, and multiple regression. Results: Children with UCP exhibited more severe (higher) DDS scores (p = .0096, Part 1; p = .0132, Part 2) and reduced speech rate than TDC (p = .0120). Furthermore, in children with UCP, total DDS scores were moderately negatively correlated with speech intelligibility (words: r = -.6162, p = .0086; sentences: r = -.60792, p = .0096). Expressive language scores were the only significant predictor of feeding and swallowing performance, and receptive language scores were the only significant predictor of motor speech skills. Conclusions: Swallowing and motor speech skills can be affected in school-age children with UCP, with wide variability of performance also noted. Preliminary cross-system interactions between swallowing, speech, and language are observed and might support the complex relationships between these domains. Further understanding these relationships in this population could have prognostic and/or therapeutic value and warrants further study., Cerebral palsy (CP) represents a group of disorders of the development of movement and posture caused by diverse nonprogressive abnormalities in the developing brain, which are frequently accompanied by disorders [...]

Purpose: Generalized linear mixed-model (GLMM) and Bayesian methods together provide a framework capable of handling a wide variety of complex data commonly encountered across the communication sciences. Using language sample analysis, we demonstrate the utility of these methods in answering specific questions regarding the differences between discourse patterns of children who have experienced a traumatic brain injury (TBI), as compared to those with typical development. Method: Language samples were collected from 55 adolescents ages 13-18 years, five of whom had experienced a TBI. We describe parameters relating to the productivity, syntactic complexity, and lexical diversity of language samples. A Bayesian GLMM is developed for each parameter of interest, relating these parameters to age, sex, prior history (TBI or typical development), and socioeconomic status, as well as the type of discourse sample (compare-contrast, cause-effect, or narrative). Statistical models are thoroughly described. Results: Comparing the discourse of adolescents with TBI to those with typical development, substantial differences are detected in productivity and lexical diversity, while differences in syntactic complexity are more moderate. Female adolescents exhibited greater syntactic complexity, while male adolescents exhibited greater productivity and lexical diversity. Generally, our models suggest more advanced discourse among adolescents who are older or who have indicators of higher socioeconomic status. Differences relating to lecture type were also detected. Conclusions: Bayesian and GLMM methods yield more informative and intuitive results than traditional statistical analyses, with a greater degree of confidence in model assumptions. We recommend that these methods be used more widely in language sample analysis.

For academic success, it is increasingly important that students of all ages can produce and comprehend expository discourse. This article provides guidance to clinicians and educators on using language sample analysis (LSA) to assess the expository language abilities of students across grades. Focusing on microstructural and macrostructural characteristics and comparing with grade-level standards, clinicians can use LSA to assess a student's production and comprehension of academic language and to guide intervention planning. Example discourse samples are included, along with a brief discussion of how the LSA results for these samples can be used for intervention planning. Using curriculum-based materials, LSA in expository contexts can lead to improved identification of students who struggle with the complex language of the classroom. Educator--clinician collaboration to identify and address these struggles can lead to improved student success at school and beyond.

Purpose: Generalized linear mixed-model (GLMM) and Bayesian methods together provide a framework capable of handling a wide variety of complex data commonly encountered across the communication sciences. Using language sample analysis, we demonstrate the utility of these methods in answering specific questions regarding the differences between discourse patterns of children who have experienced a traumatic brain injury (TBI), as compared to those with typical development. Method: Language samples were collected from 55 adolescents ages 13-18 years, five of whom had experienced a TBI. We describe parameters relating to the productivity, syntactic complexity, and lexical diversity of language samples. A Bayesian GLMM is developed for each parameter of interest, relating these parameters to age, sex, prior history (TBI or typical development), and socioeconomic status, as well as the type of discourse sample (compare-contrast, cause-effect, or narrative). Statistical models are thoroughly described. Results: Comparing the discourse of adolescents with TBI to those with typical development, substantial differences are detected in productivity and lexical diversity, while differences in syntactic complexity are more moderate. Female adolescents exhibited greater syntactic complexity, while male adolescents exhibited greater productivity and lexical diversity. Generally, our models suggest more advanced discourse among adolescents who are older or who have indicators of higher socioeconomic status. Differences relating to lecture type were also detected. Conclusions: Bayesian and GLMM methods yield more informative and intuitive results than traditional statistical analyses, with a greater degree of confidence in model assumptions. We recommend that these methods be used more widely in language sample analysis. Supplemental Material: https://doi.org/10.23641/asha.14226959, Language sampling is a method to elicit verbal or written discourse. It provides a natural, contextualized view of an individual's ability to combine multiple utterances to converse, tell a story, [...]

Purpose: Summarizing expository passages is a critical academic skill that is understudied in language research. The purpose of this study was to compare the quality of verbal summaries produced by adolescents for 3 different discourse types and to determine whether a composite measure of cognitive skill or a test of expressive syntax predicted their performance. Method: Fifty adolescents listened to, and then verbally summarized, 1 narrative and 2 expository lectures (compare-contrast and cause-effect). They also participated in testing that targeted expressive syntax and 5 cognitive subdomains. Results: Summary quality scores were significantly different across discourse types, with a medium effect size. Analyses revealed significantly higher summary quality scores for cause-effect than compare-contrast summaries. Although the composite cognitive measure contributed significantly to the prediction of quality scores for both types of expository summaries, the expressive syntax score only contributed significantly to the quality scores for narrative summaries. Conclusions: These results support previous research indicating that type of expository discourse may impact student performance. These results also show, for the first time, that cognition may play a predictive role in determining summary quality for expository but not narrative passages in this population. In addition, despite the more complex syntax commonly associated with exposition versus narratives, an expressive syntax score was only predictive of performance on narrative summaries. These findings provide new information, questions, and directions for future research for those who study academic discourse and for professionals who must identify and manage the problems of students struggling with different types of academic discourse.

To describe the relationship amongst child and family characteristics (e.g. social relationships, family functioning) and child participation after traumatic brain injury (TBI) an average of 2.65 years post-TBI (SD = 2.12). Cross-sectional, secondary analysis of data collected as part of a larger research project. N = 44 children with TBI. Analysis revealed statistically significant correlations between child participation, family functioning, and child characteristics. School-aged children with TBI might experience chronic participation restrictions, associated with challenges in family functioning. Professionals can support children with TBI and their families through follow-up services that include a focus on family-based interventions to better support long-term outcomes for this population. [ABSTRACT FROM AUTHOR]

Purpose: Although there is evidence that emotional valence of stimuli impacts lexical processes, there is limited work investigating its specific impact on lexical retrieval. The current study aimed to determine the degree to which emotional valence of pictured stimuli impacts naming latencies in healthy younger and older adults. Method: Eighteen healthy younger adults and 18 healthy older adults named positive, negative, and neutral images, and reaction time was measured. Results: Reaction times for positive and negative images were significantly longer than reaction times for neutral images. Reaction times for positive and negative images were not significantly different. Whereas older adults demonstrated significantly longer naming latencies overall than younger adults, the discrepancy in latency with age was far greater when naming emotional pictures. Conclusions: Emotional arousal of pictures appears to impact naming latency in younger and older adults. We hypothesize that the increase in naming latency for emotional stimuli is the result of a necessary disengagement of attentional resources from the emotional images prior to completion of the naming task. We propose that this process may affect older adults disproportionately due to a decline in attentional resources as part of normal aging, combined with a greater attentional preference for emotional stimuli.

BackgroundTraumatic brain injury (TBI) poses a significant threat to children’s health. Cognitive rehabilitation for pediatric TBI has the potential to improve the quality of life following the injury. Virtual reality (VR) can provide enriched cognitive training in a life-like but safe environment. However, existing VR applications for pediatric TBIs have primarily focused on physical rehabilitation. ObjectiveThis study aims to design and develop an integrative hardware and software VR system to provide rehabilitation of executive functions (EF) for children with TBI, particularly in 3 core EF: inhibitory control, working memory, and cognitive flexibility. MethodsThe VR training system was developed by an interdisciplinary team with expertise in best practices of VR design, developmental psychology, and pediatric TBI rehabilitation. Pilot usability testing of this novel system was conducted among 10 healthy children and 4 children with TBIs. ResultsOur VR-based interactive cognitive training system was developed to provide assistive training on core EF following pediatric TBI. Pilot usability testing showed adequate user satisfaction ratings for both the hardware and software components of the VR system. ConclusionsThis project designed and tested a novel VR-based system for executive function rehabilitation that is specifically adapted to children following TBI.

The motor learning literature has demonstrated that blocked practice facilitates better acquisition of motor skills, whereas random practice facilitates retention and transfer. The verbal learning and memory literature offers similar evidence. The purpose of this study was to investigate effects of blocked versus random practice in treatment for anomia. The study used a single site, randomized crossover design, with two replicated experimental phases (two blocked and two random) for each of 10 individuals with anomia. Each phase consisted of a cued picture-naming treatment. Individual treatment and maintenance effects, as well as weighted averages and group effects, were calculated using Tau-U based on the proportion of correctly named probes. Nine of 10 participants demonstrated treatment effects during each of the four phases. Acquisition was comparable for blocked and random practice. Maintenance effects were observed following seven blocked phases of treatment and 12 random phases of treatment across participants. For four of 10 participants the random schedule resulted in better maintenance of trained items. Although further research is needed, the present data suggest that for word retrieval treatment with multiple repetitions of the same items, a random presentation may benefit maintenance of treatment gains. [ABSTRACT FROM AUTHOR]

Purpose: Although there is evidence that emotional valence of stimuli impacts lexical processes, there is limited work investigating its specific impact on lexical retrieval. The current study aimed to determine the degree to which emotional valence of pictured stimuli impacts naming latencies in healthy younger and older adults. Method: Eighteen healthy younger adults and 18 healthy older adults named positive, negative, and neutral images, and reaction time was measured. Results: Reaction times for positive and negative images were significantly longer than reaction times for neutral images. Reaction times for positive and negative images were not significantly different. Whereas older adults demonstrated significantly longer naming latencies overall than younger adults, the discrepancy in latency with age was far greater when naming emotional pictures. Conclusions: Emotional arousal of pictures appears to impact naming latency in younger and older adults. We hypothesize that the increase in naming latency for emotional stimuli is the result of a necessary disengagement of attentional resources from the emotional images prior to completion of the naming task. We propose that this process may affect older adults disproportionately due to a decline in attentional resources as part of normal aging, combined with a greater attentional preference for emotional stimuli., There is a large body of evidence demonstrating that cognitive processes are influenced by emotion (e.g., Berrin-Wasserman, Winnick, & Borod, 2003; Charles, Mather, & Carstensen, 2003; Estes & Adelman, 2008; [...]

To examine the breadth of education or training on the consequences of traumatic brain injury (TBI) for children and adolescents with TBI and their families/caregivers. Systematic scoping review of literature published through July 2018 using eight databases and education, training, instruction, and pediatric search terms. Only studies including pediatric participants (age <18) with TBI or their families/caregivers were included. Six independent reviewers worked in pairs to review abstracts and full-text articles independently, and abstracted data using a REDCap database. Forty-two unique studies were included in the review. Based on TBI injury severity, 24 studies included persons with mild TBI (mTBI) and 18 studies focused on moderate/severe TBI. Six studies targeted the education or training provided to children or adolescents with TBI. TBI education was provided primarily in the emergency department or outpatient/community setting. Most studies described TBI education as the main topic of the study or intervention. Educational topics varied, such as managing TBI-related symptoms and behaviors, when to seek care, family issues, and returning to work, school, or play. The results of this scoping review may guide future research and intervention development to promote the recovery of children and adolescents with TBI. [ABSTRACT FROM AUTHOR]

BACKGROUND: Chronic and complex medical issues, including traumatic brain injuries (TBIs), have significant educational implications. The purpose of this study was to identify and summarize the literature on care coordination strategies among health care professionals, educators, and caregivers for children with special health care needs (CSHCN). Clarifying factors that influence care coordination for CSHCN can inform future studies on care coordination for students with TBI. Improved understanding of these factors may lead to better communication, reduction of unmet needs, more efficient service access, and improved long‐term outcomes for children. METHODS: A scoping review was conducted, guided by PRISMA‐ScR methodology. Five databases (CINAHL, PSYCINFO, EMBASE, ERIC, PubMed) were searched to identify relevant studies that focused on care coordination and educational settings. RESULTS: Twelve articles met inclusion criteria. Care coordination interventions for CSHCN used in educational settings focused on relationship‐building strategies, clear procedures and roles, and education of members of the school community. CONCLUSIONS: Findings highlight strategies to coordinate care for CSHCN and factors that may moderate effects of these interventions. Key stakeholders should now study these strategies specifically in children with TBI. [ABSTRACT FROM AUTHOR]