Redefining the notion of nativeness and age of first exposure: Evidence from Italian as a second and heritage language

How does age of first bilingual language exposure affect reading development in children learning to read in both of their languages? Is there a reading advantage for monolingual English children who are educated in bilingual schools? We studied children (grades 2-3, ages 7-9) in bilingual Spanish-English schools who were either from Spanish-speaking homes (new to English) or English-speaking homes (new to Spanish), as compared with English-speaking children in monolingual English schools. An early age of first bilingual language exposure had a positive effect on reading, phonological awareness, and language competence in both languages: early bilinguals (age of first exposure 0-3 years) outperformed other bilingual groups (age of first exposure 3-6 years). Remarkably, schooling in two languages afforded children from monolingual English homes an advantage in phoneme awareness skills. Early bilingual exposure is best for dual language reading development, and it may afford such a powerful positive impact on reading and language development that it may possibly ameliorate the negative effect of low SES on literacy. Further, age of first bilingual exposure provides a new tool for evaluating whether a young bilingual has a reading problem versus whether he or she is a typically-developing dual-language learner.

Although some investigations of phonological development have found that segmental accuracy is comparable in monolingual children and their bilingual peers, there is evidence that language use affects segmental accuracy in both languages. To investigate the influence of age of first exposure to English and the amount of current input-output on phonological accuracy in English and Spanish in early bilingual Spanish-English kindergarteners. Also whether parent and teacher ratings of the children's intelligibility are correlated with phonological accuracy and the amount of experience with each language. Data for 91 kindergarteners (mean age = 5;6 years) were selected from a larger dataset focusing on Spanish-English bilingual language development. All children were from Central Texas, spoke a Mexican Spanish dialect and were learning American English. Children completed a single-word phonological assessment with separate forms for English and Spanish. The assessment was analyzed for segmental accuracy: percentage of consonants and vowels correct and percentage of early-, middle- and late-developing (EML) sounds correct were calculated. Children were more accurate on vowel production than consonant production and showed a decrease in accuracy from early to middle to late sounds. The amount of current input-output explained more of the variance in phonological accuracy than age of first English exposure. Although greater current input-output of a language was associated with greater accuracy in that language, English-dominant children were only significantly more accurate in English than Spanish on late sounds, whereas Spanish-dominant children were only significantly more accurate in Spanish than English on early sounds. Higher parent and teacher ratings of intelligibility in Spanish were correlated with greater consonant accuracy in Spanish, but the same did not hold for English. Higher intelligibility ratings in English were correlated with greater current English input-output, and the same held for Spanish. Current input-output appears to be a better predictor of phonological accuracy than age of first English exposure for early bilinguals, consistent with findings on the effect of language experience on performance in other language domains in bilingual children. Although greater current input-output in a language predicts higher accuracy in that language, this interacts with sound complexity. The results highlight the utility of the EML classification in assessing bilingual children's phonology. The relationships of intelligibility ratings with current input-output and sound accuracy can shed light on the process of referral of bilingual children for speech and language services.

To examine the effect of age of first exposure to tackle football on chronic traumatic encephalopathy (CTE) pathological severity and age of neurobehavioral symptom onset in tackle football players with neuropathologically confirmed CTE. The sample included 246 tackle football players who donated their brains for neuropathological examination. Two hundred eleven were diagnosed with CTE (126 of 211 were without comorbid neurodegenerative diseases), and 35 were without CTE. Informant interviews ascertained age of first exposure and age of cognitive and behavioral/mood symptom onset. Analyses accounted for decade and duration of play. Age of exposure was not associated with CTE pathological severity, or Alzheimer's disease or Lewy body pathology. In the 211 participants with CTE, every 1 year younger participants began to play tackle football predicted earlier reported cognitive symptom onset by 2.44 years (p < 0.0001) and behavioral/mood symptoms by 2.50 years (p < 0.0001). Age of exposure before 12 predicted earlier cognitive (p < 0.0001) and behavioral/mood (p < 0.0001) symptom onset by 13.39 and 13.28 years, respectively. In participants with dementia, younger age of exposure corresponded to earlier functional impairment onset. Similar effects were observed in the 126 CTE-only participants. Effect sizes were comparable in participants without CTE. In this sample of deceased tackle football players, younger age of exposure to tackle football was not associated with CTE pathological severity, but predicted earlier neurobehavioral symptom onset. Youth exposure to tackle football may reduce resiliency to late-life neuropathology. These findings may not generalize to the broader tackle football population, and informant-report may have affected the accuracy of the estimated effects. Ann Neurol 2018;83:886-901.

Conditional and indirect effects of age of first exposure on PTSD symptoms

Increases in the availability and accessibility of Internet pornography have led growing numbers of children to become consumers of sexually explicit media. Research has identified negative behavioral and attitudinal outcomes associated with Internet pornography use in childhood and adolescence, but few studies have examined sexual victimization as a correlate. The current study aimed to examine the association between age of first Internet pornography exposure and sexual victimization. Data from 154 undergraduate women yielded several important findings. Women who viewed Internet pornography unintentionally at a younger age reported more sexual victimization. Specifically, compared to women who were first unintentionally exposed to Internet pornography at age 14 or older, women with unintentional first Internet pornography exposure before the age of 14 reported more childhood sexual abuse, sexual abuse in adulthood, and more instances of sexual coercion and aggression. Women with younger age of unintentional Internet pornography exposure also reported more interpersonal sexual objectification than women who had never viewed Internet pornography at all. Age of first intentional exposure to Internet pornography was not related to women’s self-reported experiences of objectification, although this may be because women’s intentional exposure tended to happen at older ages. Overall, the results of this study suggest that women’s unintentional Internet pornography exposure at a young age may contribute to a potentially harmful sexual socialization. Early Internet pornography exposure in childhood should be considered a potential risk factor for women’s sexual victimization.

This is the first longitudinal study to explore the best time and timing for regular versus bilingual language exposure in (pre)primary programs, using multiple measures over time so as to focus on fluctuations, trends and interactions in individual data as well as intra-individual variation over time. We studied children who had received 50/50 bilingual instruction in German and English (so-called ‘partial CLIL’ programs) as well as children in ‘minimal CLIL’ programs with almost uniquely monolingual German instruction (90% German, 10% English). Results show that, like other individual differences (ID) variables, the age factor behaves like a dynamic entity that changes over time and affects L2 literacy development differentially at different times. Furthermore, while an early age of first bilingual language exposure has no effect on the L2 development for the children in the minimal CLIL program, early-AO bilinguals in the partial CLIL program (age of first exposure 5) outperform the older-AO bilingual group (age of first exposure 7 and 9) in terms of accuracy and (syntactic and morphological) complexity but not in terms of lexical richness and fluency.

Younger age of first exposure (AFE) to American football has been associated with later‐life cognitive deficits in former National Football League players experiencing cognitive and behavioral deficits, but not in other cohorts of high school, college, amateur, or professional contact/collision sports athletes. Although several studies evaluated clinical outcomes, limited information exists among these cohorts and subclinical measures, such as blood biomarkers may serve as an early indicator of future impairments. Extracellular vesicles, including exosome‐like vesicles (ELVs), are released from cells and contain a variety of molecular cargo from the originating cell, and have emerged as reliable biomarker candidates.OBJECTIVEThe purpose of this study was to compare plasma ELV concentration, size, and microRNA (miRNA) levels between soccer players reporting AFE to soccer heading before age 10 years (AFE≤10) and soccer players reporting AFE to soccer heading after age 10 years (AFE&gt;10).METHODSCollege‐aged soccer players self‐reported AFE to soccer heading. Participants were divided into two groups based on their responses: AFE&gt;10 (n=9, 5 males, 12.33±0.24 years) and AFE≤10 (n=18, 11 males, 7.94±0.46 years). Plasma ELV concentration and size were assessed using nanoparticle tracking analysis. Total RNA was isolated from ELVs, followed by performing miRNA first strand cDNA synthesis and subsequently qPCR. Comparisons were made via unpaired t‐test (p&lt;0.05).RESULTSData are presented as mean ± SE. AFE≤10 was associated with decreased miR‐7844‐5p when compared to AFE&gt;10 (~60%, p=0.03). No changes in miRNA were observed for miR‐92b‐5p, miR‐423‐5p, miR‐24‐3p, miR‐144‐5p, miR‐221‐5p, and miR‐22‐3p. Groups did not differ in concentration (AFE≤10, 8.34 ×109 ELVs/ml plasma ±0.96 ×109 vs AFE&gt;10, 8.39 ×109 EVs/ml plasma ±0.98 ×109) or size (AFE≤10, 117.58 nm ±7.12 vs AFE&gt;10, 106.40 nm ±4.14) of circulating ELVs.CONCLUSIONCollectively these data demonstrate that younger AFE to soccer heading was associated with decreased circulating miR‐7844‐5p. Decreased circulating miR‐7844‐5p may be an early indicator of future pathology.Support or Funding InformationSupported by NIH‐NINDS R01 NS102157‐01, NIH P20 GM113125, NIH P20 GM103446, NIH R03 HD094594

Association Between Head Impact Exposure, Psychological Needs, and Indicators of Mental Health Among U.S. High School Tackle Football Players

Repetitive head impacts in young athletes are potentially detrimental to later life (e.g., age 50 + years) neurological function; however, it is unknown what the short-term effects (e.g., age 20years) are in collegiate student-athletes. The purpose of this study was to determine the effect of the estimated age of first exposure to American tackle football participation on neurocognitive performance and symptom severity scores in collegiate student-athletes. We used a cohort study in which neurocognitive performance was assessed using the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) test in 4376 male athletes (age 19.3 ± 1.5years, mass 96.3 ± 20.3kg, height 185.0 ± 7.4cm). Athletes were grouped by sport participation [American football (n = 3462) or non-contact (n = 914)] and estimated age of first exposure [< 12years (n = 3022) or ≥ 12years (n = 1354)]. The outcome measures were the four primary cognitive scores and the symptom severity score from ImPACT. We assessed primary outcomes across groups, controlling for age, learning accommodations, and concussion history. Neurocognitive performance was not associated with the estimated age of first exposure-by-group interaction. Our findings indicate that participation in American tackle football before age 12years does not result in neurocognitive deficits in college. Therefore, we suggest the following: the consequences of early exposure to repetitive head impacts do not manifest by college, the ImPACT test was not sensitive enough to identify the effects of an earlier estimated age of first exposure, or there is no association between an earlier estimated age of first exposure and neurocognitive functioning. Future longitudinal studies are warranted.

Background: The purpose of this study was to determine if earlier age of first exposure to football is associated with worse brain health in middle-aged and older adult men who played high school football.Methods: Men from the United States, aged 35 and older, who reported playing high school football, completed a customized, online health survey via the Amazon Mechanical Turk (mTurk) platform. Survey items included physical, psychological, and cognitive symptoms over the past week and over the past year, sports participation history (including age of first exposure to football), medical history, and concussion history. Participants also completed the Patient Health Questionnaire-8 (PHQ-8) and the British Columbia Post-Concussion Symptom Inventory (BC-PSI).Results: There were 186 men (age M = 51.78, SD = 10.93) who participated in high school football, and 87 (46.8%) reported football participation starting before the age of 12 and 99 (53.2%) reported football participation at or after the age of 12. Those who started playing football at an earlier age reported a greater number of lifetime concussions (M = 1.95, SD = 1.79) compared to those who started playing at age 12 or later (M = 1.28, SD = 1.52; U = 3,257.5, p = 0.003). A similar proportion of men who played football before vs. after the age of 12 reported a lifetime history of being prescribed medications for depression, anxiety, chronic pain, headaches, or memory problems. When comparing men who played football before vs. after the age of 12, the groups did not differ significantly in their ratings of depression, anger, anxiety, headaches, migraines, neck or back pain, chronic pain, concentration problems, or memory problems over the past week or the past year. The two groups did not differ significantly in their ratings of current symptoms of depression (PHQ-8; U = 4,187.0, p = 0.74) or post-concussion-like symptoms (BC-PSI; U = 3,944.0, p = 0.53). Furthermore, there were no statistically significant correlations between the age of first exposure to football, as a continuous variable, and PHQ-8 or BC-PSI scores.Conclusion: This study adds to a rapidly growing body of literature suggesting that earlier age of first exposure to football is not associated with later-in-life brain health.

ObjectivePrior studies examining small samples of symptomatic former professional football players suggest that earlier age of first exposure (AFE) to American football is associated with adverse later life health outcomes. This study examined a larger, more representative sample of former professional American football players to assess associations between AFE before age 12 (AFE < 12) and clinical outcomes compared with those who started at age 12 or older (AFE 12 +).MethodsFormer professional American football players who completed a questionnaire were dichotomized into AFE < 12 and AFE 12 + . AFE groups were compared on outcomes including symptoms of depression and anxiety, perceived cognitive difficulties, neurobehavioral dysregulation, and self-reported health conditions (e.g., headaches, sleep apnea, hypertension, chronic pain, memory loss, dementia/Alzheimer’s disease, and others).ResultsAmong 4189 former professional football players (aged 52 ± 14 years, 39% self-reported as Black), univariable associations with negligible effect sizes were seen with AFE < 12, depressive symptoms (p = 0.03; η2 = 0.001), and anxiety-related symptoms (p = 0.02; η2 = 0.001) only. Multivariable models adjusting for age, race, body mass index, playing position, number of professional seasons, and past concussion burden revealed no significant relationships between AFE < 12 and any outcome. Linear and non-linear models examining AFE as a continuous variable showed similar null results.ConclusionsIn a large cohort of former professional American-style football players, AFE was not independently associated with adverse later life outcomes. These findings are inconsistent with smaller studies of former professional football players. Studies examining AFE in professional football players may have limited utility and generalizability regarding policy implications for youth sports.

The age of first exposure (AFE) to American football participation is a growing concern for late-life function. Mixed evidence exists surrounding AFE and may be attributed to varied methods employed across studies. To examine the associations between AFE to American football participation with measures of cognitive, behavioral, and physical function and brain-related medical diagnoses across age categories among former National Football League players. We conducted a cross-sectional survey of 1784 former players (age: 52.3 ± 16.3years, AFE: 11.3 ± 2.9years, years of football: 17.5 ± 4.5years, 86.9% ≥ one lifetime concussion). Players completed a general health questionnaire recording demographics, football playing history (including AFE), and diagnoses (anxiety, depression, any form of dementia, mild cognitive impairment). Players completed Patient-Reported Outcomes Measurement Information System (PROMIS) measures assessing domains of cognitive and physical function, anxiety, depression, sleep disturbance, pain interference, and emotional-behavioral dyscontrol. Multivariable linear and binomial regression models were used to examine the associations of AFE and age with PROMIS outcomes and diagnoses, respectively. No significant AFE by age interactions were detected for PROMIS outcomes (p ≥ 0.066) or diagnoses (p ≥ 0.147). Younger AFE associated with higher PROMIS scores of anxiety (B = - 0.22, p = 0.016), depression (B = - 0.22, p = 0.010), sleep disturbances (B = - 0.16, p = 0.007), pain interference (B = - 0.19, p = 0.014), and emotional-behavioral dyscontrol (B = - 0.22, p = 0.019). Age was associated with all PROMIS outcomes (p ≤ 0.042). AFE was not associated with the prevalence of anxiety, depression, dementia, or mild cognitive impairment (p ≥ 0.449), while age was (p ≤ 0.013). AFE was significantly associated with PROMIS outcomes, albeit low-strength associations (i.e., effect sizes), but not with diagnoses. Our findings indicate AFE is a significant but minor contributing factor for health-related quality of life in this cohort. Future work should incorporate additional characterizations of cumulative head impacts and related factors when examining long-term outcomes associated with football participation.

Younger age of first exposure (AFE) to American Football (football) is associated with later-life health problems among former professional athletes in several studies; however, studies examining amateur (i.e., nonprofessional) athletes are less clear. In a cohort of former amateur American Football players, this study assessed whether AFE to football was associated with: (1) psychiatric and neurobehavioral symptoms, (2) cognitive difficulties, (3) general health problems, (4) motor symptoms, and (5) functional status. A cross-sectional survey study was conducted using the ResearchMatch platform. The key independent variable was age of first exposure to football (AFE < 12 versus AFE ≥ 12). Main outcomes included depressive symptoms (Patient Health Questionnaire-9; PHQ-9), anxiety symptoms (Generalized Anxiety Disorders-7; GAD-7), cognitive difficulties (British Columbia Cognitive Complaints Inventory; BC-CCI), Neurobehavioral Symptom Inventory (NSI) score, and prevalence of other health problems. Multivariable regressions were assessed for associations between AFE and outcome variables. In total, 107 male participants with exposure to football (mean age: 60.6 ± 15.1 years) reported an average of 4.2 ± 2.7 years of exposure to football, with an average AFE of 11.7 ± 3.1 years. In multivariable analyses, AFE < 12 was not a significant predictor of PHQ-9 (unstandardized beta,B: 0.51, standard error, SE: 1.25, p = 0.682), GAD-7 (B: 0.09, SE: 0.95, p = 0.926), NSI (B: - 0.56, SE: 2.93, p = 0.850), or BC-CCI (B: - 0.65, SE: 0.77, p = 0.403). However, more prior concussions were associated with worse PHQ-9 (B: 0.44, SE: 0.10, p < 0.001), GAD-7 (B: 0.33, SE: 0.07, p < 0.001), NSI (B: 1.04, SE: 0.23, p < 0.001), and BC-CCI scores (B: 0.26, SE: 0.06, p < 0.001). AFE < 12 did not predict general health problems or independent functional status. AFE to football was not associated with adverse psychiatric, cognitive, neurobehavioral, or general health outcomes among young, former amateur American Football players. However, more lifetime concussions were associated with adverse cognitive and psychiatric health outcomes. Future studies should examine similar outcomes in older cohorts with more comorbidities to further minimize potential confounding between general health and lack of later-life symptoms.

The current study investigates self-repairs in the speech of three groups of Russian speakers: monolingual controls (N = 12) residing in the Russian Federation, for whom Russian is their first dominant language (L1); bilingual Russian–Hebrew speaking participants (N = 12), who acquired Russian as their Heritage Language (HL) in contact with the dominant Societal Hebrew in Israel; and bilingual Russian–Chinese speakers (N = 12) residing in the Russian Federation at the time of testing, for whom Russian is their second language (L2). Picture-elicited narratives were coded for instances of self-repairs, split into Conceptualizer Repairs (C-repairs)—which imply pragmatic, semantic, or lexical changes—and Formulator Repairs (F-repairs), correcting different types of errors. In addition, self-repair initiators—such as cut-offs, hesitation pauses, and discourse markers—were annotated before each instance of self-repair. The results indicate that L2 speakers, in general, use self-repairs more frequently than L1 and HL speakers. L1 speakers hardly produced F-repairs, while HL and L2 speakers resorted to both C- and F-repairs. L1 speakers mainly used C-repairs for appropriacy, whereas HL and L2 speakers used C-repairs for rephrasing and lexical item change. As for F-repairs, HL speakers tended to change pronunciation and morphology, while L2 speakers implemented more morphological repairs. Lexical initiators of self-repairs were more common in L1 speech; however, in the L2 group we saw much more frequent cut-offs of repaired speech fragments. As such, varying self-repair strategies were employed by different speaker groups, shedding light on the underlying processes of language production. There was also evidence of cross-linguistic transfer of non-lexical self-repair initiators: HL speakers resorted to prolongations as initiators in HL-Russian (a strategy that is common in their dominant language, Hebrew), whereas L1 speakers used vocalized and silent pauses more frequently.

Objective To identify the data related with therapeutic and patients characteristics and their correlation with the inhibitor’s presence in hemophilia A in Pediatric Hematologic/Oncologic Unit. University Hospital Centre ‘Mother Teresa’, Tirana, Albania, the unique national service that treat pediatric coagulopathies. Design This analytic, observational, retrospective and case – control study analyses 32 patients (0–14 years old) diagnosed and treated in our center for hemophilia A, that had been tested for inhibitor presence (32 from 45 children with hemophilia A in Albania). Outcome measures Inhibitor’s presence (qualitative test) after 50 days of exposure, severity of the disease, breastfeeding, family history for hemophilia, age and purpose of first FVIII exposure, age of 50th exposure, time between first and 50th exposure, surgery up to 50th day of exposure, type and number of exposures episode (minor or major) and FVIII average dosage. Results Inhibitors were present in 13 from 32 patients. The mean age of the first exposure to FVIII is 20.1 months old and in 25 of 32 patients hemorrhage was the reason for the first exposure. There was no significant statistical difference between inhibitors presence and age and reasons of first exposure. Neither nor the age of the 50th exposure wasn’t correlated with inhibitors presence. The mean age between first and 50th day of exposure was 24.2 months and there was a positive correlation between this data and inhibitors presence (t-Test = 2.267; df = 30; p = 0.031), also the number of episodes of exposition until the 50th day of exposition (avg.6.5) was correlated with inhibitors presence (t-Test = 3.270; df = 30; p = 0.003). We had more major exposure episodes (78.1%) and this data influenced in inhibitor’s presence (Fisher’s Test = 6.131; df = 1; p = 0.015). The average dosage of FVIII was also correlated with inhibitor’s presence (χ2=12,799; df = 2; p = 0.002). Severity of the disease and family history for hemophilia weren’t correlated with the inhibitors. Breastfeeding with associated with lower risk for inhibitors presence (t=7.166;df=;p=0.011). Conslusions Inhibitor’s presence percentage in Albanian pediatric patients with hemophilia A is 40.6%. This data is much higher than the literature reports. Factors influencing more in the development or presence of inhibitors in our population are: high dosage of factor VIII, the high frequency of exposure episodes and the short time between first and the 50th exposure day.