Children's Accuracy Research Articles

Evaluating the validity and efficiency of tablet audiometry in school-age children

Tablet-based automated audiometry offers a portable alternative to traditional audiometry. The limited research available (e.g., Rourke et al., 2016) supports the clinical use of automated audiometry for pediatric hearing screenings, but its accuracy in children and efficiency outside of clinical environments is undetermined. This study’s objective is to evaluate the validity and efficiency of automated audiometry in school-age children. This initial phase aimed to establish its validity in a clinical setting. Hearing thresholds for 0.5, 1, 2, 4, 6, and 8 kHz were collected in children ages 6–12 years old using standard audiometry and an iPad app automated audiometry in a sound-proof booth. Tympanometry, acoustic reflex thresholds, and distortion product otoacoustic emissions were administered to examine peripheral hearing function. Preliminary results of 16 children show no significant difference between the two test durations. Automated audiometry thresholds were within 5 dB of the standard audiometry thresholds for each tested frequency, except at 6 kHz where they were within 7dB. There was no test preference among the participants. Our preliminary results support the use of automated audiometry in children. Current testing is evaluating its validity and reliability under less ideal testing environments. [Work supported by NIH COBRE Grant P30GM114736 and the Nemours Foundation.]

EFFECT OF ACUTE LYMPHOBLASTIC LEUKEMIA ON SALIVARY ALTERATIONS IN CHILDREN BEFORE AND AFTER CHEMOTHERAPY INDUCTION

Background: Approximately 2,56,000 children and young adults around the world developed acute lymphoblastic leukemia (ALL) which is the most common subtype of Leukemia. The aim of our study was to investigate the effect of acute lymphoblastic leukemia on salivary alterations in children before and after chemotherapy induction. Materials and methods: This study included 45 children aged from 5 to 9 years. The sample was divided into 3 groups: Group A (control group); clinically healthy un-medicated children, Group B: children with a previous diagnosis of ALL and did not initiate the chemotherapy treatment and Group C: hospitalized children with a previous diagnosis of ALL and who were on chemotherapy (6 months-1.5 years of treatment). From the selected children, stimulated whole saliva samples were collected in graduated tubes with funnels over a 5 minute period in the morning. Saliva samples were used to determine the stimulated salivary flow rate, salivary pH, salivary total proteins and salivary alpha amylase. Results: The results showed a significant reduction in the mean of salivary flow rate values between (group A) and (group C), also the difference was significant between (group B) and (group C). Regarding mean pH value, there was a significant difference between the 3 groups with an obvious reduction in pH values of groups B & C. Moreover, the findings showed that the means of salivary total proteins and salivary alpha amylase were significantly higher in group B than in group A and group C. Conclusion: According to ROC curve analysis salivary total proteins reflect an excellent predictor test where the value of total salivary proteins above 8.381 g/dl indicated ALL leukemia with 100% accuracy in children.

Effects of Maternal Features on the Relationship between Stress and Memory Accuracy in Children: with a Focus on Talk Style, Child and Maternal Attachment Stability

Effects of Maternal Features on the Relationship between Stress and Memory Accuracy in Children: with a Focus on Talk Style, Child and Maternal Attachment Stability

The Effects of Narrative Elaborative Training on the Accuracy of Children’s Recall

본 연구는 서술 정교화 훈련(NET)이 아동의 회상 보고 정확성에 미치는 영향에 있어 아동의 수용적 어휘력과 실행 기능 수준을 고려하여 살펴보고자 하였다. 국외의 많은 연구들은 아동의 회상 보고 정확성 향상에 NET가 효과가 있음을 보여주었다. 그러나 선행연구들에서는 연구 참여 아동의 연령이 제한되어 있고 무엇보다도 아동의 개별 특성이 고려되지 못하였다. 따라서 본 연구는 만 5-8세 아동을 대상으로 NET의 효과성을 재검증하고, 아동의 수용적 어휘력과 실행 기능 수준을 고려하여 NET과 아동 회상 보고 정확성 간의 관계를 살펴보고자 하였다. 연구 결과, 선행 연구와 동일하게 전반적으로 나이든 아동이 어린 아동보다 회상 보고의 정확성은 높았고, NET은 아동의 회상 보고 정확성에 긍정적인 영향을 미쳤다. 무엇보다도 NET을 받은 경우 아동의 개인차가 아동의 회상 보고 정확성에 미치는 영향이 NET을 받지 않은 경우와 비교해 감소하였다. 이와 같은 결과를 바탕으로 수사면담 시 아동의 개인차 특성에 의해 아동 진술의 신뢰성이 평가절하 되는 것을 최소화 하는 차원에서 면담 전 NET 제공의 가치에 대해 논의하였다.The objective of this study was to examine how the effects of narrative elaborative training(NET) on the accuracy of children’s recall are associated with children’s individual differences. Several studies in abroad have verified that NET is effective in drawing complete and accurate statements from young children during investigative interviews. However, the ages of the children who participated in these studies were limited and the associations with children’s level of cognition and language development were not explored. Thus, this study aimed at reviewing the effectiveness of NET on children aged 5-8 years and examining how much children’s individual differences, such as language and cognitive abilities, contribute to the accuracy of children’s recall in relation to NET. The findings revealed that the accuracy of children’s recall increased with increasing age and that NET also improved the accuracy of children’s recall regardless of age. Furthermore, in the group of children without NET, children’s individual differences, such as receptive language ability and executive functioning, were significant predictors of the accuracy of children’s recall. However, the same was not true in the NET group. Based on these findings, the authors discussed the implications of providing NET prior to investigative interviews to minimize the variability in the possibility of obtaining detailed statements and the reliability of the obtained statements according to children’s language and cognitive abilities.

Effects of Stress Coping Strategies on the Level of Stress and Accuracy of Children’s Memory in the Dental Treatment Context: With a focus on Children’s Age

Effects of Stress Coping Strategies on the Level of Stress and Accuracy of Children’s Memory in the Dental Treatment Context: With a focus on Children’s Age

Validation of SenseWear Armband in children, adolescents, and adults.

SenseWear Armband (SW) is a multisensor monitor to assess physical activity and energy expenditure. Its prediction algorithms have been updated periodically. The aim was to validate SW in children, adolescents, and adults. The most recent SW algorithm 5.2 (SW5.2) and the previous version 2.2 (SW2.2) were evaluated for estimation of energy expenditure during semi-structured activities in 35 children, 31 adolescents, and 36 adults with indirect calorimetry as reference. Energy expenditure estimated from waist-worn ActiGraph GT3X+ data (AG) was used for comparison. Improvements in measurement errors were demonstrated with SW5.2 compared to SW2.2, especially in children and for biking. The overall mean absolute percent error with SW5.2 was 24% in children, 23% in adolescents, and 20% in adults. The error was larger for sitting and standing (23%-32%) and for basketball and biking (19%-35%), compared to walking and running (8%-20%). The overall mean absolute error with AG was 28% in children, 22% in adolescents, and 28% in adults. The absolute percent error for biking was 32%-74% with AG. In general, SW and AG underestimated energy expenditure. However, both methods demonstrated a proportional bias, with increasing underestimation for increasing energy expenditure level, in addition to the large individual error. SW provides measures of energy expenditure level with similar accuracy in children, adolescents, and adults with the improvements in the updated algorithms. Although SW captures biking better than AG, these methods share remaining measurements errors requiring further improvements for accurate measures of physical activity and energy expenditure in clinical and epidemiological research.

27 - Feasibility and reproducibility of a new 3D automatic software for left heart chamber quantification in children.

Introduction New 3D automatic software (Heart model (HM), Philips Healthcare, Andover, Massachusetts) is now available to quantify left heart chamber size and function. Its feasibility and accuracy in children have not been reported. The aim of this study was to assess feasibility and reproducibility of HM in healthy children, and to compare LV indices obtained by this technique with classic 2D biplane method. Methods Sixty consecutive healthy children aged more than 5 years were included (mean age 6.5 years, mean weight 20.8 kg). All infants underwent TTE (Epic 7, X5-1, Philips Healthcare, Andover, Massachusetts). Left ventricle (LV) end-systolic and end-diastolic volumes, LV ejection fraction (EF) and left atrium (LA) end-systolic volume were obtained by biplane Simpson method. 3D dataset was obtained from apical 4-chamber view and analyzed using HM software. LV indices obtained by the two methods were compared. Results Feasibility of HM was 80%, in 30 cases (62.5%) with contour adjustment and 18 cases (37.5%) without contour adjustment. Intraobserver variability was (0%, 4% and 8% for HM without contour adjustment, HM with contour adjustment, and biplane method respectively). Interobserver variability was (6% and 12% for HM with contour adjustment and biplane method respectively). Test- retest variability for HM was 6.5%. Correlation between HM and biplane measurements was strong (r = 0.85 to 0.94). LVEF obtained by HM was lower than that obtained by biplane method (bias −8%). However, LV volumes and LA end-systolic volume were larger (bias +12 and +8 respectively) ( Fig. 1 ). Conclusion HM is a promising software for assessment of left heart chamber volume and function. Its feasibility in infants aged more than 5 years is good with excellent reproducibility. Working is going on to validate this technique in children with congenital heart disease and to compare it with MRI measurement as the gold standard.

The Effect of Word Frequency on Phonemic Accuracy in Children With Cochlear Implants and Peers With Typical Levels of Hearing.

The frequency of occurrence of words and sounds has a pervasive influence on typically developing children's language acquisition. For instance, highly frequent words appear earliest in a child's lexicon, and highly frequent phonemes are produced more accurately. This study evaluates (a) whether word frequency influences word accuracy and (b) whether this is also the case for children with a history of auditory deprivation. More specifically, the influence of word frequency on phonemic accuracy is examined in deaf children with a cochlear implant (CI), and compared to age-matched children with typical hearing, between word onset and age 7. Results show that highly frequent words are produced more accurately, except for words in the highest frequency regions (i.e., predominantly closed-class words). This effect is more pronounced in children with typical hearing when compared with children with CI. Thus, children with CI are sensitive to word frequency, but to a lesser extent than peers with typical hearing.

Accuracy of Children’s Perioperative Memories

Children’s declarative memories of medical procedures can influence their responses to subsequent events. No previous study has examined the accuracy of children’s declarative memories after surgery. We tested the memory of 34 anesthesia-naïve five- to nine-year-old children undergoing ambulatory surgery for accuracy of contextual details, pain, and fear two weeks postoperatively. Parents were not present during induction, and we did not use sedative premedication. Children had a mean contextual recall accuracy of 64.5%. Most children (60.6%) remembered a prompt that was given one minute after receiving nitrous oxide. Children’s memories of pain and fear were similar to their reported pain and fear on the day of surgery. Of 29 children, 6 (20.7%) exaggerated their memory of fear, and 8 of 22 children (36.4%) exaggerated their memory of pain. Although a small proportion of children had exaggerated memories, there was no evidence of consistent bias in their memory of fear or pain.

Evaluation of a semi-automated software program for the identification of vertebral fractures in children

To assess observer reliability and diagnostic accuracy in children, of a semi-automated six-point technique developed for vertebral fracture (VF) diagnosis in adults, which records percentage loss of vertebral body height. Using a semi-automated software program, five observers independently assessed T4 to L4 from the lateral spine radiographs of 137 children and adolescents for VF. A previous consensus read by three paediatric radiologists using a simplified algorithm-based qualitative technique (i.e., no software involved) served as the reference standard. Of a total of 1,781 vertebrae, 1,187 (67%) were adequately visualised according to three or more observers. Interobserver agreement in vertebral readability for each vertebral level for five observers ranged from 0.05 to 0.47 (95% CI: -0.19, 0.76). Intra-observer agreement using the intraclass correlation coefficient (ICC) ranged from 0.25 to 0.61. The overall sensitivity and specificity were 18% (95% CI: 14-22) and 97% (95% CI: 97-98), respectively. In contrast to adults, the six-point technique assessing anterior, middle, and posterior vertebral height ratios is neither satisfactorily reliable nor sensitive for VF diagnosis in children. Training of the software on paediatric images is required in order to develop a paediatric standard that incorporates not only specific vertebral body height ratios but also the age-related physiological changes in vertebral shape that occur throughout childhood.

Challenging the Credibility of Alleged Victims of Child Sexual Abuse in Scottish Courts.

This study examined the effects of credibility-challenging questions (n = 2,729) on 62 5- to 17-year-olds' testimony in child sexual abuse cases in Scotland by categorizing the type, source, and content of the credibility-challenging questions defense lawyers asked and assessing how children responded. Credibility-challenging questions comprised 14.9% of all questions asked during cross-examination. Of defense lawyers' credibility-challenging questions, 77.8% focused generally on children's honesty, whereas the remainder referred to specific inconsistencies in the children's testimony. Children resisted credibility challenges 54% of the time, significantly more often than they provided compliant responses (26.8%). The tendency to resist was significantly lower for questions focused on specific rather than general inconsistencies, and peripheral rather than central content. Overall, children resisted credibility challenges more often when the aim and content of the question could be understood easily. As this was a field study, the accuracy of children's responses could not be assessed. The findings suggest that credibility-challenging questions that place unrealistic demands on children's memory capacities (e.g., questions focused on peripheral content or highly specific details) occur frequently, and that juries should be made aware of the disproportionate effects of such questioning on the consistency of children's testimony.

Effects of providing Ground Rules and Building Open-Ended Rapport on the Accuracy of Children’s Recall according to Age in an Investigative Interview

Effects of providing Ground Rules and Building Open-Ended Rapport on the Accuracy of Children’s Recall according to Age in an Investigative Interview

Working memory components that predict word problem solving: Is it merely a function of reading, calculation, and fluid intelligence?

The purpose of this study was to assess whether the differential effects of working memory (WM) components (the central executive, phonological loop, and visual-spatial sketchpad) on math word problem-solving accuracy in children (N = 413, ages 6-10) are completely mediated by reading, calculation, and fluid intelligence. The results indicated that all three WM components predicted word problem solving in the nonmediated model, but only the storage component of WM yielded a significant direct path to word problem-solving accuracy in the fully mediated model. Fluid intelligence was found to moderate the relationship between WM and word problem solving, whereas reading, calculation, and related skills (naming speed, domain-specific knowledge) completely mediated the influence of the executive system on problem-solving accuracy. Our results are consistent with findings suggesting that storage eliminates the predictive contribution of executive WM to various measures Colom, Rebollo, Abad, & Shih (Memory & Cognition, 34: 158-171, 2006). The findings suggest that the storage component of WM, rather than the executive component, has a direct path to higher-order processing in children.

Short-Term Effects of Methylphenidate on Math Productivity in Children With Attention-Deficit/Hyperactivity Disorder are Mediated by Symptom Improvements: Evidence From a Placebo-Controlled Trial.

Although numerous studies report positive effects of methylphenidate on academic performance, the mechanism behind these improvements remains unclear. This study investigates the effects of methylphenidate on academic performance in children with attention-deficit/hyperactivity disorder (ADHD) and the mediating and moderating influence of ADHD severity, academic performance, and ADHD symptom improvement. Sixty-three children with ADHD participated in a double-blind placebo-controlled crossover study comparing the effects of long-acting methylphenidate and placebo. Dependent variables were math, reading, and spelling performance. The ADHD group performance was compared with a group of 67 typically developing children. Methylphenidate improved math productivity and accuracy in children with ADHD. The effect of methylphenidate on math productivity was partly explained by parent-rated symptom improvement, with greater efficacy for children showing more symptom improvement. Further, children showing below-average math performance while on placebo profited more from methylphenidate than children showing above-average math performance. The results from this study indicate positive effects of methylphenidate on academic performance, although these were limited to math abilities. In light of these results, expectations of parents, teachers, and treating physicians about the immediate effects of methylphenidate on academic improvement should be tempered. Moreover, our results implicate that positive effects of methylphenidate on math performance are in part due directly to effects on math ability and in part due to reductions in ADHD symptoms.

Deuterium dilution technique for body composition assessment: resolving methodological issues in children with moderate acute malnutrition

ABSTRACTChildhood malnutrition is highly prevalent and associated with high mortality risk. In observational and interventional studies among malnourished children, body composition is increasingly recognised as a key outcome. The deuterium dilution technique has generated high-quality data on body composition in studies of infants and young children in several settings, but its feasibility and accuracy in children suffering from moderate acute malnutrition requires further study. Prior to a large nutritional intervention trial among children with moderate acute malnutrition, we conducted pilot work to develop and adapt the deuterium dilution technique. We refined procedures for administration of isotope doses and collection of saliva. Furthermore, we established that equilibration time in local context is 3 h. These findings and the resulting standard operating procedures are important to improve data quality when using the deuterium dilution technique in malnutrition studies in field conditions, and may encourage a wider use of isotope techniques.

Working with the Victims and Perpetrators of Child Sexual Abuse and Exploitation

Working with the Victims and Perpetrators of Child Sexual Abuse and Exploitation

Prediction of Maximal Heart Rate in Children and Adolescents.

To identify a method to predict the maximal heart rate (MHR) in children and adolescents, as available prediction equations developed for adults have a low accuracy in children. We hypothesized that MHR may be influenced by resting heart rate, anthropometric factors, or fitness level. Cross-sectional study. Sports medicine center in primary care. Data from 627 treadmill maximal exercise tests performed by 433 pediatric athletes (age 13.7 ± 2.1 years, 70% males) were analyzed. Age, sex, sport type, stature, body mass, BMI, body fat, fitness level, resting, and MHR were recorded. To develop a prediction equation for MHR in youth, using stepwise multivariate linear regression and linear mixed model. To determine correlations between existing prediction equations and pediatric MHR. Observed MHR was 197 ± 8.6 b·min. Regression analysis revealed that resting heart rate, fitness, body mass, and fat percent were predictors of MHR (R = 0.25, P < 0.001), whereas age was not. Resting heart rate explained 15.6% of MHR variance, body mass added 5.7%, fat percent added 2.4%, and fitness added 1.2%. Existing adult equations had low correlations with observed MHR in children and adolescents (r = -0.03-0.34). A new equation to predict MHR in children and adolescents was developed, but was found to have low predictive ability, a finding similar to adult equations applied to children. Considering the narrow range of MHR in youth, we propose using 197 b·min as the mean MHR in children and adolescents, with 180 b·min the minimal threshold value (-2 standard deviations).

Accuracy of Children in Reporting Asthma Control As Determined By c-ACT (Childhood-Asthma Control Test)

Accuracy of Children in Reporting Asthma Control As Determined By c-ACT (Childhood-Asthma Control Test)

Improving homework performance among children with ADHD: A randomized clinical trial.

Evidence indicates that children with Attention Deficit Hyperactivity Disorder (ADHD) experience acute and prolonged academic impairment and underachievement including marked difficulty with completing homework. This study is the first to examine the effects of behavioral, psychostimulant, and combined treatments on homework problems, which have been shown to predict academic performance longitudinally. Children with ADHD (ages 5-12, N = 75, 71% male, 83% Hispanic/Latino) and their families were randomly assigned to either behavioral treatment (homework-focused parent training and a daily report card; BPT + DRC) or a waitlist control group. Children also participated in a concurrent psychostimulant crossover trial conducted in a summer treatment program. Children's objective homework completion and accuracy were measured as well as parent-reported child homework behaviors and parenting skills. BPT + DRC had large effects on objective measures of homework completion and accuracy (Cohen's ds from 1.40 to 2.21, ps < .001). Other findings, including unimodal medication and incremental combined treatment benefits, were not significant. Behavioral treatment focused on homework problems results in clear benefits for children's homework completion and accuracy (the difference between passing and failing, on average), whereas long-acting stimulant medication resulted in limited and largely nonsignificant acute effects on homework performance. (PsycINFO Database Record

The acquisition of tense morphology over time by English second language children with specific language impairment: Testing the cumulative effects hypothesis

ABSTRACTThe cumulative effects hypothesis (CEH) claims that bilingual development would be a challenge for children with specific language impairment (SLI). To date, research on second language (L2) children with SLI has been limited mainly to their early years of L2 exposure; however, examining the long-term outcomes of L2 children with SLI is essential for testing the CEH. Accordingly, the present study examined production and grammaticality judgments of English tense morphology from matched groups of L2 children with SLI and L2 children with typical development (TD) for 3 years, from ages 8 to 10 with 4–6 years of exposure to English. This study found that the longitudinal acquisition profile of the L2 children with SLI and TD was similar to the acquisition profile reported for monolinguals with SLI and TD. Furthermore, L2-SLI children's accuracy with tense morphology was similar to that of their monolingual age peers with SLI at the end of the study, and exceeded that of younger monolingual peers with SLI whose age matched the L2 children's length of exposure to English. These findings are not consistent with the CEH, but instead show that morphological acquisition parallel to monolinguals with SLI is possible for L2 children with SLI.