Typically Developing Children Research Articles

Testing the Continuum/Spectrum Model in Russian-Speaking Children With and Without Developmental Language Disorder.

Previously, Lancaster and Camarata (2019) showed that the continuum/spectrum model of the developmental language disorder (DLD) best explained the high heterogeneity of symptoms in children with DLD. We hypothesize that the continuum/spectrum approach can include not only children with DLD but also typically developing (TD) children with different timelines and patterns of language acquisition. This model can explain individual language profiles and deficits in children. We assessed language abilities in a group of Russian-speaking children with DLD aged 4-7 years (n = 53) and their age- and gender-matched peers without speech and language diagnoses (n = 53, TD). We evaluated the children's performance at four language levels in production and comprehension domains, using 11 subtests of the standardized language assessment for Russian: Russian Child Language Assessment Battery (RuCLAB). Using the k-means cluster method and RuCLAB scores, we obtained two clusters of children and analyzed their language performance in individual subtests. The analysis revealed that the two clusters of children both included DLD and TD participants: Group 1, with higher test scores (TD = 45, DLD = 24 children), and Group 2, with lower scores (TD = 8, DLD = 29). Children from Group 1 mostly had lower scores at one of the language levels, whereas those from Group 2 struggled at several language levels. Furthermore, children with DLD from both groups tended to be more sensitive to linguistic features such as word length, noun case, and sentence reversibility compared to TD children. The presence of two mixed groups shows that children with diagnosed DLD could perform on par with TD children, whereas some younger TD children could perform similarly to children with DLD. Our findings support the continuum/spectrum model: Linguistic skills in preschool children are a continuum, varying from high to poor skills at all language levels in comprehension and production. To describe a child's language profile, the tasks assessing all language levels should be used. https://doi.org/10.23641/asha.25521400.

Analyzing lower body movements using machine learning to classify autistic children

Autism spectrum disorder is a neurological disorder that affects children at an early age and its symptoms appear in varying degrees. Early detection of ASD and follow-up of treatment by specialists help improve autistic people's lives and reduce the symptoms they suffer from. In the past few years, a group of studies conducted gait analysis to diagnose children with autism, and although the results of these studies showed weak motor skills of Autism Spectrum Disorder children (ASD) compared to their peers of Typically Developing children (TD), there are some challenges facing researchers in this field. The first is the ability to create A safe, effective, friendly environment that reduces tension in ASD children and helps classify children into ASD/TD effectively. And the second is the ability to create an automated ASD diagnosis system. In this work, a system based on machine learning and augmented reality technology has been proposed to create an effective and friendly interactive environment that helps diagnose ASD and classify children to ASD / TD. The movement of the lower limbs of 15 ASD children and 15 TD children are tracked via a marker-less technique through a Kinect v2 sensor when playing a specific game based on kicking the ball task, that is using augmented reality technology. Then the kinematics features are extracted through Linear Discriminant Analysis technology. To determine these features' ability in the classification process, three machine learning algorithms are used, namely Support Vector Machine, Linear Discriminant Analysis, and Decision Tree. The results showed that the obtained kinematics features can classify children into ASD/TD, where the Support Vector Machine classifier obtained a high accuracy of 96.7% with sensitivity equal to 93.3% and specificity equal to 100%. In addition, the Linear Discriminant Analysis classifier obtained less accuracy of 93.3% with sensitivity equal to 93.3% and specificity equal to 93.3% compared with the Support Vector Machine classifier. Where the Decision Tree classifier obtained the lowest accuracy of 80.0% with sensitivity equal to 73.3% and specificity equal to 86.7% compared with the Support Vector Machine and Linear Discriminant Analysis classifiers. In addition to that, when using Linear Discriminant Analysis to reduce dimensions and extract features, the accuracy, sensitivity, and specificity of the Support Vector Machine classifier were increased and achieved by 100%. Based on these results, it has been proven that the proposed method is effective in classifying children to ASD/TD.

Task-related differences in the gesture production of young autistic children.

In typically developing (TD) children, gesture emerges around 9months of age, allowing children to communicate prior to speech. Due to the important role gesture plays in the early communication of autistic and TD children, various tasks have been used to assess gesture ability. However, few data exist on whether and how tasks differentially elicit gesture, particularly for samples of racially and ethnically diverse autistic children. In this study, we explored if task (a naturalistic parent-child interaction [NPCI]; structured assessment of child communication) differentially elicited rate or type of gesture production for young autistic children. This secondary analysis included baseline data from 80 racially and ethnically diverse autistic children aged 18-59months who participated in one of two larger studies. Video recordings of NPCIs and an assessment of child communication with standardised administration procedures were collected at baseline. Child gesture rate (number of gestures produced per 10min) and type were extracted from these recordings and analysed. The structured assessment elicited more gestures than the NPCI. In terms of gesture type, points, gives, and reaches accounted for 76% of child gestures. Points (which are developmentally more advanced than reaches and gives) were produced at the highest rates within book exploration. Distal points (which are more developmentally advanced than proximal or contact points) were produced at the highest rates when children were tempted to request. Our findings indicate elicitation tasks differentially elicit type and rate of gesture for young autistic children. To assess the gesture production of young autistic children, a structured task designed to elicit child requests will probe the developmental sophistication of the child's gesture repertoire, eliciting both the most gestures and the most developmentally advanced gestures. What is already known on the subject Because of the importance of gesture in early communication for autistic and typically developing children, various tasks have been used to assess it. However, little is known about whether tasks differentially elicit type or rate of gesture for young autistic children from diverse racial and ethnic backgrounds. What this paper adds to existing knowledge Elicitation tasks differentially elicit type and rate of gesture for young autistic children in the early stages of gesture. What are the potential or actual clinical implications of this work? We recommend a structured task designed to elicit child requests to assess the developmental sophistication of a child's gesture repertoire.

Attentional Bias to Angry Faces: Contrasting Responses in Typically Developing Children and Children with Autism Spectrum Disorder

IntroductionHuman faces generally attract immediate attention. However, it has been found that children with autism spectrum disorder (ASD) tend to allocate relatively less attention to faces. Previous research showed that typically developing children (TD) exhibited an attentional bias to angry faces, regardless of their anxiety levels, but it’s unclear if this applies to children with ASD. Therefore, the present study aims to investigate attentional bias induced by angry and/or happy faces in children with ASD.ObjectivesWe explored attentional bias toward angry faces in both TD children and children with ASD. We hypothesize that while TD children will show attentional capture effects in response to angry faces, children with ASD will not exhibit such attentional bias to facial stimuli, irrespective of their emotional content.MethodsBy now, five ASD participants (all male) and 34 TD participants (17 male), aged 6-12, have completed a continuous performance task. In this task, irrelevant distractors (angry or happy faces) appeared and disappeared abruptly, while the orientation of the target changed every 1,250 ms. Participants were asked to respond as quickly and accurately as possible to the orientaiton of the target. We designated the time when the distractor first appeared as T1, and subsequent time intervals at 1,250 ms increments were labeled as T2, T3, and T4. The time intervals when no distractor was present were labeled as TB (baseline). If the reaction time (RT) at T1 was significantly slower compared to TB, it indicated attentional bias by the distractor.ResultsFor the RT data, separate repeated measures ANOVAs with 2 (emotion) * 5 (time) factors were conducted for each group. The results revealed a significant main effect of time (F(4, 132) = 17.59, p < .01) and a significant interaction between emotion and time (F(3.27, 107.74) = 4.92, p < .01) only in TD. Post hoc t-tests indicated that TD children exhibited significantly slower RT at T1 compared to TB, but this difference was observed only for angry faces (t(33) = 4.84, p < .01). In contrast, no significant effect was found in children with ASD. In other words, TD demonstrated attentional bias only when exposed to angry faces, while ASD children did not exhibit attentional bias to either emotion.ConclusionsThis study aimed to investigate attentional bias to angry faces in both TD and ASD children. The results indicate that TD children exhibited an attentional bias when exposed to angry faces, whereas ASD children did not display such bias. These findings are consistent with previous research suggesting that TD children tend to show attentional bias towards angry faces, regardless of their anxiety levels. Furthermore, the absence of attentional bias to angry faces in ASD suggests that their characteristic of reduced attention to faces may contribute to the lack of attentional bias towards angry faces.Disclosure of InterestNone Declared

Assessing the Phonological Abilities of Jordanian Arabic-speaking Children with Phonological Disorders

Objectives: This study investigated the validity of four language measures, i.e., phonological mean length of utterance (PMLU), the proportion of whole-word proximity (PWP), the proportion of whole-word correctness (PWC), and percentage of correct consonants, in assessing phonological development in Jordanian Arabic (JA) speaking children with phonological disorders in comparison with typically developing (TD) children.Methods: The study involved 88 monolingual JA-speaking children within the age range of 5 to 6 years, with 44 children diagnosed with phonological disorders and 44 TD children. Each group was further categorized into two age groups, namely 5;0-5;6 and 5,7-6,0. Data were gathered by observing the interactions between the children and their caregivers or parents using age-appropriate toys. A minimum of 100 utterances were collected from each participant.Results: The study found that TD children performed better than the children with phonological disorders on all measures, indicating delayed phonological performance in the phonological disorders group. Positive correlations between the measures were also observed, indicating their ability to provide significant information about children’s phonological abilities. Specific speech sound errors and substitution patterns exhibited by children with phonological disorders were identified, highlighting the motor control and articulatory challenges experienced by this group. Age was found to be a significant factor in the development of TD children, while children with phonological disorders showed similar scores across different age groups.Conclusion: These findings support the usage of the four measures for understanding phonological development in children with phonological disorders, accurately diagnosing them and tracking their progress.

Attention toward Social and Non-Social Stimuli in Preschool Children with Autism Spectrum Disorder: A Paired Preference Eye-Tracking Study.

Different dimensions of visual attention to social (human faces) and non-social stimuli (objects) were assessed in 19 preschool children with Autism Spectrum Disorder (ASD) and 19 typically developing (TD) age, gender, and IQ-matched controls through an original paired preference eye-tracking paradigm. The present study found a significantly reduced attentional bias toward human faces in children with ASD compared to TD controls. The analysis of the total fixation time showed a significantly reduced preference for faces in children with ASD compared to TD children. Moreover, while TD children showed a significant preference for the face over the object, children in the ASD group observed the two paired pictures for a similar amount of time, thus showing no preference. Besides, children with ASD paid significantly more sustained attention to the objects than TD children. Children in the TD group paid greater sustained attention to the faces over the objects, while children in the ASD group did not differentiate between objects and faces. Finally, an age effect was found in ASD, as younger children in the group tended to prefer objects and to show more sustained attention towards them. Overall, these findings add to the literature on anomalies in attention toward social and non-social stimuli in young children with ASD compared to their TD counterparts. These results are discussed in the light of previous studies and suggest possible directions for future research.

Auxiliary Diagnosis of Children with Attention-Deficit/Hyperactivity Disorder: An Eye-Tracking Study with Novel Digital Biomarkers.

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in school-aged children. The lack of objective biomarkers for ADHD often results in missed diagnoses or misdiagnoses, which lead to inappropriate or delayed interventions. Eye-tracking technology provides an objective method to assess children's neuropsychological behavior. The purpose of this research was to develop an objective and reliable auxiliary diagnostic system for ADHD using eye-tracking technology. This system would be valuable for screening for ADHD in schools and communities and may help identify objective biomarkers for the clinical diagnosis of ADHD. We conducted a case-control study of children with ADHD and typically developing (TD) children. We designed an eye-tracking assessment paradigm based on the core cognitive deficits of ADHD and extracted various digital biomarkers that represented participant behaviors. These biomarkers and developmental patterns were compared between the ADHD and TD groups. Machine learning (ML) was implemented to validate the ability of the extracted eye-tracking biomarkers to predict ADHD. The performance of the ML models was evaluated using k-fold cross-validation. We recruited 216 participants, of whom 94 were children with ADHD and 122 were TD children. The ADHD group showed significantly poorer performance (for accuracy and completion time) than the TD group in the pro-, anti-, and delayed-saccade tasks. Additionally, there were significant group differences in digital biomarkers, such as pupil diameter fluctuation, regularity of gaze trajectory, and fixations on uninterested areas. Although the accuracy and task completion speed of the ADHD group increased over time, their eye movement patterns remained irregular. The 5-6-year-old TD group outperformed the 9-10-year-old ADHD group, and this difference remained relatively stable over time, which indicated that the ADHD group followed a unique developmental pattern. The ML model was effective in discriminating the groups, achieving an area under the curve of 0.965 and an accuracy of 0.908. The eye-tracking biomarkers proposed in this study effectively identified differences in various aspects of eye movement patterns between the ADHD and TD groups. In addition, the ML model constructed using these digital biomarkers achieved high accuracy and reliability in identifying ADHD. Our system can facilitate early screening for ADHD in schools and communities and provide clinicians with objective biomarkers as a reference. This study has been registrated at Chinese Clinical Trail Registry(No. ChiCTR2400087697).

Multi-segment foot kinematics during gait in children with spastic cerebral palsy

BackgroundFoot deformities (e.g. planovalgus and cavovarus) are very common in children with spastic cerebral palsy (CP), with the midfoot often being involved. Dynamic foot function can be assessed with 3D gait analysis including a multi-segment foot model. Incorporating a midfoot segment in such a model, allows quantification of separate Chopart and Lisfranc joint kinematics. Yet, midfoot kinematics have not previously been reported in CP. Research questionsWhat is the difference in multi-segment kinematics including midfoot joints between common foot deformities in CP and typically-developing feet? Methods103 feet of 57 children with spastic CP and related conditions were retrospectively included and compared with 15 typically-developing children. All children underwent clinical gait analysis with the Amsterdam Foot Model marker set. Multi-segment foot kinematics were calculated for three strides per foot and averaged. A k-means cluster analysis was performed to identify foot deformity groups that were present within CP data. The deformity type represented by each cluster was based on the foot posture index. Kinematic output of the clusters was compared to typically-developing data for a static standing trial and for the range of motion and kinematic waveforms during walking, using regular and SPM independent t-tests respectively. ResultsA neutral, planovalgus and varus cluster were identified. Neutral feet showed mostly similar kinematics as typically-developing data. Planovalgus feet showed increased ankle valgus and Chopart dorsiflexion, eversion and abduction. Varus feet showed increased ankle varus and Chopart inversion and adduction. SignificanceThis study is the first to describe Chopart and Lisfranc joint kinematics in different foot deformities of children with CP. It shows that adding a midfoot segment can provide additional clinical and kinematic information. It highlights joint angles that are more distinctive between deformities, which could be helpful to optimize the use of multi-segment foot kinematics in the clinical decision making process.

Non-immersive virtual reality based treatment for children with unilateral cerebral palsy: Preliminary results.

Unilateral cerebral palsy (UCP) represents about 30-40% of overall cerebral palsy diagnoses. Upper limb impairment has a significant negative impact on activities of daily living (ADL), and recent studies have shown that the use of virtual reality (VR) can increase motivation and promote an improvement in ADL. This preliminary study was aimed at exploring the acceptability and usability of a VR rehabilitation treatment, using the VITAMIN Platform, for children with UCP. A secondary goal of the study was to compare the results of usual standardized clinical scales and questionnaires with kinematic results as well as with the quantitative measures acquired by the VITAMIN platform in each exercise of the rehabilitation sessions. Six children with UCP (aged 7-15) were recruited for a preliminary investigation in using a non-immersive VR system. The treatment was composed of 10 weekly sessions of 45 minutes. Each child played five types of exergames, using the impaired upper limb to hit virtual objects projected on a wide screen. Standardized clinical scales, kinematic analysis, and questionnaires were used to extensively assess upper limb function before and at the end of treatment. Five typically-developing children provided a reference for the instrumented kinematic assessment. At the end of the treatment, Melbourne Assessment 2 (MA2) scores increased for all the participants (mean increase in range of movement (ROM) + 19.1%, accuracy + 4.6%, dexterity + 13.1%, fluency + 10.3%). Shoulder flexion-extension ROM also improved (mean increase + 10.5°), and according to the kinematic analysis, shoulder movements became more similar to reference profiles. These results were confirmed by a general improvement in performing ADL, assessed by the ABILHAND-Kids questionnaire. Finally, a general agreement among the different measures and indexes emerged from the acquired data. The results show that VR treatment with the VITAMIN platform could be engaging and functional for rehabilitation of children with UCP. The good agreement among the qualitative and quantitative measures and indexes confirms the potential of such novel treatment. However, due to the limited sample size and small number of sessions, further and larger investigations are required to evaluate the effectiveness and to generalize the results.

Finger counting to relieve working memory in children with developmental coordination disorder: Insights from behavioral and three-dimensional motion analyses

A limited number of studies have attempted to understand how motor deficits affect numerical abilities in children with developmental coordination disorder (DCD). The purpose of this study was to explore the functionality of finger-counting (FC) in children with DCD. The participants, 15 children with DCD and 15 typically developing (TD) children matched on school level and fluid reasoning abilities, were asked to use FC to solve an ordinal task with high working memory (WM) load. Behavioral measures supplemented with biomechanical measures, from three-dimensional motion analysis synchronized to a voice recording were used to assess children’s performance and FC functionality (total duration, inter-finger [IF] transition, IF variance, finger/voice synchronization, and automatization of FC movements). Children with DCD were less accurate than TD children in using FC to solve ordinal problems with high WM load. This group difference could not be accounted for by poor FC skills given that FC movement turned out to be as functional in children with DCD as in their TD peers. When added to the model as a covariate, WM captured a greater proportion of intergroup variability than manual dexterity, further suggesting that their difficulties would be better accounted for by limited WM resources than by fine motor skills.

Prenatal, perinatal and parental risk factors for autism spectrum disorder in China: a case- control study.

Autism spectrum disorder (ASD) is heritable neurodevelopmental disorders (NDDs), but environmental risk factors have also been suggested to a play a role in its development. Prenatal, perinatal and parental factors have been associated with an increased risk of ASD in children. The aim of the present study was to explore the prenatal, perinatal, and parenting risk factors in children with autism spectrum disorder (ASD) from Beijing, China by comparing them with typically developing (TD) children. A sample of 151 ASD children's parents who from rehabilitation institutions in Beijing were enrolled in this study, and an additional 151 children from kindergartens in Beijing were recruited as a control group (child age: mean = 4.4 years). TD children were matched according to age, sex and maternal education. We explored the maternal AQ (Autism Spectrum Quotient) scores (mean:19.40-19.71, no significant difference between two groups) to referring the genetic baseline. This study evaluated 17 factors with unadjusted and adjusted analyses. Birth asphyxia was associated with a more than a thirteen-fold higher risk of ASD (adjusted odds ratio (AOR) = 13.42). Breastfeeding difficulties were associated with a higher risk of ASD(AOR = 3.46). Parenting influenced the risk of ASD, with low responding (LR) and harsh or neglectful parenting associated with a higher risk of ASD in offspring (AOR = 2.37 for LR, AOR = 3.42 for harsh parenting and AOR = 3.01 for neglectful parenting). Maternal fever during pregnancy was associated with a higher risk of ASD in offspring (AOR = 3.81). Many factors were associated with ASD in offspring. Further assessment is needed to elucidate the role of modifiable environmental factors to inform prevention strategies.

3D gait analysis in children using wearable sensors: feasibility of predicting joint kinematics and kinetics with personalized machine learning models and inertial measurement units.

Introduction: Children's walking patterns evolve with age, exhibiting less repetitiveness at a young age and more variability than adults. Three-dimensional gait analysis (3DGA) is crucial for understanding and treating lower limb movement disorders in children, traditionally performed using Optical Motion Capture (OMC). Inertial Measurement Units (IMUs) offer a cost-effective alternative to OMC, although challenges like drift errors persist. Machine learning (ML) models can mitigate these issues in adults, prompting an investigation into their applicability to a heterogeneous pediatric population. This study aimed at 1) quantifying personalized and generalized ML models' performance for predicting gait time series in typically developed (TD) children using IMUs data, 2) Comparing random forest (RF) and convolutional neural networks (CNN) models' performance, 3) Finding the optimal number of IMUs required for accurate predictions. Methodology: Seventeen TD children, aged 6 to 15, participated in data collection involving OMC, force plates, and IMU sensors. Joint kinematics and kinetics (targets) were computed from OMC and force plates' data using OpenSim. Tsfresh, a Python package, extracted features from raw IMU data. Each target's ten most important features were input in the development of personalized and generalized RF and CNN models. This procedure was initially conducted with 7 IMUs placed on all lower limb segments and then performed using only two IMUs on the feet. Results: Findings suggested that the RF and CNN models demonstrated comparable performance. RF predicted joint kinematics with a 9.5% and 19.9% NRMSE for personalized and generalized models, respectively, and joint kinetics with an NRMSE of 10.7% for personalized and 15.2% for generalized models in TD children. Personalized models provided accurate estimations from IMU data in children, while generalized models lacked accuracy due to the limited dataset. Furthermore, reducing the number of IMUs from 7 to 2 did not affect the results, and the performance remained consistent. Discussion: This study proposed a promising personalized approach for gait time series prediction in children, involving an RF model and two IMUs on the feet.

Visual-motor integration in children with unilateral cerebral palsy: application of the computer-aided measure of visual-motor integration

BackgroundChildren with unilateral cerebral palsy (UCP) are encouraged to participate in the regular school curriculum. However, even when using the less-affected hand for handwriting, children with UCP still experience handwriting difficulties. Visual-motor integration (VMI) is a predictor of handwriting quality. Investigating VMI in children with UCP is important but still lacking. Conventional paper-based VMI assessments is subjective and use all-or-nothing scoring procedures, which may compromise the fidelity of VMI assessments. Moreover, identifying important shapes that are predictive of VMI performance might benefit clinical decision-making because different geometric shapes represent different developmental stepping stones of VMI. Therefore, a new computer-aided measure of VMI (the CAM-VMI) was developed to investigate VMI performance in children with UCP and to identify shapes important for predicting their VMI performance.MethodsTwenty-eight children with UCP and 28 typically-developing (TD) children were recruited. All participants were instructed to complete the CAM-VMI and Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery-VMI). The test items of the CAM-VMI consisted of nine simple geometric shapes related to writing readiness. Two scores of the CAM-VMI, namely, Error and Effort, were obtained by image registration technique. The performances on the Beery-VMI and the CAM-VMI of children with UCP and TD children were compared by independent t-test. A series of stepwise regression analyses were used to identify shapes important for predicting VMI performance in children with UCP.ResultsSignificant group differences were found in both the CAM-VMI and the Beery-VMI results. Furthermore, Error was identified as a significant aspect for predicting VMI performance in children with UCP. Specifically, the square item was the only significant predictor of VMI performance in children with UCP.ConclusionsThis study was a large-scale study that provided direct evidence of impaired VMI in school-aged children with UCP. Even when using the less-affected hand, children with UCP could not copy the geometric shapes as well as TD children did. The copied products of children with UCP demonstrated poor constructional accuracy and inappropriate alignment. Furthermore, the predictive model suggested that the constructional accuracy of a copied square is an important predictor of VMI performance in children with UCP.

Evaluation of sleep problems and related factors in children newly diagnosed with autism spectrum disorder

Objectives The aim of this study was to examine sleep problems in newly diagnosed children with autism spectrum disorder (ASD) and compared these problems with typically developing (TD) children in early childhood period. We also evaluated the factors that may be related to sleep problems in ASD group. Methods Forty-eight children with ASD and 46 TD children, and their parents were enrolled in the study. The severity of autistic symptoms and mother–child relationship of children with ASD, and developmental level of all children were assessed. The parents completed questionnaires related to their children’s sleep, behavioral problems, and their own psychiatric symptoms. Results ASD group did not differ from controls in terms of sleep problems. Sleep problems were associated with behavioral problems (p < 0.001), developmental level (p < 0.05), autism severity (p < 0.01), maternal psychopathology (p < 0.01) and mother–child relationship quality (p < 0.05) in ASD group. However, behavioral problems had the strongest association with sleep problems. Conclusions The similarity in sleep problems between children with ASD and typically developing (TD) children during early childhood highlights the clinical importance of recognizing and addressing these challenges early on. Particularly, given the strong association with behavioral problems in children with ASD, clinicians should prioritize comprehensive assessments and interventions targeting behavioral aspects to improve sleep outcomes. This study calls for further research into the developmental trajectory of sleep problems in ASD children, contributing valuable insights to the broader literature on effective clinical approaches for this population in their management.

Participation Patterns and Associated Factors in Japanese Children With Autism.

Children's participation is an important outcome for children, families, and rehabilitation. We compared participation patterns (home and community) of 6- to 12-year-old Japanese children with autism and children with typical development (TD) and explored the associations of participation with familial, environmental, and child-related factors. Twenty-five mothers of children with autism and 21 mothers of TD children completed a survey covering their child's participation and environment, family empowerment, autism symptoms, sensory processing, behavior, and demographic characteristics. Children with autism showed restricted home and community participation. Home involvement was associated with family empowerment and the children's age, whereas home frequency was linked to environmental supportiveness and household income. Japanese children with autism need appropriate support to address decreased participation. Occupational therapists may focus on family empowerment and the child's environment to facilitate the home participation of children with autism.

Slowness in writing numbers in words and in digits among children with a specific learning disorder (SLD) and typically developing (TD)

ABSTRACT Instruction Children with a Specific Learning Disorder (SLD) write linguistic material more slowly than children with typically developing (TD). However, it is not known whether the same difficulties are present when they write numbers. The goal of the present study was to fill this gap and to compare TD’s and SLD’s speed in writing numbers both in words and in digits. Methods Therefore, we examined the ability to write numbers in words and digits (numerals) in a sample of sixth- to eighth-grade children diagnosed with SLD. We assessed 32 children with SLD (17 males and 15 females) and a control group of students with TD matched for sex, age, and grade with two writing speed tasks: writing numbers in words and in digits. The two tasks were administered both in normal condition (N) and in articulatory suppression condition (AS). Results We found that 6th to 8th graders with a SLD were slower than TD children when writing numbers, both in words and in digits, and their slowness was similar in the two cases. However, when the tasks were carried out under a condition of articulatory suppression, the SLD group exhibited a conspicuous impairment, only when writing numbers in words. A similar pattern of performance was observed also in the case of writing errors. Conclusion We concluded that children with SLD have a general speed problem that may affect writing of different materials but also a specific problem related to the processing of phonological information during writing.

Muscle synergy-informed neuromusculoskeletal modelling to estimate knee contact forces in children with cerebral palsy

Cerebral palsy (CP) includes a group of neurological conditions caused by damage to the developing brain, resulting in maladaptive alterations of muscle coordination and movement. Estimates of joint moments and contact forces during locomotion are important to establish the trajectory of disease progression and plan appropriate surgical interventions in children with CP. Joint moments and contact forces can be estimated using electromyogram (EMG)-informed neuromusculoskeletal models, but a reduced number of EMG sensors would facilitate translation of these computational methods to clinics. This study developed and evaluated a muscle synergy-informed neuromusculoskeletal modelling approach using EMG recordings from three to four muscles to estimate joint moments and knee contact forces of children with CP and typically developing (TD) children during walking. Using only three to four experimental EMG sensors attached to a single leg and leveraging an EMG database of walking data of TD children, the synergy-informed approach estimated total knee contact forces comparable to those estimated by EMG-assisted approaches that used 13 EMG sensors (children with CP, n = 3, R2 = 0.95 ± 0.01, RMSE = 0.40 ± 0.14 BW; TD controls, n = 3, R2 = 0.93 ± 0.07, RMSE = 0.19 ± 0.05 BW). The proposed synergy-informed neuromusculoskeletal modelling approach could enable rapid evaluation of joint biomechanics in children with unimpaired and impaired motor control within a clinical environment.

Conducting head-mounted eye-tracking research with young children with autism and children with increased likelihood of later autism diagnosis

BackgroundOver the past years, researchers have been using head-mounted eye-tracking systems to study young children’s gaze behaviors in everyday activities through which children learn about the world. This method has great potential to further our understanding of how millisecond-level gaze behaviors create multisensory experiences and fluctuate around social environments. While this line of work can yield insight into early perceptual experiences and potential learning mechanisms, the majority of the work is exclusively conducted with typically-developing children. Sensory sensitivities, social-communication difficulties, and challenging behaviors (e.g., disruption, elopement) are common among children with developmental disorders, and they may represent potential methodological challenges for collecting high-quality data.ResultsIn this paper, we describe our research practices of using head-mounted eye trackers with 41 autistic children and 17 children with increased likelihood of later autism diagnosis without auditory or visual impairments, including those who are minimally or nonspeaking and/or have intellectual disabilities. The success rate in gathering data among children with autism was 92.68%. 3 of 41 children failed to complete the play-session, resulting in an 86.36% success rate among 1–4-year-olds and a 100.00% success rate among 5–8-year-olds. 1 of 17 children with increased likelihood of later autism diagnosis failed to complete the play-session, resulting in a success rate of 94.11%. There were numerous “challenging” behaviors relevant to the method. The most common challenging behaviors included taking the eye-tracking device off, elopement, and becoming distressed. Overall, among children with autism, 88.8% of 1–4-year-olds and 29.4% of 5–8-year-olds exhibited at least one challenging behavior.ConclusionsResearch capitalizing on this methodology has the potential to reveal early, socially-mediated gaze behaviors that are relevant for autism screening, diagnosis, and intervention purposes. We hope that our efforts in documenting our study methodology will help researchers and clinicians effectively study early naturally-occuring gaze behaviors of children during non-experimental contexts across the spectrum and other developmental disabilities using head-mounted eye-tracking. Ultimately, such applications may increase the generalizability of results, better reflect the diversity of individual characteristics, and offer new ways in which this method can contribute to the field.

Measuring Upper Extremity Activity of Children With Unilateral Cerebral Palsy Using Wrist-Worn Accelerometers: A Pilot Study.

Children with unilateral cerebral palsy (UCP) have poor strength and movement control on one side of their body, leading to impaired bimanual coordination skills. To compare duration and intensity of all-day habitual movement of the dominant and nondominant upper extremities (UEs) in typically developing (TD) children and children with UCP. Two-group observational study. Children's naturalistic settings. Convenience sample of 9 TD children and 9 children with UCP. Children wore accelerometers on both wrists all day and night for 1 wk. We compared the extent of asymmetry in bilateral arm use (intensity and duration) between the 2 groups. Compared with TD children who use both UEs equally, children with UCP were more likely to use their dominant or unaffected UE than their nondominant or affected UE during daily activities. There were no differences between groups in dominant UE activity. However, children with UCP engaged in lower levels of moderate to vigorous activity and greater levels of light activity with their nondominant or affected UE than their TD peers. Wrist-worn accelerometry can provide objective information on real-world habitual activity with both arms in children. Accelerometers are nonintrusive, easy to use, and well tolerated by children, and they allow prolonged monitoring of UE activity outside therapeutic contexts. Occupational therapists can use wrist-worn accelerometers as sensitive tools to assess asymmetries in UE use at baseline and as an outcome measure to assess the efficacy of behavioral interventions and carryover into real-world settings among children with UCP. Plain-Language Summary: This pilot study provides promising evidence that supports the use of wrist-worn accelerometry as an accurate, easy-to-use, and objective assessment tool for children with unilateral cerebral palsy (UCP) to detect asymmetries in bilateral real-world arm activity at baseline and after intensive occupational therapy interventions to improve arm function. The authors used wrist-worn accelerometry for one week with 9 typically developing (TD) children and 9 children with UCP to compare dominant or unaffected versus nondominant or affected upper extremity (UE) use for intensity and duration of activity. Compared with TD children, children with UCP had lower relative intensity of activity in the nondominant UE than the dominant UE. Wrist-worn accelerometers seem to be a sensitive measure to detect asymmetries in bilateral all-day UE use in children with UCP. The findings have implications for the use of wrist-worn accelerometers as an outcome measure to assess the efficacy of intensive therapies to improve real-world affected UE activity and bimanual function among children with UCP.

Are numerical abilities determined at early age? A brain morphology study in children and adolescents with and without developmental dyscalculia

The intraparietal sulcus (IPS) has been associated with numerical processing. A recent study reported that the IPS sulcal pattern was associated with arithmetic and symbolic number abilities in children and adults. In the present study, we evaluated the link between numerical abilities and the IPS sulcal pattern in children with Developmental Dyscalculia (DD) and typically developing children (TD), extending previous analyses considering other sulcal features and the postcentral sulcus (PoCS). First, we confirm the longitudinal sulcal pattern stability of the IPS and the PoCS. Second, we found a lower proportion of left sectioned IPS and a higher proportion of a double-horizontal IPS shape bilaterally in DD compared to TD. Third, our analyses revealed that arithmetic is the only aspect of numerical processing that is significantly related to the IPS sulcal pattern (sectioned vs not sectioned), and that this relationship is specific to the left hemisphere. And last, correlation analyses of age and arithmetic in children without a sectioned left IPS indicate that although they may have an inherent disadvantage in numerical abilities, these may improve with age. Thus, our results indicate that only the left IPS sulcal pattern is related to numerical abilities and that other factors co-determine numerical abilities.