Expressive Language Disorder Research Articles

Genotype-phenotype correlations in 294 pediatric patients with osteogenesis imperfecta.

Osteogenesis imperfecta (OI) is an inherited disorder characterized by bone fragility with extraskeletal manifestations mostly due to COL1A1 and COL1A2 variants. Currently, 23 genes have been implicated in the pathogenesis of OI; however, literature on genotype-phenotype correlation and incidence of non-skeletal clinical features are limited. This study aims to identify genotype-phenotype correlations in patients with OI, allowing clinicians to better inform families of prognosis, optimize patient care, and facilitate evidence-based clinical decision-making. We retrospectively reviewed 294 patients with OI to collect demographic data, clinical characteristics, and genotypic information. Patients were stratified by COL1A1/1A2 vs non-COL1A1/1A2 variants to evaluate differences in phenotype. The majority of OI was due to variants in COL1A1/1A2 (91%), with the remaining 9% due to non-COL1A1/1A2 variants. Most patients in the COL1A1/2 group were White compared to the non-COL1A1/2 group (78% vs 50%; p = 0.004). COL1A/1A2 patients had higher incidence of blue sclerae (83% vs 58%, p = 0.002), dentinogenesis imperfecta (49% vs 15%, p < 0.001), and family history of OI (34% vs 12%, p = 0.03). Those in the non-COL1A1/1A2 group have higher rates of scoliosis compared to those in the COL1A1/1A2 group (62% vs 40%, p = 0.04), as well as higher rates of expressive language disorder/delay (15% vs 0.4% in non-COL1A1/1A2 and COL1A1/1A2 patients, respectively; p < 0.001). Identifying the underlying molecular etiology early is imperative for optimal clinical care, allowing for appropriate risk counseling, identification of affected relatives, and improved anticipatory care and management. These data support that rare subtypes of OI occur more frequently in non-White individuals and demonstrated genetic associations with incidence of blue sclera, dentinogenesis imperfecta, scoliosis, and expressive language disorders.

Picture Exchange Communication System (PECS) to Enhance the Expressive Language Skills of Children with Developmental Language Disorders

A B S T R A C T Expressive language disorder is a child's inability to express the words and sentences they want to say in accordance with the proper language order. As a result, the subject has no friends at school, has difficulty communicating, is unable to articulate his wishes, and in the end often fights with his friends. This study aims to determine the role of Picture Exchange Communication System (PECS) in improving expressive language skills in children with expressive language disorders. The subject is a boy aged 3 years and 6 months who was diagnosed with expressive language disorder. This study applies an experimental methodology and a single-subject research design. PECS was given to children for 6 meeting sessions. The results of this study were analyzed using descriptive analysis which showed an increase in the subject's expressive language skills after the intervention. Keywords : Language development disorders, expressive language skills, Picture Exchange Communication System

Speech and Language Development, Hearing, and Feeding in Patients With Genetically Confirmed Crouzon Syndrome With Acanthosis Nigricans: A 36-Year Longitudinal Retrospective Review of Patients at the Oxford Craniofacial Unit.

Crouzon syndrome with acanthosis nigricans (CAN) is caused by the specific mutation c.1172C>A (p.Ala391Glu) in the fibroblast growth factor receptor 3 gene, and has an estimated prevalence of 1:1,000,000 births. Most cases occur de novo; however, autosomal dominant inheritance may occur. The clinical presentation typically includes craniosynostosis, midface and maxillary hypoplasia, choanal atresia/stenosis, hydrocephalus, and intracranial hypertension. Patients develop acanthosis nigricans, a hyperkeratotic skin disorder. The authors present the first known study to investigate the speech, language, hearing, and feeding of patients with CAN. A retrospective case-note review of patients with a genetically confirmed diagnosis of CAN attending the Oxford Craniofacial Unit during a 36-year period (1987-2023) was undertaken. Participants were 6 patients with genetically-confirmed CAN (5 females, 1 male), all cases arose de novo. All patients had craniosynostosis (n = 5/6 multisuture synostosis, n = 1/6 left unicoronal synostosis). Hydrocephalus was managed through ventriculoperitoneal shunt in 67% (n = 4/6) of patients, and 67% (n = 4/6) had a Chiari 1 malformation. Patients had a complex, multifactorial feeding history complicated by choanal atresia/stenosis (100%; n = 6/6), and significant midface hypoplasia. All patients required airway management through tracheostomy (83%; n = 5/6); and/or continuous positive airway pressure (67%; n = 4/6). All patients underwent adenotonsillectomy (100%; n = 6/6). Initial failure to thrive, low weight, and/or height were seen in 100% (n = 6/6) patients; 80% (n = 4/5) had reflux; 100% (n = 6/6) had nasogastric, or percutaneous endoscopic gastrostomy based feeding during their treatment journey. All patients had hearing loss (100%; n = 6/6). Early communication difficulties were common: receptive language disorder (50%; n = 3/6); expressive language disorder (50%; n = 3/6); and speech sound disorder in 50% (n = 3/6)-necessitating the use of Makaton in 80% of patients (n = 3/5). Patients with CAN experience significant respiratory, neurological, and structural obstacles to hearing, speech, language, and feeding. The authors present a recommended pathway for management to support patients in these domains.

Mother's Knowledge and Attitude Regarding Speech Delay Prevention in Children: A Cross-sectional Study in Pantai Labu Health Center of Deli Serdang Regency

Background: The term speech delay is a disorder of speech delay which is classified as an expressive language disorder or with difficulty expressing, which occurs in early childhood. The lack of communication time between young children and their parents or peers can affect their language skills. Objective: To find out whether there is a relationship between mother's knowledge and attitudes regarding preventing speech delay in children aged 1-3 years. Method: This research uses descriptive analytical research with a cross-sectional research design. The population used was all mothers who had children aged 1-3 years with a total sample of 111 people, and the sampling technique was the Non- Probability Sampling technique. Results: The results of the Chi-square test statistic showed a p-value = 0.00. With a 95% confidence level ∝ = 0.05. This means that there is a relationship between maternal knowledge and the prevention of speech delay in children aged 1-3 years in the Pantai Labu Health Center, Deli Serdang Regency. The statistical test results of the Chi-square test showed a p-value = 0.00. With a 95% confidence level ∝ = 0.05. This means that there is a relationship between the mother's attitude and the prevention of speech delay in children aged 1-3 years in the Pantai Labu Health Center. Conclusion: It is hoped to provide support and information to mothers to find out their child's language development and detect early if there are problems with their language development (speech delay).

Risiko Infeksi Plasmodium Falciparum dalam Kehamilan terhadap Perkembangan Bahasa Reseptif dan Ekspresif pada Anak Balita

This study aims to analyze the relationship between Plasmodium Falciparum infection in pregnancy and impaired receptive and expressive language development in children under five. The research method uses an observational analytical design with a case-control approach. The results of the study showed that there was no significant relationship between a history of plasmodium falciparum infection in pregnancy and receptive language disorders in children under five, and there was no meaningful relationship between a history of plasmodium falciparum infection in pregnancy and expressive language disorders in children under five. In conclusion, a history of Plasmodium falciparum infection during pregnancy is not associated with impaired receptive and expressive language development in children under five.&#x0D; &#x0D; Keywords: Expressive, Pregnancy, Language Development, Plasmodium Falciparum, Receptive

B - 19 The Role of Neuropsychology in Characterizing an Unidentified Neurodegenerative Disorder: an Adolescent Case Study.

13-year, 9-month-old biracial female with no prior medical history presented with a new onset neurodegenerative disorder following a bullying incident. This case highlights the role of neuropsychology in the characterization of neurodegenerative disorders in a pediatric population. Patient presented with 4-week history of progressive ataxia, nystagmus, and poor memory. Concern for anoxic brain injury from the bullying led to an MRI showing T2 hyperintensity in the bilateral cerebellar peduncles, pons, and midbrain with a "hot cross bun" sign. A deletion in the EPRS gene was found, known to cause hypomyelinating leukodystrophy 15; however, this mutation was not thought to explain her condition. She was diagnosed with a neurodegenerative disorder, type unknown, and severe expressive language disorder. Educational evaluation (age 8) showed low average to average cognitive functioning. Current testing showed intact effort with impaired cognitive functioning and bilateral speeded fine motor dexterity. Expressive and receptive language skills were below average to impaired; speech was slowed and dysarthric. Verbal memory was impaired, but visual memory and executive functioning testing were intact. Parent ratings indicated below average to impaired adaptive functioning. Patient received therapy for the bullying trauma and exhibited no trauma symptoms at this evaluation. Despite the unclear diagnosis, this patient experienced a significant decline in motor and speech/expressive language skills due to an unidentified neurodegenerative disorder. Neuropsychological evaluation also confirmed impacts on intelligence and receptive language and ruled out trauma and psychiatric contributions. This case highlights the role of neuropsychology in multidisciplinary work-up of an unidentified neurodegenerative condition.

Language Disorder In The Main Character Of Tyson’s Run Movie

This at finding out the types of language disorders and finding out the kinds of language therapy given to the main character of Tyson’s Run movie. The data was taken from the Tyson’s Run movie. The method used in collecting the data was documentation and note-taking of the utterances of the main character. In presenting the data analysis, descriptive qualitative methods were utilized to address the problems of this study. Following the data collection, the mixed method and reducing technique were used in analyzing the data in this study. The theory applied in this study is the theory of language disorder proposed by Carroll (2008), and the theory of language therapy proposed by Beukelman (2013), Scarpa (2013), and Adams (2005). Considering the outcomes of this study, the main character, Tyson Hollerman experiences two types of language disorder, namely expressive and receptive language disorder. From this study, there were 15 data found which indicated the presence of language disorders in Tyson. The 15 data consist of 8 data as expressive disorders and 7 data found as receptive language disorders. Furthermore, based on Tyson’s condition, he was provided with various types of language therapies such as Cognitive Behavioral Therapy, Augmentative and Alternative Communication (AAC) and Pragmatic Language Therapy to address his language disorder.

17q25.3 copy number changes: association with neurodevelopmental disorders and cardiac malformation

Copy number variants (CNVs) have been identified as common genomic variants that play a significant role in inter-individual variability. Conversely, rare recurrent CNVs have been found to be causal for many disorders with well-established genotype–phenotype relationships. However, the phenotypic implications of rare non-recurrent CNVs remain poorly understood. Herein, we re-investigated 18,542 cases reported from chromosomal microarray at Greenwood Genetic Center from 2010 to 2022 and identified 15 cases with CNVs involving the 17q25.3 region. We report the detailed clinical features of these subjects, and compare with the cases reported in the literature to determine genotype–phenotype correlations for a subset of genes in this region. The CNVs in the 17q25.3 region were found to be rare events, with a prevalence of 0.08% (15/18542) observed in our cohort. The CNVs were dispersed across the entire 17q25.3 region with variable breakpoints and no smallest region of overlap. The subjects presented with a wide range of clinical features, with neurodevelopmental disorders (autism spectrum disorder, intellectual disability, developmental delay) being the most common features (80%), then expressive language disorder (33%), and finally cardiovascular malformations (26%). The association of CNVs involving the critical gene-rich region of 17q25.3 with neurodevelopmental disorders and cardiac malformation, implicates several genes as plausible drivers for these events.

Effectiveness of group therapy versus individual therapy in acquisition of pre-linguistic skills in children with expressive language disorders

Background: Children with expressive language difficulties may find it difficult to communicate effectively. To encourage the development of prelinguistic skills and improve overall language development, early intervention is essential. Objective: To determine the effectiveness of group therapy as compared to individual therapy in the acquisition of pre-linguistic skills in children with expressive language disorders. Methods: A experimental study was conducted at special education centers of Rawalpindi &amp; Islamabad, from August 2015 to January 2016. A total of n=17 children with expressive language disorders of either gender with ages between 4-7 years were recruited through a nonprobability convenient sampling technique, with Group A (Individual Therapy) including n=7 kids and Group B (Group therapy) n=10 kids. The outcome measures were Eye contact, attention span, turn-taking, and imitation skills, noted before therapy and after completing 20 sessions post-therapy (after 7 weeks). Statistical analysis was done using SPSS 20. An Independent t-test was utilized to see any difference between groups. Results: The study included 10(58.82%) males and 7(41.18%) females with most 9(52.94%) being 6 to 7 years of age. Post therapy results revealed significantly better results for group therapy versus individual therapy (11.0±1.24 vs 8.28±1.11) for eye-contact (p=0.000); (11.0±0.94 vs 7.8±1.34) attention span (p=0.000); (11.4±0.69 vs 8.0±0.81) turn taking (p=0.000); and (10.6±1.34 vs 8.4±0.97) for imitation skills (p=002). Conclusion: The study concludes that group therapy is significantly more effective than individual therapy for improving pre-linguistic skills including eye contact, attention span, turn-taking, and imitation skills in 4 to 7 years old kids with expressive language disorders. Keywords: Language, Expressive language disorder, Pre-linguistic skills, Group therapy, Individual therapy

Language phenotypes in children with autism spectrum disorder, expressive language disorder, and typical language development

The aim of this study was to compare language abilities in 4–6-year-old Georgian-speaking children with typical language development (TLD), expressive language disorder (ELD), and autism spectrum disorder (ASD). Language linguistic components, such as phonology, semantics, syntax, morphology, and pragmatics, were examined along with verbal behavior types like “mand,” “tact,” “echoic,” and “intraverbal.” Our sample comprised 148 children, with a gender distribution of 50 girls and 98 boys. Significant differences were observed in the application of various parts of speech across the three groups. Children with ELD were found to use pronouns more frequently compared to TLD and ASD groups. Conversely, children exhibiting typical language development displayed a greater usage of conjunctions and particles than the other groups. Notably, linguistic error patterns varied across groups: children with ELD predominantly committed errors in phonetics and morphosyntax, while children with ASD had more pragmatic errors and also struggled with morphosyntax. Moreover, the ASD group was found to use “mands” and “echoics” more frequently than both the TLD and ELD groups.

A SPEECH DELAY DUE TO EXPRESSIVE LANGUAGE DISORDER WITH NORMAL HEARING: CASE REPORT

A method is required in communication to provide information to one another, including the capacity to comprehend and create communications. Language is a mental analysis of communication that includes both receptive language (understanding) and expressive language (ability to convey feelings, information, thoughts and ideas). Language disorders can appear when speaking and language development does not occur in accordance with age milestone. Anamnesis, physical examination, and supporting examinations, including an audiometric examination, revealed normal findings. Auditory growth is closely related to brain development, with the brain developing significantly until the age of three years, affecting linguistic functions.&#x0D; Objective: To be able to find out how appropriate treatment should be for patients with language disorders with normal hearing examination results.&#x0D; Case Report: A child aged 2 years and 8 months was diagnosed with expressive language disorder, considering that his history, physical exams, and OAE, BERA, and ASSR tests were all normal.&#x0D; Method: PubMed, medline, other manual searches.&#x0D; Result: OAE, BERA, ASSR with normal hearing results according to the case in this patient.&#x0D; Conclusion: Expressive language disorder occurs when a child is unable to articulate or explain the substance of his opinions and ideas verbally according to his age, and OAE, BERA, and ASSR have all been tested with normal findings. This is necessary to prevent speech and language problems and to allow cognitive, social, and scholastic skills to function properly. To enhance communication and get an improved prognosis, speech treatment and child psychologist advice should be explored.

The Assistant: A Solution for Expressive Language Disorder (ELD)

The Assistant is an app carefully designed to assist people with expressive language disorder, a lifelong condition that impacts a person’s ability to express their own ideas when they speak. The purpose of this project is to assist the user themselves in practicing how to fluently express themselves, but also to “translate” their speech for those around them that may not understand what the user is saying. Automatic speech recognition (ASR) will play a crucial role in the development of this app, as it allows the system to convert any speech into printed text. The Assistant also has an educational aspect, teaching children and young adults that it is indeed possible to help those who struggle with the basics of speech and expression through the development of an app and progressive technology. In conclusion, The Assistant has a consistent and achievable goal and can be accessed by the population with expressive language disorder if it were launched.

Psycholinguistic Study on Expressive Language Disorder of Autistic Characters in Miracle Run Movie

Recently, it has been reported that the prevalence of autism has increased significantly. One of the characteristics of autism is a language problem, or it is well-known linguistically as a language disorder. This study is conducted to analyze categories of expressive language disorder of autism represented in Miracle Run Movie and contexts affecting them in producing those utterances. This study applies a descriptive qualitative approach using Carroll's framework (1985). As the result of analysis on 75 data, Philip and Steven, as the autistic characters, face all kinds of expressive language disorders covering phonology, syntax, semantics, and pragmatics in various cases. They face phonological language disorder in the case of inappropriate stress, flat and singsong intonation, and expressionless speech. They also face syntactical language disorder in the case of echolalia and semantic language disorder involving their disability in using semantic bias. In addition, they have pragmatic language disorder in the case of fewer complex gestures, politeness strategy, spontaneous remarks, misuse of pronouns, limited repertoire devices to initiate a topic in a conversation, and tendency to use a question to gain a response from a listener. Concerning the context when the autistic characters produce expressive language disorder, there are six types of context affecting their utterances. They have expressive language disorder when they are posing a question to someone, answering a question of others, expressing their ambition, expectation, surprise, and something they dislike. This study is an excellent guide for EFL teachers interested in working with autistic students.

A Case Study of Expressive Language Disorder (Psycholinguistic Study)

Language disorder is a phenomenon that can happen to anyone, from children, adolescents, and adults to the elderly. There are several kinds of language disorders experienced by someone. This study aims to examine expressive language disorders in adolescents. The data of this research was extracted from the subject’s conversation, which was considered to have elements of language errors. The data source for this research was a teenager with the initials “NS,” who was used as the research subject. Data collection techniques used recording techniques, observation, and interviews. Data analysis techniques were carried out by describing, interpreting, and then explaining the forms of expressive language disorder and its causes. The analysis showed several forms of expressive language disorder experienced by NS, namely limited vocabulary, frequent vocabulary mistakes, difficulty forming long sentences, inability to start conversations, and difficulty rejoicing an event. Then the causal factors are cognitive, genetic, gender, and environmental factors.

Teaching Strategies for Children with Expressive Language Disorder

Students who have communication disorders will need special help from teachers in the regular education environments. This research aims to investigate the English teaching strategies and activities for students with language impairment, especially expressive language disorder. This research used descriptive qualitative research design which focus on literature study from relevance references. The collected data were analysed descriptively, thus the English teaching strategies and classroom management for students with expressive language disorder could be formulated. The result of the study showed that teaching strategies that could improve expressive language are Modelling, Expansion, Choices, Waiting or Withholding, Imitation, Parallel Talk, Picture Communication, Paraphrase, and Place Things Out of the Child’s Reach. Meanwhile, the activities that is suitable to be applied for students with expressive language disorder during instruction through which those activities are also applicable at home practice; wordless books, books with simple text, bubbles, play dough, toy animals, trains sets or car, and play food. Therefore, by implementing those strategies and activities, it is expected the students with expressive language disorder could improve their language competency either in receptive or productive use.

Prenatal, Perinatal, Postnatal risk factors, and excess screen time in autism spectrum disorder.

The aim of this study is to investigate prenatal, perinatal, and postnatal factors, screen time in a group of patients with ASD and age and sex-matched clinical controls to evaluate risk factors specific to ASD. The study included 211 ASD patients (177 boys, 34 girls; mean age 44.3±13.0 months) and 241 (190 boys, 51 girls; mean age 44.6±14.1 months) age and sex group matched clinical controls. Non-ASD diagnoses were expressive language disorder (n=135, 56.0 %), intellectual disability (n=15, 6.2%), attention deficit-hyperactivity disorder (n=6, 2.4%), oppositional disorder (n=6, 2.4%), and other behavioral or emotional problems (no diagnosis) (n=79, 32.8%). A sociodemographic data form was used to collect data regarding pre-, peri-, and postnatal factors and total daily screen exposure. According to our findings, maternal severe psychological stress and depression during pregnancy, and maternal postpartum depression were more frequent in the ASD group (p=0.005, p=0.035, and p=0.001 respectively). There was a statistically significant difference between groups with regards to maternal any medication use during pregnancy (p=0.004). The mean duration of daily screen exposure was higher in the ASD group (9.90±5.10 hours) compared to non-ASD children (4.46±3.40 hours) (p<0.001). A ROC curve showed that 8.5 hours and above total daily screen exposure (AUC=0.808 [95%CI, 0.769-0.848], p<000; 55% sensitivity, 90.5% specificity) is likely to be associated with increased risk for ASD. Our study suggests that prenatal maternal psychological stress, prenatal and postpartum depression, and excess exposure to screen might be related to an increased risk for ASD.

Expressive and Receptive Language Disorder of Shaun Murphy in The Good Doctor Series

The autistic savant is a rare condition that occurs in people with autism that affects the ability in expressing and receiving language information appropriately. This study aimed to describe the expressive and receptive language disorder of Shaun Murphy as the autistic savant main character in The Good Doctor movie. It used descriptive qualitative method to get a deep understanding of the language disorder as portrayed in the movie. The data were taken from Shaun Murphy’s utterances transcribed from The Good Doctor movie. The analysis employed the theory of Carroll to describe how autistic savant person communicates with others. The findings from this study indicated that of the twelve utterances produced by Shaun Murphy, only four from six types of language disorders were found. They included stuttering, phonological disorder, difficulty in understanding the concept, and difficulty in following directions. Shaun Murphy dominantly produced stuttering. He often spoke with stammering, hanging, and repetition of sentences. In this case, the language disorders of the main character appeared when he was panic, happy, anxious, and unconfident; which could influence his way of communication.

Language Disorder of Autism In ‘Atypical’ Series (2017-2021): A Psycholinguistics Study

The purpose of this study is to recognize what kind of language disorder experienced by Sam as an autistic in ‘Atypical’ series 2017-2021, to describe what factors of language disorder experienced by Sam, and to describe what therapy of language disorder for Sam. The researcher uses qualitative method for doing this research. The data was taken from the utterances of autistic, Sam Gardner as the main character. There were 60 phenomenon of language disorder, 58 receptive language disorder and 2 expressive language disorder. The most common symptom of receptive language disorder experienced by Sam is difficulty following verbal directions 21 data, followed by interpreting words or phrases 19 data, not appearing to listen 12 data, limited vocabulary 3 data, difficulty understanding complex sentence 2 data, and demonstrating lack of interest 1 data. Meanwhile, Sam just experienced two symptoms of expressive language disorder, word-finding difficulties 1 data and over-reliance on stock phrases 1 data. This phenomenon occurs caused by many factors, whether difficulty in joint attention, failed in integrated the information with semantic attributes, autism symptoms such as echolalia, deficits in ToM, trouble in retrieval words, etc.

Expressive Language Used by Autistic Main Character in Please Stand By (2017) Movie

People with autism spectrum disorder (ASD) have difficulty using language in communication. The language of autism sufferers in expressive language disorders includes phonological disorders, syntactic disorders, semantic disorders, and pragmatic disorders. The purpose of this study was to determine the types of expressive language disorders used by the main character in the movie Please Stand By (2017). The method of this research was descriptive qualitative because this research describes the phenomenon of expressive language disorder in the Please Stand By (2017) movie. The source of data used in this research is the script from the movie. Once collected, the data are categorized and analyzed based on their respective categories. In this research, the researcher found that Wendy exhibited several symptoms of a type of expressive language disorder, namely semantic disorders and pragmatic disorders. This disorder can be seen from the symptoms shown by the main character through her speech.

A-188 The Effect of Traumatic Experiences on Identity Among People With Expressive Language Disorders

Abstract Objective: To examine the effects of traumatic brain injury (TBI) on identity functioning. Method: TBI survivors’ recollections of their sense of identity before and after they acquired a TBI were compared. Participants (N = 15, Mage = 52.67) recruited from rehabilitation and support groups completed two clinical interviews, as well as the Trauma Impacts of Identity Functioning Scales (Waterman, 2020) and Identity Distress Scale (Berman et al., 2004). They were mostly stroke survivors with aphasia. The majority of the participants were White (53.3%). The time since they acquired an expressive language disorder ranged from 2 to 21 years ago (M = 7.33). Results: A paired samples t-test revealed a significant increase in identity distress from pre- to post-brain injury (t(14) = -3.11, p = .008, 95% CI). A ONEWAY ANOVA revealed that ratings of how important their career is to their sense of identity significantly decreased post-TBI (F(1, 13) = 17.47, p = .001, λ = .427, 95% CI). During the clinical interviews, many TBI survivors reflected that they lost a large part of themselves because they could no longer pursue their careers, and they experienced drastic changes in their relationships and life roles. Participants had identity development delays, trauma-centered identity, identity loss, identity threat, and identity affirmation. Conclusion: Identity changes post-TBI varied greatly from one survivor to another, and time since trauma was not significantly correlated with identity functioning nor identity distress, suggesting the need for future research to determine which factors influence why TBI survivors’ experience post traumatic identity disruption and/or post-traumatic growth.