Persistent Difficulties Research Articles

The abc of the b and c in Spanish: inconsistent and context dependent letter errors and the development of orthographic knowledge in primary school children

This study presents the results of a cross-sectional reading and spelling assessment conducted among 118 Spanish children in 3rd, 4th and 5th grade. The first aim was to explore whether children´s use of orthographic knowledge was modulated by lexical variables—word frequency and orthographic neighborhood—or sublexical variables—context-dependent, inconsistent or neutral letters- as well as the developmental pathway of such knowledge in both tasks. The second aim was to provide insight into the type of errors committed by children in order to detect the words and structures that convey most difficulties. Data showed that children rely on sublexical processes more than on lexical ones in reading and writing. Persistent errors in context-dependent and inconsistent letters were evident even in 5th grade, and writing involved greater difficulty in all grades. The presence of other type of errors such as substitutions, omissions or lexicalizations was negligible. Finally, an item analysis revealed that errors were located in low-frequency syllables, particularly in the first position. Data point to specific and persistent difficulties in context-dependent and inconsistent letters that may hinder the consolidation of accurate orthographic word representations in Spanish.

Neurocognitive Outcome Following Recovery from Severe Acute Respiratory Syndrome - Coronavirus-1 (SARS-CoV-1).

Severe acute respiratory syndrome (SARS) is a highly contagious viral respiratory illness associated with hypoxia and dyspnea. Many of those who contracted and recovered from SARS during the 2002-2003 outbreak reported persistent physical, psychological, and cognitive difficulties. Here, we investigated the residual influences of SARS on cognition for a subset of healthcare professionals who recovered and were referred for neuropsychological evaluation through their workplace insurance. Twenty-eight healthcare professionals were evaluated on neuropsychological and mood functioning approximately 1.5 years post-recovery from a severe respiratory illness. Test scores were compared with age-matched normative data, and correlations were examined between mood, self-report memory scales, subjective complaints (e.g., poor concentration, pain, fatigue), illness severity (i.e., length of hospitalization, oxygen use during hospital stay), and cognitive performance. Participants performed within age expectations on the majority of cognitive measures including overall memory ability. Although processing speed was generally within normal limits, 43% showed significant speed-accuracy trade-offs favoring accuracy over maintaining speed. Deficits were observed on measures of complex attention, such as working memory and the ability to sustain attention under conditions of distraction. Participants endorsed poorer memory ability than same-age peers on a meta-memory measure and mild to moderate depression and anxiety symptoms. Objective test performance was largely uncorrelated with self-reports, mood, or illness severity, except for moderate correlations between complex attention and participants' subjective ratings of Everyday Task-Oriented Memory. These findings demonstrate specific long-term cognitive deficits associated with SARS and provide further evidence of the cognitive effects of hypoxic illnesses.

Etiology of persistent mathematics difficulties from childhood to adolescence following very preterm birth

ABSTRACT Children born very preterm (VP; <32 weeks’ gestation) have poorer mathematics achievement than term-born peers. This study aimed to determine whether VP children’s mathematics difficulties persist from primary to secondary school and to explore the nature of mathematics difficulties in adolescence. For this study, 127 VP and 95 term-born adolescents were assessed at age 11–15 years. Mathematics achievement was assessed using the Wechsler Individual Achievement Test-II. Specific mathematics skills and general cognitive skills were assessed using standardized and experimental tests. VP adolescents had poorer mathematics achievement than term-born adolescents (−10.95 points; 95% CI −16.18, −5.73) and poorer number fact knowledge, understanding of arithmetic concepts, written arithmetic, counting, reading and writing large numbers, and algebra. Between-group differences in mathematics skills were no longer significant when working memory and visuospatial skills were controlled for (p’s >0.05), with the exception of writing large numbers and conceptual understanding of arithmetic. In a previous study, 83 of the VP adolescents and 49 of the term-born adolescents were assessed at age 8–10 years using measures of the same skills. Amongst these, the between-group difference in mathematics achievement remained stable over time. This study extends findings of a persistent deficit in mathematics achievement among VP children over the primary and secondary school years, and provides evidence of a deficit in factual, procedural and conceptual mathematics skills and in higher order mathematical operations among VP adolescents. We provide further evidence that VP children’s mathematics difficulties are driven by deficits in domain-general rather than domain-specific cognitive skills.

중국인 한국어 학습자의 한국어 조사 교체 습득 연구 - 양태성 이동동사 구문을 중심으로 -

This study investigated whether L1 Chinese learners of Korean can acquire case particle alternation in motion verb constructions. An acceptability judgment and self-paced reading task were conducted with L2 advanced learners of Korean in tandem with native Korean speakers. The result of the acceptability judgment task demonstrated that the L1 group accepted the sentences in both case-marking conditions, whereas the L2 groups (both higher and lower proficiency learners) only accepted the sentences in the ‘ul/lul’ condition, while rejecting the sentences in the ‘eseo’ condition. From the results of the self-paced reading task, L2 participants did not show any reading time differences between the two case-marking conditions. However, given that the L2 learners failed to demonstrate target-like knowledge of ‘in manner of motion’ verb construction in the acceptability judgment task, their reading-time patterns in the self-paced reading task may not be interpreted as their acceptance of both conditions. These findings suggest that the L1 Chinese-speaking learners of Korean have a persistent difficulty acquiring the case alternation regarding motion verb construction. (Ewha Womans University)

Multivariate analysis of 1.5 million people identifies genetic associations with traits related to self-regulation and addiction.

Behaviors and disorders related to self-regulation, such as substance use, antisocial behavior, and ADHD, are collectively referred to as externalizing and have shared genetic liability. We applied a multivariate approach that leverages genetic correlations among externalizing traits for genome-wide association analyses. By pooling data from ~1.5 million people, our approach is statistically more powerful than single-trait analyses and identifies more than 500 genetic loci. The loci were enriched for genes expressed in the brain and related to nervous system development. A polygenic score constructed from our results predicts a range of behavioral and medical outcomes that were not part of genome-wide analyses, including traits that until now lacked well-performing polygenic scores, such as opioid use disorder, suicide, HIV infections, criminal convictions, and unemployment. Our findings are consistent with the idea that persistent difficulties in self-regulation can be conceptualized as a neurodevelopmental trait with complex and far-reaching social and health correlates.

Narrative abilities of Italian preschool children with Developmental Language Disorder

Oral narrative skills have been shown to be a valid measure of the linguistic competence of preschoolers and a significant predictor of their academic achievements. A deficiency in this area can lead to long-term sequelae in socio-emotional well-being in their adult life. This paper aims to provide a complete communicative picture of narrative discourse produced by monolingual preschoolers with Developmental Language Disorder (DLD) and typical peers matched by age, taking into account around fifty verbal and non-verbal features, computed on the spoken productions elicited by retelling tasks. The main finding is that although traditional standardized neuropsychological tests fail in capturing communicative deficits of DLD children, subtle but persistent language production difficulties are demonstrated by speech disruptions, reduced syntax complexity, and overt gestural signs of discomfort. This last finding is quite intriguing, considering that self- and hetero-adaptor gestures result from uneasiness and anxiety, usually escaping awareness. Taken together, the present results suggest that the observed deficits in DLD are not exclusively linguistic in nature, but may be associated with deficient planning abilities and monitoring processes difficulties.

Prevalence of Long COVID Symptoms in Bangladesh: A Prospective Inception Cohort Study of COVID-19 Survivors

Background: The aim of this study was to identify the prevalence of ‘Long COVID’ symptoms (LCS) in a large cohort of survivors and identify any potential associated risk factors.Methods: A prospective survey was undertaken of an inception cohort of confirmed COV|ID-19 survivors (Aged 18 to 87 years). 14392 participants were recruited from 24 testing facilities across Bangladesh between June, and November 2020. All participants had a previously confirmed positive COVID-19 diagnosis, and reported persistent symptoms and difficulties in performing daily activities. Participants who consented, were contacted by telephone, and were interviewed regarding LCS, and restriction of activities of daily living. Cardio-respiratory parameters were also measured. Statistical analysis included binary logistic and multiple linear regressions were performed with LCS as the dependent variable. Associated risk factors were identified using Structural Equation Modelling (SEM).Findings: Among 2198 participants, the prevalence of LCS at 12 weeks was 16·1%. Overall, eight LCS were identified and in descending order of prominence are: fatigue, pain, dyspnea, cough, anosmia, appetite loss, headache, and chest pain. COVID survivors experienced between 1 to 5 LCS with an overall duration period of 21·8 ± 5·2 weeks. SEM predicted the length of LCS to be related to younger age, female gender, rural residence, prior functional limitation and smoking.Interpretation: In this cohort of survivors, at 31 weeks post diagnosis, the prevalence of LCS was 16·1%. The risk factors identified for presence and longer length of LCS warrant further research and consideration to support public health initiatives.Clinical Trial Registration Details: The study was registered at World Health Organization (WHO) Primary Clinical trial registry platform (CTRI/2020/09/028165) on 30/09/2020 with the title “Symptoms presentation among the COVID-19 survivors in Bangladesh”.Funding Information: No funding.Declaration of Interests: We declare no competing interests.Ethics Approval Statement: Ethical permission was obtained from the Institutional Review Board at the Institute of Physiotherapy, Rehabilitation, and Research (Ethical review committee at Bangladesh Physiotherapy Association) on September 17, 2020 (BPA-IPRR/IRB/17/09/2020/028). Verbal consent was obtained during the initial telephone call and written consent was obtained at interview. The principles of the Helsinki Declaration19 were followed throughout the research to ensure confidentiality, ethics and privacy.

One-year follow-up after the time management group intervention Let’s Get Organized

Background Time management skills are essential to maintain occupations in everyday life. People with neurodevelopmental or mental disorders often experience persistent difficulties with managing time and organizing daily life, consequently, there is a need to establish interventions with sustainable results. Aim The aim was to perform a one-year post-intervention follow-up after the intervention Let’s Get Organized (LGO-S) for people with neurodevelopmental or mental disorders. Methods The study is a one-year follow-up of a single group pre-test–post-test design. Thirty-eight persons with difficulties in time management due to neurodevelopmental or mental disorders participated. Instruments to collect data were Assessment of Time Management Skills; Weekly Calendar Planning Activity and the Satisfaction with Daily Occupations instrument. Wilcoxons’s signed-rank test was used to compare data over time. Results There were no significant differences in the participants’ outcomes between post-intervention and one-year follow-up in time management skills and regulation of emotions, satisfaction with daily occupations, and global satisfaction. A significant improvement could be seen in the subscale organization and planning at the one-year follow-up compared to post-intervention. Conclusions Improvements in time management skills, organization, and planning, regulation of emotions, and satisfaction with daily occupations after the LGO-S can be maintained in the long term.

Exploring the English Language Comprehension, Reading Fluency, and Executive Functions of Spanish-English Bilingual Adolescents with Reading Difficulties

This study examines differences in English language comprehension, reading fluency, and executive functions among Spanish-English bilinguals with reading difficulties. Reading difficulties examined included general reading difficulties, defined by low word reading and reading comprehension, and specific-reading comprehension difficulties, defined by low reading comprehension yet adequate word reading. Participants (N = 86) were categorized using multiple measures of reading comprehension and word reading in each of 6th, 7th, and 8th grade. Participants were also categorized based on persistent difficulties (i.e. remaining in the same group across multiple grades). On two measures of language comprehension, readers with either difficulty tended to demonstrate significant weaknesses relative to average readers. On passage reading fluency, readers with specific-reading comprehension difficulties performed worse than average readers but better than readers with general reading difficulties. On executive functions, readers with general reading difficulties demonstrated weaknesses relative to average readers, but there was little evidence that readers with specific-reading comprehension difficulties showed these weaknesses. These findings typically held when looking at readers with persistently defined difficulties. Longitudinal analyses indicated that 47% of students with S-RCD and 56% of students with GRD remained in their group across the three years, consistent with prior research. Findings highlight potential weaknesses in executive functions for children with general reading difficulties that should be considered when designing instruction for these students. These findings also support prior research on the importance of developing English language and reading fluency for Spanish-English bilingual children with reading difficulties.

Structure of Cognitive Functions in Monolingual Preschool Children With Typical Development and Children With Developmental Language Disorder.

Purpose Developmental language disorder (DLD) is defined by persistent difficulties with language, but a growing body of evidence suggests that it is also associated with domain-general and nonverbal information-processing deficits. However, the interconnections between cognitive functions, both nonverbal and language related, are still unclear. With the aim of gaining more comprehensive insight into the cognitive deficits related to DLD, we investigated and compared the cognitive structure of children with DLD and typically developing (TD) children. Method As a part of the Helsinki longitudinal SLI study, monolingual Finnish preschoolers (N = 154; TD group: n = 66, DLD group: n = 88) were assessed with 23 tasks measuring nonverbal and verbal reasoning, language processing, memory, visuomotor functions, attention, and social cognition. Exploratory factor analysis and structural equation modeling were performed to examine latent constructs and to test measurement invariance between the TD and DLD groups. Results Measurement invariance was not found across the TD and DLD groups. Best fitting structure for TD children included factors reflecting verbal abilities, processing speed/short-term memory, visuomotor functions, and visuoconstructive abilities/nonverbal reasoning. The DLD group's structure comprised nonverbal abilities, naming/expressive language, verbal comprehension, and verbal/declarative memory. Conclusions The findings suggest that the structure of cognitive functions differs in TD children and children with DLD already at preschool age. Nonverbal functions seem more unified, whereas verbal functions seem more varying in preschoolers with DLD compared to TD children. The results can be used in future research for prognosis of DLD and planning interventions.

P 48. Cerebrospinal fluid neurofilaments predict disease aggressiveness in Amyotrophic Lateral Sclerosis: an application of the D50 disease progression model

Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative disorder. As previous therapeutic trials in ALS have been severely hampered by high inter-individual heterogeneity in clinical phenotype, progression speed and survival, the identification of biomarkers that reliably reflect disease progression represents a priority in current ALS research. Here, we aimed to use the D50 disease progression model to investigate correlations between Cerebrospinal fluid (CSF) Neurofilament light chain (NfL) levels and disease aggressiveness in ALS patients. The D50 model quantifies patients“ individual disease trajectories and is calculated based on consecutively assessed ALS functional rating scale scores. The derived value D50 is defined as the time taken in months for a patient to lose 50% of his/her functionality and thus provides a unified measure of a patient”s overall disease aggressiveness. The relative D50 (rD50) reflects the individual disease covered and can be calculated for any timepoint in the disease course. The application of the D50 model enabled us to generate a large-scale pseudo-longitudinal analysis thereby overcoming the persistent difficulties in obtaining longitudinal CSF samples from heterogenous ALS patient cohorts. We analyzed detailed clinical data from a well-defined cohort of 156 patients with ALS. The concentration of NfL in CSF samples was measured at two different laboratories using the same procedure. Based on patients“ individual D50 values, we defined subgroups with high (<20), intermediate (20–40) or low (>40) disease aggressiveness. NfL levels were compared between these subgroups via analysis of covariance, using an array of confounding factors: age, gender, clinical phenotype, frontotemporal dementia, rD50-derived disease Phase and analysis laboratory. We found highly significant differences in NfL concentrations between all three D50 subgroups ( p < 0.001), representing an increase of NfL levels with increasing disease aggressiveness, as revealed in post-hoc analyses. The conducted analysis of covariance showed that this correlation was independent of gender, disease phenotype and Phase; however, age, analyzing laboratory, and dementia significantly influenced NfL concentration. We could show that CSF NfL is independent of patients“ individual disease covered (rD50 or derived disease Phase). Our results provided strong evidence for the potential of NfL to reflect disease aggressiveness in ALS and in addition proofed to remain at stable levels throughout the disease course. Implementation of CSF NfL as a potential read-out for future multi-center therapeutic trials in ALS is currently constrained by its demonstrated susceptibility to (pre-)analytical variations. Here we show that the D50 model is a sensitive tool that enables the discovery of correlations between clinical characteristics and CSF analytes and can accordingly recommended for future studies evaluating potential biomarkers.

Effectively improving the accuracy of PBE functional in calculating the solid band gap via machine learning

Band gap is one of the most important parameters determining the electronic, optoelectronic, and other applications of a wide range of materials including semiconductors and insulators. However, the accurate prediction of the band gap of these materials has been a persistent difficulty in quantum chemistry. Numerous studies have attempted to improve the accuracy of the predicted band gap from standard density functional theory (DFT) calculations with local density approximation (LDA) and generalized gradient approximation (GGA), which are well-known to underestimate the band gap severely. With the rapid development of material databases from both experimental and theoretical studies, herein, we develop a correction model to improve the prediction accuracy for the band gap by combing the widely used Perdew-Burke-Ernzerh (PBE-GGA) functional with machine learning approach. The correction model introduces physically meaningful but computationally efficient descriptors to fit the experimental dataset, and an artificial neural network (ANN) model is established to improve the prediction accuracy of computational results from DFT-PBE functional. The new method brings a highly accurate model for the prediction of the band gaps at high-precision G0W0 level without increasing computational cost at DFT-PBE level. Further, the error distribution of the predicted band gaps is more in line with the normal distribution compared with DFT-PBE and G0W0 methods. The band gap correction model provides a practical way to obtain GW-like quality results from standard DFT calculations, and should be valuable to perform accurate high-throughput screening of semiconductors and insulators for which GW calculations become unfeasible.

“A Difficulty in the Path of Psychoanalysis”: The Community Psychoanalysis Consortium and the Community Consultants

ABSTRACT This paper describes the functioning of the Community Psychoanalysis Consortium (CPC) and the role of the Community Consultants in the Community Psychoanalysis Track at the Psychoanalytic Institute of Northern California. The existence of the CPC and its projects is an interruption of psychoanalytic training as exclusive to privatized psychotherapeutic practice, reclaiming and extending psychoanalytic pedagogical traditions that thrive in community mental health contexts. Persistent difficulties encountered in the exchanges between those steeped in institutional psychoanalysis versus community mental health are illustrated and analyzed as symptoms of a series of broader cultural splits. The work of the CPC is a collective effort toward training psychoanalysts to perform transgressive psychoanalytic community-based work. We see this effort as essential, as those community programs that continue to operate do so under continual threat of being dismantled and/or defunded. We assert, however, that community psychoanalysis is not primarily about expanding the borders of who gets analyzed. Rather, it is about who takes up the analytic gaze, what depths are probed, what resistances are seen to be at issue, and what other investments might be possible when dominant structures are confronted and collective libidinal resources are freed up.

Numerical magnitude understanding in kindergartners: A specific and sensitive predictor of later mathematical difficulties?

Difficulties in mathematics are argued to stem from impairments of a specialized system of numerical magnitude representation. This study investigates whether different measures of numerical magnitude understanding in kindergarten uniquely predict mathematical achievement concurrently and 6 months later, and also examines the relative explanatory of each aspect of magnitude understanding. It also examines the utility of such tasks as sensitive and specific predictors of children at risk of mathematical learning difficulties. Kindergartners (N = 215, M age = 74 months) were administered a number-line estimation task, a nonsymbolic numerical discrimination task, and a nonsymbolic to word mapping task. Multiple measures of math achievement were administered concurrently and upon entering formal education (M age = 80 months). Path analysis revealed that all 3 aspects of magnitude understanding had similar explanatory power in predicting concurrent and prospective math achievement; the only exception was that nonsymbolic numerical discrimination was not a significant predictor of concurrent mathematical reasoning. Of the 3 measures of magnitude understanding, number-line estimation was found to be the most accurate predictor of persistent mathematical difficulties. Approximately half of the children misclassified as having mathematical difficulties showed inconsistent mathematical achievement across the multiple measures. The implications for screening for mathematical difficulties and for designing interventions are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Imperfect Spanish Meanings Acquisition by Advanced Russian Learners. Evidence from Acceptability Judgements Data

This study explores the difficulties on grammatical representation descriptions of Spanish Imperfect meanings by 54 first language Russian learners of Spanish with advanced proficiency levels and a control group of 18 Spanish native speakers. The results from the on-line acceptability judgments task the participants carried out indicated that interpretations of aspectual meanings typical of the Spanish Imperfect had been formed in the non-native speaker’s grammar. Moreover, a general tendency to over-accept non-adequate Preterite sentences was observed in non-native Spanish speaker groups. Furthermore, the findings revealed that progressive meaning represented a greater challenge for Russian learners of Spanish with upper-intermediate proficiency level, whereas at more advanced levels the perceptions of this meaning became closer to that of Spanish native speakers. However, the accuracy and sensitivity scores on lexical aspectual classes evidenced a persistent difficulty for non-native speakers in non-prototypical lexical-grammatical aspect combinations, which suggested a possible remaining effect of L1 transfer

Does Severity of Brain Injury on Magnetic Resonance Imaging Predict Short-Term Outcome in Neonates Who Received Therapeutic Hypothermia?

The National Institute of Child Health and Human Development (NICHD) magnetic resonance imaging (MRI) pattern of brain injury is a known biomarker of childhood outcome following therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy (HIE). However, usefulness of this classification has not been evaluated to predict short-term outcomes. The study aimed to test the hypothesis that infants with NICHD MRI pattern of severe hypoxic-ischemic brain injury will be sicker with more severe asphyxia-induced multiorgan dysfunction resulting in prolonged length of stay (LOS) following therapeutic hypothermia. We also evaluated the role of other risk factors which may prolong LOS. We retrospectively reviewed the medical records of 71 consecutively cooled neonates to examine the ability of MRI patterns of brain injury to predict the LOS. A neuroradiologist masked to outcomes classified the patterns of brain injury on MRI as per NICHD. Pattern 2A (basal ganglia thalamic, internal capsule, or watershed infarction), 2B (2A with cerebral lesions), and 3 (hemispheric devastation) of brain injury was deemed "severe injury." Out of 71 infants, 59 surviving infants had both MRI and LOS data. LOS was higher for infants who had Apgar's score of ≤5 at 10 minutes, severe HIE, seizures, coagulopathy, or needed vasopressors or inhaled nitric oxide, or had persistent feeding difficulty, or remained intubated following cooling. However, median LOS did not differ between the infants with and without MRI pattern of severe injury (15 days, interquartile range [IQR]: 9-28 vs. 12 days, IQR: 10-20; p = 0.4294). On multivariate linear regression analysis, only persistent feeding difficulty (β coefficient = 11, p = 0.001; or LOS = 11 days longer if had feeding difficulty) and ventilator days (β coefficient 1.7, p < 0.001; or LOS increased 1.7 times for each day of ventilator support) but not the severity of brain injury predicted LOS. Unlike neurodevelopmental outcome, LOS is not related to severity of brain injury as defined by the NICHD. · The NICHD pattern of brain injury on MRI predicts neurodevelopmental outcome following hypothermia treatment for neonatal HIE.. · LOS did not differ between the infants with and without MRI patterns of severe injury.. · The severity of brain injury as defined by the NICHD was not predictive of the LOS following therapeutic hypothermia..

Unclogging the Bottleneck: The role of case morphology in L2 acquisition at the syntax-discourse interface

ABSTRACT The Bottleneck Hypothesis argues that properties of inflectional morphology explain why second-language learners may face persistent difficulties in articulating meaning in target-language forms. In particular, the acquisition task proves even harder when first and second languages differ in the way they organize the mapping of functional features onto inflectional morphemes. Against this backdrop, the present study focuses on the interplay between case morphology and acquisition of syntax-discourse interface phenomena in the second language German of French native speakers. Whereas the Bottleneck Hypothesis predicts that discourse-driven syntactic alternations come for free when case morphology is in place, a concurrent prediction is made by the Interface Hypothesis, which suggests that the syntax-discourse interface is vulnerable per se, irrespective of L1-L2 differences at the interface between morphology and syntax. We tested 45 L2 learners in (i) a semicontrolled production task in context (element rearrangement task) targeting argument reordering (object fronting) as a function of the information status of discourse referents; (ii) a fill-in-the-blanks task involving the use of case endings; and (iii) a general proficiency test. Contra the Interface Hypothesis, results showed that argument reordering was affected by discourse properties of referents. Turning to the Bottleneck Hypothesis, learners’ command of case was identified as a reliable predictor of convergence in discourse-to-syntax mappings, which confirms the key role of inflectional morphology in the acquisition of other grammar areas, including interfaces between grammar and grammar-external domains such as discourse.

The Value of Speech-Language Pathologists in Auditory Rehabilitation for Adults With Cochlear Implants.

Background Standards for auditory rehabilitation are currently lacking for adults who receive cochlear implants. Speech recognition outcomes are highly variable, and many adults with cochlear implants present with suboptimal performance. Functional real-life communication abilities are not routinely measured clinically and are not strongly linked to performance on traditional measures of speech recognition. In fact, even individuals with relatively good speech recognition outcomes often present with persistent communication difficulties. In contrast to pediatric cochlear implant users, speech-language pathologists are not routinely involved in the rehabilitation of adults who receive cochlear implants. Purpose The purpose of this article is to describe the value of including a speech-language pathologist in a comprehensive approach to auditory rehabilitation for adults with cochlear implants. Method The theoretical and clinical foundations of incorporating a speech-language pathologist into an adult auditory rehabilitation program are discussed. A description of the skills and potential roles of the speech-language pathologist for providing adult cochlear implant rehabilitation services is presented, along with potential barriers to implementation. Conclusion Person-centered management of postlingually deafened adults with cochlear implants can be augmented by a more complete approach utilizing the skill set of a speech-language pathologist. Supplemental Material https://doi.org/10.23641/asha.14669652.

The course and prognostic capability of motor difficulties in infants showing early signs of autism.

Delays within the motor domain are often overlooked as an early surveillance marker for autism. The present study evaluated motor difficulties and its potential as an early predictive marker for later autism likelihood in a cohort of infants (N=96) showing early behavioral signs of autism aged 9-14 months. The motor domain was evaluated using the motor subscales of the Mullen Scales of Early Learning at baseline, and at a 6-month follow-up. The Autism Diagnostic Observation Schedule - Toddler Module (ADOS-T) was completed at follow-up as a measure of autism likelihood. Motor difficulties were common at baseline, with 63/96 (65.6%) infants scoring very low or below average in the gross motor domain and 29/96 (30.2%) in the fine motor domain. At follow-up, gross motor difficulties had resolved for many, with 23/63 (36.5%) infants maintaining these difficulties. Fine motor difficulties resolved in fewer infants, with 20/29 (69.0%) continuing to present with fine motor delays at follow-up. Adjusted linear regression models suggested that fine motor scores at baseline (β=-0.12, SE=0.04) and follow-up (β=-0.17, SE=0.05) were associated with higher ADOS-T scores; with difficulties across both timepoints (β=5.60, SE=1.35) the strongest (largest in magnitude) association with ADOS-T scores of the predictors examined. Motor difficulties are prominent in children displaying emerging signs of autism, with persistent fine motor difficulties predictive of the developing autism phenotype. The findings indicate the potential clinical value of including evaluation of motor skills within early autism surveillance measures. LAY SUMMARY: This prospective study evaluated motor development over a 6-month period in infants showing early behavioral signs of autism. Atypical motor development was a common feature of infants showing early signs of autism and persistent fine motor difficulties were predictive of the emerging autism phenotype.

The Polygenic Nature and Complex Genetic Architecture of Specific Learning Disorder.

Specific Learning Disorder (SLD) is a multifactorial, neurodevelopmental disorder which may involve persistent difficulties in reading (dyslexia), written expression and/or mathematics. Dyslexia is characterized by difficulties with speed and accuracy of word reading, deficient decoding abilities, and poor spelling. Several studies from different, but complementary, scientific disciplines have investigated possible causal/risk factors for SLD. Biological, neurological, hereditary, cognitive, linguistic-phonological, developmental and environmental factors have been incriminated. Despite worldwide agreement that SLD is highly heritable, its exact biological basis remains elusive. We herein present: (a) an update of studies that have shaped our current knowledge on the disorder’s genetic architecture; (b) a discussion on whether this genetic architecture is ‘unique’ to SLD or, alternatively, whether there is an underlying common genetic background with other neurodevelopmental disorders; and, (c) a brief discussion on whether we are at a position of generating meaningful correlations between genetic findings and anatomical data from neuroimaging studies or specific molecular/cellular pathways. We conclude with open research questions that could drive future research directions.