Praxis Tests Research Articles

Ideational Praxis, Play, and Playfulness: A Cross-Sectional Study of Autistic Children

Abstract Importance: Assessment of praxis skills is an essential aspect of understanding autistic children’s development of play and playfulness. Objective: To assess the relationship and influence of ideational praxis skills on play skills and playfulness among autistic children. Design: A cross-sectional study. Settings: Homes, schools, and early care centers across Spain. Participants: Children ages 4 yr 6 mo to 6 yr 11 mo (45 typically developing [TP] and 45 with autism spectrum disorder [ASD]). Outcomes and Measures: Student’s t tests were used to compare means between the two groups. Pearson’s correlation and multiple linear regression were used to determine possible effects of ideational skills on play and playfulness. Results: Scores for the TP group were significantly higher than those of the ASD group on all play dimensions—space management, t(88) = 4.58; material management, t(88) = 5.86; pretense–symbolism, t(88) = 8.12; and participation, t(88) = 7.31—and on the Test of Playfulness (ToP), t(88) = 10.18, and Test of Ideational Praxis (TIP), t(88) = 4.38 (all ps < .001). Multiple linear regression revealed a statistically significant effect of TIP dimensions—space management, F(3, 41) = 4.83, p < .042; material management, F(3.41) = 8.49. p < .001; pretense–symbolism, F(3, 41) = 5.66. p < .002; and participation, F(3.41) = 7.81. p < .001—and on the ToP, F(3, 41) = 5.96. p < .002. Conclusions and Relevance: Ideational praxis skills combined with diagnostic information significantly predicted play skills and playfulness, highlighting the influence of ideation on play. Plain-Language Summary: This article provides data supporting the influence of ideational praxis skills on the play skills and playfulness of autistic children. Understanding how ideational praxis skills affect the ability to recognize and act on object affordances might promote greater possibilities for play interactions among autistic children.

Improved sleep, cognitive processing and enhanced learning and memory task accuracy with Yoga nidra practice in novices

Complementary and Alternative medicine is known to have health benefits. Yoga nidra practice is an easy-to-do practice and has shown beneficial effects on stress reduction and is found to improve sleep in insomnia patients. Effect of yoga nidra practice on subjective sleep is known but its effect on sleep and cognition objectively is not documented. The aim of the study was to study the effect of yoga nidra practice on cognition and sleep using objective parameters. 41 participants were enrolled, and baseline sleep diary (SD) collected. Participants volunteered for overnight polysomnography (PSG) and cognition testing battery (CTB) comprising of Motor praxis test, emotion recognition task (ERT), digital symbol substitution task, visual object learning task (VOLT), abstract matching (AIM), line orientation task, matrix reasoning task, fractal-2-back test (NBACK), psychomotor vigilance task and balloon analog risk task. Baseline CTB and after one and two weeks of practice was compared. Power spectra density for EEG at central, frontal, and occipital locations during CTB was compared. Repeat SD and PSG after four weeks of practice were done. After yoga nidra practice, improved reaction times for all cognition tasks were seen. Post intervention compared to baseline (95%CI; p-value, effect size) showed a significant improvement in sleep efficiency of +3.62% (0.3, 5.15; p = 0.03, r = 0.42), -20min (-35.78, -5.02; p = 0.003, d = 0.84) for wake after sleep onset and +4.19 μV2 (0.5, 9.5; p = 0.04, r = 0.43) in delta during deep sleep. Accuracy increased in VOLT (95% CI: 0.08, 0.17; p = 0.002, d = 0.79), AIM (95% CI: 0.03, 0.12; p = 0.02, d = 0.61) and NBACK (95% CI: 0.02, 0.13; p = 0.04, d = 0.56); ERT accuracy increased for happy, fear and anger (95% CI: 0.07, 0.24; p = 0.004, d = 0.75) but reduced for neutral stimuli (95% CI: -0.31, -0.12; p = 0.04, r = 0.33) after yoga nidra practice. Yoga Nidra practice improved cognitive processing and night-time sleep.

A cross-sectional case–control study on the structural connectome in recovered hospitalized COVID-19 patients

COVID-19 can induce neurological sequelae, negatively affecting the quality of life. Unravelling this illness's impact on structural brain connectivity, white-matter microstructure (WMM), and cognitive performance may help elucidate its implications. This cross-sectional study aimed to investigate differences in these factors between former hospitalised COVID-19 patients (COV) and healthy controls. Group differences in structural brain connectivity were explored using Welch-two sample t-tests and two-sample Mann–Whitney U tests. Multivariate linear models were constructed (one per region) to examine fixel-based group differences. Differences in cognitive performance between groups were investigated using Wilcoxon Rank Sum tests. Possible effects of bundle-specific FD measures on cognitive performance were explored using a two-group path model. No differences in whole-brain structural organisation were found. Bundle-specific metrics showed reduced fiber density (p = 0.012, Hedges’ g = 0.884) and fiber density cross-section (p = 0.007, Hedges’ g = 0.945) in the motor segment of the corpus callosum in COV compared to healthy controls. Cognitive performance on the motor praxis and digit symbol substitution tests was worse in COV than healthy controls (p < 0.001, r = 0.688; p = 0.013, r = 422, respectively). Associations between the cognitive performance and bundle-specific FD measures differed significantly between groups. WMM and cognitive performance differences were observed between COV and healthy controls.

The Use of Verbal and Nonverbal Memory Tests for Alzheimer's Disease Screening in Taiwan Chinese.

Patients with Alzheimer's disease typically have initial deficits in memory. Memory testing can be categorized as verbal or nonverbal by the modality of the stimuli used. We compared the discriminative validity of selected verbal and nonverbal memory tests between non-dementia and Alzheimer's disease in Taiwan. Ninety-eight patients with mild Alzheimer's disease and 269 non-dementia individuals underwent story recall test (immediate and delayed recall), and constructional praxis test (copy and delayed recall). The receiver-operating characteristic curve and area under the curve were evaluated to compare between tests. Patients with Alzheimer's disease performed poorly across all memory tests, and the receiver-operating characteristic curve analysis indicated that story recall immediate and relayed recall, and constructional praxis delayed recall had good classification accuracy with area under the curve of .90, .87 and .87 respectively. These results provide support that both verbal and nonverbal memory tests are reliable measure for screening patients with Alzheimer's disease.

Predictors of Functional Communication Outcomes in Children With Idiopathic Motor Speech Disorders.

The purpose of the study was to investigate child- and intervention-level factors that predict improvements in functional communication outcomes in children with motor-based speech sound disorders. Eighty-five preschool-age children with childhood apraxia of speech (n = 37) and speech motor delay (n = 48) participated. Multivariable logistic regression models estimated odds ratios and 95% confidence intervals for the association between minimal clinically important difference in the Focus on the Outcomes of Communication Under Six scores and multiple child-level (e.g., age, sex, speech intelligibility, Kaufman Speech Praxis Test diagnostic rating scale) and intervention-level predictors (dose frequency and home practice duration). Overall, 65% of participants demonstrated minimal clinically important difference changes in the functional communication outcomes. Kaufman Speech Praxis Test rating scale was significantly associated with higher odds of noticeable change in functional communication outcomes in children. There is some evidence that delivering the intervention for 2 times per week for 10 weeks provides benefit. A rating scale based on task complexity has the potential for serving as a screening tool to triage children for intervention from waitlist and/or determining service delivery for this population.

Evaluation in Ayres Sensory Integration® Praxis Tests: Construct Validity and Internal Reliability.

Assessment of praxis using valid and reliable measures is important for understanding factors affecting occupational participation. To evaluate evidence of construct validity and internal reliability of data gathered with four newly developed praxis tests. Comparative descriptive design. Homes, schools, and therapy practices across the United States. A control group consisting of 163 children without any concerns or diagnoses and a case group of 145 children with sensory integration difficulties, ages 3 to 12 yr. Rasch analyses to evaluate construct validity, and Student's t tests to evaluate group differences. Total test scores and most item scores conformed to Rasch model expectations. Group differences were significant; the control group scored higher. Internal reliability was strong. Findings support the validity and internal reliability of the four praxis tests. What This Article Adds: This study adds to the growing body of evidence for validity and reliability of the Evaluation in Ayres Sensory Integration® tests.

USING THE SENSORY INTEGRATION TECHNIQUE FOR PEOPLE WITH AUTISM SPECTRUM DISORDERS DURING TRAINING AT THE CLIMBING SECTION

Aim: To analyze the practical application of the sensory integration technique for individuals with autism spectrum disorder at a climbing section, and to investigate the impact of physical activity on improving their proprioceptive and vestibular systems. Materials and Methods: The method of included participant observation at the climbing classes with constant recording the behavior (desirable and undesirable) was used. The sensory screening (developed by J. Ayres) was applied for recording and determining the sensory systems of the people with ASD before the start of training and again after a month. The scale of Sensory Integration and Praxis Tests (SIPT) was used for assessing certain aspects of participants’ sensory processing or perception according to the goals set during the climbing classes. Results: The results of the research showed that the application of the sensory integration technique for individuals with ACD at a climbing section promoted the dynamics of changes in their sensory system during training considering the characteristics of their sensory system. The positive changes were observed in the way the people with ACD felt about their own bodies and their involvement in sports activities that in its turn made it possible to be active and develop their sensory system. It has been identified that while planning training for the people with ASD it is necessary to take into account sensory modulation (reading sensory signals) and apply exercises for stimulating sensory sensations that will improve the motor activity of persons with ASD, their social interaction, and safety, as well. Conclusions: During training at the climbing section sensory information processing of the individuals with ASD have the impact on their body control, hand-eye coordination, and hand sensitivity during training. The improvement of sensory information processing in its turn enables people with ASD to master climbing.

Is it possible to differentiate Alzheimer’s disease from Parkinson’s disease dementia by praxis tests?

Is it possible to differentiate Alzheimer’s disease from Parkinson’s disease dementia by praxis tests?

The dementia apraxia test can detect early-onset Alzheimer's disease.

Limb apraxia is a common early sign of Alzheimer's disease (AD) and is thought to occur specifically in early-onset (before the age of 65) AD. The Dementia Apraxia Test (DATE), a test of limb and face praxis developed to support the differential diagnosis of dementia, has shown good diagnostic accuracy in detecting AD in older patients, but it has not been validated for younger age groups. We investigated how accurately DATE can detect AD in middle-aged individuals and whether apraxia is a distinctive feature in early-onset AD. A sample of mild-stage AD patients (n = 24; Mage = 61, SD = 4) was drawn from a prospective consecutive series of individuals referred to our neurology clinic for dementia investigations. A healthy comparison group (HC) of comparable age (n = 22; Mage = 61, SD = 7), sex distribution, and education was recruited. DATE was administered as a blinded experimental measure, and a receiver operating characteristic (ROC) analysis was used to define the optimal diagnostic cutoff point. The DATE classified 93% of the participants correctly as AD or HC (sensitivity 0.88, specificity 1.00, area under curve 0.968). The optimal diagnostic cutoff point was higher (49 points) than in a previous sample of older patients (45 points). Early onset did not seem to be associated with worse praxis performance in AD. DATE is an accurate tool for detecting early-onset AD within 2 years of symptom onset. The diagnostic cutoff point should be higher for middle-aged populations than for late-onset AD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Extremely preterm children and relationships of minor neurodevelopmental impairments at 6 years.

This study investigated minor impairments in neurological, sensorimotor, and neuropsychological functioning in extremely preterm-born (EPT) children compared to term-born children. The aim was to explore the most affected domains and to visualize their co-occurrences in relationship maps. A prospective cohort of 56 EPT children (35 boys) and 37 term-born controls (19 boys) were assessed at a median age of 6 years 7 months with Touwen Neurological Examination, Movement Assessment Battery for Children, 2nd edition (MABC-2), Sensory Integration and Praxis Test (SIPT), and a Developmental Neuropsychological Assessment, 2nd edition (NEPSY-II). Altogether 20 test domains were used to illustrate the frequency of impaired test performances with a bar chart profile and to construct relationship maps of co-occurring impairments. The EPT children were more likely to perform inferiorly compared to the term-born controls across all assessments, with a wider variance and more co-occurring impairments. When aggregating all impaired test domains, 45% of the EPT children had more impaired domains than any term-born child (more than five domains, p < 0.001). Relationship maps showed that minor neurological dysfunction (MND), NEPSY-II design copying, and SIPT finger identification constituted the most prominent relationship of co-occurring impairments in both groups. However, it was ten times more likely in the EPT group. Another relationship of co-occurring MND, impairment in NEPSY-II design copying, and NEPSY-II imitation of hand positions was present in the EPT group only. Multiple minor impairments accumulate among EPT children at six years, suggesting that EPT children and their families may need support and timely multi-professional interventions throughout infancy and childhood.

Occupational therapy using an Ayres Sensory integration® approach for school-age children – a randomized controlled trial

ABSTRACT Sensory-based interventions, for children with problems regarding sensory integration (SI), have become recognised by the public in recent years; many advertised intervention programmes do not truly reflect the principles of Ayres Sensory Integration approach (ASI®). Furthermore, there is still a lack of evidence-based practice to support its clinical application in Hong Kong. This study aims to investigate the effectiveness of occupational therapy (OT), with ASI® interventions, for school-age children with SI problems through randomised controlled trials. Fifty-two subjects were randomly assigned to an experimental or control group; 27 participants in the experimental group received 16 sessions (45 min each) of ASI® intervention. Pretest/posttest changes in scores for goal attainment scaling, the Sensory Integration and Praxis Test (SIPT), and the Chinese Sensory Profile showed significant improvement in the experimental group. The results indicate that the ASI® intervention is effective in treating children with SI problems.

Effects of Movement-Based Interventions on Imitation and Praxis Skills in Children With Autism Spectrum Disorder: A Comparison of Face-to-Face Versus Telehealth Modes of Delivery

Background Children with autism spectrum disorder (ASD) exhibit poor imitation, movement planning, and praxis skills that in turn compound their core social communication and behavioral difficulties. Objective Our randomized controlled trial compares the effects of 2 whole-body movement interventions (creative movement [“Play”] and general exercise [“Move”]) to those of a seated play standard-of-care intervention (“Create”) on imitation and praxis skills in children with ASD. As part of this clinical trial, we also compare face-to-face (F2F) versus telehealth (TH) modes of intervention delivery in each of the three groups. Methods A total of 44 children with ASD aged between 5 and 14 years participated in this 10-week study. Children were matched at baseline and assigned to the Play, Move, or Create groups (n=14-15/group). Approximately half of the children in each group were seen F2F, while the other half were seen via TH. Training was provided 2 times/week (60-90 minutes/session) for 8 weeks. We administered the Bilateral Motor Coordination (BMC) and Postural Praxis (PP) subtests of the Sensory Integration and Praxis Test (SIPT) at pretest and posttest and assessed spatial and temporal errors in movement execution during both tests. We calculated the percent total imitation error score for both subtests. Results For the SIPT-PP, we found a reduction in percent total errors from pretest to posttest in the Play (pretest: mean 15.8%, SE 1.1%; posttest: mean 12.9%, SE 1.1%; P≤.05), Move (pretest: mean 17.1%, SE 1.4%; posttest: mean 14.8%, SE 1.2%; P≤.05), and Create groups (pretest: mean 16.5%, SE 1.5%; posttest: mean 12.7%, SE 1.7%; P≤.05). There were no statistically significant differences in the percent reduction in total errors among children seen F2F versus via TH in the Play (F2F: mean 3.4%, SE 1.5%; TH: mean 2.4%, SE 2.1%; P=.72), Move (F2F: mean 2.6%, SE 1.6%; TH: mean 2.1%, SE 1.5%; P=.84), and Create groups (F2F: mean 6.1%, SE 1.2%; TH: mean 3.4%, SE 1.8%; P=.22). For the SIPT-BMC, children significantly reduced their percent total error scores from pretest to posttest in the Play group (pretest: mean 8.6%, SE 2.4%; posttest: mean 3.9%, SE 0.7%; P≤.05) but not in the Move and Create groups. Specifically, children in the Play group improved on spatial errors (pretest: mean 9.1%, SE 1.9%; posttest: mean 5.4%, SE 1.2%; P≤.05) and also showed a nonsignificant trend for improvement in temporal errors (pretest: mean 9.2%, SE 3.3%; posttest: mean 3.1%, SE 0.6%; P=.06). Similar to the SIPT-PP, we found no significant differences in the percent reduction in total errors among children seen F2F versus via TH (F2F: mean 2.0%, SE 1.5%; TH: mean 7.3%, SE 3.8%; P=.23). Conclusions Our pilot data suggest that imitation-based gross and fine motor training activities led to improved postural imitation skills in children with ASD across all 3 groups. However, only the Play group that received rhythmic movement practice improved on the BMC subtest of the SIPT. Our findings suggest that improvements in imitation and praxis skills are highly training-specific in children with ASD. The lack of significant differences between the F2F and TH modes across all groups suggests that TH could be a successful method of intervention delivery for promoting imitation and praxis skills in children with ASD. Conflicts of Interest None declared.

Cognitive Performance at Time of AD Diagnosis: A Clinically Augmented Register-Based Study.

We aimed to evaluate the feasibility of using real-world register data for identifying persons with mild Alzheimer’s disease (AD) and to describe their cognitive performance at the time of diagnosis. Patients diagnosed with AD during 2010–2013 (aged 60–81 years) were identified from the Finnish national health registers and enlarged with a smaller private sector sample (total n = 1,268). Patients with other disorders impacting cognition were excluded. Detailed clinical and cognitive screening data (the Consortium to Establish a Registry for Alzheimer’s Disease neuropsychological battery [CERAD-nb]) were obtained from local health records. Adequate cognitive data were available for 389 patients with mild AD (31%) of the entire AD group. The main reasons for not including patients in analyses of cognitive performance were AD diagnosis at a moderate/severe stage (n = 266, 21%), AD diagnosis given before full register coverage (n = 152, 12%), and missing CERAD-nb data (n = 139, 11%). The cognitive performance of persons with late-onset AD (n = 284), mixed cerebrovascular disease and AD (n = 51), and other AD subtypes (n = 54) was compared with that of a non-demented sample (n = 1980) from the general population. Compared with the other AD groups, patients with late-onset AD performed the worst in word list recognition, while patients with mixed cerebrovascular disease and AD performed the worst in constructional praxis and clock drawing tests. A combination of national registers and local health records can be used to collect data relevant for cognitive screening; today, the process is laborious, but it could be improved in the future with refined search algorithms and electronic data.

EASI Praxis Tests: Age Trends and Internal Consistency.

Ayres Sensory Integration® is an evidence-based practice that requires a comprehensive assessment before intervention. The Evaluation in Ayres Sensory Integration (EASI) is intended for this purpose, and psychometric data are needed to determine its validity and reliability. To evaluate the internal consistency of four EASI Praxis tests and their validity as developmental measures. Cross-sectional developmental design. Participants' homes. Typically developing children and young adolescents, ages 6 to 12 yr (N = 234). Outcomes and Measures: We analyzed four EASI Praxis tests using Cronbach's α, Pearson correlation coefficients, and one-way analysis of variance to explore internal consistency and developmental trends. The findings indicate moderate to high internal consistency for all tests. Significant correlations between age and praxis scores indicate that the EASI Praxis tests are sensitive to developmental changes. Occupational therapists can have confidence in the internal consistency and sensitivity to developmental changes of these praxis scores through early adolescence. What This Article Adds: Occupational therapists administering EASI Praxis tests can have confidence that they consistently measure praxis ability and are sensitive to developmental changes across ages 6 to 12 yr. The results suggest that praxis continues to develop into early adolescence, and adolescents may benefit from assessment and intervention targeting praxis ability.

Distinktivna obilježja deficita artikulaciono-fonoloških i leksičko-semantičkih sposobnosti dece sa razvojnim jezičkim poremećajem

Language disorder is defined as a disorder of the acquisition, comprehension or expression of spoken and/or written language that may be expressed in one or more aspects of the language system including phonology, semantics, morphology, syntax and pragmatics. Difficulties at the level of morphology and syntax are by far the most recognizable and most researched linguistic aspects, while research on other aspects of language has been left aside. The aim of this study was to determine the distinctive features of the deficit of articulation-phonological and lexical-semantic abilities in children with developmental language disorder (DLD) at a younger school age. Our research included 79 respondents, 39 of them with a diagnosis of DLD and 40 children with typical language development. The average age of the respondents in the group of children with DLD was 6.87 years, while the age of the respondents in the control group was 6.93. In the research, a prepared battery of tests was used to assess articulation-phonological abilities (Global Articulation Test, Oral Praxis Test, Phoneme Difference Test and Auditory Discrimination Test), while Vocabulary and Semantic Test was used to assess lexical and semantic abilities. Children with DLD had higher average scores on all tests used, but discriminant analysis found that synonyms, oral practice, metonyms, phonemic hearing, and auditory discrimination contributed most to group discrimination, while other variables contributed but with less projection. It is important to mention that the articulation slightly contributes to group discrimination.

The Effectiveness of Neurocognitiverehabilitation Therapy on Hand Function and Praxis in Children with Neurodevelopmental Disorder: A Case Study

The purpose of this study was to investigate the effect of neurocognitive rehabilitation treatment on the improvement and execution of hand function in children with neurodevelopmental disabilities diagnosed with intellectual disability. From May 7, 2021, the intervention was conducted once a week for a total of 20 sessions, and neurocognitive rehabilitation therapy was administered for 30 min in each session. Before and after intervention, the Erhardt Developmental Prehension Assessment (EDPA), Beery-Buktenica Developmental Test of Visual-Motor Integration, Sixth Edition (Beery VMI-6), and Sensory Profile (SP) scores were measured using the Praxis test. After neurocognitive rehabilitation treatment, the prewriting skill score on the EDPA evaluation improved from 25 points on the right hand and 22 points on the left hand to 27 points on the right hand and 27 points on the left hand. The scores improved from 58 to 65. In the SP evaluation, the scores for the multisensory processing item improved from 16 to 20 points, the fine motor/perception item improved from 9 to 12 points, and the Praxis test improved from 16 to 22 points in the sequence execution area. Neurocognitive rehabilitation therapy helps children with neurodevelopmental disorders to accurately hold a pencil and draw precisely as well as improves their ability to plan, move, and imitate hand movements, thereby helping to improve basic hand functions necessary for learning.

Identifying dementia in Down syndrome with the Severe Impairment Battery, Brief Praxis Test and Dementia Scale for People with Learning Disabilities.

Individuals with Down syndrome (DS) are at high risk for dementia, specifically Alzheimer's disease. However, many measures regularly used for the detection of dementia in the general population are not suitable for individuals with DS due in part to floor effects. Some measures, including the Severe Impairment Battery (SIB), Brief Praxis Test (BPT) and Dementia Scale for People with Learning Disabilities (DLD), have been used in clinical trials and other research with this population. Validity research is limited, particularly regarding the use of such tools for detection of prodromal dementia in the DS population. The current project presents baseline cross-sectional SIB, BPT and DLD performance in order to characterise their predictive utility in discriminating normal cognition, possible dementia and probable dementia in adult DS. Baseline SIB, BPT and DLD performances from 100 individuals (no dementia=68, possible dementia=16 & probable dementia=16) were examined from a longitudinal cohort of aging individuals with DS. Receiver operating characteristic curves investigated the accuracy of these measures in relation to consensus dementia diagnoses, diagnoses which demonstrated high percent agreement with the examining neurologist's independent diagnostic impression. The SIB and BPT exhibited fair discrimination ability for differentiating no/possible versus probable dementia [area under the curve (AUC)=0.61 and 0.66, respectively]. The DLD exhibited good discrimination ability for differentiating no versus possible/probable dementia (AUC=0.75) and further demonstrated better performance of the DLD Cognitive subscale compared with the DLD Social subscale (AUC=0.77 and 0.67, respectively). Results suggest that the SIB, BPT and DLD are able to reasonably discriminate consensus dementia diagnoses in individuals with DS, supporting their continued use in the clinical assessment of dementia in DS. The general performance of these measures suggests that further work in the area of test development is needed to improve on the AUCs for dementia status discrimination in this unique population. At present, however, the current findings suggest that the DLD may be the best option for reliable identification of prodromal dementia in this population, reinforcing the importance of including informant behaviour ratings in assessment of cognition for adults with DS.

A Case Study of the Effectiveness of Online Graduate Teacher Education in TESOL

A cadre of school teachers took part in three semesters of online coursework to earn TESOL certification. They participated in a hybrid university math course and a face-to-face summer institute on effective teaching of math to English learners. Participants took pre and post-tests aligned to Common Core elementary mathematics content and the Praxis Test for Teachers of English to Speakers of Other Languages. They were observed teaching a math lesson in the beginning of the project to evaluate effectiveness in TESOL instructional strategies. A follow up observation was conducted the following semester. Both observations were scored using the sheltered instruction observation protocol (SIOP Model). Assessment and observation results indicated statistically significant growth in content and pedagogical knowledge and application. A qualitative analysis suggests flexibility in the form of online and hybrid courses, financial support, and practical application of new concepts to current practice are key factors in successful professional development for practicing teachers.

Considerations for Addressing the Needs of Culturally and Linguistically Diverse Speech-Language Pathology Praxis Test Takers.

The primary purpose of this article is to explore the speech-language pathology (SLP) Praxis test, a barrier to culturally and linguistically diverse (CLD) individuals entering the profession, by investigating first-time pass rates and mean scores by test taker race/ethnicity. Other potential barriers to licensure and certification, as well as solutions for mitigating these barriers, will also be addressed. SLP Praxis test data from two windows of time, 2008-2011 and 2014-2020, were compared for the following: (a) proportions of test taker race/ethnicity relative to U.S. demographic estimates of racial/ethnic group proportions overall, (b) proportions of racial/ethnic groups, and (c) trends in test-taker mean scores by race/ethnicity. First-attempt pass rates by racial/ethnic groups were also calculated for the 2014-2020 testing window. The percentage of some CLD SLP Praxis test-taker groups increased since the 2008-2011 testing window but is still not representative of U.S. racial/ethnic demographics. The first-attempt pass rates and overall mean scores of CLD test-taker groups remained substantially lower than White non-Hispanic/Latinx test takers. Despite the encouraging trends in SLP Praxis test-taker racial/ethnic diversity, disparities persist between the racial/ethnic makeup of SLP Praxis test takers and the demographic makeup of the United States. Consequently, these disparities have implications for the continued lack of cultural representativeness seen in our workforce.

Primitive Reflexes and Dementia in Adults With Down Syndrome.

To determine whether primitive reflexes serve as an indicator of dementia in adults with Down syndrome (DS), we collected neurologic examination data, cognitive and behavioral assessments, and clinical consensus diagnoses of dementia from 92 adults with DS. In a cross-sectional, observational study of a regional cohort, χ2 and Fisher exact tests examined individual reflexes across the diagnostic group (no, possible, or probable dementia). In 64 participants with all 8 reflexes assessed, the number of primitive reflexes was assessed as a predictor of diagnosis using age-controlled multinomial logistic regression and of performance on clinical assessments (Brief Praxis Test [BPT], Severe Impairment Battery [SIB], and the Dementia Questionnaire for People with Learning Disabilities [DLD]) using age-adjusted linear regression. Primitive palmomental, grasp, snout, and suck reflexes were more frequent in individuals with probable dementia, but all participants showed at least 1 primitive reflex. Multiple primitive reflexes in combination served as a better indicator of dementia, with each additional abnormal reflex tripling probability of the probable dementia group membership controlling for age. Abnormal reflex count was not associated with direct assessment of cognition and praxis (SIB and BPT) but associated with informant ratings of cognitive and behavioral functioning (DLD). The presence of multiple reflexes serves as an indicator of dementia status in DS as a supplement to direct assessment of cognition and praxis. The reflex examination may serve as a tool in the multimethod evaluation for dementia in DS, as it appears unaffected by intellectual disability and language mastery.