Verbal Prompts Research Articles

Abstract 274: Verbal Prompts During Pediatric Cardiopulmonary Resuscitation in Emergency Department: A Report From the Videography in Pediatric Emergency Resuscitation (VIPER) Collaborative

Introduction: The quality of chest compressions (CC) is crucial for good outcomes for pediatric cardiac arrest. Verbal prompts from resuscitation leader or CPR coach may help to optimize it. The objective of this study is to describe the frequency of appropriate verbal prompts during pediatric CPR. We hypothesized that verbal prompts for CC would be given less frequently to infants compared to children. Methods: A report from the Videography In Pediatric Emergency Resuscitation (VIPER) Collaborative, a prospective observational database from three tertiary PEDs from December 2016 to April 2018. All study sites videorecord and review resuscitations and use a pressure sensor/monitor device during CPR. All events where chest compressions (CC) were performed under videorecorded conditions with the monitor device in use were eligible for inclusion. Events where real-time feedback from monitoring devices for CC was available were excluded (ages > 8). Data on CPR performance was collected by a combination of video review and monitor device; CC rate and depth and ventilation rate were extracted in time periods corresponding to individual CPR providers. Data on verbal prompts (time, who gave prompts, what prompt consisted of) were identified during video review. Results: There were 21 cases with total 182 providers included in database during study periods (infants: n=15, children: n=6). Verbal prompts for compression rate and depth were given in 14/21 (67%) of cases. 19/80 (24%) came from the resuscitation leader; 32/80 (40%) and from a CPR coach. 7 (3.9%) providers doing CC watched ZOLL monitor for feedback. Appropriate verbal prompts for CC rate were given to 4.2 % of providers in infants and 8.8 % in children (p=0.024). And 9.2% in infants and 10.5 % in children (p=0.064) were given to providers for CC depth. After adjusting by confounders, there weren’t any significant differences between age groups for both CC rate: OR1.22 (95%CI 0.49-3.05, P=0.670) and depth: OR 2.82 (95%CI 0.73-10.9, P=0.134). Conclusions: Verbal prompts frequency for CC rate and depth during pediatric CPR was described. There weren’t any significant differences between infants and children under 8 years old.

Efficacy of a Micro-Prompting Technology in Reducing Support Needed by People With Severe Acquired Brain Injury in Activities of Daily Living: A Randomized Control Trial.

To evaluate the effectiveness of an automated interactive prompting technology in supporting the morning routine of persons with acquired brain injury. The morning routine included maintaining personal hygiene and dressing. An inpatient neurorehabilitation hospital. Persons with acquired brain injury who required prompting when following their morning routine (n = 24), but were not limited by physical disability or dysphasia, took part in the study. Participants (67% with traumatic brain injury) had impairment on indices of memory and executive function. A randomized control trial evaluated the effect of an automated interactive micro-prompting device on the number of prompts by trained staff required for successful completion of the morning routine. Study-specific checklists assessed sequence performance, errors, and verbal prompts required over baseline, rehabilitation as usual, intervention, and return to baseline conditions. The intervention significantly reduced the support required to complete the task compared with usual rehabilitation. Micro-prompting technology is an effective assistive technology for cognition, which reduces support needs in people with significant cognitive impairments.

The (doubtful) role of financial reward in obedience to authority

ABSTRACTThe Milgram experiments are among the most well-known and important in the history of psychology. Since first published, there have been countless discussions held on the subject of what factors induce people to exhibit extreme obedience towards authority. One such potential factor, not yet explored empirically, is the receipt in advance of financial gratification by a study participant. In our experiment we compare obedience among participants in classic Milgram paradigm conditions with obedience in a situation where the participant does not receive financial gratification in advance. The results did not show that obedience differed in the two comparable situations. In conditions where the participants were not given money up front, however, it was necessary to employ more verbal prompts in order to induce obedience.

Strategies to assist uptake of pelvic floor muscle training for people with urinary incontinence: A clinician viewpoint.

The experiences and information needs of clinicians who use pelvic floor muscle training to manage urinary incontinence were explored. Qualitative methods were used to conduct thematic analysis of data collected from clinician focus groups and interviews. Participants were registered physiotherapists and continence nurses in Melbourne, Australia. Recruitment was through a combination of purposive and "snowball" sampling and continued until data adequacy was reached. Twenty-eight physiotherapists and one continence nurse participated in seven focus groups and one interview. The main finding communicated by the participants was that pelvic floor muscle training requires comprehensive descriptions of program details in order for clinicians to implement evidence-based interventions. The following themes were identified: (1) pelvic floor muscle training tailored to the needs of each individual is essential; (2) training-specific cues and verbal prompts assist patients to learn and engage with exercises; and (3) clinicians can benefit from research summaries and reports that provide explicit and comprehensive descriptions and decision rules about intervention content and progression. The data indicated that some clinicians can have difficulty interpreting and applying research findings because it is not always well reported. Clinicians who use pelvic floor muscle training to treat urinary incontinence advised can benefit from accessing explicit details of interventions tested in research and reported as effective. They viewed tailoring therapy to individual goals and the use of verbal prompts and visualization cues as important engagement strategies for effective exercise performance. Explicit reporting could be facilitated by using an exercise guideline template, such as the Consensus on Exercise Reporting Template (CERT).

Use of Video Modeling to Teach Weight Lifting Techniques to Adults with Down Syndrome

As adults with Down syndrome (DS) age strength decreases resulting in difficulty performing activities of daily living. Research suggests that progressive resistance training for adults with DS may lead to improvements in their functional ability. PRT requires minimal equipment, which may be important for individuals with DS, as they may have limited disposable income for gym memberships, and reduced access to transportation to and from training facilities. Video modeling (VM) involves the demonstration of a target behavior through the video recording of that behavior. PURPOSE: The purpose of this study was to determine whether the use of video modeling is appropriate for teaching adults with DS to perform weight lifting techniques. METHODS: Three adult males with Down syndrome, ages 24 to 34 years, participated in this study. A single subject multiple probe design across behaviors (i.e. lifts) was used to evaluate the effectiveness of VM. A certified U.S. weight lifting coach completed a task analysis for split squat (SS), punch-out squat (POS), and overhead press (OP). For baseline measures participants watched a demonstration of each lift and were then recorded performing the lift. Once baseline measures became stable, participants viewed a video of a model using correct lifting technique three times. They were then video recorded performing the lift. No verbal prompts or corrections were given. Participants performances were scored by taking the number of steps performed correctly, dividing that number by the total number of steps in the task, then multiplied by 100. RESULTS: Participants were least successful with the SS averaging 16% correct at baseline and 36% correct after viewing the videos. POS went from 50% correct to 87%; OP started at 42% and increased to 80% correct movement. Our video-modeling intervention, alone was not sufficient to produce an effective outcome across all lifts, but did help participants acquire more components of each lift. CONCLUSION: This study suggests that VM might serve as a useful component of a larger intervention; one that includes VM, rehearsal with feedback, and programmed reinforcement contingencies. It is our hope that future research with provide a path forward in this critical area.

Becoming Disciplined About Disciplinary Literacy Through Guided Retelling

AbstractBecoming more disciplined about teaching disciplinary literacy in our classrooms can be a challenge. Encouraging student production of the academic language and the demands and styles of thinking associated with each discipline requires an additional push that was often overlooked in content area instruction of the past. As this new journey in disciplinary literacy begins, supportive strategies become a necessity. In this article, the author presents guided retelling as a simple solution to the complex task of promoting disciplinary literacy in the elementary classroom. Through the use of verbal and visual prompts, guided retelling continues to be a highly implementable and adaptable tool for learners of all ages and abilities across all disciplines.

Using virtual environments to investigate wayfinding in 8- to 12-year-olds and adults

Wayfinding is the ability to learn and recall a route through an environment. Theories of wayfinding suggest that for children to learn a route successfully, they must have repeated experience of it, but in this experiment we investigated whether children could learn a route after only a single experience of the route. A total of 80 participants from the United Kingdom in four groups of 20 8-year-olds, 10-year-olds, 12-year-olds, and adults were shown a route through a 12-turn maze in a virtual environment. At each junction, there was a unique object that could be used as a landmark. Participants were “walked” along the route just once (without any verbal prompts) and then were asked to retrace the route from the start without any help. Nearly three quarters of the 12-year-olds, half of the 10-year-olds, and a third of the 8-year-olds retraced the route without any errors the first time they traveled it on their own. This finding suggests that many young children can learn routes, even with as many as 12 turns, very quickly and without the need for repeated experience. The implications for theories of wayfinding that emphasize the need for extensive experience are discussed.

How visual and kinaesthetic imagery shape movement improvisation: A pilot study

Abstract Western contemporary dance has long benefited from mental imagery practice for enhancing choreography, somatic embodiment and performance. Although science supports many psychophysical benefits of mental imagery practice, less is known about its effects on dance creation. Here, two dance educators report the results of a pilot study using two contrasting imagery modes in teaching improvisation. Four conservatory dance students engaged in two weeks of improvisation. In week one, Glenna used tactile-kinaesthetic imagery as verbal prompts. During week two, Susan emphasized visual prompts. Each mode gave rise to unique movement patterns and reflections on embodiment, bearing on future research questions. The authors aim to situate the study within the conversation on imagery specificity in teaching improvisation. In addition, the study supports the ongoing evolution of an articulate scientific-somatic discourse on tactile-kinaesthetic and visual phenomena within dance.

Customized electronic alerts to boost pneumococcal vaccinations in high risk cancer patients.

e18227 Background: Streptococcus pneumoniae remains a leading cause of serious illness, including bacteremia, meningitis, and pneumonia among adults in the United States. Approximately 10% of all patients with invasive pneumococcal disease die of their illness, but case-fatality rates are higher for immunocompromised adults including cancer patients. Current Center for Disease Control (CDC) guidelines recommend routine use of 13-valent (Prevnar 13) and 23-valent (Pneumovax 23) pneumococcal vaccines (PV) for immunocompromised patients. We conducted a quality improvement (QI) project utilizing our electronic medical record (EMR) system to improve PV compliance (PVC) rates in our patients. Methods: We created automatic reminders called best practice alerts (BPA) and linked them to a smart order set within our EMR that appeared upon opening patient charts. The smart set ordered the correct vaccine in sequence based on CDC guidelines. From August 2015- January 2017, we implemented this BPA for one of six hematology providers and the remaining providers were provided with verbal guidelines and reminders to administer PV to their patients. Results: At baseline only 22% of 3000 hematology patients within the practice had received PV. The pilot provider with the BPA linked to a smart order set within the EMR improved PVC within his patients from 23% to 66%. Providers who were just given verbal guidelines improved PVC from an average of 22% to 45%. The difference in the improvement between the pilot provider and the reference group is 21% (p < 0.001). Conclusions: In an EMR era, we took advantage of the tools within our system to improve PVC rates. BPA linked to a smart order set within the EMR provided better means of improving PVC than verbal prompts in high-risk immunocompromised patients. Additionally, the increase in PVC throughout the hematology practice is due to primary care providers using similar reminders within the same EMR. The PV BPA will be conducted as a standard of care in our clinic and will be expanded to oncology patients as well.

Development and Reliability of the Basic Skill Assessment Tool for Adolescents with Autism Spectrum Disorder.

The purpose of this study was to improve upon the first version of the basic work skills assessment tool for adolescents with autism spectrum disorder (ASD) and examine interrater and intrarater reliability using Intraclass Correlation Coefficient (ICC). The modified tool includes 2 components: (1) three tasks measuring work abilities and work attitudes and (2) a form to record the number of verbal and nonverbal prompts. 26 participants were selected by purposive sampling and divided into 3 groups—group 1 (10 subjects, aged 11–13 years), group 2 (10, aged 14–16 years), and group 3 (6, aged 17–19 years). The results show that interrater reliabilities of work abilities and work attitudes were high in all groups except that the work attitude in group 1 was moderate. Intrarater reliabilities of work abilities in group 1 and group 2 were high. Group 3 was moderate. Intrarater reliabilities of work attitudes in group 1 and group 3 were high but not in group 2 in which they were moderate. Nevertheless, interrater and intrarater reliabilities in the total scores of all groups were high, which implies that this tool is applicable for adolescents aged 11–19 years with consideration of relevance for each group.

The Use of Music to Promote Purposeful Movement in Children with Visual Impairments

Music plays a major role in education and development of all children. Although use of music in education process may seem obvious to most professionals, there are only a few studies that discuss effect of music on purposeful movement of students with visual impairments (DePountis, Cady, & Hallak, 2013; Desrochers, Oshlag, & Kennelly, 2014; Sapp, 2011). A large percentage of teachers of students with visual impairments and other professionals use music and movement to some degree when working with students. The author of this article has extensive past experiences working as a music therapist collaborating with occupational and physical therapists in a rehabilitative therapy setting while using music to promote movement for people with disabilities including those with visual impairments. The same strategies are proving beneficial in a music classroom setting to increase students' participation through movement activities. The purpose of this Practice Perspective is to provide evidence and examples of music activities that can promote purposeful movement for students with visual impairments. Music and movement Supporting evidence from field of neuroscience and music therapy suggests that people can learn or relearn movement through activities that require moving to external auditory stimuli like music. Rhythmic entrainment is ability of a person to automatically synchronize his or her physical movements to metrical structure (meter or the beat) of music (Trost et al., 2014). Neurological processing of meter is a consistent, repetitive, and predictable duration of time that involves temporally-precise two-way interactions between motor planning regions and auditory regions of brain (Patel & Iversen, 2014, p. 11). Manipulation of music's metrical structure proved beneficial for increasing duration of students' movement as well as decreasing need for verbal prompts from teacher. Activities such as marching and simple dance sequences allowed students to synchronize movement to beat. With live music, tempo could be increased or decreased or stopped and started according to beat in a game-like context. The use of props proved beneficial for some students with more severe disabilities. Students who were willing to grasp a parachute or scarves could move to beat in a more passive manner while teacher actively moved prop. Movement through instrument playing Playing musical instruments is an effective way to promote purposeful movement and reaching in upper extremities of students with visual impairments. Research suggests that Therapeutic Instrumental Music Playing (TIMP) can promote functional movement when individuals are encouraged to play musical instruments in nontraditional ways (Thaut, 2005). The key component for increasing movement and making it functional is location or placement of instrument based on a person's individualized need. This approach proved beneficial for students with more severe disabilities, including those with deafblindness. After introducing an instrument with hand-under-hand assistance, preferred instruments were placed in close proximity to students, which allowed them to participate in a manner that reinforced concepts of left or right, crossing midline, reaching over their head, and increasing range of motion. In addition, students with vision performed on percussion instruments in which they were required to visually track drum beat. The teacher would alternate placing paddle drums on students' right or left side and high or low. This activity promoted range of motion and crossing midline, as well as increasing duration of movement that usually lasted for entire song with minimal verbal cues from teacher. Music technology and movement Incorporating music technology like Thermin (see Figure 1) and Soundbeam (Figure 2) was a fun and motivating way to promote purposeful movement of students. …

Maternal guidance in at‐risk mother–child dyads: Associations with contextual variables

AbstractThe present study was designed to explore how maternal guidance (i.e., involvement and monitoring) is associated with parent‐level and contextual factors in unstructured and structured tasks. Participants were mothers who had histories of risk and disadvantage (mean age = 30.47) with their preschool‐aged children (aged 2–6 years; n males = 39, n females = 50). Maternal guidance was divided into two categories: directive (i.e., commands and command repetitions) and nondirective (i.e., queries, verbal prompts, and explanations). Results revealed that mothers with more directive guidance had higher levels of parental stress and higher levels of maternal childhood histories of social withdrawal. Furthermore, more nondirective maternal guidance was associated with higher quality of home environments. Taken together, results suggest that parenting practices are best understood in relation to contextual variables. Findings have implications for developing and implementing parenting interventions for at‐risk mothers.Highlights Explored the association between contextual factors (e.g., parent stress, home environment) and maternal guidance (mother's use of commands vs. hints or prompts). Maternal guidance was assessed observationally and commands were associated with more parental stress while hints were associated with a higher quality home environment. Understanding parents as a whole by exploring contextual factors, rather than through isolated parenting practices, may be beneficial in the application of future parenting interventions.

Learning by listing: A content analysis of students’ perceptions of older adults and grandparents

ABSTRACTViews of specific older adults may differ substantially from views of older adults in general, and such views may influence preconceived notions of aging that students bring into the classroom. Using an in-class activity, the authors tested the hypothesis that grandparents, about whom we know more individuated information, would be characterized by different, and more positive, descriptors than older adults. Following verbal prompts, undergraduates (N = 98) listed terms describing older adults and grandparents. Conventional and directed content analysis with a multistage coding scheme was employed. Results revealed that descriptors were primarily negative (e.g., sick) and emphasized physical characteristics (e.g., wrinkly) for older adults but were more positive (e.g., sweet) and highlighted personality characteristics (e.g., kind) for grandparents. Although mentioned less often for grandparents, health-related and physical characteristics were predominantly negative for both groups. This word-listing exercise highlighted heterogeneity in views of older adults and underscored the value of studying gerontology.

Children with Down Syndrome Sharing Past Personal Event Narratives with Their Teacher Aides: A Pilot Study

Personal narrative ability is crucial for social–emotional well-being and classroom participation. This study investigated the ability of 10 school-age participants with Down syndrome to share past personal experiences with their teacher aides in their school environment. To participate, children were required to speak in short sentences and be largely intelligible to unfamiliar listeners. Personal narratives were elicited using photo prompts, comprising a set of the child’s own photographs and a standard set of photographs and accompanying verbal prompts, utilising a clinical language sampling protocol. Personal narratives were analysed on quality, syntactic complexity, verbal fluency and intelligibility. Examiner behaviour was evaluated for measures of syntactic complexity, mean turn length in utterances and number of utterances. Results indicated significant difficulties in producing quality personal narratives in both photo conditions. Examiner behaviour was negatively correlated to the participants’ spoken language performance. Clinical implications are highlighted.

Neural correlates of autobiographical memory retrieval in children and adults

ABSTRACTAutobiographical memory (AM) is a critically important form of memory for life events that undergoes substantial developmental changes from childhood to adulthood. Relatively little is known regarding the functional neural correlates of AM retrieval in children as assessed with fMRI, and how they may differ from adults. We investigated this question with 14 children ages 8–11 years and 14 adults ages 19–30 years, contrasting AM retrieval with semantic memory (SM) retrieval. During scanning, participants were cued by verbal prompts to retrieve previously selected recent AMs or to verify semantic properties of words. As predicted, both groups showed AM retrieval-related increased activation in regions implicated in prior studies, including bilateral hippocampus, and prefrontal, posterior cingulate, and parietal cortices. Adults showed greater activation in the hippocampal/parahippocampal region as well as prefrontal and parietal cortex, relative to children; age-related differences were most prominent in the first 8 sec versus the second 8 sec of AM retrieval and when AM retrieval was contrasted with semantic retrieval. This study is the first to characterise similarities and differences during AM retrieval in children and adults using fMRI.

US and Chinese perceptions of simulated US courtesy

Purpose – The purpose of this study was to identify similarities and differences in US and Chinese subjects’ emotional responses to and perceptions of courtesy of simulated English-language communication prompts. Design/methodology/approach – Data were collected through a web-based stimulus administered on US and Chinese students. Subject responses to eye contact and smile images and a set of verbal expressions were measured on ratings of emotion and courtesy. Findings – Smiling with direct eye contact and warmed-up verbal expressions were found to elicit a higher level of emotional response and were perceived as viable server politeness cues. US and Chinese participants had similar responses to facial and verbal prompts. Originality/value – This paper contributes to understanding about service employee cues, such as courtesy, that can influence service quality in a cross-cultural tourism setting.

Using a verbal prompt to increase protein consumption in a hospital setting: a field study.

BackgroundSufficient protein intake among hospitalized patients may contribute to faster recovery and a decrease in healthcare costs. Nevertheless, hospitalized patients are often found to consume too little protein. This field study explored the success of a small, inexpensive intervention adapted from the marketing literature, to encourage protein consumption among hospitalized patients.MethodsThe study was performed at a hospital where patients order food by calling to the meal service. The intervention consisted of a verbal prompt: “Would you like some [target product] with that?”, which was presented to patients by trained telephone operators, after patients finished ordering their lunch. Target products were two foods rich in protein; fruit quark and yoghurt drink. For half of the patients, the verbal prompt was preceded by verbal praise on their lunch order, which was aimed to increase compliance with the verbal prompt.ResultsThree hundred and fifteen hospitalized patients, aged 18–87 years took part in the study. Verbal prompts significantly increased ordering of the target products nearly sevenfold (from ordering by 6.5 % of patients to 45.2 % of patients). Protein content of ordered lunch and all food orders of the day combined showed a trend, with orders of patients receiving only a verbal prompt or a verbal prompt and verbal praise containing a larger amount of protein than lunch orders of patients in the control condition. At an individual level, protein content of ordered food increased significantly, reaching the 25–30 g of protein per main meal recommended by dieticians of the hospital. Verbal praise did not increase compliance with the verbal prompt. Patients consumed most or all of the target product and verbal prompts were not perceived to be obtrusive.ConclusionsAlthough changing eating patterns is challenging, this study shows that simple interventions such as verbal prompts may be useful tools for health professionals to stimulate healthy food consumption among patients during hospitalization.

Optimizing Eating Performance for Older Adults With Dementia Living in Long-term Care: A Systematic Review.

Review of research to date has been focusing on maintaining weight and nutrition with little attention on optimizing eating performance. To evaluate the effectiveness of interventions on eating performance for older adults with dementia in long-term care (LTC). A systematic review was performed. Five databases including Pubmed, Medline (OVID), EBM Reviews (OVID), PsychINFO (OVID), and CINAHL (EBSCOHost) were searched between January 1980 and June 2014. Keywords included dementia, Alzheimer, feed(ing), eat(ing), mealtime(s), oral intake, autonomy, and intervention. Intervention studies that optimize eating performance and evaluate change of self-feeding or eating performance among older adults (≥65 years) with dementia in LTC were eligible. Studies were screened by title and abstract, and full texts were reviewed for eligibility. Eligible studies were classified by intervention type. Study quality was accessed using the Quality Assessment Tool for Quantitative Studies, and level of evidence using the 2011 Oxford Centre for Evidence-Based Medicine (OCEBM) Levels of Evidence. Eleven intervention studies (five randomized controlled trials [RCTs]) were identified, and classified into four types: training program, mealtime assistance, environmental modification, and multicomponent intervention. The quality of the 11 studies was generally moderate (four studies were rated as strong, four moderate, and three weak in quality), with the main threats as weak designs, lack of blinding and control for confounders, and inadequate psychometric evidence for measures. Training programs targeting older adults (Montessori methods and spaced retrieval) demonstrated good evidence in decreasing feeding difficulty. Mealtime assistance offered by nursing staff (e.g., verbal prompts and cues, positive reinforcement, appropriate praise and encouragement) also showed effectiveness in improving eating performance. This review provided preliminary support for using training and mealtime assistance to optimize eating performance for older adults with dementia in LTC. Future effectiveness studies may focus on training nursing caregivers as interventionists, lengthening intervention duration, and including residents with varying levels of cognitive impairment in diverse cultures. The effectiveness of training combined with mealtime assistance may also be tested to achieve better resident outcomes in eating performance.

Speech Interaction with Personal Assistive Robots Supporting Aging at Home for Individuals with Alzheimer’s Disease

Increases in the prevalence of dementia and Alzheimer’s disease (AD) are a growing challenge in many nations where healthcare infrastructures are ill-prepared for the upcoming demand for personal caregiving. To help individuals with AD live at home for longer, we are developing a mobile robot, called ED, intended to assist with activities of daily living through visual monitoring and verbal prompts in cases of difficulty. In a series of experiments, we study speech-based interactions between ED and each of 10 older adults with AD as the latter complete daily tasks in a simulated home environment. Traditional automatic speech recognition is evaluated in this environment, along with rates of verbal behaviors that indicate confusion or trouble with the conversation. Analysis reveals that speech recognition remains a challenge in this setup, especially during household tasks with individuals with AD. Across the verbal behaviors that indicate confusion, older adults with AD are very likely to simply ignore the robot, which accounts for over 40% of all such behaviors when interacting with the robot. This work provides a baseline assessment of the types of technical and communicative challenges that will need to be overcome for robots to be used effectively in the home for speech-based assistance with daily living.

Cognitive Development in Rural Gambia: Relating Behavior and Growth from 6 – 24 Months of Age

The goal of our project is to establish assessments to evaluate the efficacy of nutritional interventions during the first 1000 days of life. Here we examine behavioral performance on a standardised developmental assessment scale (Mullen Scales of Early Learning; MSEL) and anthropometric growth indices in infants at a research station in West Africa. 
The MSEL is a developmental assessment battery for use from birth to five years of age. We adapted the MSEL for use in The Gambia. A committee of native, dual‐language speakers and trained MSEL administrators reviewed and adapted the measure where appropriate (i.e. linguistic translation of the item‐by‐item verbal prompts, as well as the substitution of stimuli that were deemed culturally inappropriate). 225 infants ranging from 6 – 24 months of age were assessed and their MSEL scores compared with an age‐matched group of infants tested in the UK.
Relative to the U.K infants, scores of cognitive development declined over the first two years of life, particularly for the language subscales of the MSEL. An analysis of the relationship between growth and cognitive development revealed that height for age z‐scores correlated with scores on the MSEL. In particular for infants in their second year of life lower scores of cognitive development (MSEL) were related to lower height for age scores.