Difficulties In Young Children Research Articles

Behavioral Training For Pill-Swallowing Difficulties In Young Children with Autistic Disorder

Difficulty with swallowing pills is a common problem, leading to noncompliance with treatment recommendations. Many young children with autistic disorder (AD) who also show comorbid symptoms associated with attention deficit hyperactivity disorder (ADHD) have difficulty swallowing pills. This pilot study describes our experience in teaching pill-swallowing skills to 4 children with AD who also had comorbid symptoms associated with ADHD. Four children, aged 5-;6.5 years, were enrolled for pill-swallowing training, 3 of the children were Caucasian boys and 1 child was a Hispanic girl. All children met the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) diagnostic criteria for AD and ADHD-like symptoms. The children's verbal IQ ranged from 54-96, their nonverbal IQ ranged from 85-107, and the Preschool Language Scale-3 total language score ranged from 50-98. At the end of the pilot study, 2 children (50%) successfully learned to swallow the study capsules, 1 child (25%) was able to swallow the study capsules with the behavior therapist but had difficulty with the caregiver, and 1 child (25%) made slow progress and was withdrawn by the caregiver in favor of proceeding with a crushable medication for clinical care. Caregivers were appreciative of the opportunity for this short intervention. Behavioral training for pill swallowing may be indicated in some circumstances in young children with AD and/or other developmental disorders.

Elevated Glomerular Filtration Rate (GFR) in Young Patients with Sickle Cell Anemia.

Nephropathy is a well-recognized complication of sickle cell anemia (SCA) that is associated with considerable morbidity and mortality. Sickle nephropathy begins early in life, with glomerular damage characterized by hyperfiltration and glomerulomegaly, as well as tubular damage characterized by hyposthenuria. School-aged children can develop proteinuria and one-third of patients will eventually develop chronic renal failure as adults. Among the earliest markers of sickle nephropathy is glomerular hyperfiltration, typically measured as an elevated glomerular filtration rate (GFR). To date, however, no formal measurements of GFR have been published in young children with SCA, and its feasibility and interpretation in this age group have not been demonstrated. As part of a prospective, single-institution, IRB-approved open-label protocol using hydroxyurea in toddlers with SCA, the pre-treatment GFR was measured using plasma clearance of 99-Tc DTPA. The goal of this procedure was to determine the onset of hyperfiltration among young children with SCA, to identify risk factors associated with its onset, and to investigate the potential benefit of hydroxyurea in improving or preserving renal function. After intravenous injection of the DTPA radiotracer, 3–5 mL aliquots of venous blood were removed at 1 and 3 hours post-injection and analyzed for plasma radioactivity. Because DTPA is filtered at the glomerulus without substantial metabolism, secretion, or reabsorption, the plasma clearance allows an accurate and precise GFR measurement. The GFR was also estimated using the Schwartz equation, where GFR = height (cm) x k/serum creatinine, with k=0.55 for children between ages 1 and 12 years. A total of 13 children with HbSS (3 females, 10 males) were enrolled in this study, none of whom had laboratory evidence of renal disease at the time of evaluation. One child could not complete the DTPA study due to inadequate venous access. For the remaining 12 children, baseline GFR measurements were performed at age 3.0 ± 0.8 years (range 1.7 to 4.4 years) without complications. The average GFR measurement (mean ± SD) by DTPA clearance was 140.3 ± 20 mL/min/1.73m2, median 133 mL/min/1.73m2, range 117.9 to 172.7 mL/min/1.73m2 (normal 100 ± 20 mL/min/1.73m2). The baseline DTPA GFR measurement was elevated above 150 mL/min/1.73m2 in 5 of the 12 children, including 4 of 7 over age 3 years, although there was no signfiicant correlation between GFR and age or fetal hemoglobin. GFR estimates by the Schwartz equation were modestly correlated with the DTPA GFR measurements (R2 = 0.32, p = 0.055) but were typically slightly higher than the corresponding DTPA measurements. Three children who completed 24 months of hydroxyurea therapy had post-treatment DTPA clearance studies that revealed stable GFR measurements (average increase = 5.6 mL/min/1.73m2). These results illustrate that GFR measurement by DTPA clearance can be performed without difficulty in young children with SCA, requiring only peripheral intravenous access. Glomerular hyperfiltration as a manifestation of renal damage begins early in life for children with SCA, with elevated GFR values observed in the toddler age range. The Schwartz equation provides an estimate of GFR but probably cannot be used in lieu of the DTPA clearance study. Treatment with hydroxyurea may preserve renal function by abrogating further GFR hyperfiltration.

Prevalence of persistent primary reflexes and motor problems in children with reading difficulties

It has been shown that some children with reading difficulties have underlying developmental delay and that this may be related to the persistence of primary reflexes. This study investigated the prevalence of persistent primary reflexes in the ordinary primary school population and how this related to other cognitive and social factors. Three groups of 41 children were drawn from a representative, cross-sectional sample of 409 children (aged 9-10 years) attending 11 ordinary primary schools in N. Ireland. The three groups represented the bottom, middle and top 10% respectively of readers from the total sample population. The relative persistence (on a scale of 0 to 4) of the Asymmetrical Tonic Neck Reflex (ATNR) and the prevalence of motor difficulties were assessed for these 3 groups. The rôle of 5 predictor variables (verbal IQ, social deprivation, sex, month of birth and religious affiliation) in determining the reading level of the total sample was also investigated. It was found that the lowest reading group had a significantly higher mean level of ATNR (1.56 [95% CI 1.22-1.90]) compared with the middle reading group (0.56 [0.22-0.90]) and the top reading group (0.59 [0.25-0.92]). 17% of children in the lowest reading group had extremely high levels of the ATNR while 24% showed no presence of ATNR. This contrasted with 0% and 66%, respectively for both middle and top reading groups. It was also found that there was a significant difference between the lowest reading group and the top reading group on a standardised test of motor ability. Furthermore, there was evidence that ATNR persistence but not motor ability was associated with the sex of the child with boys, in particular, at risk. There was no evidence that ATNR persistence or motor ability was significantly associated with social deprivation. It was also found that there were no significant differences between dyslexic and non-dyslexic children with reading difficulties in motor (including balance) performance. This study highlights the high levels of primary reflex persistence in children with reading difficulties and it provides further evidence of the association between reading difficulties and movement difficulties in young children. However, while the implications for intervention are discussed, it is stressed that the persistence of primary reflexes cannot be used as a causal model for reading difficulties, including dyslexia.

Biliteracy and Second-Language Learners

Biliteracy and Second-Language Learners

Young children's difficulty with adjectives modifying nouns

In two experiments we tested the hypothesis that children have a basic problem in mastering the attributive relation because it involves a two-step logical-semantic integration process of the head-noun and the attributive adjective. Hebrew-speaking children were asked to interpret highly familiar adjective-noun combinations by selecting a photo that depicted the correct referent. In Experiment I there were four choices for each adjective-noun pair: correct object/correct property, correct object/wrong property, wrong object/correct property, wrong object/ wrong property. 170 children (1.6-4.4) participated. Analyses of errors and spontaneous self-corrections indicated that children initially ignored the adjective and based their responses only on the noun. In Experiment 2, in addition to the 4-choice condition, there were two simpler conditions with only two choices: the correct object/correct property, and either the correct object/wrong property, or the wrong object/correct property. 30 children (1.9-4.11) were tested. The children, and in particular the lowest-scoring third of the sample, did significantly better in the 2-pictures conditions. The results suggest that young children do possess a basic adjective vocabulary and can use it in simple discriminations, but have a considerable difficulty in integrating the information furnished by the adjective with information furnished by the noun.

ACCELERATING STRUGGLING READERS' PROGRESS: A COMPARATIVE ANALYSIS OF EXPERT OPINION AND CURRENT RESEARCH RECOMMENDATIONS

In this article, we review the findings of Rona Flippo's (1998) “Expert Study” within the comparative context of recently published reading research reports such as the National Reading Panel report (National Institute of Child Health and Human Development, 2000) and Preventing Reading Difficulties in Young Children (Snow, Burns, & Griffin, 1998). Does expert opinion square with research recommendations for helping young, struggling readers? Instructional practices that the experts categorized as either “making learning to read difficult” or “facilitating learning to read” are distilled into summary form. Areas of convergence and divergence between “expert opinion” and recent reading research recommendations are identified and discussed. Finally, recommendations of the “Expert Study” and recommendations of recent reading research reports are synthesized into a single set of instructional recommendations for accelerating the progress of struggling readers.

Young children's harmonic perception.

Harmony and tonality are two of the most difficult elements for young children to perceive and manipulate and are seldom taught in the schools until the end of early childhood. Children's gradual harmonic and tonal development has been attributed to their cumulative exposure to Western tonal music and their increasing experiential knowledge of its rules and principles. Two questions that are relevant to this problem are: (1) Can focused and systematic teaching accelerate the learning of the harmonic/tonal principles that seem to occur in an implicit way throughout childhood? (2) Are there cognitive constraints that make it difficult for young children to perceive and/or manipulate certain harmonic and tonal principles? A series of studies specifically addressed the first question and suggested some possible answers to the second one. Results showed that harmonic instruction has limited effects on children's perception of harmony and indicated that the drastic improvement in the perception of implied harmony noted approximately at age 9 is due to development rather than instruction. I propose that young children's difficulty in perceiving implied harmony stems from their attention behaviors. Older children have less memory constraints and more strategies to direct their attention to the relevant cues of the stimulus. Younger children focus their attention on the melody, if present in the stimulus, and specifically on its concrete elements such as rhythm, pitch, and contour rather than its abstract elements such as harmony and key. The inference of the abstract harmonic organization of a melody required in the perception of implied harmony is thus an elusive task for the young child.

Learning to Read in Kindergarten: Has Curriculum Development Bypassed the Controversies?

The prevailing assumption has been that a formal reading curriculum is inappropriate for kindergartners. However, district staff members and teachers in the Northern Lights School Division of Alberta were convinced that a nurturing approach to teaching reading would not endanger the and might in fact prevent some of them from encountering academic difficulties in the primary grades and beyond. WE'LL BEGIN with a simple proposition: let's teach our kindergarten students to read. We already know how to do it, so why don't we? Within schools and school districts, decisions about curriculum and instruction in literacy have to be made on the basis of present knowledge and judgment. Such decisions can't wait until all controversies have been resolved and all the evidence is in with regard to available options. In the case of kindergarten, decisions about curriculum are complicated by debates about whether there should be a formal curriculum in reading or whether the components of the kindergarten program should be designed to develop the dimensions of emergent literacy only. But research on how to teach beginning readers grows apace, and we believe that we should take advantage of it. In the Northern Lights School Division in Alberta, Canada -- a district of 20 schools and about 6,500 students -- we decided to design a formal reading curriculum for kindergarten, prepare the teachers to implement it, and conduct an action research study of student learning. Our decision stemmed from the judgment that research on beginning reading had reached the point where an effective, engaging, and multidimensional curriculum could be designed and implemented without placing our students at risk in the process. And if such a curriculum proved successful, it seemed likely that the much-publicized gap would be reduced. Over the past five years in Northern Lights, we (we includes the superintendent, Ed Wittchen; the trustees; and representative teachers and administrators) had concentrated on the development of nets for low-achieving students at the second-grade level and in grades 4 through 12.1 We based the two curriculum designs on strands of research on beginning literacy for young and for older struggling readers and writers.2 Currently, in both safety net curricula, about three-fourths of the students are progressing well and narrowing the distance between themselves and the district's average students. The others are holding their own. The need for the safety net programs and our observation of the frustration and hopelessness experienced by students who needed help caused us to consider the K-3 literacy curricula and to explore whether we could strengthen them and so reduce the need for the later safety nets. We take seriously the statement by Connie Juel, who, in reacting to the National Research Council report Preventing Reading Difficulties in Young Children, wrote that children who struggle in vain with reading in the first grade soon decide that they neither like nor want to read.3 Our teachers who work in the safety net programs confirm that their job is half instruction and half therapy. For some decades, because of the concerns about not generating demands beyond the capabilities of the students or introducing students to reading in unpleasant ways, there has been a dearth of studies on formal reading programs for kindergarten. A few studies did suggest that formal reading programs in kindergarten could have positive effects that lasted throughout schooling. For kindergarten interventions as such, though, we had to go back to Delores Durkin's work of 30 years ago. In building a kindergarten curriculum, we were not able to draw on a body of recent research on, say, alternative kindergarten reading programs or dimensions of learning to read at age 5. We drew on the literature relevant to learning to read in grades 1 through 3 and above. …

Facilitating Constructive Parent-Child Play

Research has shown that young children's behavioral and/or emotional difficulties are closely related to their attachment experience. Various presenting issues arise when parents consistently fail to meet their children's attachment needs. This article describes the rationale for the provision of a secure base for young children in the family play therapy context, with the goal of resolving presenting issues. A conceptualization based on Bowlby's attachment theory is offered. A three-stage clinical intervention, joining and assessment, modeling constructive play, and facilitating parent-child constructive play, is presented. It is concluded that the provision of a secure base should become a background concept in clinical work.

The role of perseveration in children's symbolic understanding and skill

AbstractIn the first few years of life, children become increasingly sensitive to the significance of a variety of symbolic artifacts. An extensive body of research has explored very young children's ability to use symbol‐based information as a guide to current reality. In one common task, for example, children watch as a miniature toy is hidden in a scale model, and are then asked to retrieve a larger version of the toy from the corresponding place in the room itself. Two‐and‐a‐half‐year‐old children perform very poorly in most versions of this task. Their most common error is to perseverate; that is, they search again at the location where the toy was last hidden. Two studies examined the degree to which 21/2‐year‐olds’ high rate of perseveration and poor performance stem from problems with inhibitory control. Results showed that problems with inhibitory control contribute very little to 21/2‐year‐old children's difficulty with the task. Instead, the results confirm young children's great difficulty appreciating and exploiting symbol–referent relations.

The relation between desire and false belief in children's theory of mind: no satisfaction?

Belief and desire are commonly assumed to be the core mental states needed to understand others' behavior. Few studies, however, have investigated both. The current studies assessed whether young children's difficulty with false belief can be explained by desire's dominance over belief, as J. A. Fodor's (1992) nativist theory and the theory theory (K. Bartsch & H. M. Wellman, 1995) claim, and examined the processes underlying children's understanding of desire. Desire inferences of 3- to 5-year-olds were compared with false-belief responses in 4 experiments. For the 3-year-olds, no correspondence was found between desire and belief, suggesting that desire cannot explain young children's difficulty with false belief and that desire relies on different cues than does belief. The findings indicate that studying children's understanding of desire is important for forming an accurate description of theory of mind and for evaluating the different theories of its development.

Children Placed at Risk for Learning and Behavioral Difficulties

Over the past 2 decades, a substantial knowledge base has accumulated about the fundamentals of young children's learning difficulties and behavioral problems. This information provides educators with powerful and practical information about how to identify children in need of intervention and how to ensure successful school experiences for all learners. In addition, a growing body of research is beginning to shed light on how to effectively incorporate empirically supported approaches into daily practices. This article describes a school-wide system of early identification and intervention for children placed at risk for school success and discusses how schools might implement the recommendations offered in the literature.

Children's understanding of the distinction between intentions and desires.

Much of the previous research on children's understanding of intentions confounded intentions with desires. Intentions and desires are different, in that a desire can be satisfied in a number of ways, but an intention must be satisfied by carrying out the intended action. Children 3 through 7 years of age and adults were presented with situations in which intentions were satisfied but desires were not, or vice versa, in a story-comprehension task (N = 71) and a target-hitting game (N = 45). Although 3- and 4-year-olds were unable to differentiate desires and intentions consistently, 5- and 7-year-olds often matched the adult pattern. Younger children's difficulties in understanding intentions are discussed in terms of their use of a desire-outcome matching strategy and the representational complexities of intentions.

At What Age Should Children Enter Kindergarten? A Question for Policy Makers and Parents

At What Age Should Children Enter Kindergarten? A Question for Policy Makers and Parents

Science informing policy: The National Institute of Child Health and Human Development's contribution to reading.

As pediatricians who have devoted our entire professional lives to the care of children and young adults with reading difficulties, we must respond to the misinformed commentary by Strauss1 that appeared in the January 2002 issue. It is difficult to understand how in the year 2002 and in the prestigious journal Pediatrics someone can argue against criteria for scientific research that are the universal “gold standard.” And yet, taking a giant step backwards, Strauss argues against the scientific method and against accountability in education. Specifically, Strauss criticizes the National Institute of Child Health and Human Development (NICHD) research for insisting that treatment efficacy for reading instruction be based on “experimental, not descriptive” studies. His antipathy toward experimental research is based on the “fact that the latter [descriptive] methodology is widely accepted in reading research …” Here, Strauss is partially correct; until quite recently, research in reading instruction was often descriptive. This was unfortunate because an experimental or quasi-experimental design is the only type of research design that can specifically address the question of cause and effect, that is, which reading program is most effective in teaching children to read. The descriptive methodology that Strauss advocates is not appropriate to address the question of causality and thus lacks the quality of trustworthiness that modern science and medicine demand. Within the past decade there has been an extraordinary change; largely through the vision and persistence of the NICHD and particularly, Reid Lyon, research in reading is now held to the same rigorous standard expected of research affecting other important disorders of children. Reading research, including but not limited to that conducted by NICHD-funded investigators, has recently been thoroughly and rigorously reviewed by 2 national bodies. The first is the Committee on the Prevention of Reading Difficulties in Young Children, sponsored by … Address correspondence to Sally E. Shaywitz, MD Department of Pediatrics, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510-8064. E-mail: sally.shaywitz{at}yale.edu

Challenges in managing sleep problems in young children

Ramchandani and colleagues have systematically reviewed trials of interventions for the 2 most common sleep concerns in children younger than 5years : delayed sleep onset and problematic night waking. As the authors note, there is a relative paucity of well-controlled and methodologically sound studies of these interventions. This paucity reflects the difficulties in conducting this type of research, and it leads to difficulty in translating study results to the clinical setting. Methodologic weaknesses in many of these studies include small sample size, the failure to include a control group, and reliance on subjective parental reporting to assess efficacy. In addition to these flaws in study design, a variety of other factors could have influenced treatment outcome, including individual differences in child temperament, educational level of the parent, and the presence or absence of marital difficulties. It is therefore not surprising that the more “generic” approaches, which failed to include a behavioral program tailored to the individual family or to address potential barriers to compliance with the treatment plan, were generally associated with worse clinical outcomes. In weighing the likelihood of success of any of the treatment methods discussed for an individual patient, the clinician must take these variables into account. In complex cases, referral to a sleep disorders center or a mental health professional is entirely justified. The use of medication to treat childhood behavioral problems is highly controversial. This review addresses the use of sedative medication to treat sleep problems in young children, either alone or in combination with behavioral management. There is widespread concern that medication is being used inappropriately for treating a wide range of behavioral difficulties in young children. Anecdotal evidence suggests that both over-the-counter and prescription sedatives are commonly used for pediatric sleep problems in theUnited States, even in infants. For example, in a recent survey of pediatric practitioners in the northeastern United States, we found that over 20% of the practitioners were at least occasionally recommending diphenhydramine(Benadryl) at bedtime as a treatment for night terrors, a practice not based on empirical evidence.1 Clonidine, analpha agonist with sedative properties, is used by child psychiatrists for treating delayed sleep onset in children, despite reports of potentially serious and even fatal cardiovascular side effects.2 Although the study by Ramchandani and colleagues suggests that the addition of sedative medication at the initiation of a behavioral treatment program might improve outcome, perhaps through improving parental compliance, they found little evidence supporting the use of medication as an isolated method of treatment, especially on a long-term basis. In addition, such treatment practices may implicitly encourage parents to seek out pharmacologic solutions for their child's behavioral problems, instead of instituting a more labor-intensive but ultimately more successful behavior management program. Finally, it is worth emphasizing that the definitions of sleep onset and night waking problems in young children are, to a certain extent, culturally determined. Our society places a high value on early acquisition of independent skills by children. This promotes the belief that“self-soothing” in infants is an important developmental milestone and that co-sleeping, or sleeping with a parent or sibling, is not an acceptable practice because it prevents the infant from becoming independent.Health care practitioners should be sensitive to potential cultural and individual family differences in the perception of sleep behaviors in children and take these into account in preventive and management strategies.

The determinants of arithmetic skills in young children: some observations.

The cause or causes of arithmetic difficulties in young children are manifold. The condition has its origins in a set of complex disorders and may be due to genetic factors, developmental delays, experiential limitations, language problems, and perceptual, motor, memory and other cognitive weaknesses. Other factors which may cause the disorder are inappropriate and ineffectual instructional practices. Anxiety and unfavourable attitudes towards the subject may influence mastery of arithmetic attainment in young children.

Media Reviews: Preventing Reading Difficulties in Young Children

The alarming incidence of reading failure is one of the most prevalent concerns for our nation. Growing numbers of students are reaching upper elementary, middle school, or high school unable to read at grade level. To complicate matters, divergent views in research, etiology, characteristics, prevention, intervention, and instruction have led to marked controversy in the field of reading over the past 25 years-a controversy termed the Wars to denote its intensity. Preventing Reading Difficulties in Young Children focuses on the increasing numbers of children with reading difficulties in America's schools as well as addressing the conflicts in the field of reading. The book is an essential resource for all professionals, including those interested in developing prevention and intervention reading programs for students with behavioral disorders (BD), a large number of whom have reading difficulties. The authors, chosen for their special competencies by the National Research Council, were charged with synthesizing the extensive body of reading research as well as developing a consensus on the prevention of and interventions for reading difficulties in young children. The focus included children from birth through grade 3 in special and general education settings. The goals were to (a) comprehend a rich but diverse research base; (b) translate the research findings into advice and guidance for parents, educators, publishers, and others involved in the care and instruction of the young; and (c) convey this advice to the targeted audiences through a variety of publications, conferences, and other outreach activities. The authors reviewed research from experimental investigations, qualitative studies, correlational studies, and various quasi-experimental design studies in its efforts to address project goals. In so doing, they agreed upon a definition of reading as a process of getting meaning from print, using knowledge about the written alphabet and about the sound structure of oral language for purposes of achieving understanding. This book is divided into four sections. Part I introduces the challenges of reading literacy and provides an overview of the reading process. Chapter 1 includes information about the rising demand for literacy, societal and technological challenges, and the complexities of the English language. The sources of reading difficulties are reviewed, and the demographics of correlates to reading difficulties are introduced, including socioeconomic status, ethnicity, culture, urban/suburban schools, and students from families with limited English proficiency and/or nonstandard English dialects. Chapter 2 describes the process of learning to read, taking into consideration the biological, cognitive, and instructional factors that are important as predictors for reading success and/or failure. The authors provide an overview of how children develop language and literacy skills before they are introduced to formal instruction. Research specific to children's language development, phonological awareness, and literacy development is presented, as well as the characteristics of skilled readers specific to comprehension and word identification. The chapter describes the processes of emerging literacy and transition to school for the beginning reader; learning to identify words in print; and gaining fluency, automaticity, and understanding. Tables detail the reading accomplishments of children from kindergarten through grade 3. Part 11 describes the population of children who have reading difficulties and the factors that may predict either success or failure in reading. The authors point to predictors that are (a) intrinsic to the individual and identifiable in assessment procedures, (b) identified in the family environment, and (c) associated with the larger environment of the child (e.g., neighborhood, school, community). Chapter 3 examines issues in identification and measurement, including (a) a categorical model versus a dimensional model for estimating reading difficulties; (b) specific groups of students who are not viewed as having legitimate reading problems but who should be included in estimates; and (c) the use of criterion-referenced assessment as opposed to norm-referenced assessment to identify reading difficulties. …

What Speech-Language Pathologists Need To Know About Early Reading

The National Research Council report, Preventing Reading Difficulties in Young Children, reviews research on early reading and recommends prevention strategies and optimal interventions for reading difficulties. Since speech-language pathologists often treat children whose language problems co-occur

Critical Issues: Reading and the New Literacy Studies: Reframing the National Academy of Sciences Report on Reading

This article is a reflection on the recent report from the National Academy of Sciences, Preventing Reading Difficulties in Young Children. This report, typical of many recent discussions of early reading instruction, centers on psycholinguistic aspects of reading having to do with phonological awareness, decoding, word recognition, and literal comprehension. I seek to reframe the report from the perspective of the New Literacy Studies, an interdisciplinary effort that takes a sociocultural approach to language and literacy. My approach is to stress tensions internal to the report itself as pressure points around which one could imagine a different sort of report being written, one more in the spirit of the New Literacy Studies. I take up issues such as whether or not there is a consensus in the reading field; the nature of the “literacy crisis”; relationships among reading, poverty, racism, and culture; whether or not technology leads to higher literacy demands; learning to read as against learning content; and the connections among phonological awareness, early language abilities, and the use of specific genres and registers in school.