Cognitive predictors of sentence comprehension in children with and without developmental language disorder: Implications for assessment and treatment

Abstract

Purpose: This paper summarises the clinical ramification of a large-scale study of the direct and indirect (mediated) influences of four cognitive mechanisms that are relevant to the comprehension of syntactic structure by school-age children with and without developmental language disorder (DLD).

Method: A total of 117 children with DLD and 117 propensity-matched typically-developing (TD) children completed sentence comprehension tasks and cognitive tasks related to fluid reasoning, controlled attention, speed of processing, phonological short-term memory (pSTM), complex working memory (cWM) and language knowledge in long-term memory (LTM).

Result: Results of confirmatory factor analysis (CFA) indicated that the most salient characteristics of cognitive processing in children with and without DLD were represented by a measurement model that included four latent variables: fluid reasoning, controlled attention, complex WM and language knowledge in LTM. Structural equation modelling (SEM) indicated that complex WM mediated the relationship between sentence comprehension and fluid reasoning, controlled attention and long-term memory for language knowledge.

Conclusion: Our research suggests that the most salient characteristics of cognitive processing in children with and without DLD can be condensed to four cognitive factors: fluid reasoning, controlled attention, complex WM and language knowledge in LTM. We suggest a few measures that clinicians can use to reliably assess these factors, and we summarise a functional intervention programme that is designed to promote the strategic organisation of information in ways that challenge verbal complex WM and LTM processes that support language comprehension and use.     

Effects of respite care for children with developmental disabilities: evaluation of an intervention for at risk families

Respite child care programs that provide temporary child care, support, and referral services to families of children with developmental disabilities are thought to be a critical component of formal social support interventions deemed necessary to promote healthy family functioning and prevent child maltreatment. This study describes sociodemographic characteristics, parenting stress levels, foster care placement, and founded child maltreatment rates in families of children with developmental disabilities who were using respite care services in a rural Midwestern state. Comparison of matched pre- and post-test Parenting Stress Index scores indicated significant decreases in Total Stress scores (t=3.27, df=86, p=0.0016), Parent Domain scores (t=3.55, df=86, p=0.0006), and Child Domain scores (t=2.2, df=86, p=0.02) following provision of respite care. Through logistic regression, it was determined that life stress, social support, and service level were significantly related to the occurrence of child maltreatment during enrollment ( p < 0.05). The investigator suggests that public health nurses can enhance their case management strategies when working with the parents of children with developmental disabilities by monitoring for caregiver burnout in addition to ensuring that the child is receiving care appropriate for his or her level of need.     

A Mobile Game Platform for Improving Social Communication in Children with Autism: A Feasibility Study

Background  Many children with autism cannot receive timely in-person diagnosis and therapy, especially in situations where access is limited by geography, socioeconomics, or global health concerns such as the current COVD-19 pandemic. Mobile solutions that work outside of traditional clinical environments can safeguard against gaps in access to quality care. Objective  The aim of the study is to examine the engagement level and therapeutic feasibility of a mobile game platform for children with autism. Methods  We designed a mobile application, GuessWhat , which, in its current form, delivers game-based therapy to children aged 3 to 12 in home settings through a smartphone. The phone, held by a caregiver on their forehead, displays one of a range of appropriate and therapeutically relevant prompts (e.g., a surprised face) that the child must recognize and mimic sufficiently to allow the caregiver to guess what is being imitated and proceed to the next prompt. Each game runs for 90 seconds to create a robust social exchange between the child and the caregiver. Results  We examined the therapeutic feasibility of GuessWhat in 72 children (75% male, average age 8 years 2 months) with autism who were asked to play the game for three 90-second sessions per day, 3 days per week, for a total of 4 weeks. The group showed significant improvements in Social Responsiveness Score-2 (SRS-2) total (3.97, p <0.001) and Vineland Adaptive Behavior Scales-II (VABS-II) socialization standard (5.27, p  = 0.002) scores. Conclusion  The results support that the GuessWhat mobile game is a viable approach for efficacious treatment of autism and further support the possibility that the game can be used in natural settings to increase access to treatment when barriers to care exist.     

At-home and in-group delivery of constraint-induced movement therapy in children with hemiparesis: A systematic review

Background

Constraint-induced movement therapy (CIMT) is increasingly recognized as an effective therapy for children with hemiparesis. However, the effectiveness of CIMT outside the standard rehabilitation protocol in clinical settings is less known. The aim of this systematic review was to investigate the effectiveness of CIMT conducted at home or in a group.