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PubMed1997

Reliability and validity of proxy respondent information about childhood injury: an assessment of a Canadian surveillance system.

The reliability and validity of proxy respondent information in the Canadian Hospitals Injury Reporting and Prevention Program surveillance system was assessed. A standardized form was used to collect data on injury date, location, context (activity at the time), breakdown factor (what went wrong), mechanism, product involvement, safety precaution use, and motor vehicle involvement. The test-retest method determined reliability, with the kappa coefficient quantifying agreement between respondent information provided in the emergency department and later during a telephone interview. Of 421 eligible respondents, 325 (77%) completed the telephone interview, with a median time to interview of 33 hours (range 24-70 hours). Agreement was high for all items; kappa coefficients ranged from 0.79 (substantial agreement) to 1.00 (perfect agreement). Reliability was not significantly modified by respondent view of the injury event, age of the child, language of the form, or level of respondent education. Validity was determined by measuring the agreement between respondent information and that provided by an independent witness. Witness information was considered to represent the truth. Of the 140 injury events selected, 92 (66%) had the form completed by both the original respondent and an independent witness. Kappa coefficients were greater than 0.65 for all but one item (safety precaution use), and the positive predictive value of respondent information for item categories whose prevalence was > or = 0.25 ranged from 0.82 to 0.95. The authors conclude that proxy respondent data on childhood injury are both reliable and valid.

Adolescent↗
PubMed2004

Healthy Steps: a case study of innovation in pediatric practice.

Healthy Steps (HS) represents a significant innovation in the way pediatric primary care can be delivered. Based on the standards and principles of Bright Futures and the American Academy of Pediatrics Health Supervision Guidelines, HS enhances and expands traditional pediatric care by including a child development specialist (Healthy Steps specialist) as part of the pediatric practice team. Services offered by this person, typically a nurse, early childhood educator, or social worker, include more time to spend discussing preventive issues during well-child visits, home visits, a telephone information line exclusively addressing developmental and behavioral concerns, new written materials, and more seamless linkages to community resources and parent support groups. The original HS cohort consisted of 15 pediatric practices in a variety of settings (private practices, health centers, pediatric training programs). Evaluated for the effects of HS on their family were 3737 intervention and comparison families. HS families received significantly more preventive and developmental services, compared to families in the control group. HS families were also less likely to be dissatisfied with their pediatric primary care. Additionally, HS had a positive impact on parenting in many areas including adherence to health visits, nutritional practices, developmental stimulation, appropriate disciplinary techniques, and correct sleeping position. Other outcome measures (such as initiation or duration of breastfeeding, child development knowledge, sense of competence, and reports of child language development at 2 years of age) did not differ between intervention and comparison group. Compared to other early childhood intervention efforts, HS offers a comparable positive impact on parenting at a relatively inexpensive cost: an estimated 400 dollars per family per year (compared to 4500 dollars from Early Head Start). Approximately 3 years after the evaluation of HS ended, 10 of the original 24 sites are still in operation, and an additional 24 sites have started up. Although funding and reimbursement remain an important barrier, continued growth of HS suggests an abiding interest in this approach to expand and enhance preventive and developmental care in pediatric primary care.

Child↗
PubMed1993

Identification of children with and without cleft palate from tape-recorded samples of early vocalizations and speech.

Thirty judges (5 speech pathologists, 10 mothers of children with cleft palate, and 15 mothers of noncleft children) listened to 90 tape-recorded samples of early vocalizations/speech obtained from noncleft babies and babies with cleft palate. Each sample was classified by the judges as normal or abnormal. As a group, the speech pathologists classified only 60% of the cleft samples as abnormal and 59% of the normal samples as normal. The cleft and noncleft mother groups, on the other hand, classified 37% and 25% of the cleft samples as abnormal and 59% and 73% of the normal samples as normal. Poor interjudge agreement was evident within and across the three groups of judges. The poor reliability demonstrated by the speech pathologists in identifying babies with unrepaired clefts appeared related more to a difference in interpretation of the perceptual data than an inability to hear salient information.

Age Factors↗
PubMed1992

Intervention and the hearing-impaired child--an evaluation of outcome.

The investigation was performed in order to evaluate the outcome of intervention in preschool age. The material comprises a cohort of 138 children, 76 boys and 62 girls, born during 1970-1980, living in the Copenhagen County at the time of data collection (1987), all suffering from predominantly congenital/early acquired hearing disability (i.e. hearing level greater than or equal to 35 dB HL for the average of 0.5-4 kHz on the better hearing ear). The type of school attended is used as a measure for outcome of preschool intervention. It was demonstrated that 49% attended normal class (speech), 21% attended special units (total communication), and 24% attended the school for the deaf (sign/manual). By subdivision the children (n = 75) with a hearing loss less than 75 dB HL attended normal class in 80%; 7% attended special units. The children (n = 63) with hearing loss greater than or equal to 75 dB HL attended normal class in 11%, special units in 33%, and school for the deaf in 52%. An early identification of the hearing loss was found to facilitate attendance of normal class in the group with a hearing loss less than 75 dB HL. Among the children at the school for the deaf 84% had speaking parents. The frequency of the causes of hearing loss differs significantly in the special units, when compared to the total cohort. It is concluded that the outcome of preschool intervention is related predominantly to the degree of hearing loss; that an early intervention in the group of children with hearing loss less than 75 dB HL facilitates the attendance of normal class; that the frequency of the causes of hearing impairment is different in the special units.

Adolescent↗
PubMed1998

Nasalance levels in the speech of normal Australian children.

OBJECTIVE: Nasalance scores have been shown to depend on the regional dialect of English spoken. Australian cleft palate clinics are increasingly making use of the Nasometer as part of their evaluation of velopharyngeal inadequacy. There are, however, no normative data for Australian English available as reference information. The objective of this study, therefore, was to obtain comprehensive nasalance data for a large group of Australian children, aged 4 to 9 years, for two standard nasalance passages (Zoo Passage and Nasal Sentences) and to investigate any gender or age differences within that age range. PARTICIPANTS: The participants were 245 children (123 female, 122 male) ranging in age from 4 years, 0 months, to 9 years, 3 months. The children were recruited from a variety of schools and preschools across the Sydney metropolitan region. The children all spoke Australian English, and their hearing, articulation skills, and speech resonance were within normal limits. METHOD: Mean nasalance scores were obtained for two speech passages that are used as standards for Nasometer testing (Zoo Passage and Nasal Sentences). In addition, the nasalance data were analyzed for any gender and age dependence, using separate analyses of variance for each speech passage. Five consecutive age groups were used to examine age dependence (4-, 5-, 6-, 7-, and 8-year-old children). RESULTS: A mean score of 13.1 (SD, 5.9) was obtained for the Zoo Passage, and a mean of 59.6 (SD, 8.1) for the Nasal Sentences. The analysis of variance results indicated that, at a probability level of p < 0.01, there was no statistically significant age or gender dependence for either speech passage. CONCLUSION: These normative nasalance data for children who speak Australian English will provide important reference information for clinicians who assess nasality disorders in cleft palate clinics in Australia.

Age Factors↗
PubMed2005

Analysis of distortions in children with and without phonological disorders.

PURPOSE: To verify using 4 different tests the incidence of distortions in children with and without phonological disorders. METHOD: Forty children between 4 and 10.2 years of age, divided into 2 groups: 20 with normal development and 20 with phonological disorders. All children underwent the phonology tests of the Child Language Assessment ABFW and 2 spontaneous speaking tests to assess for phonologic alterations. After recording, the data were printed, analyzed, and classified according to the distortions. Nonparametric (Mann-Whitney) statistical analysis was performed with the significance level being set at P <.05. RESULTS: The phonological disorder group had significantly more occurrences of distortions in all tests compared to the control group (naming, P = .04; imitation P <.001; spontaneous speaking 1, P = .01; and spontaneous speaking 2, P = .002. The Pearson correlation coefficients of the distortion occurrences among the 4 tests were high. CONCLUSION: The phonological disorder group presented a greater number of distortions in all tests. The most frequent ones were /s, z, 3/ and the variability found within the phonological disorder group was very high. The children in this group had unstable phonological systems and so presented a high number of different distortions. Regarding the evaluation of the phonologic system, all the tests were good evaluation methods since the correlations between them were high.

Case-Control Studies↗
PubMed2001

Assessment of vocabulary development in children after cochlear implantation.

OBJECTIVES: To assess vocabulary development in children following cochlear implantation and to evaluate the effect of age at implantation on performance. DESIGN: Retrospective study (mean follow-up, 3(1/2) years). SETTING: Tertiary center. PATIENTS: Children with prelingual deafness provided with a cochlear implant between 1988 and 1999, who serially performed the Peabody Picture Vocabulary Test-Revised (60 patients) and the Expressive One-Word Picture Vocabulary Test-Revised (52 patients). The children were subgrouped into those receiving implants at younger than 5 years and at 5 years or older. OUTCOME MEASURES: Age-equivalent vocabulary test score and gap index (chronological age minus the age-equivalent score, divided by the chronological age at the time of testing) were calculated. For each test, the following were performed: calculation of rate of change for age-equivalent score; comparison of earliest and latest gap indices means (the cohort and intergroup and intragroup comparison); and multiple regression analysis demonstrating the effect of age at implantation, sex, communication mode, etiology of deafness, and residual hearing on the rate of vocabulary development. RESULTS: Expressive and receptive vocabulary development rates were 0.93 and 0.71 (age-equivalent scores per year), respectively. Subgrouped by age at implantation, the children's rates (for both vocabularies) were not statistically different (Peabody Picture Vocabulary Test-Revised, P =.90; Expressive One-Word Picture Vocabulary Test-Revised, P =.23). The global latest gap indices were significantly less than the earliest (Peabody Picture Vocabulary Test-Revised, P =.048; Expressive One-Word Picture Vocabulary Test-Revised, P<.001), indicating an improvement in age-appropriate vocabulary development over time. The age subgroups demonstrated similar results, except for the younger group's receptive gap index. On multiple regression analysis, the significant predictive variables were residual hearing (Expressive One-Word Picture Vocabulary Test-Revised) and male sex and oral communication mode (Peabody Picture Vocabulary Test-Revised). CONCLUSIONS: Children with cochlear implants developed their vocabularies at rates that were sufficient to prevent an increase in their gap indices as related to ideal scores at testing. A late age at implantation does not singularly preclude beneficial development of vocabulary.

Age Factors↗
PubMed1976

Children with superior intelligence at 7 years of age: a prospective study of the influence of perinatal, medical, and socioeconomic factors.

Perinatal and medical information, growth, and the social background of 258 children who, in a prospective study, had superior intelligence at 7 years of age were reviewed. The subjects were divided into three categories on the basis of the results of psychological evaluation at age 7. Comparisons were made between those with superior (intelligence quotient greater than or equal to 120), average (IQ between 80 and 119), and low intelligence (IQ less than or equal to 79). A favorable parental social and educational background was the best correlate of superior intelligence in the children. Larger head size from 1 year of age was an early finding associated with superior intelligence. Greater height and weight, from 4 years of age were later findings. Correlations between psychological performance at ages 4 and 7 years were statistically significant. Perinatal factors and medical complications did not affect the intellectual status of children with superior intelligence.

Adolescent↗
PubMed2003

Behavioral inhibition and behavioral activation in young children: relations with self-regulation and adaptation to preschool in children attending Head Start.

We examine a parent-report version of the measure of behavioral inhibition and behavioral activation of Carver and White (1994), the BIS/BAS scales. Participants included 42 children (mean age = 4 years, 9 months) attending Head Start programs. Information was collected on aspects of physiological and cognitive regulation, temperamental emotionality, BIS/BAS sensitivity, and teacher report of social competence and on-task behavior in the classroom. Physiological regulation was assessed by cardiac vagal tone and was measured during a baseline period and during the administration of a mildly effortful cognitive task. Cognitive regulation was assessed by executive function and was measured using two tasks that require children to inhibit a prepotent response while remembering and executing the rule for correct responding. Parents reported on behavioral inhibition and behavioral activation and aspects of child negative emotionality associated with fear and anger. Results indicated that the BIS scale was positively related to teacher reported social competence but negatively related to on-task behavior. Associations between the BIS and each of the outcome variables were independent of relations of physiological and cognitive regulation to outcomes and were present when relations between fearful emotionality and the outcomes were not. No relations were observed between any of the BAS scales and the outcome measures. Results recommend the application of neurobiological and psychophysiological approaches to the study of children's adaptation to preschool.

Adaptation, Psychological↗
PubMed2001

Conversational repair in pediatric epilepsy.

This study examined if children with complex partial seizures disorder (CPS) and primary generalized epilepsy with absence (PGE) were impaired in the use of self-initiated repair during a conversation compared to normal children. Transcriptions of speech samples of 92 CPS, 51 PGE, and 65 normal children, ages 5-16 years, were coded for self-initiated repair according to Evans (1985). The WISC-R, a structured psychiatric interview, and seizure-related information were obtained for each child. We found impaired use of repair in both the CPS and PGE groups compared to the normal subjects. The CPS patients, particularly those with a temporal lobe focus, overused self-initiated corrections of referents and syntax compared to the PGE and normal subjects. The CPS and PGE patients with frontal lobe involvement underused fillers compared to the normal children. These findings provide additional evidence that both CPS and PGE impact the ongoing development of children's communication skills.

Adolescent↗
PubMed1993

Four-year-olds' disambiguation of action and object word reference.

Preschool-age children show a very strong tendency to map a novel noun onto an unfamiliar rather than a familiar object. This so-called disambiguation effect has been interpreted as evidence that youngers expect object labels to be mutually exclusive. In Experiment 1, 4-year-olds were observed to map a novel verb onto an unfamiliar action about twice as often as they mapped it onto a familiar one. When the unfamiliar action had been preexposed, but the familiar one had not, the mapping preference was eliminated. In Experiment 2, 4-year-olds mapped a novel noun onto an unfamiliar object about five times as often as they mapped it onto a familiar object, and this tendency was not affected by preexposure. Even when action embedding and question complexity were controlled, the disambiguation effect was stronger for object than for action words. An account is presented in which two lexical principles, Mutual Exclusivity and Feeling of Novelty, are hypothesized to apply differently to action than to object words.

Child Language↗
PubMed1994

Children's hypotheses about word meanings: is there a basic level constraint?

We tested the hypothesis that a basic level constraint guides preschool children's hypotheses about word meanings. In the first study, a puppet labeled pictures with novel words. Three-, four-, and five-year-olds then chose referents for the novel word from a set of pictures. A pretest allowed us to select three sets of items for each subject: items that were familiar at the subordinate and basic level (e.g., poodle-dog), items that were familiar at the basic level but not at the subordinate level (e.g., sedan-car), and items that were unfamiliar at both levels (e.g., manta-ray). Contrary to the basic level constraint hypothesis, children tended to interpret novel words (e.g., quadruped) at the basic level only for items where they already knew a basic level name. In a second study, using a simplified procedure, three- and four-year-olds again showed no bias toward basic level interpretations except when translation to familiar basic level words was possible. A third study controlled for the possibility that our use of multisyllabic words might have biased children against basic level interpretations; despite the use of single-syllable nonsense words, children in this study again did not favor basic level interpretations. In the final two studies, adults' ratings of picture similarity and children's judgments in a triad task confirmed that the differences in children's basic level biases could not be accounted for by differences in similarity across the item types. Taken together these results suggest that although other constraints on word meaning may be in place, preschoolers are flexible in interpreting new words at different hierarchical levels.

Child↗
PubMed1999

Realist errors in children's responses to pictures and words as representations.

In three experiments we examined the judgments made by 3- to 4- year-old children about out-of-date physical representations which no longer matched their referents. The referent was a doll wearing a sticker, and the sticker was swapped for a different one after a picture had been drawn of the initial state of affairs (Experiments 1 and 2) or after the name of the doll and its original sticker had been written down (Experiment 3). We confirmed previous findings of realist errors in identity judgments for pictures and showed also that children tended to misidentify the name of a sticker in a written list to match a change to its referent. Thus, realist errors are not confined to representations which are iconically similar to their referents. Furthermore, children also judged incorrectly that the pictures and words had actually been changed, indicating that realist errors to external representations extend to operations performed on their referents as well as to their identities.

Child Language↗
PubMed2000

Preschool children's use of trait labels to make inductive inferences.

One hundred one preschool children (ages 3 years 5 months to 4 years 10 months) participated in 3 studies examining the tendency to use verbal labels versus appearance information in making novel inductive inferences. A triad task analogous to that of S. A. Gelman and E. M. Markman (1986) was devised. Participants learned a different property for each of 2 children, and were asked which of the properties was true of a third child. One of the first 2 children was identified with the same label as the third child (e.g., both were labeled as shy) but looked different, and the other was identified with a different label than the third child but looked very similar. Results of Study 1 revealed that participants tended to use the trait labels, rather than superficial resemblance, in making psychological inferences. Studies 2 and 3 suggest that these results cannot be attributed to biases on the task. Study 4 provided a replication of the results of Study 1 in a context in which appearance information was explicitly pointed out and in which different trait labels were used.

Child Behavior↗
PubMed2005

Acoustic aspects of the formation of speech in children in the third year of life.

This study covers the third year of life as part of a longitudinal investigation of the establishment of speech in Russian children performed on the basis of listener, phonetic, and instrumented acoustical analysis. The present report addresses the establishment of those additional acoustic and phonetic characteristics in children's speech which allow speech recognition. This is the first instrumented analysis in Russian children with statistical assessment of the dynamics of vowel formants in children's words, of the establishment of characteristics (stress, lack of stress), opposition (palatalization, lack of palatalization of consonants), and voice onset time for plosive consonants. The results showed that recognition of children's words by listeners with a high probability of success resulted from the formation of a system of acoustically stable properties in the children's speech which together provide informational adequacy for verbal communication.

Adult↗