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This study investigates whether the level of language ability and presence of autistic symptomatology in adolescents with a history of SLI is associated with differences in the pattern of difficulties across a number of areas of later functioning. Fifty-two adolescents with a history of SLI participated. At age 14, 26 participants had a history of SLI but no autistic symptomatology and 26 had a history of SLI and autistic symptomatology. At age 16, outcomes were assessed in the areas of friendships, independence, academic achievement, emotional health and early work experience for both subgroups and for 85 typically developing peers. Autistic symptomatology was a strong predictor of outcomes in friendships, independence and early work experience whilst language was a strong predictor of academic achievement. No significant associations were found for later emotional health.

Background Hearing and vision impairments are highly prevalent in people with dementia and may have a negative impact on quality of life and other dementia-related outcomes. Intervening to optimise sensory impairment and support sensory function may be a means of improving dementia-related outcomes. The SENSE-Cog trial will test whether a home-based multi-part sensory intervention is effective in improving quality of life and other key outcomes in people with dementia and hearing or vision problems (or both) and their companions. Methods This is an European, multi-centre, observer-blind, pragmatic, randomised controlled trial. Three hundred fifty four people with dementia and hearing or vision impairment (or both) and their companions will be randomly assigned to receive either “care as usual” or a multi-component sensory intervention including assessment and correction of hearing or vision impairments (or both), home-based (maximum 10 visits over 18 weeks), therapist-delivered sensory support (that is, adherence to devices; improving the sensory environment (that is, lighting), communication training, and sign-posting to other support agencies). Change from baseline to intervention end (18 weeks) and post-intervention (36 weeks) will be compared between the two arms in the following outcomes: quality of life (primary endpoint), sensory and cognitive functional ability, relationships, mental well-being, health resource utilisation and cost-effectiveness. Discussion This is one of two articles outlining the SENSE-Cog trial. Here, we describe the protocol for the effectiveness of the SENSE-Cog intervention. A parallel and complementary process evaluation will be described elsewhere. If the SENSE-Cog trial demonstrates that the sensory intervention improves outcomes in dementia, we will make a toolkit of training materials, resources and information available to health and social care providers to implement the intervention in routine practice. This will be a significant contribution to the therapeutic management of people with dementia and sensory impairment. Trial registration ISRCTN (Trial ID: ISRCTN17056211 ) on 19 February 2018.

Background Optimising hearing and vision function may be important in improving a range of outcomes for people living with dementia (PwD) and their companions. The SENSE-Cog cross-national randomised controlled trial (RCT) is evaluating the effectiveness of a sensory intervention (SI) to improve quality of life for PwD with concurrent hearing and/or vision impairment, in five European countries. To ascertain how or why the intervention will, or will not, achieve its outcomes, we have designed a process evaluation to explore potential discrepancies between expected and observed outcomes. This will also help us to understand how context may influence the outcomes. Here we describe the protocol for this process evaluation, which is embedded within the RCT. Methods/design We will use a mixed methods approach with a theoretical framework derived from the UK Medical Research Council’s’ guidance on process evaluations. It will include the following: (1) evaluating how key aspects of the intervention will be delivered , which will be important to scale the intervention in real world populations; (2) characterising the contextual issues, which may shape the delivery and the impact of the intervention in different countries; and (3) investigating possible causal mechanisms through analyses of potential moderators and mediators. To avoid bias, we will analyse the process data before the analysis of the main effectiveness outcomes. Discussion This evaluation will provide insight into how the complex SENSE-Cog SI will be tailored, enacted and received across the different European contexts, all of which have unique health and social care economies. The findings will provide insight into the causal mechanisms effecting change, and will determine whether we should implement the intervention, if effective, on a wider scale for PwD and concurrent sensory impairment. Trial registration ISRCTN, ISRCTN17056211 . Registered on 19 February 2018.

Purpose: This study aimed to compare cell phone use (both oral and text-based) by adolescents with and without specific language impairment (SLI) and examine the extent to which language and social factors affect frequency of use. Method: Both interview and diary methods were used to compare oral and text-based communication using cell phones by 17-year-olds: 52 adolescents with SLI and 52 typically developing (TD) peers. Results: Overall, adolescents with SLI are motivated users of mobile technology, and they engage with both oral uses (phoning) and text-based uses (text messaging). However, adolescents with SLI do not exchange text messages as often as their TD peers. Social rather than language factors are associated with frequency of cell phone use in adolescence. Conclusions: These findings indicate that social difficulties restrict text-based uses of cell phones by adolescents with SLI, which can in turn reduce the opportunities that these adolescents have to develop social networks and make arrangements to engage in peer social interaction.

The literacy abilities of 11-year old children with specific language impairment (SLI) were investigated through comparing subgroups with current expressive-only language impairment (E-SLI, n 30), current combined expressive and receptive language impairment (ER-SLI, n 32) and a history of now-resolved language impairment (Resolved-SLI, n 28). The ER-SLI subgroup performed less well than the E-SLI subgroup on measures of single word reading and reading comprehension and in turn the E-SLI subgroup performed less well than the Resolved-SLI subgroup. Further analysis of individual variation within subgroups revealed that all three subgroups had a considerable proportion of individuals with literacy difficulties. In addition, direct comparisons of E-SLI versus ER-SLI subgroups revealed the ER-SLI subgroup to have a significantly larger proportion of children with severe literacy difficulties than the E-SLI subgroup. In contrast, the Resolved-SLI subgroup had virtually no children with severe literacy difficulties. The implications of these findings for practice are discussed.

Contact author: Gina Conti-Ramsden, Human Communication and Deafness, School of Psychological Sciences, The University of Manchester, Humanities Devas Street Building, Oxford Road, Manchester, M13 9PL, United Kingdom. Email: gina.conti-ramsden{at}manchester.ac.uk PURPOSE: Two approaches commonly used for estimating prevalence of language disorders in families were compared. The 1st involved examining a subset of language items from an investigator-based interview used to record parental information on the language and literacy difficulties in relatives. The 2nd was the direct assessment of ability in immediate family using a battery of standardized verbal ability, language, and literacy assessments. METHOD: Using these 2 methods, the prevalence of language and literacy disorders was investigated in the immediate family ( n = 271) of 93 children with a history of SLI (mean age 13;11 years). RESULTS: The overall proportion of relatives with reported language or literacy difficulty was similar for both methods (34.5% for reported difficulties compared with 35% on direct assessment). The present study further explored maternal, paternal, and sibling prevalence rates and strength of agreement between parental interview and direct assessment. When a low cutoff score was used, good agreement (of true negatives and true positives) for reading and spelling difficulties and expressive language between the 2 types of case identification method was found. CONCLUSIONS: Parents can be effective identifiers when the impairment is severe (below 2 SD s from the population mean). Poor agreement was observed between report and assessment of receptive language difficulties. KEY WORDS: specific language impairment (SLI), prevalence rates, direct assessment, parental interview CiteULike     Connotea     Del.icio.us     Digg     Facebook     Reddit     Technorati     Twitter     What's this?

The opinions of adolescents about their earlier specialist educational provision in the UK, i.e. language units, have received little attention in the literature. This study examines the views of young people and their parents on language units and also evaluates opinions concerning the young people's language difficulties. One hundred and thirty-nine adolescents with specific language impairment (SLI) aged approximately 16 years, who had all attended a language unit at 7 years of age, were interviewed along with their parents and teachers. A broadly positive experience of language unit attendance was reported by young people and their parents. However, a fifth of adolescents and nearly a third of parents thought there had been too little educational support during schooling. In addition, a fifth of the adolescents felt there were lots of ways in which they could not do things currently due to language difficulties. It was also found that nearly a third of the young people had tried to hide their language difficulties in the past year. Within the context of an overall positive picture of results, young people with SLI may require support during adolescence with regard to their continued language difficulties, their confidence and self-esteem.

IntroductionQuality of life and other key outcomes may be improved by optimising hearing and vision function in people living with dementia. To date, there is limited research assessing the efficacy of interventions aimed at improving hearing and vision in people with dementia. Here, we outline a protocol to field test a newly developed home-based intervention, designed to optimise sensory functioning in people with dementia in three European sites. The results of this study will inform the design and conduct of a full-scale randomised controlled trial (RCT) in five European sites.Methods and analysisIn this multisite, single arm, open label, feasibility study, participants with dementia (n=24) will be assessed for hearing and vision impairments and be prescribed a hearing aid and/or glasses. Each participant will have a study partner (‘dyads’). A subset of dyads will receive ‘sensory support’ from a ‘sensory support therapist’, comprising home visits over 12 weeks. The therapist will offer the following intervention: adherence support for corrective devices; adaptations to the home environment to facilitate sensory function; communication training; and referral to community-based support services. The primary outcomes will be process measures assessing the feasibility, tolerability and acceptability of: (1) the intervention components; (2) the method of implementation of the intervention and (3) the study procedures, including outcome assessment measures. Quantitative data will be collected at baseline and follow-up. Qualitative data using semistructured interviews will be collected postintervention and weekly, using participant diaries. Finally, we will explore a model of cost-effectiveness to apply in the subsequent full-scale trial. This feasibility study is a necessary step in the development of a complex, individualised, psychosocial intervention. The data gathered will allow logistical and theoretical processes to be refined in preparation for a full-scale RCT.Ethics and disseminationEthical approval was obtained in all three participating countries. Results of the field trial will be submitted for publication in a peer-reviewed journal.

Background: Optimising hearing and vision function may be important in improving a range of outcomes for people living with dementia (PwD) and their companions. The SENSE-Cog cross-national randomised controlled trial (RCT) is evaluating the effectiveness of a sensory intervention (SI) to improve quality of life for PwD with concurrent hearing and/or vision impairment, in five European countries. To ascertain how or why the intervention will, or will not, achieve its outcomes, we have designed a process evaluation to explore potential discrepancies between expected and observed outcomes. This will also help us to understand how context may influence the outcomes. Here we describe the protocol for this process evaluation, which is embedded within the RCT. Methods and analysis: We will use a mixed method approach with a theoretical framework derived from the UK Medical Research Council’s’ guidance on process evaluations. It will include the following: (1) evaluating how key aspects of the intervention will be delivered, which will be important to scale the intervention in real world populations; (2) characterising the contextual issues, which may shape the delivery and the impact of the intervention in different countries; and (3) investigating possible causal mechanisms through analyses of potential moderators and mediators. To avoid bias, we will analyse the process data before the analysis of the main effectiveness outcomes. Discussion: This evaluation will provide insight into how the complex SENSE-Cog SI will be tailored, enacted and received, across the different European contexts, all of which have unique health and social care economies. The findings will provide insight into the causal mechanisms effecting change, and will determine whether we should implement the intervention, if effective, on a wider scale for PwD and concurrent sensory impairment. Trial registration number: ISRCTN17056211. Registered on 19 February 2018. http://www.isrctn.com/ISRCTN17056211

Three subgroups of 11-year-old children with Specific Language Impairment (SLI) were identified, characterised by selective or joint impairment of receptive and expressive language or resolution of previous SLI in both of these modalities. All subgroups demonstrated normal range non-verbal IQ. The subgroups comprised 30 children with current expressive-only language impairment (E-SLI subgroup), 32 with a combination of current expressive and receptive language impairment (ER-SLI subgroup) and 28 with a history of now-resolved language impairment (Resolved-SLI subgroup). Subtype profiles were investigated through standardised tests of language, literacy and cognition. Following a secondary study to provide norm-referenced standardised data on measures of grammatical morphology and nonword repetition, subgroup profiles were investigated relative to each other and also relative to typically developing age-matched controls. The results indicated that, at 11 years, distinct subgroup profiles can identified along the receptive/expressive language distinction, although these subgroups are not homogeneous. The E-SLI subgroup displayed normal-range receptive syntax and receptive vocabulary coupled with clinical impairment in tests of expressive syntax (past tense and third-person singular), expressive vocabulary, expressive sentence recall and nonword repetition. The ER-SLI subgroup displayed impairment in receptive and expressive vocabulary, receptive and expressive syntax, sentence recall and nonword repetition. Normal range functioning for both subgroups on a test of word associations/fluency was inconsistent with other expressive language areas, indicating that this domain of language functioning is not a key area of difficulty in the profiles of children with SLI at 11 years. The Resolved SLI subgroup displayed residual difficulties (based on mean group score) only in phonological short-term memory, as measured by a nonword repetition test. However, small proportions of this subgroup also displayed difficulty with vocabulary, regardless of the modality tested. Previous language characteristics at 7 were also investigated for each subgroup. A measure of narrative-retelling at 7 years was found to be the best predictor of membership of the E-SLI vs. ER-SLI subgroups and resolved outcome generally, whereas a measure of expressive syntax additionally predicted outcome into the Resolved-SLI subgroup. Subtypes of SLI identified along the expressive/receptive distinction were not consistent with age during primary schooling, as changes in comprehension and production abilities were observed which impacted on subgroup diagnosis. The Resolved-SLI and ER-SLI subgroups were relatively stable however, compared to the E-SLI subgroup. Diagnosis based on dichotomous impairment of mean group comprehension and expression had 100% success rate for the Resolved- SLI and ER-SLI subgroups with age. The E-SLI subgroup however showed a decline from previous normal-range expressive ability at 7 years to be classed as expressive- only impaired at 11 years. Despite a subgroup criteria for non-verbal IQ in the normal range at subgroup formation (11 years old), a significant decline was observed in nonverbal IQ from 7 years to 11 years for all subgroups, suggesting that the general decline in IQ generally documented in children with SLI, is not dependent on subtype and thus not causally related to patterns of impairment in the domains of comprehension and expression. However, although no between-group differences were evident in non-verbal cognitive abilities at 7 years, by 11 years a significant difference had emerged between the ER-SLI and Resolved-SLI subgroups. The present study further found evidence of distinctive reading profiles as a function of subtype. Children displaying language impairment in the domains of both comprehension and expression also demonstrated reading difficulties in both single word reading and reading comprehension. In contrast, children with impairment in language production but not language comprehension presented with normal range ability in single word reading but had difficulties with reading comprehension. In further contrast, children whose overt language impairments appear resolved by age 11 years, also demonstrated unaffected reading skills at this time in terms of both decoding skills and reading comprehension. All subgroups showed consistent ability with age in single word reading decoding skills, suggesting that presence or absence of associated reading impairment is stable in children with SLI between age 7 and 11 years, dependent on subtype. The finding that reading problems manifest at the beginning of primary schooling are likely to be still apparent at the end of primary schooling is likely to have educational implications. The results from the study overall have implications for both research and clinical practice.