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"Thorne, John"
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Accentuate the Negative: Grammatical Errors During Narrative Production as a Clinical Marker of Central Nervous System Abnormality in School-Aged Children With Fetal Alcohol Spectrum Disorders
Purpose: The purpose of this study was to examine (a) whether increased grammatical error rates during a standardized narrative task are a more clinically useful marker of central nervous system abnormality in Fetal Alcohol Spectrum Disorders (FASD) than common measures of productivity or grammatical complexity and (b) whether combining the rate of grammatical errors with the rate of cohesive referencing errors can improve utility of a standardized narrative assessment task for FASD diagnosis. Method: The method used was retrospective analysis of narrative and clinical data from 138 children (aged 7-12 years; 69 with FASD, 69 typically developing). Narrative analysis was conducted blind to diagnosis. Measures of grammatical error, productivity and complexity, and cohesion were used independently and in combination to predict whether a story was told by a child with an FASD diagnosis. Results: Elevated grammatical error rates were more common in children with FASD, and this difference facilitated a more accurate prediction of FASD status than measures of productivity and grammatical complexity and, when combined with an accounting of cohesive referencing errors, significantly improved sensitivity to FASD over standard practice. Conclusion: Grammatical error rates during a narrative are a viable behavioral marker of the kinds of central nervous system abnormality associated with prenatal alcohol exposure, having significant potential to contribute to the FASD diagnostic process.
Journal Article
Harry Potter and the cursed child. Parts one and two : playscript
It was always difficult being Harry Potter and it isn't much easier now that he is an overworked employee of the Ministry of Magic, a husband and father of three school-age children. While Harry grapples with a past that refuses to stay where it belongs, his youngest son Albus must struggle with the weight of a family legacy he never wanted. As past and present fuse ominously, both father and son learn the uncomfortable truth: sometimes, darkness comes from unexpected places.
BOOK
Executive and Social Functioning in Fetal Alcohol Spectrum Disorders: Comparison to Autism
Executive function is an area of challenge for both children with fetal alcohol spectrum disorders (FASD) and children with autism spectrum disorder (ASD). Parent ratings of everyday executive function relate to a range of outcomes, including social functioning in ASD. Comparisons between FASD and ASD have revealed both overlapping and distinct skills, but have not addressed executive function or its relation to social function. Utilizing parent report, the current study addressed relative strengths and weaknesses across scales of everyday executive function, as well as group differences between FASD and ASD. The association between executive function and social function was also evaluated. Participants with FASD (n = 23) and ASD (n = 18) were preschool and school-age children whose caregivers completed the Behavior Rating Inventory of Executive Function (BRIEF, BRIEF-2, or BRIEF-P) and the Social Responsiveness Scale, Second Edition. For both groups and all examined executive function scales, scores exceeded the normative mean, indicating challenges. The groups differed significantly on only one executive function scale: working memory. In both groups, executive function was positively correlated with social functioning, even when controlling for nonverbal IQ. The current findings highlight an overlapping association between executive function and social function in FASD and ASD.
Journal Article
Harry Potter and the cursed child
It was always difficult being Harry Potter and it isn't much easier now that he is an overworked employee of the Ministry of Magic, a husband, and a father of three school-age children. While Harry grapples with a past that refuses to stay where it belongs, his youngest son, Albus, must struggle with the weight of a family legacy he never wanted. As past and present fuse ominously, both father and son learn the uncomfortable truth: sometimes, darkness comes from unexpected places.
Book
Listening Difficulties in Children With Fetal Alcohol Spectrum Disorders: More Than a Problem of Audibility
Purpose: Data from standardized caregiver questionnaires indicate that children with fetal alcohol spectrum disorders (FASDs) frequently exhibit atypical auditory behaviors, including reduced responsivity to spoken stimuli. Another body of evidence suggests that prenatal alcohol exposure may result in auditory dysfunction involving loss of audibility (i.e., hearing loss) and/or impaired processing of clearly audible, \"suprathreshold\" sounds necessary for sound-in-noise listening. Yet, the nexus between atypical auditory behavior and underlying auditory dysfunction in children with FASDs remains largely unexplored. Method: To investigate atypical auditory behaviors in FASDs and explore their potential physiological bases, we examined clinical data from 325 children diagnosed with FASDs at the University of Washington using the FASD 4-Digit Diagnostic Code. Atypical behaviors reported on the \"auditory filtering\" domain of the Short Sensory Profile were assessed to document their prevalence across FASD diagnoses and explore their relationship to reported hearing loss and/or central nervous system measures of cognition, attention, and language function that may indicate suprathreshold processing deficits. Results: Atypical auditory behavior was reported among 80% of children with FASDs, a prevalence that did not vary by FASD diagnostic severity or hearing status but was positively correlated with attention-deficit/hyperactivity disorder. In contrast, hearing loss was documented in the clinical records of 40% of children with fetal alcohol syndrome (FAS; a diagnosis on the fetal alcohol spectrum characterized by central nervous system dysfunction, facial dysmorphia, and growth deficiency), 16-fold more prevalent than for those with less severe FASDs (2.4%). Reported hearing loss was significantly associated with physical features characteristic of FAS. Conclusion: Children with FAS but not other FASDs may be at a particular risk for hearing loss. However, listening difficulties in the absence of hearing loss--presumably related to suprathreshold processing deficits--are prevalent across the entire fetal alcohol spectrum. The nature and impact of both listening difficulties and hearing loss in FASDs warrant further investigation.
Journal Article
Cohesive Referencing Errors During Narrative Production as Clinical Evidence of Central Nervous System Abnormality in School-Aged Children With Fetal Alcohol Spectrum Disorders
Previous evidence suggests that cohesive referencing errors made during narratives may be a behavior that is revealing of underlying central nervous system abnormality in children with fetal alcohol spectrum disorders (FASD). The current research extends this evidence.
Retrospective analysis of narrative and clinical data from 152 children (ages 6 to 14), 72 of whom had confirmed FASD, was used. Narrative analysis was conducted blind to diagnostic status, age, or gender. Group performance was compared. The associations between measures of cohesive referencing and clinically gathered indices of the degree of central nervous system abnormality were examined.
Results show clear associations between elevated rates of cohesive referencing errors and central nervous system abnormality. Elevated error rates were more common in children with FASD than those without, and prevalence increased predictably across groups with more severe central nervous system abnormality. Risk is particularly elevated for those with microcephaly or a diagnosis of fetal alcohol syndrome.
Cohesive referencing errors during narrative are a viable behavioral marker of the kinds of central nervous system abnormality associated with prenatal alcohol exposure, having significant potential to become a valuable diagnostic and research tool.
Journal Article
Exploring the Utility of a School-Age Narrative Microstructure Index: Proportion of Restricted Utterances
Purpose: This research attempted to replicate Hoffman's 2009 finding that the proportion of narrative utterances with semantic or syntactic errors (i.e., = 14% \"restricted utterances\") can differentiate school-age children with typical development from those with language impairment with a sensitivity of 83% and specificity of 88%. Method: Methods similar to Hoffman (2009) were used to evaluate an existing set of narratives from 16 age-matched pairs of 8- to 9-year-old children, half with known language impairment. Transcripts were segmented into T-units; a code of [RESTRICTED] was assigned to any utterance with semantic or syntactic errors. Results: A Welch's t test for independent samples revealed a statistically significant difference in the mean proportion of restricted utterances between the two groups after accommodation for an outlier with typical development. A cutoff of = 14% restricted utterances replicated Hoffman's (2009) sensitivity but not specificity. Post hoc analysis of specific error types found sensitivity and specificity rates similar to Hoffman's as well as a significant difference in means when using a proportion of sentence-internal morphosyntactic errors. Conclusion: Results support further exploration of utterance-level error coding for diagnostic purposes and future development of this approach to meet clinical assessment needs.
Journal Article