Heart rate-defined phases of attention, look duration, and infant performance in the paired-comparison paradigm

Four-month-old infants (N = 68) were tested in a paired-comparison familiarization-novelty recognition task in which the length of choice trials was systematically manipulated. Peak look duration during pretest and familiarization periods significantly predicted a dichotomous measure of recognition performance, but recognition was unaffected by choice-trial length. Heart rate (HR) was simultaneously assessed during the task, and the amount of time infants spent in various HR-defined phases of attention was assessed. Longer durations of looking during pretest and familiarization were significantly associated with more time spent in both sustained attention (SA) and attention termination (AT). Of these two variables, only individual differences in AT accounted for significant variance in recognition memory performance. A final analysis addressed the possibility that individual differences in AT mediated the relation between look duration and recognition performance. These findings provide support for the hypothesis that individual differences in the disengagement of attention underlie the relation between look duration and cognitive performance in early to midinfancy.

Infants' detection of contingency: a cognitive-neuroscience perspective

Advances in developmental cognitive neuroscience have generated important and interesting data that are relevant to infants' perception of contingencies. The author discusses concepts of "binding" (i.e., the binding of stimulus properties across space, and binding of events across time) within the context of the cognitive-neuroscience approach to learning. Issues relevant to infant contingency perception are also addressed. Previously published data on infant contingency perception and discrimination learning from the author's laboratory are reinterpreted in terms of these binding concepts, as well as the development of the neural substrates that presumably underlie the perception of stimulus attributes and temporal redundancy.

Recent advances in infant cognition: implications for long-chain polyunsaturated fatty acid supplementation studies

The assessment of cognitive function in early life has recently become an issue for consideration in long-chain polyunsaturated fatty acid (LC-PUFA) supplementation studies. This article reviews the various means by which such assessment has been done in past LC-PUFA supplementation studies and provides some background on recent advances in the measurement of infant cognition that may need to be considered when planning or designing future supplementation studies. These include (i) consideration of the specificity of LC-PUFA effects on cognition, (ii) inclusion of multiple tasks or levels of measurement as outcome measures, and (iii) a stronger emphasis on developmental processes in the design of such studies.

The development of visual attention in infancy

Over the past decade, the study of attention in infancy has seen dramatic progress. This review delineates four attentional functions (alertness, spatial orienting, attention to object features, and endogenous attention) that are relevant to infancy and uses these functions as a framework for summarizing the developmental course of attention in infancy. Rudimentary forms of various attentional functions are present at birth, but each of the functions exhibits different and apparently dissociable periods of postnatal change during the first years of life. The role of attention in development should therefore be considered in the context of interaction among different systems at different levels of maturity during the first years of life.

Mass hearing screening in kindergarten students

OBJECTIVE

To determine the types of hearing losses identified by mass hearing screenings in the public school system.

DESIGN

Prospective observational.

PARTICIPANTS

Students enrolled in kindergarten in the public school system.

SETTING

Major metropolitan area.

MAIN OUTCOME MEASURES

(1) hearing screening tests performed by speech pathologists using an audiometer in a quiet room; (2) formal audiologic testing including pure tone audiometry, tympanograms, speech discrimination, and acoustic impedance testing in a sound proof booth.

RESULTS

140 students failed hearing screening on two separate occasions; 91(65%) underwent formal audiologic testing at Milwaukee Public School, 43% demonstrated conductive hearing losses, 14% demonstrated sensorineural losses and 43% demonstrated normal hearing.

CONCLUSION

Mass hearing screening in the school system (1) is useful for detecting transient conductive hearing losses, (2) detects a significant number of sensorineural hearing losses and (3) has a very poor follow-through by the families of those students identified with hearing loss through the screening program.

Individual and developmental differences in disengagement of fixation in early infancy

The current study investigated whether individual and developmental differences in look duration are correlated with the latency for infants to disengage fixation from a visual stimulus. Ninety-four infants (52 3-month-olds, 42 4-month-olds) were tested in a procedure that measured ocular reaction time to shift fixation from a central target to a peripheral target under conditions in which the central-target either remained present ("competition" condition) or was removed from the display ("noncompetition" condition). Look duration was correlated with disengagement latency; longer-looking infants were slower than shorter-looking infants to shift fixation to the peripheral target on competition trials, but not noncompetition trials. Results were similar for 3- and 4-month-olds, although 3-month-olds showed slower latencies on all trials. Furthermore, long-looking infants were not consistently slower, but rather showed greater variability in their response latencies under conditions that required disengagement of fixation. The results support the position that developmental and individual differences in look duration are linked to the development of the neural attentional systems that control the ability to disengage, or inhibit, visual fixation.

Long- and short-looking infants' recognition of symmetrical and asymmetrical forms

Adults process symmetrical visual forms more rapidly than asymmetrical visual forms, presumably because symmetrical forms are amenable to a global visual encoding strategy. Individual differences in look duration during infancy have been hypothesized to covary with different modes of visual intake and encoding, with longer look durations reflecting encoding based on prolonged inspection of local visual properties, and briefer look durations reflecting encoding based on more of a global, or global-to-local processing sequence. This hypothesis predicts that short-looking infants would process symmetrical stimuli faster than asymmetrical stimuli, but that long-looking infants would not. Three experiments are described here in which this prediction is tested. Results were in general accord with the prediction, and provide further support for the hypothesis that individual differences in look duration may reflect different modes of visual encoding or inspection.

Sensitization during visual habituation sequences: procedural effects and individual differences

Although individual differences in visual habituation have long been interpreted in terms of processes derived from comparator theory, research over the last decade has suggested that arousal or arousability as manifest in sensitization may contribute to infants' attentional profiles, and thus, to individual differences in those profiles. We explored this possibility by habituating 4-month-old infants to 4 x 4, 10 x 10, or 20 x 20 checkerboards in a fixed-trial paradigm. The first specific aim was to examine the attentional characteristics of infants with habituation patterns showing sensitization versus those that did not. The second specific aim was to determine whether patterns of attention suggestive of sensitization effects reported in past research might be attributable to the use of illuminated interstimulus intervals (ISIs). Trends were observed for sensitization to occur more frequently with more complex than with less complex checkerboards. Infants who showed looking patterns characteristic of sensitization looked longer and did not habituate as readily as infants who did not show sensitization. Finally, different ISIs did not engender different levels of sensitization, but dark ISIs significantly increased infants' looking times to stimuli during trials.

Establishing pharmaceutical care services in an HIV clinic

OBJECTIVE

To present a brief overview of human immunodeficiency virus (HIV) infection and to describe the implementation of pharmaceutical care services for adult patients with HIV infection.

SETTING

University hospital clinic.

PRACTICE DESCRIPTION

A pharmacist joined a multidisciplinary team serving HIV-infected patients in January 1994.

PRACTICE INNOVATION

Current pharmacy services include taking medication histories, educating patients, counseling patients on compliance, monitoring response to therapy, identifying drug-related problems, documenting all interventions, and making therapeutic decisions and formulary choices. The pharmacist also participates in research.

INTERVENTIONS

The pharmacist sees patients immediately after their physician appointments. Patients with one or more of the following characteristics are targeted to receive pharmaceutical care: multiple drugs, history of noncompliance, initiation of new drug therapy, recently discharged from hospital or emergency department, identification of potential adverse effects, identification of potential drug-drug interactions, and presence of drug toxicities.

CONCLUSION

Pharmacists are uniquely qualified to provide a wide range of pharmaceutical care services to HIV-positive patients. Pharmacy interventions should lead to improved outcomes and decreased costs for a chronic and very expensive disease.

Individual differences in infant visual attention: recognition of degraded visual forms by four-month-olds

In 5 experiments, 4-month-old infants were tested for their ability to recognize degraded visual targets as a function of individual differences in fixation duration. Targets were degraded by removing 10% of the total contour either from vertices (vertex-absent) or from midsegments (vertex-present). Both qualitative and quantitative differences were found in long and short lookers' ability to recognize the degraded forms. Short-looking infants were able to recognize degraded forms in both vertex-absent and vertex-present conditions, but the vertex-absent discrimination was more difficult. Long-looking infants required longer familiarization times before showing evidence of recognition in the vertex-present condition, and were unable to recognize targets in which contour was removed at vertices. The findings are discussed within the framework of the persistence of early visual processing strategies, and reliance of long-looking infants on particular local elements in visual analysis.

Preservation of amplitude modulation coding in the presence of background noise by chinchilla auditory-nerve fibers

Sound envelope temporal fluctuations are important for effective processing of biologically relevant acoustic information including speech, animal vocalizations, sound-source location, and pitch. Amplitude modulation (AM) of sound envelopes can be encoded in quiet with high fidelity by many auditory neurons including those of the auditory nerve (AN) and cochlear nucleus. From both neurophysiological and clinical perspectives, it is critical to understand the effects of background masking noise on the processing of AM. To further this goal, single-unit recordings were made from AN fibers in anesthetized chinchillas. Units were classified according to spontaneous firing rate (SR) and threshold. Best frequency (BF) pure-tone bursts and AM (10-500 Hz) tone bursts were employed as stimuli at several sound levels, both in quiet and in the presence of a continuous wideband noise. It was found that (1) in quiet, low SR AN fibers show the strongest AM coding, followed in order by medium SR and high SR fibers, respectively. (2) AN units of all three classes generally preserve their AM coding even in the presence of loud (0 or +6 dB S/N) background noise and at high sound levels (over 75 dB SPL). (3) This preservation is usually achieved by lowering the average firing rate proportionately to decreases in the synchronous (fundamental frequency) response. (4) For a few AN fibers, the AM coding increases or is reduced in the presence of the background noise. These findings suggest that AN preservation of AM coding in the presence of a continuous masking noise results from shifts in the operating ranges and firing rates of AN fibers resulting from cochlear nonlinearities and adaptive mechanisms.

Serotonergic sprouting in primate MTP-induced hemiparkinsonism

Immunocytochemistry to serotonin, dopamine beta hydroxylase (DBH), and tyrosine hydroxylase (TH) was studied in the brains of 2 cebus monkeys that had developed permanent hemiparkinsonism after intracarotid injection of 1.2 mg N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), and were sacrificed after 10-12 months. A pronounced depletion of TH-immunoreactive neurons was found in the substantia nigra, caudate nucleus, and putamen, ipsilaterally to the injected side. In these dopamine-denervated structures, the number of serotonergic fibers was increased in the ipsilateral compared with the contralateral side, or with an untreated control monkey. Serotonergic neurons in the brainstem appeared to be unaffected. Topography and number of DBH-positive fibers in the control and the MPTP-injected sides were comparable.

Individual differences in infant visual attention: four-month-olds' discrimination and generalization of global and local stimulus properties

Cognitive performance and development is negatively correlated with fixation duration patterns during infancy, and evidence suggests that long-looking infants may process visual information more slowly than short-looking infants. 3 experiments described here tested the possibility that these differences may be due to differential sensitivity to global and local visual information. Infants were administered discrimination and generalization tasks involving global and local information at varying levels of familiarization time. Results indicated that 4-month-olds process visual information in a global-to-local sequence. Both long- and short-looking infants were sensitive to both types of information, although long lookers required additional familiarization time to match the performance of short lookers. Finally, apparent "generalization" of global information at brief familiarization levels was traced to insensitivity to local stimulus properties. The results do not support the hypothesis that long- and short-looking infants are differentially sensitive to global versus local visual information at 4 months of age.

Nodal size of metastatic squamous cell carcinoma of the neck

The preoperative use of computed tomographic (CT) scanning continues to be the best diagnostic method for preoperative detection of metastatic neck disease. Current accepted criteria for CT diagnosis of nodal disease are not uniform, although nodal size, nodal grouping, and central necrosis correlate strongly with malignancy. To assess the relationship of nodal size and malignancy, a multicenter study was designed to evaluate the nodes from 100 neck dissections. Sixty-nine positive neck dissections were analyzed, and every node was measured. The relationship of central necrosis was also compared with node size. Our results showed that CT scanning continues to provide a reliable picture of the histologic status of lymph nodes. Using the criterion of central necrosis or node size larger than 1 cm, only 7% of necks had nodal disease that would have been missed by CT interpretation. This study supports the continued use of preoperative CT evaluation for metastatic neck disease.

Individual differences in infant visual attention: are short lookers faster processors or feature processors?

Individual differences in the duration of infants' visual fixations are reliable and stable and have been linked to differential cognitive performance; short-looking infants typically perform better than long-looking infants. 4 experiments tested the possibility of whether short lookers' superiority on perceptual-cognitive tasks is attributable to attention to the featural details of visual stimuli, or simply to differences in the speed or efficiency of visual processing. To do this, the performance of long- and short-looking 4-month-olds was examined on separate discrimination tasks that could be solved only by processing either featural or global information. The global task was easier than the featural task, but as the amount of time allotted for infants to solve either type of task was decreased, short lookers' performance was superior to that of long lookers. These results thus lend support to a speed or efficiency of stimulus processing interpretation of infant fixation duration.

Form categorization in 10-month-olds

In five experiments, 10-month-olds were habituated to exemplars of a form category and tested for categorization in paired-comparison trials involving in-category versus out-of-category stimuli. Across these experiments, color was systematically manipulated during habituation and/or test trials. Infants categorized form when color was either held constant or varied during habituation, but failed to categorize form when exposed to color-constant stimuli during habituation and tested for categorization with novel-color form exemplars. Two subsequent experiments traced this failure to the narrow experience of exposure to color-constant exemplars during habituation. These results suggest that (a) infants' internal representation for a category will not include a stimulus dimension not varied in the exemplars from which the category was derived, but (b) if variation in that dimension is experienced, exemplars constructed of novel instances of that dimension will still be regarded as belonging to the category.

Discrimination learning during the first year: stimulus and positional cues

In four studies, 3-, 6-, and 9-month-old human infants were tested in a discrimination learning task in which visual fixation to a particular stimulus or lateral position was reinforced with an auditory stimulus. In Experiment 1, all age groups exhibited acquisition, extinction, and reinstatement of fixation to the reinforced target or position. Experiment 2 revealed that 3-month-olds retained the positional discrimination but not the stimulus discrimination after a 5-min delay between acquisition and extinction; older infants retained both types of discriminations. In Experiments 3 and 4 we investigated a possible developmental shift in the dominance of positional versus stimulus cues by training infants on displays in which stimulus and position were confounded and then by dissociating the cues on test trials. Results from both experiments indicated positional cue dominance for young infants and stimulus cue dominance for older infants. The findings are discussed in terms of differences in the attentional demands elicited by proprioceptive versus exteroceptive cues.

Discrimination learning during the first year: Stimulus and positional cues

In four studies, 3-, 6-, and 9-month-old human infants were tested in a discrimination learning task in which visual fixation to a particular stimulus or lateral position was reinforced with an auditory stimulus. In Experiment 1, all age groups exhibited acquisition, extinction, and reinstatement of fixation to the reinforced target or position. Experiment 2 revealed that 3-month-olds retained the positional discrimination but not the stimulus discrimination after a 5-min delay between acquisition and extinction; older infants retained both types of discriminations. In Experiments 3 and 4 we investigated a possible developmental shift in the dominance of positional versus stimulus cues by training infants on displays in which stimulus and position were confounded and then by dissociating the cues on test trials. Results from both experiments indicated positional cue dominance for young infants and stimulus cue dominance for older infants. The findings are discussed in terms of differences in the attentional demands elicited by proprioceptive versus exteroceptive cues.

Neonatal state profiles: reliability and short-term prediction of neurobehavioral status

Observations were made on 40 newborns prior to hospital discharge in which states were scored every 10 sec in two 35-70-min periods separated by 6-48 hours. Newborns' states, particularly sleep states and crying, were fairly reliable across observation sessions. Cluster analyses identified 3 separable state profiles that subsequently differentiated infants on the Neonatal Behavioral Assessment Scale with Kansas Supplements (NBAS-K) at 2 weeks of age. Additionally, state observations and NBAS-K exams showed significant agreement on individual differences in neurologically based measures, such as startles, tremulousness, and lability of state.

Neonatal behavioral organization and visual processing at three months

In 2 studies, the Range of State cluster derived from infants' scores on the Neonatal Behavioral Assessment Scale with Kansas Supplements (NBAS-K) was found to correlate significantly with visual discrimination performance at 3 months of age. Contrary to the expectation that NBAS-K orientation scores would predict visual discrimination at 3 months, it was neonatal behavioral state organization that related to later cognitive functioning in infancy.

Infant visual attention in the paired-comparison paradigm: test-retest and attention-performance relations

The visual behavior of infants in the paired-comparison paradigm was assessed with multiple discrimination tasks week-to-week at 4 and 7 months and longitudinally from 4 to 7 months. Results indicated that although task-to-task reliability was extremely variable and typically low, most measures of infants' attention averaged across multiple tasks were reliable from 1 week to the next as well as relatively stable over the longer longitudinal period. Across all groups, infants who had shorter fixations (i.e., more fixations per fixed-exposure period) during the familiarization phase showed higher novelty preferences. While infants' shift rate during test phases was a reliable individual characteristic at 7 months, it was not at 4 months; rather, data suggested that the difficulty of the stimulus discrimination may be related to young infants' shift rate.

A model of electrical excitation of the mammalian auditory-nerve neuron

A model of the mammalian auditory-nerve neuron has been developed based on the classical work of Frankenhauser and Huxley [(1964) J. Physiol. 171, 302-315], modified by McNeal [(1976) IEEE Trans. Biomed. Eng. BME-23, 329-336], and Reilly et al. [(1985) IEEE Trans. Biomed. Eng. BME-32, 1001-1011], and fine tuned to represent physiological data obtained from single auditory-nerve fiber experiments in squirrel monkeys. The model is capable of reproducing neural action potential waveforms due to electrical stimulation, and can reliably predict action potential thresholds and strength-duration curves. This paper explains the derivation of the mathematical model and the effects of varying certain independent parameters including fiber diameter, length of the nodes of Ranvier, internodal length, and myelin thickness. The model parameters were selected according to the anatomical findings of Liberman and Oliver [(1984) J. Comp. Neurol. 223, 163-176], and Liberman (Pers. Commun.). The length of the unmyelinated termination of the auditory-nerve that survives after aminoglycoside damage to the inner ear has not been experimentally determined. Therefore, it was investigated as an independent variable in the model. An unmyelinated terminal length of 10.0 micron was found to most accurately describe the experimental neural strength-duration curves obtained from aminoglycoside-deafened squirrel monkeys. The parameter that had the next most significant effect on the model was fiber diameter which affects all conduction pathways, across the membrane and through the fiber. Finally the results of the model are compared with behavioral data obtained from patients and monkeys implanted with cochlear prostheses. In the companion paper [(1987) Hear. Res. 31, 267-286] predictions of the model are quantitatively compared with single-neuron data from squirrel monkeys.

Auditory-nerve single-neuron thresholds to electrical stimulation from scala tympani electrodes

Single auditory-nerve neuron thresholds were studied in sensory-deafened squirrel monkeys to determine the effects of electrical stimulus shape and frequency on single-neuron thresholds. Frequency was separated into its components, pulse width and pulse rate, which were analyzed separately. Square and sinusoidal pulse shapes were compared. There were no or questionably significant threshold differences in charge per phase between sinusoidal and square pulses of the same pulse width. There was a small (less than 0.5 dB) but significant threshold advantage for 200 microseconds/phase pulses delivered at low pulse rates (156 pps) compared to higher pulse rates (625 pps and 2500 pps). Pulse width was demonstrated to be the prime determinant of single-neuron threshold, resulting in strength-duration curves similar to other mammalian myelinated neurons, but with longer chronaxies. The most efficient electrical stimulus pulse width to use for cochlear implant stimulation was determined to be 100 microseconds/phase. This pulse width delivers the lowest charge/phase at threshold. The single-neuron strength-duration curves were compared to strength-duration curves of a computer model based on the specific anatomy of auditory-nerve neurons. The membrane capacitance and resulting chronaxie of the model can be varied by altering the length of the unmyelinated termination of the neuron, representing the unmyelinated portion of the neuron between the habenula perforata and the hair cell. This unmyelinated segment of the auditory-nerve neuron may be subject to aminoglycoside damage. Simulating a 10 micron unmyelinated termination for this model neuron produces a strength-duration curve that closely fits the single-neuron data obtained from aminoglycoside deafened animals. Both the model and the single-neuron strength-duration curves differ significantly from behavioral threshold data obtained from monkeys and humans with cochlear implants. This discrepancy can best be explained by the involvement of higher level neurologic processes in the behavioral responses. These findings suggest that the basic principles of neural membrane function must be considered in developing or analyzing electrical stimulation strategies for cochlear prostheses if the appropriate stimulation of frequency specific populations of auditory-nerve neurons is the objective.