Development of an Eco-Biodevelopmental Model of Emergent Literacy Before Kindergarten: A Review

Views of Parents on Supporting Language and Literacy for Their Children With Complex Communication Needs

PURPOSE

Understanding students' home literacy environments can help speech-language pathologists, teachers, and other educators partner with families to promote language and literacy learning. This study focused on gaining insight into the views of parents of elementary-age students with intellectual and developmental disabilities who had complex communication needs related to supporting children's language and literacy learning in the home.

METHOD

This qualitative study was conducted during the COVID-19 pandemic, when many schools were utilizing remote or hybrid learning arrangements. Participants were 37 parents of students with complex communication needs in kindergarten to fourth grade. Most children had either autism or Down syndrome, and they ranged from primarily communicating prelinguistically (e.g., gestures and nonword vocalizations) to using some two to three word phrases in different modes (e.g., speech, sign, and aided augmentative and alternative communication [AAC]). Each parent was interviewed three times over the 2020-2021 school year, and data were analyzed using an inductive qualitative approach.

RESULTS

Findings showed patterns of commonalities and differences in parents' experiences, including related to their (a) goals and values about communication, language, and literacy; (b) perceptions and experiences with roles supporting language and literacy; and (c) satisfaction with supports and progress in these areas.

CONCLUSION

This study provides important insight into the views of parents related to home literacy that can be used to improve the design and delivery of interventions for school-age students with complex communication needs and their families.

Rapid Online Assessment of Reading (ROAR): Evaluation of an Online Tool for Screening Reading Skills in a Developmental-Behavioral Pediatrics Clinic

OBJECTIVE

Reading difficulties are highly prevalent and frequently co-occur with other neurodevelopmental/behavioral conditions. It is difficult to assess reading routinely in pediatric clinical practice because of time and resource constraints. Rapid Online Assessment of Reading (ROAR) is an objective, gamified assessment that children take in a web browser without adult supervision. This study's purpose was to evaluate ROAR as a screening tool for reading difficulties in a clinical setting.

METHOD

A convenience sample of 6- to 14-year-old children, attending an in-person or telehealth visit in a developmental-behavioral pediatrics (DBP) clinic participated. Children took ROAR and completed the Woodcock-Johnson IV Letter-Word Identification (LWID) and Word Attack (WA). Basic Reading Skills (BRS), a standardized aggregate score of LWID and WA, was used as the gold-standard assessment. The strength of association between standard scores on ROAR and BRS was calculated. BRS scores < 90 (bottom quartile) were classified as poor readers. Receiver operating characteristic (ROC) curve analysis was used to assess the quality of ROAR as a screening test.

RESULTS

A sample of 41 children, 78% boys, mean age 9.5 years (SD 2.0 years), completed the study. The correlation of ROAR standard score with BRS was r = 0.66, p < 0.001. ROC curve analysis with ROAR scores accurately classified poor readers with an area under the curve (AUC) of 0.90.

CONCLUSION

ROAR is a useful objective screening tool to identify children at high risk for reading difficulties. Assessment of the tool during a busy clinic was challenging, and a larger replication is warranted.

Neural synchrony underlies the positive effect of shared reading on children's language ability

Although it is well recognized that parent-child shared reading produces positive effects on children's language ability, the underlying neurocognitive mechanisms are not well understood. Here, we addressed this issue by measuring brain activities from mother-child dyads simultaneously during a shared book reading task using functional near infrared spectroscopy hyperscanning. The behavioral results showed that the long-term experience of shared reading significantly predicted children's language ability. Interestingly, the prediction was moderated by children's age: for older children over 30 months, the more the shared reading experience, the better the language performance; for younger children below 30 months, however, no significant relationship was observed. The brain results showed significant interpersonal neural synchronization between mothers and children at the superior temporal cortex, which was closely associated with older children's language ability through the mediation of long-term experience of shared reading. Finally, the results showed that the instantaneous quality of shared reading contributed to children's language ability through enhancing interpersonal neural synchronization and increasing long-term experience. Based on these findings, we tentatively proposed a theoretical model for the relationship among interpersonal neural synchronization, shared reading and children's language ability. These findings will facilitate our understanding on the role of shared reading in children's language development.

Home Literacy Environment and Interventions for Children With Intellectual and Developmental Disabilities: A Scoping Review

PURPOSE

The aim of this scoping review was to map the research literature published in English and in peer-reviewed journals related to the home literacy environment of children and youth aged 3-21 years with intellectual and developmental disabilities (IDD) who have significant support needs, including children with complex communication needs.

METHOD

A systematic search was conducted in four databases, along with forward and backward searching. The search yielded 60 studies, which included intervention and nonintervention studies. Data were charted related to participant characteristics, study focus, intervention components, study design and methodological rigor, and study results.

RESULTS

Findings provided insight into multiple dimensions of the home literacy environment for children with IDD, including the nature of parent views, practices, and interaction styles during shared reading. Findings also revealed gaps in the literature, specifically related to (a) limited representation of subgroups of children and youth with IDD, (b) limited representation of diverse families and caregivers, and (c) concerns about methodological quality.

CONCLUSION

This review identifies important directions for future research and suggests ways to improve the design and delivery of home literacy interventions for children and youth with IDD and their families, including through family-centered and culturally responsive models.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.22704817.

Neuroimaging of brain connectivity related to reading outcomes in children born preterm: A critical narrative review

Premature children are at high risk for delays in language and reading, which can lead to poor school achievement. Neuroimaging studies have assessed structural and functional connectivity by diffusion MRI, functional MRI, and magnetoencephalography, in order to better define the "reading network" in children born preterm. Findings point to differences in structural and functional connectivity compared to children born at term. It is not entirely clear whether this discrepancy is due to delayed development or alternative mechanisms for reading, which may have developed to compensate for brain injury in the perinatal period. This narrative review critically appraises the existing literature evaluating the neural basis of reading in preterm children, summarizes the current findings, and suggests future directions in the field.

Socioeconomic dissociations in the neural and cognitive bases of reading disorders

Childhood socioeconomic status (SES) strongly predicts disparities in reading development, yet it is unknown whether early environments also moderate the cognitive and neurobiological bases of reading disorders (RD) such as dyslexia, the most prevalent learning disability. SES-diverse 6-9-year-old children (n = 155, half with RD) completed behavioral and functional magnetic resonance imaging (fMRI) tasks engaging phonological and orthographic processing, which revealed corresponding double-dissociations in neurocognitive deficits. At the higher end of the SES spectrum, RD was most strongly explained by differences in phonological skill and corresponding activation in left inferior frontal and temporoparietal regions during phonological processing-widely considered the "core deficit" of RD. However, at the lower end of the SES spectrum, RD was most strongly explained by differences in rapid naming skills and corresponding activation in left temporoparietal and fusiform regions during orthographic processing. Findings indicate that children's early environments systematically moderate the neurocognitive systems underlying RD, which has implications for assessment and treatment approaches to reduce SES disparities in RD outcomes. Further, results suggest that reliance on high-SES convenience samples may mask critical heterogeneity in the foundations of both typical and disordered reading development.

Exploratory Mixed-Methods Study of a Primary Care-Based Intervention Promoting Shared Reading During Infancy

Parent-child "shared" reading can be a rich source of language exposure. Clinic-based programs, notably Reach Out and Read (ROR), are intended to enhance this. However, ROR has been traditionally introduced at 6 months and only recently expanded to younger ages. This study explored efficacy of an intervention delivered during pediatric well visits promoting shared reading prior to 6 months old, in terms of home reading attitudes and routines. The intervention group received children's books and anticipatory guidance about benefits of shared reading, whereas the control group received general age-related anticipatory guidance. Surveys were administered at the child's newborn (pre-intervention) and 6-month (post-intervention) well visits. Significant findings at 6 months included more frequent shared reading (P = .03), greater comfort reading at this age (P = .01), and greater importance attributed to shared reading (P = .04) in the intervention group relative to controls. These support the expansion of early literacy interventions such as ROR into early infancy.

A Genetic Neural Net Model for the Relationship between Pre-School and Attention in Early Childhood

This paper uses an algorithm of a genetic neural network to conduct an in-depth study and analysis of the attention relationship in pre-school education of young children. In face expression images, expression features are often concentrated and distributed in some local regions, while convolutional neural networks are homogeneous for feature extraction of facial expression images. To address the problem of the nonuniform distribution of expression features, a facial expression recognition method based on the spatial domain attention mechanism is proposed. A comparison of the differences between group and grade before the intervention using a two-way multivariate ANOVA revealed a nonsignificant interaction effect with a value of 0.90 for the group-grade interaction effect and an F-value of 0.36. The group's main effect had a value of 0.90 and an F-value of 0.36, with the experimental and control groups being equal groups on multiple dependent variables. The salient features in face expression images that are more important for facial expression recognition can be selected adaptively, and relatively high weights are assigned to these salient features. Experimental results on the image library show that the introduction of a spatial domain attention mechanism can improve the average recognition accuracy of face expressions by about 1.1% and 1.0%, respectively. A hybrid domain attention mechanism-based face expression recognition method is proposed to extract important expression features from both the spatial domain and the channel domain. Experimental results on the image library show that combining the spatial domain attention mechanism and the channel domain attention mechanism can improve the average recognition accuracy by about 2.1% and 1.5%, respectively. The use of rule games was effective in developing children's sustained and selective attention; the effect of rule games on the sustained and selective attention of older boys and girls did not show significant gender differences.

Prevalence of Developmental Dyslexia in Primary School Children: A Systematic Review and Meta-Analysis

Background: Developmental dyslexia (DD) is a specific learning disorder concerning reading acquisition that may has a lifelong negative impact on individuals. A reliable estimate of the prevalence of DD serves as the basis for diagnosis, intervention, and evidence-based health resource allocation and policy-making. Hence, the present meta-analysis aims to generate a reliable prevalence estimate of DD worldwide in primary school children and explore the potential variables related to that prevalence. Methods: Studies from the 1950s to June 2021 were collated using a combination of search terms related to DD and prevalence. Study quality was assessed using the STROBE guidelines according to the study design, with study heterogeneity assessed using the I2 statistic, and random-effects meta-analyses were conducted. Variations in the prevalence of DD in different subgroups were assessed via subgroup meta-analysis and meta-regression. Results: The pooled prevalence of DD was 7.10% (95% CI: 6.27–7.97%). The prevalence in boys was significantly higher than that in girls (boys: 9.22%, 95%CI, 8.07–10.44%; girls: 4.66%, 95% CI, 3.84–5.54%; p < 0.001), but no significant difference was found in the prevalence across different writing systems (alphabetic scripts: 7.26%, 95%CI, 5.94–8.71%; logographic scripts: 6.97%, 95%CI, 5.86–8.16%; p > 0.05) or across different orthographic depths (shallow: 7.13%, 95% CI, 5.23–9.30%; deep: 7.55%, 95% CI, 4.66–11.04%; p > 0.05). It is worth noting that most articles had small sample sizes with diverse operational definitions, making comparisons challenging. Conclusions: This study provides an estimation of worldwide DD prevalence in primary school children. The prevalence was higher in boys than in girls but was not significantly different across different writing systems.

Chronic pediatric diseases and risk for reading difficulties: a narrative review with recommendations

Literacy is a major social determinant of health, rooted in skills that develop during early childhood. Children arriving at kindergarten unprepared to learn to read are more likely to have low reading proficiency thereafter. General and health literacy are highly correlated, affecting understanding of health conditions, treatment adherence, and transition to self-care and adult healthcare services. The American Academy of Pediatrics (AAP) recommends literacy and school readiness promotion during well-visits and neurodevelopmental surveillance is emphasized across primary and subspecialty care. While genetic and environmental risk factors for reading difficulties are well-established, risks related to complex and chronic medical conditions are less appreciated and under-researched. This review applies an eco-bio-developmental framework to explore literacy across five complex chronic conditions affecting millions of children worldwide: asthma, cancer, congenital heart disease, epilepsy, and sickle cell disease. In each, integration of an efficient reading brain network may be impacted by direct factors, such as ischemia, anesthesia, and/or medications, and also indirect factors, such as altered parent-child routines, hospital stays, and missed school. By integrating literacy into care management plans for affected children, pediatric primary care and specialty providers are poised to identify risks early, target guidance and interventions, and improve academic and health outcomes. IMPACT: While genetic and environmental risk factors for reading difficulties are well-established, risks related to complex and/or chronic medical conditions such as asthma, cancer, congenital heart disease, epilepsy, and sickle cell disease are substantial, less appreciated, and under-researched. General and health literacy are highly correlated, with implications for the understanding one's health condition, treatment adherence, and transitioning to self-care, which is especially important for children with complex and/or chronic illness. Pediatric primary care and specialty providers are poised to integrate reading and literacy into care management plans for children with complex and/or chronic illness, including early screening, guidance, support, and interventions.