Narrative abilities of children with epilepsy

Data Representativeness in Accessibility Datasets: A Meta-Analysis

As data-driven systems are increasingly deployed at scale, ethical concerns have arisen around unfair and discriminatory outcomes for historically marginalized groups that are underrepresented in training data. In response, work around AI fairness and inclusion has called for datasets that are representative of various demographic groups. In this paper, we contribute an analysis of the representativeness of age, gender, and race & ethnicity in accessibility datasets-datasets sourced from people with disabilities and older adults-that can potentially play an important role in mitigating bias for inclusive AI-infused applications. We examine the current state of representation within datasets sourced by people with disabilities by reviewing publicly-available information of 190 datasets, we call these accessibility datasets. We find that accessibility datasets represent diverse ages, but have gender and race representation gaps. Additionally, we investigate how the sensitive and complex nature of demographic variables makes classification difficult and inconsistent (e.g., gender, race & ethnicity), with the source of labeling often unknown. By reflecting on the current challenges and opportunities for representation of disabled data contributors, we hope our effort expands the space of possibility for greater inclusion of marginalized communities in AI-infused systems.

Language measurement in childhood epilepsy: A review

The psychosocial well-being of children and adolescents with epilepsy is affected by comorbid language deficits. Little is known about the focus of current research in language and epilepsy. A systematic review of research was conducted to identify gaps in knowledge regarding language and epilepsy. In total, 83 published articles were eligible for inclusion. More studies included samples presenting with focal seizures (k = 39) compared to generalized seizures (k = 10), few included measures of morphology (k = 4). Most studies (k = 66) included samples of participants across a wide age range. Our review indicated t-hat future research should include a greater focus on participants with more diversity in epilepsy etiology (e.g., symptomatic epilepsy), and seizure type (e.g., generalized seizures), assessment of additional areas of language (e.g., morphology), increased focus on early childhood, focused examination of specific developmental stages, and greater use of comparison groups with an alternate epilepsy diagnosis.

Language function in childhood idiopathic epilepsy syndromes

PURPOSE

To examine the impact of diverse syndromes of focal and generalized epilepsy on language function in children with new and recent onset epilepsy. Of special interest was the degree of shared language abnormality across epilepsy syndromes and the unique effects associated with specific epilepsy syndromes.

METHODS

Participants were 136 youth with new or recent-onset (diagnosis within past 12 months) epilepsy and 107 healthy first-degree cousin controls. The participants with epilepsy included 20 with Temporal Lobe Epilepsy (TLE; M age = 12.99  years, SD = 3.11), 41 with Benign Epilepsy with Centrotemporal Spikes (BECTS; M age = 10.32, SD = 1.67), 42 with Juvenile Myoclonic Epilepsy (JME; M age = 14.85, SD = 2.75) and 33 with absence epilepsy (M age = 10.55, SD = 2.76). All children were administered a comprehensive test battery which included multiple measures of language and language-dependent abilities (i.e., verbal intelligence, vocabulary, verbal reasoning, object naming, reception word recognition, word reading, spelling, lexical and semantic fluency, verbal list learning and delayed verbal memory). Test scores were adjusted for age and gender and analyzed via MANCOVA.

RESULTS

Language abnormalities were found in all epilepsy patient groups. The most broadly affected children were those with TLE and absence epilepsy, whose performance differed significantly from controls on 8 of 11 and 9 of 11 tests respectively. Although children with JME and BECTS were less affected, significant differences from controls were found on 4 of 11 tests each. While each group had a unique profile of language deficits, commonalities were apparent across both idiopathic generalized and localization-related diagnostic categories.

DISCUSSION

The localization related and generalized idiopathic childhood epilepsies examined here were associated with impact on diverse language abilities early in the course of the disorder.

Effects of Epilepsy on Language Functions: Scoping Review and Data Mining Findings

PURPOSE

This study involved a scoping review to identify possible gaps in the empirical description of language functioning in epilepsy in adults. With access to social network data, data mining was used to determine if individuals with epilepsy are expressing language-related concerns.

METHOD

For the scoping review, scientific databases were explored to identify pertinent articles. Findings regarding the nature of epilepsy etiologies, patient characteristics, tested language modalities, and language measures were compiled. Data mining focused on social network databases to obtain a set of relevant language-related posts.

RESULTS

The search yielded 66 articles. Epilepsy etiologies except temporal lobe epilepsy and older adults were underrepresented. Most studies utilized aphasia tests and primarily assessed single-word productions; few studies included healthy control groups. Data mining revealed several posts regarding epilepsy-related language problems, including word retrieval, reading, writing, verbal memory difficulties, and negative effects of epilepsy treatment on language.

CONCLUSION

Our findings underscore the need for future specification of the integrity of language in epilepsy, particularly with respect to discourse and high-level language abilities. Increased awareness of epilepsy-related language issues and understanding the patients' perspectives about their language concerns will allow researchers and speech-language pathologists to utilize appropriate assessments and improve quality of care.

Maturation of language networks in children: A systematic review of 22years of functional MRI

Understanding how language networks change during childhood is important for theories of cognitive development and for identifying the neural causes of language impairment. Despite this, there is currently little systematic evidence regarding the typical developmental trajectory for language from the field of neuroimaging. We reviewed functional MRI (fMRI) studies published between 1992 and 2014, and quantified the evidence for age-related changes in localisation and lateralisation of fMRI activation in the language network (excluding the cerebellum and subcortical regions). Although age-related changes differed according to task type and input modality, we identified four consistent findings concerning the typical maturation of the language system. First, activation in core semantic processing regions increases with age. Second, activation in lower-level sensory and motor regions increases with age as activation in higher-level control regions reduces. We suggest that this reflects increased automaticity of language processing as children become more proficient. Third, the posterior cingulate cortex and precuneus (regions associated with the default mode network) show increasing attenuation across childhood and adolescence. Finally, language lateralisation is established by approximately 5years of age. Small increases in leftward lateralisation are observed in frontal regions, but these are tightly linked to performance.

Speed and complexity characterize attention problems in children with localization-related epilepsy

OBJECTIVE

Children with epilepsy (EPI) have a higher rate of attention-deficit/hyperactivity disorder (ADHD; 28-70%) than typically developing (TD) children (5-10%); however, attention is multidimensional. Thus, we aimed to characterize the profile of attention difficulties in children with epilepsy.

METHODS

Seventy-five children with localization-related epilepsy ages 6-16 years and 75 age-matched controls were evaluated using multimodal, multidimensional measures of attention including direct performance and parent ratings of attention as well as intelligence testing. We assessed group differences across attention measures, determined if parent rating predicted performance on attention measures, and examined if epilepsy characteristics were associated with attention skills.

RESULTS

The EPI group performed worse than the TD group on timed and complex attention aspects of attention (p < 0.05), whereas performance on simple visual and simple auditory attention tasks was comparable. Children with EPI were 12 times as likely as TD children to have clinically elevated symptoms of inattention as rated by parents, but ratings were a weak predictor of attention performance. Earlier age of onset was associated with slower motor speed (p < 0.01), but no other epilepsy-related clinical characteristics were associated with attention skills.

SIGNIFICANCE

This study clarifies the nature of the attention problems in pediatric epilepsy, which may be under-recognized. Children with EPI had difficulty with complex attention and rapid response, not simple attention. As such, they may not exhibit difficulty until later in primary school when demands increase. Parent report with standard ADHD screening tools may under-detect these higher-order attention difficulties. Thus, monitoring through direct neuropsychological performance is recommended.

Narrative performance of gifted African American school-aged children from low-income backgrounds

PURPOSE

This study investigated classroom differences in the narrative performance of school-age African American English (AAE)-speaking children in gifted and general education classrooms.

METHOD

Forty-three children, Grades 2-5, each generated fictional narratives in response to the book Frog, Where Are You? (Mayer, 1969). Differences in performance on traditional narrative measures (total number of communication units [C-units], number of different words, and mean length of utterance in words) and on AAE production (dialect density measure) between children in gifted and general education classrooms were examined.

RESULTS

There were no classroom-based differences in total number of C-units, number of different words, and mean length of utterance in words. Children in gifted education classrooms produced narratives with lower dialect density than did children in general educated classrooms. Direct logistic regression assessed whether narrative dialect density measure scores offered additional information about giftedness beyond scores on the Peabody Picture Vocabulary Test-Fourth Edition (Dunn & Dunn, 2007), a standard measure of language ability. Results indicated that a model with only Peabody Picture Vocabulary Test-Fourth Edition scores best discriminated children in the 2 classrooms.

CONCLUSION

African American children across gifted and general education classrooms produce fictional narratives of similar length, lexical diversity, and syntax complexity. However, African American children in gifted education classrooms may produce lower rates of AAE and perform better on standard measures of vocabulary than those in general education classrooms.

Fluency patterns in narratives from children with localization related epilepsy

This study assessed the relationship between fluency and language demand in children with epilepsy, a group known to demonstrate depressed language skills. Disfluency type and frequencies were analyzed in elicited narratives from 52 children. Half of these children had localization-related epilepsy (CWE), while the others were age- and gender-matched typically-developing (TD) peers. CWE were found to be significantly more disfluent overall than their matched TD peers during narrative productions, and demonstrated a higher proportion of stutter-like disfluencies, particularly prolongations. The current study adds to an emerging literature that has found depressed language skills and listener perceptions of verbal ability in children with chronic seizure activity, and contributes to the small but growing literature that suggests that disfluency during spoken language tasks may be a subtle marker of expressive language impairment.

EDUCATIONAL OBJECTIVES

The reader will be able to (a) describe why children with epilepsy might be at greater risk for language delays and or increased levels of disfluency; (b) describe profiles of fluency that differentiated children with chronic and recent-onset epilepsy from their age and gender matched peers; and (c) apply this information to monitoring of children with seizure disorder on their caseloads.