Telepractice Parent Training of Enhanced Milieu Teaching With Phonological Emphasis (EMT+PE) For Persian-Speaking Toddlers With Nonsyndromic Cleft Palate: Protocol for a Randomized Controlled Trial

BACKGROUND

Children born with a cleft palate with or without a cleft lip (CP/L) are at increased risk for delayed language development and speech sound disorders. Enhanced Milieu Teaching with Phonological Emphasis (EMT+PE) is a recommended naturalistic intervention for toddlers with CP/L. The parents' role in providing naturalistic interventions is critical and they need training based on learning principles to implement these interventions. Telepractice is an appropriate method for training parents and children with various speech-related disorders.

OBJECTIVE

This study aims to determine and compare the effectiveness of telepractice and the parent-implemented EMT+PE intervention on language and speech measures in toddlers with CP/L with usual interventions and determine the effectiveness maintenance of the intervention.

METHODS

A randomized controlled trial (RCT) will assess the efficacy of telepractice and the parent-implemented EMT+PE intervention in enhancing speech and language measures in toddlers with CP/L. Eligible participants will be randomly assigned to one of 2 groups: the conventional intervention group and the EMT+PE intervention group. Participants' speech and language measures will be evaluated remotely by trained raters before and after the intervention and 2 months after the intervention. Parents of participants in the intervention group will receive 3 months of training in speech and language supportive strategies from trained therapists using telehealth fidelity scales. Parents of participants in the control group will receive the conventional speech and language intervention by cleft team therapists. Study outcomes will include language variables (mean length of utterance) and speech production variables (percent correct consonants).

RESULTS

The protocol was approved by the Research Ethics Committee of the University of Social Welfare and Rehabilitation Sciences in February 2022. The selection process of participants, as well as training therapists and raters, commenced in January 2022, the therapy and follow-up period ended in June 2023, and pre- and postintervention assessments have been conducted. Data analysis is ongoing, and we expect to publish our results by the summer of 2024. Funding is yet to be received.

CONCLUSIONS

The results of this study may help us develop a speech and language intervention with a different delivery model for toddlers with CP/L, and the cleft team care can use these results in service delivery. Consistent with our hypothesis, speech and language measures are expected to improve.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/54426.

The development and psychometric assessment of communication skills checklist for 6- to 24-month-old Persian children

Prelinguistic skills play an important role in children's communication development. These skills are considered as significant bases for language acquisition and function conductive to later social development. Means of communication, communicative functions, skills with cognitive bases, and language comprehension are important prelinguistic skills. There is a critical period for acquiring prelinguistic skills and early identification of communication deficits is an important issue to be considered. The present study aimed to develop a communication skills checklist for Persian children aged 6- to 24-month-old and evaluate its psychometric properties. Parents of 277 Persian children aged 6- to 24-month-old participated in the current study. A checklist was first developed after an extensive literature review and various psychometric analyses in addition to regression analyses were carried out to determine its validity and reliability. The final checklist contained 36 items with high face validity and content validity (CVI > 0.62, CVR > 0.79). Also, the checklist demonstrated a high association with the CNCS (Pearson's correlation coefficient = 0.85, p < 0.001), and the construct validity showed significant differences between the four age groups (F-test = 197.881, p < 0.001). The results of the internal consistency measurement (Cronbach's alpha coefficient = 0.952) and the test-retest reliability test (ICC = 0.933, p < 0.001) revealed excellent reliability of the checklist. In conclusion, based on the psychometric assessment, this checklist is a promising tool for assessing communication skills in Persian children aged 6 to 24 months.

Sequential Associations Between Communication Acts of Children With and Without Autism Spectrum Disorder and Maternal Verbal Responses

In this study, the sequential associations between child communication acts, including spontaneous communication (SC) and elicited communication (EC), and the types of verbal responses of Iranian mothers (follow-in nondirective, follow-in directive, and redirective responses) were compared between children with autism spectrum disorder (ASD) and young typically developing (TD) children. Participants were 29 children with ASD aged 3-6 years and 40 TD children aged 13-18 months, matched on expressive vocabulary. Using time-window sequential analysis, maternal verbal responses within a time interval of 3 sec following child communication were examined during 15 min of video-recorded mother-child free play interaction. Mothers in the two groups had broadly similar patterns of response to child communication acts, but some differences in responding to child EC. Across both groups, sequential associations were stronger for maternal follow-in nondirective responses to child SC than for this type of response to child EC, and were stronger for follow-in directive responses to child EC than for follow-in directive responses to child SC. Child EC and SC acts were less likely to be followed by redirective responses than other maternal responses, again across both groups. Finally, mothers of children with ASD were more likely than mothers of TD children to follow-in to child EC with both nondirective and directive responses. Our findings suggest that mothers of children with ASD synchronize their responses with their child's SC acts to the same extent as mothers of TD children, and are more synchronous in responding to their child's EC acts. LAY SUMMARY: This observational study examined how Iranian mothers verbally responded to their children's communication acts, based on whether the children's communication was spontaneous (unprompted) or elicited (prompted by the mother). Mothers of children with autism spectrum disorder or typical development responded to their children's spontaneous communication acts in similar ways, but showed some differences in responding to children's elicited communication. By prompting their children to communicate, mothers create opportunities to give additional verbal responses to their children, which may help to support children's further language development.

Development of Communicative Functions in Normal Persian-speaking Children from 12 to 18 Months of Age: A Longitudinal Study

Objective: Communication can affect the personal and social life of people. According to International Classification of Functioning, Disability and Health (ICF), communication is one of the most important components of social participation and can have different functions such as behavior regulation (regulating the behavior of others to achieve a particular goal), social interaction (drawing attention of others to the self) and joint attention (attracting the attention of others to an event or particular object). Having knowledge of the development of communicative functions is so important in assessment, diagnosis, prognosis, and early intervention. Despite the importance and effect of communicative functions in language and communication development, no study has been conducted yet that examines the communicative function development of normal Persian-speaking toddlers. The purpose of this study was to investigate the development of communicative functions in normal Persian-speaking children from 12 to 18 months of age, regardless of communicative expressions (such as gestures, vocalization, and words). Materials & Methods: This is a longitudinal observational study. The communicative function of 11 monolingual Persian-speaking 12-month-old children (7 boys and 4 girls) living in Tehran, Iran was investigated for 7 months. Sampling was done by using purposive and snowball non-probability sampling methods. All children had healthy medical history and normal growth, were from a family with a moderate socioeconomic status, and their parents had at least a high school diploma. The participants’ developmental status was assessed by Ages and Stages Questionnaire. A demographic form with acceptable content validity was also used to determine their demographic characteristics. For 7 months (once a month, each session for one hour), the examiner filmed the child-mother interaction during a semi-structured play with a set of toys at the child’s home. Afterwards, the recorded videos were coded according by the researcher and then entered into the SPSS V. 22 software. Descriptive statistics including mean and standard deviation were used to describe the data. The Shapiro-Wilk test was used to determine the normality of data distribution, and repeated measures ANOVA (within-subject comparison) was used to analyze the data. Two raters were taught about the coding and rating of the communicative functions. To verify the validity of the data coding, 20% of the recorded samples were given to them to code communicative functions. The coding validity was determined by calculating the Intra-class Correlation Coefficient (ICC). Results: The mean frequency of behavior regulation and social interaction was constant from 12 to 18 months of age (P<0.05), while the mean frequency of joint attention was constant from 12 to 15 months of age (P<0.05) and then significantly increased at months 16 (P= 0.019), 17 (P= 0.023) and 18 (P= 0.003) compared to the 12th month. The ICC value as the criterion for coding validity was reported 90%. Conclusion: The mean frequency of joint attention increased significantly from 12 to 18 months of age, while it was constant for behavior regulation and social interaction. Our findings are consistent with the ICF’s social participation, stating that a child uses a particular type of communicative function to increase its participation in the society.

Molecular characterization of haemagglutinin-neuraminidase gene among virulent Newcastle disease viruses isolated in Iran

BACKGROUND

Virulent Newcastle disease virus (vNDV) causes great economic losses to the poultry industry throughout the world. Despite the endemicity of Newcastle disease (ND) and occurrence of recurrent outbreaks, the nature and genetic features of circulating NDV strains in Iran are largely unknown. Aims: This study was conducted to characterize 13 NDV isolates obtained from different outbreaks in various regions of Iran during 1999-2000 by sequencing and phylogenetic analysis of complete coding sequences of haemagglutinin-neuraminidase (HN) gene.

METHODS

All isolates were analyzed based on the previously determined in vivo pathogenicity indices and amino acid (aa) sequences of fusion (F) protein cleavage site (FPCS).

RESULTS

Phylogenetic analysis based on the HN gene coding region revealed a very close relationship of these viruses with the recently defined genotype XIII, and more specifically, subgenotype XIIIa viruses. Analysis of HN gene nucleotide (nt) sequences revealed that all studied isolates encode for a protein length of 571 aa and there is no C-terminal extension on HN aa sequences. Sequence analysis revealed multiple aa residue substitutions at antigenic sites or neutralizing epitopes on the HN glycoprotein of studied viruses compared with commonly used vaccinal strains.

CONCLUSION

In this study, molecular characterization of vNDV isolates, obtained from commercial poultry farms in Iran, were conducted through complete sequencing and analysis of HN gene. Isolation and molecular characterization of further NDV isolates from other parts of Iran and from neighboring countries in the region will be helpful to identify the nature and origin of indigenous viruses.

Protective effect of pravastatin on doxorubicin-induced hepatotoxicity

OBJECTIVE

The present study was designed to investigate the possible protection of pravastatin against hepatic oxidative stress and dysfunctions induced by doxorubicin in rats.

BACKGROUND

Statins have beneficial effects on oxidative stress and inflammation.

METHODS

Male Sprague-Dawley rats were divided into four groups. Control group (received saline orally), Group 2 received pravastatin (20 mg/kg, i.p. for 15 days), Group 3 received single dose doxorubicin (15 mg/kg, i.p.), Group 4 was treated with pravastatin (20 mg/kg, i.p.) daily from 5 days before to 10 days after injection of doxorubicin (15 mg/kg, i.p.). Hepatic toxicity was estimated by biochemical parameters and oxidative stress and histopathological studies.

RESULTS

Administration of doxorubicin indicated an increase in ALT, AST, ALP, TG, cholesterol, LDL and total bilirubin levels (p < 0.01). Doxorubicin caused a reduction in HDL and albumin levels (p < 0.01) as well as superoxide dismutase, glutathione peroxidase and catalase activities (p < 0.05) with a concomitant increase in liver malondialdehyde (p < 0.05) and liver damage (p < 0.001). Pravastatin reduced the scale liver injury (p < 0.001) and protected liver functions and other biochemical parameters (p < 0.01). Increase in malondialdehyde level associated with a reduction in antioxidant activities in the doxorubicin group was attenuated by pravastatin treatment (p < 0.05).

CONCLUSION

Results indicated that pravastatin has a protective effect on the liver against doxorubicin-induced hepatotoxicity in rats (Tab. 3, Fig. 2, Ref. 34).

Detection of Mycoplasma agalactiae in Small Ruminants of Southeast Iran

Agalactia is an infectious and contagious disease of small ruminants caused by Mycoplasma agalactiae (M. agalactiae). Although different microorganism strains contribute to this disease, M. agalactiae is known as the most prominent causative agent. Therefore, this study aimed to investigate the rate of M. agalactiae involvement in contagious agalactia in the southeast region of Iran. Sampling was performed from milk, conjunctiva, ear lesions, and joints exudate of suspicious sheep and goat flocks according to the reports of Iran Veterinary Organization. The presence of Mycoplasma and its species, namely M. agalactiae, was evaluated through microbial culture and polymerase chain reaction (PCR) techniques. The detected microorganisms were confirmed to be Mycoplasma and M. agalactiae by the PCR amplification of 16S rRNA and lipoprotein target genes. According to the findings of present study, 14.8% and 36.0% of the samples were diagnosed as positive for Mycoplasma by culture and PCR, respectively. Moreover, the incidence of M. agalactiae was determined as 6.1% using the specific PCR method. Therefore, it is recommended to identify the other species of Mycoplasma in small ruminant samples involved with contagious agalactiae disease.

Co-circulation of genetically distinct groups of avian paramyxovirus type 1 in pigeon Newcastle disease in Iran

Pigeons are considered as one of the major natural reservoirs in the epidemiology of Newcastle disease (ND). In this study, the partial sequence of fusion protein gene of 17 pigeon-origin ND viruses (NDVs) isolated during 2012-2013 in Iran was analysed. Since the studied isolates showed F0 protein cleavage sites compatible with velogenic NDVs, all were considered as virulent NDVs. Two isolates carried 112RRQKRF117 as the cleavage site motif, whereas the rest demonstrated 112KRQKRF117 motif which just recently has been reported among Iranian virulent NDVs. Phylogenetic analysis divided all these diverse isolates in two distinct clusters within class II genotype VI. Based on the partial fusion protein gene sequence, 15 out of 17 isolates showed the highest genetic identity to subgenotype VIb/2 and the other two isolates were placed in a distinct genetic group of genotype VI. Based on recent findings, at least two different sublineages of genotype VI are causing the ND outbreaks in the pigeon population and are circulating simultaneously along with virulent NDVs of genotype VII in various species in Iran. The continuing circulation of a diverse group of virulent NDVs as an enzootic in widespread species such as pigeon can cause outbreaks in commercial poultry flocks and also failure in controlling programmes. Therefore, the constant monitoring and awareness of the virus characteristics should be considered in controlling programmes against ND in Iran.

Isolation and Detection of Mycoplasma agalactiae from Semen Samples of Goats

Contagious agalactia (CA) is a highly infectious disease of goats and sheep, and is a form of Mycoplasmosis, which is usually enzootic. Since Mycoplasma agalactiae (M. agalactiae) is the main cause of this disease in goats, the aim of this study was to isolate and detect M. agalactiae from semen of goat bucks. Thirty-nine semen samples were collected from goat bulks, and all samples were cultured in PPLO broth medium supplemented for M. agalaciae isolation. The bacteria DNAs were extracted from clinical samples and the PCR assay was applied to detect Mycoplasma genus and M. agalactiae species using specific primers, which amplified a 163bp fragment in 16SrRNA gene and a 375bp fragment in lipoprotein gene. The PCR evaluations were performed for both the clinical samples and the cultures. Out of the 39 samples, 29 (74.3%) of the cultures were shown positive and typical Mycoplasma colonies grew on PPLO agar, which could be considered as the diagnostic method. In addition, 38 (97.4%) samples had positive PCR results for Mycoplasma genus and six (15.3%) of the samples were shown to be positive using PCR for M. agalactiae as the diagnostic method. In the present study, M. agalactiae was detected in semen of goat bulks for the first time in Iran. Therefore, it is recommended to concern semen as one of the significant sources for this pathogen and the possibility for transmission to the female goats through semen is highlighted. Moreover, presence of this microorganism in semen could be involved in infertility of goat population.