Male and Female Toddlers with DSM-5 Autism Spectrum Disorder have Similar Developmental Profiles and Core Autism Symptoms

Compare developmental profiles and core ASD symptom manifestation between male and female toddlers with DSM-5 ASD. Retrospective record review of 500 toddlers (79% male) at time of ASD diagnosis. There were no differences in developmental functioning between males and females. When adjusting for multiple comparisons, sex differences were only noted for sensory seeking behavior occurring at a higher frequency in females. Overall, there were no significant differences in demographic characteristics, developmental functioning, or manifestation of core ASD symptoms between males versus female toddlers at the time of DSM-5 ASD diagnosis.

High-Fidelity Cleft Simulation Maintains Improvements in Performance and Confidence: A Prospective Study

OBJECTIVE

High-fidelity simulation has a growing role in plastic surgical education. This study tests the hypothesis that cleft lip repair simulation followed by structured debriefing improves performance and self-confidence and that gains are maintained.

DESIGN

Prospective, single-blinded interventional study with repeated measures. Trainees performed cleft lip repair on a high-fidelity simulator followed by debriefing, immediately completed a second repair, and returned 3 months later for a third session. Anonymized simulation videos were rated using the modified Objective Structured Assessment of Technical Skills (OSATS) and the Unilateral Cleft Lip Repair competency assessment tool (UCLR). Self-assessed cleft lip knowledge/confidence and procedural self-confidence were surveyed after each simulation.

SETTING

Boston Children's Hospital, a tertiary care academic hospital in Boston, MA, USA.

PARTICIPANTS

All trainees rotating through the study setting were eligible. Twenty-six participated; 21 returned for follow-up.

RESULTS

Significant improvements (p < 0.05) occurred between the first and second simulations for OSATS, UCLR, and procedural self-confidence. Significant improvement occurred between the second and third simulations cleft lip knowledge/confidence. Compared to the first simulation, improvements were maintained at the third simulation for all variables. Training level moderately correlated with score for UCLR for the first simulation (r = 0.55, p < 0.01), deteriorated somewhat with the second (r = 0.35, p = 0.08), and no longer corelated by the third (r = 0.02, p = 0.92).

CONCLUSIONS

Objective performance and subjective self-assessed knowledge and confidence improve with high-fidelity simulation plus structured debriefing and improvement is maintained. Differences in procedure-specific performance seen with increasing training level are reduced with simulation, suggesting it may accelerate knowledge and skill acquisition.

Assessing Language Skills Using Diagnostic Classification Models: An Example Using a Language Instrument

The primary purpose of the present study was to inform and illustrate, using examples, the use of Diagnostic Classification Models (DCMs) for the assessment of skills and competencies in cognition and academic achievement. A secondary purpose was to compare and contrast traditional and contemporary psychometrics for the measurement of skills and competencies. DCMs are described along the lines of other psychometric models within the Confirmatory Factor Analysis tradition, such as the bifactor model and the known mixture models that are utilized to classify individuals into subgroups. The inclusion of interaction terms and constraints along with its confirmatory nature enables DCMs to accurately assess the possession of skills and competencies. The above is illustrated using an empirical dataset from Saudi Arabia (n = 2,642), in which language skills are evaluated on how they conform to known levels of competency, based on the CEFR (Council of Europe, 2001) using the English Proficiency Test (EPT).

Special Education Services and School-Related Quality of Life in Children With Learning Disorders and Their Families: A One-Year Follow-Up Study

Learning disorders can have adverse impacts on children and families extending beyond the academic skills deficits. The goal of the present study was to assess the impact of the school's response, following an independent evaluation, for child and family school-related quality of life (QOL). We hypothesized that a positive school response would be associated with improved QOL. Parents completed the LDQOL/15, a brief measure of school-related QOL, at the time that their child received an independent evaluation and again a year later (N = 155). At follow-up, parents reported the tenor of the school's response to the evaluation and whether special education services had changed. QOL problems were very high in this referred population, with 66% of respondents rating a level of problems in the clinical range at baseline. Predicted interactions between time of assessment (baseline/follow-up) and the school's response to the evaluation were confirmed for all outcome variables; a positive school response was associated with improved QOL. Nevertheless, the overall prevalence of school-related QOL problems remained high a year after the evaluation. These findings indicate that special education interventions can mitigate learning disabilities' impacts, but even with these services, many children with learning disorders and their families continue to be significantly affected.

Evaluating a Computerized Adaptive Testing Version of a Cognitive Ability Test Using a Simulation Study

This study evaluated the psychometric quality of a computerized adaptive testing (CAT) version of the general cognitive ability test (GCAT), using a simulation study protocol put forth by Han, K. T. (2018a). For the needs of the analysis, three different sets of items were generated, providing an item pool of 165 items. Before evaluating the efficiency of the GCAT, all items in the final item pool were linked (equated), following a sequential approach. Data were generated using a standard normal for 10,000 virtual individuals ( M = 0 and SD = 1). Using the measure’s 165-item bank, the ability value (θ) for each participant was estimated. maximum Fisher information (MFI) and maximum likelihood estimation with fences (MLEF) were used as item selection and score estimation methods, respectively. For item exposure control, the fade away method (FAM) was preferred. The termination criterion involved a minimum SE ≤ 0.33. The study revealed that the average number of items administered for 10,000 participants was 15. Moreover, the precision level in estimating the participant’s ability score was very high, as demonstrated by the CBIAS, CMAE, and CRMSE). It is concluded that the CAT version of the test is a promising alternative to administering the corresponding full-length measure since it reduces the number of administered items, prevents high rates of item exposure, and provides accurate scores with minimum measurement error.

Applying a Multidimensional Item Response Theory Approach in Validating the Dimensionality of the Positive Youth Development Scale

Positive youth development has gained a lot of attention recently since it acts as a protective factor for several risk behaviors and other important life outcomes in adolescents and young adults. The main objective of this study was to explore the factorial structure of the Positive Youth Development Scale (PYDS) using multidimensional item response theory (MIRT). Three different models were examined: a unidimensional model, a multidimensional model with six distinct dimensions, and a multidimensional bifactor model, where each item was restricted to load simultaneously on a global positive development factor as well as a domain-specific one. Results indicated that the bifactor model provided superior model fit compared to the competing models, including a testlet and purified models. The study concludes with the advantages of MIRT models in dimensionality assessment and provides some suggestions for the improvement of the PYDS’ item characteristics.

Identifying Student Subgroups as a Function of School Level Attributes: A Multilevel Latent Class Analysis

The purpose of the present study was to profile high school students’ achievement as a function of their demographic characteristics, parent attributes (e.g., education), and school behaviors (e.g., number of absences). Students were nested within schools in the Saudi Arabia Kingdom. Out of a large sample of 500k, participants involved 3 random samples of 2,000 students measured during the years 2016, 2017, and 2018. Randomization was conducted at the student level to ensure that all school units will be represented and at their respective frequency. Students were nested within 50 high schools. We adopted the multilevel latent profile analysis protocol put forth by Schmiege et al. (2018) and Mäkikangas et al. (2018) that account for nested data and tested latent class structure invariance over time. Results pointed to the presence of a 4-profile solution based on BIC, the Bayes factor, and several information criteria put forth by Masyn (2013). Latent profile separation was mostly guided by parents’ education and the number of student absences (being positive and negative predictors of high achievement classes, respectively). Two models tested whether the proportions of level 1 profiles to level 2 units are variable and whether level 2 profiles vary as a function of level 1 profiles. Results pointed to the presence of significant variability due to schools.

Incorporating Cleft Lip Simulation Into a "Bootcamp-Style" Curriculum

INTRODUCTION

The traditions of surgical education have changed little over the years. However, the increasing focus on patient safety and duty hour restrictions mandates that residents start developing complex skill sets earlier to ensure they graduate with procedural competency. Surgical training is poised to exploit high-fidelity simulation technology to mitigate these pressures.

METHODS

By revisiting principles of adult learning theory, the authors created a "bootcamp-style" cleft lip curriculum that sought to (1) maximize educational impact and (2) pilot a high-fidelity procedural trainer permitting resident operative autonomy as part of that curriculum. Trainees participated in small group educational sessions comprised of a standard cleft didactic lecture, augmented by instructional video. Participants immediately processed knowledge from the lecture/video by "operating" on the simulator, allowing opportunities for questions and self-reflection, completing the learning cycle. A self-assessment survey was taken before and after each component of the session, including a self-confidence survey to conclude the session. Anthropometric measures of lip/nasal symmetry were assessed.

RESULTS

Sixteen trainees participated in the program. Little increase in self-assessed knowledge/skill was seen after the lecture, but significant increases in most aspects of cleft lip repair were seen after simulation. The greatest increase in self-assessment was seen for the program as a whole, with significant differences across all aspects of the self-assessment. Higher levels of training were associated with both higher self-assessment scores and better lip symmetry. Regardless of level of training, all participants strongly agreed that simulation helped them actively engage in learning and should be a required aspect of training, whereas 94% (n = 15) thought simulation was much more effective than standard preparation alone.

CONCLUSIONS

This pilot curriculum illustrates a mechanism to incorporate lessons from adult learning theory into plastic surgery training using a high-fidelity simulator for deliberate practice of cleft lip repair. Further evaluation is warranted to determine whether this didactic model can accelerate the acquisition of the complex skill set required for cleft lip repair and other surgical procedures.

Identifying Subgroups of Toddlers with DSM-5 Autism Spectrum Disorder Based on Core Symptoms

The objective of this study was to identify subgroups of toddlers with DSM-5 ASD based on core ASD symptoms using a person-based analytical framework. This is a retrospective study of 500 toddlers (mean age 26 months, 79% male) with DSM-5 ASD. Data were analyzed using latent class analyses in which profiles were formed based on ASD symptomatology. Social communication (SC) symptoms favored a three-class solution, while restricted/repetitive behaviors (RRBs) favored a two-class solution. Classes with higher consistency of SC deficits were younger, with lower developmental functioning. The class with more RRBs was older, with higher functioning. If confirmed in other populations, these classes may more precisely characterize subgroups within the heterogeneous group of toddlers at time of ASD diagnosis.

Infant circulating MicroRNAs as biomarkers of effect in fetal alcohol spectrum disorders

Prenatal alcohol exposure (PAE) can result in cognitive and behavioral disabilities and growth deficits. Because alcohol-related neurobehavioral deficits may occur in the absence of overt dysmorphic features or growth deficits, there is a need to identify biomarkers of PAE that can predict neurobehavioral impairment. In this study, we assessed infant plasma extracellular, circulating miRNAs (exmiRNAs) obtained from a heavily exposed Cape Town cohort to determine whether these can be used to predict PAE-related growth restriction and cognitive impairment. PAE, controlling for smoking as a covariate, altered 27% of expressed exmiRNAs with clinically-relevant effect sizes (Cohen's d ≥ 0.4). Moreover, at 2 weeks, PAE increased correlated expression of exmiRNAs across chromosomes, suggesting potential co-regulation. In confirmatory factor analysis, the variance in expression for PAE-altered exmiRNAs at 2 weeks and 6.5 months was best described by three-factor models. Pathway analysis found that factors at 2 weeks were associated with (F1) cell maturation, cell cycle inhibition, and somatic growth, (F2) cell survival, apoptosis, cardiac development, and metabolism, and (F3) cell proliferation, skeletal development, hematopoiesis, and inflammation, and at 6.5 months with (F1) neurodevelopment, neural crest/mesoderm-derivative development and growth, (F2) immune system and inflammation, and (F3) somatic growth and cardiovascular development. Factors F3 at 2 weeks and F2 at 6.5 months partially mediated PAE-induced growth deficits, and factor F3 at 2 weeks partially mediated effects of PAE on infant recognition memory at 6.5 months. These findings indicate that infant exmiRNAs can help identify infants who will exhibit PAE-related deficits in growth and cognition.

Pathogenic Yield of Genetic Testing in Autism Spectrum Disorder

BACKGROUND AND OBJECTIVES

Genetic testing is recommended for individuals with autism spectrum disorder (ASD). Pathogenic yield varies by clinician and/or patient characteristics. Our objectives were to determine the pathogenic yield of genetic testing, the variability in rate of pathogenic results based on subject characteristics, and the percentage of pathogenic findings resulting in further medical recommendations in toddlers with a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnosis of ASD.

METHODS

We conducted a retrospective chart review of 500 toddlers, 18 to 36 months, diagnosed with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ASD (mean age: 25.8 months, 79% male). Subject demographics, medical and neuropsychological characteristics, and genetic test results were abstracted. Genetic results were divided into negative or normal, variants of unknown significance, and pathogenic. Subject characteristics were compared across results. Manual chart review determined if further recommendations were made after pathogenic results.

RESULTS

Over half of subjects (59.8%, n = 299) completed genetic testing, and of those, 36 (12.0%) had pathogenic findings. There were no significant differences in Bayley Scales of Infant Development cognitive (P = .112), language (P = .898), or motor scores (P = .488) among children with negative or normal findings versus a variant of unknown significance versus pathogenic findings. Medical recommendations in response to the genetic finding were made for 72.2% of those with pathogenic results.

CONCLUSIONS

Our findings reinforce the importance of genetic testing for toddlers diagnosed with ASD given the 12% yield and lack of phenotypic differences between subjects with and without pathogenic findings. The majority of pathogenic results lead to further medical recommendations.

Accounting for Differential Item Functioning Using Bayesian Approximate Measurement Invariance

The main thesis of the present study is to use the Bayesian structural equation modeling (BSEM) methodology of establishing approximate measurement invariance (A-MI) using data from a national examination in Saudi Arabia as an alternative to not meeting strong invariance criteria. Instead, we illustrate how to account for the absence of measurement invariance using relative compared to exact criteria. A secondary goal was to compare latent means across groups using invariant parameters only and through utilizing exact and relative evaluative-MI protocol suggested equivalence of the thresholds using prior variances equal to 0.10. Subsequent differences between groups were evaluated using effect size criteria and the prior-posterior predictive p-value (PPPP), which proved to be invaluable in attesting for differences that are beyond zero, some meaningless nonzero estimate, and the three commonly used indices of effect sizes described by Cohen in 1988 (i.e., .20, .50, and .80). Results substantiated the use of the PPPP for evaluating mean differences across groups when utilizing nonexact evaluative criteria.

Measurement Invariance and Differential Item Functioning Across Gender Within a Latent Class Analysis Framework: Evidence From a High-Stakes Test for University Admission in Saudi Arabia

The main aim of the present study was to investigate the presence of Differential Item Functioning (DIF) using a latent class (LC) analysis approach. Particularly, we examined potential sources of DIF in relation to gender. Data came from 6,265 Saudi Arabia students, who completed a high-stakes standardized admission test for university entrance. The results from a Latent Class Analysis (LCA) revealed a three-class solution (i.e., high, average, and low scorers). Then, to better understand the nature of the emerging classes and the characteristics of the people who comprise them, we applied a new stepwise approach, using the Multiple Indicator Multiple Causes (MIMIC) model. The model identified both uniform and non-uniform DIF effects for several items across all scales of the test, although, for the majority of them, the DIF effect sizes were negligible. Findings from this study have important implications for both measurement quality and interpretation of the results. Particularly, results showed that gender is a potential source of DIF for latent class indicators; thus, it is important to include those direct effects in the latent class regression model, to obtain unbiased estimates not only for the measurement parameters but also of the structural parameters. Ignoring these effects might lead to misspecification of the latent classes in terms of both the size and the characteristics of each class, which in turn, could lead to misinterpretations of the obtained latent class results. Implications of the results for practice are discussed.

Alignment of a Language Instrument Scores to CEFR Levels: Methodological and Empirical Considerations

The purpose of the present report was to assess congruence between a language-based national examination (termed English placement test - EPT) and the Common European Framework of Reference for Languages (CEFR) levels. To this end, a series of methodological steps were put forth to accumulate evidence suggesting that language performance based on the EPT instrument can be split onto meaningful subgroups based on theoretical (expert judgement on difficulty level and CEFR correspondence) and empirical considerations (i.e., how well these levels and subgroups emerged). Participants were 2642 high school graduates who took on the EPT instrument as part of their entry criteria to the university and for the purposes of the present study only the structure subscale is presented. Items were classified as reflecting specific CEFR levels and a person-based analysis attempted to classify individuals sharing the same behavioral patterns. Results using a latent class analysis (LCA) indicated that a Pre-A1, an A1 an A2 a B1 and a B2 levels were present with regard to the structure domain of language. Results showed a strong alignment between the EPT structure domain and CEFR guidelines using various methodological approaches.

An Application of Reliability Estimation in Longitudinal Designs Through Modeling Item-Specific Error Variance

The purpose of the present study was to apply the methodology developed by Raykov on modeling item-specific variance for the measurement of internal consistency reliability with longitudinal data. Participants were a randomly selected sample of 500 individuals who took on a professional qualifications test in Saudi Arabia over four different occasions. Data were analyzed by use of confirmatory factor analysis, and item error variance was corrected for item specificity. The estimation of reliability involved composite index omega. Results indicated that the initially low and unacceptable levels of internal consistency reliability approached acceptable levels after accounting for item-specific variance. Findings were verified by testing whether the difference estimates of internal consistency reliability deviated from a zero-mean distribution using 10,000 replicated samples assuming a known (symmetric) or unknown (asymmetric) population distribution of the difference reliability coefficients. Percentage improvement reliability estimates indices were also estimated along with their 95% confidence intervals. Two appendices provide annotated Mplus syntax files for future use.

Using Confidence Intervals of the Item and Test Information Functions to Test Differential Item and Test Functioning: Visual and Statistical Analyses

The purpose of the present paper was twofold: (a) to use 95% confidence intervals of the item and test information functions as a means of visualizing differences between groups on the information provided at the item and test levels, and, (b) to statistically compare item and test information functions as a method for evaluating differential item and differential test functioning. Participants were 2,305 high school students who took a Mathematics National entrance examination in Saudi Arabia. Item and test information functions, conditional standard errors of measurement and reliability were estimated for both males and females. Differences between groups became evident when plotting 95% confidence intervals of the item and test information functions and the visual findings were confirmed using population-based Z-tests of point estimates using a Monte-Carlo simulation. It was concluded that differential group behavior at the item and test levels can be evidenced using information functions and inferential tests of significance can be constructed using the bootstrap distribution. The current procedure involves both item difficulties and discrimination indices and provides increased sensitivity over the traditional methods relying on item difficulties only.

An IRT-Multiple Indicators Multiple Causes (MIMIC) Approach as a Method of Examining Item Response Latency

The analysis of response time has received increasing attention during the last decades, since evidence from several studies supported the argument that there is a direct relationship between item response time and test performance. The aim of this study was to investigate whether item response latency affects person's ability parameters, in that it represents an adaptive or maladaptive practice. To examine the above research question data from 8,475 individuals completing the computerized version of the Postgraduate General Aptitude Test (PAGAT) were analyzed. To determine the extent to which response latency affects person's ability, we used a Multiple Indicators Multiple Causes (MIMIC) model, in which every item in a scale was linked to its corresponding covariate (i.e., item response latency). We ran the MIMIC model within the Item Response Theory (IRT) framework (2-PL model). The results supported the hypothesis that item response latency could provide valuable information for getting more accurate estimations for persons' ability levels. Results indicated that for individuals who invest more time on easy items, their likelihood of success does not improve, most likely because slow and fast responders have significantly different levels of ability (fast responders are of higher ability compared to slow responders). Consequently, investing more time for low ability individuals does not prove to be adaptive. The opposite was found for difficult items: individuals spending more time on difficult items increase their likelihood of success, more likely because they are high achievers (in difficult items individuals who spent more time were of significantly higher ability compared to fast responders). Thus, it appears that there is an interaction between the difficulty of the item and person abilities that explain the effects of response time on likelihood of success. We concluded that accommodating item response latency in a computerized assessment model, can inform test quality and test takers' behavior, and in that way, enhance score measurement accuracy.

Assessing Construct Validity in Math Achievement: An Application of Multilevel Structural Equation Modeling (MSEM)

The purpose of the present study was to model math achievement at both the person and university levels of the analyses in order to understand the optimal factor structure of math competency. Data involved 2,881 students who took a national mathematics examination as part of their entry at the university public system in Saudi Arabia. Four factors from the National math examination comprised the math achievement measure, namely, numbers and operations, algebra and analysis, geometry and measurement, and, statistics and probabilities. Data were analyzed using the aggregate method and by use of Multilevel Structural Equation Modeling (MSEM). Results indicated that both a unidimensional and a 4-factor correlated model fitted the data equally well using aggregate data, where for reasons of parsimony the unidimensional model was the preferred choice with these data. When modeling data including clustering, results pointed to alternative factor structures at the person and university levels. Thus, a unidimensional model provided the best fit at the University level, whereas a four-factor correlated model was most descriptive for person level data. The optimal simple structure was evaluated using the Ryu and West (2009) methodology for partially saturating the MSEM model and also met criteria for discriminant validation as described in Gorsuch (1983). Furthermore, a university level variable, namely the year of establishment, pointed to the superiority of older institutions with regard to math achievement. It is concluded that ignoring a multilevel structure in the data may result in erroneous conclusions with regard to the optimal factor structure and the tests of structural models following that.

Quality of Life in Children and Adolescents With Learning Problems: Development and Validation of the LD/QOL15 Scale

Learning problems (LP) can have wider implications than the academic deficits per se. The goal of the present series of studies was to develop a reliable and valid quality-of-life measure targeted to children and adolescents with LP. In Study 1, using a 35-item questionnaire, we surveyed 151 parents/guardians of children referred for assessment of learning disorders. Exploratory factor analysis identified a three-factor model: Academic Performance, School Understanding, and Child/Family Psychological. These factors were validated against standardized measures of academic achievement and psychosocial functioning. The questionnaire was then reduced to 15 items-the LD/QOL15 -and administered to a community sample of 325 parents/guardians of children in Grades 1 to 8 (Study 2). The three-factor model was verified with confirmatory factor analysis. Comparison of general education ( n = 232) and LP ( n = 93) groups within the community sample documented substantial group differences ( p < .0001), with the LP group having higher mean scores. These differences were larger for older students (Grades 5-8) than younger students (Grades 1-4; p < .01). The LD/QOL15 is a brief and reliable measure that is valid to assess quality of life and, potentially, outcomes in children and adolescents with LP.

Can the Relationship Between Rapid Automatized Naming and Word Reading Be Explained by a Catastrophe? Empirical Evidence From Students With and Without Reading Difficulties

The purpose of the present study was to explain the moderating role of rapid automatized naming (RAN) in word reading with a cusp catastrophe model. We hypothesized that increases in RAN performance speed beyond a critical point would be associated with the disruption in word reading, consistent with a "generic shutdown" hypothesis. Participants were 587 elementary schoolchildren (Grades 2-4), among whom 87 had reading comprehension difficulties per the IQ-achievement discrepancy criterion. Data were analyzed via a cusp catastrophe model derived from the nonlinear dynamics systems theory. Results indicated that for children with reading comprehension difficulties, as naming speed falls below a critical level, the association between core reading processes (word recognition and decoding) becomes chaotic and unpredictable. However, after the significant common variance attributed to motivation, emotional, and internalizing symptoms measures from RAN scores was partialed out, its role as a bifurcation variable was no longer evident. Taken together, these findings suggest that RAN represents a salient cognitive measure that may be associated with psychoemotional processes that are, at least in part, responsible for unpredictable and chaotic word reading behavior among children with reading comprehension deficits.

Validation of Response Similarity Analysis for the Detection of Academic Cheating: An Experimental Study

The purpose of the present study was to evaluate various analytical means to detect academic cheating in an experimental setting. The omega index was compared and contrasted given a gold criterion of academic cheating which entailed a discrepant score between two administrations using an experimental study with real test takers. Participants were 164 elementary school students who were administered a mathematics exam followed by an equivalent mock exam under conditions of strict and relaxed, invigilation, respectively. Discrepant scores were defined as exceeding 7 responses in any direction (correct or incorrect), based on what was expected due to chance. Results indicated that the omega index was successful in capturing more than 39% of the cases who exceeded the conventional plus or minus 7 discrepancy criteria. It is concluded that the response similarity analysis may be an important tool in detecting academic cheating.

Reading Achievement, Mastery, and Performance Goal Structures Among Students With Learning Disabilities: A Nonlinear Perspective

The purpose of the present study was to examine the hypothesis that a nonlinear relationship exists between a performance-classroom climate and the reading achievement of adolescent students with learning disabilities (LD). Participants were 62 students with LD (Grades 5-9) from public elementary schools in northern Greece. Classroom climate was assessed using the Patterns of Adaptive Learning Styles. Achievement in reading was assessed using a normative reading assessment. Data were analyzed by means of catastrophe theory in which the behavior is predicted as a function of two control variables, the asymmetry factor and the bifurcation factor. Reading achievement (word identification) was predicted by students' ability to decode pseudowords (asymmetry variable) and by a mastery or performance motivational discourse (bifurcation factor). Results indicated that in classrooms with a performance goal structure, the cusp model fit the data and accounted for 54% of the variance in real word identification. In this condition, the association between pseudoword reading and real word reading was nonlinear. When a mastery climate was tested as a bifurcation variable, results indicated that its effect was nonsignificant and that instead the linear model fitted the data more adequately. Thus, increases in a classroom's performance motivational discourse are associated with sudden, unpredictable, and discontinued changes in students' reading performance.

The Impact of Non-attempted and Dually-Attempted Items on Person Abilities Using Item Response Theory

The purpose of the present study was to relate response strategy with person ability estimates. Two behavioral strategies were examined: (a) the strategy to skip items in order to save time on timed tests, and, (b) the strategy to select two responses on an item, with the hope that one of them may be considered correct. Participants were 4,422 individuals who were administered a standardized achievement measure related to math, biology, chemistry, and physics. In the present evaluation, only the physics subscale was employed. Two analyses were conducted: (a) a person-based one to identify differences between groups and potential correlates of those differences, and, (b) a measure-based analysis in order to identify the parts of the measure that were responsible for potential group differentiation. For (a) person abilities the 2-PL model was employed and later the 3-PL and 4-PL models in order to estimate upper and lower asymptotes of person abilities. For (b) differential item functioning, differential test functioning, and differential distractor functioning were investigated. Results indicated that there were significant differences between groups with completers having the highest ability compared to both non-attempters and dual responders. There were no significant differences between no-attempters and dual responders. The present findings have implications for response strategy efficacy and measure evaluation, revision, and construction.

Examining the relationship between home literacy environment and neural correlates of phonological processing in beginning readers with and without a familial risk for dyslexia: an fMRI study

Developmental dyslexia is a language-based learning disability characterized by persistent difficulty in learning to read. While an understanding of genetic contributions is emerging, the ways the environment affects brain functioning in children with developmental dyslexia are poorly understood. A relationship between the home literacy environment (HLE) and neural correlates of reading has been identified in typically developing children, yet it remains unclear whether similar effects are observable in children with a genetic predisposition for dyslexia. Understanding environmental contributions is important given that we do not understand why some genetically at-risk children do not develop dyslexia. Here, we investigate for the first time the relationship between HLE and the neural correlates of phonological processing in beginning readers with (FHD+, n = 29) and without (FHD-, n = 21) a family history of developmental dyslexia. We further controlled for socioeconomic status to isolate the neurobiological mechanism by which HLE affects reading development. Group differences revealed stronger correlation of HLE with brain activation in the left inferior/middle frontal and right fusiform gyri in FHD- compared to FHD+ children, suggesting greater impact of HLE on manipulation of phonological codes and recruitment of orthographic representations in typically developing children. In contrast, activation in the right precentral gyrus showed a significantly stronger correlation with HLE in FHD+ compared to FHD- children, suggesting emerging compensatory networks in genetically at-risk children. Overall, our results suggest that genetic predisposition for dyslexia alters contributions of HLE to early reading skills before formal reading instruction, which has important implications for educational practice and intervention models.

Language Differences at 12 Months in Infants Who Develop Autism Spectrum Disorder

Little is known about early language development in infants who later develop autism spectrum disorder (ASD). We analyzed prospective data from 346 infants, some of whom were at high risk for developing ASD, to determine if language differences could be detected at 12 months of age in the infants who later were diagnosed with ASD. Analyses revealed lower receptive and expressive language scores in infants who later were diagnosed with ASD. Controlling for overall ability to understand and produce single words, a Rasch analysis indicated that infants who later developed ASD had a higher degree of statistically unexpected word understanding and production. At 12 months of age, quantitative and qualitative language patterns distinguished infants who later developed ASD from those who did not.

Examination of the Biasing Properties of Cronbach Coefficient Alpha under Conditions of Varying Shapes of Data Distribution: A Monte Carlo Simulation

The biasing properties of Cronbach alpha in fixed-format tests were examined in a Monte Carlo simulation under conditions of varying shapes of data distribution. The distributions of data examined were normal (3, 1), uniform (1, 5), skewness biased, Kurtosis biased (leptokurtic), and U-shaped. Analysis indicated that alpha was significantly different from zero under the normal and uniform distributions; however, negative interitem correlations and marginal SDs might have been responsible for that effect. The magnitude of alpha was negligible so it is suggested that researchers can use alpha with data having various distributional properties.

Assessing Validity of Measurement in Learning Disabilities Using Hierarchical Generalized Linear Modeling: The Roles of Anxiety and Motivation

The purpose of the present studies was to test the hypothesis that the psychometric characteristics of ability scales may be significantly distorted if one accounts for emotional factors during test taking. Specifically, the present studies evaluate the effects of anxiety and motivation on the item difficulties of the Rasch model. In Study 1, the validity of a reading comprehension scale was evaluated using the Rasch model with 60 students with learning disabilities (LD). Item parameters were retested for the presence of anxiety and results indicated that the scale was substantially more difficult in its presence. Study 2 replicated the findings of Study 1 using maladaptive motivation and extended with inclusion of adaptive motivational variables in order to reverse the effect. Results using students with and without LD indicated that the difficulty levels of the scale was lower for students with LD, in the presence of positive motivation, compared with a typical student group. Study 3 extended the dichotomous hierarchical generalized linear model with polytomous data. The measures of an ability test were adjusted for the presence of anxiety and results indicated that differential item functioning was observed at both the global level and the most difficult ability item. It is concluded that the difficulty levels of a scale are heavily influenced by situational factors during testing, such as students' entry levels of motivation and affect.

A pediatric epilepsy diagnostic tool for use in resource-limited settings: A pilot study

OBJECTIVE

It is estimated that nearly 80% of the 50 million people affected with epilepsy globally live in regions where specialist care and diagnostic tests are scarce and care is often delivered through a primary health provider with limited training. To improve diagnostic accuracy of the history and physical examination, we developed and piloted a questionnaire to discriminate between focal versus generalized epilepsy, with the future goal to guide medication choices.

METHODS

Through literature review and retrospective chart review of 75 children with epilepsy at Boston Children's Hospital, a 15-item questionnaire was developed. Simple motor seizures were excluded for the purposes of this questionnaire. The questionnaire was then translated in local dialects and prospectively validated at Muhimbili National Hospital in Dar Es Salaam, Tanzania, and University Teaching Hospital in Lusaka, Zambia. Children 6months-18years of age with suspected or active epilepsy were identified, and a nonphysician administered the questionnaire to the patient's caregiver. Next, each patient was evaluated by a pediatric neurologist blinded to the questionnaire results, and together with locally obtained but remotely interpreted EEG, an electroclinical diagnosis was made. The questionnaire data were compared with this clinical gold standard.

RESULTS

A total of 59 children participated: 28 from Tanzania and 31 from Zambia. Sixteen patients were excluded: 5 were excluded because of incomplete data, and 11 did not meet criteria for epilepsy based on initial screening questions. Of the remaining 43 patients, 28 had focal or multifocal epilepsy (65%), and 15 (35%) had generalized epilepsy. The questionnaire had a sensitivity of 78% and positive predictive value of 81.5%. Data were analyzed using a Rasch model, testing the questionnaire's internal consistency, reliability, and its discriminative validity in classifying focal versus generalized epilepsy against an electroclinical diagnosis. The mean epilepsy score for focal epilepsy was 0.084 logits compared with -1.147 logits for generalized epilepsy, demonstrating a large effect size [F (1, 41)=13.490, p<0.001].

CONCLUSIONS

Our questionnaire provides a straightforward method to improve diagnostic accuracy, and could assist in bridging the diagnostic gap in pediatric epilepsy in resource-limited settings. This tool was specifically designed to be easily implemented by any healthcare provider. This pilot study prompts broader prospective validation in additional settings for further refinement, and for performance assessment of impact on provider's practice, ability to guide medication choices, and ultimately improve treatment outcomes in resource-limited regions.

Multi-Population Invariance With Dichotomous Measures

The purpose of the present study was to extend the model of measurement invariance by simultaneously estimating invariance across multiple populations in the dichotomous instrument case using multi-group confirmatory factor analytic and multiple indicator multiple causes (MIMIC) methodologies. Using the Arabic version of the General Aptitude Test (GAT), invariance was tested at the configural, metric, and scalar levels. Results indicated that the hybrid model that incorporates both the multi-group case and the MIMIC model provide a viable alternative to the measurement of invariance between variables when they interact. Metric and scalar invariance were supported for all of GAT’s subscales with the exception of Word Meaning for which lack of invariance was likely caused by model misspecification. Subtle effects were observed in favor of public school testees, but they did not exceed significance levels.

Hand preference of individuals with blindness in everyday activities: The effects of age of sight loss, age, and gender

The research aims of the present study were: (a) to assess the hand preference of blind persons in everyday activities on the basis of gender, type of blindness, and age; and (b) to conduct the above analysis at both the item level and the latent trait level, after concluding the optimum factor structure of the instrument. Participants were 82 individuals with visual impairments and blindness. Their mean age was 29.99 years. Handedness was evaluated using a modified version of the Edinburgh Handedness Inventory (Oldfield, 1971). When comparing handedness preferences across age of sight loss, gender, and age groups results indicated that there were significant differences in preference for several everyday tasks across age of sight loss and age groups but not gender. These results were also confirmed at the latent-trait mean level. The present findings add to the extant literature that highlighted hand preferences for individuals with visual impairments and blindness.

Attention-deficit/hyperactivity disorder in young children: predictors of diagnostic stability

OBJECTIVES

The goals of this study were (1) to provide estimates of diagnostic stability for a sample of young children diagnosed with attention-deficit/hyperactivity disorder (ADHD) after undergoing comprehensive multidisciplinary assessments and (2) to identify baseline child and family characteristics that predict diagnostic stability over time.

METHODS

Children aged 3 to 6 years, 11 months consecutively diagnosed with ADHD after multidisciplinary consultations at a tertiary care clinic between 2003 and 2008 were recontacted in 2012 and 2013 (N = 120). At follow-up, the primary outcome was the proportion of children who continued to meet diagnostic criteria for ADHD. To identify predictors of diagnostic stability, logistic regression models were used. In addition, a latent class model was used to independently classify subjects into distinct clusters.

RESULTS

In this cohort, 70.4% of the children contacted at follow-up continued to meet diagnostic criteria for ADHD. Predictors of diagnostic stability included externalizing and internalizing symptoms at baseline, parental history of psychopathology, and family socioeconomic status. The latent class model independently identified 3 distinct profiles: (1) children who no longer met ADHD criteria; (2) children with persistent ADHD and high parental psychopathology; and (3) children with persistent ADHD and low family socioeconomic status.

CONCLUSIONS

Young children who underwent comprehensive developmental and psychological assessments before receiving an ADHD diagnosis, had higher rates of diagnostic stability than in previous studies of community samples. Child and family factors that predict diagnostic stability have the potential to guide treatment planning for children diagnosed with ADHD before 7 years of age.

Ought-approach versus ought-avoidance: nonlinear effects on arousal under achievement situations

The present study examines the dimensions of oughts under a nonlinear perspective. Ought-approach and ought-avoidance have been proposed as two different dimensions of oughts, which have an opposite effect on subjects' arousal level under achievement situation. The change in arousal level measured by heart rates per minute (HRPM) was modeled as cusp catastrophe by implementing the two dimensions of oughts as the control parameters: the ought-approach as the asymmetry and the ought-avoidance as the bifurcation factor. The cusp model was proved by far superior from the three alternative linear models and provided the empirical evidence that the two dimensions of oughts are distinct and are associated with different processes. The ought-avoidance dimension being the bifurcation factor acts in a destructive manner by introducing nonlinearity and uncertainty in the self-regulation process (with regard to HRPM). The interpretation of the model is provided and implications are discussed.

Matthew effects in reading comprehension: myth or reality?

The presence of Matthew effects was tested in students of varying reading, spelling, and vocabulary skills. A cross-sequential design was implemented, following 587 Grade 2 through 4 students across five measurement points (waves) over 2 years. Students were administered standardized assessments of reading, spelling, and vocabulary. Results indicated that the hypothesized fan-spread pattern for Matthew effects was not evident. Low and high ability groups were formed based on 25th and 75th percentile cutoffs on initial measures of spelling, reading accuracy and fluency, vocabulary, and reading comprehension. Multilevel modeling suggested that low and high ability groups had significantly different starting points (intercepts) and their pattern of growth on passage comprehension did not indicate that the gap would increase over time. Instead, some analyses, especially of the youngest cohorts, showed significant convergence. However, there was no evidence of eventually closing the gap. Thus, although the poor students may not be getting poorer, they do not get sufficiently richer either.

Auditory discriminations of typographic attributes of documents by students with blindness

The general purpose of the present study was to test the effectiveness of various psycho-acoustic manipulations for the understanding of specific information (typographic attributes such as bold and italic) which was included in texts by individuals with and without blindness. Thirty blind and thirty sighted students participated and were asked to distinguish a number of controlled conditions of auditory components, as well as to express their preferences and opinions on the prosody of the selected acoustic features (pitch, volume and speed of the synthetic speech). Findings indicated that there were significant interactions between groups and experimental conditions across variables. The outcomes of the present study provided a rough assessment of the auditory means that may be conducive to the understanding of the specific typographic attributes. Based on these findings Text-to-Speech systems can deliver such information with all the appropriate auditory prosody in order to facilitate blind students’ memorization and comprehension and enhance inclusion.

Assessing Cognitive Interference Using the Emotional Stroop Task in Students with and Without Attention Problems

The present study describes the Emotional Stroop Task as a means to assess cognitive interference triggered by emotional stimuli in elementary school students with and without attention problems. Using the Emotional Stroop Task in a computerized environment and employing samples of students with and without attention problems (111 without and 29 with attention problems), results indicated that prolonged latencies to stimuli with heavy emotional content related to their school experiences were predictive of students’ membership, after controlling for their gender and grade levels. These effects were independent of students’ processing ability as indicated by the lack of significant differences in reaction time to neutral stimuli. It is concluded that the Emotional Stroop Task can be used to assess cognitive interference in emotionally charged conditions across groups of students.

Health-related information processing and recent health problems: evidence from a modified stroop task

Our purpose was to assess the relationship between health status and health-related information processing. We expected that persons who report a recent health problem would show greater bias towards relevant stimuli. Participants comprised two groups: the experimental with 25 students who recently had to interrupt usual activities because of their health, and a comparison group of 25 healthy students matched for demographics, health habits and current health. Using an emotional Stroop task, the experimental group demonstrated enhanced interference effects for illness and health-related versus general threat and neutral words. Satisfaction with life impacted the processing of health and illness-related stimuli.

Perceived parental bonding, fear of failure and stress during class presentations

The purpose of the present studies was to test the hypothesis that students' perceptions of parental bonding may be predictive of how individuals approach achievement situations. It was hypothesized that reports of parental overprotection would be predictive of elevated fears and subsequent stress and low achievement compared to perceived parental care. No hypotheses were specified regarding the gender of the parent. In Study 1 participants were 230 elementary school students who were assessed on motivation, stress and affect prior to a “high stakes testing”. Results indicated that paternal caring scores and, to a lesser degree, maternal caring scores were associated with lower levels of fear of failure, anxiety and depression. In Study 2, 58 college students were monitored (physiologically) during a class presentation in order to test the hypothesis that perceived parental rearing is predictive of stress through influencing fear of failure. Results from Multilevel Random Coefficient Modeling showed that perceived parental caring was associated with significantly lessened stress compared to perceived overprotection. Modeling the relationships using Structural Equation Modeling indicated that students reporting an overprotective parental style approached the task with significantly elevated fears, had elevated stress during the task, and lower task performance. Another salient finding was that students' perceptions of their fathers' parenting style was highly predictive of the stress response. The discussion reviews these findings and examines possible implications for enhancing achievement motivation in educational contexts.