Predicting variation in word decoding development in deaf and hard-of-hearing children

BACKGROUND

Deaf and hard-of-hearing (DHH) children may experience difficulties in word decoding development.

AIMS

We aimed to compare and predict the incremental word decoding development in first grade in Dutch DHH and hearing children, as a function of kindergarten reading precursors.

METHODS AND PROCEDURES

In this study, 25 DHH, and 41 hearing children participated. Kindergarten measures were phonological awareness (PA), letter knowledge (LK), rapid naming (RAN), and verbal short-term memory (VSTM). Word decoding (WD) was assessed at three consecutive time points (WD1, 2, 3) during reading instruction in first grade.

OUTCOMES AND RESULTS

The hearing children scored higher than the DHH children on PA and VSTM only, although the distribution of WD scores differed between the groups. At WD1, PA and RAN predicted WD efficiency in both groups; but PA was a stronger predictor for hearing children. At WD2, LK, RAN, and the autoregressor were predictors for both groups. While at WD3, only the autoregressor was a significant predictor.

CONCLUSIONS AND IMPLICATIONS

WD development in DHH children on average shows similar levels as in hearing children, though within the DHH group more variation was observed. WD development in DHH children is not as much driven by PA; they may use other skills to compensate.

Predicting Early Literacy: Auditory and Visual Speech Decoding in Deaf and Hard-of-Hearing Children

The current study investigated the relative contributions of auditory speech decoding (i.e., auditory discrimination) and visual speech decoding (i.e., speechreading) on phonological awareness and letter knowledge in deaf and hard-of-hearing (DHH) kindergartners (Mage = 6;4, n = 27) and hearing kindergartners (Mage = 5;10, n = 42). Hearing children scored higher on auditory discrimination and phonological awareness, with the DHH children scoring at chance level for auditory discrimination, while no differences were found on speechreading and letter knowledge. For DHH children, speechreading correlated with phonological awareness and letter knowledge, for the hearing children, auditory discrimination correlated with phonological awareness. Two regression analyses showed that speechreading predicted phonological awareness and letter knowledge in DHH children only. Speechreading may thus be a compensatory factor in early literacy for DHH children, at least for those who are exposed to spoken language in monolingual or in bilingual or bimodal-bilingual contexts, and could be important to focus on during early literacy instruction.

Simple View of Reading in Deaf and Hard-of-Hearing Adults

The present study investigated the relative contribution of the two components in the simple view of reading to the reading comprehension skills of deaf and hard-of-hearing (DHH) adults in the Netherlands. Eighty DHH adults, aged between 30 and 80 years old, were tested on word reading, reading fluency, vocabulary, and reading comprehension. Regression analyses showed that both decoding skills and vocabulary contributed to the reading comprehension skills of DHH adults, with vocabulary being the strongest predictor. For skilled decoders, the picture was somewhat different with only vocabulary being a predictor of reading comprehension. The results of this study show that the simple view of reading is applicable to DHH adults' reading comprehension skills: both decoding skills and vocabulary contribute to reading comprehension. Also, as in previous studies on the simple view of reading, as readers become more skilled in the decoding process, vocabulary becomes the only predictor of reading comprehension.

Effect of obesity on gastrointestinal transit, pressure and pH using a wireless motility capsule

BACKGROUND

Despite the increasing prevalence and medical burden of obesity, the understanding of gastrointestinal physiology in obesity is scarce, which hampers drug development.

AIM

To investigate the effect of obesity and food intake on gastrointestinal transit, pressure and pH.

MATERIAL AND METHODS

An exploratory cross-sectional study using a wireless motility capsule (SmartPill©) was performed in 11 participants with obesity and 11 age- and gender-matched participants with normal weight (group) in fasted and fed state (visit). During the first visit, the capsule was ingested after an overnight fast. During a second visit, the capsule was ingested after a nutritional drink to simulate fed state. Linear mixed models were constructed to compare segmental gastrointestinal transit, pressure and pH between groups (obesity or control) and within every group (fasted or fed).

RESULTS

Food intake slowed gastric emptying in both groups (both P < 0.0001), though food-induced gastric contractility was higher in participants with obesity compared to controls (P = 0.02). In the small intestine, a higher contractility (P = 0.001), shorter transit (P = 0.04) and lower median pH (P = 0.002) was observed in participants with obesity compared to controls. No differences were observed for colonic measurements.

CONCLUSION

Obesity has a profound impact on gastrointestinal physiology, which should be taken into account for drug development.

Intralesional steroid injections in addition to endoscopic dilation in benign refractory esophageal strictures : a systematic review

BACKGROUND AND STUDY AIMS

Benign esophageal strictures are primarily treated with dilation therapy, but strictures can recur or can be unresponsive, requiring additional or repeated treatment. This study investigates the efficacy and safety of intralesional steroid injections in addition to dilation in comparison to dilation alone in patients with benign refractory or recurrent esophageal strictures.

METHODS

A systematic search was carried out in PubMed, using the search terms "Esophageal Stenosis"[Mesh] AND "Injections, Intralesional"[Mesh]. In addition, the reference list of all selected articles was searched manually for other relevant articles. All clinical trials and case series were considered.

RESULTS

This systematic review included four randomized controlled trials, six case series and two cohort studies, comprising 341 patients with benign esophageal strictures of different etiologies. A benefit of adding intralesional steroid injections to dilation in reducing the need for repeat dilation was seen in the subgroups of peptic, radiation-induced and corrosive strictures. Results were inconsistent for anastomotic strictures and too limited for strictures due to eosinophilic esophagitis, sclerotherapy or pill esophagitis. Complications were rare and of limited severity.

CONCLUSION

Endoscopic dilation remains the first-line treatment, since its efficacy and safety are mostly satisfactory. In recurrent or refractory strictures, intralesional steroid injections are advised in peptic strictures and can be considered in radiation- induced, corrosive strictures and anastomotic strictures. It is recommended to restrict the steroid use to a maximum of three sessions and to consider alternative treatment if treatment effects remain insufficient.

Meckel's enterolith : a rare cause of mechanical small bowel subobstruction

Meckel's diverticulum is the most common congenital gastrointestinal malformation and may present with bleeding, obstruction and diverticulitis. Symptomatic Meckel's diverticulum is associated with age <50 years, male gender, diverticular length > 2 cm and ectopic mucosa. Formation of enteroliths is a rare complication of Meckel's diverticulum and the majority of stones will remain in the diverticulum. Factors promoting enterolith formation through precipitation of calcium in the small intestinal alkaline environment include stasis as well as diverticular anatomy and histology. Mechanical obstruction due to liberation of enteroliths is even more rare and other mechanisms include intussusception, adhesions, volvulus and neoplasms. Visualization of enteroliths on plain abdominal films is challenging because not all stones are radiopaque. Surgical diverticulectomy or segmental bowel resection with anastomosis is preferred in case of complications. We present a case of mechanical small bowel sub-obstruction resulting from an expelled Meckel's enterolith.

It Takes Two to Read: Interactive Reading with Young Deaf and Hard-of-Hearing Children

Interactive storybook reading is an important activity to enhance the emergent literacy skills of young deaf and hard-of-hearing (DHH) children. Parents have a crucial role to play in promoting their children's literacy development. However, parents often do not read in an interactive way; therefore guidance is recommended in applying these interactive reading strategies. In the present study we examined how parent reading behavior was affected by implementing an interactive reading training program for parents of young DHH children. Parents of 18 DHH toddlers in the Netherlands participated in a series of group training sessions and their interactive reading behavior was compared to that of 10 parents who did not participate. The results showed that parents' interactive reading behavior tended to increase after they participated in the interactive reading program. After the program, they applied the interactive reading strategies more often than parents who had not participated in the program. The findings suggest that interactive reading programs should be incorporated into early intervention programs for DHH children.

Functional dyspepsia is associated with duodenal eosinophilia in an Australian paediatric cohort

BACKGROUND

The pathophysiology of functional dyspepsia (FD) remains unknown. Duodenal eosinophil infiltration has been reported.

AIM

To assess the association between dyspeptic symptoms and duodenal eosinophilia in children undergoing upper gastrointestinal endoscopy.

METHODS

In this retrospective cohort study, children with normal upper endoscopy and routine histology at a single tertiary paediatric centre between 2010 and 2014 were included. FD was defined as epigastric pain or discomfort >2 months without response to acid suppression. Controls presented with nonerosive reflux disease, dysphagia or rumination syndrome. Intramucosal eosinophil counts were compared between the groups using uni- and multivariate regression analyses.

RESULTS

Thirty-six cases and 36 nonmatched controls were identified. Atopic history (39% vs. 25%) and psychological comorbidity (53% vs. 39%; both P = 0.2) were frequent in cases and controls. Self-reported nausea (64% vs. 17%; P < 0.0001), lethargy (19% vs. 0%; P = 0.005) and family functional gastrointestinal disorder(FGID) (28% vs. 3%; P = 0.003) were more common in cases than controls. Duodenal eosinophil counts [median (IQR): 151 (118-207) vs. 76 (60-106) per mm² ; P < 0.001] were significantly higher in cases than controls with >112 eosinophils per mm² predictive for FD (OR: 33.6, 95% CI: 7.1-159.0; P < 0.001). Duodenal eosinophilia was associated with weight loss (OR: 7.1, 95% CI: 1.1-45.5; P = 0.04).

CONCLUSIONS

Functional dyspepsia in children is strongly associated with duodenal eosinophilia, in the absence of endoscopic or routine histological findings. Frequent atopic and psychological comorbidity illustrate likely multifactorial mechanisms.

Interactive Reading with Young Deaf and Hard-of-Hearing Children in eBooks Versus Print Books

Interactive storybook reading is effective in enhancing deaf and hard-of-hearing (DHH) children's emergent literacy skills. The current digital era gives parents more opportunities to read books with their child. From an early age on, interaction between parent and child during literacy activities is very important for the development of emergent literacy skills. The purpose of the present study was to explore the opportunities of eBooks on a tablet for interactive reading with young DHH children. Parent and child interactive behavior in reading print books was compared to eBooks in 18 parents and their 1- to 3-year-old DHH child. All parents followed an interactive reading program after which their interactive reading behaviors were observed while reading print books and eBooks with their child. Results mainly showed similar interactive reading behaviors in parents and children when reading print books or eBooks, except for a lower occurrence of pointing to pictures/objects in the parent behavior when reading the eBooks. These results give parents and professionals even more opportunities for interactive storybook reading with DHH children, and thus more opportunities to enhance their language and literacy skills. Tablets can be easily taken with you making eBooks accessible for interactive reading wherever you are.

Balloon dilation of the esophago-gastric junction affects lower and upper esophageal sphincter function in achalasia

BACKGROUND

Pneumatic dilation of the lower esophageal sphincter (LES) in achalasia has an unappreciated effect on upper esophageal sphincter (UES) function. We studied UES pressure patterns at baseline and alterations in UES parameters resulting from therapy.

METHODS

High-resolution manometry (HRM) tracings from 50 achalasia patients, seen at a tertiary center between January 2009 and July 2011, were reviewed. Manometric parameters studied were (i) LES: resting pressure (restP), 4-second integrated relaxation pressure (IRP4); (ii) UES: resting pressure (restP), minimal relaxation pressure (MRP), peak pressure (PP), relaxation interval (RI), intrabolus pressure (IBP), and deglutitive sphincter resistance (DSR). Mixed models analyses with LES and UES parameters as dependent variables and treatment stage as within-subject independent variable of interest were used. Correlations between treatment-induced changes in LES, UES, and esophageal body (EB) parameters were performed.

KEY RESULTS

Pre- and posttreatment HRM tracings were available from 50 patients (mean age 52.7 ± 18.6 years, 29 men). Upper esophageal sphincter parameters MRP (17.9 ± 1.2 vs 15.2 ± 0.9 mmHg; p = 0.02) and IBP (31.5 ± 1.5 vs 27.4 ± 1.2 mmHg; p = 0.009) were significantly reduced after initial balloon dilation and this effect was significant in type II achalasia (p = 0.002 and p = 0.0006). Peak pressure, RI, and DSR were not. The therapeutic effect on LES IRP4 correlated significantly with the change in UES MRP, statistically mediated by the change in EB deglutitive pressure (p = 0.004 and p = 0.0002).

CONCLUSIONS & INFERENCES

We present the first HRM study demonstrating that pneumatic dilation of the LES affects intraesophageal and UES pressures in patients with achalasia.

Does acupuncture activate endogenous analgesia in chronic whiplash-associated disorders? A randomized crossover trial

BACKGROUND

Many patients with chronic pain, including those with chronic whiplash-associated disorders (WAD), show features of central sensitization. Randomized trials examining whether treatments are able to influence the process of central sensitization in patients with chronic WAD are emerging. Therefore, the present study aimed at examining whether acupuncture results in activation of endogenous analgesia and relief in symptoms in patients with chronic WAD.

METHODS

In this randomized crossover pilot trial with blinded assessors, each patient (n = 39) received two treatment sessions of identical duration, with acupuncture and relaxation therapy randomly crossed over in visit 2. Primary outcome measurement included immediate activation of endogenous analgesia i.e., pressure pain sensitivity and conditioned pain modulation. Secondary outcome measurements included pain relief and reduced disability level.

RESULTS

Local pressure pain sensitivity at baseline and during conditioned pain modulation decreased significantly more following acupuncture compared with relaxation (time × group interactions: p < 0.001), both in the neck and at a site distinct from the painful region. When comparing the effects of acupuncture versus relaxation, no differences were observed on conditioned pain modulation, temporal summation of pressure pain, neck disability or symptom severity (all p-values >0.05).

CONCLUSION

It was shown that one session of acupuncture treatment results in acute improvements in pressure pain sensitivity in the neck and calf of patients with chronic WAD. Acupuncture had no effect on conditioned pain modulation or temporal summation of pressure pain. Both acupuncture and relaxation appear to be well-tolerated treatments for people with chronic WAD. These findings suggest that acupuncture treatment activates endogenous analgesia in patients with chronic WAD.

Are deaf students' reading challenges really about reading?

Reading achievement among deaf students typically lags significantly behind hearing peers, a situation that has changed little despite decades of research. This lack of progress and recent findings indicating that deaf students face many of the same challenges in comprehending sign language as they do in comprehending text suggest that difficulties frequently observed in their learning from text may involve more than just reading. Two experiments examined college students' learning of material from science texts. Passages were presented to deaf (signing) students in print or American Sign Language and to hearing students in print or auditorially. Several measures of learning indicated that the deaf students learned as much or more from print as they did from sign language, but less than hearing students in both cases. These and other results suggest that challenges to deaf students' reading comprehension may be more complex than is generally assumed.