Realising economic and social rights for children with communication and swallowing disability: Sustainable Development Goals 1, 8 and 10

PURPOSE

This commentary describes the economic disempowerment of children with communication and/or swallowing disability and outlines why attending to their economic and social needs is essential for the realisation of the United Nations' Agenda 2030.

RESULT

Children with communication and/or swallowing disability encounter intersectional disempowerment on account of both their disability, and their status as children. In particular, they experience unique barriers to the realisation of their economic and social rights. This presents a number of challenges to the realisation of Agenda 2030, and its Sustainable Development Goals (SDGs). Drawing on the broader disability rights and child rights literature, we outline these issues, and describe four empowering solutions, within the scope of this special issue commentary.

CONCLUSION

We describe that speech-language pathologists must interpret the discussion of these issues as a call to action for our profession. This commentary focusses on the Agenda 2030 Sustainable Development Goals of, No Poverty (SDG 1), Decent Work and Economic Growth (SDG 8), and Reduced Inequalities (SDG 10), and also addresses the goals of Zero Hunger (SDG 2), Good Health and Well-Being (SDG 3), Quality Education (SDG 4), Gender Equality (SDG 5) and Partnerships for the Goals (SDG 17).

The ASQ-TRAK: Validating a culturally adapted developmental screening tool for Australian Aboriginal children

BACKGROUND

Developmental monitoring, performed using culturally relevant tools, is of critical importance for all young children. The ASQ-TRAK is the culturally and linguistically adapted Ages and Stages Questionnaire (ASQ-3), a developmental screening tool, for Australian Aboriginal children. While the ASQ-TRAK has been well received in practice, investigating its psychometric properties will enable professionals to make informed decisions about its use.

AIMS

To conduct a rigorous validation study of the ASQ-TRAK by applying Kane's argument-based approach.

SUBJECTS

The ASQ-TRAK, Bayley-III and/or BDI-2 were administered cross-sectionally to 336 Australian Aboriginal children aged 2-48 months across ten participating sites in the Northern Territory and South Australia. A sample of staff and caregivers completed feedback surveys about the ASQ-TRAK.

RESULTS

ASQ-TRAK domain scores were moderately positively correlated with corresponding domain scores on the Bayley-III or BDI-2. Inter-rater and inter-instrument reliability were high. Sensitivity (83%), specificity (83%) and negative predictive value (99%) were acceptable. Staff and caregivers expressed high levels of satisfaction with the ASQ-TRAK.

CONCLUSIONS

Regular developmental screening can provide important information about developmental vulnerability and the need for services. The ASQ-TRAK should be administered by trained Aboriginal community-based workers and the implementation approach carefully planned. Areas for future research include longitudinal follow-up of children, investigating existing norms and cut-off scores, and considering the appropriateness of the ASQ-TRAK with Aboriginal people from different locations. The ASQ-TRAK has the potential to fill an important gap by enabling better access to high-quality developmental monitoring and targeted early intervention.

Associations between early maternal behaviours and child language at 36 months in a cohort experiencing adversity

BACKGROUND

Variations in parenting, more specifically less responsive and more directive parenting, contribute to language difficulties for children experiencing adversity. Further investigation of associations between specific responsive and directive behaviours and child language is required to understand how behaviours shape language over time within different populations. As language is dyadic, further exploration of how mother-child interactions moderate associations is also important.

AIMS

To investigate associations between specific responsive and directive maternal behaviours, the quality of mother-child interaction (fluency and connectedness) and child language in a cohort experiencing adversity.

METHODS & PROCEDURES

Pregnant women experiencing adversity were recruited from maternity hospitals in Australia. At 12 months, videos of mother-infant free play were collected. Videos were coded for maternal behaviours and fluency and connectedness (n = 249). At 36 months, child language was measured using a standardized language test. Linear regression models were used to examine associations and the moderating role of fluency and connectedness was explored.

OUTCOMES & RESULTS

Responsive yes/no questions were positively associated with language scores. Unsuccessful redirectives were negatively associated with language scores. The moderation effect of fluency and connectedness was equivocal in the current data.

CONCLUSIONS & IMPLICATIONS

Findings reproduce and extend previous research highlighting key features of mother-child interactions associated with child language trajectories. Findings also augment knowledge of risk and protective factors related to language for children experiencing adversity and highlight where targeted interventions might be successful.

Concurrent associations between maternal behaviours and infant communication within a cohort of women and their infants experiencing adversity

PURPOSE

Evidence suggests that children living in adversity are at greater risk of poorer language than their peers with the quality of parental interactions potentially mediating this association. Studies typically measure the mediatory impact of generic interaction styles making it difficult to discern which particular aspects of the interaction are facilitating language. This study aims to bridge this gap by identifying specific maternal behaviours associated with concurrent infant communication, in a cohort of 12-month old infants and their mothers experiencing adversity.

METHOD

A total of 249 mother-infant free-play videos were collected from women experiencing adversity in Victoria and Tasmania, Australia. From those videos, specific maternal behaviours, infant communication acts and the interaction quality were coded.

RESULT

Maternal verbal imitations uniquely predicted concurrent use of infant vocalisations, total words and unique words. Furthermore, the more fluent and connected the mother-infant dyad, the stronger the association between imitations and all three infant measures.

CONCLUSION

Frequent use of maternal imitations, within highly connected mother-infant dyads, may help mediate the impact of adversity on early communication. This information is important for early years professionals working with at-risk populations in augmenting current knowledge of risk and protective factors related to early language.

Predictive validity of verbal and non-verbal communication and mother-child turn-taking at 12 months on language outcomes at 24 and 36 months in a cohort of infants experiencing adversity: a preliminary study

BACKGROUND

Parent-reported measures of early communication have limitations for use with infants experiencing adversity. Observational measures of early non-verbal and verbal communicative behaviours and mother-child turn-taking may provide a complementary method of capturing early communication skills for these children.

AIMS

To explore the predictive validity of verbal and non-verbal behaviours and mother-child conversational turn-taking (fluency and connectedness) at child age 12 months in relation to language measures at 24 and 36 months in a cohort of infants experiencing adversity.

METHODS & PROCEDURES

Pregnant women experiencing adversity were recruited from maternity hospitals in Australia. At 12 months, 190 infants were videoed during mother-child free-play. Verbal and non-verbal communicative behaviours and fluency and connectedness were measured from the 12-month videos. Predictive validity of 12-month behaviours was calculated in relation to mean length of utterance and number of unique words at 24 months and Clinical Evaluation of Language Fundamentals Preschool-Second Edition (CELF-P2) Core Language scores at 36 months.

OUTCOMES & RESULTS

All 12-month behaviours had adequate specificity but poor sensitivity when compared with other predictive validity studies using published early language measures. However, in adjusted regression models, fluency and connectedness and verbal behaviours at 12 months predicted unique words at 24 months. Fluency and connectedness also predicted CELF-P2 scores at 36 months.

CONCLUSIONS & IMPLICATIONS

Findings reconfirm the difficulty in early identification of children at risk of later language difficulties. All 12-month measures were more accurate at identifying those children who will have better language than those children who will not. As fluency and connectedness was the only measure to predict 24- and 36-month language in adjusted regression models, it may be an important factor to consider when measuring early language skills for infants experiencing adversity. Future research could combine observational measures of early communication and fluency and connectedness with other predictors of language to try to increase prediction accuracy.

Susceptibility of strawberries, blackberries, and cherries to Aspergillus mold growth and aflatoxin production

The susceptibility of blackberries, cherries, and strawberries to Aspergillus growth and aflatoxin production has been examined. Three aflatoxigenic isolates of Aspergillus, A. flavus ATCC 15548 and NRRL 3251 as well as A. parasiticus NRRL 2999, were cultured on homogenates of the fruits for 14 days at 28 +/- 2 degrees C. Percent mycelial growth and spore infestation were determined each day with a calibrated grid. At day 14 each culture was frozen at -5 degrees C until aflatoxins were extracted with methylene chloride and water. Aflatoxins were separated by thin layer chromatography (TLC) with benzene-methanol-acetic acid (90 + 5 + 5). This extraction and solvent system provided satisfactory separations of the aflatoxins and was free of background interference on the TLC plates. Although all fruits served as substrates for both Aspergillus growth and aflatoxin production, cherries appeared to be a more favorable substrate than did blackberries, and the latter was more favorable than strawberries. Whereas A. flavus produced both B1 and G1 on all substrates, it yielded B2 and G2 only on cherries. Although A. parasiticus NRRL 2999 synthesized B1, B2, G1, and G2 on both blackberries and cherries, no aflatoxins were detected on strawberries. In contrast, A. flavus NRRL 3251 failed to produce detectable levels of aflatoxin on any substrate. All substrates supported both mycelial growth and subsequent sporulation with cherries greater than blackberries greater than strawberries.

Potential mold growth, aflatoxin production, and antimycotic activity of selected natural spices and herbs

Ground spices and herbs are evaluated as substrates for mycelial growth, sporulation, and aflatoxin production. Three toxigenic strains of Aspergilli, A. flavus ATCC 15548, A. flavus NRRL 3251, and A. parasiticus NRRL 2999, were cultured on moist, commercially packaged herbs and spices. All substrates used were ground and included thyme, celery seed, oregano, cinnamon, ginger, caraway seed, clove, mustard, sesame seed, and rosemary leaves. Following inoculation of the natural materials in sterile bottles containing sterile water, the cultures were incubated 30 days at 23 +/- 4 degrees C. Not all strains of Aspergilli grew, sporulated, or produced toxins. There were definite strain differences and definite substrate differences for the variables evaluated. Sesame seed produced toxins B1, G1, and G2, with a mean of 167 ppm for 3 strains. A. flavus ATCC 15548 was the greatest overall toxin producer followed by A. parasiticus NRRL 2999 and A. flavus NRRL 3251. Ginger and rosemary leaves were also substantial producer-substrates. Mustard, caraway seed, and celery seed were judged as intermediate-producing substrates. Absolute antimycotic substrates were cinnamon and clove. Antiaflatoxigenic substrates were thyme and oregano. Mustard also may be antimycotic. Aflatoxins B1 and G1 were the more commonly found toxins.

Growth, Sporulation and Aflatoxin Production by Aspergillus parasiticus on Strained Baby Foods

The potential for aflatoxin production by Aspergillus parasiticus on strained baby food was evaluated. Four puréed foods were inoculated with the mold and cultured at 15 and 26 C in two series of experiments. The aflatoxigenic mold produced mycelia and sporulated at both temperatures. The foods ranked in mean total yield of aflatoxin (μg/g of substrate) in the following order: peas > squash > green beans > pears. The ranking held consistent for both temperatures. Aflatoxins B₁ and G₁ were produced in higher percentages than B₂ and G₂ in each food at both temperatures. At 26 C, total aflatoxin produced ranged from 8 to 71 μg/g of substrate, and at 15 C, the mean for the four foods was from 3 to 50 μg/g of substrate. Temperature and substrate were the primary variables which contributed to sporulation rate, toxin production and toxin ratios. Peas and squash should be considered primary and highly supportive substrates for aflatoxin production if conditions should arise for spores to contaminate the products either during or after processing. Absolute prevention of aflatoxigenic spore contamination in these foods studied is essential. An occasional testing of these foods for aflatoxin seems warranted. A lower temperature during aflatoxin formation decreased the total toxin formed, but did not prohibit aflatoxin occurrence. A lower temperature also tended to divert the type of toxin produced from B₁ to the less dangerous G₁ and G₂. Aflatoxin would appear to be a problem in these foods only under rare and unusual circumstances in relation to processing and consumer usage. If such aflatoxigenic spore contamination should occur, the levels produced would be significant.

Aflatoxigenic Potential for Aspergilli on sucrose substrates

Sucrose concentrations of 3, 10, 20, and 30% in Czapek Dox broth served as the carbon source for growth, aflatoxin production, and sporulation for Aspergillus parasiticus NRRL 2999 and A. flavus NRRL 3557, 5862, and 5013. All cultures produced mycelial growth and sporulated in all sucrose concentrations during the 12-day growth period. The area of mycelial mat coverage per hour increased directly with increased sugar concentrations. The 20 and 30% sucrose concentrations inhibited mycelial growth for 5862. The 30% sucrose cultures of 3557 and 5862 failed to produce detectable levels of aflatoxins. All other isolates produced B1 and G1 in an approximately 4:1 ratio in all sucrose concentrations. Only 2999 was a substantial producer of aflatoxin in all 4 sucrose cultures, ranging from 72 to 96 micrograms/mL medium. A. flavus 5013 produced the most toxin, 144 and 126 micrograms/mL medium in the 10 and 20% sucrose cultures, respectively. The 10 and 20% sucrose cultures were most conducive to aflatoxin production. Since these sucrose levels correspond closely to the levels in many food and drink products, especially home-made products, care and attention should be taken to keep them free of aflatoxigenic spores. Extensive mycelial growth and sporulation, even in aflatoxigenic strains, do not necessarily result in comparably high aflatoxin levels. Routine extraction and quantitation procedures for aflatoxin were applicable and provided satisfactory results.

Aflatoxigenic potential of dried figs, apricots, pineapples, and raisins

Spores from 3 aflatoxigenic strains were applied to the surface of dried figs, pineapple slices, apricots, and raisins. Half of the samples of each foodstuff was autoclaved (cooked) before inoculation. All 3 strains produced some toxin but not in all of the foodstuffs. No aflatoxins were found in any of the raisin cultures. The overall potential for toxin production in the dried fruit was apricot greater than fig greater than pineapple greater than raisin. Among the cooked substrates, the order was apricot greater than pineapple greater than fig=raisin. For the raw dried fruits, the ranking was fig greater than pineapple greater than apricot greater than or equal to raisin. Pineapple was considered the best broad spectrum substrate of the foodstuffs evaluated in the study.

Evaluation of potential for aflatoxin occurrence on celery, cauliflower, lettuce, and taro root inoculated with Aspergillus flavus and A. parasiticus

Culture samples of lettuce, cauliflower, celery, and taro root (Colocasia esculenta) were assayed for the presence of aflatoxin after inoculation with Aspergillus flavus and A. parasiticus. Cultures of A. flavus produced both aflatoxins B1 and G1 on taro root, but produced by B1 on lettuce, cauliflower, and celery. For taro root, the percentage of aflatoxin G1 produced was considerably greater than that of B1. While A. parasiticus did produce mycelia and spores on the lettuce and taro root samples, there were not detectable levels of any aflatoxin produced. All the samples studied were successfully extracted and analyzed qualitatively and quantatively for the presence of aflatoxin by using official AOAC thin layer chromatographic procedures. There is sufficient evidence that Aspergilli can grow on some leafy produce and one strain produced aflatoxins.

Evaluating the inhibitory action of honey on fungal growth, sporulation, and aflatoxin production

Unprocessed honey was inoculated with toxigenic strains of Aspergillus flavus NRRL 5862 and A. parasiticus NRRL 2999. The fungi grew and sporulated in varying amounts of honey diluted with water, but none of the cultures produced detectable levels of aflatoxin. Growth and subsequent sporulation were seen only in media containing up to and including 60% of honey. Media having 40% of honey showed growth and sporulation by day two. Neither species of Aspergillus produced toxins even in 10% honey. These results confirm our earlier observations that pure honey inhibited fungal growth and now even diluted honey seems capable of inhibiting toxin production or possibly neutralizing it. The general procedures recommended by the AOAC for extraction and thin layer chromatography were applied successfully in analyzing the honey substrate for aflatoxin.

Aflatoxin occurrence on raw and cooked york soybeans inoculated with three aspergillus isolates

Raw and cooked soybean media were inoculated in separate experiments with Aspergillus flavus NRRL 3251, A. flavus ATCC 15548, and A. parasiticus NRRL 2999 isolates. The toatl quantity of aflatoxins produced and the percentage distribution of aflatoxins B1, B2, G1, and G2 varied with the state of the medium (raw or cooked) and with the fungal isolate used. Cooked soybean medium supported higher aflatoxin productions by A. flavus NRRL 3251 and A. parasiticus NRRL 2999 than did raw medium. Larger quantities of aflatoxins B1, B2, G1, and G2 were produced by A. flavus ATCC 15548 on raw soybean medium than were produced by any of the isolates on cooked medium. Application of these data is discussed briefly in relation to possible use of soybean media as a source of aflatoxin production.