The informant matters: Differences in bullying victim categorization rates assessed with self- and peer-reports in children with developmental language disorder and reading difficulties

BACKGROUND

Children with Developmental Language Disorder (DLD) and Reading Difficulties (RD) can show more peer relation problems depending on the informant.

AIMS

(1) To explore bullying victims' categorization, evaluated by self- and peer-reports, in children with DLD and RD; and (2) to assess agreement rates between informants.

METHOD AND PROCEDURES

Victimization was assessed using a self-report (EBIP-Q) and a peer-report sociogram (CESC) in a sample of 83 participants (9-12 years; 10.5 ± 1.1 years), comprising of DLD (n = 19), RD (n = 32), and Control (n = 32) groups.

OUTCOMES AND RESULTS

We found a higher frequency of the rejected sociometric profile in the DLD and RD groups, a higher peer-reported victimization in the DLD group, and more severe self-reported victimization in the DLD and RD groups. Odds of being classified as victimized were higher for self-report except in the DLD group. Informants' agreement was high using the most restrictive EBIP-Q criterion (7 points) for both the Control and the RD groups, being non-significant for the DLD group regardless of the criteria used.

CONCLUSIONS AND IMPLICATIONS

We found a higher victimization risk in children with language difficulties, although self-assessment seems to under-detect children with DLD according to the agreement rates, pointing out the need to combine assessments and informants. WHAT DOES THIS PAPER ADD?: Several studies have shown that children with DLD or RD obtain higher scores of victimization and score lower on several scales of social skills with continuous data. Although continuous analyses are usual in research, professional decisions are usually based on cut-off criteria more than how high or low a score is in contrast to another group. This is one of the first works that analyses victimization following the cut-off criteria of self and peer assessments that professionals used in the school settings in children with DLD and RD. Our results will raise awareness among school professionals based on the evidence about the high risk of victimization, especially in children with DLD, and the implications of selecting between several measures of victimization, in this group of children. We think that our results would help to better detect and prevent bullying in schools for children with DLD.

DLD is a potential therapeutic target for COVID-19 infection in diffuse large B-cell lymphoma patients

Since the discovery of copper induces cell death(cuprotosis) in 2022, it has been one of the biggest research hotspots. cuprotosis related genes (CRGs) has been demonstrated to be a potential therapeutic target for cancer, however, the molecular mechanism of CRGs in coronavirus disease 2019 (COVID-19) infected in DLBCL patients has not been reported yet. Therefore, our research objective is first to elucidate the mechanism and role of CRGs in COVID-19. Secondly, we conducted univariate and multivariate analysis and machine learning to screen for CRGs with common expression differences in COVID-19 and DLBCL. Finally, the functional role and immune mechanism of genes in DLBCL were confirmed through cell experiments and immune analysis. The research results show that CRGs play an important role in the occurrence and development of COVID-19. Univariate analysis and machine learning confirm that dihydrolipoamide dehydrogenase (DLD) is the common key gene of COVID-19 and DLBCL. Inhibiting the expression of DLD can significantly inhibit the cycle progression and promote cell apoptosis of DLBCL cells and can target positive regulation of Lysine-specific demethylase 1 (LSD1, also known as KDM1A) to inhibit the proliferation of DLBCL cells and promote cell apoptosis. The immune analysis results show that high-expression of DLD may reduce T cell-mediated anti-tumor immunity by regulating immune infiltration of CD8 + T cells and positively regulating immune checkpoints LAG3 and CD276. Reducing the expression of DLD can effectively enhance T cell-mediated anti-tumor immunity, thereby clearing cancer cells and preventing cancer growth. In conclusion, DLD may be a potential therapeutic target for COVID-19 infection in DLBCL patients. Our research provides a theoretical basis for improving the clinical treatment of COVID-19 infection in DLBCL.

A comparison of learning and retention of a syntactic construction between Cantonese-speaking children with and without DLD in a priming task

Procedural circuit Deficit Hypothesis (PDH) of Developmental Language Disorder (DLD) predicts problems with learning and retention of grammar. Twenty 7- to 9-year-old Cantonese-speaking children with DLD and their typically developing (TD) age peers participated in a syntactic priming task that was given in two sessions one week apart. Production of Indirect Object Relative Clause (IORC) was tested using a probe test before and after the priming task, and one week later. The study involved two cycles of learning and retention, and two levels of prior knowledge. Bayesian linear mixed effects modelling was used for data analysis. Children with DLD learned, and possibly retained, IORC less well than TD children after age, working memory and general grammatical knowledge were controlled for. No interaction effects were significant, meaning that cycle and prior knowledge affected both groups similarly in learning and retention. Results were discussed in relation to PDH and the Complementary Learning Systems Theory.

Dihydrolipoyl dehydrogenase promotes white adipocytes browning by activating the RAS/ERK pathway and undergoing crotonylation modification

Acetylation modification has a wide range of functional roles in almost all physiological processes, such as transcription and energy metabolism. Crotonylation modification is mainly involved in RNA processing, nucleic acid metabolism, chromosome assembly and gene expression, and it's found that there is a competitive relationship between crotonylation modification and acetylation modification. Previous study found that dihydrolipoyl dehydrogenase (DLD) was highly expressed in brown adipose tissue (BAT) of white adipose tissue browning model mice, suggesting that DLD is closely related to white fat browning. This study was performed by quantitative real-time PCR (qPCR), Western blotting (WB), Enzyme-linked immunosorbent assay (ELISA), Immunofluorescence staining, JC-1 staining, Mito-Tracker Red CMXRos staining, Oil red O staining, Bodipy staining, HE staining, and Blood lipid quadruple test. The assay revealed that DLD promotes browning of white adipose tissue in mice. Cellularly, DLD was found to promote white adipocytes browning by activating mitochondrial function through the RAS/ERK pathway. Further studies revealed that the crotonylation modification and acetylation modification of DLD had mutual inhibitory effects. Meanwhile, DLD crotonylation promoted white adipocytes browning, while DLD acetylation did the opposite. Finally, protein interaction analysis and Co-immunoprecipitation (Co-IP) assays identified Sirtuin3 (SIRT3) as a decrotonylation and deacetylation modification enzyme of regulates DLD. In conclusion, DLD promotes browning of white adipocytes by activating mitochondrial function through crotonylation modification and the RAS/ERK pathway, providing a theoretical basis for the control and treatment of obesity, which is of great significance for the treatment of obesity and obesity-related diseases in the future.

Exploring grammatical development in children aged 2;6 to 7: a novel approach using elicited production

The assessment of children's grammatical skills is a crucial component of diagnosing language disorders. Elicited production is a commonly used method for obtaining data on a child's productive language abilities. We introduce a new instrument developed as part of the third edition of a standardised test battery for German. This instrument utilises elicited production, wherein participants describe coloured pictures depicting everyday situations, in order to generate four test scores: mean length of utterances, completeness of utterances, and two grammar scores comprising relevant target structures. The construction of the grammar scores was inspired by the Index of Productive Syntax (IPSyn), modified for German and computerised. The detailed results provide a comprehensive profile of a child's syntactic and morphological strengths and weaknesses. Analysis of data collected from 348 monolingual German children who formed part of the norming sample, aged between 2;6 and 6;11 years of age, revealed age-related changes in these scores. Additionally, the age range was determined for both grammatical milestones and 'red flags', which may indicate potential problems in language development. In conclusion, the newly developed, time-efficient instrument allows for a detailed assessment of grammatical skills, identification of potential intervention targets, and facilitates various research objectives.

The use of referring expressions in Mandarin-speaking children with and without developmental language disorder

This study investigated the use of referring expressions in Mandarin-speaking children with and without developmental language disorder (DLD). The data consist of narratives elicited from 18 children with DLD and 18 typically-developing (TD) children matched on chronological age. Participants' referring expressions were analysed in terms of referential form, function, and adequacy. The overall results of form - function mappings showed that the two groups of children were quite similar in their referential choices, indicating that both groups were sensitive to function constraints and listener needs. On the other hand, children with DLD were less successful than TD children in producing adequate subsequent mentions, suggesting that referential adequacy would be useful for identifying areas of difficulty children with DLD would have in referencing.

Collaborative working in speech and language therapy for children with DLD-What are parents' needs?

BACKGROUND

Collaborative practice between therapists and parents is a key element of family-centred care and is essential if we want to address family priorities and needs in interventions. However, collaborative practice is challenging for speech and language therapists (SLTs) and parents. To facilitate collaboration, collaborative practices need to be implemented into speech and language therapy for young children with developmental language disorders (DLD) and their families. Actual change and implementation of collaboration in practice will be successful only when it corresponds with patients' needs, in our case the needs of parents of young children with DLD.

AIMS

To explore parents' needs in their collaboration with SLTs during therapy for their young child with DLD.

METHODS & PROCEDURES

Parents of children with (a risk of) DLD in the age of 2-6 years were eligible for participation. We recruited parents via SLTs. Twelve parents of children with DLD participated in semi-structured interviews about their needs in collaboration with SLTs. We used a phenomenological approach focusing on parents' lived experiences. We transcribed the interviews verbatim. All interviews were read/listened to and discussed by our parent panel, multiple researchers and the interviewer. Two researchers independently analysed the data using the reflective thematic analysis of Braun and Clarke.

OUTCOMES & RESULTS

The analysis of the interviews resulted in six themes: (1) knowing what to expect, (2) knowing how to contribute, (3) feeling capable of supporting the child, (4) trusting the therapist, (5) alignment with parents and children's needs, preferences and priorities and (6) time and space for asking questions and sharing information.

CONCLUSIONS & IMPLICATIONS

Parents want SLTs to invest time in collaborating with them. Parents need SLTs to empower them to become a collaborative partner and enable them to support their child in daily life. Parents need knowledge about the therapy process and diagnosis and skills in how to support their child's language development. Also, they need emotional support to feel secure enough to support their child, to ask questions to therapists and to bring up their own thoughts and opinions in therapy. Parents' needs are in line with collaborative working as described in literature, which underlines the importance of implementing collaborative working in speech and language therapy for young children with DLD.

WHAT THIS PAPER ADDS

What is already known on the subject Several reviews have explored parents' perspectives on speech and language therapy. Results reveal parents' experiences with speech and language therapy in general, and parents' perspectives on specific topics such as shared decision-making and parents/therapists roles in therapy. What this study adds This study adds insights into parents' needs to ensure collaboration with speech and language therapists (SLTs). Parents of young children with developmental language disorders (DLD) need SLTs to invest time to create optimal collaboration. It is important for parents to have enough knowledge about DLD and the SLT process, skills and confidence in how to support their child and opportunities to share thoughts and questions with SLTs. Our results underline the importance of parents being empowered by SLTs to become a collaborative partner. What are the clinical implications of this work? When children are referred to speech and language therapy, parents often venture into an unknown journey. They need support from SLTs to become a collaborative partner in speech and language therapy. Parents need SLTs to invest time in sharing knowledge, skills and power and align therapy to parents' and child's needs, preferences, priorities and expectations.

Selective short-term memory impairment for verbalizable visual objects in children with Developmental Language Disorder

BACKGROUND

Developmental language disorder (DLD) affects the ability to acquire and make use of native language. Possible underlying cognitive mechanisms are related to memory functions.

AIMS

The aim was examination of the relationship between visual short-term memory of objects as well as audiovisual short-term memory, and particular nonverbal and language abilities.

METHODS AND PROCEDURES

The study included 7-9-year-old children with DLD and matched control group. Participants completed the Language Development Test, the Stanford-Binet IQ scale (SB5), and two short-term memory tasks: immediate recall of the visually presented pictograms and immediate recall of audiovisually presented sequences of syllables.

OUTCOMES AND RESULTS

The results revealed diminished levels of short-term visual memory for objects as well as audiovisual memory in children with DLD. However, there were no group differences in the control task of WM.

CONCLUSIONS AND IMPLICATIONS

Results supported the idea of diminished abilities in children with DLD to perform mental operations on verbalizable visual objects. Importantly non-verbal working memory ability, which cannot easily be supported by verbal representations, is at typical levels. This suggests that verbalization ability should be taken into account in the assessment of seemingly non-verbal cognitive functions among children with DLD.

THE USE OF CLASSIFIERS IN VIETNAMESE IN TYPICAL AND ATYPICAL LANGUAGE DEVELOPMENT

The acquisition of numeral classifiers and their associated syntactic structures has been documented and studied in a broad range of East and Southeast Asian languages among typically-developing (TD) young speakers. However, little research has considered how classifiers are acquired by children with developmental language disorder (DLD). The current paper compares and analyzes the development of numeral classifier patterns among a set of Vietnamese speakers, TD and DLD, studied over three years, from kindergarten to second grade. The investigation highlights differences in the performance of children with TD and DLD and describes the areas of classifier use that seem to be most challenging. Children with DLD produced more errors of classifier omission in kindergarten, showed more random alternations in representational forms, and delays in the development of three element classifier structures. Findings are discussed in terms of future directions in the study of classifier use in Vietnamese speakers with DLD.

Mismatch Responses to Speech Contrasts in Preschoolers with and without Developmental Language Disorder

This study compared cortical responses to speech in preschoolers with typical language development (TLD) and with Developmental Language Disorder (DLD). We investigated whether top-down language effects modulate speech perception in young children in an adult-like manner. We compared cortical mismatch responses (MMRs) during the passive perception of speech contrasts in three groups of participants: preschoolers with TLD (n = 11), preschoolers with DLD (n = 16), and adults (n = 20). We also measured children's phonological skills and investigated whether they are associated with the cortical discrimination of phonemic changes involving different linguistic complexities. The results indicated top-down language effects in adults, with enhanced cortical discrimination of lexical stimuli but not of non-words. In preschoolers, the TLD and DLD groups did not differ in the MMR measures, and no top-down effects were detected. Moreover, we found no association between MMRs and phonological skills, even though the DLD group's phonological skills were significantly lower. Our findings suggest that top-down language modulations in speech discrimination may not be present during early childhood, and that children with DLD may not exhibit cortical speech perception deficits. The lack of association between phonological and MMR measures indicates that further research is needed to understand the link between language skills and cortical activity in preschoolers.

Language Skills in Children with Attention Deficit Hyperactivity Disorder and Developmental Language Disorder: A Systematic Review

(1) Background: Attention Deficit Hyperactivity Disorder (ADHD) and Developmental Language Disorder (DLD) are neurodevelopmental disorders that affect various areas of children's development, such as language. It exists an emerging idea that ADHD is characterised by the presence of language difficulties, which can be explained by the high comorbidity between ADHD and DLD. The aim of this review is to analyse the empirical evidence of language competence in children aged 6-17 years old, diagnosed with ADHD and/or DLD. (2) Method: Fifteen studies with experimental designs were identified from Scopus, PsycINFO, and WoS databases, reporting on language skills in children diagnosed with ADHD and/or DLD. Studies relating executive functioning to language skills in this target population were also included. (3) Results: The literature is heterogeneous and different components of language are also examined. Even though the results are contradictory, they convincingly demonstrate there are overlapping symptoms between ADHD and DLD, such as language skills and executive functions. (4) Conclusions: The differences in the samples limit the generalisability of the results. Therefore, this review highlights the importance of considering language skills when designing individualised interventions for the population with ADHD and DLD, both in comorbidity and in isolation.

Atypical phonological processes in naming errors of children with language impairment

The current study explored the characteristics of phonological errors of preschool children with DLD (Developmental Language Disorder), distinguishing between typical versus atypical phonological processes in segmental, syllabic and word levels. The analysis included 87 responses of words with phonological errors from a naming test, produced by 13 preschool children with DLD, aged 4;4-6;3 years. These responses included 166 phonological processes, which were classified into typical and atypical processes at the levels of: segments, syllables, and prosodic words. The findings revealed that 70% of the phonological processes were atypical. Furthermore, ten children produced more atypical processes, and there were more atypical than typical processes in segmental and word levels. It is suggested that some children with DLD represent phonological processes that are similar to those that children with speech and sound disorders produce. Therefore, clinically, the results emphasise the importance of analysing the typical and atypical characteristics of phonological errors as part of language assessment.

Abilities of children with developmental language disorders in perceiving phonological, grammatical, and semantic structures

This study aims to investigate the perception of phonological, grammatical, and semantic structures by 8 children (age range: 8;2-9;5) with developmental language disorders (DLD). Another 8 age-matched (age range: 8;4-10;0) typically developing (TD) children served as controls. The results demonstrated that children with DLD had lower performance than children with TD in the phonology and grammar tests, corroborating earlier findings, which reported difficulties of children with DLD in discriminating voicing contrasts and perceiving grammatical structures. However, both groups had similar performance in the semantic test. The absence of semantic atypicality can be explained possibly due to the simplicity of the sentences included in the test. The study offers important clinical implications for the identification and treatment of the disorder.

Locus of nonword repetition impairments in Mandarin-speaking children with developmental language disorder

Current theories of nonword repetition (NWR) impairments for children with Developmental Language Disorder (DLD) are developed predominantly using data from Indo-European languages. Seldom have relevant theories been attested to the morph-syllabic language Mandarin Chinese. The present research aimed to explore the locus of NWR impairments for Mandarin children with DLD. 80 Mandarin-speaking children with typical development (TD) and 80 children with DLD were compared on nonword repetition accuracy and error types. It was a three-factor design with language groups (children with DLD vs. TD children) as the between-subjects factor, and components (onset, rhyme, and tone) and syllable numbers (one to four syllables) as the within-subjects factors. The analysis showed that both groups had less accuracy on the two phonological segments (onset and rhyme) relative to tone and showed more errors in multi-syllable nonwords. Children with DLD exhibited more noticeable errors in onsets and rhymes, although they did not display similar issues with tones compared to TD children. Repeated measures ANOVAs showed that children with DLD had pronounced errors in onsets, especially in repeating multi-syllable nonwords. Error type analysis revealed that children with DLD displayed more multiple than single errors in nonword repetition. The results support the "segment-to-frame association" theory, suggesting that Mandarin children with DLD are constrained in the concurrent mapping process between onsets, rhymes, and tones.

Creating the conditions for robust early language development for all: Part two: Evidence informed public health framework for child language in the early years

BACKGROUND

One of the most significant developmental accomplishments is the emergence of language in early childhood. Whilst this process is effortless for most children, others can face significant hurdles. Identifying, in the early years, which children will go on to have developmental language disorder is, however, fraught with several well-documented challenges. In the preceding paper we described and linked new research evidence about factors that influence language development in the early years, noting that exposure to some may be time sensitive and that these influences cluster together and can accumulate over time. We demonstrated that risk profiles were associated with and characterised low language trajectories, and we considered how this information could be integrated into a concept that moves beyond screening at single time points in the early years. We argue that this evidence might be used to build an improved early years framework for language thereby creating a more equitable surveillance system that does not leave children living in less advantageous circumstances behind. Underpinning this thinking was a bioecological framework that incorporates the social, environmental and family factors in the child's ecosystem known to influence language development in the early years.

AIMS

To develop a proposal for the design and implementation of an early language public health framework based on current best evidence METHODS: We synthesised the findings from the companion paper (Reilly & McKean 2023) regarding early language trajectories, inequalities and clustering of risks with key public health concepts, relevant intervention evidence and implementation theories to develop a new framework for language surveillance and preventative interventions in the early years.

MAIN CONTRIBUTION

An evidence informed early language public health framework is presented. Describing in turn (1) essential components; (2) relevant interventions; (3) essential qualities for implementation ((i) probabilistic, (ii) proportionate, (iii) developmental and sustained and (iv) codesigned); (4) system-level structures and (5) processes required to adopt and embed an early language public health framework in an existing Local Government Area's child health surveillance and early prevention-intervention systems.

CONCLUSIONS

Children's language development influences their life chances across the life course and language difficulties are unfairly distributed across society. Current evidence points to the need for whole systems approaches to early child language and enables a blueprint for such a framework to be described.

WHAT THIS PAPER ADDS

What is already known on the subject Early child language development sets the stage for a child's life chances and language difficulties can have profound long-term consequences. Such difficulties are unfairly distributed across society and the reach of preventative services is not universal or equitable.

WHAT THIS STUDY ADDS

Several effective primary and secondary preventative interventions exist but their successful implementation is not straightforward. An early language public health framework of surveillance and intervention is described to provide equitable and effective early interventions to children from 0-4 years. We detail the essential components, interventions and qualities of that framework and describe system-level structures and processes required to adopt and embed an early language public health framework in a given locality. WHAT ARE THE CLINICAL IMPLICATIONS OF THIS WORK?: A whole systems approach to early child language is required and should be co-designed through local collaboration with family, community and children's services stakeholders. A public health speech and language therapist role could catalyse the implementation of such approaches and support continuous improvement.

A randomized study of parent- versus child-directed intervention for Dutch toddlers with DLD

BACKGROUND

Indirect speech and language therapy, such as parent-implemented intervention, has been shown to be an effective approach for young children with speech and language disorders. However, relatively few studies have compared outcomes of parent-directed therapy with child-directed intervention, that is, individual therapy of a child delivered by a speech and language therapist (SLT). Although speech and language therapists (SLTs) regard parental engagement as imperative for successful intervention, currently they predominantly use child-directed intervention.

AIM

To evaluate the effect of parent- versus child-directed speech-language therapy embedded in usual care intervention for young children with developmental language disorder (DLD).

METHODS & PROCEDURES

In a randomized trial, forty-six 3-year-old monolingual children with DLD were assigned to parent-directed intervention or child-directed intervention groups. In addition, all children received usual care in special-language daycare centres. Outcomes included children's language development and functional communication, parents' language output, parents' perceptions and their self-efficacy. These were assessed at three time intervals, that is, at baseline, immediately after 6 months of treatment, and 1 year after baseline. The parent-directed intervention consisted of twelve 50-min sessions every 2 weeks with parent and child, consisting of parental training with immediate feedback by (SLTs. Children in the child-directed intervention group received individual speech-language therapy in weekly 30-min sessions for 6 months.

OUTCOMES & RESULTS

Intervention in both groups was equally effective. All children improved significantly in receptive and expressive language measures as well as in functional communication at all intervals. All parents used significantly more language support strategies and were less concerned about their child's participation in communication. Parents in the parent-directed intervention group reported increased self-efficacy in stimulating their child's language development. In contrast, parents in the child-directed intervention group reported a decrease in self-efficacy. Though modest, these group differences were significant in both the short and long terms. Both parents and SLTs were positive about the parent-directed intervention.

CONCLUSIONS & IMPLICATIONS

The effects of parent- and child-directed intervention for young children with DLD are similar. The parent-directed intervention adds to treatment options for parents as well as for SLTs and creates choices for shared decision-making.

WHAT THIS PAPER ADDS

What is already known on the subject Language therapy for young children with DLD comprises various delivery models. Two of these are child- and parent-directed therapy by SLTs. Compared with no treatment, both delivery models are effective, but it is unclear if one of these results in better language outcomes than the other. SLTs value child-directed intervention more highly than indirect approaches where treatment is delivered by others. This study aims to compare the relative effectiveness of parent-directed intervention with child-directed intervention, both parts of multi-component usual care intervention. What this paper adds to existing knowledge This randomized trial indicates that a parent-directed intervention model is as effective as child-directed intervention by SLTs for children's language development and functional communication. Parents' use of language support strategies was also similar in both intervention models, in the short and long terms. Like in child-directed therapy, parent-directed intervention reduces parents' concerns. Contrary to child-directed treatment, parent-directed intervention increases parents' self-efficacy, that is, supporting their child's language development. What are the potential or actual clinical implications of this work? Though SLTs predominantly choose a child-directed intervention model, the study results show that they can consider parent-directed approaches too. There are no significant differences in children's language outcomes as a function of parent- or child-directed intervention. Furthermore, parents and SLTs were positive about the parent-directed intervention program and the SLTs evaluated it as valuable and feasible.

Preferred argument structure in the oral narratives of adolescents with and without SLI

According to the theory of 'Preferred Argument Structure' (PAS), the realisation and distribution of core arguments including the subject of a transitive verb (A), the direct object of a transitive verb (O) or the subject of an intransitive verb (S) in spoken discourse are subject to both grammatical and pragmatic constraints. However, previous studies on the formulation of argument structure have largely focused on the syntactic difficulties of children with SLI. In addition, little is known about the developmental outcomes in argument structure for adolescents with SLI. In this study, we compared PAS in the narratives of 19 adolescents with SLI (Mean age = 14.3; SD = 0.64) and 19 adolescents with typical language development (TLD; Mean age = 14.5; SD = 0.84). The core arguments of the predicate in each narrative based on the wordless picture storybook 'Frog, where are you?' were coded for grammatical roles (A, O and S), referential forms (lexical forms and non-lexical form including null and pronominal forms) and information status (given, accessible and new information). The data were then analysed for conformity to the grammatical and pragmatic constraints of the PAS theory. The two groups were found to be similar in their conformity to the pragmatic constraints but differed in how they conform to the syntactic constraints. In particular, the adolescents with SLI were more likely to produce clauses with two lexical arguments, and the lexical arguments occurred significantly more frequently at the subject role of a transitive verb than the TLD groups. Our results provide further evidence that it is a persistent grammatical deficit, rather than a pragmatic deficit, which poses a special challenge for adolescents with SLI in their formulation of argument structure in narratives.

Neuropsychological profile of children with Autism Spectrum Disorder and children with Developmental Language Disorder and its relationship with social communication

OBJECTIVE

The objective of this study was to probe neuropsychological mechanisms of social communication in children with Autism Spectrum Disorders (ASD) and children with Developmental Language Disorders (DLD). Due to overlap of symptoms that include social dysfunction, diagnostic boundaries between these two developmental disorders remain unclear. This study hypothesizes that these two groups of children differ in the characteristics and in the underlying mechanisms of their social issues.

METHOD

This study examines a wide range of neuropsychological domains in search of a relationship with social communication. A total of 75 children with ASD and 26 children with DLD are included. A cross-battery assessment of neuropsychological functions is conducted, and social communication is evaluated using the Social Responsiveness Scale (SRS).

RESULTS

The neuropsychological profile for the ASD group differs from the DLD group, with the former demonstrating higher scores on Visual Processing and Comprehension, whereas the DLD group scores higher on Fluid Reasoning, Visual Processing and Processing Speed. Correlation analysis reveals that the association between neuropsychological domains and social communication differs between the groups.

DISCUSSION

Children with ASD and DLD clearly have distinctive neuropsychological profiles-their strengths and weaknesses are not equivalent. Such results motivate broad assessment of neuropsychological functions, as this assists in differentiating ASD from DLD for theragnostic purposes.

The pathogenesis of DLD-mediated cuproptosis induced spinal cord injury and its regulation on immune microenvironment

Introduction

Spinal cord injury (SCI) is a severe central nervous system injury that leads to significant sensory and motor impairment. Copper, an essential trace element in the human body, plays a vital role in various biological functions and is strictly regulated by copper chaperones and transporters. Cuproptosis, a novel type of metal ion-induced cell death, is distinct from iron deprivation. Copper deprivation is closely associated with mitochondrial metabolism and mediated by protein fatty acid acylation.

Methods

In this study, we investigated the effects of cuproptosis-related genes (CRGs) on disease progression and the immune microenvironment in acute spinal cord injury (ASCI) patients. We obtained the gene expression profiles of peripheral blood leukocytes from ASCI patients using the Gene Expression Omnibus (GEO) database. We performed differential gene analysis, constructed protein-protein interaction networks, conducted weighted gene co-expression network analysis (WGCNA), and built a risk model.

Results

Our analysis revealed that dihydrolipoamide dehydrogenase (DLD), a regulator of copper toxicity, was significantly associated with ASCI, and DLD expression was significantly upregulated after ASCI. Furthermore, gene ontology (GO) enrichment analysis and gene set variation analysis (GSVA) showed abnormal activation of metabolism-related processes. Immune infiltration analysis indicated a significant decrease in T cell numbers in ASCI patients, while M2 macrophage numbers were significantly increased and positively correlated with DLD expression.

Discussion

In summary, our study demonstrated that DLD affects the ASCI immune microenvironment by promoting copper toxicity, leading to increased peripheral M2 macrophage polarization and systemic immunosuppression. Thus, DLD has potential as a promising biomarker for ASCI, providing a foundation for future clinical interventions.

Language gains in 4-6-year-old children with developmental language disorder and the relation with language profile, severity, multilingualism and non-verbal cognition

BACKGROUND

Early and effective treatment for children with developmental language disorder (DLD) is important. Although a growing body of research shows the effects of interventions at the group level, clinicians observe large individual differences in language growth, and differences in outcomes across language domains. A systematic understanding of how child characteristics contribute to changes in language skills is still lacking.

AIMS

To assess changes in the language domains: expressive morphosyntax; receptive and expressive vocabulary; and comprehension, in children in special needs education for DLD. To explore if differences in language gains between children are related to child characteristics: language profile; severity of the disorder; being raised mono- or multilingually; and cognitive ability.

METHODS & PROCEDURES

We extracted data from school records of 154 children (4-6 years old) in special needs education offering a language and communication-stimulating educational environment, including speech and language therapy. Changes in language were measured by comparing the scores on standardized language tests at the beginning and the end of a school year. Next, we related language change to language profile (receptive-expressive versus expressive-only disorders), severity (initial scores), growing up mono- and multilingually, and children's reported non-verbal IQ scores.

OUTCOMES & RESULTS

Overall, the children showed significant improvements in expressive morphosyntax, expressive vocabulary and language comprehension. Baseline scores and gains were lowest for expressive morphosyntax. Differences in language gains between children with receptive-expressive disorders and expressive-only disorders were not significant. There was more improvement in children with lower initial scores. There were no differences between mono- and multilingual children, except for expressive vocabulary. There was no evidence of a relation between non-verbal IQ scores and language growth.

CONCLUSIONS & IMPLICATIONS

Children with DLD in special needs education showed gains in language performance during one school year. There was, however, little change in morphosyntactic scores, which supports previous studies concluding that poor morphosyntax is a persistent characteristic of DLD. Our results indicate that it is important to include all children with DLD in intervention: children with receptive-expressive and expressive disorders; mono- and multilingual children, and children with high, average and low non-verbal IQ scores. We did not find negative relations between these child factors and changes in language skills.

WHAT THIS PAPER ADDS

What is already known on the subject Intervention studies indicate that intervention can be effective, but not for all children with DLD, and not in all language domains. Longitudinal studies on language development show stable growth patterns in children with DLD at the group level. A systematic understanding of how child characteristics contribute to changes in language skills is still lacking. What this paper adds to existing knowledge In this study, we report on the language gains of a cohort of 154 children with DLD (4-6 years old), in a special education setting for children with language disorders. Our sample includes children with receptive-expressive disorders and expressive-only disorders, and monolingual as well as multilingual children. Our results show that children's language skills improved. The co-normed tests we used revealed that the children had much lower growth in morphosyntax than in the other language domains. Language gains between children with receptive-expressive and expressive-only language disorders did not differ, children with lower initial test scores showed more improvement than children with higher initial scores, multilingual children showed more gains in expressive vocabulary than monolingual children, and there was no effect of non-verbal IQ on change in language scores. What are the potential or actual clinical implications of this work? The results suggest that catching up on language is possible for children with DLD. It is important to include all children with DLD in intervention: mono- and multilingual children; children with receptive-expressive and expressive disorders; and children with high, average and low non-verbal IQ scores. We did not find negative relations between these child factors and changes in language skills. The limited growth in morphosyntax compared with other linguistic areas warrants the attention of both practitioners and researchers, with a particular focus on the implementation of research findings in clinical practice.

The contribution of visual and linguistic cues to the production of passives in ADHD and DLD: evidence from thematic priming

This study investigated how thematic priming via visual and linguistic cues influences the choice of syntactic voice in healthy French-speaking adults and in French-speaking children with typical and atypical development. In particular, we focused on children with attention deficit hyperactivity disorder (ADHD) and developmental language disorder (DLD), two clinical groups with documented syntactic difficulties. Twenty adults (M= 24;7) and 60 children aged 6-11 (20 typically developing, 20 with DLD and 20 with ADHD) were presented with agent or patient cues that progressively increased in strength over three conditions: a no cue condition, a visual cue condition with two cue types (perceptual vs. referential) and a linguistic cue condition with two cue types (topicalization of the agent/patient with and without subsequent sentence initiation). Results showed that all participants produced more passives after having been presented with a patient cue, regardless of cue type (cue > no cue), but linguistic cues facilitated the production of passives significantly more than visual cues (linguistic cue > visual cue). We also found that children with DLD were more sensitive than children with ADHD to visual cues (DLD > ADHD), which were more implicit than the linguistic cues and may have required more attentional resources. The opposite pattern (ADHD > DLD) was true for the linguistic cues, which required syntactic processing. These findings highlight how the development of dynamic tools using cue modality and cue sensitivity might be useful for discriminating children with and without syntactic impairment.

A randomized phase 2 clinical trial of phentolamine mesylate eye drops in patients with severe night vision disturbances

PURPOSE

Dim light vision disturbances (DLD) comprise a wide range of symptoms affecting the quality of vision at low illumination including glare, halos, and starbursts. This exploratory study investigated 1.0% phentolamine mesylate ophthalmic solution (PMOS) as a treatment to improve vision and image quality for patients with DLD.

METHODS

In this placebo-controlled, randomized, double-masked clinical trial, 24 adult patients with severe DLD were randomized in a 2:1 ratio to receive either one dose of PMOS or placebo. Subjects were eligible if they reported experiencing severe night vision difficulty that was not eliminated by distance spectacle correction and scored ≥0.3 log units below the normal range of contrast sensitivity assessed under mesopic conditions with glare at ≥2 spatial frequencies. Key efficacy outcomes were change from baseline in pupil diameter, contrast sensitivity, and visual acuity. Safety measures including intraocular pressure, conjunctival hyperemia, and systemic effects were also assessed.

RESULTS

Eight subjects were randomized to placebo (63% female; mean age 47 years) and 16 were randomized to PMOS (75% female; mean age 42 years). Mean (SD) pupil diameter of PMOS-treated subjects decreased significantly - 1.3 mm (0 to - 2.8 mm) with p < 0.0001. Mean contrast sensitivity with glare in PMOS-treated subjects improved significantly post-treatment at spatial frequencies 3, 6, 12, and 18 cycles per degree (p ≤ 0.03). PMOS also demonstrated improvements in the numbers of letters read for mesopic and photopic, high- and low-contrast visual acuity (LCVA). Importantly, a statistically greater proportion of PMOS-treated eyes registered mesopic LCVA 5 letter (69% vs. 31%, p = 0.029) and 10 letter (34% vs. 6%, p = 0.04) improvement, with a trend at 15 letters (19% vs. 0%, p = 0.16). PMOS was well tolerated with the only reported side effect being a mild increase in conjunctival hyperemia.

CONCLUSION

PMOS was well tolerated and effectively reduced pupil size with improvements in contrast sensitivity and visual acuity in adults with severe DLD. Future Phase 3 studies should be conducted to further evaluate its potential to treat DLD.

TRIAL REGISTRATION

The trial registration number is NCT04004507 (02/07/2019). Retrospectively registered.

Overlapping in memory profiles in Spanish children with autism spectrum disorders, developmental language disorders, and attention deficit hyperactivity disorder

Neurodevelopmental disorders do not have biological markers that allow for their identification. This means that in most cases, diagnosis is based on behavior. This approach implies that difficulties will exist in establishing the diagnostic boundaries of the different nosological entities, and it argues that neurodevelopmental disorders probably share neuropsychological deficits. Our main objective was to study whether neurodevelopmental disorders share a common endophenotype. We carried out a study of memory in children with Autism Spectrum Disorders (ASD), Developmental Language Disorders (DLD), and Attention Deficit Hyperactivity Disorder (ADHD). For this purpose, we administered an extensive neuropsychological battery to evaluate memory to 24(ASD), 25(DLD), and 25(ADHD) children. The results obtained by these three clinical groups were contrasted with those obtained by a group of 25 children of typical development (TD). TD group performed better in all memory tasks, except the recognition task than the clinical groups, and the clinical groups showed slight differences among themselves in their performance in memory tasks. These results show that memory deficits could represent a common endophenotype at least in these three neurodevelopmental disorders and emphasize the need to intervene in memory disorders in this population.

Use of Aspect Markers by Mandarin-speaking Children with High-Functioning Autism Plus Language Impairment and Children with Developmental Language Disorder

INTRODUCTION

This study investigates the comprehension and production of four typical Mandarin aspect markers zai-, -le, -zhe, and -guo by preschool children with high functioning autism plus language impairment (HFA-LI) and those with developmental language disorder (DLD), by comparing them with typically developing age-matched (TDA) children.

METHODS

Twenty children with HFA-LI (M/F: 18/2; mean age: 5.20), 20 with DLD (M/F: 11/9; mean age: 5.25), and 20 TDA children (M/F:14/6; mean age:5.27) completed a picture-choice task and priming picture-description task. The results were analyzed using non-parametric methods.

RESULTS

In the comprehension task, the HFA-LI and DLD groups achieved lower accuracy than the TDA group on zai-, -le, and -guo. The comprehension of aspect markers in the HFA-LI and DLD groups was affected by lexical aspect. In the production task, the HFA-LI and DLD groups produced fewer sentences with the target aspect marker for all four aspect markers than the TDA group. However, they produced more sentences with bare verb forms for zai- and -guo than the TDA group. Furthermore, all three groups tended to combine aspect markers with their semantically inherent types of verbs (e.g, zai-+Activity verbs). The HFA-LI group produced more sentences irrelevant to the task than the other two groups for -zhe and -guo, and some children in the HFA-LI group produced ungrammatical sentences in which both the progressive zai- and perfective -le were used.

CONCLUSIONS

Children with HFA-LI and DLD demonstrate similarities in the comprehension and production of Mandarin aspect markers, given their poor comprehension of the aspect markers zai-, -le and -guo, and poor production of all four aspect markers compared to their TDA peers. Their performance was also impacted by lexical aspect.

The Genetic and Molecular Basis of Developmental Language Disorder: A Review

Language disorders are highly heritable and are influenced by complex interactions between genetic and environmental factors. Despite more than twenty years of research, we still lack critical understanding of the biological underpinnings of language. This review provides an overview of the genetic landscape of developmental language disorders (DLD), with an emphasis on the importance of defining the specific features (the phenotype) of DLD to inform gene discovery. We review the specific phenotype of DLD in the genetic literature, and the influence of historic variation in diagnostic inclusion criteria on researchers' ability to compare and replicate genotype-phenotype studies. This review provides an overview of the recently identified gene pathways in populations with DLD and explores current state-of-the-art approaches to genetic analysis based on the hypothesised architecture of DLD. We will show how recent global efforts to unify diagnostic criteria have vastly increased sample size and allow for large multi-cohort metanalyses, leading the identification of a growing number of contributory loci. We emphasise the important role of estimating the genetic architecture of DLD to decipher underlying genetic associations. Finally, we explore the potential for epigenetics and environmental interactions to further unravel the biological basis of language disorders.

Phonological characteristics of novel gesture production in children with developmental language disorder: Longitudinal findings

Children with developmental language disorder (DLD; aka specific language impairment) are characterized based on deficits in language, especially morphosyntax, in the absence of other explanatory conditions. However, deficits in speech production, as well as fine and gross motor skill, have also been observed, implicating both the linguistic and motor systems. Situated at the intersection of these domains, and providing insight into both, is manual gesture. In the current work, we asked whether children with DLD showed phonological deficits in the production of novel gestures and whether gesture production at 4 years of age is related to language and motor outcomes two years later. Twenty-eight children (14 with DLD) participated in a two-year longitudinal novel gesture production study. At the first and final time points, language and fine motor skills were measured and gestures were analyzed for phonological feature accuracy, including handshape, path, and orientation. Results indicated that, while early deficits in phonological accuracy did not persist for children with DLD, all children struggled with orientation while handshape was the most accurate. Early handshape and orientation accuracy were also predictive of later language skill, but only for the children with DLD. Theoretical and clinical implications of these findings are discussed.

Characterizing macro- and micro-structures of narrative skills for Mandarin-speaking school-age children with specific language impairment

INTRODUCTION

Little is known about the narrative skills of Mandarin-speaking children with specific language impairment (SLI). This study was aimed to capture the features of narratives for school-age Mandarin-speaking children with SLI.

METHODS

Oral narrative samples by 55 Mandarin-speaking children with SLI [higher grades, recruited from Grade 4-5, n = 26, M_age = 11.00 years, SD = 0.56; lower grades, recruited from Grade 1-3, n = 29, M_age = 8.05 years, SD = 0.89] were compared with typically developing (TD) children on macro- and micro-structures of narratives.

RESULTS

The results revealed that across grades, for macrostructure, children with SLI lagged behind TD children in narrative pattern scores. For microstructure, children with SLI were constrained in the total number of words, the total number of different words, and the mean length of utterance. They also used fewer serial verb constructions, clausal objects, and temporality conjunctions. They were less adequate in the three referential functions of introduction, maintenance, and switch. Furthermore, the results showed that older children demonstrated higher narrative pattern scores, longer MLU, and higher proportions of conjunctions and referential forms of switch.

CONCLUSIONS

These results suggest that both macro- and micro-structure measures in narratives are sensitive to linguistic difficulties for children with SLI and that some of these measures are sensitive to grade growth. The findings shed light on the assessment and developmental changes of school-age Mandarin-speaking children with SLI and TD children.

Comparing Theory of Mind Development in Children with Autism Spectrum Disorder, Developmental Language Disorder, and Typical Development

BACKGROUND

Theory of mind (ToM) is the ability to recognize, comprehend, and consider oneself's and others' mental states and perspectives to predict and explain behaviors and motivations. It is widely accepted that children with autism spectrum disorder (ASD) experience difficulties with ToM. However, there are also findings suggesting that ToM abilities might also be compromised in children with Developmental Language Disorders (DLD).

PURPOSE

To assess ToM abilities in three groups of children: 1. ASD with no language difficulties; 2. DLD, known for their language disorder; and 3. TD with no language issues.

MATERIALS AND METHODS

A total of 41 preschool children aged 5-to-6 were examined and assigned to one of the three groups based on previous clinical reports and a standardized Hebrew language assessment tool. Nonverbal IQ was established with a standardized test to verify within average range placement (>75 IQ). ToM skills were examined with a Hebrew version of the ToM Task Battery and parent's questionnaire (ToMI).

RESULTS

Children with ASD had significantly lower ToM scores compared to the children with DLD, and TD. The ToM scores of the children with DLD were similar to the scores of the TD children. According to the parents' questionnaires, both the ASD children and the DLD children had less developed ToM skills compared to their TD peers.

CONCLUSION

The present findings suggest that children with ASD have a fundamental difficulty in ToM that is independent of their language abilities. Children with DLD show difficulties in everyday social interactions that involve ToM. It is possible that both ASD and language disorders influence ToM development, suggesting that different developmental routes affect the acquisition of ToM.

ACR Appropriateness Criteria® Diffuse Lung Disease

Diffuse lung disease, frequently referred to as interstitial lung disease, encompasses numerous disorders affecting the lung parenchyma. The potential etiologies of diffuse lung disease are broad with several hundred established clinical syndromes and pathologies currently identified. Imaging plays a critical role in diagnosis and follow-up of many of these diseases, although multidisciplinary discussion is the current standard for diagnosis of several DLDs. This document aims to establish guidelines for evaluation of diffuse lung diseases for 1) initial imaging of suspected diffuse lung disease, 2) initial imaging of suspected acute exacerbation or acute deterioration in cases of confirmed diffuse lung disease, and 3) clinically indicated routine follow-up of confirmed diffuse lung disease without acute deterioration. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

Microfluidic Obstacle Arrays Induce Large Reversible Shape Change in Red Blood Cells

Red blood cell (RBC) shape change under static and dynamic shear stress has been a source of interest for at least 50 years. High-speed time-lapse microscopy was used to observe the rate of deformation and relaxation when RBCs are subjected to periodic shear stress and deformation forces as they pass through an obstacle. We show that red blood cells are reversibly deformed and take on characteristic shapes not previously seen in physiological buffers when the maximum shear stress was between 2.2 and 25 Pa (strain rate 2200 to 25,000 s⁻¹). We quantify the rates of RBC deformation and recovery using Kaplan–Meier survival analysis. The time to deformation decreased from 320 to 23 milliseconds with increasing flow rates, but the distance traveled before deformation changed little. Shape recovery, a measure of degree of deformation, takes tens of milliseconds at the lowest flow rates and reached saturation at 2.4 s at a shear stress of 11.2 Pa indicating a maximum degree of deformation was reached. The rates and types of deformation have relevance in red blood cell disorders and in blood cell behavior in microfluidic devices.

Does rhythmic priming improve grammatical processing in Hungarian-speaking children with and without developmental language disorder?

Research has described several features shared between musical rhythm and speech or language, and experimental studies consistently show associations between performance on tasks in the two domains as well as impaired rhythm processing in children with language disorders. Motivated by these results, in the current study our first aim was to explore whether a short exposure to a regular musical rhythm (i.e., rhythmic priming) can improve subsequent grammatical processing in preschool‐aged Hungarian‐speaking children with and without developmental language disorder (DLD). Second, we investigated whether rhythmic priming is specific to grammar processing by assessing priming in two additional domains: a linguistic but non‐grammatical task (picture naming) and a non‐linguistic task (nonverbal Stroop task). Third, to confirm that the rhythmic priming effect originates from the facilitating effect of the regular rhythm and not the negative effect of the control condition, we added a third condition, silence, for all the three tasks. Both groups of children showed better performance on the grammaticality judgment task in the regular compared to both the irregular and the silent conditions but no such effect appeared in the non‐grammatical and non‐linguistic tasks. These results suggest that (1) rhythmic priming can improve grammatical processing in Hungarian, a language with complex morphosyntax, both in children with and without DLD, (2) the effect is specific to grammar and (3) is a result of the facilitating effect of the regular rhythm. These results could motivate further research about integrating rhythmic priming into traditional speech‐language therapy. A video abstract of this article can be viewed at https://youtu.be/zKzGuIjZyvU.

The Role of the Rare Variants in the Genes Encoding the Alpha-Ketoglutarate Dehydrogenase in Alzheimer's Disease

There is increasing evidence that several mitochondrial abnormalities are present in the brains of patients with Alzheimer's disease (AD). Decreased alpha-ketoglutarate dehydrogenase complex (αKGDHc) activity was identified in some patients with AD. The αKGDHc is a key enzyme in the Krebs cycle. This enzyme is very sensitive to the harmful effect of reactive oxygen species, which gives them a critical role in the Alzheimer and mitochondrial disease research area. Previously, several genetic risk factors were described in association with AD. Our aim was to analyze the associations of rare damaging variants in the genes encoding αKGDHc subunits and AD. The three genes (OGDH, DLST, DLD) encoding αKGDHc subunits were sequenced from different brain regions of 11 patients with histologically confirmed AD and the blood of further 35 AD patients. As a control group, we screened 134 persons with whole-exome sequencing. In all subunits, a one-one rare variant was identified with unknown significance based on American College of Medical Genetics and Genomics (ACMG) classification. Based on the literature research and our experience, R263H mutation in the DLD gene seems likely to be pathogenic. In the different cerebral areas, the αKGDHc mutational profile was the same, indicating the presence of germline variants. We hypothesize that the heterozygous missense R263H in the DLD gene may have a role in AD as a mild genetic risk factor.

Drug Loading and Distribution of ADCs After Reduction or IdeS Digestion and Reduction

High-resolution native mass spectrometry (MS) provides accurate mass measurements (within 30 ppm) of intact ADCs and can also yield drug load distribution (DLD) and average drug to antibody ratio (DAR) in parallel with hydrophobic interaction chromatography (HIC). Native MS is furthermore unique in its ability to simultaneously detect covalent and noncovalent species in a mixture and for HIC peak identity assessment offline or online.As an orthogonal method described in this chapter, LC-MS following ADC reduction or IdeS (Fabricator) digestion and reduction can also be used to measure the DLD of light chain and Fd fragments for hinge native cysteine residues such as brentuximab vedotin. Both methods allow also the measurement of average DAR for both monomeric and multimeric species. In addition, the Fc fragments can be analyzed in the same run, providing a complete glycoprofile and the demonstration or absence of additional conjugation of this subdomain involved in FcRn and Fc-gammaR binding.

Developmental Language Disorder: Wake and Sleep Epileptiform Discharges and Co-morbid Neurodevelopmental Disorders

Developmental language disorder (DLD) is frequently associated with other developmental diseases and may lead to a handicap through adolescence or adulthood. The aim of our retrospective study was to characterize DLD subgroups, their etiological factors and clinical comorbidities, and the role of epileptiform discharges in wake and sleep recordings. Fifty-five children (42 male, mean age 6.2 ± 1.4 years, range 4-9 years) were included in the present study and underwent phoniatric, psychologic, neurologic, as well as wake and nocturnal electroencephalography (EEG) or polysomnography (PSG) examinations. A receptive form of DLD was determined in 34 children (63.0%), and an expressive form was found in 20 children (37.0%). Poor cooperation in one child did not permit exact classification. DLD children with the receptive form had significantly lower mean phonemic hearing (79.1% ± 10.9) in comparison with those with the expressive form (89.7% ± 6.2, p < 0.001). A high amount of perinatal risk factors was found in both groups (50.9%) as well as comorbid developmental diseases. Developmental motor coordination disorder was diagnosed in 33 children (61.1%), and attention deficit or hyperactivity disorder was diagnosed in 39 children (70.9%). Almost one half of DLD children (49.1%) showed abnormalities on the wake EEG; epileptiform discharges were found in 20 children (36.4%). Nocturnal EEG and PSG recordings showed enhanced epileptiform discharges, and they were found in 30 children (55.6%, p = 0.01). The wake EEG showed focal discharges predominantly in the temporal or temporo-parieto-occipital regions bilaterally, while in the sleep recordings, focal activity was shifted to the fronto-temporo-central areas (p < 0.001). Almost all epileptiform discharges appeared in non-rapid eye movement (NREM) sleep. A close connection was found between DLD and perinatal risk factors, as well as neurodevelopmental disorders. Epileptiform discharges showed an enhancement in nocturnal sleep, and the distribution of focal discharges changed.

Emotional Competence Mediates the Relationship between Communication Problems and Reactive Externalizing Problems in Children with and without Developmental Language Disorder: A Longitudinal Study

Language problems are a risk factor for externalizing problems, but the developmental path remains unclear. Emotional competence may mediate the relationship, especially when externalizing problems are reactive in nature, such as in Oppositional Deviant Disorder (ODD) and reactive aggression. We examined the development of reactive and proactive externalizing problems in children with (n = 98) and without (n = 156) Developmental Language Disorder (DLD; age: 8-16 years) over 18 months. Relationships with communicative risk factors (structural, pragmatic and emotion communication) and the mediating role of emotional competence (emotion recognition and anger dysregulation) were examined. Multi-level analyses showed that increasing emotion recognition and decreasing anger dysregulation were longitudinally related to decreasing ODD symptoms in both groups, whereas anger dysregulation was related to more reactive aggression in children with DLD alone. Pragmatic and emotion communication problems were related to more reactive externalizing problems, but these relationships were mediated by emotional competence, suggesting that problems in emotional competence explain the communication problems of children with DLD. Therefore, in addition to interventions for communication skills, there is a need to address the emotional competence of children with DLD, as this decreases the risk for reactive externalizing problems.

The Association of Dyslexia and Developmental Speech and Language Disorder Candidate Genes with Reading and Language Abilities in Adults

Reading and language abilities are critical for educational achievement and success in adulthood. Variation in these traits is highly heritable, but the underlying genetic architecture is largely undiscovered. Genetic studies of reading and language skills traditionally focus on children with developmental disorders; however, much larger unselected adult samples are available, increasing power to identify associations with specific genetic variants of small effect size. We introduce an Australian adult population cohort (41.7-73.2 years of age, N = 1505) in which we obtained data using validated measures of several aspects of reading and language abilities. We performed genetic association analysis for a reading and spelling composite score, nonword reading (assessing phonological processing: a core component in learning to read), phonetic spelling, self-reported reading impairment and nonword repetition (a marker of language ability). Given the limited power in a sample of this size (~80% power to find a minimum effect size of 0.005), we focused on analyzing candidate genes that have been associated with dyslexia and developmental speech and language disorders in prior studies. In gene-based tests, FOXP2, a gene implicated in speech/language disorders, was associated with nonword repetition (p < .001), phonetic spelling (p = .002) and the reading and spelling composite score (p < .001). Gene-set analyses of candidate dyslexia and speech/language disorder genes were not significant. These findings contribute to the assessment of genetic associations in reading and language disorders, crucial for understanding their etiology and informing intervention strategies, and validate the approach of using unselected adult samples for gene discovery in language and reading.

The joint effects of bilingualism, DLD and item frequency on children's lexical-retrieval performance

BACKGROUND

Bilingual children and children diagnosed with developmental language disorder (DLD) are characterized by reduced lexical-retrieval abilities. Few studies examined their joint contribution and the mechanisms underlying these effects in the lexical domain.

AIMS

To explore the joint effects of bilingualism and DLD by adopting a four-group comparison in which the difference between bi- and monolingual children with DLD is directly compared with that of bi- and monolingual children with typical language development (TLD). In addition, to examine the mechanisms underlying the effects of bilingualism and DLD on children's lexical-retrieval abilities, we tested how item's characteristics (frequency of use) modulate the effects of bilingualism and DLD.

METHODS & PROCEDURES

Fifty-eight children (aged 9-14 years) participated in the current study. They were either Hebrew monolingual or Hebrew-English bilinguals and were either diagnosed with DLD or had TLD. Children completed a Hebrew picture-naming task and verbal short-term memory tests. The influence of participants' characteristics, including bilingualism, DLD and verbal short-term memory, as well as item's characteristics (frequency of use) were tested.

OUTCOMES & RESULTS

Accuracy analysis revealed that bilingual children scored lower than monolingual children and that children with DLD scored lower than children with TLD. Critically, the two factors interacted such that their joint presence resulted in less-than-additive effects. Specifically, although bilingual children with DLD performed worse than all other groups, they performed better than expected under an additive model. Interestingly, monolingual children with DLD performed similarly to bilingual children with TLD. Increased verbal short-term memory was associated with better performance across the four groups. Finally, bilingualism and DLD interacted with item frequency, such that being bilingual, having DLD, or both, resulted in increased sensitivity to item frequency manifested in exceptionally lower performance on low-frequency items.

CONCLUSIONS & IMPLICATIONS

The findings suggest that the strength of linguistic representations contribute to the effects of bilingualism and DLD. Further, the presence of bilingualism in the context of DLD does not exaggerate the impact of DLD. Clinically, this suggests that differences between bi- and monolingual children with DLD must be considered in reference to the gap in lexical-retrieval performance observed between bi- and monolingual children with TLD. Finally, because monolingual children with DLD and bilingual children with TLD performed similarly, sensitive diagnostic tools and intervention programmes should be adopted to allow correct identification and treatment of bilingual children with DLD.

Microfluidics-Based Approaches to the Isolation of African Trypanosomes

African trypanosomes are responsible for significant levels of disease in both humans and animals. The protozoan parasites are free-living flagellates, usually transmitted by arthropod vectors, including the tsetse fly. In the mammalian host they live in the bloodstream and, in the case of human-infectious species, later invade the central nervous system. Diagnosis of the disease requires the positive identification of parasites in the bloodstream. This can be particularly challenging where parasite numbers are low, as is often the case in peripheral blood. Enriching parasites from body fluids is an important part of the diagnostic pathway. As more is learned about the physicochemical properties of trypanosomes, this information can be exploited through use of different microfluidic-based approaches to isolate the parasites from blood or other fluids. Here, we discuss recent advances in the use of microfluidics to separate trypanosomes from blood and to isolate single trypanosomes for analyses including drug screening.

Difficulties in recognition of pyruvate dehydrogenase complex deficiency on the basis of clinical and biochemical features. The role of next-generation sequencing

Pyruvate dehydrogenase complex (PDHc) defect is a well-known cause of mitochondrial disorders (MD) with at least six responsible genes (PDHA1, PDHB, DLAT, DLD, PDHX, PDP1). The aim of this work was to assess the diagnostic value of biochemical methods in recognition of PDHc defect in Polish patients with suspicion of MD.

In the first step, Western blot of the E1α subunit was performed on 86 archive muscle bioptates with suspicion of MD. In the second step, Sanger PDHA1 sequencing was performed in 21 cases with low E1α expression. In the third step, 7 patients with negative results of PDHA1 sequencing were subjected to whole-exome sequencing (WES). This protocol revealed 4 patients with PDHA1 and one with DLD mutations. Four additional probands were diagnosed outside the protocol (WES or Sanger sequencing).

The molecular characterization of PDHc defect was conducted in a total of 9 probands: 5 according to and 4 off the protocol. Additionally, two affected relatives were recognized by a family study. Altogether we identified seven different PDHA1 changes, including two novel variants [c.464T > C (p.Met155Thr) and c.856_859dupACTT (p.Arg288Leufs*10)] and one DLD variant.

The lactate response to glucose load in the PDHA1 subset was compared to a subset of non PDHc-related MD. Opposite responses were observed, with an increase of 23% and decrease of 27%, respectively.

The results show that determining lactate response to glucose load and muscle E1α expression may contribute to distinguishing PDHc-related and other MD, however, WES is becoming the method of choice for MD diagnostics.

Candidate gene analysis of the surfactant protein D gene in pediatric diffuse lung disease

Mutations in surfactant-associated genes cause childhood diffuse lung disease. Mice lacking surfactant protein D develop lung disease with age. However, we identified no novel surfactant protein D gene (SFTPD) coding or splice region variants in 73 unrelated children with diffuse lung disease from a cohort enriched for genetic surfactant dysfunction.