Using Nonword Repetition to Identify Language Impairment in Bilingual Children: A Meta-Analysis of Diagnostic Accuracy

2021 ◽  
pp. 1-21
Author(s):  
José A. Ortiz
Keyword(s):  
Diagnostic Accuracy ◽  
Language Impairment ◽  
Meta Analysis ◽  
Nonword Repetition ◽  
Bilingual Children ◽  
Eligibility Criteria ◽  
Study Results ◽  
Meta Regression Analysis ◽  
Word Search ◽  
Meta Analyses

Purpose Nonword repetition has been endorsed as a less biased method of assessment for children from culturally and linguistically diverse backgrounds, but there are currently no systematic reviews or meta-analyses on its use with bilingual children. The purpose of this study was to evaluate diagnostic accuracy of nonword repetition in the identification of language impairment (LI) in bilingual children. Method Using a key word search of peer-reviewed literature from several large electronic databases, as well as ancestral and forward searches, 13 studies were identified that met the eligibility criteria. Studies were evaluated on the basis of quality of evidence, design characteristics, and reported diagnostic accuracy. A meta-regression analysis, based on study results, was conducted to identify task characteristics that may be associated with better classification accuracy. Results Diagnostic accuracy across studies ranged from poor to good. Bilingual children with LI performed with more difficulty on nonword repetition tasks than those with typical language. Quasi-universal tasks, which account for the phonotactic constraints of multiple languages, exhibited better diagnostic accuracy and resulted in less misidentification of children with typical language than language-specific tasks. Conclusions Evidence suggests that nonword repetition may be a useful tool in the assessment and screening of LI in bilingual children, though it should be used in conjunction with other measures. Quasi-universal tasks demonstrate the potential to further reduce assessment bias, but extant research is limited.

The Use of Dynamic Assessment for the Diagnosis of Language Disorders in Bilingual Children: A Meta-Analysis

2019 ◽  
Vol 28 (3) ◽  
pp. 1298-1317 ◽  
Author(s):  
Carla I. Orellana ◽  
Rebekah Wada ◽  
Ronald B. Gillam
Keyword(s):  
Diagnostic Accuracy ◽  
Language Impairment ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Dynamic Assessment ◽  
Language Disorders ◽  
Learning Ability ◽  
Bilingual Children ◽  
Typically Developing ◽  
Study Results

Purpose Dynamic assessment (DA) has generally been accepted and recommended for use with bilingual children; however, no meta-analysis or systematic review of the diagnostic accuracy for language impairment within this population exists. Therefore, this study aimed to examine the current use of DA and its diagnostic accuracy for language impairment in bilingual children. Method Through a key word search of PsycINFO, ERIC, Academic Search Premier, and MEDLINE via EBSCOhost, 7 studies were identified. Participants ranged from 3 to 8 years old. Areas of language addressed through DA included labeling single words, morpheme rule learning, ability to learn nonwords, and narratives. Study results were analyzed with respect to diagnostic accuracy, participant modifiability, and methodological quality. Results Overall, participants with typically developing language received higher scores on the language assessments used in DA studies compared to participants with a language impairment. Gain scores were generally not useful for differentiating between children who did or did not have language impairments. However, clinician judgments of modifiability during the teaching phase of DA consistently yielded significant group effects favoring the typically developing children. Across the 7 studies, sensitivity and specificity were reasonably high, with all studies meeting or close to meeting the set criteria (≥ 0.8). Conclusion Suggestive evidence supports the use of DA for diagnosing language disorders in bilingual children. However, limitations in the methodological quality of the studies that were reviewed could have resulted in inflated diagnostic accuracy and decreased validity. Supplemental Material https://doi.org/10.23641/asha.8232926

Nonword Repetition in Bilingual Assessment: A Guide to Clinical Application

2021 ◽  
pp. 1-11
Author(s):  
José A. Ortiz
Keyword(s):  
Diagnostic Accuracy ◽  
Clinical Application ◽  
Diagnostic Tool ◽  
Language Impairment ◽  
Alternative Assessment ◽  
Language Assessment ◽  
Nonword Repetition ◽  
Bilingual Children ◽  
Bilingual Assessment ◽  
Method Of Assessment

Purpose: Nonword repetition (NWR) is a useful tool in the identification of language impairment in bilingual children. As a method of alternative assessment, the task is less biased than many traditional forms of assessment. Despite its potential utility, the use of NWR in language assessment is limited. The goal of this tutorial is to provide speech-language pathologists with the information needed to use NWR as a diagnostic tool in bilingual assessment by describing research into its diagnostic accuracy and considerations for clinical application. Conclusions: NWR is a useful diagnostic tool in bilingual language assessment when used as part of an assessment battery. Although its diagnostic accuracy limits its ability to be used in the absence of other tools, it can provide valuable information that can be used to strengthen clinical impressions. When using NWR measures, clinicians should take several important aspects in account, including the language and age for which it was intended, the type of stimuli included, and the scoring procedures. Clinicians who work with bilingual children should consider including NWR in their diagnostic toolkits, as a less biased method of assessment.

Evaluation of Three Proposed Markers for Language Impairment in English: A Meta-Analysis of Diagnostic Accuracy Studies

2014 ◽  
Vol 57 (6) ◽  
pp. 2261-2273 ◽  
Author(s):  
Monika Pawłowska
Keyword(s):  
Diagnostic Accuracy ◽  
Language Impairment ◽  
Meta Analysis ◽  
Nonword Repetition ◽  
Future Research ◽  
Likelihood Ratios ◽  
Sentence Repetition ◽  
Study Heterogeneity ◽  
English Speaking ◽  
Verb Tense

Purpose The goal of the study was to determine to what extent 3 proposed markers of language impairment (LI) in English (verb tense, nonword repetition, and sentence repetition) accurately distinguish affected and unaffected English-speaking individuals. Method Electronic databases were searched for diagnostic accuracy studies involving the 3 markers. Quality of relevant studies was described. Numbers of true and false positives and negatives were extracted and used to calculate likelihood ratios (LRs). Results Thirteen studies met the selection criteria. The majority were based on clinically ascertained samples. Pooled LRs and 95% confidence intervals (CIs) for tense (LR+) and sentence repetition (LR+ and LR−) were suggestive of presence (LR+) or absence (LR−) of LI. Wide CIs around the value of inconsistency I 2 index reduced reliability of pooled values for sentence repetition. High between-study heterogeneity precluded pooling of LR values for tense (LR−) and nonword repetition (LR+ and LR−). Conclusion The limited evidence available suggests that the proposed markers may be at best suggestive of LI in English. Future research may refine existing marker tasks to increase their accuracy and test the most promising tasks in unselected samples of participants with and without LI.

Laser Influence on Dental Sensitivity Compared to Other Light Sources Used During In-office Dental Bleaching: Systematic Review and Meta-analysis

2020 ◽  
Vol 45 (6) ◽  
pp. 589-597
Author(s):  
BGS Casado ◽  
EP Pellizzer ◽  
JR Souto Maior ◽  
CAA Lemos ◽  
BCE Vasconcelos ◽  
...  
Keyword(s):  
Randomized Clinical Trials ◽  
Color Change ◽  
Meta Analysis ◽  
Present Review ◽  
Cochrane Library ◽  
Light Sources ◽  
Eligibility Criteria ◽  
Tooth Color ◽  
Significant Difference ◽  
Meta Analyses

Clinical Relevance The use of laser light during bleaching will not reduce the incidence or severity of sensitivity and will not increase the degree of color change compared with nonlaser light sources. SUMMARY Objective: To evaluate whether the use of laser during in-office bleaching promotes a reduction in dental sensitivity after bleaching compared with other light sources. Methods: The present review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and is registered with PROSPERO (CDR42018096591). Searches were conducted in the PubMed/Medline, Web of Science, and Cochrane Library databases for relevant articles published up to August 2018. Only randomized clinical trials among adults that compared the use of laser during in-office whitening and other light sources were considered eligible. Results: After analysis of the texts retrieved during the database search, six articles met the eligibility criteria and were selected for the present review. For the outcome dental sensitivity, no significant difference was found favoring any type of light either for intensity (mean difference [MD]: −1.60; confidence interval [CI]: −3.42 to 0.22; p=0.09) or incidence (MD: 1.00; CI: 0.755 to 1.33; p=1.00). Regarding change in tooth color, no significant differences were found between the use of the laser and other light sources (MD: −2.22; CI: −6.36 to 1.93; p=0.29). Conclusions: Within the limitations of the present study, laser exerts no influence on tooth sensitivity compared with other light sources when used during in-office bleaching. The included studies demonstrated that laser use during in-office bleaching may have no influence on tooth color change.

scholarly journals Efficacy and safety of instantaneous wave-free ratio in patients undergoing coronary revascularisation: protocol for a systematic review

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017868
Author(s):  
Joey S.W. Kwong ◽  
Sheyu Li ◽  
Wan-Jie Gu ◽  
Hao Chen ◽  
Chao Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Coronary Revascularisation ◽  
Eligibility Criteria ◽  
Registration Number ◽  
Collection Form ◽  
Randomised Controlled ◽  
Meta Analyses

IntroductionEffective selection of coronary lesions for revascularisation is pivotal in the management of symptoms and adverse outcomes in patients with coronary artery disease. Recently, instantaneous ‘wave-free’ ratio (iFR) has been proposed as a new diagnostic index for assessing the severity of coronary stenoses without the need of pharmacological vasodilation. Evidence of the effectiveness of iFR-guided revascularisation is emerging and a systematic review is warranted.Methods and analysisThis is a protocol for a systematic review of randomised controlled trials and controlled observational studies. Electronic sources including MEDLINE via Ovid, Embase, Cochrane databases and ClinicalTrials.gov will be searched for potentially eligible studies investigating the effects of iFR-guided strategy in patients undergoing coronary revascularisation. Studies will be selected against transparent eligibility criteria and data will be extracted using a prestandardised data collection form by two independent authors. Risk of bias in included studies and overall quality of evidence will be assessed using validated methodological tools. Meta-analysis will be performed using the Review Manager software. Our systematic review will be performed according to the guidance from the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.Ethics and disseminationEthics approval is not required. Results of the systematic review will be disseminated as conference proceedings and peer-reviewed journal publication.Trial registration numberThis protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42017065460.

scholarly journals Nonword Repetition and Sentence Imitation as Clinical Markers for Primary Language Impairment in bilingual French-English- and English-French-speaking children in Northern Ontario

2017 ◽  
Vol 1 ◽  
pp. 61-69
Author(s):  
Sara Dubreuil-Piché ◽  
Jenna Lachance ◽  
Chantal Mayer-Crittenden
Keyword(s):  
Language Impairment ◽  
Theoretical Background ◽  
Target Language ◽  
Nonword Repetition ◽  
Bilingual Children ◽  
Primary Language ◽  
Clinical Markers ◽  
Language Exposure ◽  
Sentence Imitation ◽  
Primary Language Impairment

Studies indicate that nonword repetition and sentence imitation are useful tools when assessing bilingual children. Bilingual children with primary language impairment (PLI) typically score lower on these two tasks than their typically developing counterparts. Studies show that bilingual children are not disadvantaged during nonword repetition if they have limited language exposure. However, since sentence imitation tasks are constructed with words from the target language, it is expected that it would be more influenced by previous language exposure. The goal of this article will be to review the influence of bilingual exposure on both tasks. This review provides the theoretical background for future studies that will compare the accuracy of both tasks when identifying PLI in bilingual children.

scholarly journals Evaluation of Preeclampsia Results after Use of Metformin in Gestation: Systematic Review and Meta-analysis

2018 ◽  
Vol 40 (11) ◽  
pp. 713-721 ◽  
Author(s):  
Iramar Nascimento ◽  
Guilherme Dienstmann ◽  
Matheus de Souza ◽  
Raquel Fleig ◽  
Carla Hoffmann ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Time ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Eligibility Criteria ◽  
Time Segment ◽  
Meta Analyses ◽  
The Cochrane Collaboration ◽  
Lower Correlation

Objective Does the use of metformin have an influence on the outcomes of preeclampsia (PE)? Sources of Data The descriptors pregnancy, metformin, treatment, and preeclampsia associated with the Boolean operators AND and OR were found in the MEDLINE, LILACS, Embase and Cochrane databases. A flowchart with exclusion criteria and inclusion strategy using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, and eligibility criteria was used. Data were extracted regarding the type of study, the applied dosage, treatment time, segment, bias risks, and the Patient, Intervention, Comparison and Outcome (PICO) strategy to identify the quality of the study. Selection of Studies Total number of journals in the initial search (n = 824); exclusions from repeated articles on different search engines (n = 253); exclusions after reading the titles, when the title had no correlations with the proposed theme (n = 164); exclusions due to incompatibility with the criteria established in the methodological analysis (n = 185), exclusion of articles with lower correlation with the objective of the present study (n = 187); and final bibliographic selection (n = 35). Data Collection At first, a systematic review of the literature was performed. Subsequently, from the main selection, randomized and non-randomized trials with metformin that presented their results in absolute and relative numbers of PE outcomes were selected. The variables were treated statistically in the meta-analysis with the Review Manager software (RevMan), version 5.3. Copenhagen: Nordic Cochrane Centre, The Cochrane Collaboration. Denmark in the Hovedistaden region. Synthesis of Data The study showed that metmorfin presented greater preventive effects for pregnancy-induced hypertension and was less effective for PE. Conclusion Metformin may gain place in preventive treatments for PE, once the dosages, the gestational age, and treatment time are particularly evaluated. A methodological strategy with an improved perspective of innovative and/or carefully progressive dosages during pregnancy to avoid side effects and the possibility of maternal-fetal risks is suggested.

scholarly journals Can physical testing be used to distinguish between migraine and cervicogenic headache sufferers? A protocol for a systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031587 ◽  
Author(s):  
Ernesto Anarte ◽  
Gabriela Ferreira Carvalho ◽  
Annika Schwarz ◽  
Kerstin Luedtke ◽  
Deborah Falla
Keyword(s):  
Systematic Review ◽  
Differential Diagnosis ◽  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Cervicogenic Headache ◽  
Ethical Approval ◽  
Black Scale ◽  
Physical Tests ◽  
Meta Analyses ◽  
Asymptomatic Subjects

IntroductionDifferential diagnosis of migraine and cervicogenic headache (CGH) can be challenging given the large overlap of symptoms, commonly leading to misdiagnosis and ineffective treatment. In order to strengthen the differential diagnosis of headache, previous studies have evaluated the utility of physical tests to examine for musculoskeletal impairment, mainly in the cervical spine, which could be provoking or triggering headache. However, no systematic review has attempted to evaluate whether physical tests can differentiate CGH from migraine or both conditions from asymptomatic subjects.Methods/analysisA systematic review protocol has been designed and is reported in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). A sensitive topic-based search strategy is planned which will include databases, hand searching of key journals and consultation of relevant leading authors in this field. Terms and keywords will be selected after discussion and agreement. Two independent reviewers will perform the search and select studies according to inclusion and exclusion criteria, including any cohort or observational studies evaluating the topic of this review; a third reviewer will confirm accuracy. A narrative synthesis will be developed for all included studies and, if possible, a meta-analysis will be conducted. The overall quality of the evidence will be assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) checklist for diagnostic accuracy studies and the Downs and Black scale for those studies where the QUADAS-2 checklist cannot be applied.Ethics and disseminationEthical approval is not required since no patient information will be collected. The results will provide a deeper understanding about the possibility of using physical tests to differentiate cervicogenic headache from migraine and from asymptomatic subjects, which has direct relevance for clinicians managing people with headache. The results will be published in a peer-reviewed journal and presented at scientific conferences.PROSPERO registration numberCRD42019135269.

scholarly journals Comparing the Effects of Docosahexaenoic and Eicosapentaenoic Acids on Inflammation Markers Using Pairwise and Network Meta-Analyses of Randomized Controlled Trials

2020 ◽  
Author(s):  
Cécile Vors ◽  
Janie Allaire ◽  
Sonia Blanco Mejia ◽  
Tauseef A Khan ◽  
John L Sievenpiper ◽  
...  
Keyword(s):  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Eligibility Criteria ◽  
Necrosis Factor Alpha ◽  
Assessment Development ◽  
Evaluation Approach ◽  
Tnf Α ◽  
Mean Differences ◽  
Meta Analyses

ABSTRACT Recent data from randomized clinical trials (RCTs) suggest that DHA may have stronger anti-inflammatory effects than EPA. This body of evidence has not yet been quantitatively reviewed. The aim of this study was to compare the effect of DHA and EPA on several markers of systemic inflammation by pairwise and network meta-analyses of RCTs. MEDLINE, EMBASE, and The Cochrane Library were searched through to September 2019. We included RCTs of ≥7 d on adults regardless of health status that directly compared the effects of DHA with EPA and RCTs of indirect comparisons, in which the effects of DHA or EPA were compared individually to a control fatty acid. Differences in circulating concentrations of C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α) and adiponectin were the primary outcome measures. Data were pooled by pairwise and network meta-analysis and expressed as mean differences (MDs) with 95% CIs. Heterogeneity was assessed (Cochran Q statistic) and quantified (I2 statistic) in the pairwise meta-analysis. Inconsistency and transitivity were evaluated in the network meta-analysis. The certainty of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. Eligibility criteria were met by 5 RCTs (N = 411) for the pairwise meta-analysis and 20 RCTs (N = 1231) for the network meta-analysis. In the pairwise meta-analysis, DHA and EPA had similar effects on plasma CRP [MDDHA versus EPA = 0.14 mg/L (95% CI: –0.57, 0.85); I2 = 61%], IL-6 [MDDHA versus EPA = 0.10 pg/mL (–0.15, 0.34); I2 = 40%], and TNF-α [MDDHA versus EPA = –0.10 pg/mL (–0.37, 0.18); I2 = 40%]. In the network meta-analysis, the effects of DHA and EPA on plasma CRP [MDDHA versus EPA = –0.33 mg/L (–0.75, 0.10)], IL-6 [MDDHA versus EPA = 0.09 pg/mL (–0.12, 0.30)], and TNF-α [MDDHA versus EPA = –0.02 pg/mL (–0.25, 0.20)] were also similar. DHA and EPA had similar effects on plasma adiponectin in the network meta-analysis. Results from pairwise and network meta-analyses suggest that supplementation with either DHA or EPA does not differentially modify systemic markers of subclinical inflammation.

scholarly journals Association of age and colostrum discarding with breast-feeding practice in Ethiopia: systematic review and meta-analyses

2019 ◽  
Vol 22 (11) ◽  
pp. 2063-2082 ◽  
Author(s):  
Sisay Mulugeta Alemu ◽  
Yihun Mulugeta Alemu ◽  
Tesfa Dejenie Habtewold
Keyword(s):  
Breast Feeding ◽  
Meta Analysis ◽  
Reproductive Age ◽  
Feeding Practice ◽  
Timely Initiation ◽  
Inverse Variance ◽  
Newcastle Ottawa Scale ◽  
Meta Regression Analysis ◽  
Meta Analyses

AbstractObjectiveTo investigate whether maternal/caregiver’s age, infant age (0–6 months) and discarding colostrum affects timely initiation of breast-feeding (TIBF) and exclusive breast-feeding (EBF) in Ethiopia.DesignA systematic search of PubMed, SCOPUS, EMBASE, CINHAL, Web of Science and WHO Global Health Library electronic databases was done for all articles published in English from 2000 to January 2018. Two reviewers independently screened, extracted and graded the quality of studies using Newcastle–Ottawa Scale. A weighted inverse-variance random-effects model meta-analysis, cumulative meta-analysis and mixed-effects meta-regression analysis were done.SettingAll observational studies conducted in Ethiopia.ParticipantsMothers of children aged less than 2 years.ResultA total of forty articles (fourteen studies on TIBF and twenty-six on EBF) were included. TIBF was associated with colostrum discarding (OR=0·38; 95 % CI 0·21, 0·68) but not with maternal/caregiver’s age (OR=0·98; 95 % CI 0·83, 1·15). In addition, colostrum discarding (OR=0·53; 95 % CI 0·36, 0·78) and infant age (OR=1·77; 95 % CI 1·38, 2·27) were significantly associated with EBF but not maternal/caregiver’s age (OR=1·09; 95 % CI 0·84, 1·41).ConclusionsThere was no association between maternal/caregiver’s age and breast-feeding practice (EBF and TIBF). Colostrum discarding was associated with both EBF and TIBF. This evidence could be helpful to counsel all mothers of reproductive age and who discard colostrum.

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