Pediatric Sleep Apnea: The Overnight Electroencephalogram as a Phenotypic Biomarker

Pediatric obstructive sleep apnea (OSA) is a prevalent disorder that disrupts sleep and is associated with neurocognitive and behavioral negative consequences, potentially hampering the development of children for years. However, its relationships with sleep electroencephalogram (EEG) have been scarcely investigated. Here, our main objective was to characterize the overnight EEG of OSA-affected children and its putative relationships with polysomnographic measures and cognitive functions. A two-step analysis involving 294 children (176 controls, 57% males, age range: 5–9 years) was conducted for this purpose. First, the activity and irregularity of overnight EEG spectrum were characterized in the typical frequency bands by means of relative spectral power and spectral entropy, respectively: δ1 (0.1–2 Hz), δ2 (2–4 Hz), θ (4–8 Hz), α (8–13 Hz), σ (10–16 Hz), β1 (13–19 Hz), β2 (19–30 Hz), and γ (30–70 Hz). Then, a correlation network analysis was conducted to evaluate relationships between them, six polysomnography variables (apnea–hypopnea index, respiratory arousal index, spontaneous arousal index, overnight minimum blood oxygen saturation, wake time after sleep onset, and sleep efficiency), and six cognitive scores (differential ability scales, Peabody picture vocabulary test, expressive vocabulary test, design copying, phonological processing, and tower test). We found that as the severity of the disease increases, OSA broadly affects sleep EEG to the point that the information from the different frequency bands becomes more similar, regardless of activity or irregularity. EEG activity and irregularity information from the most severely affected children were significantly associated with polysomnographic variables, which were coherent with both micro and macro sleep disruptions. We hypothesize that the EEG changes caused by OSA could be related to the occurrence of respiratory-related arousals, as well as thalamic inhibition in the slow oscillation generation due to increases in arousal levels aimed at recovery from respiratory events. Furthermore, relationships between sleep EEG and cognitive scores emerged regarding language, visual–spatial processing, and executive function with pronounced associations found with EEG irregularity in δ1 (Peabody picture vocabulary test and expressive vocabulary test maximum absolute correlations 0.61 and 0.54) and β2 (phonological processing, 0.74; design copying, 0.65; and Tow 0.52). Our results show that overnight EEG informs both sleep alterations and cognitive effects of pediatric OSA. Moreover, EEG irregularity provides new information that complements and expands the classic EEG activity analysis. These findings lay the foundation for the use of sleep EEG to assess cognitive changes in pediatric OSA.

A-119 PPVT Impacted by Neuropathology in Moderate to Severe TBI

Objective Estimating premorbid intellectual functioning after brain injury is a critical element of determining cognitive decline. However, little research has been conducted on how Peabody Picture Vocabulary Test (PPVT-IV) performs in adults after traumatic brain injury (TBI). Given that PPVT measures receptive vocabulary, it has potential to serve as a hold measure test. The objective was to explore characteristics of PPVT in TBI relative to a commonly used proxy of premorbid function (Wechsler Test of Adult Reading, WTAR). Method Sixty-one adults with moderate to severe TBI underwent a comprehensive neuropsychological evaluation and structural neuroimaging. Principal components analyses were used to create cognitive composite scores. Pearson’s correlations were conducted to explore the relationships between PPVT/WTAR standard scores (SS) and neuropathology (white matter integrity as whole brain functional anisotropy [FA]). The relationships between PPVT/WTAR SSs and cognitive constructs were similarly examined. Results PPVT was significantly related to FA (r = 0.34, p = 0.014). However, there was no relationship between WTAR and neuropathology. PPVT was significantly related to age (r = 0.38, p = 0.006), so this variable was controlled for in associated analyses (NB. WTAR was not related to age). PPVT was found to be significantly related to contextualized and noncontextualized memory, attention, executive function, and processing speed (all ps < 0.05). In contrast, WTAR was only significantly related to contextualized memory, attention, and executive function. Conclusions PPVT appears to be impacted by neuropathology, indicating that it may not be appropriate as a hold measure after TBI. This may be explained by PPVT’s significant relationship with fluid intelligence domains known to be impacted after neurologic insult.

The Lexical Development of Canadian-Born Romanian L1 Bilingual Kindergarteners

This study charts the lexical development of three sequential bilingual kindergarteners whose first language, Romanian, was acquired naturalistically at home, and whose second language, English, was acquired in kindergarten. The children’s lexical development in English and Romanian was assessed at five different points over a two-year period via the PPVT-4 (peabody picture vocabulary test 4) and a specially adapted PPVT-4 for Romanian. The children’s lexical repertoires were further analyzed to uncover home versus school and cognate versus non-cognate acquisitional differences. In addition, because there is no database of lexical items acquired by monolingual Romanian children, the PPVT-4 adapted for Romanian was administered to 22 monolingual six-year-old Romanian children in Sibiu, Romania. The findings indicate the following: (i) the three bilinguals’ receptive vocabulary in English was below average when they joined kindergarten, and at or above average two years later; (ii) their lexical growth in Romanian was steady; (iii) the bilinguals’ scores for words belonging to a home register reflected ceiling effects in English and Romanian (i.e., were very well known); (iv) academic words were known to an equal extent in English and Romanian, but scores were lower than for the home register; and (v) there was no definitive evidence of cognate facilitation. A comparison of the monolingual and bilingual Romanian repertoires reflects the following: (i) equally high scores for home items; (ii) differences in scores in the academic register in favour of the Romanian monolinguals; and (iii) important lifestyle and cultural differences between the groups. The Romanian children, for example, were more familiar than their Canadian counterparts with items related to home maintenance, such as șmirghăluiește (‘sanding’) and mistrie (‘trowel’), or items probably learned in school, such as foca (‘walrus’) and broască țestoasă (‘tortoise’).

The Lexical Development of Canadian-Born Romanian L1 Bilingual Kindergarteners

This study charts the lexical development of three sequential bilingual kindergarteners whose first language, Romanian, was acquired naturalistically at home, and whose second language, English, was acquired in kindergarten. The children’s lexical development in English and Romanian was assessed at five different points over a two-year period via the PPVT-4 (peabody picture vocabulary test 4) and a specially adapted PPVT-4 for Romanian. The children’s lexical repertoires were further analyzed to uncover home versus school and cognate versus non-cognate acquisitional differences. In addition, because there is no database of lexical items acquired by monolingual Romanian children, the PPVT-4 adapted for Romanian was administered to 22 monolingual six-year-old Romanian children in Sibiu, Romania. The findings indicate the following: (i) the three bilinguals’ receptive vocabulary in English was below average when they joined kindergarten, and at or above average two years later; (ii) their lexical growth in Romanian was steady; (iii) the bilinguals’ scores for words belonging to a home register reflected ceiling effects in English and Romanian (i.e., were very well known); (iv) academic words were known to an equal extent in English and Romanian, but scores were lower than for the home register; and (v) there was no definitive evidence of cognate facilitation. A comparison of the monolingual and bilingual Romanian repertoires reflects the following: (i) equally high scores for home items; (ii) differences in scores in the academic register in favour of the Romanian monolinguals; and (iii) important lifestyle and cultural differences between the groups. The Romanian children, for example, were more familiar than their Canadian counterparts with items related to home maintenance, such as șmirghăluiește (‘sanding’) and mistrie (‘trowel’), or items probably learned in school, such as foca (‘walrus’) and broască țestoasă (‘tortoise’).

Ανάπτυξη κλίμακας για την αξιολόγηση της κοινωνικής αυτο-αποτελεσματικότητας των παιδαγωγών και διερεύνηση της σχέσης της με την αλληλεπίδραση παιδαγωγού-παιδιού και τα μαθησιακά αποτελέσματα

Η παρούσα διατριβή εισάγει στο πεδίο της εκπαίδευσης την έννοια της Kοινωνικής Aυτο-αποτελεσματικότητας των εκπαιδευτικών. Η έννοια της Κοινωνικής Αυτο-αποτελεσματικότητας (Social Self-Efficacy) απαντάται συχνότερα στο επιστημονικό πεδίο του μάνατζμεντ και αναφέρεται στις πεποιθήσεις για τις ικανότητες του ατόμου σε σχέση με την επίδοση του στις διαπροσωπικές σχέσεις. Στην επιστήμη της παιδαγωγικής, το μεγαλύτερο μέρος των ερευνητών εστιάζει την προσοχή του στη γενική αυτο-αποτελεσματικότητα των εκπαιδευτικών και τη σύνδεση της με τη διδασκαλία και τα ακαδημαϊκά επιτεύγματα των μαθητών, παραμελώντας σημαντικά την έννοια της αυτo-αποτελεσματικότητας σχετικά με τις αλληλεπιδράσεις παιδαγωγού-μαθητή. Η παρούσα διδακτορική διατριβή έχει δύο βασικούς σκοπούς. Ο πρώτος σκοπός αφορά την εισαγωγή της έννοιας της κοινωνικής αυτο-αποτελεσματικότητας των εκπαιδευτικών, με την διατύπωση ενός σαφούς ορισμού και την περιγραφή των διαστάσεών της. Ο δεύτερος σκοπός αφορά την κατασκευή ενός αξιόπιστου και έγκυρου εργαλείου μέτρησης της Κοινωνικής Αυτο-αποτελεσματικότητας των εκπαιδευτικών προκειμένου να εκτιμηθεί η έννοια στην Ελλάδα. Επιμέρους στόχος της διατριβής είναι η διερεύνηση των σχέσεων μεταξύ της Κοινωνικής Αυτο-αποτελεσματικότητας των εκπαιδευτικών, με την ποιότητα των σχέσεων εκπαιδευτικών-μαθητών και με τα μαθησιακά αποτελέσματα των μαθητών. Για την εκπλήρωση των παραπάνω σκοπών πραγματοποιήθηκαν δύο πιλοτικές και μια κύρια έρευνας. Μέσω της πιλοτικής εφαρμογή της Kλίμακας της Κοινωνικής Αυτο-αποτελεσματικότητας των Εκπαιδευτικών (ΚΚΑΕ) σε 162 παιδαγωγούς πρώιμης παιδικής ηλικίας διερευνάται η αρχική εγκυρότητα και αξιοπιστία της. Η κύρια μελέτη επιβεβαιώνει την αξιοπιστία και την εγκυρότητα της νέας κλίμακας σε ένα δείγμα 488 νηπιαγωγών. Ακόμη ο έλεγχος της εγκυρότητας του κριτηρίου της ΚΚΑΕ πραγματώνεται με την ποιότητα των σχέσεων εκπαιδευτικών-μαθητών αποκαλύπτεται μέσω της συμμετοχής 979 παιδιών και των αντίστοιχων εκπαιδευτικών από 123 τάξεις δημόσιων νηπιαγωγείων της Ελλάδας. Τα εργαλεία που χρησιμοποιήθηκαν για τη συλλογή των δεδομένων είναι: α) η Κλίμακα Κοινωνικής Αυτο-αποτελεσματικότητας Εκπαιδευτικών (ΚΚΑΕ), β) η κλίμακα Student-Teacher Relationship Scale (STRS), γ) η κλίμακα Child Appraisal of Relationship with Teacher Scale (CARTS), δ) το Peabody Picture Vocabulary Test-Revised (PPVT-R) και τέλος, ε) μια προσαρμογή του Test of Early Mathematics Ability - Short (TEMA-3). Τα αποτελέσματα των μελετών φανερώνουν την πολυδιάστατη φύση της ΚΚΑΕ αναδεικνύοντας τους πέντε παράγοντες. Επιπρόσθετα, ορισμένα δημογραφικά χαρακτηριστικά των παιδαγωγών συνδέονται με τη κοινωνική αυτο-αποτελεσματικότητα τους. Σε ότι αφορά το προφίλ της κοινωνικής αυτο-αποτελεσματικότητας των εκπαιδευτικών φαίνεται ότι οι παιδαγωγοί σημειώνουν υψηλά επίπεδα κοινωνικής αυτο-αποτελεσματικότητας. Επιπλέον, η σημασία της έννοιας αναδεικνύεται από τα ευρήματα της συσχέτισής της με την ποιότητα των αλληλεπιδράσεων εκπαιδευτικών– μαθητών στη τάξη. Η σημασία της διατριβής έγκειται στο γεγονός ότι προσφέρει νέες πληροφορίες στους εκπαιδευτικούς για τις ικανότητες τους αναφορικά με τις σχέσεις και αλληλεπιδράσεις με τους μαθητές. Οι πληροφορίες αυτές αναφέρονται στη γνώση που ανακύπτει από την αυτο-αξιολόγηση των πεποιθήσεων των εκπαιδευτικών και ενισχύει τον εντοπισμό των τομέων του παιδαγωγικού έργου που ενδεχομένως να χρειάζεται βελτίωση, εξέλιξη ή πρόσθετη επιμόρφωση. Αυτή η γνώση αποτελεί βασική προϋπόθεση για την αποτελεσματική ενίσχυση των αλληλεπιδράσεων εκπαιδευτικών–μαθητών και για το σχεδιασμό στοχευμένων επιμορφώσεων και παρεμβάσεων προς την κατεύθυνση της αποτελεσματικής διαχείρισης της τάξης, αλλά και της δημιουργίας θετικού κλίματος στην τάξη. Επιπρόσθετα, η δημιουργία ενός αξιόπιστου και έγκυρου εργαλείου για τη μέτρηση της ΚΚΑΕ, αποτελεί ακόμη μία συνεισφορά της παρούσας διατριβής.

Validitas Konstruk Peabody Picture Vocabulary Test-Edisi Keempat (PPVT-4) pada Anak dengan Sindrom Down

Receptive language is importance to facilitate the acquisition of language skills. Measuring receptive language skills is crucial, especially for children with language limitations, such as children with Down Syndrome (DS). This study aims to examine the construct validity of the Peabody Picture Vocabulary Test - Fourth Edition (PPVT-4) in children with DS. The research respondents consisted of 98 children with DS who are members of Persatuan Orang Tua Anak dengan Down Syndrome (POTADS) in the Jakarta, Bandung and Padang. Data were collected individually and administered by a psychologist. Data were analyzed using confimatory factor analysis (CFA). The results show that the one-factor model for set-1 to set-10 fit with the data and all items were valid, except for item 106. The implication is the PPVT-4 can be used to measure receptive language abilities of children with DS and estimate of the age equivalent of receptive language abilities.

Predictors of Treatment Response for Preschool Children With Developmental Language Disorder

Purpose Enhanced Conversational Recast treatment is an effective intervention for remediating expressive grammatical deficits in preschool-age children with developmental language disorder, but not all children respond equally well. In this study, we sought to identify which child-level variables predict response to treatment of morphological deficits. Method Predictor variables of interest, including pre-intervention test scores and target morpheme production, age, and mother's level of education (proxy for socio-economic status) were included in analyses. The sample included 105 children ( M = 5;1 [years;months]) with developmental language disorder who participated in 5 weeks of daily Enhanced Conversational Recast treatment. Classification and regression tree analysis was used to identify covariates that predicted children's generalization of their trained grammatical morpheme, as measured by treatment effect size d . Results Our analysis indicates that the Structured Photographic Expressive Language Test–Preschool 2 (SPELT-P 2) scores and the Peabody Picture Vocabulary Test–Fourth Edition scores significantly predicted the degree of benefit a child derived from Enhanced Conversational Recast treatment. Specifically, a SPELT-P 2 score above 75 (but still in the impaired range, < 87) combined with a high Peabody Picture Vocabulary Test–Fourth Edition score (> 100) yielded the largest treatment effect size, whereas a SPELT-P 2 score below 75 predicted the smallest treatment effect size. Other variables included in the model did not significantly predict treatment outcomes. Conclusions Understanding individual differences in response to treatment will allow service providers to make evidence-based decisions regarding how likely a child is to benefit from Enhanced Conversational Recast treatment and the expected magnitude of the response based on the child's background characteristics.