Fleeting: a Novel Ultrasonic Vocalization in Mice That Allows to Define Altered Developmental Milestones in Autism Spectrum Disorder

A major mode of rodent communication occurs through ultrasonic vocalizations (USVs), which are influenced by environmental factors, mouse strain or genetic background and, importantly, by developmental stage. However, few studies have looked into the age-dependent evolution of spectral features of mouse USVs. Here, we report the existence of a novel vocalization, previously unreported, which we named “Fleeting” consisting of two acoustic elements produced with a narrow silent temporal interval between them. Strikingly, this vocalization pattern was extinguished after the second postnatal week, and this temporal pattern was associated with increased emission of Complex vocalizations, by gradual loss of the inter-element interval, suggesting a maturation process occurring at this time point. Importantly, the Fleeting vocalization was analyzed in a mouse model (Tsc2+/-) of Autism Spectrum Disorder (ASD), and showed an abnormal persistence, in particular in females which presented delayed conversion of Fleeting into Complex vocalizations compared with males. The identification of this novel vocalization represents an important insight into the maturation of mouse vocal repertoire and may be used as a developmental milestone in studies on neurodevelopmental disorders with communication impairments.

Who Speaks with My Synthesized Voice? Some Roles of Other-initiated Repair in Augmented Intaraction

As conversation analysis shows, all talk is highly collaborative, and meaning is created dialogically and sequentially, via the concerted actions of all the participants involved. In the case of people with communication impairments, the collaborative character of talk is even more manifest. A speaker with dysarthria, for example, may communicate through typing their messages to a text-to-speech communication app or device, using a communication (alphabet) board, or gazing at objects. This article focuses on one type of co-construction effort aimed at helping an augmented speaker to communicate, a process that can be called other-initiated repair. Although this practice is a common way of achieving understanding with people who have communication needs, in some cases repair initiation is used to do more than that. In this paper, I conduct conversation analysis of a video-recording of naturalistic interactions inside a Russian-speaking family involving a 10-year-old girl with dysarthria who communicates with her parents through an eyetracker-controlled computer interface. In this case, her parents use the structural position of repair initiation on the girl’s words not only to clarify the meaning of her message but to continue the preceding polemics over the mom’s birthday present. I argue that although this is just one instance of the use of other-repair in playful communication between family members, The potentiality of providing the type of guessing which aligns with the guesser’s interests is present in other repair sequences. This can be consequential for lives of people with communication needs when done in more official settings. Studying similar repair sequences can help better delineate 'good' scaffolding strategies in co-construction of speech of someone with communication needs.

Convergent and Construct Validity of a Conversation Difficulties Outcome Measure in Primary Progressive Aphasia

Cognition and language changes, and their impacts on functional communication, are central to many dementias. Thus, functional communication, including conversation difficulties, is an important endpoint for clinical trials. To develop robust outcomes in primary progressive aphasia (PPA), a dementia characterized by communication impairments, we examined the convergent and construct validity of the Perception of Conversation Difficulties-Dementia Alzheimer’s Type (PCI-DAT; Orange et al., 2009). The PCI-DAT is a care partner reported measure of conversation difficulties. Eighty-two care partners with a mean age of 64.8 years (SD=10.61; 85% spouses, 5% adult children, 10% friends/siblings) whose mean relationship duration to the person with PPA was 39.1 (SD=15.1) years completed the study. Pearson’s correlation indicated a significant, modest correlation (r=-0.54, p<0.0001) between the PCI-DAT Perception of Conversation Difficulties subscale and the Communication Effectiveness Index (Lomas et al., 1989) suggesting strong convergent validity. A Rasch analysis conducted on the same PCI-DAT subscale showed high person (0.92) and item (0.95) reliability indicating a robust overall scale structure that adequately evaluates various levels of conversation difficulty severity in PPA. Six items (27%) had minor ‘fit’ issues (defined by Wright and Linacre, 1994 as having infit statistics < 0.6 or > 1.4) relative to the underlying construct. Results suggest strong convergent and construct validity of the PCI-DAT in PPA and indicate items that will benefit from further development. Overall, our results suggest that the PCI-DAT holds promise for use as a functional communication endpoint in PPA clinical trials. Data for all five PCI-DAT subscales will be presented.

Standardized Self-Report Tools in Geriatric Medicine Practice: A Quality Improvement Study

Comprehensive geriatric assessment (CGA)—a multidimensional diagnostic process to determine medical, cognitive, and functional capacity—has historically included a narrative history supplemented by use of tools to assess domains such as mood or cognition based on assessor preference. This approach to CGA likely works to assess individuals but with increasing clinical complexity and frailty among older adults, a non-standardized approach may mean that key issues are not assessed, and program quality cannot be determined. The COVID-19 pandemic added to these challenges as social distancing practices meant limited face-to-face appointments and use of phone and video assessments. This quality improvement study implemented the interRAI Check-Up Self-Report instrument through a software platform in a specialized geriatric services practice. The instrument can be used over the phone and summarizes specific health problems and needs as well as information about caregiver status and financial trade-offs. Focus groups were also conducted with specialized geriatric services interprofessional team to explore their experiences with implementation. The descriptive analysis of the self-report data revealed expected geriatric issues, such as cognitive and functional impairment, falls and pain. Clients were also commonly experiencing medical instability, cardiorespiratory symptoms, communication impairments, and elevated risk for emergency department visit. Staff found the self-report tool feasible, easy to use, efficient, and the program-level metrics helpful for program planning. In conclusion, introduction of a standardized self-report enhanced CGA by creating a systematic method to flag, track, and prioritize all areas of need for immediate and future care planning at both the client and program level.

Toward better characterization of restricted and unusual interests in youth with autism

Despite their high prevalence and clinical importance in autism, unusual and restricted interests remain under-researched and poorly understood. This study aimed to characterize the frequency and type of interests in autism by coding caregivers’ open-ended responses in a sample of 237 autistic children and adolescents ( Mage = 8.27 years, SDage = 4.07; range: 2.08–18.25 years). It further aimed to explore the effects of age, sex, cognitive functioning and social and communication deficits on the number and type of interests. We found that 75% of autistic youth had at least one interest and that 50% of those children showed two or more different interests. The most frequent interests were sensory-based (43%), with a majority of these interests relating to the visual modality. Interest within vehicles/transportation, fictional characters, television/digital versatile disk/movies, computers, and video games, constructive, mechanical objects, animals and plants, and attachment to specific objects were also prevalent. Logistic regression showed that being male, having a co-occurring intellectual disability and having more severe social and communication impairments were associated with a higher probability of having one or more restricted interests. Sex was significantly associated with the type (χ2 = 37.52, Phi = 0.37, p = 0.021) of restricted interests, with females showing a significantly higher percentage of creative interests and males significantly higher percentage of interest in characters, vehicles/transportation, computers/video games, mechanical objects and constructive interests. Theoretical and measurement implications are discussed. Lay abstract Despite being highly prevalent among people with autism, restricted and unusual interests remain under-researched and poorly understood. This article confirms that restricted interests are very frequent and varied among children and adolescents with autism. It also further extends current knowledge in this area by characterizing the relationship between the presence, number, and type of restricted interests with chronological age, sex, cognitive functioning, and social and communication symptoms.

Identification of Autism Spectrum Disorder With Functional Graph Discriminative Network

Autism spectrum disorder (ASD) is a specific brain disease that causes communication impairments and restricted interests. Functional connectivity analysis methodology is widely used in neuroscience research and shows much potential in discriminating ASD patients from healthy controls. However, due to heterogeneity of ASD patients, the performance of conventional functional connectivity classification methods is relatively poor. Graph neural network is an effective graph representation method to model structured data like functional connectivity. In this paper, we proposed a functional graph discriminative network (FGDN) for ASD classification. On the basis of pre-built graph templates, the proposed FGDN is able to effectively distinguish ASD patient from health controls. Moreover, we studied the size of training set for effective training, inter-site predictions, and discriminative brain regions. Discriminative brain regions were determined by the proposed model to investigate its applicability and biomarkers for ASD identification. For functional connectivity classification and analysis, FGDN is not only an effective tool for ASD identification but also a potential technique in neuroscience research.

Pain Assessment for Individuals with Advanced Dementia in Care Homes: A Systematic Review

Pain is prevalent in older people, especially in those with advanced dementia who have communication impairments. Although pain is recognised to be present in this population, it is often under-assessed and ineffectively managed. The assessment of pain in advanced dementia is extremely challenging and complex, particularly in institutional settings such as care homes. This study systematically reviews the literature to examine and characterise the evidence for the use of pain assessment tools in care homes with individuals living with advanced dementia. Relevant publications were sourced from electronic bibliometric medical databases including AMED, CINAHL Plus, Medline, PsycINFO, EMBASE, TRIP Pro, Google Scholar, and HINARI. The database search was supplemented by screening citations and reference lists, in addition to a grey literature searches. The search identified 2221 studies, among which 26 were included in the review. The majority of the studies were observational, which created a rich source of data to create four major themes. The findings were informed and shaped by working with key stakeholders to develop a conceptual model that can contribute to developing evidence-based practice. This highlights the importance of a comprehensive, multi-disciplinary approach to pain assessment in this population, which is beyond the use of tools.

The Triad of Cognition, Language, and Communication in Traumatic Brain Injury: A Correlational Study

Objectives Traumatic brain injury (TBI) is associated with deficits in cognition, language, and communication along with physical and psychosocial consequences. This study aimed at evaluating the association between cognition, language, and communication in a cohort of patients with TBI in southern India using standardized language specific assessment tools. Materials and Methods The present correlational study included 30 patients with TBI of any severity, that is, mild, moderate, and severe within the postinjury period of 6 to 36 months. Comprehensive evaluation of cognition, language, and communication was done using National Institute of Mental Health and Neurosciences Neuropsychology Battery, Indian adapted versions of Western Aphasia Battery and La Trobe Communication Questionnaire (LCQ) respectively. Data Analysis Measures of descriptive statistics, that is, mean, median, percentages, and frequencies, were used. Raw scores, that is, aphasia quotient (AQ), and subdomain scores for LCQ, that is, LCQ-quality, quantity, relation, manner, and cognition, were calculated. Composite scores for the three neuropsychological domains, that is, attention and processing speed, executive function, learning and memory, were evaluated. Partial correlation was computed for identifying the association between the three variables by controlling for age, education, duration, and severity of injury. Results A significant correlation was found between AQ and measures of attention and executive functioning and all measures of LCQ except LCQ-manner. Further, a significant correlation was found between executive functioning and LCQ-total, LCQ-quantity, and LCQ cognition. No correlation was found between measures of attention and memory with communication. Conclusion A good language and executive functioning are associated with better communication abilities in patients with TBI thus emphasizing on the importance of a multidisciplinary team for the management of cognitive-communication impairments following a TBI.

Stroke rehabilitation and recovery

Stroke is the UK's leading cause of disability. Stroke rehabilitation can maximise recovery and improve quality of life. This article discusses some post-stroke impairments, including hemiplegia, dysphagia, communication impairments and neglect, and how rehabilitation can address these. Developing techniques of adaptation or compensation is vital, since the extent of stroke recovery is dependent on successful neuroplasticity, with healthy neurons adapting to compensate for damaged ones.

Revisiting an RCT study of a parent education program for Latinx parents in the United States: Are treatment effects maintained over time?

This study examined maintenance of treatment effects in a culturally tailored parent education program for Latinx families of children with autism spectrum disorder using a behavior maintenance framework. In a two-site randomized waitlist-control study, we compared differences in parent and child outcomes across three timepoints using linear mixed models to determine whether outcomes observed at 4 months after baseline (Time 2) were maintained for an additional 4-month period (Time 3). Parent outcomes included family empowerment, self-reported confidence in, and frequency of using evidence-based strategies. Child outcomes included parent-reported challenging behaviors, social communication impairments, and the number of services received. Participants were 109 Latina mothers (intervention = 54, control = 55) of children with autism spectrum disorder. Results showed that at Time 3, mothers in the intervention groups reported significantly greater confidence in and frequency of using evidence-based strategies, and that their child received significantly more services. Site-specific treatment differences were found in outcomes such as parent-reported empowerment and child social communication impairments. Findings suggest that the intervention for Latinx parents of children with autism spectrum disorder was efficacious and could be maintained, and that site-specific policy and service differences may need to be examined in future research to inform dissemination and implementation. Lay abstract Background: We conducted a follow-up investigation of a two-site randomized controlled trial in the United States. We examined whether the treatment effects in a culturally tailored parent education program for Latinx families of children with autism spectrum disorder were maintained over time. Methods: Using linear mixed models, we compared differences in parent and child outcomes across three timepoints: baseline, 4 months after baseline (Time 2), and 8 months after baseline (T3). Parent outcomes included family empowerment, self-reported confidence in, and frequency of using evidence-based strategies. Child outcomes included parent-reported challenging behaviors, social communication impairments, and the number of services received. Participants were 109 Latina mothers (intervention = 54, control = 55) of children with autism spectrum disorder. Results: After intervention at both Time 2 and Time 3 in both sites, mothers in the intervention groups reported significantly greater confidence in and frequency of using evidence-based strategies, and that their child received significantly more services. We also found that there were treatment differences across the two study sites in several outcomes. Implications: The intervention for Latinx parents of children with autism spectrum disorder was efficacious and could be maintained, and that site-specific policy and service differences may need to be examined in future research to inform dissemination and implementation.