Grunt Vocalizations in Children With Disabilities: Relationships With Assessed Cognition and Language

Purpose The purpose of this study was to investigate the relationship of the grunt vocalizations to cognitive and expressive language status in children with disabilities. Children with typical development produce communicative grunts at the onset of referential word production and comprehension at 14–16 months of age and continue to use this vocalization for communication as they develop language. Method All grunt vocalizations produced by 26 children with disabilities (mental age: 3–56 months; communicative age: 47–69 months) were identified from video-recorded seminaturalistic play sessions. Grunts were identified as accompanying effort or attention or as communicative bids. Participants were grouped as prelinguistic, emergent, language delay, and language competent based on standardized assessments of cognitive and language level. The Mann–Whitney U test (1947) compared groups to determine the relationships between grunt production and cognitive and language status. Results As hypothesized, participants in the language delay group produced significantly more communicative grunts than those in the language competent group ( W = 39, p = .028 < .05). The children with a cognitive and language level lower than 9 months (prelinguistic group) failed to produce communicative grunts. Conclusions The results document grunt production in children with disabilities in the same contexts as typical children and support the hypothesized relationship between assessed cognition and language and communicative grunt production. These results require replication. This vocalization, if recognized in treatment, may unlock verbal communication in many nonverbal children with disabilities. Future longitudinal research should include controlled intervention to determine the potential effectiveness of building broader communicative skills on this simple vocalization.

Newborn Infant Parasympathetic Evaluation Index for the Assessment of Procedural Pain in Nonanesthetized Infants: A Multicenter Pilot Study

Objective The aim of this study is to evaluate the ability of the Newborn Infant Parasympathetic Evaluation (NIPE) index to detect the response to nociceptive stimuli in nonanesthetized infants and to compare these results to simultaneous scoring by behavioral scales. Study Design Thirty-six nonanesthetized infants admitted to neonatal/pediatric intensive care unit (N/PICUs) were enrolled to the study. Due to faulty records of the data, three patients had to be excluded. To detect pain caused by noxious stimuli, the heart-rate-variability-derived NIPE index and behavioral pain scales designed for measuring procedural pain in nonverbal children were used. Results Forty-one painful events were available for analysis. We observed in the whole group a statistically significant decrease in NIPE values at 1, 2, and 3 minutes after a painful stimulus, in comparison to the NIPE value at rest and the statistically significant differences between the minimum NIPE value within 3 minutes after the stimulus in comparison to NIPE value at rest in the whole group, as well as in the subgroups of moderate and severe pain. Receiver operating characteristic (ROC) analysis has shown the strong sensitivity and specificity of the NIPE in detecting the noxious stimuli (ROC AUC: 0.767). We also found that the stronger the sensation of pain was, the more rapidly NIPE reached its lowest value. Discussion Our study indicates that the painful procedures are associated with a significant decrease in the NIPE value within 3 minutes after a noxious stimulus. Based on our observation, the minimum value within 3 minutes from the painful procedure seems to be the most distinctive value.

Music Therapists’ Perceptions of the Therapeutic Potentials Using Music When Working With Verbal Children on the Autism Spectrum: A Qualitative Analysis

While there are numerous descriptions of the use of music and its therapeutic potential by music therapists working with nonverbal children on the autism spectrum, only limited literature focuses on exploring how music therapists use music and perceive its therapeutic potential when working with children on the spectrum who have verbal skills. This qualitative study aimed to explore music therapists’ descriptions of the use of music and its therapeutic potential in their work with children on the autism spectrum who have verbal skills. Semi-structured interviews were conducted with six qualified music therapists from Israel and then analyzed according to the principles of interpretative phenomenological analysis (IPA). Three main themes were identified: (a) musical infrastructure, which describes how the music therapists facilitated musical experiences to support the children’s ability to regulate their arousal, attention and emotions; (b) the meeting point between musical and verbal playfulness, which reflects the music therapists’ beliefs about how musical experiences add vitality and support the development of both verbal and nonverbal imaginative play; and (c) musical responses, which describes the different ways music therapists use their voice and songs to interact musically with verbal children. The experiences described by the participants emphasize the importance of the therapist musically attuning to the child’s emotional, physiological, creative, and playful qualities, even when the child has verbal skills. These musical interactions help to create a shared experience between the child and therapist that are perceived to help the child’s different forms of regulation, continuity, and vitality within the play.

Framework for Selecting Vocabulary for Preliterate Children Who Use Augmentative and Alternative Communication

Purpose Nearly 50% of school-based speech-language pathologists (SLPs) provide services to school-age children who use augmentative and alternative communication (AAC). However, many SLPs report having insufficient knowledge in the area of AAC implementation. The objective of this tutorial is to provide clinicians with a framework for supporting 1 area of AAC implementation: vocabulary selection for preliterate children who use AAC. Method This tutorial focuses on 4 variables that clinicians should consider when selecting vocabulary: (a) contexts/environments where the vocabulary can be used, (b) time span during which the vocabulary will be relevant, (c) whether the vocabulary can elicit and maintain interactions with other people, and (d) whether the vocabulary will facilitate developmentally appropriate grammatical structures. This tutorial focuses on the role that these variables play in language development in verbal children with typical development, verbal children with language impairment, and nonverbal children who use AAC. Results Use of the 4 variables highlighted above may help practicing SLPs select vocabulary that will best facilitate language acquisition in preliterate children who use AAC.