Assessment of Gaze Fixations and Shifts in Children with Cerebral Palsy: A Comparison of Computer- and Object-Based Approaches.

: Gaze behaviours, such as fixation on single objects, and switching gaze between two objects are important for signaling messages, making choices or controlling a computer for children with cerebral palsy (CP) and similar movement disabilities. Observing these behaviours can be challenging for clinicians, with a lack of agreement on how they can be objectively quantified or rated. : This study compares two methods of eliciting and observing gaze behaviours: a computer presentation using an eye tracker and an object presentation scored by two independent observers in order to explore the utility of each to clinicians working in this area.

Assessing aspects of early social communication in non-speaking children with bilateral cerebral palsy.

Purpose: Research suggests that rates for autism may be higher in cerebral palsy than in the general population. For those with severe bilateral physical impairment (GMFCS level IV and V) and little or no speech, describing a profile of social communication skills has been difficult because there are currently no assessments for early social communication specifically tailored for these children. Our aim was to explore the assessment of aspects of joint attention and social reciprocity in this group of children with CP.

What relationships exist between nouns and verbs and the use of prepositions, adverbs, and adjectives in children and adolescents who use speech generating devices?

The relationships between the use of nouns and verbs, and other word classes have been well established in the typical language development literature. However, questions remain as to whether the same relationships are seen in the language use of individuals who use graphic symbol-based augmentative and alternative communication (AAC). The aim of the study was to examine relationships between the use of verbs and nouns, and the use of prepositions, adverbs, and adjectives through a secondary analysis of language transcripts taken from 12 children and adolescents who used aided AAC in conversation with an adult.

The Functional Vision for Communication Questionnaire (FVC-Q): Exploring Parental Report of Non-Speaking Children's Fixation Skills Using a Structured History-Taking Approach.

This paper explores whether a structured history-taking tool yields useful descriptions of children's looking skills. Parents of 32 children referred to a specialist communication clinic reported their child's looking skills using the Functional Vision for Communication Questionnaire (FVC-Q), providing descriptions of single object fixation, fixation shifts between objects and fixation shifts from object to person. Descriptions were compared with clinical assessment.

The ability of typically developing 2-3 year olds to infer the control mechanism for eye-gaze technology and the impact of causal language instruction.

Purpose: Little is known about how children learn to control eye-gaze technology, and clinicians lack information to guide decision-making. This paper examines whether typically developing 2-3 year olds can infer for themselves the causal mechanisms by which eye-gaze technology is controlled, whether a teaching intervention based on causal language improves performance and how their performance compares to the same task accessed via a touchscreen. Typically developing children's (n = 9, Mean Age 28.

Relationship between lexicon and grammar in children and youth who use augmentative and alternative communication.

The present study investigated the relationship between lexicon and grammar in individuals who use graphic symbol-based aided augmentative and alternative communication (AAC). Data came from 60 transcripts of generalization sessions that were part of two previous intervention studies, aimed at improving the expressive vocabulary and grammar of 12 children and youth who used graphic symbol-based AAC. The specific aims of the current study were to (a) describe vocabulary composition across different levels of expressive vocabulary and (b) analyze the relationship between global measures of expressive vocabulary and the use of grammar in individuals who use aided AAC.

Interventions for pre-school children with co-occurring phonological speech sound disorder and expressive language difficulties: A scoping review.

Background: Recent evidence suggests that pre-school children with co-occurring phonological speech sound disorder (SSD) and expressive language difficulties are at a higher risk of ongoing communication and literacy needs in comparison with children with these difficulties in isolation. However, to date there has been no systematic or scoping review of the literature specific to interventions for children with this dual profile.

Aims: To explore the evidence regarding interventions for pre-school children with co-occurring phonological SSD and expressive language difficulties, including the content/delivery of such interventions, areas of speech and language targeted, and a broad overview of study quality.

Prompting for repair as a language teaching strategy for augmentative and alternative communication.

Conversational repair has been found to play a fundamental role in the acquisition of language. This paper describes existing research on conversational repair and its relationship to language learning, whether a first language or a second language, as well as its relevance to augmentative and alternative communication (AAC). A case is made for incorporating prompts to repair in conversation-based language interventions with children learning to use AAC.

Stakeholder consensus for decision making in eye-gaze control technology for children, adolescents and adults with cerebral palsy service provision: findings from a Delphi study.

Background: Limited research exists to guide clinical decisions about trialling, selecting, implementing and evaluating eye-gaze control technology. This paper reports on the outcomes of a Delphi study that was conducted to build international stakeholder consensus to inform decision making about trialling and implementing eye-gaze control technology with people with cerebral palsy.

Methods: A three-round online Delphi survey was conducted.

Development and testing of the eye-pointing classification scale for children with cerebral palsy.

Purpose: The aim of this study was to develop and test a new classification scale to describe looking behaviours (gaze fixations and gaze shifts) in relation to eye-pointing.

Methods: The Eye-pointing Classification Scale (EpCS) was developed and tested following established procedures for the construction and evaluation of equivalent scales, and involved 2 phases: Drawing on research literature, Phase 1 involved initial drafting of the scale through a series of multi-disciplinary group discussions; evaluation of the scale through a survey procedure, and subsequent expert group evaluation. Phase 2, was an examination of scale reliability and relationships between child characteristics and level of EpCS classification.

Recast type, repair, and acquisition in AAC mediated interaction.

The present study investigated the effects of different types of recasts and prompts on the rate of repair and spontaneous use of novel vocabulary by eight children with severe motor speech disabilities who used speech-generating technologies to communicate. Data came from 60 transcripts of clinical sessions that were part of a conversation-based intervention designed to teach them pronouns, verbs, and verb inflections. The results showed that, when presented alone, interrogative choice and declarative recasts led to the highest rates of child repair.

Conversation-based intervention for adolescents using augmentative and alternative communication.

This study evaluated the effects of a conversation-based intervention on the use of verbs, personal pronouns, bound morphemes and spontaneous clauses in adolescents with cerebral palsy who use augmentative and alternative communication (AAC). Four teenage girls aged from 14 to 18 years participated in the study. After a baseline period, a conversation-based intervention was provided for each participant in the context of a personal collage-building activity.

Language learning, recasts, and interaction involving AAC: background and potential for intervention.

For children with typical development, language is learned through everyday discursive interaction. Adults mediate child participation in such interactions through the deployment of a range of co-constructive strategies, including repeating, questioning, prompting, expanding, and reformulating the child's utterances. Adult reformulations of child utterances, also known as recasts, have also been shown to relate to the acquisition of linguistic structures in children with language and learning disabilities and children and adults learning a foreign language.

Assessing true and false belief in young children with cerebral palsy through anticipatory gaze behaviours: a pilot study.

Children with a clinical description of cerebral palsy (CP) commonly experience cognitive and sensory difficulties that co-occur with motor impairment, and for some children this can include impairments in social communication. While research has begun to examine theory of mind abilities in children with CP, relatively little is known about social communication difficulties in this population. Assessing theory of mind abilities in children with CP using traditional procedures such as the classic Sally-Anne task can be problematic if performance is affected by physical difficulties in signalling responses and/or by cognitive and language demands inherent to the task itself.

Journal reading patterns and preferences of pediatricians.

Purpose: To describe the journal reading patterns of pediatrician members of the American Academy of Pediatrics (AAP) and compare results to similar surveys of medical faculty and physicians. The research also explored factors that might influence changes in reading patterns in the future, such as adoption of PDA technology.

Methodology: A random sample of 2,000 AAP members was drawn from the AAP membership list, with paper surveys distributed in mid-2004.

The role of cement viscosity on cement-bone apposition and strength: an in vitro model with medullary bleeding.

We compared the mechanical and morphological characteristics of cement-bone structures created with either standard- or low-viscosity cement using a human cadaver model that simulated intramedullary bleeding. The goal is to determine if the viscosity of the cement would affect the strength of the cement-bone interface and the degree of apposition between the cement and bone. The tensile strength of cement-bone constructs with standard-viscosity cement (2.

Stem-cement porosity may explain early loosening of cemented femoral hip components: experimental-computational in vitro study.

A combination of laboratory experiment and computational simulation was performed to assess the role of interface porosity on stem migration. The early motion of in vitro prepared cemented femoral components was measured during application of cyclic stair climbing loads. Following testing, transverse sections were obtained and the distribution of pores at the stem-cement interface was determined.

The effect of low-viscosity cement on mantle morphology and femoral stem micromotion: a cadaver model with simulated blood flow.

Background: Limited data exist on the performance of low-viscosity cement in clinically realistic cadaver models.

Methods: Paired stem/cement/femur constructs were generated with low-viscosity and standard-viscosity cements. The constructs were created and tested under simulated in vivo conditions, for which novel techniques were developed during this study.

Cement-implant interface gaps explain the poor results of CMW3 for femoral stem fixation: A cadaver study of migration, fatigue and mantle morphology.

Background: The Norwegian Arthroplasty Register reported that CMW3 cement performed poorly for femoral stem fixation.

Methods: We implanted collared, satin-finished stems (Ra = 0.35 microm) into cadaver femora using CMW3 and with Simplex as control.

Long-term clinical, radiological and histopathological follow-up of a well-fixed Mckee-Farrar metal-on-metal total hip arthroplasty.

Metal-on-metal is one potential bearing option for total hip arthroplasty (THA). Proponents of the bearing have suggested that if the tribology is optimal, volumetric wear may occur at levels at least one order of magnitude lower than metal-on-polyethylene bearings. We present a unique postmortem case of a well fixed, metal-on-metal, McKee-Farrar total hip arthroplasty implanted 30 years previously that was clinically asymptomatic in life.

Polymerase chain reaction can detect bacterial DNA in aseptically loose total hip arthroplasties.

Identifying low-grade infection in failed total hip arthroplasties is an important but difficult task. This study investigated the ability of the polymerase chain reaction to identify low-grade infection during revision of total hip arthroplasties that failed from aseptic causes. One hundred thirteen specimens from 31 total hip arthroplasties revised for aseptic loosening were compared with 105 control specimens from 28 primary total hip arthroplasties.

Contamination of primary total hip replacements in standard and ultra-clean operating theaters detected by the polymerase chain reaction.

Background: Many organisms that are responsible for low-grade infection after total hip replacement (THR) are not recognized by routine culture.

Patients And Methods: We examined wound contamination during primary total hip replacement performed in standard and ultra-clean operating theaters. 20 THRs were performed in each type of theater.