| 1. |
- Lavesson, Ann, et al.
(författare)
-
Development of a language screening instrument for Swedish 4-year-olds
- 2018
-
Ingår i: International journal of language and communication disorders. - : Wiley. - 1368-2822 .- 1460-6984. ; 53:3, s. 605-614
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe Swedish Program for health surveillance of preschool children includes screening of language and communication abilities. One important language screening is carried out at age 4 years as part of a general screening conducted by health nurses at child health centres. The instruments presently in use for this screening mainly focus on expressive phonology. This may result in both over-referral of children with phonological difficulties and under-referral of children with language disorders (LDs), involving difficulties with vocabulary, grammar and/or language comprehension. Previous research has proposed non-word repetition as a clinical marker for LD. It has also been found that higher predictive power is achieved when non-word repetition is combined with the assessment of lexical/semantic skills. Taking these findings into account, the construction of a language screening instrument may yield more adequate referrals to speech-language therapists (SLTs). AimsTo construct a new standardized language screening instrument for 4-year-olds and to test its properties. Methods & ProceduresAn instrument was developed and revised after piloting. A population of 352 children was screened at the regular 4-year check-up by 11 health nurses. The final sample consisted of 328 children aged 46-53 months (23% multilingual). Children performing below a preliminary cut-off were referred to an SLT (n = 52). Five SLTs carried out an assessment on average within 5 weeks using a gold standard language test battery. Children who screened negatively were followed up with a parent questionnaire at age 5;6. Outcomes & ResultsThirty-one true-positives and 11 false-positives were identified after SLT assessment. A further six children were identified as false-negatives (two through referral to an SLT and four through parent questionnaire at age 5;6). A receiver-operating characteristics curve with a C statistic of .94 was calculated. Based on optimal cut-off, the sensitivity of the screening instrument was found to be .84, and specificity was .96. Multilingual children performed similar to monolingual children; boys performed significantly lower than girls; and children with a family history of language-related problems performed lower than those without. Interrater reliability was high, as was Cronbach's alpha. Conclusions & ImplicationsThe screening instrument seems sufficiently valid for its purpose to identify children who need further assessment by an SLT. A follow-up study including SLT assessment for all children to check for false-negatives would be interesting in future, as would studies comparing results from the 4-year screening with those from earlier screens.
|
|
| 2. |
|
|
| 3. |
- Herlitz, Anders, 1981, et al.
(författare)
-
The Counseling, Self-care, Adherence Approach to Person-centered Care and Shared Decision Making: Moral Psychology, Executive Autonomy, and Ethics in Multi-dimensional Care Decisions
- 2016
-
Ingår i: Health Communication. - : Informa UK Limited. - 1041-0236 .- 1532-7027. ; 31:8, s. 964-973
-
Tidskriftsartikel (refereegranskat)abstract
- This article argues that standard models of person-centred care (PCC) and shared decision making (SDM) rely on simplistic, often unrealistic assumptions of patient capacities that entail that PCC/SDM might have detrimental effects in many applications. We suggest a complementary PCC/SDM approach to ensure that patients are able to execute rational decisions taken jointly with care professionals when performing self-care. Illustrated by concrete examples from a study of adolescent diabetes care, we suggest a combination of moral and psychological considerations to support the claim that standard PCC/SDM threatens to systematically undermine its own goals. This threat is due to a tension between the ethical requirements of SDM in ideal circumstances and more long-term needs actualized by the context of self-care handled by patients with limited capacities for taking responsibility and adhere to their own rational decisions. To improve this situation, we suggest a counseling, self-care, adherence approach to PCC/SDM, where more attention is given to how treatment goals are internalized by patients, how patients perceive choice situations, and what emotional feedback patients are given. This focus may involve less of a concentration on autonomous and rational clinical decision making otherwise stressed in standard PCC/SDM advocacy.
|
|
| 4. |
- Hedenius, Martina, 1970-, et al.
(författare)
-
Impaired implicit sequence learning in children with developmental dyslexia
- 2013
-
Ingår i: Research in Developmental Disabilities. - : Elsevier. - 0891-4222 .- 1873-3379. ; 34:11, s. 3924-3935
-
Tidskriftsartikel (refereegranskat)abstract
- It has been proposed that an impairment of procedural memory underlies a range of linguistic, cognitive and motor impairments observed in developmental dyslexia (DD). However, studies designed to test this hypothesis using the implicit sequence learning paradigm have yielded inconsistent results. A fundamental aspect of procedural learning is that it takes place over an extended time-period that may be divided into distinct stages based on both behavioural characteristics and neural correlates of performance. Yet, no study of implicit sequence learning in children with DD has included learning stages beyond a single practice session. The present study was designed to fill this important gap by extending the investigation to include the effects of overnight consolidation as well as those of further practice on a subsequent day. The results suggest that the most pronounced procedural learning impairment in DD may emerge only after extended practice, in learning stages beyond a single practice session.
|
|
| 5. |
|
|
| 6. |
- Wennergren, Göran, 1947
(författare)
-
I en sal på lasarettet
- 2022
-
Ingår i: Barnläkaren. - 1651-0534. ; :6
-
Recension (övrigt vetenskapligt/konstnärligt)
|
|
| 7. |
|
|
| 8. |
- Hansson, Kristina, et al.
(författare)
-
Language impairment in children with CI : An investigation of Swedish
- 2018
-
Ingår i: Lingua. - : Elsevier BV. - 0024-3841. ; 213, s. 63-77
-
Tidskriftsartikel (refereegranskat)abstract
- In spite of earlier implantation, bilateral implants and advances in the care of deaf children with cochlear implants (CI) within-group variation in language skills is large. We use three tasks with predictive value of language impairment in Swedish to identify children with CI most at risk for persistent difficulties in language development, in need of language intervention. The clinical markers investigated are nonword repetition and past tense inflection. We also assessed language comprehension, a predictor of severe language impairment associated with poorer prognosis. Fifteen Swedish-speaking deaf children with CI and 15 controls aged 5–8 years participated. Most children with CI had bilateral implants and had been fitted with CIs before 12 months. At least 70% in the group with CI performed >1.25 and 47% >2 SD below controls on more than one measure, showing risk for persistent language impairment. Speech perception was more crucial in the nonword repetition and language comprehension tasks. No time factor was significantly related to outcome. We conclude that it is important to allocate resources for continuous follow-up and language intervention. Research and care of children with CI will profit from better integration of knowledge from the fields of audiology, speech-language pathology and linguistics.
|
|
| 9. |
- Munthe, Christian, 1962, et al.
(författare)
-
Questioning the patient in person centred care: ethical aspects: children, forensic psychiatry, and public health
- 2017
-
Ingår i: Medical Argumentation and Patient Centred Care, University of Amsterdam, October 26-27, 2017..
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The paper explores the room, both conceptually and ethically, for questioning, contradicting and adapting positions to patients in three specific areas: care of patients with vulnerable cpapcities for taking responsibility (adolescents and psychiatry), contexts of constrained autonomy (forensic care), and public health (antobiotic resistance stewardship and vaccination). These areas in various ethically relevant ways exhibit non-standard settings, compared to usual assumptions about the nature of patients and institutional contexts made when person centredness and shared decision-making are held out as primarily emancipating concepts. The paper probes to what extent that ethical idea may be maintained also in such non-standard settings.
|
|
| 10. |
- Nayeb, Laleh, et al.
(författare)
-
Modifying a language screening tool for three-year-old children identified severe language disorders six months earlier
- 2019
-
Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 108:9, s. 1642-1648
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: We examined if routine Swedish language screening for developmental language disorder (DLD) carried out at three years of age could be performed as effectively six months earlier. Methods: This study observed 105 monolingual Swedish-speaking children (53% boys) aged 29-31 months at three Swedish child health centres. We compared their ability to combine three words, as per the existing protocol, and two words. They also underwent a comprehension task. Speech and language pathologists clinically assessed the children for DLD and their results were compared with the nurse-led screening. Results: The results for the three-word and two-word criterion were the following: sensitivity (100% versus 91%) specificity (81% versus 91%), positive predictive (38% versus 56%) and negative predictive value (100% versus 99%). The three-word criterion identified 29 children with possible DLD, including 11 cases later confirmed, and the two-word criterion identified 18 possible cases, including 10 confirmed cases. DLD was overrepresented in the 10% of children who did not cooperate with the nurse-led screening. Conclusion: Changing the required word combinations from three to two words worked well. The three-word test identified one extra confirmed case, but resulted in 10 more false positives. Lack of cooperation during screening constituted an increased risk for DLD.
|
|
