Browsing by Person "O'Hare, Anne"

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A clinical assessment tool for advanced theory of mind performance in 5 to 12 year olds.
(Springer Verlag, 2009) O'Hare, Anne; Bremner, Lynne; Nash, Marysia; Happ, Francesca; Pettigrew, Luisa M.
One hundred forty typically developing 5- to 12-year-old children were assessed with a test of advanced theory of mind employing Happ's strange stories. There was no significant difference in performance between boys and girls. The stories discriminated performance across the different ages with the lowest performance being in the younger children who nevertheless managed to achieve a third of their potential total. However, some of the individual mentalising concepts such as persuasion were too difficult for these younger children. This normative data provides a useful clinical tool to measure mentalising ability in more able children with autism spectrum disorder.
A national study to investigate the clinical use of standardised instruments in autism spectrum disorder assessment of children and adults in Scotland
(Elsevier, 2016-07-07) Rutherford, Marion; McKenzie, Karen; McClure, Iain; Forsyth, Kirsty; O'Hare, Anne; McCartney, Deborah; Finlayson, Ian R.; Scottish Government
Background: There are few large scale studies about the nature and extent of the actual use of standardised assessments for Autism Spectrum Disorder diagnosis in clinical practice. This study compares and contrasts practice in diagnostic services for both adults and children. Method: We conducted an analysis of retrospective case notes from 150 cases (70 adult, 80 children) assessed for Autism Spectrum Disorder by 16 diagnostic services. Results: We found differences between adult and child services in staff training and use of standardised assessment during diagnosis. All child services had staff trained in and regularly using standardised assessments. Most adult services had staff trained in using instruments but only half used them regularly. Administration of standardised ASD assessments was ten times more likely in children than in adults (OR = 10.1; CI = 4.24, 24.0). Child services selected the ADOS as the standardised tool and Adult services selected the DISCO, with very little overlap. Decisions to administer standardised tools were not based on case complexity but rather the same process was applied to all referrals within a service. The three recommended components of assessment (clinical history, clinical observation and contextual information) were included for the majority of cases, although clinical observation was more frequently used with children than with adults. Conclusions: Based on the findings, we suggest a need for a wider range of appropriate assessments for use with adults, particularly those with an intellectual disability and for further research into the reasons behind the choices clinicians make during the assessment process. For child services in Scotland, there is a need for more training in use of current diagnostic interviews. Clinicians did not vary tools used based on complexity, suggesting that this is a notion still to be clearly defined and operationalised in clinical decision making about the use of standardised assessments.
Articulation disorders in children with high functioning autism.
(2004) Gibbon, Fiona; McCann, Joanne; Peppe, Sue JE; O'Hare, Anne; Rutherford, Marion
Assessing prosodic and pragmatic ability in children with high-functioning autism
(2006) Peppé, Sue JE; McCann, Joanne; Gibbon, Fiona; O'Hare, Anne; Rutherford, Marion
Children with high-functioning autism are widely reported to show deficits in both prosodic and pragmatic ability. New procedures for assessing both of these are now available and have been used in a study of 31 children with high-functioning autism and 72 controls. Some of the findings from a review of the literature on prosodic skills in individuals with autism are presented, and it is shown how these skills are addressed in a new prosodic assessment procedure, PEPS-C. A case study of a child with high-functioning autism shows how his prosodic skills can be evaluated on the prosody assessment procedure, and how his skills compare with those of controls. He is also assessed for pragmatic ability. Results of both assessments are considered together to show how, in the case of this child, specific prosodic skill-levels can affect pragmatic ability.
Assessing prosodic and pragmatic ability in children with high-functioning autism.
(2006) Peppé, Sue JE; McCann, Joanne; Gibbon, Fiona; O'Hare, Anne; Rutherford, Marion
Children with high-functioning autism are widely reported to show deficits in both prosodic and pragmatic ability. New procedures for assessing both of these are now available and have been used in a study of 31 children with high-functioning autism and 72 controls. Some of the findings from a review of the literature on prosodic skills in individuals with autism are presented, and it is shown how these skills are addressed in a new prosodic assessment procedure, PEPS-C. A case study of a child with high-functioning autism shows how his prosodic skills can be evaluated on the prosody assessment procedure, and how his skills compare with those of controls. He is also assessed for pragmatic ability. Results of both assessments are considered together to show how, in the case of this child, specific prosodic skill-levels can affect pragmatic ability.
CMIP and ATP2C2 Modulate Phonological Short-Term Memory in Language Impairment
(2009-08-14) Newbury, D. F.; Winchester, Laura; Addis, L.; Paracchini, Silvia; Buckingham, Lyn-Louise; Clark, Ann; Cohen, W.; Cowie, H.; Dworzynski, Katharina; Everitt, Andrea; Goodyer, I. M.; Hennessy, E.; Kindley, A. D.; Miller, Laura L.; Nasir, J.; O'Hare, Anne; Shaw, D.; Simkin, Z.; Simonoff, E.; Slonims, V.; Watson, Jocelynne; Ragoussis, Jiannis; Fisher, S. E.; Seckl, J.; Helms, P. J.; Bolton, P. F.; Pickles, A.; Conti-Ramsden, G.; Baird, G.; Bishop, DVM; Monaco, A. P.
Specific language impairment (SLI) is a common developmental disorder characterized by difficulties in language acquisition despite otherwise normal development and in the absence of any obvious explanatory factors. We performed a high-density screen of SLI1, a region of chromosome 16q that shows highly significant and consistent linkage to nonword repetition, a measure of phonological short-term memory that is commonly impaired in SLI. Using two independent language-impaired samples, one family-based (211 families) and another selected from a population cohort on the basis of extreme language measures (490 cases), we detected association to two genes in the SLI1 region: that encoding c-maf-inducing protein (CMIP, minP = 5.5 10-7 at rs6564903) and that encoding calcium-transporting ATPase, type2C, member2 (ATP2C2, minP = 2.0 10-5 at rs11860694). Regression modeling indicated that each of these loci exerts an independent effect upon nonword repetition ability. Despite the consistent findings in language-impaired samples, investigation in a large unselected cohort (n = 3612) did not detect association. We therefore propose that variants in CMIP and ATP2C2 act to modulate phonological short-term memory primarily in the context of language impairment. As such, this investigation supports the hypothesis that some causes of language impairment are distinct from factors that influence normal language variation. This work therefore implicates CMIP and ATP2C2 in the etiology of SLI and provides molecular evidence for the importance of phonological short-term memory in language acquisition.
Community‐based participation of children with and without disabilities
(Wiley, 2019-11-25) Arakelyan, Stella; Maciver, Donald; Rush, Robert; O'Hare, Anne; Forsyth, Kirsty
AIM To describe and compare the socio-demographic characteristics and community-based participation of children with and without disabilities.
Development, psychometrics and feasibility of the School Participation Questionnaire: A teacher measure of participation related constructs
(Elsevier, 2020-09-19) Maciver, Donald; Tyagi, Vaibhav; Kramer, Jessica; Richmond, Janet; Todorova, Liliya; Romero-Ayuso, Dulce; Nakamura-Thomas, Hiromi; van Hartingsveldt, Margo; Johnston, Lorna; O'Hare, Anne; Forsyth, Kirsty
Background We report development of the SPQ (School Participation Questionnaire) a teacher-completed measure of participation related constructs for schools. The SPQ was developed to support participation-related assessment, interventions, and research in the inclusive school context.
Effects of computer-based intervention through acoustically modified speech (Fast ForWord) in severe mixed receptive-expressive language impairment: outcomes from a randomized controlled trial.
(2005) Cohen, W.; Hodson, Ann; O'Hare, Anne; Boyle, James; Durrani, Tariq; McCartney, Elspeth; Mattey, Mike; Naftalin, Lionel; Watson, Jocelynne
Seventy-seven children between the ages of 6 and 10 years, with severe mixed receptive-expressive specific language impairment (SLI), participated in a randomized controlled trial (RCT) of Fast ForWord (FFW; Scientific Learning Corporation, 1997, 2001). FFW is a computer-based intervention for treating SLI using acoustically enhanced speech stimuli. These stimuli are modified to exaggerate their time and intensity properties as part of an adaptive training process. All children who participated in the RCT maintained their regular speech and language therapy and school regime throughout the trial. Standardized measures of receptive and expressive language were used to assess performance at baseline and to measure outcome from treatment at 9 weeks and 6 months. Children were allocated to 1 of 3 groups. Group A (n = 23) received the FFW intervention as a home-based therapy for 6 weeks. Group B (n = 27) received commercially available computer-based activities designed to promote language as a control for computer games exposure. Group C (n = 27) received no additional study intervention. Each group made significant gains in language scores, but there was no additional effect for either computer intervention. Thus, the findings from this RCT do not support the efficacy of FFW as an intervention for children with severe mixed receptive-expressive SLI.
Expressive prosody in children with autism spectrum conditions
(2011-01) Peppé, Sue JE; Cleland, Joanne; Gibbon, Fiona; O'Hare, Anne; Martinez-Castilla, P.
The expressive prosodic abilities of two groups of school-age children with autism spectrum conditions (ASC), Asperger's syndrome (AS) and high-functioning autism (HFA), were compared with those of typically-developing controls. The HFA group showed impairment relative to age-matched controls on all the prosody tasks assessed (affect, sentence-type, contrastive stress, phrasing and imitation) while the AS showed impairment only on phrasing and imitation. Compared with lexically-matched controls, impairment on several tasks (affect, contrastive stress and imitation) was found in the HFA group but little in the AS group (phrasing and imitation). Comparisons between the ASC groups showed significant differences on prosody skills. Impairment in prosodic skills may therefore be a reliable indicator of autism spectrum subgroups, at least as far as communicative functioning is concerned. There were also significant differences between ASC groups and lexically-matched typically-developing children on expressive language skills, but the incomplete correlation of the prosody results with scores on language tasks suggests that the prosodic differences between the two groups may not all be attributable to the level of language skills. Suggested further research is to investigate the relationship of prosody and language skills in this population more closely, and to develop a prosody test as part of the diagnostic criteria of ASC.
Factors influencing waiting times for diagnosis of Autism Spectrum Disorder in children and adults
(Elsevier, 2015-08-26) McKenzie, Karen; Forsyth, Kirsty; O'Hare, Anne; McClure, Iain; Rutherford, Marion; Murray, Aja; Irvine, Linda
Aims: To identify the main factors predicting delays in diagnosis for Autism Spectrum Disorder (ASD) at three stages in the diagnostic process: wait for first appointment; assessment duration, and total wait for diagnosis. Method: Data were gathered from 150 case notes (80 child and 70 adult cases) from 16 diagnosing services across Scotland. Results: Having more information pre-assessment was associated with a reduced duration of the diagnostic process for children. This relationship was partially mediated by a reduction in the number of contacts required for diagnosis. In adults, having more factors associated with ASD (increased risk) reduced the wait time from referral to first appointment, but increased the overall duration of the diagnostic process. The latter relationship was partially mediated by an increase in the number of contacts required for diagnosis. Conclusion: Within children's services, increasing the amount of relevant information available pre-assessment is likely to reduce total duration of the assessment process by reducing number of contacts required. Having a high risk of ASD as an adult appears to result in being seen more quickly following referral, but also to increase the number of contacts needed and assessment duration. As a result, it increases and total duration overall. 2015 Elsevier Ltd.
Family factors associated with participation of children with disabilities: A systematic review
(Wiley, 2019-01-06) Arakelyan, Stella; Maciver, Donald; Rush, Robert; O'Hare, Anne; Forsyth, Kirsty
AIM: The aim of this review was to synthesise empirical evidence of family factors associated with participation of children with disabilities aged 5-12 years to inform the development of family-centred participation-fostering interventions. METHOD: A systematic search was performed for articles published in English between 2001 and 2017 in MEDLINE, PsycINFO, CINAHL, Scopus and ASSIA following the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines (registration no: CRD42017078202). Quality of evidence was appraised using the Research Triangle Institute Item Bank. Family factors associated with participation were identified and assessed using a multistage “semi-quantitative” approach. RESULTS: Thirty studies were included in the review. Four non-modifiable “status” factors consistently associated with participation were parental ethnicity, parental education, family type and family socio-economic status. Six modifiable “process” factors with consistent associations with participation were parental mental and physical health functioning, parental self-efficacy beliefs, parental support, parental time, family preferences and activity orientation. INTERPRETATION: Rehabilitation professionals should direct their focus towards modifiable family factors as primary targets for family-centred interventions. Strategies that can improve families’ access to information, counselling, and community support services are likely to support children’s participation by empowering families and optimizing their health and well-being.
Genetic and phenotypic effects of phonological short-term memory and grammatical morphology in specific language impairment
(2008-06) Falcaro, M.; Pickles, A.; Newbury, D. F.; Addis, L.; Banfield, E.; Fisher, S. E.; Monaco, A. P.; Simkin, Z.; Conti-Ramsden, G.; Newbury, D. F.; Banfield, E.; Addis, L.; Cleak, J. D.; Cardon, L. R.; Merriden, M. J.; Goodyer, I. M.; Simonoff, E.; Bolton, P. F.; Slonims, V.; Baird, G.; Everitt, Andrea; Hennessy, E.; Shaw, D.; Helms, P. J.; Kindley, A. D.; Clark, Ann; Watson, Jocelynne; O'Hare, Anne; Seckl, J.; Cowie, H.; Cohen, W.; Nasir, J.; Bishop, DVM
Deficits in phonological short-term memory and aspects of verb grammar morphology have been proposed as phenotypic markers of specific language impairment (SLI) with the suggestion that these traits are likely to be under different genetic influences. This investigation in 300 first-degree relatives of 93 probands with SLI examined familial aggregation and genetic linkage of two measures thought to index these two traits, non-word repetition and tense marking. In particular, the involvement of chromosomes 16q and 19q was examined as previous studies found these two regions to be related to SLI. Results showed a strong association between relatives' and probands' scores on non-word repetition. In contrast, no association was found for tense marking when examined as a continuous measure. However, significant familial aggregation was found when tense marking was treated as a binary measure with a cut-off point of -1.5 SD, suggestive of the possibility that qualitative distinctions in the trait may be familial while quantitative variability may be more a consequence of non-familial factors. Linkage analyses supported previous findings of the SLI Consortium of linkage to chromosome 16q for phonological short-term memory and to chromosome 19q for expressive language. In addition, we report new findings that relate to the past tense phenotype. For the continuous measure, linkage was found on both chromosomes, but evidence was stronger on chromosome 19. For the binary measure, linkage was observed on chromosome 19 but not on chromosome 16. 2007 The Authors.
Implementation of a practice development model to reduce the wait for Autism Spectrum diagnosis in adults
(SpringerNature, 2018-03-03) Rutherford, Marion; Forsyth, Kirsty; McKenzie, K.; McClure, Iain; Murray, A.; McCartney, Deborah; Irvine, Lindesay; O'Hare, Anne
This study examined waiting times for diagnostic assessment of Autism Spectrum Disorder in 11 adult services, prior to and following the implementation of a 12 month change program. Methods to support change are reported and a multi-level modelling approach determined the effect of the change program on overall wait times. Results were statistically significant (b = − 0.25, t(136) = − 2.88, p = 0.005). The average time individuals waited for diagnosis across all services reduced from 149.4 days prior to the change program and 119.5 days after it, with an average reduction of 29.9 days overall. This innovative intervention provides a promising framework for service improvement to reduce the wait for diagnostic assessment of ASD in adults across the range of spectrum presentations.
Improving Efficiency and Quality of the Children's ASD Diagnostic Pathway: Lessons Learned from Practice
(SpringerNature, 2017-11-30) Rutherford, Marion; Burns, Morag; Gray, Duncan; Bremner, Lynne; Clegg, Sarah; Russell, Lucy; Smith, Charlie; O'Hare, Anne
The 'autism diagnosis crisis' and long waiting times for assessment are as yet unresolved, leading to undue stress and limiting access to effective support. There is therefore a significant need for evidence to support practitioners in the development of efficient services, delivering acceptable waiting times and effectively meeting guideline standards. This study reports statistically significant reductions in waiting times for autism diagnostic assessment following a children's health service improvement programme. The average wait between referral and first appointment reduced from 14.2 to 10.4 weeks (t(21) = 4.3, p < 0.05) and between referral and diagnosis shared, reduced from 270 to 122.5 days, (t(20) = 5.5, p < 0.05). The proportion of girls identified increased from 5.6 to 2.7:1. Methods reported include: local improvement action planning; evidence based pathways; systematic clinical data gathering and a training plan. This is a highly significant finding for many health services wrestling with the challenges of demand and capacity for autism diagnosis and assessment.
Increased prevalence of sex chromosome aneuploidies in specific language impairment and dyslexia.
(Wiley, 2014-04) Simpson, Nuala H.; Addis, Laura; Brandler, William M.; Slonims, Vicky; Clark, Ann; Watson, Jocelynne; Scerri, Thomas S.; Hennessy, Elizabeth R.; Bolton, Patrick F.; Conti-Ramsden, Gina; Fairfax, Benjamin P.; Knight, Julian C.; Stein, John; Talcott, Joel B.; O'Hare, Anne; Baird, Gillian; Paracchini, Silvia; Fisher, Simon E.; Newbury, Dianne F.; Consortium, Sli
AIM Sex chromosome aneuploidies increase the risk of spoken or written language disorders but individuals with specific language impairment (SLI) or dyslexia do not routinely undergo cytogenetic analysis. We assess the frequency of sex chromosome aneuploidies in individuals with language impairment or dyslexia. METHOD Genome-wide single nucleotide polymorphism genotyping was performed in three sample sets: a clinical cohort of individuals with speech and language deficits (87 probands: 61 males, 26 females; age range 4 to 23 years), a replication cohort of individuals with SLI, from both clinical and epidemiological samples (209 probands: 139 males, 70 females; age range 4 to 17 years), and a set of individuals with dyslexia (314 probands: 224 males, 90 females; age range 7 to 18 years). RESULTS In the clinical language-impaired cohort, three abnormal karyotypic results were identified in probands (proband yield 3.4%). In the SLI replication cohort, six abnormalities were identified providing a consistent proband yield (2.9%). In the sample of individuals with dyslexia, two sex chromosome aneuploidies were found giving a lower proband yield of 0.6%. In total, two XYY, four XXY (Klinefelter syndrome), three XXX, one XO (Turner syndrome), and one unresolved karyotype were identified. INTERPRETATION The frequency of sex chromosome aneuploidies within each of the three cohorts was increased over the expected population frequency (approximately 0.25%) suggesting that genetic testing may prove worthwhile for individuals with language and literacy problems and normal non-verbal IQ. Early detection of these aneuploidies can provide information and direct the appropriate management for individuals.
Management of developmental speech and language disorders: Part 1
(BMJ Publishing Group, 2015-07-24) O'Hare, Anne; Bremner, Lynne
The identification of developmental problems in a child's acquisition of speech, language and/or communication is a core activity in child surveillance. These are common difficulties with up to 15% of toddlers being 'late talkers' and 7% of children entering school with persisting impairments of their language development. These delays can confer disadvantages in the long term, adversely affecting language, cognition, academic attainment, behaviour and mental health. All children presenting with significant speech and language delay should be investigated with a comprehensive hearing assessment and be considered for speech and language therapy assessment. Socioeconomic adversity correlates with delayed language development. Clinical assessment should confirm that the presentation is definitely not acquired (see part 2) and will also guide whether the difficulty is primary, in which there are often familial patterns, or secondary, from a very wide range of aetiologies. Symptoms may be salient, such as the regression of communication in <3-year-olds which 'flags up' autism spectrum disorder. Further investigation will be informed from this clinical assessment, for example, genetic investigation for sex aneuploidies in enduring primary difficulties. Management of the speech and language difficulty itself is the realm of the speech and language therapist, who has an ever-increasing evidence-based choice of interventions. This should take place within a multidisciplinary team, particularly for children with more severe conditions who may benefit from individualised parental and educational supports. 2015 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health.
Parent focused interventions for older children or adults with ASD and parent wellbeing outcomes: A systematic review with meta-analysis
(Elsevier, 2019-09-11) Rutherford, Marion; Singh Roy, Anusua; Rush, Robert; McCartney, Deborah; O'Hare, Anne; Forsyth, Kirsty
Background: There is a need for better evidence in relation to parent-focussed interventions for older children (over 7 years) and adults, which are recommended in clinical guidelines.
Phonetic and phonological errors in children with high functioning autism and Asperger syndrome
(2010) Cleland, Joanne; Gibbon, Fiona; Peppe, Sue JE; O'Hare, Anne; Rutherford, Marion
This study involved a qualitative analysis of speech errors in children with autism spectrum disorders (ASDs). Participants were 69 children aged 5-13 years; 30 had high functioning autism and 39 had Asperger syndrome. On a standardized test of articulation, the minority (12%) of participants presented with standard scores below the normal range, indicating a speech delay/disorder. Although all the other children had standard scores within the normal range, a sizeable proportion (33% of those with normal standard scores) presented with a small number of errors. Overall 41% of the group produced at least some speech errors. The speech of children with ASD was characterized by mainly developmental phonological processes (gliding, cluster reduction and final consonant deletion most frequently), but non-developmental error types (such as phoneme specific nasal emission and initial consonant deletion) were found both in children identified as performing below the normal range in the standardized speech test and in those who performed within the normal range. Non-developmental distortions occurred relatively frequently in the children with ASD and previous studies of adolescents and adults with ASDs shows similar errors, suggesting that they do not resolve over time. Whether or not speech disorders are related specifically to ASD, their presence adds an additional communication and social barrier and should be diagnosed and treated as early as possible in individual children. 2009 The Speech Pathology Association of Australia Limited.
Prosodic ability in children with autism
(Royal Society of Speech Language Therapists, 2005) McCann, Joanne; Peppe, Sue JE; Gibbon, Fiona; O'Hare, Anne; Rutherford, Marion
Background - Quality of life (QOL) is suboptimal in end-stage renal disease. However, studies indicate that QOL is already impaired prior to the initiation of renal replacement therapy, implying that the initial decline originates in the chronic kidney disease (CKD) phase of the renal disease trajectory. Given the significance of QOL as a clinical outcome, there is a paucity of QOL research in CKD. Aims - To measure QOL at three distinct phases (based on creatinine clearance - Ccr) of the disease trajectory in CKD: normal renal function (NRF) with underlying renal disease, moderate CKD, and advanced CKD (Ccr >=75, 40-60, and <=30 ml/minute, respectively), and to establish if QOL is different between these groups. Methods - Data was collected from 25 patients from each of the Ccr bands (N=75). We measured self-reported QOL (Schedule for the Evaluation of Individual Quality of Life - SEIQOL), uraemic symptoms (Leicester Uraemic Symptom Scale - LUSS), and laboratory variables. Results - SEIQOL was significantly lower (p<0.001), and symptom number, frequency, and intrusiveness significantly higher (all p<0.001) in the advanced CKD group when compared to the NRF group. Although SEIQOL and symptom intrusiveness did not differ between the advanced and moderate CKD groups, SEIQOL was significantly lower (p<0.05) and symptom intrusiveness significantly higher (p<0.05) in the moderate CKD group when compared to the NRF group. Conclusion - QOL is already impaired in moderate CKD. The significant difference in QOL and symptom intrusiveness between the moderate CKD and NRF groups may denote a causal relationship between symptom intrusiveness and QOL early in CKD.